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Implementation of an efficient SARS-CoV-2 specimen pooling strategy for high throughput diagnostic testing. Sci Rep 2021; 11:17793. [PMID: 34493744 PMCID: PMC8423848 DOI: 10.1038/s41598-021-96934-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/18/2021] [Indexed: 12/21/2022] Open
Abstract
The rapid identification and isolation of infected individuals remains a key strategy for controlling the spread of SARS-CoV-2. Frequent testing of populations to detect infection early in asymptomatic or presymptomatic individuals can be a powerful tool for intercepting transmission, especially when the viral prevalence is low. However, RT-PCR testing-the gold standard of SARS-CoV-2 diagnosis-is expensive, making regular testing of every individual unfeasible. Sample pooling is one approach to lowering costs. By combining samples and testing them in groups the number of tests required is reduced, substantially lowering costs. Here we report on the implementation of pooling strategies using 3-d and 4-d hypercubes to test a professional sports team in South Africa. We have shown that infected samples can be reliably detected in groups of 27 and 81, with minimal loss of assay sensitivity for samples with individual Ct values of up to 32. We report on the automation of sample pooling, using a liquid-handling robot and an automated web interface to identify positive samples. We conclude that hypercube pooling allows for the reliable RT-PCR detection of SARS-CoV-2 infection, at significantly lower costs than lateral flow antigen (LFA) tests.
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Cost Effectiveness of a Platelet-rich Plasma Preparation Technique for Clinical Use. WOUNDS : A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE 2018; 30:186-190. [PMID: 30059343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Despite limited clinical evidence, platelet-rich plasma (PRP) is currently used for the treatment of various soft tissue injuries, but optimal use of PRP has yet to be determined. In many instances, PRP is prepared using commercial devices that lack standardized preparation techniques and consistent quality of the PRP produced. OBJECTIVE The aim of this study is to explore a simple, easy, economical method of PRP preparation that is practical for clinical use. MATERIALS AND METHODS This cross-sectional study was conducted at the Sports Medicine Clinic at the University of Malaya Medical Centre, Malaysia. Participants were healthy postgraduate students and staff at the Sports Medicine Department. The PRP was prepared using a single centrifugation technique. Leukocyte and platelet levels were compared with that of a whole blood baseline and a commercial preparation kit. RESULTS The PRP produced using this technique contained significantly higher mean platelet (1725.0 vs. 273.9 x 109/L) and leukocyte (33.6 vs. 7.7 x 109/L) levels compared with whole blood. There was no significant difference in the mean platelet and leukocyte levels between the PRP produced in this study and by a commercial PRP system. CONCLUSIONS A single-centrifugation protocol using readily available materials in a typical clinical setting could produce PRP of comparable quality to those of a commercial PRP production system.
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The STAP-study: The (cost) effectiveness of custom made orthotic insoles in the treatment for plantar fasciopathy in general practice and sports medicine: design of a randomized controlled trial. BMC Musculoskelet Disord 2016; 17:31. [PMID: 26772739 PMCID: PMC4715321 DOI: 10.1186/s12891-016-0889-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/09/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Plantar fasciopathy is a common cause of foot pain, accounting for 11 to 15% of all foot symptoms requiring professional care in adults. Although many patients have complete resolution of symptoms within 12 months, many patients wish to reduce this period as much as possible. Orthotic devices are a frequently applied option of treatment in daily practice, despite a lack of evidence on the effectiveness. Therefore, the objective is to study the (cost)-effectiveness of custom made insoles by a podiatrist, compared to placebo insoles and usual care in patients with plantar fasciopathy in general practice and sports medicine clinics. METHOD/DESIGN This study is a multi-center three-armed participant and assessor-blinded randomized controlled trial with 6-months follow-up. Patients with plantar fasciopathy, with a minimum duration of complaints of 2 weeks and aged between 18 and 65, who visit their general practitioner or sport physician are eligible for inclusion. A total of 185 patients will be randomized into three parallel groups. One group will receive usual care by the general practitioner or sports physician alone, one group will be referred to a podiatrist and will receive a custom made insole, and one group will be referred to a podiatrist and will receive a placebo insole. The primary outcome will be the change from baseline to 12 weeks follow-up in pain severity at rest and during activity on a 0-10 numerical rating scale (NRS). Secondary outcomes include foot function (according to the Foot Function Index) at 6, 12 and 26 weeks, recovery (7-point Likert) at 6, 12 and 26 weeks, pain at rest and during activity (NRS) at 6 and 26 weeks and cost-effectiveness of the intervention at 26-weeks. Measurements will take place at baseline and at, 2, 4, 6, 12 and 26 weeks of follow-up. DISCUSSION The treatment of plantar fasciopathy is a challenge for health care professionals. Orthotic devices are frequently applied, despite a lack of evidence of the effectiveness on patient reported outcome. The results of this randomized controlled trial will improve the evidence base for treating this troublesome condition in daily practice. TRIAL REGISTRATION Dutch Trial Registration: NTR5346 . Date of registration: August 5(th) 2015.
