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Articles by Eddy Lang
Cardiac arrest - Symptoms, diagnosis and treatment
Summary Cardiac arrest is a sudden state of circulatory failure due to a loss of cardiac systolic function. The most common shockable rhythms associated with cardiac arrest are pulseless ventricular tachycardia and ventricular fibrillation. The most common underlying causes are ischemic heart disease and myocardial infarction. In some settings, cardiac arrest is the result of respiratory arrest triggered by opioid toxicity.
Artificial Intelligence-powered tiered early warning framework addressing high false alarm rates for in-hospital mortality prediction
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15 hours ago NONTHABURI, Thailand (AP) — Thailand’s “Death Fest” invites people to confront mortality while also offering practical services and spiritual advice for the inevitable. The unusual fair, now in its second year, has broached the subject that’s uncomfortable for many. It’s also one of the central …
By Lijuan Wu, Liyi Mai, Hongnian Wang, Jinxin Huang, Xinrong He, Xueyun Zhan, Anna Khalemsky, Vijaya Kumar, James Paxton, Dionyssios Tsilimingras, Shan Liu, Gabriele Savioli, Niels K. Rathlev, Karim Tazarourte, Anna Slagman, Michael Christ, Muhammad Qureshi, Hani Hariri, Shamai Grossman, Bei Hu Verified, Huajun Wang, Binbin He, Phillip D. Levy, Brian O’Neil, Seth R. Gemme, Lisa Kurland, Eddy Lang, Jinle Lin, Huiying Liang, Xin Li Verified, Abdelouahab Bellou
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Artificial Intelligence-powered tiered early warning framework addressing high false alarm rates for in-hospital mortality prediction
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Abstracts Alert fatigue remains a major barrier to the effective deployment of predictive models in emergency care, particularly in the context of rare but critical outcomes such as in-hospital mortality (IHM), which often occurs in less than 5.0% of patients admitted from the emergency department (ED). Severe class imbalance leads to low positive predictive value (PPV), undermining the clinical utility of even high-performance predictive models.
By Lijuan Wu, Jinxin Huang, Xinrong He, Anna Khalemsky, Vijaya Kumar, James Paxton, Shan Liu, Gabriele Savioli, Karim Tazarourte, Anna Slagman, Michael Christ, Muhammad Qureshi, Shamai Grossman, Bei Hu Verified, Huajun Wang, Binbin He, Phillip D. Levy, Brian O’Neil, Seth R. Gemme, Lisa Kurland, Eddy Lang, Jinle Lin, Huiying Liang, Xin Li Verified, Abdelouahab Bellou, Liyi Mai, Hongnian Wang, Xueyun Zhan, Dionyssios Tsilimingras, Niels K. Rathlev, Hani Hariri
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Nature
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Privately paid, direct-to-consumer diagnostic testing: let the buyer beware
CMAJ February 09, 2026 198 (5) E181-E182; DOI: https://doi.org/10.1503/cmaj.260109 Article Responses Metrics PDF Alberta’s Ministry of Health recently announced plans to enable residents to privately purchase diagnostic testing services, including laboratory and imaging tests, without a referral from a health care provider.
Recommendation on screening adults for depression using a screening tool
Key messages for the public Depression negatively affects how a person feels, thinks, or behaves, results in impaired functioning in social and work settings, and can lead to thoughts of suicide. Our systematic review found evidence that using screening questionnaires to identify people who may have depression might not improve their health or well-being.
Expanded disease definitions in Alzheimer’s disease and the new era of disease-modifying drugs
Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Care for older adults living with dementia in the emergency department: a systematic review and meta-synthesis of care partner roles and perspectives
Handling editor Mary Dawood Contributors DJ, JH-L and ZG contributed to the study conception and design. Data collection, data extraction and synthesis were performed by DJ and BF. The first draft of the manuscript was written by DJ and BF. KR, EL, JH-L and ZG critically reviewed and revised the content of all manuscript drafts as well as the revised manuscript. DJ prepared the final and revised manuscripts and submitted the study. ZG is the guarantor and was responsible for overall supervision.
