{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:43:09Z","timestamp":1775184189760,"version":"3.50.1"},"reference-count":38,"publisher":"Walter de Gruyter GmbH","issue":"9","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jom-2024-0261_abs_001\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Although a large proportion of US emergency physicians are osteopathic physicians (Doctor of Osteopathic Medicine [DOs]), the frequency of osteopathic manipulative medicine (OMM) use in emergency departments (EDs) is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2024-0261_abs_021\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We aimed to estimate the frequency of OMM in EDs across the US and describe the cohort who received OMM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2024-0261_abs_003\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective cohort study of ED patients from 2018 to 2021 in the Nationwide Emergency Department Sample (NEDS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Encounters with OMM were identified by diagnosis and procedure codes. We calculated weighted frequencies of encounters with OMM per 100,000 ED encounters with 95\u202f% confidence intervals (CIs) by year, accounting for the complex survey design of\u00a0NEDS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2024-0261_abs_004\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 9,576 encounters with OMM during the study period. The weighted frequency of encounters with OMM per 100,000 ED encounters was 6.9 (95\u202f% CI, 3.8 to 11.5) for 2018, 8.6 (4.3\u201315.5) for 2019, 12.6 (3.5\u201332.0) for 2020, and 5.5 (3.3\u20138.5) for 2021. Most patients were female (5,669, 59.2\u202f%) with a median age of 53 (interquartile range [IQR] 36 to 67). The majority were from metropolitan teaching hospitals (7,094, 74.1\u202f%), and about half were admitted (4,565, 47.7\u202f%). The most common osteopathic diagnosis code was segmental and somatic dysfunction of the thoracic region (4,202 of 21,358 [19.7\u202f%] codes).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jom-2024-0261_abs_005\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>OMM is infrequently provided across hospital-owned US EDs. Further research is needed to describe the frequency of OMM across all acute care settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jom-2024-0261","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T14:54:39Z","timestamp":1747925679000},"page":"449-455","source":"Crossref","is-referenced-by-count":3,"title":["The epidemiology of osteopathic diagnoses and treatments in United\u00a0States emergency departments from 2018 to 2021"],"prefix":"10.1515","volume":"125","author":[{"given":"Aviya","family":"Distefano","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Jerry M. Wallace School of Osteopathic Medicine , Campbell University , Lillington , NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Jerry M. Wallace School of Osteopathic Medicine , Campbell University , Lillington , NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlin M.","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Jerry M. Wallace School of Osteopathic Medicine , Campbell University , Lillington , NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhimitri A.","family":"Nikolla","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , 6596 Allegheny Health Network, Saint Vincent Hospital , Erie , PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"2025082206050941587_j_jom-2024-0261_ref_001","doi-asserted-by":"crossref","unstructured":"Pollard, JA, Leveque, EA, Lewin, MR. Osteopathic physicians in emergency medicine. Ann Emerg Med 2003;42:261\u20135. https:\/\/doi.org\/10.1067\/mem.2003.236.","DOI":"10.1067\/mem.2003.236"},{"key":"2025082206050941587_j_jom-2024-0261_ref_002","unstructured":"Smith, KA, Nikolla, D, Maniya, O. Osteopathic medicine: what exactly is a DO? EMRA. Updated 2019-08-12. http:\/\/www.emra.org\/emresident\/article\/osteopathic-medicine\/ [Accessed 05 Jan 2022]."},{"key":"2025082206050941587_j_jom-2024-0261_ref_003","doi-asserted-by":"crossref","unstructured":"Barnum, S, Craig, B, Wang, X, Sandella, J, Tsai, TH, Boulet, J, et al.. A concordance study of COMLEX-USA and USMLE scores. 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Pursuing osteopathic recognition: a national survey on US program director perspectives. J\u00a0Grad Med Educ 2025;17:81\u20138. https:\/\/doi.org\/10.4300\/jgme-d-24-00352.1.","DOI":"10.4300\/JGME-D-24-00352.1"},{"key":"2025082206050941587_j_jom-2024-0261_ref_009","unstructured":"Active physicians with a DO degree by specialty 2021. https:\/\/www.aamc.org\/data-reports\/workforce\/data\/active-physicians-do-degree-specialty-2021 [Accessed 26 Jul 2024]."},{"key":"2025082206050941587_j_jom-2024-0261_ref_010","doi-asserted-by":"crossref","unstructured":"Pelletier, J, Capistrant, T, Nordt, SP. Osteopathic manipulation and its applicability in the emergency department: a narrative review. Am J Emerg Med 2024;84:74\u201380. https:\/\/doi.org\/10.1016\/j.ajem.2024.07.050.","DOI":"10.1016\/j.ajem.2024.07.050"},{"key":"2025082206050941587_j_jom-2024-0261_ref_011","doi-asserted-by":"crossref","unstructured":"Ault, B, Levy, D. Osteopathic manipulative treatment use in the emergency department: a retrospective medical record review. J\u00a0Am Osteopath Assoc 2015;115:132\u20137. https:\/\/doi.org\/10.7556\/jaoa.2015.026.","DOI":"10.7556\/jaoa.2015.026"},{"key":"2025082206050941587_j_jom-2024-0261_ref_012","unstructured":"Eisenhart, AW, Gaeta, TJ, Yens, DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. J\u00a0Am Osteopath Assoc 2003;103:417\u201321."},{"key":"2025082206050941587_j_jom-2024-0261_ref_013","unstructured":"McReynolds, TM, Sheridan, BJ. Intramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial. J\u00a0Am Osteopath Assoc 2005;105:57\u201368."},{"key":"2025082206050941587_j_jom-2024-0261_ref_014","doi-asserted-by":"crossref","unstructured":"Gianneschi, G, Patel, S, Hinfey, P. 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