American Journal of Emergency Medicine最新文献

{"title":"Empowering front-line physicians with AI: Evaluating large language models in everyday ENT care","authors":"Sholem Hack ,&nbsp;Habib G. Zalzal ,&nbsp;Rebecca Attal ,&nbsp;Armin Farzad ,&nbsp;Lilia Ann Crew ,&nbsp;Idit Tessler ,&nbsp;Talya Frankel ,&nbsp;Ben Gvili ,&nbsp;Shaked Shivatzki ,&nbsp;Amit Wolfovitz ,&nbsp;Noa Rozendorn","doi":"10.1016/j.ajem.2026.01.029","DOIUrl":"10.1016/j.ajem.2026.01.029","url":null,"abstract":"<div><h3>Purpose</h3><div>Artificial intelligence systems known as large language models are being evaluated for clinical decision support, yet their role in emergency and primary care remains limited. Physicians in these settings often encounter ear, nose, and throat conditions where diagnostic uncertainty, unnecessary testing, and inappropriate referrals contribute to patient risk and healthcare inefficiency. This study compared the performance of advanced large language models with physicians in diagnosis, management, and referral across common and high-acuity otolaryngologic scenarios.</div></div><div><h3>Methods</h3><div>Twelve clinical vignettes representing routine and urgent presentations were developed and validated by otolaryngologists. One hundred practicing physicians in family medicine and emergency medicine, including residents and attending physicians, completed all vignettes by providing a diagnosis, management plan, and referral decision. Four large language models (Gemini-2.0, ChatGPT-4.0, ChatGPT-5, and OpenEvidence) were tested using identical prompts. Model outputs were anonymized, randomized, and rated by a blinded expert panel using the Quality Analysis of Medical Artificial Intelligence tool, which assesses accuracy, clarity, completeness, sourcing, relevance, and usefulness.</div></div><div><h3>Results</h3><div>Physicians achieved mean diagnostic accuracy of 91.6% and management accuracy of 87.9%. In non-urgent cases, 30.4% of responses represented inappropriate referral. Only half recognized the need for urgent referral in a cerebrospinal fluid leak scenario. Large language models demonstrated comparable diagnostic and management accuracy with higher referral appropriateness.</div></div><div><h3>Conclusions</h3><div>Large language models showed consistent, guideline-concordant reasoning in simulated emergency and primary-care otolaryngology cases. Their potential lies in supporting, not replacing, clinical judgment through responsible integration and real-world validation.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 90-97"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the coronavirus pandemic on bystander CPR, dispatcher-assisted CPR, EMS response time, and survival outcomes in China","authors":"Yaping Hou MPH ,&nbsp;Wentao Sang PhD ,&nbsp;Ying Deng PhD ,&nbsp;Jiaqi Zheng PhD ,&nbsp;Zhepei Yuan PhD ,&nbsp;Dong Xia MB ,&nbsp;Xue Zhao MD ,&nbsp;Wen Zheng PhD ,&nbsp;Mingjie Wang MPH ,&nbsp;Peiwu Li PhD ,&nbsp;Feng Xu PhD ,&nbsp;Yuguo Chen PhD","doi":"10.1016/j.ajem.2026.01.024","DOIUrl":"10.1016/j.ajem.2026.01.024","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate whether the COVID-19 pandemic affected out-of-hospital cardiac arrest (OHCA) care and outcomes across multiple regions in China, despite the country's strict containment measures.</div></div><div><h3>Methods</h3><div>Data from the BASeline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) Utstein Registry between 2019 and 2020 were analyzed. OHCA cases from 18 Emergency Medical Services (EMS) agencies were included. The primary outcome was survival to hospital discharge or 30 days, while secondary outcomes included return of spontaneous circulation (ROSC), and favorable neurologic outcome (Cerebral Performance Category [CPC] score 1–2). Three periods were compared: pre-COVID-19, outbreak, and regular prevention and control. Multilevel logistic regression adjusted for Utstein variables and center-level clustering was used.</div></div><div><h3>Results</h3><div>A total of 16,595 patients received CPR (pre-COVID-19 <em>n</em> = 3890; outbreak <em>n</em> = 5939; regular prevention and control <em>n</em> = 6766). Survival to hospital discharge or 30 days did not differ significantly across periods. ROSC was lower during the outbreak (5.3% vs. 3.6%, AOR 0.80, <em>P</em> = 0.045) and regular prevention and control periods (5.3% vs. 3.5%, AOR 0.80, P = 0.045). Bystander CPR and dispatcher-assisted CPR were significantly less frequent during the regular prevention and control period. EMS response time was longer in the regular prevention and control period (median 12 min vs. 11 min; AOR 1.25, <em>P</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic impacted the EMS system in China, reducing bystander CPR, dispatcher-assisted CPR, and ROSC, and increasing EMS response times. However, survival and neurological outcomes did not deteriorate significantly.