Navigating the emergence of point-of-care diagnostics in paediatric emergency medicine
Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways. Paediatric Emergency Medicine Child Health Epidemiology Point-of-care (POC) diagnostics have become a cornerstone of everyday paediatric emergency medicine (PEM).
Finding the professional age “sweet spot” in emergency medicine
Corresponding Author Joe Nemeth Jr MD Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada Department of Pediatrics, McGill University, Montreal, Quebec, Canada Department of Critical Care, McGill University, Montreal, Quebec, Canada Correspondence Joe Nemeth Jr., Department of Emergency Medicine, McGill University, Montreal, QC H4A 3J1, Canada. Email: joe.nemeth@mcgill.ca Search for more papers by this author
In ischemic stroke, EVT improved 90-d function more than usual care across admission SBP levels
Authors: Maryam Bahreini, MD; Eddy Lang, MD Affiliations: McGill University, Montreal, Quebec, Canada (M.B.) University of Calgary, Calgary, Alberta, Canada (E.L.) Disclosures: The commentators have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J23-0055. This article was published at Annals.org on 1 August 2023. ACP Journal Club is editorially independent from Annals of Internal Medicine.
In large acute ischemic stroke, adding endovascular thrombectomy to medical therapy improved function at 90 d
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In acute ischemic stroke, early IV tenecteplase was noninferior to alteplase for excellent functional outcome
Affiliations: University of Ottawa, Ottawa, Ontario, Canada (E.F.) University of Calgary, Calgary, Alberta, Canada (E.L.) Disclosures: The commentators have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J22-0090. This article was published at Annals.org on 1 November 2022. ACP Journal Club is editorially independent from Annals of Internal Medicine.
Recommendation on instrument-based screening for depression during pregnancy and the postpartum period
KEY POINTS The Canadian Task Force on Preventive Health Care recommends against screening all individuals for depression during pregnancy and the postpartum period (up to 1 year after childbirth), using questionnaires (conditional recommendation, very low–certainty evidence).
Overdiagnosis: Good intentions gone bad
Peter was a thriving young software engineer; he is now on an extended leave of absence due to debilitating anxiety. It began with a CT scan for frequent migraines that showed a benign-appearing small intracranial mass. The conspicuous finding led to an MRI that re-demonstrated the abnormality.
In support of addiction and mental health patients in emergency departments
Our health-care system has unfairly stacked the cards against patients suffering from addictions and mental illness. This is evident in many areas but is prominently seen in our local emergency departments. This system-level bias is, in turn, a significant reason why emergency care is under severe strain and placing all Canadians at risk.
In ischemic stroke upon wakening, IV thrombolysis or EVT improves functional outcome at 90 d
Source Citation Roaldsen MB, Lindekleiv H, Mathiesen EB. Intravenous thrombolytic treatment and endovascular thrombectomy for ischaemic wake-up stroke. Cochrane Database Syst Rev. 2021;12:CD010995. https://pubmed.ncbi.nlm.nih.gov/34850380 Clinical Impact Ratings Emergency Med: Hospitalists: Neurology: References 1. Bassetti C, Aldrich M. Night time versus daytime transient ischaemic attack and ischaemic stroke: a prospective study of 110 patients. J Neurol Neurosurg Psychiatry. 1999;67:463-7.
In suspected PE, YEARS rule + D-dimer was noninferior to D-dimer alone to rule out PE
Source Citation Freund Y, Chauvin A, Jimenez S, et al. Effect of a diagnostic strategy using an elevated and age-adjusted D-dimer threshold on thromboembolic events in emergency department patients with suspected pulmonary embolism: a randomized clinical trial. JAMA. 2021;326:2141-9. https://pubmed.ncbi.nlm.nih.gov/34874418 Clinical Impact Ratings Emergency Med: Hospitalists: Reference 1. Levi M, van Es N. Diagnostic strategies for suspected pulmonary embolism. JAMA. 2021;326:2135-6.
