Eugene Zaverio Oddone

Journal Article Mil Med · July 22, 2023 INTRODUCTION: Peer support is a well-established part of veteran care and a cost-effective way to support individuals pursuing health behavior change. Common models of peer support, peer coaching, and mutual peer support have limitations that could be mini ... Full text Link to item Cite

Implementing evidence-based telephone coaching for health behavior program enrollment: A quality improvement project.

Journal Article Fam Syst Health · June 2023 INTRODUCTION: This program evaluation describes the use of implementation facilitation to support uptake of a telephone-based engagement coaching intervention, ACTIVATE, using paraprofessional staff, to support health behavior program enrollment. METHOD: T ... Full text Link to item Cite

Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE): A randomized trial to improve post myocardial infarction management.

Journal Article Patient Educ Couns · September 2022 OBJECTIVE: We evaluated the impact of a low intensity web-based and intensive nurse-administered intervention to reduce systolic blood pressure (SBP) among patients with prior MI. METHODS: Secondary Prevention Risk Interventions via Telemedicine and Tailor ... Full text Open Access Link to item Cite

Psychological distress among medically complex veterans with a recent emergency department visit.

Journal Article Psychol Serv · May 2022 Medical complexity and psychological distress are associated with frequent emergency department (ED) use. Despite this known association, our understanding is limited about which patients are at risk for persistent psychological distress and what patterns ... Full text Link to item Cite

Which patients benefit most from completing health risk assessments: comparing methods to identify heterogeneity of treatment effects

Journal Article Health Services and Outcomes Research Methodology · December 1, 2021 Methods for identifying heterogeneity of treatment effects in randomized trials have seen recent advances, yet applying these methods to health services intervention trials has not been well investigated. Our objective was to compare two approaches—predict ... Full text Cite

Patient experiences with a phone-based cardiovascular risk reduction intervention: Are there differences between women and men?

Journal Article Patient Educ Couns · November 2021 OBJECTIVES: To explore gender-based differences in experiences with a telehealth-delivered intervention for reduction of cardiovascular risk. METHODS: We conducted 23 semi-structured qualitative interviews by telephone with 11 women and 12 men who received ... Full text Open Access Link to item Cite

Video-Enhanced Care Management for Medically Complex Older Adults with Cognitive Impairment.

Journal Article J Am Geriatr Soc · January 2021 OBJECTIVE: This pilot study assessed feasibility of video-enhanced care management for complex older veterans with suspected mild cognitive impairment (CI) and their care partners, compared with telephone delivery. DESIGN: Pilot randomized controlled trial ... Full text Link to item Cite

Discrimination Experiences and Depressive Symptoms among African Americans with Osteoarthritis Enrolled in a Pain Coping Skills Training Randomized Controlled Trial.

Journal Article J Health Care Poor Underserved · 2021 African Americans are more likely than members of other racial groups to report perceived discrimination in health care settings, and discrimination is linked to depression. Using data from a randomized controlled trial of pain coping skills training (PCST ... Full text Link to item Cite

A data-driven examination of which patients follow trial protocol.

Journal Article Contemp Clin Trials Commun · September 2020 UNLABELLED: Protocol adherence in behavioral intervention clinical trials is critical to trial success. There is increasing interest in understanding which patients are more likely to adhere to trial protocols. The objective of this study was to demonstrat ... Full text Link to item Cite

Acceptability of telephone-based pain coping skills training among African Americans with osteoarthritis enrolled in a randomized controlled trial: a mixed methods analysis.

Journal Article BMC Musculoskelet Disord · August 14, 2020 BACKGROUND: Osteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity. The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study examined a culturally enhanced Pa ... Full text Link to item Cite

Effect of Adding Telephone-Based Brief Coaching to an mHealth App (Stay Strong) for Promoting Physical Activity Among Veterans: Randomized Controlled Trial.

Journal Article J Med Internet Res · August 4, 2020 BACKGROUND: Though maintaining physical conditioning and a healthy weight are requirements of active military duty, many US veterans lose conditioning and rapidly gain weight after discharge from active duty service. Mobile health (mHealth) interventions u ... Full text Link to item Cite

Short-Term VA Health Care Expenditures Following a Health Risk Assessment and Coaching Trial.

Journal Article J Gen Intern Med · May 2020 BACKGROUND: Short-term health care costs following completion of health risk assessments and coaching programs in the VA have not been assessed. OBJECTIVE: To compare VA health care expenditures among veterans who participated in a behavioral intervention ... Full text Link to item Cite

Implementation of a group physical therapy program for Veterans with knee osteoarthritis.

Journal Article BMC Musculoskelet Disord · February 3, 2020 BACKGROUND: A previous randomized clinical trial found that a Group Physical Therapy (PT) program for knee osteoarthritis yielded similar improvements in pain and function compared with traditional individual PT. Based on these findings the Group PT progra ... Full text Open Access Link to item Cite

Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial.

Journal Article J Gen Intern Med · January 2020 BACKGROUND: Little research has been done on primary care-based models to improve health care use after an emergency department (ED) visit. OBJECTIVE: To examine the effectiveness of a primary care-based, nurse telephone support intervention for Veterans t ... Full text Link to item Cite

Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.

Journal Article J Gen Intern Med · October 2019 OBJECTIVE: To evaluate the effectiveness of Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES), a skills training program for caregivers of persons with functional or cognitive impairments. DESIGN: A two-arm RCT. SETTING: Single Veter ... Full text Link to item Cite

Composite measures of physical activity and pain associate better with functional assessments than pain alone in knee osteoarthritis.

Journal Article Clin Rheumatol · August 2019 INTRODUCTION: Recent research showed that physical activity (PA)-adjusted pain measures were more strongly associated with radiographic osteoarthritis (OA) severity than an unadjusted pain measure. This exploratory study examined whether PA-adjusted pain m ... Full text Link to item Cite

Pain coping skills training for African Americans with osteoarthritis: results of a randomized controlled trial.

Journal Article Pain · June 2019 African Americans bear a disproportionate burden of osteoarthritis (OA), but they have been underrepresented in trials of behavioral interventions for pain. This trial examined a culturally tailored pain coping skills training (CST) program, compared to a ... Full text Link to item Cite

Health Coaching Has Differential Effects on Veterans with Limited Health Literacy and Numeracy: a Secondary Analysis of ACTIVATE.

Journal Article J Gen Intern Med · April 2019 BACKGROUND: Health coaching is an effective behavior change strategy. Understanding if there is a differential impact of health coaching on patients with low health literacy has not been well investigated. OBJECTIVE: To determine whether a telephone coachi ... Full text Link to item Cite

Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.

Journal Article Health Sci Rep · March 2019 BACKGROUND AND AIMS: Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, ... Full text Open Access Link to item Cite

Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs.

Journal Article Med Care Res Rev · February 2019 This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how ... Full text Link to item Cite

Understanding the Effect of Adding Automated and Human Coaching to a Mobile Health Physical Activity App for Afghanistan and Iraq Veterans: Protocol for a Randomized Controlled Trial of the Stay Strong Intervention.

Journal Article JMIR Res Protoc · January 29, 2019 BACKGROUND: Although maintaining a healthy weight and physical conditioning are requirements of active military duty, many US veterans rapidly gain weight and lose conditioning when they separate from active-duty service. Mobile health (mHealth) interventi ... Full text Link to item Cite

Pain coping skills training for African Americans with osteoarthritis study: baseline participant characteristics and comparison to prior studies.

Journal Article BMC Musculoskelet Disord · September 19, 2018 BACKGROUND: The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA). This dis ... Full text Link to item Cite

A Coaching by Telephone Intervention on Engaging Patients to Address Modifiable Cardiovascular Risk Factors: a Randomized Controlled Trial.

Journal Article J Gen Intern Med · September 2018 BACKGROUND: A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. OBJECTIVE: To test whether telephone-based health coaching after completion of a co ... Full text Link to item Cite

The influence of oral statin medications on progression of glaucomatous visual field loss: A propensity score analysis.

Journal Article Ophthalmic Epidemiol · June 2018 PURPOSE: The purpose of this study was to examine the association between oral statin use and the progression of open angle glaucoma. METHODS: Medical records of 847 Veterans were reviewed to collect statin use history, record demographic and comorbid medi ... Full text Link to item Cite

Understanding women veterans' preferences for peer support interventions to promote heart healthy behaviors: A qualitative study.

Journal Article Prev Med Rep · June 2018 Peer support may be an effective strategy to improve heart healthy behaviors among populations who have a strong communal identity, such as women veterans. Women veterans are a particularly important group to target as they are the fastest growing sub-popu ... Full text Link to item Cite

Telemedicine cardiovascular risk reduction in veterans: The CITIES trial.

Journal Article Am Heart J · May 2018 BACKGROUND: Comprehensive programs addressing tailored patient self-management and pharmacotherapy may reduce barriers to cardiovascular disease (CVD) risk reduction. METHODS: This is a 2-arm (clinical pharmacist specialist-delivered, telehealth interventi ... Full text Open Access Link to item Cite

Cognitive Mediators of Change in Physical Functioning in Response to a Multifaceted Intervention for Managing Osteoarthritis.

Journal Article Int J Behav Med · April 2018 PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-effica ... Full text Link to item Cite

Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis.

Journal Article BMC Musculoskelet Disord · March 9, 2018 BACKGROUND: Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans wit ... Full text Open Access Link to item Cite

A feasibility study to develop and test a Spanish patient and provider intervention for managing osteoarthritis in Hispanic/Latino adults (PRIMO-Latino).

Journal Article Pilot Feasibility Stud · 2018 BACKGROUND: Arthritis affects approximately 50 million adults in the USA. Hispanics/Latinos have a higher prevalence of arthritis-attributed activity limitations primarily related to osteoarthritis (OA). Hispanic/Latinos are less likely to receive hip repl ... Full text Open Access Link to item Cite

Risk stratification for return emergency department visits among high-risk patients.

Journal Article Am J Manag Care · August 1, 2017 OBJECTIVES: To compare 2 methods of identifying patients at high-risk of repeat emergency department (ED) use: high Care Assessment Need (CAN) score (≥90), derived from a model using Veterans Health Administration (VHA) data, and "Super User" status, defin ... Link to item Cite

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease.

Journal Article J Womens Health (Larchmt) · July 2017 BACKGROUND: Compared with men, women have poorer lipid control. Although potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated (1) whether satisfac ... Full text Open Access Link to item Cite

Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation.

