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https://www.readbyqxmd.com/read/28340241/pragmatic-trial-informatics-a-perspective-from-the-nih-health-care-systems-research-collaboratory
#1
Rachel L Richesson, Beverly B Green, Reesa Laws, Jon Puro, Michael G Kahn, Alan Bauck, Michelle Smerek, Erik G Van Eaton, Meredith Zozus, W Ed Hammond, Kari A Stephens, Greg E Simon
Pragmatic clinical trials (PCTs) are research investigations embedded in health care settings designed to increase the efficiency of research and its relevance to clinical practice. The Health Care Systems Research Collaboratory, initiated by the National Institutes of Health Common Fund in 2010, is a pioneering cooperative aimed at identifying and overcoming operational challenges to pragmatic research. Drawing from our experience, we present 4 broad categories of informatics-related challenges: (1) using clinical data for research, (2) integrating data from heterogeneous systems, (3) using electronic health records to support intervention delivery or health system change, and (4) assessing and improving data capture to define study populations and outcomes...
March 14, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340230/determinants-of-opioid-prescribing-for-nonmalignant-chronic-pain-in-us-outpatient-settings
#2
Rafia S Rasu, Maureen E Knell
Study Objectives.:  Identify prescribing trends for opioid use in non-malignant chronic pain (NMCP) from the National Ambulatory Medical Care Survey (NAMCS). Determine predictors of opioid use based on patient-specific factors. Design.:  This cross-sectional study analyzed NAMCS data from 2000 to 2007. Pain medications prescribed were retrieved using NAMCS drug codes. Multivariate logistic models examined determinants of opioid prescribing among NMCP patients...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#3
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338585/a-16-year-journey-in-the-study-of-rheumatoid-hand-disease
#4
Kevin C Chung, Sandra V Kotsis
Evidence-based medicine is a relatively new concept in hand surgery. A lack of high-level evidence often leads to uncertainty in the effectiveness of various procedures and regional variation in their use. Rheumatoid hand surgery has been plagued by a lack of quality data that has caused controversy between rheumatologists and hand surgeons. Research over the past 16 years has strived to provide data that can be used to provide evidence-based care for rheumatoid arthritis (RA) patients. The Silicone Arthroplasty in Rheumatoid Arthritis (SARA) Study is a prospective, long-term cohort study of RA patients with severe metacarpophalangeal joint deformity who have elected to undergo or to not undergo metacarpophalangeal joint arthroplasty...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28338345/challenges-and-driving-forces-for-business-plans-in-biobanking
#5
Tanja Macheiner, Berthold Huppertz, Michaela Bayer, Karine Sargsyan
BACKGROUND: Due to increased utilization of biospecimens for research and emergence of new technologies, the availability and quality of biospecimens and their collection are coming more and more into focus. However, the long-term economic situation of biobanks is still mostly unclear. Also, the common sustainable utilization of various international biobanks is challenging due to local differences in sample processing, law and ethics. AIM: This article discusses possible strategies to achieve a sustainable utilization of biospecimens as part of the business plan of biobanks...
March 24, 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28337818/exploration-of-information-and-support-needs-in-relation-to-health-concerns-diet-and-physical-activity-in-colorectal-cancer-survivors
#6
S J Hardcastle, C Maxwell-Smith, M S Hagger, M O'Connor, C Platell
The purpose of the current study was to explore colorectal cancer survivors' information and support needs in relation to health concerns and health behaviour change. Face-to-face interviews were conducted with participants who had completed active treatment for cancer within the previous 2 years. Participants were colorectal cancer survivors (N = 24, men = 11, women = 13 M, age = 69.38 years, SD = 4.19) recruited from a hospital in Perth, Australia on the basis that they had existing morbidities that put them at increased risk of cardiovascular disease...
March 24, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28337491/meeting-report-unesco-merck-africa-research-summit-2015-accelerating-access-and-sustaining-innovation-from-africa-for-africa
#7
R W Omange, A O Ocholla, A O Kwallah, S N Kageha, J Mwangi, R K Cherutich, Odeny T A, T Nzomo, S Angwenyi, P Yonga, F Kariuki, M Kyalo, P C Mutai, F Nindo, E M Songok
BACKGROUND: The Ebola virus disease outbreak of 2014 was the largest, longest and most devastating in the history of the disease. It demonstrated the social and economic impact an emerging infectious disease can have in a globalized world. Health systems in affected countries were stretched to the point of near collapse, while social relations and traditional practices were negatively impacted. Heads of African research institutions, African government representatives, leaders of global pharmaceutical companies, global infectious disease experts and close to 100 young African researchers from 25 countries; Assembled in Geneva on 19 and 20th October 2015, for the inaugural UNESCO-Merck Africa Summit sponsored by the United Nations Educational, Science and Culture Organization and Merck KGA...
