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Gregory P. Samsa

Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics
Duke Box 2721, Durham, NC 27710
2424 Erwin Road Ste 1105, 11045 Hock Plaza, Durham, NC 27705

Selected Publications


Accelerating resident research within quantitative collaboration units in academic healthcare

Journal Article Stat · June 1, 2024 With increased access to biomedical and electronic health records data and the complexity of research questions, individuals in residency programmes who aim to conduct research require specialized educational programmes and biostatistics support. Biostatis ... Full text Cite

Biomedical Researchers Should be Taught Statistics Differently than Biostatisticians in Training: Illustration of a Module within a Clinical Research Seminar Course

Journal Article Journal of Curriculum and Teaching · May 1, 2024 The predominant model for biomedical research is team science. Two critical members of the team are the clinical investigator and the biostatistician. Typically, the biostatistician performs statistical analyses and the clinical investigator interprets the ... Full text Cite

A Curriculum Review of Programming Courses in a Master of Biostatistics Program

Journal Article Journal of Curriculum and Teaching · February 1, 2024 Computing is a core competency for collaborative biostatisticians, who work on interdisciplinary scientific teams in medicine and publich health. However, computing is a broad field that encompases many underlying pedagogical constructs and subspeciality t ... Full text Cite

Fabrication in a study about honesty: A lost episode of columbo illustrating how forensic statistics is performed

Journal Article Accountability in Research · January 1, 2024 The three steps of a typical forensic statistical analysis are (1) verify that the raw data file is correct; (2) verify that the statistical analysis file derived from the raw data file is correct; and (3) verify that the statistical analyses are appropria ... Full text Cite

Treatment Effect Estimates From Pilot Trials Are Unreliable.

Journal Article J Pain Symptom Manage · December 2023 CONTEXT: The CONSORT guideline defines a pilot trial as a small-scale version of a desired future efficacy trial that is intended to answer the key questions of whether and how a larger study should be done. For example, a pilot trial might evaluate differ ... Full text Link to item Cite

Evaluation of antibiotic-resistant bacteria in home kitchens and bathrooms: Is there a link between home disinfectant use and antibiotic resistance?

Journal Article Am J Infect Control · November 2023 OBJECTIVE: To determine the relationship between home disinfectant use and the prevalence of antibiotic resistance among environmental isolates of human pathogens. METHODS: Bacteria were cultured from 5 kitchen and 5 bathroom sites using quantitative metho ... Full text Link to item Cite

Needles in a Haystack: Finding Qualitative and Quantitative Collaborators in Academic Medical Centers.

Journal Article Acad Med · August 1, 2023 Translational research is a data-driven process that involves transforming scientific laboratory- and clinic-based discoveries into products and activities with real-world impact to improve individual and population health. Successful execution of translat ... Full text Link to item Cite

Institutional approaches to preventing questionable research practices.

Journal Article Account Res · May 2023 Questionable research practices (QRP) are actions taken by researchers that span a range of concern related to violation of research best practices, and ultimately expose institutions and research participants to risk. Numerous studies have shown that QRP ... Full text Link to item Cite

Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative.

Journal Article J Palliat Care · April 2023 BACKGROUND: Pancreatic cancer has a poor 5-year survival and carries significant morbidity. Pain is a commonly studied symptom in pancreatic cancer; however, few studies examine the frequency of multiple patient-reported symptoms. Our aim is to ascertain p ... Full text Link to item Cite

A Visual Tool to Help Develop a Statistical Analysis Plan for Randomized Trials in Palliative Care.

Journal Article J Pain Symptom Manage · January 2023 Collaboration with a statistician about the design of a statistical analysis plan can be enhanced by illustrating how statisticians conceptualize their task. This conceptualization can be represented by a directed acyclic graph (DAG), which illustrates the ... Full text Link to item Cite

Hybrid-delivered cognitive behavioral symptom management and activity coaching intervention for patients undergoing hematopoietic stem cell transplant: Findings from intervention development and a pilot randomized trial.

Journal Article J Psychosoc Oncol · 2023 OBJECTIVE: Develop and pilot test a mobile health (mHealth) cognitive behavioral coping skills training and activity coaching protocol (HCT Symptoms and Steps) for hematopoietic stem cell transplant (HCT) patients. DESIGN: Two-phase, mixed methods study. S ... Full text Link to item Cite

Are Simulated Coding Interviews a Fair and Practical Examination Format for Non-professional Programmers Enrolled in a Master's Degree Program in Biostatistics?

