CJEM Articles: Ian Ball
Displaying 1-2 of 2 results
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November
2005
7
6
Ian Ball, Jamie A Seabrook, Scott Millington, William McCauley
Objectives: Emergency medicine (EM) residents work intimately with emergency department staff, and many residents become staff at the institutions that train them. As such, it is in the interest of all training sites to attract the strongest candidates to their programs. The goal of this study was to determine what factors make programs most appealing to EM residency applicants.
Methods: A survey was developed to assess the relative importance of 20 factors used by EM residency applicants in selecting a Royal College of Physicians and Surgeons of Canada residency program. The survey was piloted on 17 University of Western Ontario EM residency candidates in 2003, and validated on 26 EM residency candidates applying to 8 sites across Canada in 2004.
Results: The 20 surveyed factors fell into 4 categories. The most important factors were those relating to interactions with the program (4.5 out of 5), followed by factors relating to the program itself (3.5), personal factors (3.4), and lastly, factors relating to the city/province (2.9).
Conclusions: These data suggest that the most important factors are "interactions with a program" and program characteristics. Both of these are largely within a program's control. By striving to make their curriculum, interview days and medical student electives more appealing a residency program can improve its ability to attract the strongest residency candidates. -
March
2005
7
2
Erica Battram, George A. Wells, Ian Ball, Ian G. Stiell, John E. Mahoney, Linda Papa
Objectives: There is no set of prospectively validated criteria to identify the emergency department (ED) patients with renal colic who are most likely to eventually have to undergo an intervention. This study prospectively assessed predictors of intervention in this patient population.
Methods: This prospective cohort study included adult patients with renal colic who presented to 2 tertiary care hospital EDs. Patients had an 18-variable data form completed by an emergency physician and a radiological study to confirm urolithiasis. After discharge, patients were followed at 1 and 4 weeks to assess for intervention. The outcome criteria included the patient having had at least 1 of the following procedures performed: extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, percutaneous nephrostomy or open surgery. Data were analyzed using appropriate univariate techniques, and those variables associated with intervention were combined using logistic regression analysis.
Results: Over an 8-month period, 245 patients with confirmed urolithiasis were followed; 20% (95% confidence interval [CI] 15%-25%) eventually had a procedure to remove their calculi. Three variables were significantly correlated with having a procedure: i) size of calculus ≥ 6 mm (odds ratio [OR] 10.7, 95% CI 4.6-24.8), ii) location of calculus above mid-ureter (OR 6.9, 95% CI 3.0-15.9), and iii) Visual Analogue Scale score for pain at discharge from the ED ≥ 2 cm (OR 2.6, 95% CI 1.0-6.8). The area under receiver operating characteristic curve was 0.77 (95% C I 0.70-0.84) (p < 0.001). If all variables were present there was a 90% probability of the patient having an intervention performed within 4 weeks of discharge from the ED. Conversely, if none of the variables were present there was only a 4% probability of an intervention. Overall, the model had a sensitivity of 92% (95% CI 89%-96%) and a specificity of 63% (95% CI 57%-69%).
Conclusions: This study has identified variables that could potentially be used to identify those renal colic patients who require an intervention after ED evaluation. Future studies will prospectively validate this model.
