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Johns JD, Choe EJ, Chisolm PF, Pothast MJ, Randolph JR, Chou J, Maxwell JH. The impact of COVID-19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma. Head Neck 2024; 46:1698-1705. [PMID: 38433326 DOI: 10.1002/hed.27714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/03/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The impact of both COVID-19 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown. OBJECTIVE To determine the impact of COVID-19 infection and vaccination status on 60-day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC. METHODS This was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID-19 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical/demographic data, vaccination status, and incidence of 60-day mortality, 60-day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60-day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID-19 infection, vaccination status, morbidity and mortality were investigated. RESULTS Of the 14 262 patients with HNSCC who were tested for COVID-19 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60-day mortality (4.7% vs. 2.0%, respectively; p < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID-19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID-19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test. CONCLUSION COVID-19 infection may significantly increase rates of 60-day mortality and respiratory complications in patients with HNSCC. COVID-19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.
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Affiliation(s)
- James D Johns
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Erica J Choe
- Georgetown University School of Medicine, Washington, DC, USA
| | - Paul F Chisolm
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | | | - Jackson R Randolph
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Jiling Chou
- Center for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Hyattsville, Maryland, USA
| | - Jessica H Maxwell
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
- Department of Surgery, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
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Kavanagh KT, Cormier LE, Pontus C, Bergman A, Webley W. Long COVID's Impact on Patients, Workers, & Society: A review. Medicine (Baltimore) 2024; 103:e37502. [PMID: 38518038 PMCID: PMC10957027 DOI: 10.1097/md.0000000000037502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/14/2024] [Indexed: 03/24/2024] Open
Abstract
The incidence of long COVID in adult survivors of an acute SARS-CoV-2 infection is approximately 11%. Of those afflicted, 26% have difficulty with day-to-day activities. The majority of long COIVD cases occur after mild or asymptomatic acute infection. Children can spread SARS-CoV-2 infections and can also develop long-term neurological, endocrine (type I diabetes), and immunological sequelae. Immunological hypofunction is exemplified by the recent large outbreaks of respiratory syncytial virus and streptococcal infections. Neurological manifestations are associated with anatomical brain damage demonstrated on brain scans and autopsy studies. The prefrontal cortex is particularly susceptible. Common symptoms include brain fog, memory loss, executive dysfunction, and personality changes. The impact on society has been profound. Fewer than half of previously employed adults who develop long COVID are working full-time, and 42% of patients reported food insecurity and 20% reported difficulties paying rent. Vaccination not only helps prevent severe COVID-19, but numerous studies have found beneficial effects in preventing and mitigating long COVID. There is also evidence that vaccination after an acute infection can lessen the symptoms of long COVID. Physical and occupational therapy can also help patients regain function, but the approach must be "low and slow." Too much physical or mental activity can result in post-exertional malaise and set back the recovery process by days or weeks. The complexity of long COVID presentations coupled with rampant organized disinformation, have caused significant segments of the public to ignore sound public health advice. Further research is needed regarding treatment and effective public communication.
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Affiliation(s)
| | | | | | | | - Wilmore Webley
- Department of Microbiology, University of Massachusetts Amherst, Amherst, MA
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3
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Redelmeier DA, Wang J, Drover SSM. COVID Vaccine Hesitancy and Long-Term Traffic Risks. Am J Med 2024; 137:227-235.e6. [PMID: 37890570 DOI: 10.1016/j.amjmed.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND COVID vaccine hesitancy identifies a discrepancy between personal decisions and public guidelines. We tested whether COVID vaccine hesitancy was associated with the long-term risks of a traffic crash. METHODS We conducted a population-based longitudinal cohort analysis of adults by determining COVID vaccination status through linkages to electronic medical records. Traffic crashes requiring emergency medical care were defined by multicenter outcome ascertainment of all hospitals throughout the region over the subsequent year. RESULTS We identified 11,598,549 total individuals, of whom 1,210,754 had not received a COVID vaccine. A total of 54,558 were subsequently injured in traffic crashes during the 1-year follow-up interval, equal to a risk of 4704 per million. Those who had not received a COVID vaccine had a 58% higher risk than those who had received a COVID vaccine (6983 vs 4438 per million, P < .001). The increased traffic risks among unvaccinated individuals included diverse subgroups, were accentuated for single-vehicle crashes, extended to fatal outcomes, exceeded the risks associated with sleep apnea, and persisted after adjustment for baseline characteristics. The increased risks were validated in analyses using Artificial Intelligence techniques and generally larger than the risks of other adverse events frequently ascribed to COVID vaccination. CONCLUSIONS COVID vaccine hesitancy is associated with significant increased long-term risks of a traffic crash. A greater awareness of traffic risks might encourage patients to take protective actions for personal safety.
