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Record W3007722239 · doi:10.1097/cxa.0000000000000075

Incidence and Correlates of Cannabinoid-Related Psychiatric Emergency Care: A Retrospective, Multiyear Cohort Study

2020· article· en· W3007722239 on OpenAlex
Anees Bahji

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
venuePublished in a venue whose home country is Canada.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueThe Canadian Journal of Addiction · 2020
Typearticle
Languageen
FieldHealth Professions
TopicHomelessness and Social Issues
Canadian institutionsQueen's University
Fundersnot available
KeywordsCannabisMedicinePsychiatryOdds ratioRetrospective cohort studyConfidence intervalTriageEmergency departmentInternal medicine

Abstract

fetched live from OpenAlex

ABSTRACTRésumé Background: In October 2018, Canada legalized recreational cannabis use. To date, only a few studies have reviewed shifts in emergency department (ED) utilization for cannabis-related psychiatric presentations. Aims: To describe the characteristics of patients seeking ED care for cannabis-related psychiatric presentations, and to identify demographic and clinical characteristics that were associated with psychiatric inpatient admission for such presentations. Methods: Retrospective cohort study with multivariate logistic regression. Findings: Over a 4-year period, 715 cannabis-related presentations were recorded (50% female, mean age 27.1 years). Time trend analysis showed a significant increase in the number of visits by fiscal year. The most common reason for ED presentation was harmful use of cannabis (60%). 8% of all visits required psychiatric admission; predictors of psychiatric admission were arrival by police (adjusted odds ratio [AOR] = 14.5; 95% confidence interval [CI] = 6.0–35.0), arrival by ambulance (AOR = 2.6; 95% CI = 1.4–4.9), and triage score (AOR = 0.4; 95% CI = 0.3–0.6). Length of stay, sex, age, and service provider (e.g., psychiatry, medicine, surgery) were not associated with disposition in the ED. Admissions was more likely for cannabis-induced psychosis or cannabis-related mental and behavioural disorders. Conclusion: EDs are serving increasing numbers of patients in psychiatric crisis related to cannabinoid-use before the legalization of recreational cannabis in Canada. A decision support tool could be developed and validated in the future to provide reliable, clinically relevant information to providers and case managers relevant to cannabis-related ED presentations. Contexte: En octobre 2018, le Canada a légalisé la consommation récréative de cannabis. À ce jour, seules quelques études ont examiné les changements dans l’utilisation des services d’urgence (DE) pour les présentations psychiatriques liées au cannabis. Objectifs: Décrire les caractéristiques des patients qui demandent des soins d’urgence pour des présentations psychiatriques liées au cannabis et identifier les caractéristiques démographiques et cliniques associées à l’admission en psychiatrie pour ces présentations. Méthodes: Étude de cohorte rétrospective avec régression logistique multi-variée. Résultats: Sur une période de quatre ans, 715 présentations liées au cannabis ont été enregistrées (50% de femmes, âge moyen 27,1 ans). L’analyse des tendances temporelles a montré une augmentation significative du nombre de visites par année fiscale. La raison la plus courante de la présentation à l’urgence était l’usage nocif du cannabis (60%). 8% de toutes les visites ont nécessité une admission psychiatrique; les signes prédictifs de l’admission en psychiatrie étaient l’arrivée de policiers (rapport de cotes ajusté [AOR] = 14,5; intervalle de confiance à 95% [IC] = 6,0–35,0), l’arrivée par ambulance (AOR = 2,6; IC à 95% = 1,4–4,9) et score de triage (AOR = 0,4; IC à 95% = 0,3–0,6). La durée du séjour, le sexe, l’âge et le fournisseur de services (p. Ex., Psychiatrie, médecine, chirurgie) n’étaient pas associés à la décision prise à l’urgence. Les admis étaient plus susceptibles de souffrir de psychose induite par le cannabis ou de troubles mentaux et comportementaux liés au cannabis. Conclusion: Les services d’urgence desservent un nombre croissant de patients en crise psychiatrique liés à l’utilisation de cannabinoïdes avant la légalisation du cannabis récréatif au Canada. Un outil d’aide à la décision pourrait être développé et validé à l’avenir afin de fournir des informations fiables et cliniquement pertinentes aux prestataires et aux gestionnaires de cas concernant les présentations au SU liées au cannabis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.332
Threshold uncertainty score0.920

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.018
GPT teacher head0.320
Teacher spread0.302 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it