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Cost-effectiveness of pre-participation screening of athletes with ECG in Europe and Algeria. Intern Emerg Med 2015; 10:143-50. [PMID: 25164412 DOI: 10.1007/s11739-014-1123-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
The aim of this study is to evaluate the cost-effectiveness of ECG in combination with family and personal history and physical examination in order to detect cardiovascular diseases that might cause sudden death in athletes. The study was conducted on a cohort of 6,634, mainly young professional and recreational athletes, 1,071 from Algeria and 5,563 from Europe (France, Germany and Greece). Each athlete underwent medical history, physical examination, and resting 12-lead ECG. 293 athletes (4.4 %), 149 in Europe (2.7 %) and 144 in Algeria (13.4 %) required further tests, and 56 were diagnosed with cardiovascular disease and thus disqualified. The cost-effectiveness ratio (CER) was calculated as the ratio between the cost of screening and the number of statistical life-years saved by the intervention. The estimated reduced risk of death deriving from treatment or disqualification resulted in the saving of 79.1 statistical life-years in Europe and 136.3 in Algeria. CER of screening was 4,071 purchasing-power-parity-adjusted US dollars ($PPP) in Europe and 582 $PPP in Algeria. The results of this study strongly support the utilisation of 12-lead ECG in the pre-participation screening of young athletes, especially in countries where secondary preventive care is not highly developed.
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Economic uncertainty and performing arts medicine. MEDICAL PROBLEMS OF PERFORMING ARTISTS 2012; 27:173-174. [PMID: 23247871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Running to the doctor. MEDICAL ECONOMICS 2012; 89:66-67. [PMID: 24383207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Quantifying the variability of financial disclosure information reported by authors presenting research at multiple sports medicine conferences. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2011; 40:583-587. [PMID: 22263213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In the study reported here, we compared self-reported industry relationships of authors who attended 3 major orthopedic sports medicine conferences during a single calendar year. Our goal was to calculate the variability between disclosure information over time. A significant percentage of authors who attended these meetings were inconsistent in submitting their disclosure information. In addition, most authors with irregularities had more than 1 discrepancy. We believe that the vast majority of the observed discrepancies did not result from intentional deception on the part of the authors but instead from ongoing confusion regarding which industry relationships should be acknowledged for particular meetings (some specialty societies require that all relationships be divulged, whereas others require only those affiliations directly applicable to research being presented). In the absence of a uniform disclosure policy that is widely adopted by many specialty societies, these findings suggest that the disclosure process will continue to be plagued by inconsistent reporting of financial conflicts of interest.
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Key factors for providing appropriate medical care in secondary school athletics: athletic training services and budget. J Athl Train 2010; 45:75-86. [PMID: 20064052 PMCID: PMC2808759 DOI: 10.4085/1062-6050-45.1.75] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. OBJECTIVE To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. DESIGN Cross-sectional study. SETTING Mailed and e-mailed survey. PATIENTS OR OTHER PARTICIPANTS One hundred sixty-six South Carolina high schools. INTERVENTION(S) The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. MAIN OUTCOME MEASURE(S) The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. RESULTS Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R(2) = 0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget. CONCLUSIONS The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.
