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Christopher Ethan Cox

Professor of Medicine
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Duke Box 102043, Durham, NC 27710
Dept of Medicine, Division of Pulmonary and Crit, Durham, NC 27710

Selected Publications


Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial.

Journal Article JAMA Intern Med · July 1, 2024 IMPORTANCE: Although psychological distress is common among survivors of critical illness, there are few tailored therapies. OBJECTIVE: To determine the optimal method for delivering a mindfulness intervention via a mobile app for critical illness survivor ... Full text Link to item Cite

Mobile App-Based Mindfulness Intervention for Addressing Psychological Distress Among Survivors of Hospitalization for COVID-19 Infection.

Journal Article CHEST Crit Care · June 2024 BACKGROUND: Psychological distress symptoms are present and persistent among many patients who survive a critical illness like COVID-19. RESEARCH QUESTION: Could a self-directed mobile app-delivered mindfulness intervention be feasibly and rapidly implemen ... Full text Link to item Cite

EMPOWER: A Multi-Site Pilot Trial to Reduce Distress in Surrogate Decision-Makers in the ICU.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Efforts to reduce the psychological distress of surrogate decision-makers of critically ill patients have had limited success, and some have even exacerbated distress. OBJECTIVES: The aim of this study was to determine the feasibility, acceptabili ... Full text Link to item Cite

Systematic Literature Review of Health-Related Quality-of-Life Measures for Caregivers of Older Adult Trauma Patients.

Journal Article J Surg Res · May 2024 INTRODUCTION: As the older adult population increases, hospitals treat more older adults with injuries. After leaving, these patients suffer from decreased mobility and independence, relying on care from others. Family members often assume this responsibil ... Full text Link to item Cite

Barriers and Facilitators Impacting Lung Cancer Screening Uptake Among Black Veterans: A Qualitative Study.

Journal Article J Natl Compr Canc Netw · April 18, 2024 BACKGROUND: Racial disparities in lung cancer screening (LCS) are well established. Black Veterans are among those at the highest risk for developing lung cancer but are less likely to complete LCS. We sought to identify barriers and facilitators to LCS up ... Full text Link to item Cite

Racial Differences in Shared Decision-Making About Critical Illness.

Journal Article JAMA Intern Med · April 1, 2024 IMPORTANCE: Shared decision-making is the preferred method for evaluating complex tradeoffs in the care of patients with critical illness. However, it remains unknown whether critical care clinicians engage diverse patients and caregivers equitably in shar ... Full text Link to item Cite

Utility of skin tone on pulse oximetry in critically ill patients: a prospective cohort study.

Journal Article medRxiv · February 27, 2024 IMPORTANCE: Pulse oximetry, a ubiquitous vital sign in modern medicine, has inequitable accuracy that disproportionately affects Black and Hispanic patients, with associated increases in mortality, organ dysfunction, and oxygen therapy. Although the root c ... Full text Open Access Link to item Cite

Defining the Time-limited Trial for Patients with Critical Illness: An Official American Thoracic Society Workshop Report.

Journal Article Ann Am Thorac Soc · February 2024 In critical care, the specific, structured approach to patient care known as a "time-limited trial" has been promoted in the literature to help patients, surrogate decision makers, and clinicians navigate consequential decisions about life-sustaining thera ... Full text Link to item Cite

Mobile Application-Based Communication Facilitation Platform for Family Members of Critically Ill Patients: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · January 2, 2024 IMPORTANCE: Unmet and racially disparate palliative care needs are common in intensive care unit (ICU) settings. OBJECTIVE: To test the effect of a primary palliative care intervention vs usual care control both overall and by family member race. DESIGN, S ... Full text Link to item Cite

Mobile Mindfulness for Psychological Distress and Burnout among Frontline COVID-19 Nurses: A Pilot Randomized Trial.

Journal Article Ann Am Thorac Soc · October 2023 Rationale: The coronavirus disease (COVID-19) pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking. Objectives: To determine the ... Full text Link to item Cite

Neighborhood Socioeconomic Disadvantage, Healthcare Access, and Outcomes of Hospitalizations for Common Pulmonary Conditions: A National Study of Medicare Beneficiaries.

Journal Article Ann Am Thorac Soc · October 2023 Rationale: Understanding how systemic forces and environmental exposures impact patient outcomes is critical to advancing health equity and improving population health for patients with pulmonary disease. This relationship has not yet been assessed at the ... Full text Link to item Cite

Digital solutions and the future of recovery after critical illness.

Journal Article Curr Opin Crit Care · October 1, 2023 PURPOSE OF REVIEW: Digital technologies may address known physical and psychological barriers to recovery experienced by intensive care survivors following hospital discharge and provide solutions to care fragmentation and unmet needs. The review highlight ... Full text Link to item Cite

Going beyond the means: Exploring the role of bias from digital determinants of health in technologies.

Journal Article PLOS Digit Health · October 2023 BACKGROUND: In light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical formul ... Full text Link to item Cite

Factors Associated With Triage Decisions in Older Adult Trauma Patients: Impact on Mortality and Morbidity.

Journal Article J Surg Res · August 2023 INTRODUCTION: As medical advances have significantly increased the life expectancy among older adults, the number of older patients requiring trauma care has risen proportionately. Nevertheless, it is unclear among this growing population which sociodemogr ... Full text Link to item Cite

Neighborhood socioeconomic deprivation, healthcare access, and 30-day mortality and readmission after sepsis or critical illness: findings from a nationwide study.

Journal Article Critical care (London, England) · July 2023 BackgroundTo determine if neighborhood socioeconomic deprivation independently predicts 30-day mortality and readmission for patients with sepsis or critical illness after adjusting for individual poverty, demographics, comorbidity burden, access ... Full text Cite

Feasibility of Mobile App-based Coping Skills Training for Cardiorespiratory Failure Survivors: The Blueprint Pilot Randomized Controlled Trial.

Journal Article Ann Am Thorac Soc · June 2023 Rationale: Psychological distress symptoms are common among patients recently hospitalized with cardiorespiratory failure, yet there are few effective postdischarge therapies that are relevant to their experiences. Objectives: To determine the feasibility ... Full text Link to item Cite

Racial Disparities in Lung Cancer Screening Among Veterans, 2013 to 2021.

Journal Article JAMA Netw Open · June 1, 2023 IMPORTANCE: Racial disparities in lung cancer screening (LCS) are often ascribed to barriers such as cost, insurance status, access to care, and transportation. Because these barriers are minimized within the Veterans Affairs system, there is a question of ... Full text Link to item Cite

Insurance Status and Ethnicity Impact Health Disparities in Rates of Advance Directives in Trauma.