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 135-140"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photic sneeze reflex: When light becomes lethal","authors":"Subramanian Senthilkumaran ,&nbsp;S.V. Arathisenthil ,&nbsp;Sivakumar Girija ,&nbsp;Patne Sanjay ,&nbsp;Ponniah Thirumalaikolundusubramanian","doi":"10.1016/j.ajem.2026.01.042","DOIUrl":"10.1016/j.ajem.2026.01.042","url":null,"abstract":"<div><h3>Background</h3><div>Photic sneeze reflex (PSR) is an autosomal dominant condition characterized by paroxysmal sneezing in response to bright light exposure. This is also known by the acronym ACHOO (Autosomal Dominant Compelling Helio-Ophthalmic Outburst) syndrome. Even though it has precipitated motor vehicle accidents (MVAs) leading to trauma, it remains yet as an underrecognized entity in emergency settings.</div></div><div><h3>Case presentation</h3><div>A 26-year-old male delivery boy who drives a scooter presented to ED with left periorbital swelling following an MVA triggered by PSR, while exiting a covered parking into sunlight. This was his third MVA in three months, all linked to photic transitions, with prior episodes causing vehicle damage only. He reported a three-month history of sneezing (10–15 bursts) triggered by sunlight and during tooth brushing, unresponsive to toothpaste changes. Examination revealed a left orbital floor fracture with inferior rectus entrapment, confirmed by CT scan. Allergy evaluation showed low total IgE (5 IU/mL) and negative specific IgE, ruling out allergic etiology. PSR was diagnosed and he underwent surgical repair, and received preventive counseling.</div></div><div><h3>Conclusion</h3><div>Life-threatening MVAs are likely <strong>to</strong> occur following PSR. In order to overcome such events, an early diagnosis, occupational counseling and prevention strategies are suggested. Emergency physicians should suspect light-induced sneezing, if vital signs are stable and the allergy workup is negative in such cases.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 170-172"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New world screwworm: A focused review for the emergency medicine clinician","authors":"Brit Long MD ,&nbsp;Anissa Finley DO ,&nbsp;Stephen Y. Liang MD, MPHS ,&nbsp;Heather A. Heaton MD","doi":"10.1016/j.ajem.2026.01.007","DOIUrl":"10.1016/j.ajem.2026.01.007","url":null,"abstract":"<div><h3>Introduction</h3><div>New World Screwworm (NWS), or <em>Cochliomyia hominivorax</em>, is a potentially fatal disease due to severe larvae infestation and tissue destruction. A resurgence has been reported.</div></div><div><h3>Objective</h3><div>This narrative review provides a focused overview of NWS for the emergency clinician, including the epidemiology, presentation, diagnosis, and management of the disease.</div></div><div><h3>Discussion</h3><div>NWS is endemic to tropical and subtropical America. While previously eradicated in the U.S., several human cases have been recently reported. This insect primarily infests livestock but may also affect humans. Female flies are attracted to mucosal surfaces and wounds and lay hundreds of eggs. Once hatching, larvae burrow into these surfaces and cause extensive damage by ingesting live tissue. Humans at risk include those with significant immunocompromise, open wounds, and those around animals. Infested patients present with severe swelling, bleeding, pain, and open, malodorous wounds. Larvae are usually visible in the wound. Bacterial superinfections may also occur. Suspected cases should be reported to the local or state public health department and the Centers for Disease Control and Prevention. Diagnosis includes morphologic identification of larvae removed from a wound. Larvae should be placed in a leak-proof container with 70% ethanol. Serum laboratory testing may also be needed in patients with evidence of bacterial superinfection and sepsis. Treatment includes removal of all larvae and often extensive debridement. Reevaluation of the wound within 48 h is recommended. Antibiotics are necessary for those with bacterial superinfection.</div></div><div><h3>Conclusion</h3><div>Emergency clinicians should be aware of the presentation, diagnosis, evaluation, and management of NWS to ensure optimal outcomes.