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Open research questions in Emergency and Acute Care Studies

228 unresolved questions extracted from the limitations and future-work sections of 1,368 Emergency and Acute Care Studies papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Study authors were not contacted to obtain unpublished assessment instruments or additional tool documentation, - Data extraction and framework mapping were limited to information available within published manuscripts and associated supplementary materials, - No study described application programming interface (API)-enabled integration with electronic health records or real-time dashboard linkage

    Paediatric readiness assessment tools in emergency care: a scoping review · 2026 · DOI

  • Lack of a universally accepted definition or standardised framework for paediatric readiness assessment. Inconsistent representation of important system-level determinants of emergency care capacity, including infrastructure reliability, organisational culture, and digital integration. Need for greater harmonisation of core readiness domains to support international benchmarking and contextual adaptation across health systems.

    Paediatric readiness assessment tools in emergency care: a scoping review · 2026 · DOI

  • In contrast, pediatric readiness for inpatient care in community hospitals remains poorly defined.

    Voices From the Community: How Inpatient Clinicians Experience Caring for Deteriorating Children · 2026 · DOI

  • BACKGROUND AND OBJECTIVES: The Dutch Triage Standard (NTS) supports nurses in assessing case urgency in out-of-hours general practice (GP) care; however, its suitability for fever-related pediatric cases remains debated.

    Performance of the Dutch Triage standard in managing fever in children in out-of-hours primary care: a secondary analysis of the chili study · 2026 · DOI

  • Callers in the most deprived quintile were 22 years younger at the median than those in the least deprived, and the absence of standardised and adjusted analyses is a major limitation.

    Call Rates, Acuity and Outcomes Across Deprivation Quintiles: A Service Evaluation Using Yorkshire Ambulance Service Data with Embedded Patient and Public Involvement · 2026 · DOI

  • Previous studies on validity in obstetric triage systems are scarce and inconclusive regarding internal and external validity.

    Validating obstetric triage systems, what are we really measuring - A modified Delphi process introducing outcome measures for obstetric emergency triage systems · 2025 · DOI

  • Despite their vulnerability, limited data exist on factors influencing survival in this group.

    Prognostic factors influencing survival in nonagenarian patients admitted to the emergency department: a retrospective study · 2025 · DOI

  • Crowding often necessitates ED waiting room and hallway care, but there has been limited research on approaches to care for older adults in these settings.

    Waiting room and hallway care for older adults: a qualitative study with emergency nurses and technicians · 2025 · DOI

  • However, its clinical safety and effect on key outcomes remain unexplored in randomized clinical trials.

    Video Streaming or Telephone Communication During Emergency Medical Services Dispatch Calls · 2025 · DOI

  • However, the variation in the types of patient accesses to these departments remains poorly understood.

    Emergency Departments in Contemporary Healthcare: Are They Still for Emergencies? An Analysis of over 1 Million Attendances · 2024 · DOI

  • Sensitivity analysis showed mixed results for PICU admissions, while zero-inflation Poisson analysis confirmed a reduction in non-ICU arrests.

    Impact of Rapid Response Teams on Pediatric Care: An Interrupted Time Series Analysis of Unplanned PICU Admissions and Cardiac Arrests · 2024 · DOI

  • Little is known about how professional health care providers perceive and experience ED care for older patients.

    “The stay here is, of course, not appropriate for an old person”: the perspective of healthcare providers on older patients in the emergency department · 2024 · DOI

  • Future work should focus on clinical validation, system integration, and ethical considerations. Researchers need to conduct real-world tests on AI systems while enhancing their interpretability capabilities. Finding ways to remove biased data is necessary for AI to achieve its full potential in emergency care.

    Transforming Emergency Departments through AI: A Review of Predictive and Operational Schemes · 2026 · DOI

  • The subjective human-based approach for conventional triage operations is inadequate for consistent outcomes and peak efficiency. There is a need for AI-driven solutions to improve healthcare outcomes, optimize care sequences, and increase triage precision. The integration of AI into EDs has drawbacks, such as algorithmic bias and data privacy issues.