Journal Article Am Surg · January 2023 INTRODUCTION: Advanced directives (ADs) provide a framework from which families may understand patient's wishes. However, end-of-life planning may not be prioritized by everyone. This analysis aimed to determine what populations have ADs and how they affec ... Full text Link to item Cite

Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial.

Journal Article JAMA Intern Med · July 1, 2024 IMPORTANCE: Although psychological distress is common among survivors of critical illness, there are few tailored therapies. OBJECTIVE: To determine the optimal method for delivering a mindfulness intervention via a mobile app for critical illness survivor ... Full text Link to item Cite

Mobile App-Based Mindfulness Intervention for Addressing Psychological Distress Among Survivors of Hospitalization for COVID-19 Infection.

Journal Article CHEST Crit Care · June 2024 BACKGROUND: Psychological distress symptoms are present and persistent among many patients who survive a critical illness like COVID-19. RESEARCH QUESTION: Could a self-directed mobile app-delivered mindfulness intervention be feasibly and rapidly implemen ... Full text Link to item Cite

EMPOWER: A Multi-Site Pilot Trial to Reduce Distress in Surrogate Decision-Makers in the ICU.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Efforts to reduce the psychological distress of surrogate decision-makers of critically ill patients have had limited success, and some have even exacerbated distress. OBJECTIVES: The aim of this study was to determine the feasibility, acceptabili ... Full text Link to item Cite

Systematic Literature Review of Health-Related Quality-of-Life Measures for Caregivers of Older Adult Trauma Patients.

Journal Article J Surg Res · May 2024 INTRODUCTION: As the older adult population increases, hospitals treat more older adults with injuries. After leaving, these patients suffer from decreased mobility and independence, relying on care from others. Family members often assume this responsibil ... Full text Link to item Cite

Barriers and Facilitators Impacting Lung Cancer Screening Uptake Among Black Veterans: A Qualitative Study.

Journal Article J Natl Compr Canc Netw · April 18, 2024 BACKGROUND: Racial disparities in lung cancer screening (LCS) are well established. Black Veterans are among those at the highest risk for developing lung cancer but are less likely to complete LCS. We sought to identify barriers and facilitators to LCS up ... Full text Link to item Cite

Racial Differences in Shared Decision-Making About Critical Illness.

Journal Article JAMA Intern Med · April 1, 2024 IMPORTANCE: Shared decision-making is the preferred method for evaluating complex tradeoffs in the care of patients with critical illness. However, it remains unknown whether critical care clinicians engage diverse patients and caregivers equitably in shar ... Full text Link to item Cite

Utility of skin tone on pulse oximetry in critically ill patients: a prospective cohort study.

Journal Article medRxiv · February 27, 2024 IMPORTANCE: Pulse oximetry, a ubiquitous vital sign in modern medicine, has inequitable accuracy that disproportionately affects Black and Hispanic patients, with associated increases in mortality, organ dysfunction, and oxygen therapy. Although the root c ... Full text Open Access Link to item Cite

Defining the Time-limited Trial for Patients with Critical Illness: An Official American Thoracic Society Workshop Report.

Journal Article Ann Am Thorac Soc · February 2024 In critical care, the specific, structured approach to patient care known as a "time-limited trial" has been promoted in the literature to help patients, surrogate decision makers, and clinicians navigate consequential decisions about life-sustaining thera ... Full text Link to item Cite

Mobile Application-Based Communication Facilitation Platform for Family Members of Critically Ill Patients: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · January 2, 2024 IMPORTANCE: Unmet and racially disparate palliative care needs are common in intensive care unit (ICU) settings. OBJECTIVE: To test the effect of a primary palliative care intervention vs usual care control both overall and by family member race. DESIGN, S ... Full text Link to item Cite

Mobile Mindfulness for Psychological Distress and Burnout among Frontline COVID-19 Nurses: A Pilot Randomized Trial.

Journal Article Ann Am Thorac Soc · October 2023 Rationale: The coronavirus disease (COVID-19) pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking. Objectives: To determine the ... Full text Link to item Cite

Neighborhood Socioeconomic Disadvantage, Healthcare Access, and Outcomes of Hospitalizations for Common Pulmonary Conditions: A National Study of Medicare Beneficiaries.

Journal Article Ann Am Thorac Soc · October 2023 Rationale: Understanding how systemic forces and environmental exposures impact patient outcomes is critical to advancing health equity and improving population health for patients with pulmonary disease. This relationship has not yet been assessed at the ... Full text Link to item Cite

Digital solutions and the future of recovery after critical illness.

Journal Article Curr Opin Crit Care · October 1, 2023 PURPOSE OF REVIEW: Digital technologies may address known physical and psychological barriers to recovery experienced by intensive care survivors following hospital discharge and provide solutions to care fragmentation and unmet needs. The review highlight ... Full text Link to item Cite

Going beyond the means: Exploring the role of bias from digital determinants of health in technologies.

Journal Article PLOS Digit Health · October 2023 BACKGROUND: In light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical formul ... Full text Link to item Cite

Factors Associated With Triage Decisions in Older Adult Trauma Patients: Impact on Mortality and Morbidity.

Journal Article J Surg Res · August 2023 INTRODUCTION: As medical advances have significantly increased the life expectancy among older adults, the number of older patients requiring trauma care has risen proportionately. Nevertheless, it is unclear among this growing population which sociodemogr ... Full text Link to item Cite

Neighborhood socioeconomic deprivation, healthcare access, and 30-day mortality and readmission after sepsis or critical illness: findings from a nationwide study.

Journal Article Critical care (London, England) · July 2023 BackgroundTo determine if neighborhood socioeconomic deprivation independently predicts 30-day mortality and readmission for patients with sepsis or critical illness after adjusting for individual poverty, demographics, comorbidity burden, access ... Full text Cite

Feasibility of Mobile App-based Coping Skills Training for Cardiorespiratory Failure Survivors: The Blueprint Pilot Randomized Controlled Trial.

Journal Article Ann Am Thorac Soc · June 2023 Rationale: Psychological distress symptoms are common among patients recently hospitalized with cardiorespiratory failure, yet there are few effective postdischarge therapies that are relevant to their experiences. Objectives: To determine the feasibility ... Full text Link to item Cite

Racial Disparities in Lung Cancer Screening Among Veterans, 2013 to 2021.