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 8-12"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pharyngeal obstruction from a glass methamphetamine pipe: A case report","authors":"Jacob N. Watson MD ,&nbsp;AJ Graham DO","doi":"10.1016/j.ajem.2026.01.021","DOIUrl":"10.1016/j.ajem.2026.01.021","url":null,"abstract":"<div><div>Acute airway foreign bodies are an uncommon but life-threatening pathology encountered in the emergency department.</div><div>We present the case of a 41 year old female who presented for acute obstruction of the posterior pharynx following attempted ingestion of a glass methamphetamine pipe in efforts to conceal evidence from law enforcement officers. She exhibited mild trismus and muffled voice. No respiratory distress, stridor or hypoxia was appreciated. Workup revealed a vertically oriented cylindrical glass foreign body, approximately 10 cm spanning the distance between the proximal esophagus and posterior nasopharynx.</div><div>Treatment was initiated with low-dose benzodiazepine therapy for anxiolysis, administered nebulized lidocaine while preparations were made for emergency cricothyroidotomy and rapid sequence intubation with fiberoptic support. Otolaryngology was emergently consulted and ultimately the decision was made to attempt removal, with a plan for emergent surgical airway placement if unsuccessful. The patient was positioned with the neck hyperextended and ketamine was given for sedation. Using a pair of rubberized Magill forceps that we created, the glass pipe was successfully removed. The patient returned to her pre-procedural baseline and was discharged.</div><div>Patients with acute airway obstruction can rapidly decline and otolaryngology support is often not readily available. In this report we will discuss the considerations in managing acute airway foreign bodies, maneuvers and specialized tools to assist with bedside removal.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 123-125"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Physician Notification of CT-detected Hepatic Steatosis","authors":"Mert Erogul MD ,&nbsp;Sarah Kabariti MPH ,&nbsp;Antonios Likourezos MA MPH ,&nbsp;Suzanne Bialeck MD ,&nbsp;Aaron Chen MD ,&nbsp;Jefferson Drapkin MPH","doi":"10.1016/j.ajem.2026.01.038","DOIUrl":"10.1016/j.ajem.2026.01.038","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition globally and a leading cause of liver-related morbidity. Although often asymptomatic, MASLD is frequently identified incidentally on emergency department (ED) imaging. Timely patient notification is critical, as early intervention may alter disease trajectory.</div></div><div><h3>Objective</h3><div>To determine the proportion of ED patients with CT evidence of hepatic steatosis who recall being informed of the diagnosis by their ED physician.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study with prospective follow-up at two ED sites within the Maimonides Health system from March to June 2025. Adult patients (18–80 years) with incidental hepatic steatosis noted on CT imaging were identified. Exclusion criteria included hospital admission, non-English language, known liver disease, alcohol use disorder, or psychiatric conditions precluding interview. Structured telephone interviews assessed patient recall of physician notification. The primary outcome was patient-reported awareness of the diagnosis.</div></div><div><h3>Results</h3><div>Of 171 eligible patients, 150 completed interviews (mean age 47.2 years; 50% female). Only 17 patients (11.3%) recalled being informed of their diagnosis. Notification rates did not differ significantly by sex (13.3% men vs. 9.3% women; <em>P</em> = .440).</div></div><div><h3>Conclusions</h3><div>Fewer than one in eight ED patients with CT evidence of hepatic steatosis recalled being notified of their diagnosis. This communication gap represents a missed opportunity for early MASLD intervention and underscores the need for systematic approaches to ensure patient awareness and follow-up.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 176-179"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocolized trauma team activations improve trauma patient outcomes and decrease decision-making intervals","authors":"Yau-Ren Chang ,&nbsp;Hu-Lin Christina Wang ,&nbsp;Chien Wu ,&nbsp;Po-Cheng Chen ,&nbsp;Keng-Li Lin ,&nbsp;Chih-Yuan Fu ,&nbsp;Heng-Fu Lin","doi":"10.1016/j.ajem.2026.01.011","DOIUrl":"10.1016/j.ajem.2026.01.