Commentary: Masks should be part of our post-pandemic normal
CALGARY, Alberta: Public health measures, such as masking and physical distancing, that have been a high-profile part of the COVID-19 response for the past two years are now beginning to be lifted. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections. These effects are a valuable research discovery from the pandemic.
The Case for Masking
Analysis Coronavirus How continuing the practice could keep us healthier, protect the vulnerable and cushion our health-care systems. Rutvij A Khanolkar and Eddy S Lang TodayThe Conversation Rutvij A. Khanolkar is a medical student at the University of Calgary. Eddy S. Lang is a professor at the Cumming School of Medicine at the University of Calgary. This article was originally published on the Conversation.
Should Measures Like Masking Continue Beyond The Pandemic?
THE CANADIAN PRESS/Graham Hughes Public health measures, such as masking and physical distancing, that have been a high-profile part of the COVID-19 response for the past two years are now beginning to lift. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections. These effects are a valuable research discovery from the pandemic.
Should public health measures like masking continue beyond the pandemic?
Public health measures, such as masking and physical distancing, that have been a high-profile part of the COVID-19 response for the past two years are now beginning to lift. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections. These effects are a valuable research discovery from the pandemic.
Should Public Health Measures Like Masking Continue Beyond The Pandemic? Data Shows Their Benefits
By Rutvij A. Khanolkar and Eddy S. Lang for The Conversation Calgary, Mar 13 (The Conversation) Public health measures, such as masking and physical distancing, that have been a high-profile part of the Covid-19 response for the past two years are now beginning to lift. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections.
Should public health measures like masking continue beyond the pandemic? Data on viral infections shows their benefits
Public health measures, such as masking and physical distancing, that have been a high-profile part of the COVID-19 response for the past two years are now beginning to lift. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections. These effects are a valuable research discovery from the pandemic.
WHO provides 2 conditional recommendations for casirivimab–imdevimab combination therapy in COVID-19 | Annals of Internal Medicine
Using GRADE in situations of emergencies and urgencies: certainty in evidence and recommendations matters during the COVID-19 pandemic, now more than ever and no matter what. J Clin Epidemiol. 2020;127:202-7. [PMID:
PRIORITY risk model predicted critical outcomes in patients hospitalized with COVID-19
Martínez-Lacalzada M, Viteri-Noël A, Manzano L, et al. Predicting critical illness on initial diagnosis of COVID-19 based on easily-obtained clinical variables: development and validation of the PRIORITY model. Clin Microbiol Infect. 2021. [Epub ahead of print]. https://pubmed.ncbi.nlm.nih.gov/34274525
High-Sensitivity Cardiac Troponins and Clinical Decision Making in Caring for Patients With Chest Pain
Affiliations: Departments of Emergency Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (A.D.M., E.S.L.) Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (C.M.O.) Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4342. Corresponding Author: Andrew D.
In adults hospitalized with COVID-19, the 5-variable SOARS score predicted in-hospital mortality
Risk stratification of patients admitted to hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ. 2020;370:m3339. [PMID:
A safe return to sport and the right to play during COVID-19
Letters Open Access Fiona E.
In adults hospitalized with COVID-19, the quick COVID-19 Severity Index predicted 24-h respiratory decompensation
Disclosures: The commentators have disclosed no conflicts of interest. The forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-7313.
Covid-19: an opportunity to reduce unnecessary healthcare
News & Views Covid-19: an...
Authentic Emergency Department Leadership During a Pandemic
Access April 2020 , pp. 1-5 Eddy Lang (a1), Howard Ovens (a2), Michael J.