Journal Article JAMA Netw Open · June 1, 2023 IMPORTANCE: Racial disparities in lung cancer screening (LCS) are often ascribed to barriers such as cost, insurance status, access to care, and transportation. Because these barriers are minimized within the Veterans Affairs system, there is a question of ... Full text Link to item Cite

Insurance Status and Ethnicity Impact Health Disparities in Rates of Advance Directives in Trauma.

Journal Article Am Surg · January 2023 INTRODUCTION: Advanced directives (ADs) provide a framework from which families may understand patient's wishes. However, end-of-life planning may not be prioritized by everyone. This analysis aimed to determine what populations have ADs and how they affec ... Full text Link to item Cite

Trajectories of Palliative Care Needs in the ICU and Long-Term Psychological Distress Symptoms.

Journal Article Crit Care Med · January 1, 2023 OBJECTIVES: While palliative care needs are assumed to improve during ICU care, few empiric data exist on need trajectories or their impact on long-term outcomes. We aimed to describe trajectories of palliative care needs during ICU care and to determine i ... Full text Link to item Cite

Addressing Unmet Needs Among Family Members of Critically Ill Patients: The ICUconnect Randomized Clinical Trial

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2023 Cite

What Is Chronic Critical Illness and What Outcomes Can Be Expected

Chapter · January 1, 2023 Chronic critical illness (CCI) occurs when a patient survives the acute phase of critical illness but experiences persistent organ dysfunction and is characterized by prolonged intensive care needs. Mortality for patients with CCI is high, with survivors e ... Full text Cite

Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness.

Journal Article J Crit Care · December 2022 PURPOSE: Few quality improvement tools specific to patients with persistent or chronic critical illness exist to aid delivery of high-quality care. Using experience-based co-design methods, we sought consensus from key stakeholders on the most important ac ... Full text Link to item Cite

Palliative care phenotypes among critically ill patients and family members: intensive care unit prospective cohort study.

Journal Article BMJ Support Palliat Care · September 27, 2022 OBJECTIVE: Because the heterogeneity of patients in intensive care units (ICUs) and family members represents a challenge to palliative care delivery, we aimed to determine if distinct phenotypes of palliative care needs exist. METHODS: Prospective cohort ... Full text Link to item Cite

Palliative Care Early in the Care Continuum among Patients with Serious Respiratory Illness: An Official ATS/AAHPM/HPNA/SWHPN Policy Statement.

Journal Article Am J Respir Crit Care Med · September 15, 2022 Background: Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care ... Full text Link to item Cite

Underutilization of Acetaminophen in Older Adult Trauma Patients.

Journal Article Am Surg · August 2022 INTRODUCTION: Older adults are more vulnerable to opioid-associated morbidity. The purpose of this study was to determine the frequency and timing of acetaminophen and opioid use in the postoperative period. METHODS: Older adult trauma patients (≥65 years) ... Full text Link to item Cite

Improving Outcomes Measurement in Palliative Care: The Lasting Impact of Randy Curtis and his Collaborators.

Journal Article J Pain Symptom Manage · June 2022 Palliative care research is deeply challenging for many reasons, not the least of which is the conceptual and operational difficulty of measuring outcomes within a seriously ill population such as critically ill patients and their family members. This manu ... Full text Link to item Cite

Surrogates of Patients With Severe Acute Brain Injury Experience Persistent Anxiety and Depression Over the 6 Months After ICU Admission.

Journal Article J Pain Symptom Manage · June 2022 CONTEXT: Severe Acute Brain Injury (SABI) is neurologically devastating, and surrogates for these patients may struggle with particularly complex decisions due to substantial prognostic uncertainty. OBJECTIVES: To compare anxiety and depression symptoms ov ... Full text Link to item Cite

Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients.

Journal Article Palliat Support Care · April 2022 OBJECTIVE: The objectives of this study were to develop and refine EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), a brief manualized cognitive-behavioral, acceptance-based intervention for surrogate decision-makers of critica ... Full text Link to item Cite

Posttraumatic Stress Disorder Symptom Clusters in Surrogate Decision Makers of Patients Experiencing Chronic Critical Illness.

Journal Article Crit Care Explor · March 2022 UNLABELLED: Symptoms of posttraumatic stress disorder (PTSD) are common among surrogate decision makers of patients with chronic critical illness (CCI). PTSD symptoms can be categorized into clusters including intrusion, avoidance, and hyperarousal, each o ... Full text Open Access Link to item Cite

Assessment of Clinical Palliative Care Trigger Status vs Actual Needs Among Critically Ill Patients and Their Family Members.

Journal Article JAMA Netw Open · January 4, 2022 IMPORTANCE: Palliative care consultations in intensive care units (ICUs) are increasingly prompted by clinical characteristics associated with mortality or resource utilization. However, it is not known whether these triggers reflect actual palliative care ... Full text Link to item Cite

SICQ Coping and the Health-Related Quality of Life and Recovery of Critically Ill ICU Patients: A Prospective Cohort Study.

Journal Article Chest · January 2022 BACKGROUND: The coping styles of the Sickness Insight in Coping Questionnaire (SICQ; positivism, redefinition, toughness, fighting spirit, nonacceptance) may affect the health and recovery of hospitalized critically ill patients. RESEARCH QUESTION: Do the ... Full text Link to item Cite

Trends in Location of Death Among Older Adult Americans After Falls.

Journal Article Gerontol Geriatr Med · 2022 Introduction: Fall-related mortality is increasing among older adults, yet trends and changes in the location of fall-attributed deaths are unknown; additionally, potential disparities are understudied. Methods: To assess trends/factors associated with pla ... Full text Link to item Cite

Factors Associated with Physicians Perceptions of Interpersonal Conflict with Families in the Intensive Care Unit

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2022 Cite

Racial and Ethnic Differences in Health Care Utilization Following Severe Acute Brain Injury in the United States.

Conference J Intensive Care Med · November 2021 OBJECTIVE: To examine racial and ethnic differences in the utilization of 3 interventions (tracheostomy placement, gastrostomy tube placement, and hospice utilization) among patients with severe acute brain injury (SABI). DESIGN: Retrospective cohort study ... Full text Link to item Cite

The Association between Patient Health Status and Surrogate Decision Maker Post-Traumatic Stress Disorder Symptoms in Chronic Critical Illness.