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Medical help to avert student sports tragedies is an expensive problem lawmakers are trying to solve. STATE LEGISLATURES 2009; 35:55-57. [PMID: 19650252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Professional indemnity insurance and the practice of medicine during bullfights in France. MEDICINE AND LAW 2008; 27:767-774. [PMID: 19202855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Bullfighting can provoke strong reactions, for fans and laymen alike. Risks to the health of participants are inseparable from the spectacle. Organisers call on a medical team whose main task is to treat the bullfighter's injuries. Despite the special features of this medical practice doctors are not exempt from the possibility of the question of their liability being raised in the event of medical malpractice and large financial damages for the bullfighter if he is harmed. The doctor's public liability and professional indemnity insurance contract is therefore all the more important, in fact, this insurance covers damages for harm caused by the policy holder from the moment he is declared liable. In the statute of 4th March 2002, the French legislature brought in compulsory insurance for health professionals with the aim of achieving the best possible compensation for harm. While public liability and professional indemnity insurance is compulsory for doctors, the purpose of making this insurance compulsory is to cover compensation for harm suffered by the victim. In the case of bullfights, faced with insufficient legal regulation and the fact that more often than not the medicine practised in this field is on a voluntary basis, it might be interesting to offer some thoughts on the special features of the insurance contract that ought to be adapted to these extreme working conditions.
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Clinical management. Hospitals put some muscle into sports medicine. HOSPITALS & HEALTH NETWORKS 2008; 82:43-48. [PMID: 19031843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Creating and promoting a sports performance service offering. THE JOURNAL OF MEDICAL PRACTICE MANAGEMENT : MPM 2007; 22:294-7. [PMID: 17494488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Many private hospitals and physician groups are exploring the possibility of expanding their facilities to include advanced ancillary services. Services such as a sports performance center provide additional opportunities for quality patient care and at the same time augment the bottom line. By offering additional ancillary services, healthcare organizations such as an orthopaedics practice can become a full-service center enabling clinicians to more fully provide care to their patients. Marketing and promotion play a crucial role in this type of service. These activities must be designed and carried out in a way that encourages productive results and collaboration as the organization strives to position itself as a full-service center and as a sports specialist in its community.
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Take me out to the hospital. TRUSTEE : THE JOURNAL FOR HOSPITAL GOVERNING BOARDS 2006; 59:29-32. [PMID: 17016869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Measurement of baseline shoulder function in subjects receiving workers' compensation versus noncompensated subjects. J Shoulder Elbow Surg 2005; 14:286-97. [PMID: 15889028 DOI: 10.1016/j.jse.2004.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to ascertain whether a measurable difference existed in normative scores for the American Shoulder and Elbow Surgeons (ASES) questionnaire between subjects who had an active workers' compensation claim (WC) with no known shoulder injury and subjects without a compensation claim (non-WC). Subjects with non-shoulder-related orthopaedic injuries were recruited from a suburban orthopaedic sports medicine clinic and an urban occupational medicine clinic. They were asked to complete a composite questionnaire that consisted of demographic information and the ASES questionnaire. There were no significant differences in the ASES scores between subject groups. There were significant differences between subject groups with regard to work hours (P = .0001), work demands (P = .0001), and tobacco use (P = .0001). Subject group was also significantly associated with education level (P = .0001), marital status (P = .0001), work demands (P = .0001), gender (P = .0001), and sports participation (P = .0314). The ASES score was significantly affected by marital status (P = .0476), sports participation (P = .0008), and age (P = .0129).