Journal Article Transl Behav Med · June 2017 The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC pr ... Full text Link to item Cite

A Coaching by Telephone Intervention for Veterans and Care Team Engagement (ACTIVATE): A study protocol for a Hybrid Type I effectiveness-implementation randomized controlled trial.

Journal Article Contemp Clin Trials · April 2017 INTRODUCTION: A large proportion of deaths and many illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. Health risk assessments (HRAs) are widely available online but have not been consist ... Full text Link to item Cite

Linkage between theory-based measurement of organizational readiness for change and lessons learned conducting quality improvement-focused research.

Journal Article Learn Health Syst · April 2017 Organizations have different levels of readiness to implement change in the patient care process. The Hypertension Telemedicine Nurse Implementation Project for Veterans (HTN-IMPROVE) is an example of an innovation that seeks to enhance delivery of care fo ... Full text Open Access Link to item Cite

Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

Journal Article Ann Intern Med · March 21, 2017 BACKGROUND: A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. OBJECTIVE: To examine whether patient-based, prov ... Full text Open Access Link to item Cite

Characteristics and Health Care Preferences Associated with Cardiovascular Disease Risk among Women Veterans.

Journal Article Womens Health Issues · 2017 BACKGROUND: Women veterans are at increased risk for cardiovascular disease (CVD), but little is known about comorbidities and healthcare preferences associated with CVD risk in this population. METHODS: We describe the prevalence of CVD-relevant health be ... Full text Link to item Cite

Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial.

Journal Article BMC Musculoskelet Disord · August 23, 2016 BACKGROUND: African Americans bear a disproportionate burden of osteoarthritis (OA), with higher prevalence rates, more severe pain, and more functional limitations. One key barrier to addressing these disparities has been limited engagement of African Ame ... Full text Link to item Cite

Consideration of Out-of-Office Blood Pressure Monitoring in Hypertension Management.

Journal Article J Clin Hypertens (Greenwich) · May 2016 Full text Open Access Link to item Cite

Group Versus Individual Physical Therapy for Veterans With Knee Osteoarthritis: Randomized Clinical Trial.

Journal Article Phys Ther · May 2016 BACKGROUND: Efficient approaches are needed for delivering nonpharmacological interventions for management of knee osteoarthritis (OA). OBJECTIVE: This trial compared group-based versus individual physical therapy interventions for management of knee OA. D ... Full text Open Access Link to item Cite

Baseline Antihypertensive Drug Count and Patient Response to Hypertension Medication Management.

Journal Article J Clin Hypertens (Greenwich) · April 2016 Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To addr ... Full text Open Access Link to item Cite

A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial.

Journal Article Ann Intern Med · January 19, 2016 BACKGROUND: Management of osteoarthritis requires both medical and behavioral strategies, but some recommended therapies are underused. OBJECTIVE: To examine the effectiveness of a combined patient and provider intervention for improving osteoarthritis out ... Full text Open Access Link to item Cite

"To Improve Is to Change": Improving U.S. Healthcare.

Journal Article Am J Med Sci · January 2016 Full text Link to item Cite

Primary Care: Medicine's Gordian Knot.

Journal Article Am J Med Sci · January 2016 Primary care is the cornerstone of effective and efficient healthcare systems. Patients prefer a trusted primary care provider to serve as the first contact for all of their healthcare questions, to help them make important health decisions, to help guide ... Full text Link to item Cite

The association of comorbid conditions with patient-reported outcomes in Veterans with hip and knee osteoarthritis.

Conference Clin Rheumatol · August 2015 There is limited understanding of how comorbid health conditions affect osteoarthritis (OA)-related outcomes. This study examined associations of different comorbidity measures with baseline OA-related patient-reported outcomes (PROs) among patients with h ... Full text Link to item Cite

Effect of Allowing Choice of Diet on Weight Loss: A Randomized Trial.

Journal Article Ann Intern Med · June 16, 2015 BACKGROUND: Choosing a diet rather than being prescribed one could improve weight loss. OBJECTIVE: To examine whether offering choice of diet improves weight loss. DESIGN: Double-randomized preference trial of choice between 2 diets (choice) versus random ... Full text Link to item Cite

Patient-reported medication adherence barriers among patients with cardiovascular risk factors.

Journal Article J Manag Care Spec Pharm · June 2015 BACKGROUND: Many patients experience barriers that make it difficult to take cardiovascular disease (CVD)-related medications as prescribed. The Cardiovascular Intervention Improvement Telemedicine Study (CITIES) was a tailored behavioral pharmacist-admini ... Full text Open Access Link to item Cite

Reply: To PMID 24849310.

Journal Article Hepatology · May 2015 Full text Link to item Cite

Error in Figure

Journal Article JAMA Internal Medicine · March 1, 2015 Full text Cite

Shared medical appointments for patients with diabetes mellitus: a systematic review.

Journal Article J Gen Intern Med · January 2015 OBJECTIVES: Shared medical appointments (SMAs) are an increasingly used system-redesign strategy for improving access to and quality of chronic illness care. We conducted a systematic review of the existing literature on SMA interventions for patients with ... Full text Link to item Cite

Clinic variation in recruitment metrics, patient characteristics and treatment use in a randomized clinical trial of osteoarthritis management.

Journal Article BMC Musculoskelet Disord · December 6, 2014 BACKGROUND: The Patient and PRovider Interventions for Managing Osteoarthritis (OA) in Primary Care (PRIMO) study is one of the first health services trials targeting OA in a multi-site, primary care network. This multi-site approach is important for asses ... Full text Open Access Link to item Cite

Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: study design and methods.

Journal Article Contemp Clin Trials · November 2014 BACKGROUND: An explicit goal of Patient Aligned Care Teams (PACTs) within the Veterans Health Administration is to promote continuity of care in primary care clinics and thereby reduce Emergency Department (ED) utilization; however, there has been little r ... Full text Link to item Cite

Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES): study design and methodology.

Journal Article Contemp Clin Trials · July 2014 Within the Veterans Health Administration (VHA), the largest integrated health care system in the US, approximately 8.5 million Veteran patients receive informal care. Despite a need for training, half of VHA caregivers report that they have not received t ... Full text Link to item Cite

Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care?

Journal Article Circ Cardiovasc Qual Outcomes · March 2014 BACKGROUND: Hypertension self-management has been shown to improve systolic blood pressure (BP) control, but longer-term economic and clinical impacts are unknown. The purpose of this article is to examine clinical and economic outcomes 18 months after com ... Full text Open Access Link to item Cite

The Cardiovascular Intervention Improvement Telemedicine Study (CITIES): rationale for a tailored behavioral and educational pharmacist-administered intervention for achieving cardiovascular disease risk reduction.

Journal Article Telemed J E Health · February 2014 BACKGROUND: Hypertension, hyperlipidemia, and diabetes are significant, but often preventable, contributors to cardiovascular disease (CVD) risk. Medication and behavioral nonadherence are significant barriers to successful hypertension, hyperlidemia, and ... Full text Link to item Cite

Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.

Journal Article Res Gerontol Nurs · 2014 During hospitalization, older adults are at high risk for cascade iatrogenesis, the serial development of complications. In this retrospective, descriptive, case-control pilot study, 28 patients (cases) who developed respiratory failure after an elective s ... Full text Link to item Cite

Heart matters: Gender and racial differences cardiovascular disease risk factor control among veterans.

Journal Article Womens Health Issues · 2014 BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors ... Full text Open Access Link to item Cite

Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study.

Journal Article Implement Sci · September 8, 2013 BACKGROUND: Hypertension is prevalent and often sub-optimally controlled; however, interventions to improve blood pressure control have had limited success. OBJECTIVES: Through implementation of an evidence-based nurse-delivered self-management phone inter ... Full text Open Access Link to item Cite

Health services use of older veterans treated and released from veterans affairs medical center emergency departments.

Journal Article J Am Geriatr Soc · September 2013 OBJECTIVES: To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Medical Center (VAMC) EDs. PARTICIPANTS: Nationally re ... Full text Link to item Cite

Adverse impact of coercive treatments on psychiatric inpatients' satisfaction with care.

Journal Article Community Ment Health J · August 2013 Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient ca ... Full text Link to item Cite

Differences in osteoarthritis self-management support intervention outcomes according to race and health literacy.

Journal Article Health Educ Res · June 2013 We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effect ... Full text Open Access Link to item Cite

Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice.

Journal Article Contemp Clin Trials · May 2013 A variety of diet approaches achieve moderate weight loss in many individuals. Yet, most diet interventions fail to achieve meaningful weight loss in more than a few individuals, likely due to inadequate adherence to the diet. It is widely conjectured that ... Full text Link to item Cite

The composition of intern work while on call.

Journal Article J Gen Intern Med · April 2013 Full text Link to item Cite

Telemedicine cardiovascular risk reduction in veterans.

Journal Article Am Heart J · April 2013 BACKGROUND: Patients with co-occurrence of hypertension, hyperlipidemia, and diabetes have an increased risk of cardiovascular disease (CVD) events. Comprehensive programs addressing both tailored patient self-management and pharmacotherapy are needed to a ... Full text Open Access Link to item Cite

Group physical therapy for veterans with knee osteoarthritis: study design and methodology.

Journal Article Contemp Clin Trials · March 2013 Physical therapy (PT) is a key component of treatment for knee osteoarthritis (OA) and can decrease pain and improve function. Given the expected rise in prevalence of knee OA and the associated demand for treatment, there is a need for models of care that ... Full text Open Access Link to item Cite

Hospital readmission rates: are we measuring the right thing?

Journal Article Ann Intern Med · December 18, 2012 Full text Link to item Cite

Racial differences in the effect of a telephone-delivered hypertension disease management program.

Journal Article J Gen Intern Med · December 2012 BACKGROUND: African Americans are significantly more likely than whites to have uncontrolled hypertension, contributing to significant disparities in cardiovascular disease and events. OBJECTIVE: The goal of this study was to examine whether there were dif ... Full text Open Access Link to item Cite

Older veterans and emergency department discharge information.

Journal Article BMJ Qual Saf · October 2012 BACKGROUND: Study goals were to assess older veterans' understanding of their emergency department (ED) discharge information and to determine the association between understanding discharge information and patient assessment of overall quality of care. ME ... Full text Link to item Cite

Economic evaluation of telephone self-management interventions for blood pressure control.

