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Second, the comparison study was based on reliable data obtained by means of a request to official authorities, without the need of prior research authorization or subject's consent.
Also excluded were patients transported to a hospital other than the study hospital as well as those who did not grant research authorization.
Of the 248 patients who did not meet inclusion criteria, 195 did not meet the geographic restrictions and 53 did not grant research authorization.
Patients were excluded from the study if they did not have prior research authorization for their medical records to be reviewed; they had active bleeding, or they were started on comfort care patients within 12 h of admission.
Patients in the chest pain unit were eligible for the study if they were residents of our center's county or one of the surrounding nine counties and granted research authorization in compliance with Minnesota Statute 144.335.
Patients with denial of Minnesota research authorization, known pregnancy, documented history of complex congenital heart disease, patent foramen ovale, moderate or greater valvular stenosis or regurgitation, prior heart failure, asymptomatic LV dysfunction, prior cor-pulmonale, pulmonary hypertension or recent acute coronary syndrome (<1 week) were excluded from the study.
Patients aged < 18 year or without research authorization were excluded.
Patients were excluded if they did not give research authorization for medical record review.
Only patients who gave permission to use their medical record for research (research authorization) were included in this study.
The study was approved by Mayo Clinic Institutional Review Board for the use of existing medical records of patients who gave prior research authorization.
Patients who had 'do not resuscitate/do not intubate' preferences (DNR/DNI) or refused research authorization were excluded.
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