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https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#1
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28378409/diffusion-of-digital-breast-tomosynthesis-among-women-in-primary-care-associations-with-insurance-type
#2
Cheryl R Clark, Tor D Tosteson, Anna N A Tosteson, Tracy Onega, Julie E Weiss, Kimberly A Harris, Jennifer S Haas
Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among women aged 40-89...
April 4, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28377941/proof-of-concept-for-a-novel-curriculum-learning-a-second-language-during-anesthesiology-residency
#3
Kate Mitchell Cohen, Alvaro Andres Macias, Robert Lekowski, Mercedes Concepcion, Jose Zeballos
This article describes a novel curriculum for anesthesiology residents matriculating through Brigham and Women's Department of Anesthesiology. It is offered electively and provides physician residents with time to acquire language skills through a medically-focused immersion program abroad. It is designed for them to learn or improve a second language and then to speak it while practicing perioperative medicine. Ultimately, the elective curriculum will equip future anesthesiologists with the communication tools to deliver professional and compassionate patient care both within the United States and internationally...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28347447/user-requirements-for-a-chronic-kidney-disease-clinical-decision-support-tool-to-promote-timely-referral
#4
Joy Gulla, Pamela M Neri, David W Bates, Lipika Samal
BACKGROUND: Timely referral of patients with CKD has been associated with cost and mortality benefits, but referrals are often done too late in the course of the disease. Clinical decision support (CDS) offers a potential solution, but interventions have failed because they were not designed to support the physician workflow. We sought to identify user requirements for a chronic kidney disease (CKD) CDS system to promote timely referral. METHODS: We interviewed primary care physicians (PCPs) to identify data needs for a CKD CDS system that would encourage timely referral and also gathered information about workflow to assess risk factors for progression of CKD...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28345442/predicting-1-year-statin-adherence-among-prevalent-users-a-retrospective-cohort-study
#5
Alexis A Krumme, Jessica M Franklin, Danielle L Isaman, Olga S Matlin, Angela Y Tong, Claire M Spettell, Troyen A Brennan, William H Shrank, Niteesh K Choudhry
BACKGROUND: Attempts to predict who is at risk of future nonadherence have largely focused on predictions at the time of therapy initiation; however, these users are only a small proportion of all patients on therapy at any point in time. Methods to predict nonadherence for established medication users, which have not been previously described in the literature, would be helpful to guide efforts to enhance the use of evidence-based therapies. OBJECTIVE: To test approaches for adherence prediction among prevalent statin users, namely the use of short-term filling behavior, investigator-specified predictors from medical and pharmacy administrative claims, and the empirical selection of potential predictors using the high-dimensional propensity score variable selection algorithm...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28334567/review-of-nonformulary-medication-approvals-in-an-academic-medical-center
#6
Qoua L Her, Mary G Amato, Diane L Seger, James F Gilmore, John Fanikos, Julie M Fiskio, David W Bates
BACKGROUND: The Joint Commission requires hospitals to formally review formulary medications at least annually based on new clinical information. Although review of nonformulary medication (NFM) use is not required, frequent and inappropriate use of NFMs has the potential to increase hospital costs, negatively affect quality of care, and increase medication errors. Limited resources may restrict an institution's ability to review NFM use in addition to the required annual formulary review...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#7
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28267211/retrospective-review-of-serotonergic-medication-tolerability-in-patients-with-neuroendocrine-tumors-with-biochemically-proven-carcinoid-syndrome
#8
Diana D Shi, David P Yuppa, Trevor Dutton, Lauren K Brais, Sarah L Minden, Ilana M Braun, Matthew H Kulke, Jennifer A Chan, Fremonta L Meyer
BACKGROUND: Patients with carcinoid tumors frequently could benefit from the pharmacologic treatment of depression and anxiety. However, many prescribers avoid serotonergic medications due to the theoretical risk of exacerbating carcinoid syndrome. METHODS: The authors conducted a retrospective chart review of patients with carcinoid tumors and elevated serotonin levels (as measured by 24-hour urine 5-hydroxyindoleacetic acid [5-HIAA]) at Dana-Farber/Brigham and Women's Cancer Center who initiated treatment with serotonergic antidepressants after a carcinoid diagnosis from 2003 to 2016...
March 7, 2017: Cancer
https://www.readbyqxmd.com/read/28264721/densitometric-and-local-histogram-based-analysis-of-computed-tomography-images-in-patients-with-idiopathic-pulmonary-fibrosis
#9
Samuel Y Ash, Rola Harmouche, Diego Lassala Lopez Vallejo, Julian A Villalba, Kris Ostridge, River Gunville, Carolyn E Come, Jorge Onieva Onieva, James C Ross, Gary M Hunninghake, Souheil Y El-Chemaly, Tracy J Doyle, Pietro Nardelli, Gonzalo V Sanchez-Ferrero, Hilary J Goldberg, Ivan O Rosas, Raul San Jose Estepar, George R Washko
BACKGROUND: Prior studies of clinical prognostication in idiopathic pulmonary fibrosis (IPF) using computed tomography (CT) have often used subjective analyses or have evaluated quantitative measures in isolation. This study examined associations between both densitometric and local histogram based quantitative CT measurements with pulmonary function test (PFT) parameters and mortality. In addition, this study sought to compare risk prediction scores that incorporate quantitative CT measures with previously described systems...
