People tend to delay care this time of year, even if they have symptoms, UCSF doctor says.

People tend to delay care around the holidays, says Dr. Steven Polevoi of UCSF.

Steven Polevoi, M.D., has seen it all.

During his 23-year career, the medical director of the UCSF Emergency Department has done everything from treat traumatic injuries to deliver babies. While medical emergencies occur throughout the year, Polevoi sees the winter season and its related overindulgence as a pivotal time for preventing emergencies by listening to our bodies.

“People tend to delay care around the holidays,” said Polevoi, whose emergency medicine team treats about 3,000 patients every month. “They may have symptoms of cardiovascular disease such as abdominal or chest discomfort which they interpret as indigestion or overeating, but in fact it could be cardiac ischemia.”

Cardiac ischemia — which could lead to a heart attack — occurs when blood flow and oxygen to the heart are dramatically reduced by narrowing of the coronary arteries. Symptoms include discomfort in the upper abdomen or chest that is often described as a heavy sensation or pressure, like “an elephant sitting on my chest.”

“You meet the patient and they tell you their story,” Polevoi said. “You say, ‘Why didn’t you come sooner?’ and they say, ‘Well, I was traveling or I was having a party.’ These can be subtle symptoms patients interpret as something other than a serious condition.”

People can sometimes confuse a serious heart condition with acid reflux or heartburn – especially around the time of holiday feasting — because the symptoms are similar.

Heart-related deaths increase by 5 percent during the holiday season. Fatal heart attacks peak on Christmas, the day after Christmas, and New Year’s Day, according to a national Circulation study published in 2004.

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UC Davis’ Nathan Kuppermann awarded by American College of Emergency Physicians.

Nathan Kuppermann, UC Davis

The American College of Emergency Physicians (ACEP) has recognized Nathan Kuppermann, professor of emergency medicine and pediatrics and chair of the UC Davis Department of Emergency Medicine, with its 2011 Outstanding Contribution in Research Award, the only research-related honor awarded by ACEP this year.

Kuppermann received the award this week in San Francisco at the organization’s Scientific Assembly, the largest annual gathering of emergency physicians in the country. He was among a select group of physicians recognized by ACEP for excellence across a wide range of activities, including leadership, policy, education and research.

Kuppermann’s work at UC Davis and as founding chair and a principal investigator of the Pediatric Emergency Care Applied Research Network (PECARN) has earned him an international reputation for excellence in academic emergency medicine. Through PECARN and other collaborations, he established a network of pediatric emergency departments nationwide that work together to perform high-impact research to improve the care of acutely ill and injured children. Together, PECARN members and other pediatric emergency medicine collaborators have enrolled many thousands of participants in studies that have resulted in new and definitive evidence and recommendations for various pediatric emergency conditions, including the development of indications for pediatric head trauma imaging, the evaluation of fever and meningitis in young children, and assessing the risks for cerebral edema in children with diabetic ketoacidosis.

Earlier this year, he helped to further advance the field of pediatric emergency medicine in Argentina, and is now helping develop the first pediatric emergency medicine research network between that country and Uruguay. In addition, Kuppermann is leading a new, $3.3 million grant from the National Institutes of Health (NIH) that provides a training program for the next generation of emergency medicine researchers who will explore the care of adults and children with acute traumatic injuries and emergent medical illnesses.

Kuppermann was elected to the Institute of Medicine in 2010 and is the recipient of numerous research awards, including the Pediatric Emergency Medicine and Critical Care Research Award from the American Academy of Pediatrics Section on Emergency Medicine. He is the primary or senior author of nearly 100 research papers published in leading journals, including the New England Journal of Medicine, Journal of the American Medical Association, The Lancet, Annals of Emergency Medicine and Pediatrics.

