ArticleJournal of the American College of Emergency Physicians open2026
Smart Dosing, Better Outcomes: An Electronic Medical Record Intervention for Cancer Pain in the Emergency Department.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: We hypothesized that an electronic medical record (EMR)-based best practice advisory (BPA), offering individualized opioid dosing for cancer patients with high opioid tolerance, would improve pain control and reduce hospital admissions in the emergency department (ED). Methods: We conducted a retrospective cohort study from May 2020 to May 2024 across 2 academic EDs affiliated with a National Comprehensive Cancer Network cancer center. Adult patients with active cancer, a morphine equivalent daily dose (MEDD) ≥100, and an ED opioid order were eligible. The BPA calculated MEDD-based opioid dosing recommendations and provided safety measures. Patients were categorized as BPA+ (recommendation followed) or BPA- (recommendation ignored). The primary outcome was hospital admission. Secondary outcomes included ED length of stay and change in pain scores. Results: Among 1193 patient encounters, 719 (60.3%) received BPA-directed therapy. BPA+ was associated with a lower odds ratio (OR) of admission compared to BPA- (OR, 0.67; 95% CI, 0.49-0.80). The BPA was associated with decreased admission rates in patients with an Eastern Cooperative Oncology Group performance status of 4 (54% vs 80% admitted) and stage 4 cancer (57% vs 68% admitted). BPA+ was also associated with greater median pain improvement (-2 vs -1) and shorter ED stays (8.2 vs 8.9 hours). Among patients receiving multiple opioid doses, greater BPA adherence was associated with sustained pain reduction, while BPA nonadherence showed diminished response. Conclusion: An EMR-integrated BPA for opioid-tolerant cancer patients was associated with improved ED pain management and reduced admissions. These findings support broader use of EMR-based tools to promote guideline-concordant, personalized care for cancer-related pain.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.