March 7, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28244949/cross-disciplinary-perceptions-of-structured-interprofessional-rounds-in-promoting-teamwork-within-an-academic-tertiary-care-obstetric-unit
#10
Anthony Chau, Mary A Vijjeswarapu, Margaret Hickey, David Acker, Chuan-Chin Huang, Lawrence C Tsen
BACKGROUND: In 2005, physician and nursing leaders at Brigham and Women's Hospital initiated structured interprofessional rounds (SIPRs) on the labor and delivery (L&D) suite to improve team communication. We performed a cross-sectional analysis of providers' perceptions of SIPRs and their effectiveness in improving teamwork. We hypothesized that on average, providers would perceive SIPRs as being effective in promoting teamwork, but ratings would differ among professional groups. METHODS: After a factor analysis and internal consistency assessment, a 19-item paper-based questionnaire was used to evaluate providers' perceptions using a 5-point Likert scale...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244139/quantitative-computed-tomography-assessment-of-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#11
Lee Gazourian, Samuel Ash, Emily E K Meserve, Alejandro Diaz, Raul San Jose Estepar, Souheil Y El-Chemaly, Ivan O Rosas, Miguel Divo, Anne L Fuhlbrigge, Phillip C Camp, Vincent T Ho, Ami S Bhatt, Hilary J Goldberg, Lynette M Sholl, George R Washko
BACKGROUND: Bronchiolitis obliterans syndrome (BOS) is a clinical manifestation of chronic allograft rejection following lung transplantation. We examined the quantitative measurements of the proximal airway and vessels and pathologic correlations in subjects with BOS. METHODS: Patients who received a lung transplant at the Brigham and Women's Hospital between December 1, 2002 and December 31, 2010 were included in this study. We characterized the quantitative CT measures of proximal airways and vessels and pathological changes...
February 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28231475/the-use-and-yield-of-continuous-eeg-in-critically-ill-patients-a-comparative-study-of-three-centers
#12
Vincent Alvarez, Andres A Rodriguez Ruiz, Suzette LaRoche, Lawrence J Hirsch, Christopher Parres, Paula E Voinescu, Andres Fernandez, Ognen A Petroff, Nishi Rampal, Hiba Arif Haider, Jong Woo Lee
OBJECTIVE: Continuous EEG (cEEG) monitoring of critically ill patients has gained widespread use, but there is substantial reported variability in its use. We analyzed cEEG and antiseizure drug (ASD) usage at three high volume centers. METHODS: We utilized a multicenter cEEG database used daily as a clinical reporting tool in three tertiary care sites (Emory Hospital, Brigham and Women's Hospital and Yale - New Haven Hospital). We compared the cEEG usage patterns, seizure frequency, detection of rhythmic/periodic patterns (RPP), and ASD use between the sites...
April 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28222088/gender-differences-in-bladder-cancer-treatment-decision-making
#13
Rachel A Pozzar, Donna L Berry
PURPOSE/OBJECTIVES: To explore gender differences in bladder cancer treatment decision making.
. RESEARCH APPROACH: Secondary qualitative analysis of interview transcripts.
. SETTING: One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. PARTICIPANTS: As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews...
March 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28209748/the-use-of-hyperbaric-oxygen-for-the-prevention-and-management-of-osteoradionecrosis-of-the-jaw-a-dana-farber-brigham-and-women-s-cancer-center-multidisciplinary-guideline
#14
REVIEW
Ahmed Sultan, Glenn J Hanna, Danielle N Margalit, Nicole Chau, Laura A Goguen, Francisco M Marty, Guilherme Rabinowits, Jonathan D Schoenfeld, Stephen T Sonis, Tom Thomas, Roy B Tishler, Nathaniel S Treister, Alessandro Villa, Sook-Bin Woo, Robert Haddad, Hani Mawardi
BACKGROUND: Osteoradionecrosis of the jaw (ORN) is an infrequent yet potentially devastating complication of radiation therapy to the head and neck region. Treatment options include antimicrobial therapy, local sequestrectomy, resection, and the use of hyperbaric oxygen (HBO). Published data on ORN are difficult to compare because of the lack of a universally accepted classification and staging system, and the literature on the use of HBO to either prevent or successfully manage ORN is controversial and inconclusive...