Journal Article Am Heart J · June 2012 BACKGROUND: Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs ... Full text Open Access Link to item Cite

Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.

Journal Article BMC Musculoskelet Disord · April 24, 2012 BACKGROUND: Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some ... Full text Open Access Link to item Cite

Participant evaluation of a telephone-based osteoarthritis self-management program, 2006-2009.

Journal Article Prev Chronic Dis · 2012 INTRODUCTION: Self-management support interventions can help improve osteoarthritis outcomes but are underused. Little is known about how participants evaluate the helpfulness of these programs. We describe participants' evaluations of a telephone-based, o ... Open Access Link to item Cite

A high-density genome-wide association screen of sporadic ALS in US veterans.

Journal Article PLoS One · 2012 Following reports of an increased incidence of amyotrophic lateral sclerosis (ALS) in U.S. veterans, we have conducted a high-density genome-wide association study (GWAS) of ALS outcome and survival time in a sample of U.S. veterans. We tested ∼1.3 million ... Full text Link to item Cite

Measuring blood pressure for decision making and quality reporting.

Journal Article Ann Intern Med · October 18, 2011 Full text Open Access Link to item Cite

Treatment intensification in a hypertension telemanagement trial: clinical inertia or good clinical judgment?

Journal Article Hypertension · October 2011 Clinical inertia represents a barrier to hypertension management. As part of a hypertension telemanagement trial designed to overcome clinical inertia, we evaluated study physician reactions to elevated home blood pressures. We studied 296 patients from th ... Full text Open Access Link to item Cite

Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.

Journal Article Arch Intern Med · July 11, 2011 BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible ... Full text Open Access Link to item Cite

The trials and tribulations of enrolling couples in a randomized, controlled trial: a self-management program for hyperlipidemia as a model.

Journal Article Patient Educ Couns · July 2011 OBJECTIVE: Capitalizing on spousal support may enhance the effectiveness of interventions for chronic disease management. However, couples-based interventions present logistical challenges. We describe our experience and lessons learned while recruiting co ... Full text Open Access Link to item Cite

Measuring blood pressure for decision making and quality reporting: where and how many measures?

Journal Article Ann Intern Med · June 21, 2011 BACKGROUND: The optimal setting and number of blood pressure (BP) measurements that should be used for clinical decision making and quality reporting are uncertain. OBJECTIVE: To compare strategies for home or clinic BP measurement and their effect on clas ... Full text Open Access Link to item Cite

Emergency department visits in veterans affairs medical facilities

Journal Article American Journal of Managed Care · June 1, 2011 Objective: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-and-release ED visit in patients from Veterans Affairs Medical Centers (VAMCs). Study Design: Retrospective cohort ... Cite

Racial differences in two self-management hypertension interventions.

Journal Article Am J Med · May 2011 BACKGROUND: Only one half of Americans have their blood pressure controlled, and there are significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of 2 patient-directed interventions designed to imp ... Full text Open Access Link to item Cite

The effectiveness of personalized coronary heart disease and stroke risk communication.

Journal Article Am Heart J · April 2011 BACKGROUND: Current guidelines recommend global risk assessment to guide vascular risk factor management; however, most provider-patient communication focuses on individual risk factors in isolation. We sought to evaluate the impact of personalized coronar ... Full text Open Access Link to item Cite

Older patients' understanding of emergency department discharge information and its relationship with adverse outcomes.

Journal Article J Patient Saf · March 2011 OBJECTIVES: To describe older patients' understanding of emergency department (ED) discharge information and to explore the relationship between understanding of ED discharge information and adverse outcomes. METHODS: Telephone interviews were conducted wi ... Full text Link to item Cite

Secondary prevention risk interventions via telemedicine and tailored patient education (SPRITE): a randomized trial to improve postmyocardial infarction management.

Journal Article Circ Cardiovasc Qual Outcomes · March 2011 BACKGROUND: Secondary prevention by risk factor modification improves patient outcomes, yet it is often not achieved in clinical practice. Reasons for failure stem from challenges of prioritizing risk factor reduction and engaging patients in changing thei ... Full text Open Access Link to item Cite

Telephone-based self-management of osteoarthritis: A randomized trial.

Journal Article Ann Intern Med · November 2, 2010 BACKGROUND: Osteoarthritis is a leading cause of pain and disability, and self-management behaviors for osteoarthritis are underutilized. OBJECTIVE: To examine the effectiveness of a telephone-based self-management intervention for hip or knee osteoarthrit ... Full text Open Access Link to item Cite

Patient self-management support: novel strategies in hypertension and heart disease.

Journal Article Cardiol Clin · November 2010 Cardiovascular diseases (CVDs) have become the leading cause of death and disability in most countries in the world. This article addresses how patient self-management is a crucial component of effective high-quality health care for hypertension and CVD. T ... Full text Link to item Cite

Obesity and receipt of clinical preventive services in veterans.

Journal Article Obesity (Silver Spring) · September 2010 Although obese individuals utilize health care at higher rates than their normal weight counterparts, they may be less likely to receive certain preventive services. We conducted a retrospective cohort study of veterans with visits to 136 national Veterans ... Full text Link to item Cite

Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients.

Journal Article Am Heart J · August 2010 BACKGROUND: Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. ... Full text Open Access Link to item Cite

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295).

Journal Article Implement Sci · July 16, 2010 BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implemen ... Full text Open Access Link to item Cite

Do diabetic veterans use the Internet? Self-reported usage, skills, and interest in using My HealtheVet Web portal.

Journal Article Telemed J E Health · June 2010 OBJECTIVE: The Veterans Health Administration has developed My HealtheVet (MHV), a Web-based portal that links veterans to their care in the veteran affairs (VA) system. The objective of this study was to measure diabetic veterans' access to and use of the ... Full text Open Access Link to item Cite

Association between blood lead and the risk of amyotrophic lateral sclerosis.

Journal Article Am J Epidemiol · May 15, 2010 The authors conducted a 2003-2007 case-control study including 184 cases and 194 controls to examine the association between blood lead and the risk of amyotrophic lateral sclerosis (ALS) among US veterans and to explore the influence on this association o ... Full text Link to item Cite

Association of ALS with head injury, cigarette smoking and APOE genotypes.

Journal Article J Neurol Sci · April 15, 2010 OBJECTIVE: An increased risk of ALS has been reported for US veterans, but the cause is unknown. Since head injury and cigarette smoking are two previously implicated environmental risk factors that are more common in military than civilian study populatio ... Full text Link to item Cite

Informal and formal care infrastructure and perceived need for caregiver training for frail US veterans referred to home and community-based services.

Journal Article Chronic Illn · March 2010 OBJECTIVES: To describe the informal care network of US veterans referred to home and community-based services (Homemaker Home Health services, H/HHA, or Home-Based Primary Care, HBPC) at the Durham Veterans Affairs Medical Center (VAMC), including: quanti ... Full text Link to item Cite

Economic evaluation of home blood pressure monitoring with or without telephonic behavioral self-management in patients with hypertension.

Journal Article Am J Hypertens · February 2010 BACKGROUND: The Take Control of Your Blood Pressure trial evaluated the effect of a multicomponent telephonic behavioral lifestyle intervention, patient self-monitoring, and both interventions combined compared with usual care on reducing systolic blood pr ... Full text Link to item Cite

Racial differences in osteoarthritis pain and function: potential explanatory factors.

Journal Article Osteoarthritis Cartilage · February 2010 OBJECTIVE: This study examined factors underlying racial differences in pain and function among patients with hip and/or knee osteoarthritis (OA). METHODS: Participants were n=491 African Americans and Caucasians enrolled in a clinical trial of telephone-b ... Full text Link to item Cite

A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.

Journal Article Arch Intern Med · January 25, 2010 BACKGROUND: Two potent weight loss therapies, a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O + LFD), are available to the public but, to our knowledge, have never been compared. METHODS: Overweight or obese o ... Full text Link to item Cite

Time to diagnosis in the National Registry of Veterans with Amyotrophic Lateral Sclerosis.

Journal Article Amyotroph Lateral Scler · 2010 Our objective was to determine the interval from symptom onset to diagnosis, and to evaluate associated factors in a cohort of U.S. Veterans with motor neuron diseases. We retrospectively evaluated 1359 patients enrolled in the National Registry of Veteran ... Full text Link to item Cite

Two self-management interventions to improve hypertension control: a randomized trial.

Journal Article Ann Intern Med · November 17, 2009 BACKGROUND: Fewer than 40% of persons with hypertension in the United States have adequate blood pressure (BP) control. OBJECTIVE: To compare 2 self-management interventions for improving BP control among hypertensive patients. DESIGN: A 2 x 2 randomized t ... Full text Link to item Cite

Cascade iatrogenesis: factors leading to the development of adverse events in hospitalized older adults.

Journal Article Int J Nurs Stud · November 2009 Older adults are at particular risk for injuries associated with hospitalization and the rate of adverse events increases significantly with age. The purpose of this paper is to review factors associated with the development of adverse events in hospitaliz ... Full text Link to item Cite

The Cholesterol, Hypertension, and Glucose Education (CHANGE) study for African Americans with diabetes: study design and methodology.

Journal Article Am Heart J · September 2009 BACKGROUND: Cardiovascular disease (CVD) and diabetes account for over one third of the mortality difference between African Americans and white patients. The increased CVD risk in African Americans is due in large part to the clustering of multiple CVD ri ... Full text Link to item Cite

Comparison of medicine resident diabetes care between Veterans Affairs and academic health care systems.

Journal Article J Gen Intern Med · August 2009 BACKGROUND: Although others have reported national disparities in the quality of diabetes care between the Veterans Affairs (VA) and private health care delivery systems, it is not known whether these differences persist among internal medicine resident pr ... Full text Link to item Cite

The effect of a hypertension self-management intervention on diabetes and cholesterol control.

Journal Article Am J Med · July 2009 BACKGROUND: Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-dens ... Full text Link to item Cite

A two-stage genome-wide association study of sporadic amyotrophic lateral sclerosis.

Journal Article Hum Mol Genet · April 15, 2009 The cause of sporadic amyotrophic lateral sclerosis (ALS) is largely unknown, but genetic factors are thought to play a significant role in determining susceptibility to motor neuron degeneration. To identify genetic variants altering risk of ALS, we under ... Full text Link to item Cite

Correlation between symptoms and function in older adults with comorbidity.