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma team activation (TTA) is widely recognized to improve outcomes in trauma care; however, few studies have examined its long-term maturation and the effects of protocolized implementation. This study aimed to evaluate the impact of a comprehensive trauma team protocol introduced in 2012 in a single institution and to identify factors associated with patient outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of trauma patients who underwent TTA between 2006 and 2023 at a single medical center in Taiwan. The generalized protocol was implemented in 2012 for trauma patients who fulfilled the TTA criteria. Patients &lt;18 years old, who were dead or had unknown vital signs on arrival at the emergency department (ED) or had been transferred from other institutions were excluded. The primary outcomes were the patient clinical outcomes; the time intervals to critical decision-making points after TTA were evaluated as secondary outcomes. Logistic regression was performed to identify independent risk factors.</div></div><div><h3>Results</h3><div>The study included 3002 patients. Compared with patients in the pre-protocolized stage (<em>n</em> = 518), patients in the protocolized stage (<em>n</em> = 2484) had a higher survival rate (90.5% vs. 79.7%, <em>p</em> &lt; 0.001), lower morbidity (0.8% vs. 10.6%, p &lt; 0.001), a higher success rate of nonoperative management (NOM) (39.0% vs. 27.2%, p &lt; 0.001), and shorter ED-to-computed tomography (CT) times (39.0 vs. 52.6 min, <em>p</em> = 0.001). Multivariate analysis identified age, Trauma Score and Injury Severity Score (TRISS), Glasgow Coma Scale (GCS) score, and treatment stage as independent predictors of survival. In addition, timely ED-to-CT (≤60 min) was more frequent in the protocolized stage.</div></div><div><h3>Conclusion</h3><div>Implementing a protocolized TTA system is feasible and can enhance the quality of trauma care, both in processes and outcomes. The treatment stage itself, independent of patient condition, serves as a determinant of clinical results. Tertiary trauma centers should consider adopting a standardized TTA protocol to improve patient outcomes.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 1-7"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieved blood pressure during the first 12 h and clinical outcomes in patients with out-of-hospital cardiac arrest","authors":"Chen-Hsi Chang M.D. ,&nbsp;Shih-Neng Lin M.D. ,&nbsp;Hao-Wei Lee M.D. ,&nbsp;Ming-Jen Kuo M.D. ,&nbsp;Pai-Feng Hsu M.D., Ph.D. ,&nbsp;I-Hsin Lee M.D. ,&nbsp;Teh-Fu Hsu M.D. ,&nbsp;Chorng-Kuang How M.D. ,&nbsp;Yenn-Jiang Lin M.D., Ph.D. ,&nbsp;Chin-Chou Huang M.D., Ph.D.","doi":"10.1016/j.ajem.2026.01.009","DOIUrl":"10.1016/j.ajem.2026.01.009","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a significant correlation between mean arterial pressure (MAP) levels after the return of spontaneous circulation (ROSC) and the outcomes of out-of-hospital cardiac arrest (OHCA) patients. This study investigates the impact of MAP regulation within 12 h post-ROSC on OHCA outcomes.</div></div><div><h3>Methods</h3><div>This retrospective, single-center cohort study included non-traumatic OHCA patients who achieved ROSC at a medical center in Taiwan between January 1, 2017, and December 31, 2022. The primary outcomes were 30-day mortality and neurological status assessed by the Cerebral Performance Category (CPC) score.</div></div><div><h3>Results</h3><div>A total of 231 OHCA survivors were included in the analysis. Patients were stratified into three tertiles based on MAP distribution, with each group consisting of 77 patients, as follows: MAP &lt; 80 mmHg, 80 ≤ MAP &lt;95 mmHg, and MAP ≥ 95 mmHg, based on measurements taken within the first 12 h post-ROSC. No significant differences were observed in mortality or CPC scores between the 80 ≤ MAP &lt; 95 mmHg and ≥ 95 mmHg groups. However, MAP levels below 80 mmHg were correlated with significantly higher 30-day mortality (hazard ratio [HR] = 1.760, 95% confidence interval [CI] = 1.130–2.760, <em>P</em> = 0.013) and worse neurological outcomes (HR = 1.560, 95% CI = 1.060–2.300, <em>P</em> = 0.023).</div></div><div><h3>Conclusion</h3><div>MAP &lt;80 mmHg within the first 12 h post-ROSC is a strong predictor of poor clinical outcomes in OHCA patients, while a higher MAP target (≥ 95 mmHg) is not associated with additional benefit in the early post-arrest period.