Shyam Mohan Sivasankar

All Publications

• Research Dissemination Strategies in Pediatric Emergency Care Using a Professional Twitter (X) Account: A Mixed Methods Developmental Study of a Logic Model Framework. JMIR formative research Hooley, G. C., Magana, J. N., Woods, J. M., Sivasankar, S., VonHoltz, L., Schmidt, A. R., Chang, T. P., Lin, M. 2025; 9: e59481

  Abstract

  Research dissemination is a vital step in bridging the gap between the publication of cutting-edge research and its adoption into clinical practice. Social media platforms like Twitter (rebranded as X) offer promising channels for dissemination, yet research organizations lack clear guidance on establishing a professional social media presence. We present a structured framework based on our research network's multiyear experience developing a Twitter account for research dissemination.This study aimed to provide a roadmap for organizations aiming to create a professional Twitter account for research dissemination.This was a mixed methods study analyzing the Pediatric Emergency Care Applied Research Network (PECARN) Twitter team's 4-year experience (2020-2023) with building a social media account. Using the nominal group technique qualitative approach, we recorded insights from the 6 team members' experiences in a round-robin fashion until response saturation. In addition, we analyzed internal Slack (Slack Technologies) communications to identify key developmental events. Together, these were then prioritized by consensus to elucidate key developmental events that enhanced both social media and scientific engagement. This process was informed by quantitative data from Twitter performance metrics and Altmetric Attention Scores for journal publications collected over a 39-month period. Together, these elements informed the design of a logic model framework.The nominal group technique generated 63 thematic statements which included issues such as organizational structure, content strategy, technologies, analytics, organizational priorities, and challenges. These statements coalesced into the 7 domains (priorities, assumptions, inputs, outputs, outcomes, and external factors) that comprise the logic model. Inputs included organizational support (eg, executive-level champion and funding), specialized personnel (eg, content writer and analytics manager), and operational technologies (eg, communications and data analytics tools). Outputs encompassed targeted activities, such as engaging with other Twitter accounts, publishing high-quality tweets highlighting scholarly work, and developing a dynamic operations manual for the Twitter team. Outcomes were measured through tweet metrics, account analytics, and article-level impact scores.Our logic model roadmap, based on our practical multiyear experience and data-driven strategies, can serve as a guide for research organizations or medical institutions aiming to incorporate Twitter or other social media platforms for research dissemination.

  View details for DOI 10.2196/59481

  View details for PubMedID 40554778

• Pediatric emergency medicine fellowship point-of-care ultrasound training in 2020. AEM education and training Cramer, N., Cantwell, L., Ong, H., Sivasankar, S. M., Graff, D., Lawson, S. L., Wilson, P. M., Noorbakhsh, K. A., Mickley, M., Zuckerbraun, N. S., Sobolewski, B., Soung, J. K., Azhdam, D. B., Wagner Neville, D. N., Hincapie, M. R., Marin, J. R. 2021; 5 (4): e10643

  Abstract

  Objectives: The primary objective was to survey pediatric emergency medicine (PEM) leaders and fellows regarding point-of-care ultrasound (POCUS) training in PEM fellowship programs, including teaching methods, training requirements, and applications taught. Secondary objectives were to compare fellows' and program leaders' perceptions of fellow POCUS competency and training barriers.Methods: This was a cross-sectional survey of U.S. PEM fellows and fellowship program leaders of the 78 fellowship programs using two online group-specific surveys exploring five domains: program demographics; training strategies and requirements; perceived competency; barriers, strengths, and weaknesses of POCUS training; and POCUS satisfaction.Results: Eighty-three percent (65/78) of programs and 53% (298/558) of fellows responded. All participating PEM fellowship programs included POCUS training in their curriculum. Among the 65 programs, 97% of programs and 92% of programs utilized didactics and supervised scanning shifts as educational techniques, respectively. Sixty percent of programs integrated numerical benchmarks and 49% of programs incorporated real-time, hands-on demonstration as training requirements. Of the 19 POCUS applications deemed in the literature as core requirements for fellows, at least 75% of the 298 fellows reported training in 13 of those applications. Although less than half of fellows endorsed competency for identifying intussusception, ultrasound-guided pericardiocentesis, and transvaginal pregnancy evaluation, a higher proportion of leaders reported fellows as competent for these applications (40% vs. 68%, p≤ 0.001; 21% vs. 39%, p=0.003; and 21% vs. 43%, p≤0.001). Forty-six percent of fellows endorsed a lack of PEM POCUS evidence as a training barrier compared to 31% of leaders (p=0.02), and 39% of leaders endorsed a lack of local financial support as a training barrier compared to 23% of fellows (p=0.01).Conclusions: Although most PEM fellowship programs provide POCUS training, there is variation in content and requirements. Training does conform to many of the expert recommended guidelines; however, there are some discrepancies and perceived barriers to POCUS training remain.