Journal Article Journal of Curriculum and Teaching · January 1, 2023 This report describes an innovative and evidence-based approach to implementing coding interviews as an examination format for non-professional programmers: namely, students in a Master of Biostatistics program taking a course in the language of SAS. In ad ... Full text Cite

Essential team science skills for biostatisticians on collaborative research teams.

Journal Article J Clin Transl Sci · 2023 INTRODUCTION: Despite the critical role that quantitative scientists play in biomedical research, graduate programs in quantitative fields often focus on technical and methodological skills, not on collaborative and leadership skills. In this study, we eva ... Full text Link to item Cite

Experiential Learning Methods for Biostatistics Students: A Model for Embedding Student Interns in Academic Health Centers.

Journal Article Stat · December 2022 This manuscript describes an experiential learning program for future collaborative biostatisticians (CBs) developed within an academic medical center. The program is a collaborative effort between the Biostatistics, Epidemiology, and Research Design (BERD ... Full text Link to item Cite

Designing Psychosocial Intervention Pilot Studies: A Tutorial for Palliative Care Investigators.

Journal Article J Pain Symptom Manage · June 2022 This is a tutorial on designing a persuasive pilot study of a psychosocial intervention (e.g., behavioral symptom management) in the palliative care setting. This tutorial is most relevant for early stages of intervention research that aims to progress tow ... Full text Link to item Cite

A Course in Biology and Communication Skills for Master of Biostatistics Students

Journal Article Journal of Curriculum and Teaching · January 1, 2022 We describe an innovative, semester-long course in biology and communication skills for masterā€™s degree students in biostatistics. The primary goal of the course is to make the connection between biological science and statistics more explicit. The seconda ... Full text Cite

Preorientation Curriculum: An Approach for Preparing Students with Heterogenous Backgrounds for Training in a Master of Biostatistics Program

Journal Article Journal of Curriculum and Teaching · January 1, 2022 We describe an innovative preorientation curriculum (POC) for a Master of Biostatistics (MB) program. The goal of the POC is to fill critical skills gaps for students entering the MB program from heterogeneous backgrounds so they are prepared to engage in ... Full text Cite

Administrative Considerations Pertaining to the Use of Creative Methods of Student Assessment: A Theoretically Grounded Reflection from a Master of Biostatistics Program

Journal Article Journal of Curriculum and Teaching · January 1, 2022 Student evaluation is a key consideration for educational program administrators because program success depends on students' ability to demonstrate successful development of core competencies. Student evaluations must therefore be aligned with learning ob ... Full text Cite

Redesign of a First-Year Theory Course Sequence in Biostatistics

Journal Article Journal of Curriculum and Teaching · January 1, 2022 This communication describes the process and results of a curriculum review of a first-year sequence of courses in statistical inference within a Master of Biostatistics program. Our primary aim was to develop an innovative course in statistical theory tha ... Full text Cite

A novel decision aid for acute myeloid leukemia: a feasibility and preliminary efficacy trial.

Journal Article Support Care Cancer · July 2021 PURPOSE: Acute myeloid leukemia (AML) is a hematologic malignancy characterized by a poor prognosis but also a paradoxical possibility of cure. This renders decision-making complex and imminent. Unfortunately, many patients with AML misestimate their progn ... Full text Link to item Cite

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

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

Behavioral cancer pain intervention using videoconferencing and a mobile application for medically underserved patients: Rationale, design, and methods of a prospective multisite randomized controlled trial.

Journal Article Contemp Clin Trials · March 2021 BACKGROUND: Women with breast cancer in medically underserved areas are particularly vulnerable to persistent pain and disability. Behavioral pain interventions reduce pain and improve outcomes. Cancer patients in medically underserved areas receive limite ... Full text Link to item Cite

The biomedical research pyramid: A model for the practice of biostatistics

Journal Article Journal of Curriculum and Teaching · February 1, 2021 Biostatisticians apply statistical methods to solve problems in the biological sciences. Successful practioners of biostatistics have advanced technical knowledge, are skilled communicators, and can seamlesslessly integrate with interdisciplinary scientifi ... Full text Cite

Evolution of a qualifying examination from a timed closed-book format to an open-book collaborative take-home format: A case study and commentary

Journal Article Journal of Curriculum and Teaching · February 1, 2021 Objective: Our master's program in biostatistics requires a qualifying examination (QE). A curriculum review led us to question whether to replace a closed-book format with an open-book one. Our goal was to improve the QE. Methods: This is a case study and ... Full text Cite

Associations of Patient Characteristics and Care Setting with Complexity of Specialty Palliative Care Visits.