Kuppermann holds the Bo Tomas Brofeldt Endowed Chair in the UC Davis Department of Emergency Medicine. He received his medical degree from UC San Francisco, completed his residency at Harbor-UCLA Medical Center in Torrance and a fellowship in pediatric emergency medicine at Children’s Hospital Boston. He also holds a master’s degree in public health from the Harvard School of Public Health.

UC Davis Health System is advancing the health of patients everywhere by providing excellent patient care, conducting groundbreaking research, fostering innovative, interprofessional education, and creating dynamic, productive partnerships with the community. The academic health system includes one of the country’s best medical schools, a 645-bed acute-care teaching hospital, an 800-member physician’s practice group and the new Betty Irene Moore School of Nursing. It is home to a National Cancer Institute-designated cancer center, an international neurodevelopmental institute, a stem cell institute and a comprehensive children’s hospital. Other nationally prominent centers focus on advancing telemedicine, improving vascular care, eliminating health disparities and translating research findings into new treatments for patients. Together, they make UC Davis a hub of innovation that is transforming health for all. For more information, visit healthsystem.ucdavis.edu.

Members of the UC Irvine-based Center for Disaster Medical Sciences geared up for the crisis.

Kristi Koenig, UC Irvine

As Eastern seaboard states from the Carolinas to Maine prepared for the onslaught of the hurricane-force storm Irene, members of the Center for Disaster Medical Sciences geared up for the crisis.

The UC Irvine-based organization is closely monitoring the storm, which will affect millions of Americans and strain public health response resources.

CDMS members, many of whom are engaged in national preparedness, will deploy should assistance be needed.  Among them:

• Dr. Ken Miller serves as medical officer for the FEMA Urban Search and Rescue Incident Support Team.  In addition, he is the National Disaster Medical System (NDMS) Assistant Deputy Chief Medical Officer for Region IX and medical advisor to the Orange County Chapter of the American Red Cross.

• Dr. Chip Schreiber developed the PsySTART Rapid Mental Health Triage and Incident Management System, which is in use by the American Red Cross.  He is ready to deploy with the US Public Health Service should assistance be needed.

• In addition to Dr. Schreiber, several other CDMS leaders are also members of the CA-1 Disaster Medical Assistance Team (Orange County DMAT), including Darlene Bradley (operations chief and chief nursing officer) and Sherlene Stepp (supervisory nurse).  The DMAT could be activated if help is needed.

The CDMS trains fellows to be prepared for all types of disasters (both from the U.S. and internationally) in the Emergency Medical Services and Disaster Medical Sciences Fellowship.

“Hurricane Irene is a good reminder that we need to be prepared for all types of disasters in California,” says CDMS Director Kristi L. Koenig, MD. “Being ready to care for yourself and your family for at least 72 hours is imperative—whether it’s for a hurricane or for an earthquake.”

See www.ready.gov or http://cms.calema.ca.gov/preparednesshome.aspx for tips on how to prepare for a disaster.

UC Irvine expert:

Dr. Kristi L. Koenig – professor of emergency medicine, director of public health preparedness and director of the Center for Disaster Medical Sciences at the UC Irvine Medical Center – has expertise in disaster medicine, public health preparedness, emergency management and emergency medical services. She previously served for more than five years as principal advisor on emergency management and disaster medicine to the Office of the Under Secretary for Health in the Department of Veterans, Affairs. The co-author of the textbook, Koenig and Schultz’s Disaster Medicine, she can discuss public health and emergency medicine responses to hurricanes and powerful tropical storms. Koenig can be reached by email at: kkoenig@uci.edu.

Many individuals killed or injured were indoors or at home, completely unaware of events leading to the gunfire.

Garen Wintemute, UC Davis

In the first nationwide study of stray-bullet shootings, Garen Wintemute, professor of emergency medicine and director of the Violence Prevention Research Program at UC Davis School of Medicine and Medical Center, quantifies mortality and injury among victims of these unexpected events. His research is published as a letter in Wednesday’s (Aug. 3) issue of the Journal of the American Medical Association.