    Transforming Emergency Departments through AI: A Review of Predictive and Operational Schemes · 2026 · DOI

  • Current emergency medical dispatch systems are limited by ambiguous symptom descriptions, linguistic diversity, and high cognitive load. There is a need for a more structured and standardized approach to emergency medical dispatch.

    DispatchMAS: fusing taxonomy and artificial intelligence agents for emergency medical services · 2026 · DOI

  • Despite the promising results, this study has several limitations. First, our evaluation was conducted in a simulated environment, which cannot fully replicate the high-stress, unpredictable nature of real-world 911 calls, Li et al. BMC Emergency Medicine (2026) 26:78 Page 17 of 20 including background noise and extreme caller emotional states, as well as low-affect/stoic presentations where urgency may be less overtly displayed in talk [60, 61]. While our main evaluation uses English dialogues, we additionally conducted an English-only stress test in which the caller agent’s functional English communication was constrained (fluent English vs LEP-English prompt setting). This supplementary analysis found no statistically significant between-condition differences across rubric dimensions, although guidance delivery showed the largest non-significant trends (Supplementary Methods S7). In this supplementary experiment, “limited proficiency” was operationalized as an Englishonly prompt constraint rather than true multilingual or interpreter-mediated communication. Specifically, the caller agent was instructed to remain English-speaking but use short phrases, simple vocabulary, grammatical errors, occasional misunderstanding, and greater difficulty responding to long or bundled questions. This manipulation was intended to approximate reduced functional English communication under stress, allowing a controlled test of how constrained comprehension and expression may affect dispatch interaction quality. However, this design does not capture true multilingual interactions (e.g., mixed-language or code-switched calls), nor does it evaluate how language identification, translation, or culturally specific phrasing might affect comprehension and repair; extending the framework to non-English and mixed-language dispatch scenarios remains an important direction for future work. Second, to simplify scenario generation and enable controlled comparisons, we fixed the caller location to a single placeholder address (“123 Main Street”) across cases. This choice reduces diversity in address formats and removes realistic complexities that often drive dispatch delays and miscommunication in practice (e.g., incomplete addresses, landmarks, apartment/building identifiers, rural locations, caller uncertainty, or mobile callers in transit). Future studies should introduce location variability and structured address perturbations to more faithfully test location elicitation, confirmation strategies, and error recovery under realistic conditions.

    DispatchMAS: fusing taxonomy and artificial intelligence agents for emergency medical services · 2026 · DOI

  • There is a lack of research on the implementation of virtual urgent care in rural EDs. Prior studies have focused on the effectiveness of virtual care, but not its implementation.

    Implementing virtual urgent care services in emergency departments: a multi-site focus group study of adaptation and sustainability · 2026 · DOI

  • A key strength of this study is its multi-site, qualitative design, which enabled rich, contextualized insights into the implementation of virtual urgent care across diverse rural settings, including multiple professional roles also ensured a range of perspectives from frontline staff. Limitations include participant demographics were not collected to preserve anonymity in small settings, limiting the ability to assess how experiences varied by role or tenure, because data relied on self-report and group discussion. There is also a risk of recall bias and social desirability bias.

    Implementing virtual urgent care services in emergency departments: a multi-site focus group study of adaptation and sustainability · 2026 · DOI

  • Assessing the severity of an emergency by telephone is challenging, especially in pediatric cases. Children may be unable to articulate their symptoms or may present and express them differently from adults. The use of video streaming may improve patient assessment and dispatch decision-making, but its effectiveness is unknown.

    Video-assisted versus telephone-only pediatric emergency calls: a predefined substudy of the cluster randomized CAM-VISION trial · 2026 · DOI

  • The study identifies a gap in the understanding of the use of video streaming in pediatric emergency calls. The study highlights the challenges of assessing pediatric emergencies by telephone.