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Affiliation(s)
- Donald A Redelmeier
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada; Center for Leading Injury Prevention Practice Education & Research, Sunnybrook Research Institute, Toronto, Ont, Canada.
| | - Jonathan Wang
- Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
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4
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Filipas DK, Labban M, Beatrici E, Stone BV, Qian Z, D Andrea V, Ludwig TA, Reis LO, Cole AP, Trinh QD. Exploring preventive care practices among unvaccinated individuals in the United States during the COVID-19 pandemic. Vaccine 2024; 42:441-447. [PMID: 38184391 DOI: 10.1016/j.vaccine.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Building on a Canadian study associating unvaccinated individuals to increased car accidents, we examined the relationship between COVID-19 vaccination status and US preventive care practices. METHODS We queried the 2021 National Health Interview Survey. First, we fitted a model to identify respondent-level factors associated with receipt of at least one COVID-19 vaccination. Second, we fitted a survey-weighted logistic regression model adjusted for respondent-level characteristics to examine whether the receipt of at least one COVID-19 vaccination predicted the receipt of preventive care services. Preventive care services assessed included serum cholesterol, glucose, and blood pressure measurements, as well as guideline-concordant cancer screening including breast, cervical, colorectal, and prostate cancer screening. RESULTS Factors predicting receipt of COVID-19 vaccination were age (adjusted Odds Ratio (aOR) 1.03; 95 % confidence interval (CI) [1.03-1.03]), Hispanic (aOR 1.25; 95 % CI [1.08-1.44]), and non-Hispanic Asian (aOR 3.52; 95 % CI [2.74-4.52]) ethnicity/race, and history of cancer (aOR 1.61; 95 % CI [1.13-2.30]). Unvaccinated respondents were less likely to have received serum cholesterol (aOR 0.69; 95 % CI [0.50-0.70), serum glucose (aOR 0.65; 95 % CI [0.56-0.75]), or blood pressure measurements (aOR 0.47; 95 % CI [0.33-0.66]); and were less likely to have received breast cancer (aOR 0.35; 95 % CI [0.25-0.48]), colorectal cancer (aOR 0.52; 95 % CI [0.46-0.60]) and prostate cancer screening (aOR 0.61; 95 % CI [0.48-0.76]). There was no significant association between unvaccinated respondents receiving cervical cancer screening (aOR 0.96; 95 % CI [0.81-1.13]; p = 0.616). CONCLUSION Non-receipt of COVID-19 vaccination was associated with non-receipt of preventive care services including cancer screening. Further studies are needed to assess if this association is due to system-level factors or reflects a general distrust of medical preventive care amongst this population.
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Affiliation(s)
- Dejan K Filipas
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA; University Medical Center Hamburg-Eppendorf, Department of Urology, Hamburg, Germany
| | - Muhieddien Labban
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Edoardo Beatrici
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Benjamin V Stone
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Zhiyu Qian
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Vincent D Andrea
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Tim A Ludwig
- University Medical Center Hamburg-Eppendorf, Department of Urology, Hamburg, Germany
| | - Leonardo O Reis
- UroScience, State University of Campinas, Unicamp and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, Sao Paulo State, Brazil
| | - Alexander P Cole
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Quoc-Dien Trinh
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
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Lapointe-Shaw L, Salahub C, Austin PC, Bai L, Bhatia RS, Bird C, Glazier RH, Hedden L, Ivers NM, Martin D, Shuldiner J, Spithoff S, Tadrous M, Kiran T. Virtual Visits With Own Family Physician vs Outside Family Physician and Emergency Department Use. JAMA Netw Open 2023; 6:e2349452. [PMID: 38150254 PMCID: PMC10753397 DOI: 10.1001/jamanetworkopen.2023.49452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
Importance Virtual visits became more common after the COVID-19 pandemic, but it is unclear in what context they are best used. Objective To investigate whether there was a difference in subsequent emergency department use between patients who had a virtual visit with their own family physician vs those who had virtual visits with an outside physician. Design, Setting, and Participants This propensity score-matched cohort study was conducted among all Ontario residents attached to a family physician as of April 1, 2021, who had a virtual family physician visit in the subsequent year (to March 31, 2022). Exposure The type of virtual family physician visit, with own or outside physician, was determined. In a secondary analysis, own physician visits were compared with visits with a physician working in direct-to-consumer telemedicine. Main Outcome and Measure The primary outcome was an emergency department visit within 7 days after the virtual visit. Results Among 5 229 240 Ontario residents with a family physician and virtual visit, 4 173 869 patients (79.8%) had a virtual encounter with their own physician (mean [SD] age, 49.3 [21.5] years; 2 420 712 females [58.0%]) and 1 055 371 patients (20.2%) had an encounter with an outside physician (mean [SD] age, 41.8 [20.9] years; 605 614 females [57.4%]). In the matched cohort of 1 885 966 patients, those who saw an outside physician were 66% more likely to visit an emergency department within 7 days than those who had a virtual visit with their own physician (30 748 of 942 983 patients [3.3%] vs 18 519 of 942 983 patients [2.0%]; risk difference, 1.3% [95% CI, 1.2%-1.3%]; relative risk, 1.66 [95% CI, 1.63-1.69]). The increase in the risk of emergency department visits was greater when comparing 30 216 patients with definite direct-to-consumer telemedicine visits with 30 216 patients with own physician visits (risk difference, 4.1% [95% CI, 3.8%-4.5%]; relative risk, 2.99 [95% CI, 2.74-3.27]). Conclusions and Relevance In this study, patients whose virtual visit was with an outside physician were more likely to visit an emergency department in the next 7 days than those whose virtual visit was with their own family physician. These findings suggest that primary care virtual visits may be best used within an existing clinical relationship.