2017: African Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28336734/time-to-publication-for-publicly-funded-clinical-trials-in-australia-an-observational-study
#8
Linn Beate Strand, Philip Clarke, Nicholas Graves, Adrian G Barnett
OBJECTIVE: To examine the length of time between receiving funding and publishing the protocol and main paper for randomised controlled trials. DESIGN: An observational study using survival analysis. SETTING: Publicly funded health and medical research in Australia. PARTICIPANTS: Randomised controlled trials funded by the National Health and Medical Research Council of Australia between 2008 and 2010. MAIN OUTCOME MEASURES: Time from funding to the protocol paper and main results paper...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28335754/the-structural-and-health-policy-environment-for-delivering-integrated-hiv-and-substance-use-disorder-treatments-in-puerto-rico
#9
Jared A Leff, Diana Hernández, Paul A Teixeira, Pedro C Castellón, Daniel J Feaster, Allan E Rodriguez, Jorge L Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R Metsch, Bruce R Schackman
BACKGROUND: HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28335031/ethics-of-health-policy-and-systems-research-a-scoping-review-of-the-literature
#10
Bridget Pratt, Amy Paul, Adnan A Hyder, Joseph Ali
Health policy and systems research (HPSR) is increasingly funded and undertaken as part of health system strengthening efforts worldwide. HPSR ethics is also a relatively new and emerging field, with numerous normative and descriptive questions that have largely not been considered. Normative questions include what ethical principles and values should guide HPSR. Descriptive questions include what ethical concerns arise when conducting HPSR. A small but growing body of scholarly work characterizes the various ethics issues inherent in HPSR...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334786/lessons-learned-from-community-based-participatory-research-establishing-a-partnership-to-support-lesbian-gay-bisexual-and-transgender-ageing-in-place
#11
Leslie A Wright, Diane K King, Jessica H Retrum, Kenneth Helander, Shari Wilkins, Jennifer M Boggs, Jennifer Dickman Portz, Kathryn Nearing, Wendolyn S Gozansky
Background.: Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. Objective.: To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN)...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334775/early-assessment-of-the-10-step-patient-engagement-framework-for-patient-centred-outcomes-research-studies-the-first-three-steps
#12
Yewande Sofolahan-Oladeinde, Robin P Newhouse, Danielle C Lavallee, Jennifer C Huang, C Daniel Mullins
Background.: A key principle of patient-centred outcomes research (PCOR) is the engagement of patients and other stakeholders in the research process, but the evidence is still emerging on the impact patient engagement has on the research process. A 10-step framework has been developed to provide methodological guidance for patient engagement throughout the research process. However, the utility of the framework for patient engagement has not been tested in actual research studies. Objective...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334581/a-gap-analysis-needs-assessment-tool-to-drive-a-care-delivery-and-research-agenda-for-integration-of-care-and-sharing-of-best-practices-across-a-health-system
#13
Sherita Hill Golden, Daniel Hager, Lois J Gould, Nestoras Mathioudakis, Peter J Pronovost
BACKGROUND: In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. METHODS: The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334372/simulations-imaging-and-modeling-a-unique-theme-for-an-undergraduate-research-program-in-biomechanics
#14
Stephanie M George, Zachary J Domire
As the reliance on computational models to inform experiments and evaluate medical devices grows, the demand for students with modeling experience will grow. In this paper, we report on the three year experience of a National Science Foundation funded Research Experiences for Undergraduates (REU) based on the theme simulations, imaging, and modeling in biomechanics. While directly applicable to REU sites, our findings also apply to those creating other types of summer undergraduate research programs. The objective of the paper is to examine if a theme of simulations, imaging, and modeling will improve students' understanding of the important topic of modeling, provide an overall positive research experience, and provide an interdisciplinary experience...