  View details for DOI 10.1002/aet2.10643

  View details for PubMedID 34568713

• Emergency department treatment of asthma in children: A review JACEP Open Lee, M. O., Sivasankar, S., Pokrajac, N., Smith, C., Lumba-Brown, A. 2020

  View details for DOI 10.1002/emp2.12224

• Teaching How to Teach in a Train-the-Trainer Program. Journal of graduate medical education Feltes, M. n., Becker, J. n., McCall, N. n., Mbanjumucyo, G. n., Sivasankar, S. n., Wang, N. E. 2019; 11 (4 Suppl): 202–4

  View details for DOI 10.4300/JGME-D-18-01014

  View details for PubMedID 31428287

  View details for PubMedCentralID PMC6697297

• A Web-based Decision Tool to Estimate Subarachnoid Hemorrhage Risk in Emergency Department Patients. Cureus Manella, H., Sivasankar, S., Perry, J. J., Pfeil, S., Senyak, J., Shachter, R., Govindarajan, P. 2018; 10 (1): e2096

  Abstract

  Subarachnoid hemorrhage (SAH) from a leaking aneurysm is a neurological emergency. SAH patients often present with headache-a common chief complaint among emergency department patients. If unrecognized, 70% of the patients with re-bleeds die and one third are left with neurological deficits. Therefore, it is critical to distinguish the signs and symptoms of SAH from benign causes of headache, perform the appropriate diagnostic tests and treat in a timely manner in order to reduce the disability and mortality associated with this condition. In patients with suspected SAH, traditional diagnostic strategies in the emergency department employ non-contrast computed tomography (CT) of the brain to detect blood in the subarachnoid space followed by lumbar puncture if there is a high clinical probability of aneurysmal bleed without any evidence of blood on CT scan. While the older generation CT scanners were less sensitive to blood detection in the subarachnoid space, recent advances in CT imaging have resulted in sensitivity approaching 100% for detection of blood in the subarachnoid space specifically within six hours of symptom onset. Therefore, the benefit of lumbar puncture is controversial when performed within the first six hours of symptom onset. Despite this, lumbar puncture is still commonly performed in the emergency department, exposing patients to unnecessary procedural risks. The objective of this research study is to develop a web-based risk calculator that estimates the risk of SAH based on time to emergency department presentation after symptom onset, physical findings and imaging characteristics with the goal of reducing unnecessary lumbar punctures in the emergency department. In this technical report, we describe the prototype calculator, the mathematical basis of the model and provide a link to the web-based prototype. In the future, we will refine the prototype, make it user-friendly to physicians, staff and patients and study its benefits in the emergency department.

  View details for DOI 10.7759/cureus.2096

  View details for PubMedID 29568717

  View details for PubMedCentralID PMC5862466

• MRI vs. Ultrasound as the initial imaging modality for pediatric and young adult patients with suspected appendicitis. Academic emergency medicine Imler, D., Keller, C., Sivasankar, S., Wang, N. E., Vasanawala, S., Bruzoni, M., Quinn, J. 2017

  Abstract

  While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US.In this single-center prospective cohort study, we sought to determine the difference in total length of stay and charges between rapid MRI and US as the initial imaging modality in pediatric and young adult patients presenting to the Emergency Department (ED) with suspected appendicitis. We hypothesized that rapid MRI would be more efficient and cost effective than US as the initial imaging modality in the ED diagnosis of appendicitis.A prospective randomized cohort study of consecutive patients was conducted in patients 2-30 years of age in an academic ED with access to both rapid MRI and US imaging modalities 24/7. Prior to the start of the study, the days of the week were randomized to either rapid MRI or US as the initial imaging modality. Physicians evaluated patients with suspected appendicitis per their usual manner. If the physician decided to obtain radiologic imaging, the pre-determined imaging modality for the day of the week was used. All decisions regarding other diagnostic testing and/or further imaging were left to the physician's discretion. Time intervals (min) between triage, order placement, start of imaging, end of imaging, image result and disposition (discharge vs. admission), as well as total charges (diagnostic testing, imaging and repeat ED visits) were recorded.Over a 100-day period, 82 patients were imaged to evaluate for appendicitis; 45/82 (55%) of patients were in the US first group; and 37/82 (45%) patients were in the rapid MRI first group. There were no differences in patient demographics or clinical characteristics between the groups and no cases of missed appendicitis in either group. 11/45 (24%) of US first patients had inconclusive studies, resulting in follow-up rapid MRI and 5 return ED visits contrasted with no inconclusive studies or return visits (p< 0.05) in the rapid MRI group. The rapid MRI compared to US group was associated with longer ED length of stay (mean difference 100 min; 95% CI 35-169) and increased ED charges (mean difference $4,887; 95% CI $1,821 - $8,513).In the diagnosis of appendicitis, US first imaging is more time efficient and less costly than rapid MRI despite inconclusive studies after US imaging. Unless the process of obtaining a rapid MRI becomes more efficient and less expensive, US should be the first line imaging modality for appendicitis in patients 2-30 years of age. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1111/acem.13180

  View details for PubMedID 28207968