Journal Article J Palliat Med · January 2021 Background: Information routinely collected during a palliative care consultation request may help predict the level of complexity of that patient encounter. Objectives: We examined whether patient and consultation characteristics, as captured in consultat ... Full text Link to item Cite

Aerobic Versus Resistance Training Effects on Ventricular-Arterial Coupling and Vascular Function in the STRRIDE-AT/RT Trial.

Journal Article Front Cardiovasc Med · 2021 Background: The goal was studying the differential effects of aerobic training (AT) vs. resistance training (RT) on cardiac and peripheral arterial capacity on cardiopulmonary (CP) and peripheral vascular (PV) function in sedentary and obese adults. Method ... Full text Link to item Cite

Does Cancer Treatment-Related Financial Distress Worsen Over Time?

Journal Article North Carolina Medical Journal · January 1, 2021 Background Patients with cancer are at risk for both objective and subjective financial distress. Financial distress during treatment is adversely associated with physical and mental well-being. Little is known about whether patientsā€™ subjective financial ... Full text Cite

An analysis of missing items in real-world electronic patient reported outcomes data: implications for clinical care.

Journal Article Support Care Cancer · November 2020 PURPOSE: Utilization of electronic patient-reported outcomes (ePROs) in the clinic can improve quality of life and prolong survival in cancer care. However, there remain unanswered questions regarding trends in missing data and the potential effect on real ... Full text Link to item Cite

Methods for training collaborative biostatisticians.

Journal Article J Clin Transl Sci · August 4, 2020 The emphasis on team science in clinical and translational research increases the importance of collaborative biostatisticians (CBs) in healthcare. Adequate training and development of CBs ensure appropriate conduct of robust and meaningful research and, t ... Full text Link to item Cite

Some statistical memes which sound correct but aren't quite: Application to the analysis of observational databases used in learning health systems.

Journal Article Learn Health Syst · July 2020 We consider four memes, correct within the context of randomized trials but requiring modification for the analysis of the observational databases typically associated with learning health systems: (a) the right answer always requires randomization; (b) a ... Full text Link to item Cite

"No more than one day per week" seems simple enough: So why is conflict of commitment so confusing?

Journal Article Account Res · May 2020 Conflict of interest (COI) and conflict of commitment (COC) are similar in that both concern the "risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest" (Institute of Medicine). The Instit ... Full text Link to item Cite

Vascular Cellular Adhesion Molecule-1 (VCAM-1) and Memory Impairment in African-Americans after Small Vessel-Type Stroke.

Journal Article J Stroke Cerebrovasc Dis · April 2020 BACKGROUND: African-Americans (AA) are 3 times more likely to have small-vessel-type ischemic strokes (SVS) than Whites. Small vessel strokes are associated with cognitive impairment, a relationship incompletely explained by white matter hyperintensity (WM ... Full text Link to item Cite

The need for a Serious Illness Digital Ecosystem (SIDE) to improve outcomes for patients receiving palliative and hospice care.

Journal Article Am J Manag Care · April 2020 Palliative and hospice care services produce immense benefits for patients living with serious illness and for their families. Due to the national shift toward value-based payment models, health systems and payers share a heightened awareness of the need t ... Full text Open Access Link to item Cite

Prognostic significance of primary tumor sidedness in patients undergoing liver resection for metastatic colorectal cancer.

Journal Article HPB (Oxford) · December 2019 BACKGROUND: Approximately 38% of patients with colorectal cancer will develop isolated liver metastases. Sidedness of colon tumor is identified in non-metastatic and unresected metastatic cancers as predictive of survival, yet its dedicated analysis in res ... Full text Link to item Cite

Real-world experience with electronic patient reported outcomes and missing items: "Don't ask me irrelevant questions".

Conference Journal of Clinical Oncology · November 1, 2019 99 Background: Electronic patient-reported outcomes (ePROs) can improve quality of life and prolong survival in patients with cancer by enhancing the detection and tracking of unmet supportive care needs. However, there remain un ... Full text Cite

Pruritus in patients with solid tumors: an overlooked supportive care need.

Journal Article Support Care Cancer · October 2019 PURPOSE: Pruritus is a common symptom in cutaneous malignancies, but its impact on patients with solid tumors is unclear. We explored the impact and management of pruritus in patients with solid tumors, using patient-reported outcomes (PRO) data from a rea ... Full text Link to item Cite

Usability of PCforMe in Patients With Advanced Cancer Referred to Outpatient Palliative Care: Results of a Randomized, Active-Controlled Pilot Trial.