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Clinical productivity measures of ambulatory sports medicine in an academic department. Fam Med 2005; 37:235-6. [PMID: 15812685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Coding and reimbursement in sports medicine. South Med J 2004; 97:875-6. [PMID: 15455976 DOI: 10.1097/01.smj.0000140120.77360.3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE The Ottawa ankle rule (OAR) is a clinical decision rule used in emergency departments to identify which patients with acute ankle/midfoot injury require radiography. The purpose of this study was to implement the OAR, with a modification to improve the specificity for identifying malleolar fractures (the "Buffalo rule"), in a sports medicine center and measure impact on physician practice and cost savings. METHODS All pediatric and adult patients presenting to a university sports medicine walk-in clinic with acute (< or = 10 d old) ankle/midfoot injury had the rule applied by primary care providers. Exclusion criteria included pregnancy, isolated skin injury, > 10 d since injury, second evaluation for same injury, obvious deformity of ankle or foot, or altered sensorium. RESULTS In 217 patients (mean age, 23.3 +/- 8.5 yr; range, 10-64 yr) there were 24 clinically significant (i.e., nonavulsion) fractures (fracture rate 3.7% per year for 3 yr), all of which were identified by the rule (100% sensitivity). In 193 patients with malleolar pain, the sensitivity for malleolar fracture (with 95% confidence intervals) was 100% (78-100%) and specificity was 45% (43-46%). In 24 patients with midfoot pain, sensitivity was 100% (65-100%) and specificity was 35% (21-49%). Thirty-five percent of radiographic series (76 of 217) were foregone for a cost savings of almost $6000. One hundred percent follow-up on those patients for whom x-rays were obtained found no missed fractures and they were subjectively satisfied with their care. CONCLUSION The OAR reduced radiography in acute ankle/midfoot injury and saved money in relatively younger patients in the outpatient sports urgent care setting without missing any clinically significant fractures. The specificity of the Buffalo malleolar rule in the present implementation study, however, was not a significant improvement over the OAR malleolar rule. Widespread application of the OAR could save substantial resources without compromising quality of care.
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Cost containment in sports rehabilitation. Phys Med Rehabil Clin N Am 2000; 11:721-8, vii. [PMID: 11092014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Defining high-quality care and cost-effectiveness is not an easy task. In this article, the authors describe several strategies that have practical applicability for the clinician treating patients with sports-related injuries. Integration of some of these strategies may allow the more quality-based, cost-efficient use of available resources in sports rehabilitation.
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Looking into the crystal ball. REHAB MANAGEMENT 2000; 13:24-7. [PMID: 11702378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Abstract
Mandatory preparticipation examinations (PPE) are labor intensive, offer little routine health maintenance and are poor predictors of future injury or illness. Our objective was to develop a new PPE for the Stanford University varsity athletes that improved both quality of primary and preventive care and physician time efficiency. This PPE is based on the annual submission, by each athlete, of a comprehensive medical history questionnaire that is then summarized in a two-page report for the examining physician. The questionnaire was developed through a search of MEDLINE from 1966 to 1997, review of PPE from 11 other institutions, and discussion with two experts from each of seven main content areas: medical and musculoskeletal history, eating, menstrual and sleep disorders, stress and health risk behaviors. Content validity was assessed by 10 sports medicine physicians and four epidemiologists. It was then programmed for the World Wide Web (http:// www.stanford.edu/dept/sportsmed/). The questionnaire demonstrated a 97 +/- 2% sensitivity in detecting positive responses requiring physician attention. Sixteen physicians administered the 1997/98 PPE; using the summary reports, 15 found improvement in their ability to provide overall medical care including health issues beyond clearance; 13 noted a decrease in time needed for each athlete exam. Over 90% of athletes who used the web site found it "easy" or "moderately easy" to access and complete. Initial assessment of this new PPE format shows good athlete compliance, improved exam efficiency and a strong increase in subjective physician satisfaction with the quality of screening and medical care provided. The data indicate a need for improvement of routine health maintenance in this population. The database offers opportunities to study trends, risk factors, and results of interventions.