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Affiliation(s)
- Lauren Lapointe-Shaw
- University Health Network, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
- Division of General Internal Medicine and Geriatrics, University Health Network and Sinai Health System, Toronto, Ontario, Canada
| | | | - Peter C. Austin
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Li Bai
- ICES, Toronto, Ontario, Canada
| | - R. Sacha Bhatia
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Cardiology, University Health Network, Toronto, Ontario, Canada
| | | | - Richard H. Glazier
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Noah M. Ivers
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Family Medicine, Women’s College Hospital, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Danielle Martin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Family Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Jennifer Shuldiner
- Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
| | - Sheryl Spithoff
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Family Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Mina Tadrous
- ICES, Toronto, Ontario, Canada
- Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Tara Kiran
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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Wilson J, Rinner C, Kone AP, Bosveld E. Vaccine hesitancy was not shown to be associated with traffic safety or driver behavior. Front Public Health 2023; 11:1204205. [PMID: 37869201 PMCID: PMC10585163 DOI: 10.3389/fpubh.2023.1204205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Jeff Wilson
- Novometrix Research Inc., Moffat, ON, Canada
| | - Claus Rinner
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON, Canada
| | - Anna Pefoyo Kone
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Edward Bosveld
- Department of Politics and International Studies, Redeemer University, Hamilton, ON, Canada
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Adepoju VA, Imoyera W. Addressing COVID Vaccine Hesitancy and Its Impact on Road Crashes. Am J Med 2023; 136:e179. [PMID: 37612020 DOI: 10.1016/j.amjmed.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/02/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Victor Abiola Adepoju
- Department of HIV and Infectious Diseases, Jhpiego Nigeria (an affiliate of Johns Hopkins University), Abuja, Nigeria.
| | - Winifred Imoyera
- Department of HIV and Infectious Diseases, Jhpiego Nigeria (an affiliate of Johns Hopkins University), Abuja, Nigeria
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Redelmeier DA, Wang J, Thiruchelvam D. The Reply. Am J Med 2023; 136:e180-e181. [PMID: 37612021 DOI: 10.1016/j.amjmed.2023.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Donald A Redelmeier
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada; Center for Leading Injury Prevention Practice Education & Research, Toronto, Ont, Canada.
| | - Jonathan Wang
- Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
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Schabas R, Grant J, Fulford M, Rau N. Comments on COVID Vaccine Hesitancy and Traffic Crash Risk. Am J Med 2023; 136:e146. [PMID: 37344093 DOI: 10.1016/j.amjmed.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 06/23/2023]
Affiliation(s)
| | | | | | - Neil Rau
- University of Toronto, Toronto, ON, Canada
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Redelmeier DA, Wang J, Thiruchelvam D. The Reply. Am J Med 2023; 136:e147-e148. [PMID: 37344094 DOI: 10.1016/j.amjmed.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Donald A Redelmeier
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ont, Canada; Center for Leading Injury Prevention Practice Education & Research, Toronto, Ont, Canada.
| | - Jonathan Wang
- Department of Medicine, University of Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ont, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ont, Canada
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Redelmeier DA, Wang J, Thiruchelvam D. The Reply. Am J Med 2023; 136:e101. [PMID: 37137573 PMCID: PMC10150232 DOI: 10.1016/j.amjmed.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 05/05/2023]
Affiliation(s)
- Donald A Redelmeier
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ONT, Canada; Department of Medicine, University of Toronto, Toronto, ONT, Canada; Institute for Clinical Evaluative Sciences, Toronto, ONT, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, ONT, Canada; Center for Leading Injury Prevention Practice Education & Research, Toronto, ONT, Canada.
| | - Jonathan Wang
- Department of Medicine, University of Toronto, Toronto, ONT, Canada; Institute for Clinical Evaluative Sciences, Toronto, ONT, Canada
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ONT, Canada; Institute for Clinical Evaluative Sciences, Toronto, ONT, Canada
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