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{
    "pk": 18052,
    "title": "Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People: Recommendations for Immediate Action to Improve Care",
    "subtitle": null,
    "abstract": "Introduction: \nWe conducted this systematic review to identify emergency department (ED) relevant recommendations in current guidelines for care of transgender and gender-diverse (TGD)people internationally.\nMethods:\n Using PRISMA criteria, we did a systematic search of Ovid Medline, EMBASE, and CINAHL and a hand search of gray literature for clinical practice guidelines (CPG) or best practice statements (BPS) published until June 31, 2021. Articles were included if they were in English, included medical or paramedical care of TGD populations of any age, in any setting, region or nation, and were national or international in scope. Exclusion criteria included primary research studies, review articles, narrative reviews or otherwise non-CPG or BPS, editorials, or letters to the editor, articles of regional or individual hospital scope, non-medical articles, articles not in English, or if a more recent version of the guideline existed. Recommendations relevant to ED care were identified, recorded, and assessed for quality using the AGREE-II and AGREE-REX criteria. We performed interclass correlation coefficient for interrater reliability. Recommendations were coded for the relevant point of care while in the ED (triage, registration, rooming, investigations, etc.).\nResults: \nWe screened 1,658 unique articles, and 1,555 were excluded. Of the remaining 103 articles included, seven had recommendations relevant to care in the ED, comprising a total of 10 recommendations. Four guidelines and eight recommendations were of high quality. They included recommendations for testing, prevention, referral, and provision of post-exposure prophylaxis for HIV, and culturally competent care of TGD people.\nConclusions:\n This is the most comprehensive review to date of guidelines and best practices statements offering recommendations for care of ED TGD patients, and several are immediately actionable. There are also many opportunities to build community-led research programs to synthesize and inform a comprehensive dedicated guideline for care of TGD people in emergency settings.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "transgender, non-binary, gender diversity, emergency medicine"
        }
    ],
    "section": "Health Equity",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/90h811cd",
    "frozenauthors": [
        {
            "first_name": "Michael",
            "middle_name": "I.",
            "last_name": "Kruse",
            "name_suffix": "",
            "institution": "McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada",
            "department": "None"
        },
        {
            "first_name": "Alexandra",
            "middle_name": "",
            "last_name": "Clarizio",
            "name_suffix": "",
            "institution": "McMaster University, Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada",
            "department": "None"
        },
        {
            "first_name": "Sawyer",
            "middle_name": "",
            "last_name": "Karabelas-Pittman",
            "name_suffix": "",
            "institution": "Queen’s University School of Medicine, Kingston, Ontario, Canada",
            "department": "None"
        },
        {
            "first_name": "Blair",
            "middle_name": "L.",
            "last_name": "Bigham",
            "name_suffix": "",
            "institution": "Scarbrough Health Network, Department of Critical Care, Toronto, Ontario, Canada",
            "department": "None"
        },
        {
            "first_name": "Suneel",
            "middle_name": "",
            "last_name": "Upadhye",
            "name_suffix": "",
            "institution": "McMaster University, Division of Emergency Medicine, Hamilton, Ontario, Canada",
            "department": "None"
        }
    ],
    "date_submitted": "2023-04-17T15:32:58-05:00",
    "date_accepted": "2023-04-17T15:32:58-05:00",
    "date_published": "2023-12-20T14:14:05-06:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18052/galley/9204/download/"
        }
    ]
}