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Presidential address of the American Orthopaedic Society for Sports Medicine. Some thoughts on perspective and the business of medicine. Am J Sports Med 1999; 27:694-8. [PMID: 10569352 DOI: 10.1177/03635465990270060201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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The integration of primary care sports medicine into an academic emergency medicine practice: academic and revenue enhancement. Acad Emerg Med 1999; 6:828-32. [PMID: 10463556 DOI: 10.1111/j.1553-2712.1999.tb01216.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine whether integrating primary care sports medicine into academic emergency medicine (EM) can enhance both revenue and the academic program. METHODS A retrospective descriptive review of all patients seen in a primary care sports medicine practice at a university hospital sports medicine clinic was done over a 24-month period. All patients seen initially in the ED for a sports injury either by the author or by another EM faculty member with follow-up by the author in the sports medicine clinic were included in the study group. The study group was analyzed for diagnoses, payor mix, and revenue generated by the ED follow-up sports medicine clinic visits. RESULTS There were 199 patients who met the inclusion criteria. This resulted in 483 ED follow-up sports medicine clinic visits. The author practiced 13 hours/week in the ED and 16 hours/week in the primary care sports medicine practice, which resulted in 1,536 sports medicine clinic hours. The study group accounted for 20% of the total patient volume in the author's primary care sports medicine practice. There were 111 lower-extremity injuries (knee 52%, foot/ankle 40%, hip/pelvis 8%), 81 upper-extremity injuries (hand/wrist 48%, shoulder 43%, elbow 9%), and seven spine injuries. Payor mix was 47% traditional indemnity, 45% HMO, 4% self-pay, and 4% Medicare/Medicaid. Total charges for the ED follow-up sports medicine clinic visits were $44,767 ($92.68/visit) and net receipts were $30,276 ($62.68/visit). This represented 20% of the total charges and 16% of the net receipts in the author's sports medicine practice during this period. Revenue generated by the ED follow-up sports medicine clinic visits could have supported 12% of the equivalent cost of the base pay for a full-time EM faculty position. CONCLUSION The integration of primary care sports medicine into an academic EM faculty practice can enhance revenue through the establishment of an ED follow-up sports medicine clinic while also providing an opportunity to expand resident learning experiences.
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Sports medicine and the eye care professional. JOURNAL OF THE AMERICAN OPTOMETRIC ASSOCIATION 1998; 69:395-413. [PMID: 9646586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND There are more than 40,000 eye injuries every year in the United States--many of which are sports-related. Sports injuries are a common cause of severe vision loss. Today, contact sports, racket sports, and other high-risk athletic activities are more popular on an organized and informal level. Those engaging in these activities should wear the proper eye and facial protection, so as to minimize the risk of severe injury and potential vision loss. CASE REPORTS Case studies are used to illustrate examples of sports-related clinical experiences encountered in a primary care practice. A description of protective devices, a discussion of product liability, the standard of care, and the doctor's responsibility to the patient complement the case scenarios. Emphasis is placed on prevention and particular attention should be paid to the patient at high risk and to the one-eyed patient. CONCLUSION Sports-related eye injuries have a high risk for ocular morbidity and subsequent severe vision loss. Many sports related injuries are preventable and the primary care practitioner can provide important information and education regarding protection and avoidance for those participating in high-risk activities. The provider should promote compliance and be adequately informed as to product liability, standards, manufacturers of the devices, and indications for the use of specific devices.
