ER vs. ED: A comparison of televised and real-life emergency medicine

Background: Although accurate health-related representations of medical situations on television can be valuable, inaccurate portrayals can engender misinformation. Objective: The purpose of this study was to compare sociodemographic and medical characteristics of patients depicted on television vs. actual United States (US) Emergency Department (ED) patients. Methods: Two independently working coders analyzed all 22 programs in one complete year of the popular "emergency room" drama ER. Inter-rater reliability was excellent, and all initial coding differences were easily adjudicated. Actual health data were obtained from the National Heath and Ambulatory Medical Care Survey from the same year. Chi-squared goodness-of-fit tests were used to compare televised vs. real distribution across key sociodemographic and medical variables. Results: Ages at the extremes of age (i.e., ≤ 4 and ≥ 45 years) were less commonly represented on television compared with reality. Characters on television vs. reality were less commonly women (31.2% vs. 52.9%, respectively), African-American (12.7% vs. 20.3%), or Hispanic (7.1% vs. 12.5%). The two most common acuity categories for television were the extreme categories "non-urgent" and "emergent," whereas the two most common categories for reality were the middle categories "semi- urgent" and "urgent." Televised visits compared with reality were most commonly due to injury (63.5% vs. 37.0%, respectively), and televised injuries were less commonly work-related (4.2% vs. 14.8%, respectively). Conclusions: Comparison of represented and actual characteristics of ED patients may be valuable in helping us determine what types of patient misperceptions may exist, as well as what types of interventions may be beneficial in correcting that potential misinformation. © 2012 Elsevier Inc

Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder

Objective: To use ecological momentary assessment techniques to measure the association of major depressive disorder (MDD) with media use. Design: Data were collected using an ecological momentary assessment protocol with cellular telephone - based brief interviews. Setting: Participants received as many as 60 telephone calls from a trained staff member during 5 extendedweekends in an 8-week period. Participants: One hundred six adolescent participants who were part of a larger neurobehavioral study of depression in Pittsburgh from January 1, 2003, through December 31, 2008. Main Exposure: At each call, participants were asked whether they were using the following 5 types of media: television or movies, music, video games, Internet, and print media, such as magazines, newspapers, and books. Main Outcome Measures: We developed multivariable models to determine the independent association of each type of media use with MDD, controlling for sociodemographic variables. Results: Of the 106 participants, 46 were diagnosed as having MDD. In multivariable models controlling for age, sex, and race, each increasing quartile of audio use was associated with an 80% increase in the odds of having MDD (odds ratio,1.8; 95% confidence interval, 1.1-2.8; P=.01 for trend). Conversely, each increasing quartile of print media use was associated with a 50% decrease in the odds of having MDD (odds ratio,0.5; 95% confidence interval, 0.3-0.9; P=.009 for trend). Conclusions: Major depressive disorder is positively associated with popular music exposure and negatively associated with reading print media such as books. Further research elucidating the directionality and strength of these relationships may help advance understanding of the relationships between media use and MDD. ©2011 American Medical Association. All rights reserved