Journal Article Ann Am Thorac Soc · November 2021 Rationale: Surrogate decision-makers of patients with chronic critical illness (CCI) are at high risk for symptoms of post-traumatic stress disorder (PTSD). Whether patient health status after hospital discharge is a risk factor for surrogate PTSD symptoms ... Full text Link to item Cite

Impact of a Real-Time, Pharmacist-Led, Intensive Care Unit-Based Feedback Intervention on Analgesia and Sedation Quality Among Mechanically Ventilated Patients.

Journal Article J Nurs Care Qual · July 2021 BACKGROUND: Consensus guidelines for pain, agitation, and delirium (PAD) in mechanically ventilated patients recommend maintaining a light level of sedation. LOCAL PROBLEM: Consistent attainment of target PAD assessments in mechanically ventilated ICU pati ... Full text Link to item Cite

A Pilot Randomized Trial of an Interactive Web-based Tool to Support Surrogate Decision Makers in the Intensive Care Unit.

Journal Article Ann Am Thorac Soc · July 2021 Rationale: Breakdowns in clinician-family communication in intensive care units (ICUs) are common, yet there are no easily scaled interventions to prevent this problem.Objectives: To assess the feasibility, usability, acceptability, and perceived effective ... Full text Link to item Cite

Two Questions About the Design of Cluster Randomized Trials: A Tutorial.

Journal Article J Pain Symptom Manage · April 2021 This is a short tutorial on two key questions that pertain to cluster randomized trials (CRTs): 1) Should I perform a CRT? and 2) If so, how do I derive the sample size? In summary, a CRT is the best option when you "must" (e.g., the intervention can only ... Full text Link to item Cite

Improving racial disparities in unmet palliative care needs among intensive care unit family members with a needs-targeted app intervention: The ICUconnect randomized clinical trial.

Journal Article Contemp Clin Trials · April 2021 INTRODUCTION: The technologies used to treat the millions who receive care in intensive care unit (ICUs) each year have steadily advanced. However, the quality of ICU-based communication has remained suboptimal, particularly concerning for Black patients a ... Full text Link to item Cite

Effectiveness of Quetiapine as a Sedative Adjunct in Mechanically Ventilated Adults Without Delirium.

Journal Article Ann Pharmacother · February 2021 BACKGROUND: Quetiapine is an atypical antipsychotic that is commonly used in the Intensive Care Unit (ICU). The utility of quetiapine as a sedative adjunct has not yet been evaluated, but has been described previously in studies evaluating quetiapine for d ... Full text Link to item Cite

Palliative Care Triggers vs Actual Unmet Needs Among ICU Patients and Family Members

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2021 Cite

AdheRence to Inhaled Corticosteroids in Asthma (ARICA): A Randomized Controlled Pilot Study

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2021 Cite

Operationalizing needs-focused palliative care for older adults in intensive care units: Design of and rationale for the PCplanner randomized clinical trial.

Journal Article Contemp Clin Trials · November 2020 INTRODUCTION: The number of older adults who receive life support in an intensive care unit (ICU), now 2 million per year, is increasing while survival remains unchanged. Because the quality of ICU-based palliative care is highly variable, we developed a m ... Full text Link to item Cite

Optimizing a self-directed mobile mindfulness intervention for improving cardiorespiratory failure survivors' psychological distress (LIFT2): Design and rationale of a randomized factorial experimental clinical trial.

Journal Article Contemp Clin Trials · September 2020 INTRODUCTION: Although as many as 75% of the >2 million annual intensive care unit (ICU) survivors experience symptoms of psychological distress that persist for months to years, few therapies exist that target their symptoms and accommodate their unique n ... Full text Link to item Cite

The Patient and Family Member Experience of Financial Stress Related to Critical Illness.

Journal Article J Palliat Med · July 2020 Background: The experience of financial stress during and after critical illness for patients and their family is poorly understood. Objectives: Our objectives were to (1) explore common financial concerns, their contribution to emotional stress, and poten ... Full text Link to item Cite

Developing the family support tool: An interactive, web-based tool to help families navigate the complexities of surrogate decision making in ICUs.

Journal Article J Crit Care · April 2020 INTRODUCTION: Although family members of incapacitated, critically ill patients often struggle in the role of surrogate decision maker, there are no low-cost, easily-scaled interventions to address this problem. AIM OF THE STUDY: To develop and pilot-test ... Full text Link to item Cite

"I'm Leaving": Factors That Impact Against Medical Advice Disposition Post-Trauma.

Journal Article J Emerg Med · April 2020 BACKGROUND: Discharge against medical advice (AMA) is an important, yet understudied, aspect of health care-particularly in trauma populations. AMA discharges result in increased mortality, increased readmission rates, and higher health care costs. OBJECTI ... Full text Link to item Cite

Performance Characteristics of a Simplified Bedside Strength Assessment in Critically Ill Patients

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2020 Cite

A Pharmacy-Based Electronic Handoff Tool to Reduce Discharge Prescribing of Atypical Antipsychotics Initiated in the Intensive Care Unit: A Quality Improvement Initiative.

Journal Article J Pharm Pract · August 2019 PURPOSE: To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate, hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naive critically ill adults. METHODS: T ... Full text Link to item Cite

Enhancing & Mobilizing the POtential for Wellness & Emotional Resilience (EMPOWER) among Surrogate Decision-Makers of ICU Patients: study protocol for a randomized controlled trial.

Journal Article Trials · July 9, 2019 BACKGROUND: Critical illness increases the risk for poor mental health outcomes among both patients and their informal caregivers, especially their surrogate decision-makers. Surrogates who must make life-and-death medical decisions on behalf of incapacita ... Full text Link to item Cite

Modifiable elements of ICU supportive care and communication are associated with surrogates' PTSD symptoms.

Journal Article Intensive Care Med · May 2019 PURPOSE: To identify specific components of ICU clinician supportive care and communication that are associated with increased post-traumatic stress disorder (PTSD) symptoms for surrogate decision makers of patients with chronic critical illness (CCI). MET ... Full text Link to item Cite

Addressing religion and spirituality in the intensive care unit: A survey of clinicians.

Journal Article Palliat Support Care · April 2019 OBJECTIVE: Studies have shown that when religious and spiritual concerns are addressed by the medical team, patients are more satisfied with their care and have lower healthcare costs. However, little is known about how intensive care unit (ICU) clinicians ... Full text Link to item Cite

Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation: A Randomized Clinical Trial.

