Annals of Emergency Medicine
Volume 55, Issue 5 , Pages 449-457.e2 , May 2010

Pregnancy Testing in Women of Reproductive Age in US Emergency Departments, 2002 to 2006: Assessment of a National Quality Measure

Presented as a poster at the 2008 ACEP Research Forum, October 2008, Chicago, IL.

  • Jeremiah D. Schuur, MD, MHS

      Affiliations

    • Department of Emergency Medicine, Brigham and Women's Hospital, and the Department of Medicine, Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress for correspondence: Jeremiah D. Schuur, MD, MHS, Brigham and Women's Hospital, Department of Emergency Medicine, 75 Francis St, Boston, MA 02115; 617-525-8872, fax 617-264-6848
    • ,
  • Sarah A. Tibbetts, MD

      Affiliations

    • Department of Emergency Medicine, North Shore Medical Center, Salem, MA
    • ,
  • Jesse M. Pines, MD, MBA, MSCE

      Affiliations

    • Department of Emergency Medicine and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA

Received 6 January 2009 ,Revised 28 July 2009 ,Accepted 17 August 2009.

References 

  1. Hospital Compare: a quality tool provided by Medicare. http://www.hospitalcompare.hhs.govAccessed December 10, 2008
  2. National Quality Forum. NQF endorses measures to address care coordination and efficiency in hospital emergency departments [press release]. National Quality Forum Web site http://www.qualityforum.org/News_And_Resources/Press_Releases/2008/NQF_ENDORSES_MEASURES_TO_ADDRESS_CARE_COORDINATION_AND_EFFICIENCY_IN_HOSPITAL_EMERGENCY_DEPARTMENTS.aspxAccessed September 10, 2009
  3. Clinical policy: critical issues for the initial evaluation and management of patients presenting with a chief complaint of nontraumatic acute abdominal pain. Ann Emerg Med. 2000;36:406–415
  4. Hedges JR, Kaib JJ, Armao JC. Detection of ectopic pregnancy in an outpatient population: the role of the beta-HCG level. J Emerg Med. 1984;2:85–93
  5. Ramoska EA, Sacchetti AD, Nepp M. Reliability of patient history in determining the possibility of pregnancy. Ann Emerg Med. 1989;18:48–50
  6. Kaplan BC, Dart RG, Moskos M, et al. Ectopic pregnancy: prospective study with improved diagnostic accuracy. Ann Emerg Med. 1996;28:10–17
  7. Kohn MA, Kerr K, Malkevich D, et al. Beta-human chorionic gonadotropin levels and the likelihood of ectopic pregnancy in emergency department patients with abdominal pain or vaginal bleeding. Acad Emerg Med. 2003;10:119–126
  8. Walls RM, Resnick J. The Joint Commission on Accreditation of Healthcare Organizations and Center for Medicare and Medicaid services community-acquired pneumonia initiative: what went wrong?. Ann Emerg Med. 2005;46:409–411
  9. Pines JM. Measuring antibiotic timing for pneumonia in the emergency department: another nail in the coffin. Ann Emerg Med. 2007;49:561–563
  10. Wachter RM, Flanders SA, Fee C, et al. Public reporting of antibiotic timing in patients with pneumonia: lessons from a flawed performance measure. Ann Intern Med. 2008;149:29–32
  11. Kanwar M, Brar N, Khatib R, et al. Misdiagnosis of community-acquired pneumonia and inappropriate utilization of antibiotics: side effects of the 4-h antibiotic administration rule. Chest. 2007;131:1865–1869
  12. Welker JA, Huston M, McCue JD. Antibiotic timing and errors in diagnosing pneumonia. Arch Intern Med. 2008;168:351–356
  13. Jha AK, Li Z, Orav EJ, et al. Care in U.S. hospitals—the hospital quality alliance program. N Engl J Med. 2005;353:265–274
  14. National Quality Forum. NQF member and public comments requested on the draft report “National voluntary consensus standards for emergency care—phase II: hospital-based emergency department care.”. National Quality Forum Web site http://www.qualityforum.org/projects/ongoing/emergency/comments2/index.aspAccessed December 10, 2008
  15. 2006 ICD-9-CM volume 1: diagnosis codes. ICD9Data.com Web site http://www.icd9data.com/2006/Volume1/default.htmAccessed December 10, 2008
  16. Schneider D, Appleton L, McLemore T. A reason for visit classification for ambulatory care. Vital Health Stat 2. 1979;2:i-vi, 1-63
  17. Public-Use Data File Documentation (2006 National Hospital Ambulatory Medical Care Survey). Hyattsville, MD: National Center for Health Statistics; 2006;ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHAMCS/doc06.pdfAccessed September 10, 2009
  18. Centers for Disease Control and Prevention. Ambulatory health care data. National Hospital Ambulatory Medical Care Survey (NHAMCS) Web site http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htmAccessed December 10, 2008
  19. Ramakrishnan K, Scheid DC. Ectopic pregnancy: forget the “classic presentation” if you want to catch it sooner. J Fam Pract. 2006;55:388–395
  20. Agency for Healthcare Research and Quality. HCUP clinical classifications software (CCS) for ICD-9-CM (Healthcare Cost and Utilization Project (HCUP). 2000-2003). http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jspAccessed January 11, 2009
  21. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  22. Hing E, Gousen S, Burt C. Guide to using masked design variables to estimate standard errors in public use files of the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Inquiry. 2003;40:401–415
  23. SAS documentation of survey procedures. http://support.sas.com/documentation/cdl/en/statugsurveylogistic/61836/PDF/default/statugsurveylogistic.pdfAccessed January 11, 2009
  24. Pezzin LE, Keyl PM, Green GB. Disparities in the emergency department evaluation of chest pain patients. Acad Emerg Med. 2007;14:149–156
  25. Schuur JD, Justice A. Measuring quality of care in syncope: case definition affects reported electrocardiogram use but does not bias reporting. Acad Emerg Med. 2009;16:40–49
  26. Saraiya M, Lee N, Blackman D, et al. Self-reported papanicolaou smears and hysterectomies among women in the United States. Obstet Gyencol. 2001;98:269–278
  27. Henderson KD, Bernstein L, Henderson B, et al. Predictors of the timing of natural menopause in the Multiethnic Cohort Study. Am J Epidemiol. 2008;167:1287–1294
  28. Luborsky JL, Meyer P, Sowers MF, et al. Premature menopause in a multi-ethnic population study of the menopause transition. Hum Reprod. 2003;18:199–206
  29. National Quality Forum. NQF measure submission form version 3.0. National Quality Forum Web site http://www.qualityforum.org/pdf/fmMeasureSubmissionVer3.0-2008-08-25.docAccessed December 10, 2008
  30. National Quality Forum. Current NQF-endorsed measures. National Quality Forum Web site http://www.qualityforum.org/pdf/Btblendorsedmeasurescurrent.xls2008Accessed December 10, 2008

 Supervising editor: Rita K. Cydulka, MD, MS

 Author contributions: JDS and JMP conceived the study. JDS managed the data and performed statistical analyses on NHAMCS. JDS, SAT, and JMP managed data on the 4 hospital chart review. JMP provided statistical advice on study design. JDS drafted the article, and SAT and JMP contributed substantially to its revision. JDS takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online November 22, 2009.

 Reprints not available from the authors.

 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Please see page 450 for the Editor's Capsule Summary of this article.

PII: S0196-0644(09)01444-9

doi: 10.1016/j.annemergmed.2009.08.017

Annals of Emergency Medicine
Volume 55, Issue 5 , Pages 449-457.e2 , May 2010

Article Tools