Just the Facts: Protecting frontline clinicians during the COVID-19 pandemic
Paul Atkinson (a1) (a2), James French (a1), Eddy Lang (a3), Tamara McColl (a4) and Laurie Mazurik (a5)...
Emergency Strategic Clinical Network
KEY POINTS The Emergency Strategic Clinical Network (ESCN) connects patients, staff and physicians at Alberta’s 103 emergency departments and 6 urgent care centres. The ESCN works to align care with patient needs, translate evidence into practice and develop new evidence where none exists. Since 2012, the ESCN has engaged in projects such as standardized training, integrated care pathways and research to improve care for vulnerable populations.
In pregnant women, the pregnancy-adapted YEARS algorithm ruled out PE, with a low rate of VTE at 3 months
van der Pol LM, Tromeur C, Bistervels IM, et al; Artemis Study Investigators. Pregnancy-adapted YEARS algorithm for diagnosis of suspected pulmonary embolism. N Engl J Med. 2019;380:1139-49. 30893534 Emergency Med: Hospitalists: In pregnant women with suspected pulmonary embolism (PE), what is the risk for venous thromboembolism (VTE) after PE is ruled out with the pregnancy-adapted YEARS algorithm? Prospective cohort study (ARTEMIS study). Netherlands Trial Register NL5726.
In pregnant women, the pregnancy-adapted YEARS algorithm ruled out PE, with a low rate of VTE at 3 months
van der Pol LM, Tromeur C, Bistervels IM, et al; Artemis Study Investigators. Pregnancy-adapted YEARS algorithm for diagnosis of suspected pulmonary embolism. N Engl J Med. 2019;380:1139-49. 30893534 Emergency Med: Hospitalists: In pregnant women with suspected pulmonary embolism (PE), what is the risk for venous thromboembolism (VTE) after PE is ruled out with the pregnancy-adapted YEARS algorithm? Prospective cohort study (ARTEMIS study). Netherlands Trial Register NL5726.
Evidence-Based Guidelines for EMS Administration of Naloxone
Background Impact of the Opioid Crisis Rates of opioid overdose (OD) in the United States have increased fourfold since 2000, with data for 2016 indicating that over 42,000 died from opioid overdose that year alone (1). In 2016, opioid overdose deaths (3) overtook traffic crashes (4) as the leading cause of death by traumatic injury in the United States.
Emergency Departments as the Health Safety Nets of Society: A Descriptive and Multicenter Analysis of Social Worker Support in the Emergency Room
The demand for SW support is significant and complex in these large urban EDs. However, the impact on patient care and resource use is substantial, and the data indicates that SW integration may be of universal benefit to EDs. Further studies are warranted to accurately characterize the amount and type of SW necessary for optimal patient outcomes and hospital resource use.
In perfusion imaging-selected acute ischemic stroke, thrombectomy at 6 to 16 hours improved functional outcomes
Albers GW, Marks MP, Kemp S, et al; DEFUSE 3 Investigators. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med. 2018;378:708-18. 29364767 In acute ischemic stroke with potentially reversible ischemic brain tissue, does adding endovascular thrombectomy to standard medical therapy 6 to 16 hours after onset improve 90-day functional outcomes?
Eliciting patient values and preferences to inform shared decision making in preventive screening
As part of a series of papers on implementing guideline recommendations in the context of preventive health care, 2 of our previous papers discussed communicating harms and benefits, and shared decision making (SDM).1,2 In the latter paper we met John, a 66-year-old smoker, who at his most recent visit to your office wished to focus on quitting smoking. At that time, John was informed of his eligibility for a low-dose chest computed tomography (CT) scan to screen for lung cancer.