“Stray-bullet shootings create fear and insecurity in many communities,” said Wintemute. “People stay indoors, don’t let their children play outside, and alter the patterns of their daily lives to avoid being struck by a bullet meant for someone else. Yet no research has been conducted at the national level to explore the epidemiology of these shootings. Such information is often important to identifying preventive measures.”

For the study, Wintemute used Google and Yahoo news alerting services and the news archives of GunPolicy.org to track news stories published between March 2008 and February 2009 that contained the phrase “stray bullet.” He defined stray-bullet shootings as situations where a bullet escaped an intended sociogeographic space and resulted in the injury of at least one person, either from the gunshot itself or a secondary mechanism, such as an injury from glass sent flying by a stray bullet. Typical scenarios included violence, shooting sports, celebratory gunfire and related activities. Cases also included shootings of bystanders who had no active role in a violent incident, and unintentional gunfire when the shooter and the person shot were not the same person.

Using these criteria, Wintemute and his colleagues identified 284 stray-bullet shootings events, in which 317 people were killed or injured. Most were incidental to violence. Unlike the risk pattern for violence, which most frequently affects young men, most persons struck by stray bullets were outside the 15-34 age range, and more than 40 percent were females.

In addition, most of the persons shot (81 percent) were unaware of the events leading to the gunfire that caused their injuries. Many (40.7 percent) were at home, and of these most (68.2 percent) were indoors. Of the 65 people who died, most died on the day they were shot, and many died at the shooting scene.

“Stray-bullet shootings are largely a byproduct of intentional violence, what we euphemistically call ‘collateral damage,’” Wintemute said. “Those who are shot have little or no warning; opportunities to take preventive measures once the shooting starts are limited. Unless we intend to bulletproof entire communities and their residents, we will only be able to prevent these shootings to the extent that we are able to prevent firearm violence.”

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The gap in access to primary care could expand, according to UC Davis researchers.

UC Davis Dr. Richard Kravitz (left) on hospital rounds with medical students.

The amount of time physicians spend on the job can vary widely based on specialty, according to UC Davis research published July 11 in the Archives of Internal Medicine. More than 25 work hours per week separated the most time-consuming specialty of vascular surgery and the least time consuming of pediatric emergency medicine.

Coupled with their previous research on physician pay, the authors note that primary care physicians (pediatricians, family practitioners, geriatricians and internal medicine specialists) have working hours toward the middle of the range but earn toward the lower end of the wage scale. Together, the outcomes indicate that the gap in access to primary care physicians is likely to expand.

“It is doubtful that medical students will want to enter primary care if there continues to be such a mismatch between hours worked and wages compared with other specialties,” said J. Paul Leigh, professor of public health sciences and lead author of the study. “Policymakers who make medical payment decisions should strive for better balance.”

Leigh said the current study has important implications for health care reform, which will greatly increase demand for primary care doctors who are already in short supply.

“We can expect 30 million more Americans to have insurance soon, and they’ll all need primary-care physicians to help manage their care,” said Leigh. “The results could be an even bigger shortfall in primary care providers than currently expected.”

In conducting the work-hours study, Leigh and his colleagues used data from a nationally representative sample of physicians in the 2004 to 2005 Community Tracking Survey. More than 6,000 physicians working in 41 different specialties were included. Work hours involved time spent on all medically related activities. Data was analyzed for physicians who worked 20 to 100 hours per week and at least 26 weeks in a year.

In addition to vascular surgery, specialties with work hours that far exceeded the average were critical care, neonatal and perinatal medicine, and thoracic surgery. In addition to pediatric emergency medicine, specialties involving the fewest work hours were occupational medicine, dermatology, and physical medicine and rehabilitation.

“The specialists at the top of the work-hours ladder tend to provide more intensive care, often in hospital settings,” said Richard Kravitz, professor of internal medicine and a study co-author. “Vascular surgeons, for instance, perform highly complex surgeries, often on an urgent basis. The specialists toward the bottom of the ladder, on the other hand, tend to have more controllable hours.”