Journal Article J Am Geriatr Soc · April 2009 OBJECTIVES: To describe the relationship between symptom scores and mobility function measures, assess whether symptom scores and disease scores are similarly associated with mobility function, and identify clusters of symptoms that are most strongly assoc ... Full text Link to item Cite

Patient education and provider decision support to control blood pressure in primary care: a cluster randomized trial.

Journal Article Am Heart J · March 2009 BACKGROUND: Less than one third of the 65 million Americans with hypertension have adequate blood pressure (BP) control. This study examined the effectiveness of 2 interventions for improving patient BP control. METHODS: This was a 2-level (primary care pr ... Full text Link to item Cite

Study protocol: Couples Partnering for Lipid Enhancing Strategies (CouPLES) - a randomized, controlled trial.

Journal Article Trials · February 6, 2009 BACKGROUND: Almost 50% of Americans have elevated low-density lipoprotein cholesterol (LDL-C). The behaviors required to lower LDL-C levels may be difficult to adhere to if they are inconsistent with spouses' health practices, and, alternatively, may be en ... Full text Link to item Cite

Clinical aspects of ALS in Gulf War veterans.

Journal Article Amyotroph Lateral Scler · February 2009 The increased incidence of ALS in military veterans of the first Persian Gulf War raised speculation that they may have a 'Persian Gulf' variant of ALS with atypical clinical features. Medical records of military veterans with ALS, previously identified in ... Full text Link to item Cite

Feasibility of blood pressure telemonitoring in patients with poor blood pressure control.

Journal Article J Telemed Telecare · 2009 We examined the feasibility of using home blood pressure (BP) telemonitoring devices for managing patients with poor BP control. We enrolled 591 subjects with a diagnosis of hypertension. Patients were randomized to usual care (n = 147) or to the intervent ... Full text Link to item Cite

Factors associated with survival in the National Registry of Veterans with ALS.

Journal Article Amyotroph Lateral Scler · 2009 The clinical course of patients with ALS is highly variable. While the median survival time from symptom onset is 2-4 years, there are reports of survival ranging from less than a year to more than 40 years. Such variability makes planning difficult for pa ... Full text Link to item Cite

Strategies for analyzing multilevel cluster-randomized studies with binary outcomes collected at varying intervals of time.

Journal Article Stat Med · December 20, 2008 Frequently, studies are conducted in a real clinic setting. When the outcome of interest is collected longitudinally over a specified period of time, this design can lead to unequally spaced intervals and varying numbers of assessments. In our study, these ... Full text Link to item Cite

Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study.

Journal Article BMC Health Serv Res · October 23, 2008 BACKGROUND: Limited literacy is common among patients with chronic conditions and is associated with poor health outcomes. We sought to determine the association between literacy and blood pressure in primary care patients with hypertension and to determin ... Full text Link to item Cite

Patient and social environment factors associated with self blood pressure monitoring by male veterans with hypertension.

Journal Article J Clin Hypertens (Greenwich) · September 2008 Self blood pressure monitoring (SBPM) can facilitate hypertension management, but determinants of SBPM are understudied. The authors examined the relationship of patient and social environment characteristics to monitor possession and frequency of SBPM in ... Full text Link to item Cite

Frequency and predictors of adverse health outcomes in older Medicare beneficiaries discharged from the emergency department.

Journal Article Med Care · August 2008 BACKGROUND: Older adults who are discharged from the emergency department (ED) may be at risk for subsequent adverse outcomes; however, this has not been fully investigated in national, population-based samples. The goal of this study was to determine the ... Full text Link to item Cite

The Self-Management of OsteoArthritis in Veterans (SeMOA) Study: design and methodology.

Journal Article Contemp Clin Trials · July 2008 BACKGROUND: Osteoarthritis (OA) is a leading cause of disability among adults. Although self-management behaviors such as exercise and weight management can improve pain and function, these behaviors are vastly underutilized. There is a need to implement e ... Full text Link to item Cite

Racial differences in blood pressure control: potential explanatory factors.

Journal Article J Gen Intern Med · May 2008 OBJECTIVE: The objective of the study was to identify potential explanatory factors for racial differences in blood pressure (BP) control. DESIGN: The design of the study was a cross-sectional study PATIENTS/PARTICIPANTS: The study included 608 patients wi ... Full text Link to item Cite

Quality of pharmacotherapy and outcomes for older veterans discharged from the emergency department.

Journal Article J Am Geriatr Soc · May 2008 OBJECTIVES: To determine whether suboptimal pharmacotherapy increases the risk of adverse outcomes in older adults discharged from the emergency department (ED). DESIGN: Retrospective, cohort study. SETTING: Academically affiliated Veterans Affairs Medical ... Full text Link to item Cite

Perceived and actual stroke risk among men with hypertension.

Journal Article J Clin Hypertens (Greenwich) · April 2008 The purposes of this study were to determine whether there is a significant correlation between the perceived and actual stroke risk among hypertensive patients and to identify patient characteristics associated with inaccurate estimation of stroke risk. T ... Full text Link to item Cite

Take Control of Your Blood Pressure (TCYB) study: a multifactorial tailored behavioral and educational intervention for achieving blood pressure control.

Journal Article Patient Educ Couns · March 2008 OBJECTIVE: Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control. METHODS: Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nu ... Full text Link to item Cite

Selective adherence to antihypertensive medications as a patient-driven means to preserving sexual potency.

Journal Article Patient Prefer Adherence · February 2, 2008 OBJECTIVE: To describe hypertensive patients' experiences with sexual side effects and their consequences for antihypertensive medication adherence. METHODS: Data were from a study conducted to identify facilitators of and barriers to adherence to blood pr ... Full text Link to item Cite

Amyotrophic lateral sclerosis among 1991 Gulf War veterans: evidence for a time-limited outbreak.

Journal Article Neuroepidemiology · 2008 BACKGROUND: In follow-up to recent reports of an elevated risk of amyotrophic lateral sclerosis (ALS) among 1991 Gulf War veterans, we analyzed the distribution of disease onset times to determine whether the excess risk was time limited. METHODS: This sec ... Full text Link to item Cite

Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis: the GENEVA study. Rationale, study design and demographic characteristics.

Journal Article Neuroepidemiology · 2008 Recent reports of a potentially increased risk of amyotrophic lateral sclerosis (ALS) for veterans deployed to the 1990-1991 Persian Gulf War prompted the Department of Veterans Affairs to establish a National Registry of Veterans with ALS, charged with th ... Full text Link to item Cite

The National Registry of Veterans with amyotrophic lateral sclerosis.

Journal Article Neuroepidemiology · 2008 BACKGROUND: The Department of Veterans Affairs (VA) Cooperative Studies Program has established a National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS). This article describes the objectives, methods, and sample involved in the registry. M ... Full text Link to item Cite

Veterans Affairs Research and Development: using science to improve health care for veterans.

Journal Article N C Med J · 2008 VA has a rich tradition in supporting research in areas that span basic science to health system implementation. Its unique success is tied to the fact that researchers are focused on issues that arise from a unique population--our nation's veterans. Moreo ... Link to item Cite

Adverse health outcomes after discharge from the emergency department--incidence and risk factors in a veteran population.

Journal Article J Gen Intern Med · November 2007 BACKGROUND: An Emergency Department (ED) visit represents a time of significant risk for an older adult; however, little is known about adverse outcomes after an ED visit in the VA system. OBJECTIVES: 1) To describe the frequency and type of adverse health ... Full text Link to item Cite

The quality of pharmacotherapy in older veterans discharged from the emergency department or urgent care clinic.

Journal Article J Am Geriatr Soc · September 2007 OBJECTIVES: To determine the prevalence and type of suboptimal pharmacotherapy that older veterans discharged from the emergency department (ED) or urgent care clinic (UCC) receive and to examine factors associated with suboptimal pharmacotherapy in this p ... Full text Link to item Cite

Characteristics associated with participation in DNA banking: The National Registry of Veterans with ALS.

Journal Article Contemp Clin Trials · September 2007 Featured Publication OBJECTIVE: Characteristics that may influence participation in DNA banks are not well defined. The purpose of this study was to examine characteristics associated with participation in a DNA bank among veterans diagnosed with Amyotrophic Lateral Sclerosis ... Full text Link to item Cite

Association of antihypertensive therapy and diastolic hypotension in chronic kidney disease.

Journal Article Hypertension · September 2007 The extent to which chronic kidney disease (CKD) affects achievement of blood pressure targets is not comprehensively understood. We evaluated the effects of CKD (estimated glomerular filtration rate: <60 mL/min per 1.73 m(2)) on achievement of blood press ... Full text Link to item Cite

How asymptomatic is asymptomatic carotid stenosis?

Journal Article Radiology · July 2007 Full text Link to item Cite

Hypertension Intervention Nurse Telemedicine Study (HINTS): testing a multifactorial tailored behavioral/educational and a medication management intervention for blood pressure control.

Journal Article Am Heart J · June 2007 Featured Publication BACKGROUND: Only 31% of Americans with hypertension have their blood pressure (BP) under effective control. We describe a study that tests 3 different interventions in a randomized controlled trial using home BP telemedicine monitoring. METHODS: A sample o ... Full text Link to item Cite

Does participatory decision making improve hypertension self-care behaviors and outcomes?

Journal Article Journal of clinical hypertension (Greenwich, Conn.) · May 2007 This study examined patients' perceptions of their providers' participatory decision making (PDM) style and hypertension self-care behaviors and outcomes. Five hundred fifty-four veterans with hypertension enrolled in the Veterans' Study to Improve the Con ... Full text Cite

Association of intradialytic blood pressure changes with hospitalization and mortality rates in prevalent ESRD patients.

Journal Article Kidney Int · March 2007 Featured Publication The relationship between blood pressure (BP) and clinical outcomes among hemodialysis patients is complex and incompletely understood. This study sought to assess the relationship between blood pressure changes with hemodialysis and clinical outcomes durin ... Full text Link to item Cite

Satisfaction and outcomes of depressed older adults with psychiatric clinical nurse specialists in primary care

Journal Article Journal of the American Psychiatric Nurses Association · February 1, 2007 Background: Recent models integrating depression care management into primary care have demonstrated improved clinical outcomes and patient satisfaction. To date, none have examined psychiatric-mental health clinical nurse specialists (PCNSs) as providers ... Full text Cite

Sydenham Society: racial variations in carotid endarterectomy.