Review: In acute ischemic stroke, adding endovascular therapy to t-PA improves functional independence at 90 days
Published: Ann Intern Med. 2015;163(8):JC4. DOI: 10.7326/ACPJC-2015-163-8-004
Dr. Eddy Lang: It may be time to reconsider long-term use of PPIs for gastroesophageal reflux disease
There are alternatives to long-term use of PPIs for gastroesophageal reflux disease. nebari / Getty Images/iStockphoto Adam knew he was in trouble after indulging in some late night doughnuts on the Calgary Stampede grounds. He had been experiencing heartburn intermittently over the years when eating rich or spicy foods but now things were a lot worse with upset stomach persisting for over a week and over the counter anti-acid medications providing only partial relief.
Dr. Eddy Lang: What works best in treating opioid use disorder?
John was an ordinary middle-aged dad who was also an avid cyclist. That is until a biking accident left him with a shattered humerus bone in his shoulder and what would be the beginning of a downward spiral. In the emergency department, the fracture was stabilized in anticipation of more definitive surgery and due to the severity of his pain, he was prescribed a small number of opioid tablets and instructed to use them sparingly.
Dr. Eddy Lang: What works best in treating opioid use disorder?
John was an ordinary middle-aged dad who was also an avid cyclist. That is until a biking accident left him with a shattered humerus bone in his shoulder and what would be the beginning of a downward spiral. In the emergency department, the fracture was stabilized in anticipation of more definitive surgery and due to the severity of his pain, he was prescribed a small number of opioid tablets and instructed to use them sparingly.
Dr. Eddy Lang: Studies shine light on health effects of vegetarian and vegan diets
New studies focus on vegan and vegetarian diets. All photos credit Kris Kirkham / - With winter courses and exams coming to an end, Naomi found herself with a lot of extra time on her hands. She spent much of that free time watching documentaries related to nutrition and the environmental impact of food consumption on the planet. The result? After seeing a few videos from the People for Ethical Treatment of Animals (PETA) website, she decided to become a devout vegetarian.
Comparative evaluation of 2-hour rapid diagnostic algorithms for acute myocardial infarction using high-sensitivity cardiac Troponin T
The objective of the ED assessment of chest pain and symptoms of ACS is to rapidly and accurately differentiate patients at high risk of adverse cardiac events from low-risk patients who may be suitable for early ED discharge.
Dr. Eddy Lang: Jury's still out on whether probiotics promote healthy teeth and gums
Two cavities. The last words Sasha, a mother of three children, wanted to hear at the dentist’s office as her son Spencer was getting a checkup. Spencer, who recently turned four, has now collected five cavities over the course of his young life. These cavities occurred despite Sasha’s diligent efforts to brush and floss Spencer’s teeth twice a day, and minimize how much snacking he does. With dental care being so expensive in Calgary, Sasha feels frustrated and hopeless.
Dr. Eddy Lang: Pursuing a pill-free approach to treating back pain
Three months ago, Bruce threw his back out while bending over to help his grandson tie his skates. Although he has had occasional back trouble in the past, this flare-up was different and simply did not want to go away. The pain was constant, deep and worsened when walking or making sudden movements. It was definitely starting to interfere with his everyday life, preventing him from gardening, driving for long periods of time and even feeling present at family gatherings.
Dr. Eddy Lang: Love doesn't hurt, marriage is good for you
The reasons why are complex, but marriage appears to reduce a persons chance of cardiovascular disease. Photo by Maria Teijeiro /Getty Images Article content Have you ever wondered why the heart has always been the symbol for love? What is it about this blood-pumping dynamo of an organ that reminds us of amorous affection and relationships? Wouldn’t the brain be more appropriate? Maybe the connection comes from the fluttering in the chest that sometimes accompanies strong romantic emotions.
Dr. Eddy Lang: Love doesn't hurt, marriage is good for you
Advertisement 1 Article content Have you ever wondered why the heart has always been the symbol for love? What is it about this blood-pumping dynamo of an organ that reminds us of amorous affection and relationships? Wouldn’t the brain be more appropriate? Maybe the connection comes from the fluttering in the chest that sometimes accompanies strong romantic emotions. Alternatively, it has been suggested that love and marriage in particular are good for our health.
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