In general, physicians with the fewest hours care for more stable patients, usually in outpatient settings, or have fixed shifts, said Kravitz, whose research focuses on improving quality of care and patient satisfaction. He added that the study results help explain current difficulties in recruiting physicians into certain specialties.

“Two specialty areas with particular difficulties in meeting population needs are primary care and general surgery,” said Kravitz. “Looking at our data, it is easy to understand why. Primary care physicians have middling hours and low pay. General surgeons work long hours and have middling pay.”

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Peter Sokolove will lead California chapter of American College of Emergency Physicians.

Peter Sokolove, UC Davis

Peter E. Sokolove, professor and vice chair for academic affairs in the Department of Emergency Medicine at UC Davis School of Medicine, was elected president of the California chapter of the American College of Emergency Physicians (California ACEP) on June 22. His term is for one year.

California ACEP’s vision is that all Californians have timely access to high-quality emergency care through a comprehensive emergency medical services system capable of generating a coordinated response to disasters and health-care crises. With more than 2,600 members, the organization represents about 80 percent of California’s board-certified emergency physicians and sponsors the Emergency Medicine Political Action Committee, the state’s largest medical specialty political action committee.

As president, Sokolove will lead California ACEP in carrying out its mission to support emergency physicians in providing the highest quality of care to all patients and to their communities. He also will steer the organization as the primary collective political voice on emergency medicine issues in California.

“This is a challenging time for emergency medicine and for patients who rely on California’s emergency departments,” said Sokolove. “I look forward to seeking solutions to those challenges and improving emergency care for California’s patients.”

Sokolove specializes in the treatment of critically ill and injured patients and has lectured widely on range of controversial and important topics, from the diagnosis and management of medical and traumatic emergencies to the hazards emergency health care workers face while delivering care. In collaboration with other faculty in the department, he also has explored the utility of laboratory testing for identifying unsuspected intra-abdominal injuries in pediatric blunt trauma and the utility of anticonvulsant agents for the prevention of early post-traumatic seizures in children with blunt head injury.

Sokolove received his medical degree from Harvard Medical School in 1991 and completed an internship and residency training at Harbor-UCLA Medical Center in 1994.

In recognition of his commitment to excellence in academic emergency medicine, he has received many honors and awards. The Emergency Medicine Residents’ Association honored him with the Joseph F. Waeckerle Founder’s Award in 2009 and the Residency Director of the Year Award in 2005. The American College of Emergency Physicians also awarded him the California Emergency Medical Residents Award in 2008, National Faculty Teaching Award in 2001, California Education Award in 1999, Outstanding Speaker of the Year award in 1998 and Rookie Faculty of the Year award in 1997. He also received the UC Davis School of Medicine’s Dean’s Award for Excellence in Education in 2009.

UC Davis Medical Center is a comprehensive academic medical center where clinical practice, teaching and research converge to advance human health. Centers of excellence include the National Cancer Institute-designated UC Davis Cancer Center; the region’s only level 1 pediatric and adult trauma centers; the UC Davis MIND Institute, devoted to finding treatments and cures for neurodevelopmental disorders; and the UC Davis Children’s Hospital. The medical center serves a 33-county, 65,000-square-mile area that stretches north to the Oregon border and east to Nevada. It further extends its reach through the award-winning telemedicine program, which gives remote, medically underserved communities throughout California unprecedented access to specialty and subspecialty care. For more information, visit medicalcenter.ucdavis.edu.

UC Davis is one of only six institutions nationwide to receive the training grant.

Nathan Kuppermann, UC Davis

Emergency medicine research leaders at UC Davis will train the next generation of investigators in the field through a new, $3.3 million grant from the National Institutes of Health (NIH).