Journal Article J Clin Epidemiol · February 2007 Full text Link to item Cite

Previous involuntary commitment is associated with current perceptions of coercion in voluntarily hospitalized patients

Journal Article International Journal of Forensic Mental Health · January 1, 2007 Involuntary psychiatric treatment is sometimes necessary and beneficial, but may also exert negative effects. The impact of involuntary commitment on subsequent mental health treatment experience is poorly understood. We examined whether history of involun ... Full text Cite

The Take Control of Your Blood pressure (TCYB) study: study design and methodology.

Journal Article Contemp Clin Trials · January 2007 Featured Publication BACKGROUND: Among the 65 million Americans with hypertension, only approximately 31% have their blood pressure under control (<140/90 mm/Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for blood pressur ... Full text Link to item Cite

The impact of health status on physicians' intentions to offer cancer screening to older women.

Journal Article J Gerontol A Biol Sci Med Sci · August 2006 BACKGROUND: Screening for breast and cervical cancer reduces disease-specific mortality, but high rates of comorbidity and disability among elderly persons may alter the risks and benefits of screening. METHODS: We performed a mail survey of primary care p ... Full text Link to item Cite

A multidimensional integrative medicine intervention to improve cardiovascular risk.

Journal Article J Gen Intern Med · July 2006 Featured Publication BACKGROUND: Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reductio ... Full text Link to item Cite

Exploring the generalist-subspecialist interface in internal medicine.

Journal Article Am J Med · June 2006 Full text Link to item Cite

Comorbid posttraumatic stress disorder is associated with suicidality in male veterans with schizophrenia or schizoaffective disorder.

Journal Article Schizophr Res · May 2006 The purpose of this study was to determine if patients with schizophrenia or schizoaffective disorders and comorbid posttraumatic stress disorder (PTSD) are at higher risk for suicidality than patients without comorbid PTSD. Participants were 165 male vete ... Full text Link to item Cite

Medication barriers and anti-hypertensive medication adherence: the moderating role of locus of control.

Journal Article Psychol Health Med · February 2006 Locus of control as a moderator of the relationship between medication barriers (e.g., side-effects, forgetting to take medication, and keeping track of pills) and anti-hypertensive medication adherence was examined. Baseline data were obtained from 588 hy ... Full text Link to item Cite

Racial differences in blood pressure control: potential explanatory factors.

Journal Article Am J Med · January 2006 Featured Publication PURPOSE: Poor blood pressure control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among African Americans. We explored antihypertensive medication adherence and other factors that may explain ... Full text Link to item Cite

Racial differences in health concern.

Journal Article J Natl Med Assoc · January 2006 Featured Publication An understanding of racial differences in risk-related affect may help explain racial differences in health behaviors and outcomes and provide additional opportunities for intervention. In phone interviews with a random community sample of 197 whites, 155 ... Link to item Cite

Identifying barriers to hypertension guideline adherence using clinician feedback at the point of care.

Journal Article AMIA Annu Symp Proc · 2006 Factors contributing to low adherence to clinical guidelines by clinicians are not well understood. The user interface of ATHENA-HTN, a guideline-based decision support system (DSS) for hypertension, presents a novel opportunity to collect clinician feedba ... Link to item Cite

Effect of an opioid management system on opioid prescribing and unscheduled visits in a large primary care clinic

Journal Article Journal of Clinical Outcomes Management · December 1, 2005 • Objective: To measure the effect of an explicit pain management program on unscheduled patient visits, prescribing behavior, and opioid use. • Design: Retrospective cohort study. • Setting: General medicine practice of a university-affiliated Veterans Af ... Cite

Subjective and objective evaluations of health among middle-aged and older veterans with hypertension.

Journal Article J Aging Health · October 2005 OBJECTIVE: The congruence between self-rated health and objective health was examined for associations with health factors related to hypertension (health behaviors, medication barriers, and perceived blood-pressure control). METHODS: The Charlson Comorbid ... Full text Link to item Cite

New technologies and their influence on existing interventions

Chapter · August 21, 2005 Full text Cite

Conclusion

Chapter · August 21, 2005 Full text Cite

Improving adherence with clinical guidelines

Journal Article · August 21, 2005 Full text Cite

Perceived discrimination and reported delay of pharmacy prescriptions and medical tests.

Journal Article J Gen Intern Med · July 2005 Featured Publication BACKGROUND: Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE: Determine whether perceptions of unfair treatment because of race or ethnicity a ... Full text Link to item Cite

How well do clinic-based blood pressure measurements agree with the mercury standard?

Journal Article J Gen Intern Med · July 2005 Featured Publication BACKGROUND: Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP ... Full text Link to item Cite

Variations in coronary procedure utilization depending on body mass index.

Journal Article Arch Intern Med · June 27, 2005 Featured Publication BACKGROUND: Increased body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) is a risk factor for coronary heart disease and is associated with lower preventive services utilization. The relationship between BMI ... Full text Link to item Cite

Patient satisfaction and use of Veterans Affairs versus non-Veterans Affairs healthcare services by veterans.

Journal Article Med Care · May 2005 Featured Publication OBJECTIVES: Chronically ill patients who are not satisfied with their care may change healthcare providers or systems, which could disrupt continuity of care and impede management of their conditions. We examined whether patient satisfaction affected subse ... Full text Link to item Cite

Improving blood pressure control by tailored feedback to patients and clinicians.

Journal Article Am Heart J · May 2005 Featured Publication Full text Link to item Cite

Nurse administered telephone intervention for blood pressure control: a patient-tailored multifactorial intervention.

Journal Article Patient Educ Couns · April 2005 Featured Publication OBJECTIVES: A randomized controlled trial involving a nurse administered patient-tailored intervention is being conducted to improve blood pressure (BP) control. METHODS: Veterans with hypertension from an outpatient primary care clinic completed a baselin ... Full text Link to item Cite

The veterans' study to improve the control of hypertension (V-STITCH): design and methodology.

Journal Article Contemp Clin Trials · April 2005 Featured Publication BACKGROUND: Among the 60 million Americans with hypertension, only approximately 31% have their blood pressure (BP) under control (<140/90 mm Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for BP, inte ... Full text Link to item Cite

Overcoming clinical inertia: A visit-specific scale for measuring quality in hypertension care

Journal Article Journal of Clinical Outcomes Management · March 1, 2005 • Objective: To develop a valid, reproducible scale that quantifies a provider's reaction to uncontrolled blood pressure. • Design: Retrospective chart review. • Setting and participants: 70 patients with hypertension who were treated with antihypertensive ... Cite

Improving depression outcomes in older adults with comorbid medical illness.

Journal Article Gen Hosp Psychiatry · 2005 BACKGROUND: Depression is common in older adults and often coexists with multiple chronic diseases, which may complicate its diagnosis and treatment. OBJECTIVE: To determine whether or not the presence of multiple comorbid medical illnesses affects patient ... Full text Link to item Cite

Perceived racial/ethnic bias in healthcare in Durham County, North Carolina: a comparison of community and national samples.

Journal Article N C Med J · 2005 BACKGROUND: We sought to compare findings of a national survey of perceptions of racial/ethnic discrimination in healthcare to those of a community survey, with emphasis on the perceptions of Latinos. METHODS: Responses from a national survey were compared ... Link to item Cite

For the patient. Who trusts healthcare institutions? Results from a community-based sample.

Journal Article Ethn Dis · 2005 Featured Publication Link to item Cite

Intentional and unintentional nonadherence to antihypertensive medication.

Journal Article Ann Pharmacother · 2005 Featured Publication BACKGROUND: Hypertension is poorly controlled in the US due to medication nonadherence. Recent evidence suggests that nonadherence can be classified as intentional or unintentional and different patient characteristics, such as the experience of adverse ef ... Full text Link to item Cite

Who trusts healthcare institutions? Results from a community-based sample.

Journal Article Ethn Dis · 2005 Featured Publication OBJECTIVE: The goal of this research was to examine racial differences in trust in various healthcare institutions. METHOD: In telephone interviews, 195 Whites, 183 Blacks, and 171 Latinos from Durham, NC indicated how often they trust various institutions ... Link to item Cite

Utility of hemoglobin A1c in predicting diabetes risk.

Journal Article J Gen Intern Med · December 2004 Featured Publication BACKGROUND: There is controversy surrounding the issue of whether, and how, to screen adults for type 2 diabetes. Our objective was to measure the incidence of new diabetes among outpatients enrolled in a health care system, and to determine whether hemogl ... Full text Link to item Cite

Clinician awareness of adherence to hypertension guidelines.

Journal Article Am J Med · November 15, 2004 PURPOSE: Little is known about how well clinicians are aware of their own adherence to clinical guidelines, an important indicator of quality. We compared clinicians' beliefs about their adherence to hypertension guidelines with data on their actual perfor ... Full text Link to item Cite

The relationship between perceived barriers to healthcare and self-rated health

Journal Article Psychology, Health and Medicine · November 1, 2004 The main purpose of the current investigation is to examine the extent to which health care barriers are uniquely associated with individual differences in self-rated health. Self-rated health can be easily assessed and is predictive of mortality, health c ... Full text Cite

Racial/ethnic variations in non-steroidal anti-inflammatory drug (NSAID) use among patients with osteoarthritis.

Journal Article Pharmacoepidemiol Drug Saf · October 2004 Featured Publication PURPOSE: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed drugs for the treatment of osteoarthritis (OA). While there are documented racial differences in the use of opioid analgesics, little is known about racial differences ... Full text Link to item Cite

The National Registry of Veterans with Amyotrophic Lateral Sclerosis: Department of Veterans Affairs Cooperative Studies Program (CSP) #500a.

Journal Article Amyotroph Lateral Scler Other Motor Neuron Disord · September 2004 Featured Publication In response to concern about the development of ALS among veterans of the U.S. armed forces, particularly Gulf War veterans, the Department of Veterans Affairs established a national registry of veterans with ALS. This Registry will identify living veteran ... Full text Link to item Cite

Enrollment in clinical trials according to patients race: experience from the VA Cooperative Studies Program (1975-2000).

Journal Article Control Clin Trials · August 2004 Featured Publication BACKGROUND: Racial distribution of clinical trial participants is important because results from these studies serve to define evidence-based practice. This report summarizes the experience of the VA Cooperative Studies Program (CSP) in enrolling white, bl ... Full text Link to item Cite

Telemedicine and hypertension

Journal Article Journal of Clinical Outcomes Management · August 1, 2004 • Objective: To review telemedicine approaches for management of hypertension. • Methods: Review of studies that illustrate the use of telemedicine in hypertension and discussion of an ongoing clinical trial, the Take Control of Your Blood Pressure study, ... Cite

Patient risk perceptions for carotid endarterectomy: which patients are strongly averse to surgery?