Journal Article Ann Intern Med · March 5, 2019 BACKGROUND: Treatment decisions commonly have to be made in intensive care units (ICUs). These decisions are difficult for surrogate decision makers and often lead to decisional conflict, psychological distress, and treatments misaligned with patient prefe ... Full text Link to item Cite

Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.

Journal Article Thorax · January 2019 BACKGROUND: Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. METHODS: Pilot randomised cli ... Full text Link to item Cite

Intensive Care Clinicians' Views on the Role of Chaplains.

Journal Article J Health Care Chaplain · 2019 There is evidence that addressing the religious and spiritual needs of patients has positive effects on patient satisfaction and health care utilization. However, in the intensive care unit (ICU), chaplains are often consulted only at the very end of life, ... Full text Link to item Cite

Risk Factors for Post-Traumatic Stress Disorder Symptoms in Surrogate Decision-Makers of Patients with Chronic Critical Illness.

Journal Article Ann Am Thorac Soc · December 2018 RATIONALE: Chronically critically ill patients are often dependent on family members for surrogate decision-making, and these surrogates are at high risk for emotional distress. We hypothesized that patient- and surrogate-specific risk factors for surrogat ... Full text Link to item Cite

Patient-centered Outcomes Research in Pulmonary, Critical Care, and Sleep Medicine. An Official American Thoracic Society Workshop Report.

Journal Article Ann Am Thorac Soc · September 2018 Patient-centered outcomes research (PCOR) represents a paradigm shift in research methods aimed to create the body of evidence that supports clinical practice and informs health care decisions. PCOR integrates patients and other key stakeholders including ... Full text Link to item Cite

Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness.

Journal Article Crit Care Med · June 2018 OBJECTIVES: Little is known about the experience of financial stress for patients who survive critical illness or their families. Our objective was to describe the prevalence of financial stress among critically ill patients and their families, identify cl ... Full text Link to item Cite

How Surrogate Decision-Makers for Patients With Chronic Critical Illness Perceive and Carry Out Their Role.

Journal Article Crit Care Med · May 2018 OBJECTIVES: Family members commonly make medical decision for patients with chronic critical illness. This study examines how family members approach this decision-making role in real time. DESIGN: Qualitative analysis of interviews with family members in ... Full text Link to item Cite

Rapid Response Events in Hospitalized Patients: Patient Symptoms and Clinician Communication.

Journal Article J Pain Symptom Manage · March 2018 CONTEXT: Patients triggering rapid response team (RRT) intervention are at high risk for adverse outcomes. Data on symptom burden of these patients do not currently exist, and current symptom management and communication practices of RRT clinicians are unk ... Full text Link to item Cite

Effects of a Telephone- and Web-based Coping Skills Training Program Compared with an Education Program for Survivors of Critical Illness and Their Family Members. A Randomized Clinical Trial.

Journal Article Am J Respir Crit Care Med · January 1, 2018 RATIONALE: Many survivors of critical illness and their family members experience significant psychological distress after patient discharge. OBJECTIVES: To compare the effects of a coping skills training (CST) program with an education program on patient ... Full text Link to item Cite

Palliative Care Planner: A Pilot Study to Evaluate Acceptability and Usability of an Electronic Health Records System-integrated, Needs-targeted App Platform.

Journal Article Ann Am Thorac Soc · January 2018 RATIONALE: The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. OBJECTIVE: To develop and pilot an app platform for clinicians and ICU patients and their family members that enhances the deliv ... Full text Link to item Cite

Risk Factors for Post-Traumatic Stress Disorder in Family Caregivers for the Chronically Critically Ill

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2018 Link to item Cite

Prevalence, Risk-Factors, and Outcomes of Financial Stress in Survivors of Critical Illness

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2018 Link to item Cite

Effect of a Self-Directed Mobile App Mindfulness Program for ICU Survivors: A Pilot RCT

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2018 Link to item Cite

The Voice of Surrogate Decision-Makers. Family Responses to Prognostic Information in Chronic Critical Illness.

Journal Article Am J Respir Crit Care Med · October 1, 2017 RATIONALE: Information from clinicians about the expected course of the patient's illness is relevant and important for decision-making by surrogates for chronically critically ill patients on mechanical ventilation. OBJECTIVES: To observe how surrogates o ... Full text Link to item Cite

Improving ICU-Based Palliative Care Delivery: A Multicenter, Multidisciplinary Survey of Critical Care Clinician Attitudes and Beliefs.

Journal Article Crit Care Med · April 2017 OBJECTIVE: Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care d ... Full text Link to item Cite

Developing a Research Agenda for Integrating Palliative Care into Critical Care and Pulmonary Practice To Improve Patient and Family Outcomes.

Journal Article J Palliat Med · April 2017 BACKGROUND: Palliative care is a medical specialty and philosophy of care that focuses on reducing suffering among patients with serious illness and their family members, regardless of disease diagnosis or prognosis. As critical illness or moderate to seve ... Full text Link to item Cite

Clinical Momentum in the Intensive Care Unit. A Latent Contributor to Unwanted Care.

Journal Article Ann Am Thorac Soc · March 2017 Many older adults in the United States receive invasive medical care near the end of life, often in an intensive care unit (ICU). However, most older adults report preferences to avoid this type of medical care and to prioritize comfort and quality of life ... Full text Link to item Cite

Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU.

Journal Article Crit Care Med · January 2017 OBJECTIVE: To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. METHODS: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines a ... Full text Link to item Cite

Addressing The Religious And Spiritual Needs Of Icu Patients: A Survey Of Icu Clinicians

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2017 Link to item Cite

Coping Skills Training To Improve Psychological Distress Among Critical Illness Survivors: A Randomized Clinical Trial

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2017 Link to item Cite

Primary Palliative Care Needs And Practices During Rapid Response Events In Hospitalized Patients

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2017 Link to item Cite

Performance of Consultative Palliative Care Model in Achieving Quality Metrics in the ICU.

Journal Article J Pain Symptom Manage · December 2016 CONTEXT: Quality metrics for intensive care unit (ICU)-based palliative care have been proposed, but it is unknown how consultative palliative care can contribute to performance on these measures. OBJECTIVES: Assess adherence to proposed quality metrics of ... Full text Link to item Cite

Mechanical Ventilator Discontinuation Process.

Journal Article Clin Chest Med · December 2016 The goal of this article is to discuss approaches to discontinuing invasive mechanical ventilation in a general intensive care unit (ICU) population. It considers approaches in which the clinician expects patient survival, as well as those that do not. Add ... Full text Link to item Cite

Measuring Adaptive Coping of Hospitalized Patients With a Severe Medical Condition: The Sickness Insight in Coping Questionnaire.

