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IntroductionOptimising emergency department (ED) patient experience is vital to ensure care quality. However, there are few validated instruments to measure the experiences of specific patient groups, including older adults. We previously developed a draft 82-item Patient Reported Experience Measure (PREM-ED 65) for adults ≥65 attending the ED. This study aimed to derive a final item list and provide initial validation of the PREM-ED 65 survey.MethodsA cross-sectional study involving patients in 18 EDs in England. Adults aged 65 years or over, deemed eligible for ED discharge, were recruited between May and August 2021 and asked to complete the 82-item PREM at the end of the ED visit and 7–10 days post discharge. Test–retest reliability was assessed 7—10 days following initial attendance. Analysis included descriptive statistics, including per-item proportions of responses, hierarchical item reduction, exploratory factor analysis (EFA), reliability testing and assessment of criterion validity.ResultsFive hundred and ten initial surveys and 52 retest surveys were completed. The median respondent age was 76. A similar gender mix (men 47.5% vs women 50.7%) and reason for attendance (40.3% injury vs 49.0% illness) was observed. Most participants self-reported their ethnicity as white (88.6%).Hierarchical item reduction identified 53/82 (64.6%) items for exclusion, due to inadequate engagement (n=33), ceiling effects (n=5), excessive inter-item correlation (n=12) or significant differential validity (n=3). Twenty-nine items were retained.EFA revealed 25 out of the 29 items demonstrating high factor loadings (>0.4) across four scales with an Eigenvalue >1. These scales were interpreted as measuring ‘relational care’, ‘the ED environment’, ‘staying informed’ and ‘pain assessment’. Cronbach alpha for the scales ranged from 0.786 to 0.944, indicating good internal consistency. Test–retest reliability was adequate (intraclass correlation coefficient 0.67). Criterion validity was fair (r=0.397) when measured against the Friends and Families Test question.ConclusionsPsychometric testing demonstrates that the 25-item PREM-ED 65 is suitable for administration to adults ≥65 years old up to 10 days following ED discharge.

[...]the genetic variation at CYP1, CYP2C8, CYP3A4, CYP2C9, CYP2C19 and CYP2D6 was described at global as well as in India by genotyping new population samples and by collecting data from the literature. Altered activity variants occur in all geographic regions, reaching extremely high frequencies in some populations, which has many important clinical consequences; each of the CYP genes studied shows a distinct geographic pattern of variation reflecting past evolutionary processes; effect of demography on pharmacogenetic variation should be also considered at themicro geographic scale; and several geographic regions of pharmacogenetic interest are still poorly characterized. Li Y, Millikan RC, Bell DA, Cui L, TseCh-KJ, Newman B, Conway K. Polychlorinated biphenyls, cytochrome P450 1A1 (CYP1A1) polymorphisms, and breast cancer risk among African American women and white women in North Carolina: a population-based case-control study. AquilantecL, Langaee TY, Lopez Lm, Yarandi HN, Tromberg JS, Mohuczy D, et al., Influence of coagulation factor, vitamin K epoxide reductase complex subunit 1, and cytochrome P450 2c9 gene polymorphisms on warfarin dose requirements.