Journal Article J Vasc Surg · July 2004 Featured Publication BACKGROUND AND PURPOSE: Patient risk perception for surgery may be central to their willingness to undergo surgery. This study examined potential factors associated with patient aversion of surgery. METHODS: This is a secondary data analysis of a prospecti ... Full text Link to item Cite

Technologies for receiving test results in primary care practices and the impact of managed care

Journal Article Journal of Clinical Outcomes Management · April 1, 2004 • Objective: To assess the availability and use of technologies that facilitate the receipt of diagnostic test results in primary care offices, physicians' perceptions of delays in receiving results, and the effect of managed care market penetration on the ... Cite

Evaluating provider adherence in a trial of a guideline-based decision support system for hypertension.

Journal Article Studies in health technology and informatics · January 2004 Measurement of provider adherence to a guideline-based decision support system (DSS) presents a number of important challenges. Establishing a causal relationship between the DSS and change in concordance requires consideration of both the primary intentio ... Cite

Who doesn't receive carotid endarterectomy when appropriate?

Journal Article J Vasc Surg · January 2004 Featured Publication OBJECTIVE: The purpose of this study was to identify clinical and nonclinical factors associated with failure to perform carotid endarterectomy (CEA) in patients with clinically appropriate indications. We analyzed data from a prospective cohort study perf ... Full text Link to item Cite

Patient and clinician satisfaction with a store-and-forward teledermatology consult system.

Journal Article Telemed J E Health · 2004 Featured Publication The aim of this study was to assess satisfaction with and acceptance of a store and forward teledermatology consult system among patients, referring primary-care clinicians, and consultant dermatologists. As part of a randomized clinical trial that compare ... Full text Link to item Cite

Congestive heart failure patients' perceptions of quality of life: the integration of physical and psychosocial factors.

Journal Article Aging Ment Health · January 2004 Featured Publication Congestive heart failure (CHF) lowers survival and worsens the quality of life (QOL) of over four million older Americans. Both clinicians and standardized instruments used to assess the QOL of patients with CHF focus primarily on physical symptoms rather ... Full text Link to item Cite

Evaluating provider adherence in a trial of a guideline-based decision support system for hypertension.

Journal Article Stud Health Technol Inform · 2004 Measurement of provider adherence to a guideline-based decision support system (DSS) presents a number of important challenges. Establishing a causal relationship between the DSS and change in concordance requires consideration of both the primary intentio ... Link to item Cite

Nonsteroidal antiinflammatory drug use among patients with GI bleeding.

Journal Article Ann Pharmacother · 2004 Featured Publication BACKGROUND: Previous studies have suggested that recommended gastroprotective strategies such as gastroprotective agents (GPAs) and cyclooxygenase (COX) 2 inhibitors may be underutilized among individuals at risk for nonsteroidal antiinflammatory drug (NSA ... Full text Link to item Cite

Translating research into practice: organizational issues in implementing automated decision support for hypertension in three medical centers.

Journal Article J Am Med Inform Assoc · 2004 Information technology can support the implementation of clinical research findings in practice settings. Technology can address the quality gap in health care by providing automated decision support to clinicians that integrates guideline knowledge with e ... Full text Link to item Cite

Cancer in the elderly: to screen or not to screen?

Journal Article J Am Geriatr Soc · December 2003 Full text Link to item Cite

Racial differences in health care utilization among patients with osteoarthritis.

Journal Article J Rheumatol · October 2003 Featured Publication OBJECTIVE: Research has identified racial variations in certain aspects of osteoarthritis (OA) related medical care. We compared health services utilization between African American and white veteran outpatients with OA. METHODS: Subjects were 1612 white a ... Link to item Cite

Clinical identifiers of complicated Staphylococcus aureus bacteremia.

Journal Article Arch Intern Med · September 22, 2003 Featured Publication BACKGROUND: Complications of Staphylococcus aureus bacteremia (SAB) are often difficult to identify. The ability to accurately predict the likelihood of these complications would impact patient management. This investigation sought to define readily availa ... Full text Link to item Cite

Staphylococcus aureus bacteremia after median sternotomy: clinical utility of blood culture results in the identification of postoperative mediastinitis.

Journal Article Circulation · July 8, 2003 Featured Publication BACKGROUND: Mediastinitis is a complication of coronary artery bypass graft surgery (CABG) that can be difficult to diagnose. This study evaluated the utility of blood culture results in identifying patients with mediastinitis. METHODS AND RESULTS: All uni ... Full text Link to item Cite

Healthcare access and utilization by patients infected with human immunodeficiency virus: does gender matter?

Journal Article J Womens Health (Larchmt) · May 2003 OBJECTIVE: To examine access to and utilization of primary healthcare services with respect to gender. Greater family and child-rearing responsibilities are possible barriers to healthcare access and utilization for women with HIV infection. METHODS: This ... Full text Link to item Cite

Is specialty care associated with improved survival of patients with congestive heart failure?

Journal Article Am Heart J · February 2003 Featured Publication BACKGROUND: Implementation of the complex treatment strategies that have been shown to improve survival of patients with congestive heart failure (CHF) may require certain expertise. We wanted to examine the association between pattern of outpatient care a ... Full text Link to item Cite

Quality of care for patients diagnosed with diabetes at screening.

Journal Article Diabetes Care · February 2003 Featured Publication OBJECTIVE: Screening for diabetes has the potential to be an effective intervention, especially if patients have intensive treatment of their newly diagnosed diabetes and comorbid hypertension. We wished to determine the process and quality of diabetes car ... Full text Link to item Cite

Racial differences in survival post cerebral infarction among the elderly.

Journal Article Neurology · January 28, 2003 Featured Publication OBJECTIVE: To investigate whether there are differences in poststroke survival between African American and white patients, aged 65 and over, in the United States. METHODS: A biracial cohort of patients was selected from a random 20% national sample of Med ... Full text Link to item Cite

An economic analysis of a store and forward teledermatology consult system.

Journal Article Telemed J E Health · 2003 Our objective was to assess the economic impact of store-and-forward teledermatology in a United States Department of Veterans Affairs (VA) health care setting. Patients being referred to the Dermatology Consult Service from the Primary Care Clinics at the ... Full text Link to item Cite

Implementing a disease management intervention for depression in primary care: a random work sampling study.

Journal Article Gen Hosp Psychiatry · 2003 We describe the daily work activities of 13 Depression Clinical Specialists (DCSs) at 7 national sites who served as care managers in an effective multisite randomized trial of a disease management model for depression in primary care. DCSs carried portabl ... Full text Link to item Cite

Impacting late life depression: integrating a depression intervention into primary care.

Journal Article Psychiatr Q · 2003 groups and semi-structured individual interviews with all Depression Clinical Specialists (DCSs) working with Project IMPACT (Improving Mood: Promoting Access to Collaborative Treatment), a study testing a collaborative care intervention for late life depr ... Full text Link to item Cite

Carotid endarterectomy and race: do clinical indications and patient preferences account for differences?

Journal Article Stroke · December 2002 BACKGROUND AND PURPOSE: Carotid endarterectomy (CE) has been proved to reduce the risk of stroke for certain patients, but black patients are less likely than whites to receive CE. The purpose of this work was to determine the importance of clinical indica ... Full text Link to item Cite

To what extent should quality of care decisions be based on health outcomes data? Application to carotid endarterectomy.

Journal Article Stroke · December 2002 BACKGROUND AND PURPOSE: Most quality improvement methods implicitly assume that facilities with high complication rates are likely to have substandard processes of care, a stable characteristic that, in the absence of intervention, will persist over time. ... Full text Link to item Cite

Improving the clinical examination for a low ankle-brachial index

Journal Article International Journal of Angiology · October 16, 2002 We sought to determine clinical examination features that predict an abnormal ankle-brachial index (ABI). Eleven United States and Canadian university-affiliated practices participated. Patients over age 55 (n = 218) presenting for an outpatient appointmen ... Full text Cite

The effect of comorbid illness on receipt of cancer screening by older people.

Journal Article J Am Geriatr Soc · October 2002 OBJECTIVES: To identify associations between the type and number of diagnoses and receipt of screening for breast, cervical, and colorectal cancer by older people. DESIGN: Sixth annual follow-up of a community-based survey with 4,162 participants aged 65 a ... Full text Link to item Cite

Improving the quality of anticoagulation of patients with atrial fibrillation in managed care organizations: results of the managing anticoagulation services trial.

Journal Article Am J Med · July 2002 Featured Publication Randomized trials have indicated that well-managed anticoagulation with warfarin could prevent more than half of the strokes related to atrial fibrillation. However, many patients with atrial fibrillation who are eligible for this therapy either do not rec ... Full text Link to item Cite

Impact of diabetes screening on quality of life.

Journal Article Diabetes Care · June 2002 Featured Publication OBJECTIVE: Diagnosis of a chronic illness can have a negative impact on patients' perception of their well-being ("labeling" effect). We sought to determine the effects of a new diagnosis of diabetes, discovered by systematic screening, on patients' health ... Full text Link to item Cite

A model of psychosocial and cultural antecedents of blood pressure control.

Journal Article J Natl Med Assoc · April 2002 Featured Publication Hypertension is a major modifiable risk factor for stroke, congestive heart failure, and end-stage renal disease. Hypertension is particularly prevalent and deadly among African Americans. Effective treatment for hypertension has been available for decades ... Link to item Cite

Training physicians for careers in clinical research: a tailored educational experience.

Journal Article Nat Biotechnol · January 2002 Full text Link to item Cite

Contribution of the Veterans Health Administration in understanding racial disparities in access and utilization of health care: a spirit of inquiry.

Journal Article Med Care · January 2002 Full text Link to item Cite

Racial variations in postoperative outcomes of carotid endarterectomy: evidence from the Veterans Affairs National Surgical Quality Improvement Program.

Journal Article Med Care · January 2002 CONTEXT: Black patients and Hispanic patients receive carotid endarterectomy (CEA) at lower rates than white patients. It is unclear whether worse surgical outcomes are influencing clinical decision-making regarding use of the operation among minority grou ... Link to item Cite

Teledermatology's impact on time to intervention among referrals to a dermatology consult service.