Journal Article J Pain Symptom Manage · September 2019 CONTEXT: Low utilization of palliative care services warrant testing of new solutions to educate and engage patients around the benefits of palliative care. OBJECTIVES: We sought out to develop and test a novel, mobile health solution to prepare patients f ... Full text Link to item Cite

A behavioral cancer pain intervention: A randomized noninferiority trial comparing in-person with videoconference delivery.

Journal Article Psychooncology · August 2019 OBJECTIVE: Behavioral cancer pain interventions are efficacious for improving important pain outcomes; yet, traditional in-person delivery limits patient access. This study compared videoconference-delivered mobile health pain coping skills training (mPCST ... Full text Link to item Cite

Managing the science in the presence of financial conflict of interest.

Journal Article Account Res · August 2019 We consider the question of why (primarily) and how (secondarily) to perform scientific oversight of research performed by investigators with a financial conflict of interest (COI). One way to frame the trade-off of having investigators with financial COI ... Full text Link to item Cite

Patient-reported distress in Hodgkin lymphoma across the survivorship continuum.

Journal Article Support Care Cancer · July 2019 PURPOSE: Hodgkin lymphoma (HL) survivors face long-term, elevated risk of treatment-related sequelae, including psychosocial distress associated with poor health outcomes. The magnitude and sources of distress are not well described in the routine care of ... Full text Link to item Cite

Implementation of a responsible conduct of research education program at Duke University School of Medicine.

Journal Article Account Res · July 2019 Academic medical centers rarely require all of their research faculty and staff to participate in educational programs on the responsible conduct of research (RCR). There is also little published evidence of RCR programs addressing high-profile, internal c ... Full text Link to item Cite

Caregiver-guided pain coping skills training for patients with advanced cancer: Background, design, and challenges for the CaringPals study.

Journal Article Clin Trials · June 2019 BACKGROUND/AIMS: Pain is a major concern of patients with advanced cancer and their caregivers. There is strong evidence that pain coping skills training interventions based on cognitive-behavioral principles can reduce pain severity and pain interference. ... Full text Link to item Cite

Characteristics and Trends Among Patients With Cardiovascular Disease Referred to Palliative Care.

Journal Article JAMA Netw Open · May 3, 2019 IMPORTANCE: Use of palliative care (PC) for patients with cardiovascular disease (CVD) has increased recently. However, it is unknown if patients are receiving earlier referrals to PC. OBJECTIVE: To assess characteristics and trends of patients with CVD re ... Full text Link to item Cite

Public Awareness of HIV Pre-Exposure Prophylaxis in Durham, North Carolina: Results of a Community Survey.

Journal Article N C Med J · 2019 BACKGROUND Adoption of HIV pre-exposure prophylaxis (PrEP) remains limited among populations at greatest risk for HIV acquisition. This study aims to assess awareness of PrEP among individuals in Durham, North Carolina, which has one of the highest rates o ... Full text Link to item Cite

A Guide to Reproducibility in Preclinical Research.

Journal Article Acad Med · January 2019 Many have raised concerns about the reproducibility of biomedical research. In this Perspective, the authors address this "reproducibility crisis" by distilling discussions around reproducibility into a simple guide to facilitate understanding of the topic ... Full text Link to item Cite

Two questions about the analysis and interpretation of randomised trials.

Journal Article Int J Hyperthermia · December 2018 This non-technical tutorial focus on two questions about the analysis of data from randomised trials. Which is the more appropriate analysis of data from a randomised trial - an unadjusted analysis or an adjusted one? When a result is not statistically sig ... Full text Link to item Cite

Effect of Dextroamphetamine on Poststroke Motor Recovery: A Randomized Clinical Trial.

Journal Article JAMA Neurol · December 1, 2018 IMPORTANCE: Data from animal models show that the administration of dextroamphetamine combined with task-relevant training facilitates recovery after focal brain injury. Results of clinical trials in patients with stroke have been inconsistent. OBJECTIVES: ... Full text Link to item Cite

Going for Broke: A Longitudinal Study of Patient-Reported Financial Sacrifice in Cancer Care.

Journal Article J Oncol Pract · September 2018 PURPOSE: Patients with cancer are at risk for substantial treatment-related costs; however, little is known about patients' willingness to sacrifice to receive cancer care and how their attitudes and burden may change with time. PATIENTS AND METHODS: We co ... Full text Link to item Cite

The Surprise Question and Identification of Palliative Care Needs among Hospitalized Patients with Advanced Hematologic or Solid Malignancies.

