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Reposted by Cameron Gettel MD MHS

Your Local Epidemiologist @ylepidemiologist.bsky.social · Aug 13

1/ It’s been a struggle to process what happened at the CDC just a few days ago. The facts are coming in: one officer died, 500 rounds fired, 200 bullets made contact with 6 CDC buildings, hundreds of staff sheltered in place for hours. The intention is undeniable: this was an attempted massacre.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Aug 5

Just out in @agsjournal.bsky.social!
We developed and piloted an AI + care coach intervention to support ED-to-home transitions for people with dementia or cognitive impairment + their caregivers.

🧠↑ caregiver self-efficacy
📉↓ caregiver burden

Read more: doi.org/10.1111/jgs....

doi.org

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Cameron Gettel MD MHS @camerongettel.bsky.social · Jul 3

📊 Our new study asks: Will ACGME’s 2025 proposal really boost EM resident experience? @saemonline.bsky.social

✅ 97% of programs already meet the 3000-patient volume
➡️ 3→4 yr shift barely changes volume exposure
🏥 Rural & urban programs look similar

Read more: doi.org/10.1002/aet2...
#EM #MedEd

Patient Volume Requirements: Evaluation of the 2025 ACGME Proposal for Emergency Medicine Residency Programs

Objectives The 2025 ACGME proposed that all EM residency programs must be 4 years and achieve a minimum of 3000 patients per resident. We characterize the current residency program patient volume pe...

doi.org

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Reposted by Cameron Gettel MD MHS

Liz Goldberg, MD, ScM @lizgoldbergmd.bsky.social · May 14

Congrats to @camerongettel.bsky.social @agem-saem.bsky.social on developing a new care transition measure for older emergency department patients! The PROM-OTED score!

#SAEM25 @saemonline.bsky.social

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Reposted by Cameron Gettel MD MHS

Liz Goldberg, MD, ScM @lizgoldbergmd.bsky.social · May 6

There's a trend to adapt #emergencydepartments to better meet the unique needs of our growing population of older adults.

Grateful to @ahascience.bsky.social and Mike Merschel for spotlighting this important shift!

#EMSky #GeriSky @acepnation.bsky.social
www.heart.org/en/news/2025...

These emergency rooms adapt to the needs of older adults

Nobody wants to have to visit the emergency department, but "age-friendly" care seeks to make the experience safer for older people.

www.heart.org

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 22

I’m sorry for your loss Sarah - she sounds like an incredible woman and accomplished a great deal and positively influenced many lives in too short of a time

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

9/ @alzassociation.bsky.social @alzheimerssoc.bsky.social @istaart.bsky.social

#emergencydepartment #dementia #Alzheimers #cognitiveimpairment #EndAlz #medsky

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

8/ Bottom line:
✅ Screening for CI in the ED can work
🚫 Current diagnostic care transitions often break down
📈 Nearly 80% of those who followed up had confirmed CI

Let’s close the gap between detection and diagnosis - the ED can serve as a critical touchpoint.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

7/ We see real promise in pairing cognitive screening with EHR automation. Risk models, auto-referrals, and prompts could lighten ED workload and reduce missed diagnoses. Future work should explore AI and EHR-enhanced pathways. We’re just scratching the surface.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

6/ What could help?
• Options like home-based evaluations
• Tech support (e.g., EHR-based alerts or automated referral prompts)
• Risk stratification to prioritize patients needing urgent follow-up
• Public health campaigns to reduce stigma and promote follow-up

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

5/ Why the referral and follow-up rates are suboptimal:
• Dementia stigma—patients/families may avoid referral
• ED teams overwhelmed
• Fragmented systems, no clear outpatient path
• CI may limit follow-up, esp. without care partner
• Unclear who’s responsible for post-discharge follow-up

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

4/ The problem: despite effective screening and high follow-up yield, most at-risk patients weren’t referred or didn’t follow up. A huge missed opportunity - EDs are often the first touchpoint for undiagnosed CI. Early detection → timely treatment, caregiver support, better outcomes.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

3/ Of those 100 referred, only 19 completed an outpatient cognitive evaluation – again a big drop. Among them:
🧠 79% were diagnosed with some form of CI
🧠 63% had probable dementia
💊 Many were prescribed meds for CI, dementia, or depression.

When the ED refers and patients follow-up…it matters.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

2/ First, we screened 9,359 older adults in the ED for memory/thinking problems. ~5% of patients and 33% of care partners flagged possible CI – 650 in total were eligible for referral. Yet only 100 were actually referred. That’s a big drop – we’ll get to potential reasons for this in a bit.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Apr 21

🧵 1/ Check out our team’s new study in @alzdemjournals.bsky.social on ED-based cognitive impairment (CI) screening and referral. What we found highlights both promise and pain points in real-world detection and follow-up for CI and dementia in the acute care setting.

bit.ly/4cMO8M0

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Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

6/ This work is directly responsive to efforts from the multidisciplinary Geriatric Emergency care Applied Research (GEAR) network:

gearnetwork.org
pubmed.ncbi.nlm.nih.gov/34328674/

Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

5/ 🏥 By providing insights into patients' perspectives on ED discharge and follow-up care, PROM-OTED can help health providers improve discharge processes and allow researchers to measure what matters to patients in future studies.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

4/ ⏱️ With a mean completion time of just 5 minutes, the PROM-OTED tool can be administered via phone or electronically—making it feasible for diverse patient populations.

#GeriatricEmergencyMedicine #GeriEM #EmergencyMedicine #CareTransitions

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Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

3/ ✅ The final 18-item PROM-OTED tool measures critical aspects like understanding discharge instructions, medication management, follow-up care, and quality of life. It’s validated with excellent reliability and a robust factor structure.

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Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

2/ 🧑‍🔬 Our study involved 290 older adults (65+) discharged from EDs over 3 years, using qualitative interviews, item generation, and psychometric testing to create a reliable measure of care transition outcomes post-ED discharge. #PatientReportedOutcomes #EDCare

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Cameron Gettel MD MHS @camerongettel.bsky.social · Mar 30

1/ 🚨 ED care transitions are critical for older adults, but no standardized tools have been available to measure patient-reported outcomes. Here we share the development and validation of the PROM-OTED tool to address this gap.

Access in @aem-journal.bsky.social: pubmed.ncbi.nlm.nih.gov/40155783/

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Reposted by Cameron Gettel MD MHS

Liz Goldberg, MD, ScM @lizgoldbergmd.bsky.social · Feb 27

Grateful to present with @camerongettel.bsky.social @manish-shah.bsky.social & others on how we are improving #dementia care in the #emergencydepartment.

#Geriatrics #EMSky @agem-saem.bsky.social

Register here: alz-org.zoom.us/webinar/regi...

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Reposted by Cameron Gettel MD MHS

NPR @npr.org · Feb 27

Sue Bell became one of the first Alzheimer's patients in the U.S. to receive the drug now marketed as Leqembi. Did it make a difference?

Did a new Alzheimer's Disease drug keep this patient's brain healthier for longer?

Sue Bell became one of the first Alzheimer's patients in the U.S. to receive the drug now marketed as Leqembi. Her husband isn't sure if it made a difference.

www.npr.org

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Cameron Gettel MD MHS @camerongettel.bsky.social · Jan 30

#alzsky #dementia #alzheimer #alzheimers #alz #sciencesky

Cameron Gettel MD MHS @camerongettel.bsky.social · Jan 30

10/ The big takeaway? Dementia care programs aren’t failing—they’re evolving. We must refine, target, & implement them better. GUIDE is an opportunity to learn from research & build a more effective, scalable system. Let’s get it right. 🚀🧠

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