Journal Article Telemed J E Health · 2002 The aim of this study was to determine if a teledermatology consult system, using store-and-forward digital imaging technology, results in patients achieving a shorter time from referral date to date of initial definitive intervention when compared to a tr ... Full text Link to item Cite

Screening for diabetes in an outpatient clinic population.

Journal Article J Gen Intern Med · January 2002 Featured Publication BACKGROUND: Opportunistic disease screening is the routine, asymptomatic disease screening of patients at the time of a physician encounter for other reasons. While the prevalence of unrecognized diabetes in community populations is well known, the prevale ... Full text Link to item Cite

Primary care for patients infected with human immunodeficiency virus: a randomized controlled trial.

Journal Article J Gen Intern Med · September 2001 Featured Publication OBJECTIVE: To measure the impact of a teaching intervention and to compare process and outcomes of care for HIV-infected patients randomly assigned to a general medicine clinic (GMC) or an infectious disease clinic (IDC) for primary care. DESIGN: Prospecti ... Full text Link to item Cite

Multisite randomized controlled trials in health services research: scientific challenges and operational issues.

Journal Article Med Care · June 2001 Featured Publication Although well-designed randomized controlled trials (RCT) provide the strongest evidence regarding causation, only relatively recently have they been used by health services researchers to study the organization, delivery, quality, and outcomes of care. Mo ... Full text Link to item Cite

Medical care: past, present, and future.

Journal Article Med Care · January 2001 Full text Link to item Cite

Culturally-sensitive weight loss program produces significant reduction in weight, blood pressure, and cholesterol in eight weeks.

Journal Article J Natl Med Assoc · November 2000 Featured Publication Dietary and behavioral needs of special populations are rarely considered in traditional weight loss programs. This study assessed the impact of culturally-sensitive modifications to the Duke University Rice Diet weight loss program for African-American di ... Link to item Cite

Predicting non-elective hospital readmissions: a multi-site study. Department of Veterans Affairs Cooperative Study Group on Primary Care and Readmissions.

Journal Article J Clin Epidemiol · November 2000 OBJECTIVE: To determine clinical and patient-centered factors predicting non-elective hospital readmissions. DESIGN: Secondary analysis from a randomized clinical trial. CLINICAL SETTING: Nine VA medical centers. PARTICIPANTS: Patients discharged from the ... Full text Link to item Cite

Management of acute exacerbations of chronic obstructive pulmonary disease.

Journal Article Evid Rep Technol Assess (Summ) · September 2000 Link to item Cite

Community impact of anticoagulation services: rationale and design of the Managing Anticoagulation Services Trial (MAST).

Journal Article J Thromb Thrombolysis · June 2000 Featured Publication We describe the design of the Managing Anti-coagulation Services Trial (MAST), a practice-improvement trial testing whether anticoagulation services are a preferred method of managing anticoagulation for stroke prevention among patients with atrial fibrill ... Full text Link to item Cite

Quality Enhancement Research Initiative in stroke: prevention, treatment, and rehabilitation.

Journal Article Med Care · June 2000 Stroke is the third leading cause of death and a leading cause of adult disability in the United States. Both within and outside of the Veterans Health Administration (VHA), the lack of a systematic approach to stroke prevention and treatment may have cont ... Full text Link to item Cite

Racial variation in wanting and obtaining mental health services among women veterans in a primary care clinic.

Journal Article J Natl Med Assoc · May 2000 Epidemiologic studies suggest that African-American women may be less likely to obtain mental health services. Racial differences were explored in wanting and obtaining mental health services among women in an equal access primary care clinic setting after ... Link to item Cite

Racial variation in initial stroke severity.

Journal Article Stroke · March 2000 Featured Publication BACKGROUND AND PURPOSE: Blacks experience greater morbidity and mortality from stroke than do whites. The degree to which this is due to the severity of the initial stroke is not known. The objective of this study is to determine whether there is a racial ... Full text Link to item Cite

The role of peer-reviewed journals in science.

Journal Article Med Care · January 2000 Full text Link to item Cite

Racial inequity of access to carotid imaging.

Journal Article Stroke · November 1999 Full text Link to item Cite

Race, presenting signs and symptoms, use of carotid artery imaging, and appropriateness of carotid endarterectomy.

Journal Article Stroke · July 1999 Featured Publication BACKGROUND AND PURPOSE: We sought to determine whether there are racial differences in use of carotid artery imaging after controlling for clinical factors and to ascertain racial differences in presenting signs and symptoms and overall appropriateness for ... Full text Link to item Cite

Measuring costs in multisite randomized controlled trials: lessons from the VA Cooperative Studies Program.

Journal Article Med Care · April 1999 OBJECTIVES: The interest in the economic impact of new health care interventions has increased dramatically over recent years; however, the results can be highly variable depending upon the economic assumptions made and the approaches taken in collecting t ... Full text Link to item Cite

Enhanced access to primary care for patients with congestive heart failure. Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission.

Journal Article Eff Clin Pract · 1999 OBJECTIVE: To determine whether enhanced access to primary care affects the diagnostic evaluation, pharmacologic management, or health outcomes of patients hospitalized with congestive heart failure (CHF). DESIGN: Multisite randomized, controlled trial. SE ... Link to item Cite

Foot education improves knowledge and satisfaction among patients at high risk for diabetic foot ulcer.

Journal Article Diabetes Educ · 1999 PURPOSE: The purpose of this study was to evaluate an intensive diabetes foot education program for veterans at high risk for foot ulcer. METHODS: We invited 100 consecutive patients with diabetes from a Department of Veterans Affairs Medical Center clinic ... Full text Link to item Cite

Multicenter review of preoperative risk factors for endarterectomy for asymptomatic carotid artery stenosis.

Journal Article Stroke · April 1998 BACKGROUND AND PURPOSE: The benefit of carotid endarterectomy is highly dependent on surgical risk. However, little data are available concerning factors affecting the risk of endarterectomy performed for asymptomatic carotid artery stenosis outside the se ... Full text Link to item Cite

Cooperative studies in health services research in the Department of Veterans Affairs.

Journal Article Control Clin Trials · April 1998 The Department of Veterans Affairs, through its Cooperative Studies Program, has a long history of conducting large-scale, multihospital biomedical clinical trials. The agency's Health Services Research and Development Service, although newer, has a distin ... Full text Link to item Cite

Understanding racial variation in the use of carotid endarterectomy: the role of aversion to surgery.

Journal Article J Natl Med Assoc · January 1998 Featured Publication Previous studies indicate that African-American patients undergo carotid endarterectomy at one fourth the rate of white patients. This study was undertaken to determine if differences in aversion to carotid endarterectomy might account for some of the raci ... Link to item Cite

Hospital credentialing for laparoscopic cholecystectomy: is stricter better?

Journal Article Clin Perform Qual Health Care · 1998 OBJECTIVE: Hospital credentialing standards for laparoscopic cholecystectomy were established to improve surgical outcomes, but standards vary by hospital. We hypothesized that more stringent credentialing would result in better outcomes. DESIGN: Univariat ... Link to item Cite

Prognostic value of the clinical examination of the diabetic foot ulcer.

Journal Article J Gen Intern Med · September 1997 OBJECTIVE: To determine the value of the history, physical examination, and magnetic resonance imaging (MRI) in predicting successful primary healing of a foot ulcer in a diabetic patient. DESIGN: Prospective cohort study. SETTING: Durham (NC) Veterans Aff ... Full text Link to item Cite

Influence of projected complication rates on estimated appropriate use rates for carotid endarterectomy. Appropriateness Project Investigators. Academic Medical Center Consortium.

Journal Article Health Serv Res · August 1997 OBJECTIVE: To examine specifically the influence of estimated perioperative mortality and stroke rate on the assessment of appropriateness of carotid endarterectomy. DATA SOURCES/STUDY SETTING: An expert panel convened to rate the appropriateness of a vari ... Link to item Cite

Influence of projected complication rates on estimated appropriate use rates for carotid endarterectomy

Journal Article Health Services Research · August 1, 1997 Objective. To examine specifically the influence of estimated perioperative mortality and stroke rate on the assessment of appropriateness of carotid endarterectomy. Data Sources/Study Setting. An expert panel convened to rate the appropriateness of a vari ... Cite

Greater access to primary care increased both patient satisfaction and hospital readmissions

Journal Article Evidence-Based Medicine · November 1, 1996 Cite

Classifying general medicine readmissions. Are they preventable? Veterans Affairs Cooperative Studies in Health Services Group on Primary Care and Hospital Readmissions.

Journal Article J Gen Intern Med · October 1996 Featured Publication OBJECTIVES: To describe a new quality assessment method used to classify the preventability of hospitalization in terms of patient, clinician, or system factors. DESIGN: The instrument was developed in two phases. Phase 1 was a prospective comparison of ad ... Full text Link to item Cite

AIDS-related Pneumocystis carinii pneumonia in older patients.

Journal Article J Gen Intern Med · October 1996 MAIN RESULTS: Compared with younger patients, patients aged 50 years or older were less likely to have acquired HIV via intravenous drug use or homosexual contact (p = .0001). Older patients were more likely to have comorbid diseases (12% vs 4%; p = .0001) ... Full text Link to item Cite

A trial of increased access to primary care.

Journal Article N Engl J Med · September 19, 1996 Full text Link to item Cite

Diuretics and sudden cardiac death.

Journal Article Ann Intern Med · August 15, 1996 Full text Link to item Cite

Clinical and radiographic findings that lead to intervention in diabetic patients with foot ulcers. A nationwide survey of primary care physicians.

Journal Article Diabetes Care · July 1996 OBJECTIVE: To determine which elements of clinical history, physical examination, and diagnostic tests are important to primary care physicians in their management of foot ulcers in diabetic patients. RESEARCH DESIGN AND METHODS: We conducted a national ma ... Full text Link to item Cite

Does increased access to primary care reduce hospital readmissions? Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission.

Journal Article N Engl J Med · May 30, 1996 BACKGROUND: For chronically ill patients, readmission to the hospital can be frequent and costly. We studied the effect of an intervention designed to increase access to primary care after discharge from the hospital, with the goals of reducing readmission ... Full text Link to item Cite

Are health-related quality-of-life measures affected by the mode of administration?

