Evidence map›Paper›PMID 40561990›Full record

ArticleThe western journal of emergency medicine2025

Evaluating the Implementation of a "COVID-19 Test" Chief Concern in the Emergency Department.

Collin Michels, Daniel J Hekman, Rebecca J Schwei, Ryan E Tsuchida, Joshua Gauger, Irene Hurst, Joshua Glazer, Jenna Brink, Ciara Barclay-Buchanan, Manish N Shah and 2 more

Abstract read
In one paragraph

Article in The western journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Collin MichelsUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Daniel J HekmanUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Rebecca J SchweiUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Ryan E TsuchidaUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Joshua GaugerUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Irene HurstUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Joshua GlazerUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Jenna BrinkUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Ciara Barclay-BuchananUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Manish N ShahUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Azita G HamedaniUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.
Michael PuliaUniversity of Wisconsin-Madison School of Medicine and Public Health, BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the COVID-19 pandemic, rapid, at-home testing for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was inconsistently available. Consequently, for some patients, emergency departments (ED) became the preferred site to access COVID-19 testing. To improve operational efficiency, our ED implemented a "COVID-19 Test" chief concern (CC). Our primary objective in this analysis was to broadly assess the utilization of the new "COVID-19 Test" CC and associated clinical care.

methodsWe conducted a retrospective analysis of ED encounters from an academic ED and an affiliated, community-based ED of all patients after the establishment of a CC of "COVID-19 Test" from October 11, 2021-July 31, 2022. The data were extracted from the electronic health record. We calculated descriptive demographic statistics and ran a univariate and multivariate logistic regression with additional diagnostic or therapeutic interventions (binary) as the outcome variable to generate odds ratios (OR) and 95% confidence intervals (CI).

resultsA total of 320 patients were assigned a "COVID-19 Test" CC by a triage nurse. This was 0.5% of all ED encounters in this time frame. Of those, 45% were found to be SARS-CoV-2 positive. Admission or repeat ED visit at 72 hours occurred in 5.3% of patients. Nearly half (46.9%) of patients assigned a "COVID-19 Test" CC underwent additional ED interventions. Patients on Medicaid and those who self-identified as Black or Hispanic/Latino were disproportionately represented in the "COVID-19 Test" CC group as compared to the overall ED population. In multivariate analysis, an Emergency Severity Index of 1, 2 or 3 was associated with significantly higher odds of receiving additional interventions compared to ESI of 4 or 5 (adjusted OR: 46.85; 95% CI 13.28-165.26; P <0.001).

conclusionPatients assigned a chief concern of "COVID-19 Test" had a high COVID-19 positivity rate, often underwent additional ED interventions, and were at low risk of return ED visits or admission. Minoritized and low-income patients were disproportionately represented in the "COVID-19 Test" CC group, highlighting potential disparities in access to at-home COVID-19 testing and implementation of this CC.

Indexed as

COVID-19COVID-19 TestingEmergency Service, HospitalAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2Triage

Identifiers

PMID40561990
PMCPMC12208069

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.