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Emergency medicine ... the most dangerous games -news-. HOSPITALS & HEALTH NETWORKS 1996; 70:10. [PMID: 8832828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Magnetic resonance imaging of knee disorders. Clinical value and cost-effectiveness in a sports medicine practice. Am J Sports Med 1996; 24:99-103. [PMID: 8638763 DOI: 10.1177/036354659602400118] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To prospectively evaluate the clinical value of magnetic resonance imaging of the knee in a referral sports medicine practice, we performed a three-part study. First, we asked 72 consecutive patients a series of clinically relevant questions regarding the ordering of their magnetic resonance imaging scans. Second, we asked the treating physicians at our center if the magnetic resonance imaging findings changed the diagnosis or treatment. Third, we compared the clinical evaluation with the findings on magnetic resonance imaging scans for 37 patients who had arthroscopic confirmation. From the physician's perspective, in only three cases would the results of the scan have changed the diagnosis. Information from the scans was judged to contribute to patient treatment in only 14 of 72 patients. Finally, comparison of clinical evaluation and magnetic resonance imaging findings with findings during arthroscopic procedures showed that clinical evaluation had a sensitivity and specificity of 100% for diagnosis of anterior cruciate ligament injuries, whereas magnetic resonance imaging was 95% sensitive and 88% specific. For isolated meniscal lesions, the clinical assessment had a sensitivity and specificity of 91% compared with 82% and 87%, respectively, for magnetic resonance imaging. For evaluation of articular surface damage, the predictive value of a positive test was 100% for clinical assessment and 33% for the magnetic resonance imaging. We conclude that magnetic resonance imaging is overused in the evaluation of knee disorders and not a cost-effective method for evaluating injuries when compared with a skilled examiner. Clinical assessment equals or surpasses the magnetic resonance imaging in accuracy.
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Combining sports medicine, rehabilitation and family clinical care makes physical and fiscal sense for UW clinics. WISCONSIN MEDICAL JOURNAL 1996; 95:37-40. [PMID: 8650953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Vicissitudes of life and medicine. Am J Sports Med 1995; 23:652-4. [PMID: 8600728 DOI: 10.1177/036354659502300602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Report weighs fitness-center issues. MODERN HEALTHCARE 1995; 25:102. [PMID: 10141310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Limited screening echocardiography in athletic exams: economic and administrative aspects. INDIANA MEDICINE : THE JOURNAL OF THE INDIANA STATE MEDICAL ASSOCIATION 1993; 86:514-7. [PMID: 8270778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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'Joint' venture boosts referrals. Hospital stems outmigration by promoting itself and orthopedic practice. Terre Haute Regional Hospital. PROFILES IN HEALTHCARE MARKETING 1993:2-7. [PMID: 10125017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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It's time to close the health-and-racket clubs. MEDICAL ECONOMICS 1992; 69:21-2, 24-5. [PMID: 10116182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Baxter, Olympic Committee forge donation deal. MODERN HEALTHCARE 1991; 21:10. [PMID: 10114623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Baylor tackles sports medicine in a big way. HEALTH SYSTEMS REVIEW 1991; 24:31-2, 34, 48. [PMID: 10111940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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39
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Sports clinics and hospital trusts. Br J Sports Med 1991; 25:69. [PMID: 1751892 PMCID: PMC1478818 DOI: 10.1136/bjsm.25.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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40
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Medical costs. Am J Sports Med 1991; 19:103. [PMID: 2039058 DOI: 10.1177/036354659101900201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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41
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All eyes on this health club. PROFILES IN HEALTHCARE MARKETING 1991:64-71. [PMID: 10108551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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42
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Sports medicine attracts a young, healthy market. HOSPITALS 1990; 64:49. [PMID: 2227898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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43
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Sports medicine centers offer marginal profits. HEALTH CARE STRATEGIC MANAGEMENT 1990; 8:1, 23-6. [PMID: 10107807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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44
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45
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Hospitals sports medicine programs are healthy ventures. TRUSTEE : THE JOURNAL FOR HOSPITAL GOVERNING BOARDS 1989; 42:15, 17. [PMID: 10296612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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46
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Hospitals competing in sports medicine. MODERN HEALTHCARE 1987; 17:26-8, 30, 32. [PMID: 10283574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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47
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Sports malls--hospital diversification and applications. Health Mark Q 1987; 4:65-74. [PMID: 10279288 DOI: 10.1300/j026v04n01_07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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48
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Expanding audiences for fitness. The RightStart for young stars. PROFILES IN HOSPITAL MARKETING 1986:24. [PMID: 10284360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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49
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Care of sports injuries in New Zealand--who pays? THE NEW ZEALAND MEDICAL JOURNAL 1986; 99:240-2. [PMID: 3458071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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50
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Marketing a sports medicine clinic. PROFILES IN HOSPITAL MARKETING 1985:25-9. [PMID: 10279512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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