The five-year training grant will fund the education of faculty in emergency medicine, pediatric emergency medicine and associated disciplines in collaborative, multicenter research into the care of adults and children with acute traumatic injuries and emergent medical illnesses.

UC Davis is one of only six institutions nationwide to receive the training grant, which is funded by the the National Heart, Lung and Blood Institute of the NIH.

The grant and associated research will be led by Nathan Kuppermann, professor and chair of the Department of Emergency Medicine in the UC Davis School of Medicine and director of the emergency department at the UC Davis Medical Center. The co-principal investigator will be James Holmes, professor of emergency medicine and emergency department research fellowship director.

Under Kuppermann’s leadership, the UC Davis Department of Emergency Medicine has assumed an important role in moving the field of emergency medicine research forward, making significant contributions to the discipline.

Kuppermann, a professor of both emergency medicine and pediatrics, is founding chair and a principal investigator of the Pediatric Emergency Care Applied Research Network, or PECARN, the first federally funded pediatric emergency research network in the country. Pediatric emergency medicine research by Kuppermann and his colleagues has been published in high-impact medical journals on wide-ranging topics including pediatric head trauma, the risk of bacteremia and meningitis in young children with fevers and the risk factors for cerebral edema in children with diabetic ketoacidosis.

“Our goal is to enhance the science and improve the care of adults and children with acute medical illnesses and injuries, including severe trauma, cardiovascular diseases, hematological diseases, and respiratory diseases,” Kuppermann said.

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Large, multistate study shows certain gun owners are more likely to drink excessively.

Garen Wintemute, UC Davis

Gun owners who carry concealed weapons or have confronted another person with a gun are more than twice as likely to drink heavily as people who do not own guns, according to a study by UC Davis researchers. Binge drinking, chronic heavy alcohol use, and drinking and driving were all more common among gun owners generally than among non-owners, even after adjusting for factors such as age, sex, race, and state of residence.  But alcohol abuse was most common among firearm owners who participated in gun-related behaviors that carry a risk of violence, which also included having a loaded, unlocked firearm in the home and driving or riding in a vehicle with a loaded firearm.

The UC Davis study, which appears online in the journal Injury Prevention, analyzed telephone survey results for more than 15,000 people in eight states. The highest levels of alcohol abuse were reported by gun owners who engaged in dangerous behavior with their weapons. For example, gun owners who also drove or rode in motor vehicles with loaded guns were more than four times as likely to drink and drive as were people who did not own guns.  But gun owners who did not travel with loaded guns were still more than twice as likely to drink and drive as were people who did not own guns.

“It’s not surprising that risky behaviors go together,” said Garen J. Wintemute, author of the study and director of the UC Davis Violence Prevention Research Program. “This is of particular concern given that alcohol intoxication also impairs a gun user’s accuracy as well as his judgment on whether to shoot.”

Wintemute, a professor of emergency medicine at the UC Davis School of Medicine and one of the world’s foremost experts on gun-related violence, analyzed data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Study data on firearms ownership and alcohol use came from telephone interviews done in 1996 and 1997 with people in Alaska, Colorado, Hawaii, Mississippi, New Hampshire, New Jersey, North Dakota and Ohio. Participants were asked if they owned a gun, as well as if they engaged in specific firearm-related behaviors. Respondents also were asked about their consumption of alcohol, including whether they have had five or more alcoholic drinks on one occasion; if they drove after consuming “perhaps too much” alcohol; or if they had 60 or more drinks per month.

The article suggests several reasons why dangerous behavior involving alcohol and firearms might be linked. Drinking can impair judgment and lead people to use firearms in ways that they would otherwise avoid. Alternatively, underlying personality traits, such as impulsiveness or an inclination to take risks, could lead to an increase in dangerous behavior involving alcohol and guns.

The study also evaluated gun owners who indicated that they had attended a firearm-safety workshop in the previous three years. Those respondents were less likely to engage in alcohol-related risk behaviors than those who had not attended a workshop.