    Video-assisted versus telephone-only pediatric emergency calls: a predefined substudy of the cluster randomized CAM-VISION trial · 2026 · DOI

  • The lack of training for EMS personnel in palliative care. The need for a consistent approach to palliative care.

    Reframing Emergency Medical Service in the context of chronic non-communicable disease and palliative care · 2026 · DOI

  • Although the period of data researched and presented was only over 4 months (01 January 2019 to 30 April 2019), the study highlights gaps in EMS data related to patients with NCDs who may require palliative care, noting that symptoms and keywords merely estimate potential need rather than accurately identifying current demand. Structural deficiencies in PRFs, such as the omission of risk factors like smoking, likely lead to underdiagnoses of conditions such as chronic obstructive pulmonary disease and emphasise the need for repeat call-out data for better insight; this is also a limitation of the retrospective research design. The timing and restrictions on data collection presented by COVID-19 influenced the timing and consistency of data collection, which could have resulted in inaccurate and missing data.

    Reframing Emergency Medical Service in the context of chronic non-communicable disease and palliative care · 2026 · DOI

  • The paper identifies a gap in the existing literature on the use of machine learning models in pediatric emergency departments. The paper highlights the need for standardized methods, explainable AI, and prospective validation for clinical use. The paper acknowledges that the high degree of heterogeneity among studies limits the ability to draw firm conclusions.

    Machine learning to predict hospital admission at triage in paediatric emergency care: A meta-analysis · 2026 · DOI

  • Our study has several strengths and limitations. One of the key strengths of this study is its rigorous methodol- ogy, adhering to PRISMA guidelines for transparency and reproducibility and employing the PROBAST framework to assess the quality and risk of bias in included studies [7]. Furthermore, this is the first systematic review and meta- analysis to evaluate the diagnostic accuracy of ML mod- els in predicting hospital admission in the paediatric ED from data obtained at triage, providing a comprehensive synthesis of available evidence. A sensitivity analysis was conducted to assess the robustness of the findings, ensuring the reliability of the results. Despite the promising findings, limitations must be acknowledged. The small number of included studies and the high degree of heterogeneity—stemming from vari- ations in data preprocessing, variable selection, outcome definitions, and unspecified hospitalization timing—limit generalizability. Future meta-analyses should address these European Journal of Pediatrics (2026) 185:229 Page 11 of 12 229 issues through study stratification or meta-regression. In addition, the absence of a standardized definition of hospi- tal admission, often influenced by subjective clinical judg- ment, affects model reproducibility and warrants further investigation using more objective criteria. Furthermore, hospitalization timings were unspecified across studies and therefore will likely be a source of heterogeneity. Most models were developed using retrospective data with lim- ited external validation, highlighting the need for prospec- tive studies to confirm clinical utility. Incomplete reporting in some studies also impacted quality assessment. Finally, although restricting inclusion to studies using data avail- able at triage facilitated comparability, it excluded models incorporating additional diagnostic data, potentially limit- ing variable identification. This was done to avoid the intro- duction of important disparities in training data that could lead to biased or overly optimistic estimates of diagnostic performance. Future research should incorporate a broader range of studies while accounting for differences in model development and training to support the advancement of ML implementation in paediatric emergency department triage.

    Machine learning to predict hospital admission at triage in paediatric emergency care: A meta-analysis · 2026 · DOI

  • Increasing patient volumes, prolonged lengths of stay, and systemic bottlenecks lead to ED overcrowding and ambulance offload delays. Access block, a 'whole of health system' phenomenon, contributes to ED overcrowding. Limited bed availability is a central driver of ED overcrowding.

    Declining Ambulance Offload Delays and Stabilised Emergency Department Length of Stay Post-COVID: An Interrupted Time Series Analysis · 2026 · DOI

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228 open questions have been extracted from the limitations and future-work passages of 1,368 Emergency and Acute Care Studies papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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