Journal Article J Palliat Med · June 2018 BACKGROUND: Little is known about quality of life (QOL), depression, and end-of-life (EOL) outcomes among hospitalized patients with advanced cancer. OBJECTIVE: To assess whether the surprise question identifies inpatients with advanced cancer likely to ha ... Full text Link to item Cite

An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S.

Journal Article AIDS Care · May 2018 Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but many primary care physicians (PCPs) have not incorporated PrEP into practice. While PrEP may be a key strategy to reducing high HIV transmission rates in the southern US, knowledge ... Full text Link to item Cite

The impact of remission status on patients' experiences with acute myeloid leukemia (AML): an exploratory analysis of longitudinal patient-reported outcomes data.

Journal Article Support Care Cancer · May 2018 PURPOSE: Shared decision-making in acute myeloid leukemia (AML) requires understanding patients' longitudinal experiences of illness, but little is known about the impact of remission status on patient-reported outcomes (PROs). We aimed to explore the asso ... Full text Link to item Cite

A Cohort Study of Patient-Reported Outcomes and Healthcare Utilization in Acute Myeloid Leukemia Patients Receiving Active Cancer Therapy in the Last Six Months of Life.

Journal Article J Palliat Med · May 2018 BACKGROUND: Evidence about the unique palliative care needs of patients with acute myeloid leukemia (AML) is limited. Improving the care of these patients will require a better understanding of their unmet needs, including symptom burden at the end of life ... Full text Link to item Cite

An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial.

Journal Article JMIR Mhealth Uhealth · March 19, 2018 BACKGROUND: Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT). OBJECTIVE: This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mP ... Full text Link to item Cite

Patient-Reported Distress in Myelodysplastic Syndromes and Its Association With Clinical Outcomes: A Retrospective Cohort Study.

Journal Article J Natl Compr Canc Netw · March 2018 Background: NCCN defines distress as a multifactorial, unpleasant emotional experience of a psychological nature that may interfere with patients' ability to cope with cancer symptoms and treatment. Patients with myelodysplastic syndromes (MDS) are at risk ... Full text Link to item Cite

Predicting 6- and 12-Month Risk of Mortality in Patients With Platinum-Resistant Advanced-Stage Ovarian Cancer: Prognostic Model to Guide Palliative Care Referrals.

Journal Article Int J Gynecol Cancer · February 2018 OBJECTIVE: Predictive models are increasingly being used in clinical practice. The aim of the study was to develop a predictive model to identify patients with platinum-resistant ovarian cancer with a prognosis of less than 6 to 12 months who may benefit f ... Full text Link to item Cite

Comparing the Palliative Care Needs of Patients With Hematologic and Solid Malignancies.

Journal Article J Pain Symptom Manage · January 2018 CONTEXT: Hematologic cancer patients use palliative care services less frequently than their solid tumor counterparts. Prior work suggests that these patients have a sizable symptom burden, but comparisons between hematologic and solid tumor patients near ... Full text Link to item Cite

Out-of-Pocket Costs, Financial Distress, and Underinsurance in Cancer Care.

Journal Article JAMA Oncol · November 1, 2017 This cross-sectional survey study examines financial distress and cost expectations among patients with cancer presenting for anticancer therapy. ... Full text Link to item Cite

Integration of Electronic Patient-Reported Outcomes Into Routine Cancer Care: An Analysis of Factors Affecting Data Completeness.

Journal Article JCO Clin Cancer Inform · November 2017 PURPOSE: Routinely collected patient-reported outcomes (PROs) could provide invaluable data to a patient-centered learning health system but are often highly missing in clinical trials. We analyzed our experience with PROs to understand patterns of missing ... Full text Link to item Cite

Quality of life is significantly associated with survival in women with advanced epithelial ovarian cancer: An ancillary data analysis of the NRG Oncology/Gynecologic Oncology Group (GOG-0218) study.

Journal Article Gynecol Oncol · October 2017 OBJECTIVE: Evaluate association between baseline quality of life (QOL) and changes in QOL measured by FACT-O TOI with progression-free disease (PFS) and overall survival (OS) in advanced epithelial ovarian cancer (EOC). METHODS: Patients enrolled in GOG-02 ... Full text Link to item Cite

An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial (Preprint)

Journal Article · July 27, 2017 BACKGROUNDPain is a challenge for patients following hematopoietic stem cell transplantation (HCT). Full text Cite

Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness.