Journal Article J Clin Epidemiol · February 1996 While measures of health-related quality of life (HRQOL) are increasingly being used as outcomes in clinical trials, it is unknown whether HRQOL assessments are influenced by the method of administration. We compared telephone, face-to-face, and self-admin ... Full text Link to item Cite

Can a summary laboratory score predict health status and inpatient utilization

Journal Article Drug Information Journal · 1996 The Genie score is a summary laboratory score derived from the average of a patient's deviations from specified normal laboratory values. The ability of the Genie score to predict important inpatient resource use, functional status, and patient comorbidity ... Cite

Clinical and radiology findings that lead to intervention in diabetic patients with a foot ulcer: A nationwide survey of primary care physicians

Journal Article Journal of Investigative Medicine · January 1, 1996 We conducted a national mail survey of 600 primary care physicians to determine which elements of the clinical history and physical examination, and which diagnostic tests, influence their decisions to order radiology studies, surgical referral, and hospit ... Cite

The role of antineutrophil cytoplasmic antibody (c-ANCA) testing in the diagnosis of Wegener granulomatosis. A literature review and meta-analysis.

Journal Article Ann Intern Med · December 15, 1995 PURPOSE: To summarize the literature on the clinical utility of antineutrophil cytoplasmic antibody (c-ANCA) as a diagnostic marker for Wegener granulomatosis. DATA SOURCES: A structured literature search was done using MEDLINE; this search, combined with ... Full text Link to item Cite

Endarterectomy for asymptomatic carotid artery stenosis.

Journal Article JAMA · November 15, 1995 Full text Link to item Cite

Bedside science reduces laboratory art.

Journal Article Circulation · November 1, 1995 Link to item Cite

Noninvasive carotid artery testing.

Journal Article Ann Intern Med · October 15, 1995 Full text Link to item Cite

US national survey of physician practices for the secondary and tertiary prevention of ischemic stroke. Design, service availability, and common practices.

Journal Article Stroke · September 1995 BACKGROUND AND PURPOSE: Stroke is largely a preventable disease. However, there are little data available concerning the use of stroke prevention diagnostic and treatment modalities by practicing physicians. These data are critical for the rational allocat ... Full text Link to item Cite

Measuring activities in clinical trials using random work sampling: implications for cost-effectiveness analysis and measurement of the intervention.

Journal Article J Clin Epidemiol · August 1995 Determining research-related costs from intervention-related costs is important for both clinical and health services research. Often this task involves estimating what proportion of the workday personnel spend on a variety of activities. We used a portabl ... Full text Link to item Cite

Noninvasive carotid artery testing. A meta-analytic review.

Journal Article Ann Intern Med · March 1, 1995 PURPOSE: To compare the operating characteristics of six noninvasive tests for carotid artery stenosis. DATA SOURCES: A structured search was done using MEDLINE, reference lists from selected articles, and bibliographies from neurology textbooks that focus ... Full text Link to item Cite

Endarterectomy for Asymptomatic Carotid Artery Stenosis-Replys

Journal Article JAMA: The Journal of the American Medical Association · 1995 Because the number of patients screened (42 000) greatly exceeded the number of patients randomized (1662), the generalizability of the ACAS results needs to be examined more closely. Although the ACAS authors were careful in their report, they failed to h ... Full text Cite

Theories explaining racial differences in the utilization of diagnostic and therapeutic procedures for cerebrovascular disease.

Journal Article Milbank Q · 1995 Featured Publication Despite a higher risk of stroke, blacks are less likely than whites to receive the invasive procedures that are used to diagnose and treat cerebrovascular disease, particularly carotid endarterectomy. Explanations for the lower rate of procedural use inclu ... Link to item Cite

Teaching cardiovascular examination skills [7]

Journal Article American Journal of Medicine · 1995 Cite

Endarterectomy for asymptomatic carotid artery stenosis [1]

Journal Article Journal of the American Medical Association · 1995 Cite

Cost-effectiveness models of clinical trials of new pharmaceuticals for AIDS-related Pneumocystis carinii pneumonia: are they helpful to policy makers?

Journal Article Clin Perform Qual Health Care · 1995 BACKGROUND: Pneumocystis carinii pneumonia (PCP) has been the most common and most costly complication of acquired immunodeficiency syndrome (AIDS). Because of concern over the high costs of care for persons with AIDS, policy makers have instituted a numbe ... Link to item Cite

A comparison of work-sampling and time-and-motion techniques for studies in health services research.

Journal Article Health Serv Res · December 1994 Link to item Cite

Lack of association between patients' measured burden of disease and risk for hospital readmission.

Journal Article J Clin Epidemiol · November 1994 Identifying patients at increased risk for hospital readmission is important for clinicians, health policy-makers, hospital administrators, and researchers. We used a retrospective case-control design to compare the clinimetric properties of five validated ... Full text Link to item Cite

Preoperative risk factors for carotid endarterectomy.

Journal Article Stroke · October 1994 Link to item Cite

Multicenter review of preoperative risk factors for carotid endarterectomy in patients with ipsilateral symptoms.

Journal Article Stroke · June 1994 BACKGROUND AND PURPOSE: Randomized clinical trials have shown that carotid endarterectomy decreases the risk of subsequent stroke in patients with high-grade carotid stenosis and ipsilateral transient ischemic attack or minor stroke. The benefit of surgery ... Full text Link to item Cite

Time analysis of a general medicine service: results from a random work sampling study.

Journal Article J Gen Intern Med · May 1994 OBJECTIVE: To describe a novel method of time analysis for health care settings by quantifying internal medicine housestaff's work activities and contacts. DESIGN: Observational work sampling study based on random sampling technique. SETTING: General medic ... Full text Link to item Cite

Integrating scientific writing into a statistics curriculum: A course in statistically based scientific writing

Journal Article American Statistician · January 1, 1994 A course in writing and critical appraisal of medical papers that uses statistics is described, and its relationship to the goal of better integrating scientific writing into the statistics curriculum is discussed. It is concluded that writing should play ... Full text Cite

Global judgments versus decision-model-facilitated judgments: are experts internally consistent?

Journal Article Med Decis Making · 1994 A widely used method for evaluating the appropriateness of medical procedures and practices is the "modified Delphi" approach using expert panelists' global ratings. However, several difficulties in the assignment of global ratings have led to a search for ... Full text Link to item Cite

Racial variations in the rates of carotid angiography and endarterectomy in patients with stroke and transient ischemic attack.

Journal Article Arch Intern Med · December 27, 1993 BACKGROUND: Carotid endarterectomy is emerging as the treatment of choice for patients with symptomatic carotid artery stenosis at low operative risk. We sought to determine if racial variations in the rate of carotid angiography and endarterectomy exist i ... Link to item Cite

Cost effectiveness analysis of early zidovudine treatment of HIV infected patients.

Journal Article BMJ · November 20, 1993 OBJECTIVE--To compare cost effectiveness of early and later treatment with zidovudine for patients infected with HIV. DESIGN--Markov chain analysis of cost effectiveness based on results of use of health care and efficacy from a trial of zidovudine treatme ... Full text Link to item Cite

Comparison of housestaff's estimates of their workday activities with results of a random work-sampling study.

Journal Article Acad Med · November 1993 BACKGROUND: Accurately quantifying housestaff's workday activities is acquiring increasing importance as resources become constrained and programs become more accountable for medical education. The authors compared a traditional method of time analysis bas ... Link to item Cite

Teaching cardiovascular examination skills: results from a randomized controlled trial.

Journal Article Am J Med · October 1993 Featured Publication PURPOSE: To evaluate the effectiveness of a teaching program designed to improve interns' cardiovascular examination skills. PARTICIPANTS: All 56 interns rotating on a mandatory 4-week inpatient cardiology service during 1 academic year (July 1989-June 199 ... Full text Link to item Cite

Predicting complications of carotid endarterectomy.

Journal Article Stroke · September 1993 BACKGROUND AND PURPOSE: Carotid endarterectomy has been shown to be beneficial in patients with high-grade carotid stenosis and ipsilateral transient ischemic attack or stroke. This benefit will be realized only if the operation is performed safely. We sou ... Full text Link to item Cite

A cost-effectiveness analysis of hepatitis B vaccine in predialysis patients.

Journal Article Health Serv Res · April 1993 OBJECTIVE: Our objective was to assess the cost effectiveness of hepatitis B vaccine in predialysis patients. DATA SOURCES: Costs were calculated from estimated rates of health services use and unit costs of resource use. Efficacy data were based on probab ... Link to item Cite

Assessing housestaff diagnostic skills using a cardiology patient simulator.

Journal Article Ann Intern Med · November 1, 1992 OBJECTIVE: To assess the cardiovascular physical examination skills of internal medicine housestaff. DESIGN: Cross-sectional assessment of housestaff performance on three valvular abnormality simulations conducted on the cardiology patient simulator, "Harv ... Full text Link to item Cite

Can screening older patients for cancer save lives?

Journal Article Clin Geriatr Med · February 1992 Cancer screening of the elderly is warranted for those cancers for which early detection and treatment improve life expectancy. There is excellent evidence to include screening for breast cancer with clinical examination and mammography for elderly women. ... Link to item Cite

Intravenous drug use fools us again. The importance of open lung biopsy in evaluating a patient with progressive interstitial lung disease presenting with pneumothorax.

Journal Article N C Med J · August 1991 Link to item Cite

Worrisome rash in an undergraduate.

Journal Article N C Med J · July 1991 Link to item Cite

Strategies to reduce hospital readmissions: a review.

Journal Article QRB Qual Rev Bull · August 1989 Full text Link to item Cite

A COST-EFFECTIVENESS ANALYSIS OF HEPATITIS-B VACCINE IN DIALYSIS AND PRE-DIALYSIS PATIENTS

Journal Article CLINICAL RESEARCH · April 1, 1989 Link to item Cite

Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review.

Journal Article Rev Infect Dis · 1989 Actinobacillus actinomycetemcomitans is a small fastidious gram-negative coccobacillus that fails to grow on MacConkey's agar. Slow growth in broth may lead to delays in diagnosis. First described in 1912, A. actinomycetemcomitans has been recognized since ... Full text Link to item Cite

A COST-EFFECTIVENESS ANALYSIS OF HEPATITIS-B VACCINE IN DIALYSIS AND PRE-DIALYSIS PATIENTS

Journal Article CLINICAL RESEARCH · 1989 Cite

Acute pulmonary decompensation due to amphotericin B in the absence of granulocyte transfusions.

Journal Article N Engl J Med · September 25, 1986 Full text Link to item Cite