COVID-19 in a rural health system in New York - case series and an approach to management

  1. Eyal Kedar
  2. Regina Scott
  3. Daniel Soule
  4. Carly Lovelett
  5. Kyle Tower
  6. Kylie Broughal
  7. Daniel Jaremczuk
  8. Sara Mohaddes
  9. Imre Rainey-Spence
  10. Timothy Atkinson

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Abstract

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  1. Version published to 10.22605/rrh6464
  2. ScreenIT

    SciScore for 10.1101/2020.10.15.20213348: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the SLHS institutional review board.
    Consent: A waiver of consent was obtained for patients lost to follow-up.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    These are just several examples, and what is even more important than our team’s COVID-19 experience is the larger lesson that in the setting of resource limitation small teams of generalists can be used to respond to a wide range of medical events. Another lesson is that having the infrastructure and experience to conduct clinical trials is invaluable in a pandemic. At a time when the majority of rural sites lack this infrastructure6-7 there is often a divergence between national treatment guideline8-9 and the on the ground reality for rural hospitals. In our own case, outside of convalescent plasma we were not enrolled in any clinical trials over the dates of this case series. We were unable to establish access to remdesivir for any of our patients and IV tocilizumab was obtained only after a significant procurement effort by our inpatient COVID-19 team. Furthermore, there was on average a nearly two week delay between the day of request and the day of receipt of convalescent plasma for the patients in this series. Fortunately, we were ultimately able to develop a clinical trial opportunity for our hospitalized COVID-19 patients. A third and overarching lesson is that crisis management either in or out of a pandemic requires adequate networks of care. Such networks must include systems for centralizing and streamlining healthcare resources, good communication between physicians and advanced practice providers at hub and spoke hospitals, clinical research infrastructure and ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.10.15.20213348v1 on medRxiv