Journal Article J Pain Symptom Manage · June 2017 BACKGROUND: Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature i ... Full text Link to item Cite

Design and Rationale of the Metastatic Renal Cell Carcinoma (MaRCC) Registry: A Prospective Academic and Community-Based Study of Patients With Metastatic Renal Cell Cancer.

Journal Article Cancer Invest · May 28, 2017 The Metastatic Renal Cell Cancer Registry, a large, nationally representative, prospective registry of patients with metastatic renal cell carcinoma (mRCC), aims to understand real-world treatment patterns and outcomes of patients with mRCC in routine clin ... Full text Link to item Cite

Patient-reported distress in myelodysplastic syndromes and its relationship with clinical outcomes.

Conference Journal of Clinical Oncology · May 20, 2017 e21564 Background: The National Comprehensive Cancer Network (NCCN) defines distress as an unpleasant emotional experience associated with the psychosocial complications of cancer. Patients with myelodysplastic syndromes (MDS) ar ... Full text Cite

Sexual orientation differences in HIV testing motivation among college men.

Journal Article J Am Coll Health · April 2017 OBJECTIVE: To investigate sexual orientation differences in college men's motivations for HIV testing. PARTICIPANTS: 665 male college students in the Southeastern United States from 2006 to 2014. METHODS: Students completed a survey on HIV risk factors and ... Full text Link to item Cite

Anticholinergic Drug Burden in Noncancer Versus Cancer Patients Near the End of Life.

Journal Article J Pain Symptom Manage · November 2016 CONTEXT: Anticholinergic drugs can cause several side effects, impairing cognition and quality of life (QOL). Cancer patients are often exposed to increasing cumulative anticholinergic load (ACL) as they approach death, but this burden has not been examine ... Full text Link to item Cite

Patient-reported distress in adults with myelodysplastic syndromes (MDS).

Conference Journal of Clinical Oncology · October 9, 2016 80 Background: MDS are hematopoietic malignancies that are incurable in most patients. The National Comprehensive Cancer Network (NCCN) defines distress as an unpleasant emotional experience associated with the psychosocial compl ... Full text Cite

Effects of exercise training alone vs a combined exercise and nutritional lifestyle intervention on glucose homeostasis in prediabetic individuals: a randomised controlled trial.

Journal Article Diabetologia · October 2016 AIMS/HYPOTHESIS: Although the Diabetes Prevention Program (DPP) established lifestyle changes (diet, exercise and weight loss) as the 'gold standard' preventive therapy for diabetes, the relative contribution of exercise alone to the overall utility of the ... Full text Link to item Cite

Quality of Life is Similar between Long-term Survivors of Indolent and Aggressive Non-Hodgkin Lymphoma.

Journal Article Cancer Invest · July 2, 2016 Differences in quality of life (QOL) of long-term survivors of aggressive or indolent subtypes of non-Hodgkin lymphoma (NHL) have not been frequently evaluated. We assessed these differences by analyzing results of a large QOL survey of long-term NHL survi ... Full text Link to item Cite

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

Journal Article Psychooncology · June 2016 BACKGROUND: Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. METHODS: We conducted ... Full text Link to item Cite

Pilot study of an online app to reduce cancer patients' financial burden.

Conference Journal of Clinical Oncology · May 20, 2016 Full text Cite

Patient-Reported Outcomes After Choice for Contralateral Prophylactic Mastectomy.

Conference J Clin Oncol · May 1, 2016 PURPOSE: The rate of contralateral prophylactic mastectomies (CPMs) continues to rise, although there is little evidence to support improvement in quality of life (QOL) with CPM. We sought to ascertain whether patient-reported outcomes and, more specifical ... Full text Link to item Cite

An Exploratory Factor Analysis of the Scale Structure of the Patient Care Monitor Version 2.0.

Journal Article J Pain Symptom Manage · April 2016 CONTEXT: The Patient Care Monitor (PCM), version 2.0, is an electronic patient-reported outcomes instrument designed to be embedded into oncology practices. One key psychometric component of an instrument is its factor structure. OBJECTIVES: To validate th ... Full text Link to item Cite

Characterizing the Hospice and Palliative Care Workforce in the U.S.: Clinician Demographics and Professional Responsibilities.