Journal Article Crit Care Med · September 2016 OBJECTIVES: Adaptive coping strategies are associated with less psychological distress. However, there is no brief, specific, and validated instrument for assessing adaptive coping among seriously ill patients. Our objective was to examine the validity and ... Full text Link to item Cite

Coping as a Multifaceted Construct: Associations With Psychological Outcomes Among Family Members of Mechanical Ventilation Survivors.

Journal Article Crit Care Med · September 2016 OBJECTIVES: To develop and evaluate a preliminary multifaceted model for coping among family members of patients who survive mechanical ventilation. DESIGN AND SETTING: In this multicenter cross-sectional survey, we interviewed family members of mechanical ... Full text Link to item Cite

Effect of Palliative Care-Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial.

Journal Article JAMA · July 5, 2016 IMPORTANCE: Family caregivers of patients with chronic critical illness experience significant psychological distress. OBJECTIVE: To determine whether family informational and emotional support meetings led by palliative care clinicians improve family anxi ... Full text Link to item Cite

Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness.

Journal Article Am J Crit Care · July 2016 BACKGROUND: Web-based electronic patient-reported outcomes (ePRO) measures are increasingly used to facilitate patient-centered health assessments. However, it is unknown if ePRO completion is feasible for recently ill intensive care unit (ICU) survivors a ... Full text Link to item Cite

Using Technology to Create a More Humanistic Approach to Integrating Palliative Care into the Intensive Care Unit.

Journal Article Am J Respir Crit Care Med · February 1, 2016 A decade ago, the major obstacles to integration of palliative care into the intensive care unit (ICU) were the limited number of providers trained in palliative care, an immature evidence base, and a lack of appreciation for the importance of palliative c ... Full text Link to item Cite

Development and Validation of a Mortality Prediction Model for Patients Receiving 14 Days of Mechanical Ventilation.

Journal Article Crit Care Med · November 2015 OBJECTIVES: The existing risk prediction model for patients requiring prolonged mechanical ventilation is not applicable until after 21 days of mechanical ventilation. We sought to develop and validate a mortality prediction model for patients earlier in t ... Full text Link to item Cite

Therapeutic Alliance between the Caregivers of Critical Illness Survivors and Intensive Care Unit Clinicians.

Journal Article Ann Am Thorac Soc · November 2015 RATIONALE: Therapeutic alliance is a novel measure of the multifaceted caregiver-clinician relationship and a promising intervention target for improving patient-centered outcomes. However, therapeutic alliance has not been studied in an intensive care uni ... Full text Link to item Cite

"The Patient Is Dying, Please Call the Chaplain": The Activities of Chaplains in One Medical Center's Intensive Care Units.

Journal Article J Pain Symptom Manage · October 2015 CONTEXT: Patients and families commonly experience spiritual stress during an intensive care unit (ICU) admission. Although most patients report that they want spiritual support, little is known about how these issues are addressed by hospital chaplains. O ... Full text Link to item Cite

Symptom Burden of Chronic Lung Disease Compared with Lung Cancer at Time of Referral for Palliative Care Consultation.

Journal Article Ann Am Thorac Soc · September 2015 RATIONALE: A growing evidence base supports provision of palliative care services alongside life-prolonging care. Whereas palliative care processes have been implemented widely in the care of patients with lung cancer, the same is not true for patients wit ... Full text Link to item Cite

The epidemiology of chronic critical illness in the United States*.

Journal Article Crit Care Med · February 2015 OBJECTIVES: The epidemiology of chronic critical illness is not well characterized. We sought to determine the prevalence, outcomes, and associated costs of chronic critical illness in the United States. DESIGN: Population-based cohort study using data fro ... Full text Link to item Cite

The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative.

Journal Article Am J Respir Crit Care Med · February 1, 2015 RATIONALE: The CDC introduced ventilator-associated event (VAE) definitions in January 2013. Little is known about VAE prevention. We hypothesized that daily, coordinated spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) might pre ... Full text Link to item Cite

Fluid management with a simplified conservative protocol for the acute respiratory distress syndrome*.

Journal Article Crit Care Med · February 2015 OBJECTIVES: In the Fluid and Catheter Treatment Trial (FACTT) of the National Institutes of Health Acute Respiratory Distress Syndrome Network, a conservative fluid protocol (FACTT Conservative) resulted in a lower cumulative fluid balance and better outco ... Full text Link to item Cite

Development and usability testing of a Web-based decision aid for families of patients receiving prolonged mechanical ventilation.

Journal Article Ann Intensive Care · 2015 BACKGROUND: Web-based decision aids are increasingly important in medical research and clinical care. However, few have been studied in an intensive care unit setting. The objectives of this study were to develop a Web-based decision aid for family members ... Full text Open Access Link to item Cite

Resilience And Psychological Distress Among Surrogate Decision Makers Of Critically Ill Patients

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2015 Link to item Cite

Use Of Hospice In Place In Medical Intensive Care Unit Patients

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2015 Link to item Cite

User Testing Of A Web-Based Decision Aid For Families Receiving Prolonged Mechanical Ventilation

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2015 Link to item Cite

Epidemiology of methicillin-resistant Staphylococcus aureus pneumonia in community hospitals.

Journal Article Infect Control Hosp Epidemiol · December 2014 OBJECTIVE: Describe the epidemiology of healthcare-related (ie, healthcare-associated and hospital-acquired) pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) among hospitalized patients in community hospitals. DESIGN: Retrospective cohor ... Full text Link to item Cite

The ProVent model learns to speak French.

Journal Article Crit Care · October 20, 2014 Leroy and colleagues report on the accuracy of the Prolonged Mechanical Ventilation Prognostic Model ('ProVent') in a cohort study of patients ventilated for at least 21 days in one of three hospitals in the north of France. This study is noteworthy becaus ... Full text Link to item Cite

Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

Journal Article Curr Opin Crit Care · October 2014 PURPOSE OF REVIEW: Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare ... Full text Link to item Cite

A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness.

Journal Article Am J Respir Crit Care Med · August 15, 2014 In the setting of a complex critical illness, preference-sensitive decision making-choosing between two or more reasonable treatment options-can be difficult for patients, families, and clinicians alike. A common challenge to making high-quality decisions ... Full text Link to item Cite

Exploring the impact of augmenting sedation assessment with physiologic monitors.