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 13-20"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test results and follow-up care stemming from an ED-based cervical cancer intervention","authors":"Beau Abar,&nbsp;Nancy Wood,&nbsp;Joely Merriman,&nbsp;David Adler","doi":"10.1016/j.ajem.2026.01.031","DOIUrl":"10.1016/j.ajem.2026.01.031","url":null,"abstract":"<div><h3>Background</h3><div>More than 4300 lives are lost to cervical cancer in the US annually. The survival rate is nearly 100% when precancerous lesions are identified and acted upon appropriately. A randomized controlled trial of two Emergency Department-based (ED) cervical cancer screening interventions demonstrated that patients in each condition received screening at rates far above an untreated historical control group. While screening represents a necessary first step in preventing cervical cancer morbidity and mortality, a lack of data on subsequent clinical care limits appreciation of ED-based screening efforts.</div></div><div><h3>Objective</h3><div>The current study describes test results and subsequent care observed among patients who received documented cervical cancer screening following an ED-based intervention.</div></div><div><h3>Methods</h3><div>Information on HPV infections, Pap test results, and cervical cancer diagnoses documented in the electronic health record were collected from women ages 21–65 who were (a) enrolled into the above-mentioned trial and (b) received cervical cancer screening over the 365-days post enrollment.</div></div><div><h3>Results</h3><div>181 women received screening. Of those who had a Pap test, 12% had abnormal findings. Compared to a national rate of 3.8%, significantly elevated risk was observed (Z = 5.55, <em>p</em> &lt; 0.001). High-risk HPV infection was observed in 15% among those tested, elevated from an estimated nationwide prevalence of 11% (<em>Z</em> = 1.63, <em>p</em> = 0.052). Notably, nearly half of patients who went on to have colposcopy and cervical biopsy did not have a routine women's health provider.</div></div><div><h3>Conclusion</h3><div>ED-based cervical cancer screening interventions have meaningful positive impact on subsequent testing and care.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 78-80"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in emergency medicine: a narrative review","authors":"Angelica Rego ,&nbsp;Juan Pablo Arango-Ibanez ,&nbsp;R. Andrew Taylor ,&nbsp;Moira E. Smith ,&nbsp;Derick D. Jones ,&nbsp;Jessica Pelletier ,&nbsp;James E. Colletti ,&nbsp;Michael Gottlieb ,&nbsp;Brit Long","doi":"10.1016/j.ajem.2026.01.028","DOIUrl":"10.1016/j.ajem.2026.01.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Artificial intelligence (AI) is increasingly embedded in healthcare, with expanding applications in emergency medicine (EM).</div></div><div><h3>Objective</h3><div>This focused narrative review provides an overview of key applications, limitations, and future directions of AI that are most relevant for emergency clinicians.</div></div><div><h3>Discussion</h3><div>AI refers broadly to computational systems capable of performing tasks that typically require human intelligence, including pattern recognition, prediction, and language understanding. Within EM, AI is being deployed across the care continuum. Prehospital uses include triage, dispatch, patient assessment, protocol adherence, and decision support. There are several uses of AI in radiology, including diagnosis as well as improving efficiency, safety, and education. AI can be used to assist with point-of-care ultrasound, including imaging indication, acquisition, interpretation, and medical decision-making. AI may be used to improve emergency department patient registration, redirection, triage, waiting time, and data entry, as well as diagnostic support. Use of AI in pediatric EM may improve triage, clinical decision-making and diagnostic support, documentation, prognostication, and managing patient disposition and bed availability. AI implications in trauma include improved triage, decision-making, management, and prognostication. Prognosis and predictive analysis uses include prognostic modeling, operational, and system-level prediction, optimizing triage, and data integrity and synthesis. AI shows promise for enhancing clinical education, particularly in helping to individualize the learning process. Potential limitations include data quality and bias, reporting standards, interpretability and transparency, external validation and generalizability, clinical workflow integration, and human factors.</div></div><div><h3>Conclusions</h3><div>AI demonstrates promise across multiple domains for enhancing the practice of EM. Clinicians should understand its potential uses and limitations.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"102 ","pages":"Pages 155-165"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}