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Allowing a period of observation can avoid unnecessary exposure to radiation.

A multicenter study of more than 40,000 children with minor blunt head trauma, led by Children’s Hospital Boston and UC Davis Health System, shows that allowing a period of observation reduces the use of head computed tomography (CT) scans by as much as half without compromising care and without exposing children to the dangers of ionizing radiation.

The results, which appear online today (May 9), and in the June 2011 issue of Pediatrics, show that roughly half of the children taken to hospital emergency rooms for head injuries receive a head CT scan. Yet true traumatic brain injury is uncommon.

“Only 2 to 3 percent of children with head trauma really have something serious going on,” said Lise Nigrovic, assistant professor of pediatrics at Harvard Medical School and a pediatric emergency specialist at Children’s Hospital Boston, who co-authored the study with Nathan Kuppermann, professor of pediatrics and professor and chair of emergency medicine at UC Davis. “If you can be watched in the emergency department for a few hours, you may not need a CT.”

The study noted that cranial CT scans present additional risks to children with head injuries because of the radiation exposure involved in the scan. A child’s growing brain tissue is more sensitive to radiation. Additionally, because of their longer life expectancy, the risk of a child developing a radiation-induced malignancy is greater.

“There is a clear need to develop appropriate and safe guidelines for decreasing the number of inappropriate head CT scans that we do on children,” said Kuppermann. “The results of this analysis demonstrate that a period of observation before deciding to use head CT scans on many injured children can spare them from inappropriate radiation when it is not called for, while not increasing the risk of missing important brain injuries.”

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“Gun Fight” premieres April 13.

Garen Wintemute, an emergency room physician and public health epidemiologist at UC Davis Medical Center, is among the featured experts in the documentary “Gun Fight,” which premieres on HBO on Wednesday (April 13). The documentary, directed by two-time Oscar-winning filmmaker Barbara Kopple, looks at the complex issues surrounding firearms and debate over how best to reduce gun violence in the U.S.Kopple and her film team shadowed Wintemute and emergency department physicians and nurses in December 2008 as they worked busy shifts. The level 1 trauma center cares for patients from a 33-county area of Northern California, treating more than 4,750 trauma cases each year. The documentary blends original footage with archival scenes to reflect America’s growing gun culture and its deadly impacts.

A professor of emergency medicine and director of the UC Davis Violence Prevention Research Program, Wintemute is a nationally recognized authority on the prevention of firearm violence and in the field of injury epidemiology. He pioneered the first studies that systematically recorded both questionable and blatantly illegal transactions at gun shows and revealed their potential to serve as places where criminals can easily obtain firearms. As part of his research, Wintemute has shown how illegal gun sales can be curbed through increased regulation without adversely affecting gun-show attendance or business.

The HBO documentary notes that there are an estimated 250 million guns in the United States today, and over the past dozen years guns purchased both legally and illegally have found their way into the wrong hands, resulting in a string of deadly shootings around the nation.

“I invited the documentary crew to our medical center because it’s crucial that people better understand the level of gun violence that emergency and trauma teams around the country deal with week in and week out,” said Wintemute, who has often used his free time to go undercover at gun shows and investigate how illegal gun sales are made. “My immediate goal is always focused on saving lives in our emergency room. But my larger focus has been on identifying and reducing the very causes of gun violence that injure or kill the people my colleagues and I see all too often.”

Kopple, who won Best Documentary Feature Academy Awards for 1977’s “Harlan County, U.S.A.” and 1991’s “American Dream,”  obtained footage at gun-rights conventions and gatherings, following and interviewing people who were deeply committed to defending what they regard as their Second Amendment rights. “Gun Fight” uses the 2007 Virginia Tech massacre as a starting point to explore different aspects of the gun issue.