Journal Article Aust Crit Care · August 2014 BACKGROUND: Pharmacological sedation is a necessary tool in the management of critically ill, mechanically ventilated patients. The intensive care unit (ICU) sedation strategy is to use the least amount of medication to meet safety and comfort goals. Titra ... Full text Link to item Cite

Development and preliminary evaluation of a telephone-based mindfulness training intervention for survivors of critical illness.

Journal Article Ann Am Thorac Soc · February 2014 RATIONALE: Persistent symptoms of psychological distress represent an unmet need among intensive care unit (ICU) survivors. OBJECTIVES: We aimed to develop and pilot test a simple telephone-based mindfulness training intervention to address this population ... Full text Link to item Cite

Cost and health care utilization in ARDS--different from other critical illness?

Journal Article Semin Respir Crit Care Med · August 2013 Costs of care in the intensive care unit are a frequent target for concern in the current health care system. Utilization of critical care services in the United States is increasing and will continue to do so. Acute respiratory distress syndrome (ARDS) is ... Full text Link to item Cite

Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers.

Journal Article Intensive Care Med · August 2012 PURPOSE: Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training int ... Full text Link to item Cite

Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation.

Journal Article Crit Care Med · August 2012 OBJECTIVE: Shared decision making is inadequate in intensive care units. Decision aids can improve decision making quality, though their role in an intensive care units setting is unclear. We aimed to develop and pilot test a decision aid for shared decisi ... Full text Link to item Cite

Medical and economic implications of prolonged mechanical ventilation and expedited post-acute care.

Journal Article Semin Respir Crit Care Med · August 2012 This article describes the increasingly common phenomenon of prolonged mechanical ventilation in the context of the transition between the acute care hospital and post-acute care. Prolonged mechanical ventilation or chronic critical illness is associated w ... Full text Link to item Cite

Persistent systemic inflammation in chronic critical illness.

Journal Article Respir Care · June 2012 Chronic critical illness (CCI) is syndrome of neuromuscular weakness, brain dysfunction, malnutrition, endocrinopathies, and symptom distress. Two conceptual themes may be useful in discussing CCI. The first is a clinical roadmap in which a patient suffers ... Full text Link to item Cite

A multicenter mortality prediction model for patients receiving prolonged mechanical ventilation.

Journal Article Crit Care Med · April 2012 OBJECTIVE: Significant deficiencies exist in the communication of prognosis for patients requiring prolonged mechanical ventilation after acute illness, in part because of clinician uncertainty about long-term outcomes. We sought to refine a mortality pred ... Full text Link to item Cite

Development and validation of a printed information brochure for families of chronically critically ill patients.

Journal Article Crit Care Med · January 2012 OBJECTIVE: Families and other surrogate decisionmakers for chronically critically ill patients often lack information about patient prognosis or options for care. This study describes an approach to develop and validate a printed information brochure about ... Full text Link to item Cite

Dermal and ocular exposure systems for the development of models of sulfur mustard-induced injury.

Journal Article Toxicol Mech Methods · September 2011 Sulfur mustard (SM) is a chemical threat agent for which the effects have no current treatment. Due to the ease of synthesis and dispersal of this material, the need to develop therapeutics is evident. The present article details the techniques used to dev ... Full text Link to item Cite

Management of dyspnea within a rapid learning healthcare model.

Journal Article Curr Opin Support Palliat Care · June 2011 PURPOSE OF REVIEW: This review addresses a distressing symptom experienced by many palliative care patients, for which available interventions have been only partially effective. A new model of healthcare delivery and research - rapid learning healthcare - ... Full text Link to item Cite

Chronic critical illness.

Journal Article Am J Respir Crit Care Med · August 15, 2010 Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other ... Full text Link to item Cite

One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study.

Journal Article Ann Intern Med · August 3, 2010 Featured Publication BACKGROUND: Growing numbers of critically ill patients receive prolonged mechanical ventilation. Little is known about the patterns of care as patients transition from acute care hospitals to postacute care facilities or about the associated resource utili ... Full text Link to item Cite

The author replies

Journal Article Critical Care Medicine · May 1, 2010 Full text Cite

Critical Conversations: Prolonged Mechanical Ventilation

Journal Article ICU Director · March 1, 2010 Full text Cite

Expectations and outcomes of prolonged mechanical ventilation.

Journal Article Crit Care Med · November 2009 Featured Publication OBJECTIVE: To compare prolonged mechanical ventilation decision-makers' expectations for long-term patient outcomes with prospectively observed outcomes and to characterize important elements of the surrogate-physician interaction surrounding prolonged mec ... Full text Link to item Cite

Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers.

Journal Article Crit Care Med · October 2009 Featured Publication OBJECTIVE: To characterize the effects of critical illness in the daily lives and functioning of acute respiratory distress syndrome survivors. Survivors of acute respiratory distress syndrome, a systemic critical illness, often report poor quality of life ... Full text Link to item Cite

Current teaching and evaluation methods in critical care medicine: has the Accreditation Council for Graduate Medical Education affected how we practice and teach in the intensive care unit?

Journal Article Crit Care Med · January 2009 OBJECTIVE: To determine the impact of the Accreditation Council for Graduate Medical Education mandates for duty hours and competencies on instruction, evaluation, and patient care in intensive care units in the United States. DESIGN: A Web-based survey wa ... Full text Link to item Cite

Potentially Ineffective Care (PIC) and Prolonged Mechanical Ventilation (PMV)

Journal Article AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2009 Link to item Cite

Evaluation of the ProVent Model for Predicting In-Hospital Mortality in Patients Receiving Mechanical Ventilation for 14 Days

Journal Article AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2009 Link to item Cite

A prognostic model for one-year mortality in patients requiring prolonged mechanical ventilation.

Journal Article Crit Care Med · July 2008 Featured Publication OBJECTIVE: A measure that identifies patients who are at high risk of mortality after prolonged ventilation will help physicians communicate prognoses to patients or surrogate decision makers. Our objective was to develop and validate a prognostic model fo ... Full text Link to item Cite

Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study.

Journal Article Diabetes Care · April 2008 OBJECTIVE: The aim of this study was to test the hypothesis that diabetes is independently associated with reduced lung function, both cross-sectionally and longitudinally. RESEARCH DESIGN AND METHODS: We conducted cross-sectional and prospective analyses ... Full text Link to item Cite

Economic evaluation of propofol and lorazepam for critically ill patients undergoing mechanical ventilation.