Journal Article J Pain Symptom Manage · March 2016 CONTEXT: Palliative care services are growing at an unprecedented pace. Yet, the characteristics of the clinician population who deliver these services are not known. Information on the roles, motivations, and future plans of the clinician workforce would ... Full text Link to item Cite

Physician treatment selection in the prospective Metastatic Renal Cell Cancer (MaRCC) Registry.

Conference Journal of Clinical Oncology · January 10, 2016 563 Background: Clinical trials mRCC pts are different from real world pts, resulting in bias in the literature. The MaRCC Registry is designed to survey questions not asked in tri als, such as why physicians make certain managem ... Full text Cite

Front-line management patterns in the prospective metastatic renal cell cancer (MaRCC) registry.

Conference Journal of Clinical Oncology · January 10, 2016 617 Background: Over the past decade, seven agents were approved for metastatic renal cell carcinoma (mRCC) leading to a rapidly evolving clinical landscape. Clinical trials addressing treatment efficacy, sequencing, and other qu ... Full text Cite

Development and Refinement of a Learning Health Systems Training Program.

Journal Article EGEMS (Wash DC) · 2016 CONTEXT: In the emerging Learning Health System (LHS), the application and generation of medical knowledge are a natural outgrowth of patient care. Achieving this ideal requires a physician workforce adept in information systems, quality improvement method ... Full text Open Access Link to item Cite

What bothers lung cancer patients the most? A prospective, longitudinal electronic patient-reported outcomes study in advanced non-small cell lung cancer.

Journal Article Support Care Cancer · December 2015 PURPOSE: Patients with advanced non-small cell lung cancer (aNSCLC) face a significant symptom burden. Little is known about the frequency and severity of symptoms over time, so we longitudinally characterized patients' symptoms using the Patient Care Moni ... Full text Link to item Cite

Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke.

Journal Article Transl Stroke Res · December 2015 The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflamma ... Full text Link to item Cite

Evaluation of Pillars4life: a virtual coping skills program for cancer survivors.

Journal Article Psychooncology · November 2015 OBJECTIVE: Pillars4Life is an educational program that teaches coping skills to cancer patients in a virtual group setting; it was recently implemented at 17 hospitals across the USA. The cost-effective, scalable, and assessable Pillars4Life curriculum tar ... Full text Link to item Cite

Practical Dyspnea Assessment: Relationship Between the 0-10 Numerical Rating Scale and the Four-Level Categorical Verbal Descriptor Scale of Dyspnea Intensity.

Journal Article J Pain Symptom Manage · October 2015 CONTEXT: Measurement of dyspnea is important for clinical care and research. OBJECTIVES: To characterize the relationship between the 0-10 Numerical Rating Scale (NRS) and four-level categorical Verbal Descriptor Scale (VDS) for dyspnea assessment. METHODS ... Full text Link to item Cite

A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain.

Journal Article J Pain Symptom Manage · October 2015 CONTEXT: Pain coping skills training (PCST) interventions have shown efficacy for reducing pain and providing other benefits in patients with cancer. However, their reach is often limited because of a variety of barriers (e.g., travel, physical burden, cos ... Full text Link to item Cite

The utility of cost discussions between patients with cancer and oncologists.

Journal Article Am J Manag Care · September 2015 OBJECTIVES: Patients with cancer can experience substantial financial burden. Little is known about patients' preferences for incorporating cost discussions into treatment decision making or about the ramifications of those discussions. The objective of th ... Link to item Cite

Validation and real-world assessment of the Functional Assessment of Anorexia-Cachexia Therapy (FAACT) scale in patients with advanced non-small cell lung cancer and the cancer anorexia-cachexia syndrome (CACS).

Journal Article Support Care Cancer · August 2015 PURPOSE: Patients with cancer anorexia-cachexia syndrome (CACS) suffer a significant symptom burden, impaired quality of life (QoL), and shorter survival. Measurement of QoL impairments related to CACS is thereby important both in clinical practice and in ... Full text Link to item Cite

Patient-reported outcomes as end points and outcome indicators in solid tumours.

Journal Article Nat Rev Clin Oncol · June 2015 Patient-reported outcome (PRO) measures, such as quality of life, have been associated with relevant clinical end points and are prognostic for survival outcomes in a variety of solid cancers in adults. In the past few years, PROs have garnered a greater i ... Full text Link to item Cite

Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.

Journal Article Thorax · May 2015 We searched MEDLINE, EMBASE and the Cochrane Controlled Trials Register to determine whether oxygen relieves dyspnoea in mildly or non-hypoxemic COPD and included 18 randomised controlled trials (431 participants) in the meta-analysis using Cochrane method ... Full text Link to item Cite

Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.