March 23, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28333835/zero-preventable-deaths-after-traumatic-injury-an-achievable-goal
#15
Philip C Spinella
Preventable deaths after injury must be reduced to improve outcomes for trauma patients. The elimination of preventable deaths after injury has been documented by the 75th US Army Ranger Regiment. Therefore, zero preventable deaths after injury is an achievable goal. Trauma is the most common cause of death between the ages of 1-46 and is the most common cause of life-years lost, before 75 years of age, compared to all other etiologies. Traumatic Hemorrhagic Shock (THS) is the leading cause of death that is preventable after injury, accounting for potentially 17,000 preventable deaths per year in the US...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333607/understanding-faculty-and-trainee-needs-related-to-scholarly-activity-in-a-large-nonuniversity-graduate-medical-education-program
#16
Davida Becker, Hanna Garth, Rachel Hollander, Felice Klein, Marc Klau
CONTEXT: Graduate medical education (GME) programs must develop curriculum to ensure scholarly activity among trainees and faculty to meet accreditation requirements and to support evidence-based medicine. OBJECTIVE: Test whether research-related needs and interests varied across four groups: primary care trainees, specialty trainees, primary care faculty, and specialty faculty. DESIGN: We surveyed a random sample of trainees and faculty in Kaiser Permanente Southern California's GME programs...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28333338/drug-discovery-for-male-subfertility-using-high-throughput-screening-a-new-approach-to-an-unsolved-problem
#17
Sarah J Martins da Silva, Sean G Brown, Keith Sutton, Louise V King, Halil Ruso, David W Gray, Paul G Wyatt, Mark C Kelly, Christopher L R Barratt, Anthony G Hope
STUDY QUESTION: Can pharma drug discovery approaches be utilized to transform investigation into novel therapeutics for male infertility? SUMMARY ANSWER: High-throughput screening (HTS) is a viable approach to much-needed drug discovery for male factor infertility. WHAT IS KNOWN ALREADY: There is both huge demand and a genuine clinical need for new treatment options for infertile men. However, the time, effort and resources required for drug discovery are currently exorbitant, due to the unique challenges of the cellular, physical and functional properties of human spermatozoa and a lack of appropriate assay platform...
March 16, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333321/preconception-and-early-pregnancy-maternal-haemodynamic-changes-in-healthy-women-in-relation-to-pregnancy-viability
#18
F L Foo, A Collins, C M McEniery, P R Bennett, I B Wilkinson, C C Lees
STUDY QUESTION: Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? SUMMARY ANSWER: Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. WHAT IS KNOWN ALREADY: Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link...
March 16, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333301/preconception-maternal-lipoprotein-levels-in-relation-to-fecundability
#19
Sarah J Pugh, Enrique F Schisterman, Richard W Browne, Anne M Lynch, Sunni L Mumford, Neil J Perkins, Robert Silver, Lindsey Sjaarda, Joseph B Stanford, Jean Wactawski-Wende, Brian Wilcox, Katherine L Grantz
STUDY QUESTION: Are maternal preconception lipid levels associated with fecundability? SUMMARY ANSWER: Fecundability was reduced for all abnormal female lipid levels including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total triglyceride levels. WHAT IS KNOWN ALREADY: Subfecundity affects 7-15% of the population and lipid disorders are hypothesized to play a role since cholesterol acts as a substrate for the synthesis of steroid hormones...
March 15, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333300/comparison-of-global-gene-expression-profiles-of-microdissected-human-foetal-leydig-cells-with-their-normal-and-hyperplastic-adult-equivalents
#20
Grete Lottrup, Kirstine Belling, Henrik Leffers, John E Nielsen, Marlene D Dalgaard, Anders Juul, Niels E Skakkebæk, Søren Brunak, Ewa Rajpert-De Meyts
STUDY QUESTION: Do human adult Leydig cells (ALCs) within hyperplastic micronodules display characteristics of foetal LCs (FLCs)? SUMMARY ANSWER: The gene expression profiles of FLCs and all ALC subgroups were clearly different, but there were no significant differences in expressed genes between the normally clustered and hyperplastic ALCs. WHAT IS KNOWN ALREADY: LCs are the primary androgen producing cells in males throughout development and appear in chronologically distinct populations; FLCs, neonatal LCs and ALCs...
March 17, 2017: Molecular Human Reproduction
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