In the documentary, UC Davis physicians Erik Laurin, associate professor of emergency medicine, and Lynette Scherer, chief of trauma and emergency surgery service, illustrate the devastating impact of gun violence on health.  The program also features Colin Goddard, a survivor of the Virginia Tech massacre; Richard Feldman, a former National Rifle Association spokesman and lobbyist for gun manufacturers; Paul Helmke, president of the Brady Campaign and the Brady Center to Prevent Gun Violence; Scott Melzer, assistant professor of sociology at Albion College and author of “Gun Crusaders: The NRA’s Culture War”; and Alan Gottlieb, founder of the Second Amendment Foundation.

“Gun Fight” debuts Wednesday, April 13 (9:30-11 p.m. ET/PT) on HBO.  For more information, visit www.hbo.com/documentaries/gun-fight/video/trailer.html#.

About the UC Davis Violence Prevention Research Program
The Violence Prevention Research Program is an organized research program of the University of California, Davis. Its work addresses the causes, nature, and prevention of violence. Our current major areas of emphasis are the prediction of criminal behavior, the effectiveness of waiting period/background check programs for prospective purchasers of firearms, and the determinants of firearm violence. Its mission is to conduct research that will further America’s efforts to understand and prevent violence.

The grant is to study whether patients with renal stones can be treated as effectively with ultrasound as radiation-delivering CT scans.

Rebecca Smith-Bindman, UC San Francisco

As concerns mount about unregulated radiation dosages from CT scans, Rebecca Smith-Bindman’s study will examine if ultrasound is a viable alternative for patients with renal stones.

Smith-Bindman, MD, a professor of radiology at UCSF, recently received a $9.2 million comparative effectiveness award through the federal economic stimulus package known as the American Recovery and Reinvestment Act (ARRA).

The ARRA grant is to study whether emergency room patients with renal stones can be treated as effectively with ultrasound as radiation-delivering CT scans. The grant follows Smith-Bindman’s research published last December that found radiation doses from common CT procedures vary widely and are higher than generally thought, raising concerns about increased risk for cancer.

That research reviewed procedures performed on 1,119 patients at four San Francisco Bay Area institutions over five months and found a 13-fold variation between the highest and lowest radiation dose for each type of CT procedure.

“Dose awareness has increased profoundly in the last six months, and at UCSF, we’re really making a concerted effort to try and reduce the doses associated with a large number of CT scan types,” said Smith-Bindman. “That’s resulted in improved safety by lowering the dose for the same study type. “

The grant is among more than 45 awards UCSF has received through ARRA that have been targeted towards understanding of what works – and doesn’t – in real-life hospital and clinic practice settings. Known as comparative effectiveness research, the projects involve multiple medical centers throughout the nation, assessing actual clinical practice and patient outcomes in areas ranging from prenatal testing and children’s oral health to treating stroke and traumatic brain injuries.

The grants are particularly significant in the ongoing debate over health care reform, with the increasing scrutiny on both the cost of health care and the quality provided. In that context, comparative effectiveness research – or identifying the best practices among different health care models in preventing, diagnosing, treating, and monitoring disease — has been touted as one possible solution to rising health care costs.

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C. Eric McCoy, Christy Carroll will serve two-year terms.

(Left) C. Eric McCoy and Christy Carroll, UC Irvine

A UC Irvine physician and nurse will join the Orange County Emergency Medical Services Quality Assurance Board, which monitors and studies how to enhance the level of care provided by the county’s EMS system.

Dr. C. Eric McCoy, assistant clinical professor of emergency medicine, and Christy Carroll, trauma injury prevention coordinator, were among eight people recently appointed to two-year terms by county supervisors.

“The EMS Quality Assurance Board is extremely important to the operation of the county’s emergency medical system,” said Laurent Repass, EMS coordinator for the agency. “It takes a specialized group of people to help evaluate and recommend ways to improve our system and better serve the county.”

Orange County EMS oversees pre-hospital and emergency medical care administered by ambulances, emergency medical technicians, paramedics and hospital emergency departments.

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