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Record W3195803376 · doi:10.1136/emermed-2021-999.2

02 Leveraging paramedic data to investigate the effect of COVID-19 on community opioid overdoses

2021· article· en· W3195803376 on OpenAlexaffabout
J Chris Smith, Wesley S. Burr

Bibliographic record

VenueEmergency Medicine Journal · 2021
Typearticle
Languageen
FieldMedicine
TopicOpioid Use Disorder Treatment
Canadian institutionsTrent University
Fundersnot available
KeywordsMedicine(+)-NaloxoneOpioid overdoseEmergency medicineOpioidEmergency departmentMedical emergencyInternal medicinePsychiatry

Abstract

fetched live from OpenAlex

Background Opioid overdoses in Canada have shown dramatic increases over recent years, despite significant investments in harm reduction. Most community monitoring currently relies on emergency department and coroner data. Our team has previously shown that paramedic data can be a useful addition to the current metrics as paramedics regularly interact with opioid overdose patients. This study examines paramedic data to investigate the changes to community opioid overdoses in the era of COVID-19 to better support our strategic partners in their battle against the opioid crisis. Methods The electronic ambulance call report database of Peterborough Paramedics (Ontario, Canada) was examined. De-identified records for patients from 2017-2020 with documented problem codes of ‘Opioid Overdose’ were extracted. Patients receiving paramedic naloxone were also included. The data was cleaned and analysed, and incomplete records were removed. Statistical models including chi-squared tests of goodness-of-fit and post hoc pairwise t-tests were applied to the data. Ethics approval for this study was granted by the Trent University’s Research Ethics Board. Results 788 opioid overdoses were identified out of 72,737 patients. There were 263 opioid overdoses found in 2020 representing 1.4% patients, a significant increase from 2017-2019 (p value: 0.006). The proportion of patients receiving paramedic naloxone was significantly increased from previous years (p value: 0.005) while bystander naloxone administration was significantly decreased (p value 0.002). Age, gender, and pick-up location types were not significantly different between 2020 and previous years. Conclusion Despite reduced overall call volumes in 2020, paramedics observed an increase in opioid overdoses. The increase in paramedic naloxone administration and decrease in bystander naloxone administration may indicate changes in usage practices of community opioid users or an instability in the drug supply. These factors must be considered in future opioid harm reduction strategies and public health COVID-19 containment measures.

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.

How this classification was reachedexpand

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)0.003
metaresearch head score (Gemma)0.011
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.233
Threshold uncertainty score0.997

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.011
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0100.000

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 head0.136
GPT teacher head0.408
Teacher spread0.271 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2021
Admission routes2
Has abstractyes

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