March 2017: Oncologist
https://www.readbyqxmd.com/read/28183574/the-effects-of-dynamic-airway-photographs-on-preoperative-airway-planning-among-a-panel-of-anesthetists
#15
M Tariq Hanifi, Marc Philip T Pimentel, Christine Motzkus, James Gosnell, Linda S Aglio
STUDY OBJECTIVE: To determine whether having preoperative airway photographs will change the preanesthetic airway plan. DESIGN: Questionnaire. SETTING: American academic medical center (Brigham and Women's Hospital, Boston MA). SUBJECTS: Twenty-five test subjects (American Society of Anesthesiologists 1-4) were enrolled to have their preoperative airway photographs taken as well as to have a customary preoperative history and physical examination...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28114622/association-between-serum-micrornas-and-magnetic-resonance-imaging-measures-of-multiple-sclerosis-severity
#16
Keren Regev, Brian C Healy, Fariha Khalid, Anu Paul, Renxin Chu, Shahamat Tauhid, Subhash Tummala, Camilo Diaz-Cruz, Radhika Raheja, Maria A Mazzola, Felipe von Glehn, Pia Kivisakk, Sheena L Dupuy, Gloria Kim, Tanuja Chitnis, Howard L Weiner, Roopali Gandhi, Rohit Bakshi
Importance: MicroRNAs (miRNAs) are promising multiple sclerosis (MS) biomarkers. Establishing the association between miRNAs and magnetic resonance imaging (MRI) measures of disease severity will help define their significance and potential impact. Objective: To correlate circulating miRNAs in the serum of patients with MS to brain and spinal MRI. Design, Setting, and Participants: A cross-sectional study comparing serum miRNA samples with MRI metrics was conducted at a tertiary MS referral center...
March 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28079640/comparison-of-the-american-joint-committee-on-cancer-seventh-edition-and-brigham-and-women-s-hospital-cutaneous-squamous-cell-carcinoma-tumor-staging-in-immunosuppressed-patients
#17
Jessica L Gonzalez, Kiera Cunningham, Rebecca Silverman, Elena Madan, Bichchau M Nguyen
BACKGROUND: The American Joint Committee on Cancer 7th edition (AJCC-7) and Brigham and Women's Hospital (BWH) staging criteria for cutaneous squamous cell carcinoma (cSCC) have not been validated in immunosuppressed patients. OBJECTIVE: To compare the AJCC-7 and BWH staging systems for cSCCs in immunosuppressed patients. METHODS AND MATERIALS: A single-institution retrospective cohort study of cSCCs in immunosuppressed patients. Risks of local recurrence (LR), nodal metastasis (NM), in-transit metastasis, and any poor outcome (PO) were compared among AJCC-7 and BWH tumor T stages...
January 10, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28074487/higher-25-hydroxyvitamin-d-levels-are-associated-with-greater-odds-of-remission-with-anti-tumour-necrosis-factor-%C3%AE-medications-among-patients-with-inflammatory-bowel-diseases
#18
R W Winter, E Collins, B Cao, M Carrellas, A M Crowell, J R Korzenik
BACKGROUND: Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti-tumour necrosis factor-α (anti-TNF-α) medications among patients with IBD. AIM: To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti-TNF-α medication. METHODS: A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28068187/a-century-of-surgical-innovation-at-a-boston-hospital
#19
JaBaris D Swain, Gaurav Sharma, Rowza T Rumma, P Marco Fisichella, Edward Whang
BACKGROUND: Innovation has been a central focus of the Department of Surgery at the Brigham and Women's Hospital since its very inception. Here we review examples of innovations originating in this Department and analyze factors that have been critical to successful innovation. Finally, we discuss challenges to sustainability of innovation in this Department. METHODS: Narrative review of the literature, interviews, and personal observations. RESULTS: Examples of innovations reviewed here were each dependent on three critical elements: 1) multidisciplinary collaboration among surgical innovators and individuals outside of surgery who offered complementary skills and expertise, 2) a rich institutional environment that sustained a diverse complement of innovators working in close proximity, and 3) Department Chairmen who facilitated the work of innovators and promoted their contributions, rather than seeking personal prestige or financial gain...
February 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28061829/patterns-of-gestational-diabetes-diagnosis-inside-and-outside-of-clinical-guidelines
#20
Jacinda M Nicklas, Chloe A Zera, Janet Lui, Ellen W Seely
BACKGROUND: Hospital discharge codes are often used to determine the incidence of gestational diabetes mellitus (GDM) at state and national levels. Previous studies demonstrate substantial variability in the accuracy of GDM reporting, and rarely report how the GDM was diagnosed. Our aim was to identify deliveries coded as gestational diabetes, and then to determine how the diagnosis was assigned and whether the diagnosis followed established guidelines. METHODS: We identified which deliveries were coded at discharge as complicated by GDM at the Brigham and Women's Hospital in Boston, MA for the year 2010...
January 6, 2017: BMC Pregnancy and Childbirth
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