Journal Article Crit Care Med · March 2008 Featured Publication OBJECTIVE: The economic implications of sedative choice in the management of patients receiving mechanical ventilation are unclear because of differences in costs and clinical outcomes associated with specific sedatives. Therefore, we aimed to determine th ... Full text Link to item Cite

An economic evaluation of prolonged mechanical ventilation.

Journal Article Crit Care Med · August 2007 Featured Publication OBJECTIVE: Patients who receive prolonged mechanical ventilation have high resource utilization and relatively poor outcomes, especially the elderly, and are increasing in number. The economic implications of prolonged mechanical ventilation provision, how ... Full text Link to item Cite

Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: a prospective cohort study.

Journal Article Crit Care · 2007 Featured Publication INTRODUCTION: The outcomes of patients ventilated for longer than average are unclear, in part because of the lack of an accepted definition of prolonged mechanical ventilation (PMV). To better understand the implications of PMV provision, we compared one- ... Full text Link to item Cite

Expectations and outcomes of gastric feeding tubes.

Journal Article Am J Med · June 2006 PURPOSE: To compare expected outcomes with actual outcomes from tube feeding in adult patients. SUBJECTS AND METHODS: This prospective cohort study was conducted in two North Carolina hospitals. Surrogates were interviewed shortly after feeding tube insert ... Full text Link to item Cite

Surrogates' perceptions about feeding tube placement decisions.

Journal Article Patient Educ Couns · May 2006 OBJECTIVES: (1) To determine surrogates perceptions about who made the decision to place the feeding tube and who they would have preferred to have made the decision. (2) To determine surrogates' perceptions of the information they received to make this de ... Full text Link to item Cite

The effect of thalidomide on corticosteroid-dependent pulmonary sarcoidosis.

Journal Article Sarcoidosis Vasc Diffuse Lung Dis · March 2006 STUDY OBJECTIVE: To determine the benefit and corticosteroid-sparing potential of thalidomide in corticosteroid-dependent pulmonary sarcoidosis. METHODS: The study was a prospective open-label pilot study. Ten subjects were enrolled who had pulmonary sarco ... Full text Link to item Cite

The changing epidemiology of mechanical ventilation: a population-based study.

Journal Article J Intensive Care Med · 2006 The number of critical care beds in the United States has been increasing considerably, but it is unclear how these additional beds have been used. Mechanical ventilation for acute respiratory failure almost always demands ICU care and is likely to be a re ... Full text Link to item Cite

Providing palliative care for patients receiving mechanical ventilation in an intensive care unit: Part 2: Withdrawing ventilation

Journal Article Progress in Palliative Care · September 21, 2005 Mechanical ventilation is often withdrawn from patients in expectation of death in intensive care units (ICUs). This process involves close collaboration between families and loved ones, physicians, nurses, respiratory therapists, and other healthcare prov ... Full text Cite

Sarcoidosis.

Journal Article Med Clin North Am · July 2005 Sarcoidosis is a disease found in most populations worldwide, although it has a proclivity for relatively young African-American women in the United States. Although the pathogenesis is unknown, there likely are social, environmental, and genetic factors t ... Full text Link to item Cite

Providing palliative care for patients receiving mechanical ventilation. Part I: Invasive and non-invasive ventilation

Journal Article Progress in Palliative Care · June 30, 2005 Intensive care units (ICUs) provide care to many patients who ultimately die while receiving, or after withdrawal of, mechanical ventilation. During the transition from curative to palliative care, it is important to emphasise comfort and symptoms' relief. ... Full text Cite

Increase in tracheostomy for prolonged mechanical ventilation in North Carolina, 1993-2002.

Journal Article Crit Care Med · November 2004 Featured Publication OBJECTIVE: Patients who require tracheostomy for prolonged mechanical ventilation have poor outcomes and high costs of care. However, recent longitudinal trends relevant to these patients and their care have not been described. We aimed to describe trends ... Full text Link to item Cite

Trends in the use of feeding tubes in North Carolina hospitals.

Journal Article J Gen Intern Med · October 2004 OBJECTIVE: National data describing the placement of feeding tubes demonstrated a rapid increase in use in the early and mid-1990s. In the past several years, substantial concerns have arisen regarding the appropriateness of the procedure in many chronical ... Full text Link to item Cite

Expectations and outcomes of gastric feeding tubes.

Conference JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2004 Link to item Cite

Health-related quality of life of persons with sarcoidosis.

Journal Article Chest · March 2004 STUDY OBJECTIVES: To describe the health-related quality of life (HRQL) and mental health of persons with sarcoidosis, as well as to assess physician-patient agreement about the presence of sarcoidosis symptoms. DESIGN AND SETTING: Cross-sectional study at ... Full text Link to item Cite

Cost-effectiveness of ultrasound in preventing femoral venous catheter-associated pulmonary embolism.

Journal Article Am J Respir Crit Care Med · December 15, 2003 Featured Publication Femoral central venous catheter use is complicated by a high risk of deep venous thrombosis despite antithrombotic prophylaxis. Although some have recommended screening for femoral catheter-associated thrombosis to prevent pulmonary embolism (PE), this str ... Full text Link to item Cite

Evidence-based medical education: caution.

Journal Article Am J Respir Crit Care Med · September 15, 2003 Full text Link to item Cite

Evidence-based medical education: Caution

Journal Article AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · September 15, 2003 Link to item Cite

The Sarcoidosis Health Questionnaire: a new measure of health-related quality of life.

Journal Article Am J Respir Crit Care Med · August 1, 2003 The Sarcoidosis Health Questionnaire (SHQ) is a health-related quality-of-life (HRQL) instrument we designed in a two-part study to allow patients to describe their satisfaction with life as it is affected by sarcoidosis. In the Development Study, we creat ... Full text Link to item Cite

Effectiveness of medical resident education in mechanical ventilation.

Journal Article Am J Respir Crit Care Med · January 1, 2003 Specific methods of mechanical ventilation management reduce mortality and lower health care costs. However, in the face of a predicted deficit of intensivists, it is unclear whether residency programs are training internists to provide effective care for ... Full text Link to item Cite

Laboratory process improvement through point-of-care testing.

Journal Article Jt Comm J Qual Improv · July 1997 BACKGROUND: In the 1992-1996 period Methodist Clinical Laboratory Services of the Methodist Health Group, Indianapolis, was restructuring all work processes. In one initiative, point-of-care testing (POCT) was used to optimize the decision cycle time while ... Full text Link to item Cite