Factor first! Emergency department management of persons with hemophilia: a single-center study
Bibliographic record
Abstract
BACKGROUND: Timely hemostatic therapy is essential when persons with hemophilia (PwH) present to the emergency department (ED), with guidelines recommending treatment at the time a bleed is suspected ('Factor First' strategy). RESEARCH DESIGN AND METHODS: This study examined ED management of PwH in Southern Alberta from 2014 to 2022, focusing on adherence to guidelines. RESULTS: A total of 393 ED visits from 191 adults with hemophilia A or B were identified. Most visits (86%) required emergent or urgent care. Median times from ED registration to ordering and administering hemostatic therapy were 2.9 and 4.2 hours, respectively, with treatment given within 2 hours in a minority of cases. Laboratory tests were ordered in nearly half of visits, with a median ordering time of 65 minutes. Use of individualized emergency management protocols increased over time, reaching 91.4% in 2022. Median ED stay was 3.4 hours, and approximately 25% of visits had a hemophilia-related admission diagnosis. CONCLUSIONS: These findings highlight persistent delays and nonadherence to best practice recommendations, emphasizing the need for targeted quality improvement interventions to ensure timely, guideline-concordant care for PwH in emergency settings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".