Journal Article JAMA Intern Med · May 2015 IMPORTANCE: For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy fo ... Full text Link to item Cite

Correlation between the international consensus definition of the Cancer Anorexia-Cachexia Syndrome (CACS) and patient-centered outcomes in advanced non-small cell lung cancer.

Journal Article J Pain Symptom Manage · April 2015 CONTEXT: The cancer anorexia-cachexia syndrome (CACS) is common in patients with advanced solid tumors and is associated with adverse outcomes including poor quality of life (QOL), impaired functioning, and shortened survival. OBJECTIVES: To apply the rece ... Full text Link to item Cite

A national snapshot of satisfaction with breast cancer procedures.

Conference Ann Surg Oncol · February 2015 PURPOSE: Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With co ... Full text Link to item Cite

Has It Really Been Demonstrated That Most Genomic Research Findings Are False?

Journal Article American Statistician · January 1, 2015 In a widely cited article, Ioannidis argued that most published research findings are false; particularly discovery research involving massive testing, genomics being a typical example. However, his argument ignores adjustment for multiple testing and thus ... Full text Cite

Patient preferences in advanced or recurrent ovarian cancer.

Journal Article Cancer · December 1, 2014 BACKGROUND: The objective of this study was to elucidate relative preferences of women with ovarian cancer for symptoms, treatment-related side effects, and progression-free survival (PFS) relevant to choosing a treatment regimen. METHODS: Women with advan ... Full text Link to item Cite

There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers.

Journal Article J Clin Oncol · October 1, 2014 PURPOSE: To identify insured services that are most important to Medicare beneficiaries with cancer and their family caregivers when coverage is limited. METHODS: A total of 440 participants (patients, n = 246; caregivers, n = 194) were enrolled onto the C ... Full text Link to item Cite

A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.

Journal Article BMC Health Serv Res · July 19, 2014 BACKGROUND: Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prio ... Full text Link to item Cite

Patient-oncologist cost communication, financial distress, and medication adherence.

Journal Article J Oncol Pract · May 2014 BACKGROUND: Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. METHODS: We surveyed insured adults receiving antica ... Full text Link to item Cite

Self-reported financial burden and satisfaction with care among patients with cancer.

Journal Article Oncologist · April 2014 BACKGROUND: Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. METHODS: This was an observational, cross-secti ... Full text Link to item Cite

Is there a relationship between posttraumatic stress and growth after a lymphoma diagnosis?

Journal Article Psychooncology · March 2014 OBJECTIVE: There are conflicting empirical data regarding the relationship between posttraumatic stress (PTS) and growth (PTG) observed in cancer survivors. Clarification of this association could inform evidence-based therapeutic recommendations to promot ... Full text Link to item Cite

Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer.

Journal Article J Oncol Pract · November 2013 The authors found that cost-related medication nonadherence was prevalent among patients with cancer who sought financial assistance. ... Full text Link to item Cite

The influence of a physician and patient intervention program on dietary intake.

Journal Article J Acad Nutr Diet · November 2013 BACKGROUND: Efficient dietary interventions for patients with hypertension in clinical settings are needed. OBJECTIVE: To assess the separate and combined influence of a physician intervention (MD-I) and a patient intervention (PT-I) on dietary intakes of ... Full text Link to item Cite

The effect of palliative care on patient functioning.

Journal Article J Palliat Med · October 2013 BACKGROUND: Palliative care is increasingly viewed as a care option that should not only be offered to patients very near the end of life. An important question is whether increased use of palliative care soon after a patient's referral will improve patien ... Full text Link to item Cite

Diagnosing HIV infection in primary care settings: missed opportunities.

Journal Article AIDS Patient Care STDS · July 2013 In the United States, 20% of HIV-infected persons are unaware of their diagnosis. Improved application of HIV screening recommendations in healthcare settings may facilitate diagnosis. Clinical patient data and previous healthcare visits were reviewed from ... Full text Link to item Cite

Delivery strategies to optimize resource utilization and performance status for patients with advanced life-limiting illness: results from the "palliative care trial" [ISRCTN 81117481].

Journal Article J Pain Symptom Manage · March 2013 CONTEXT: Evidence-based approaches are needed to improve the delivery of specialized palliative care. OBJECTIVES: The aim of this trial was to improve on current models of service provision. METHODS: This 2Ɨ2Ɨ2 factorial cluster randomized controlled trial ... Full text Link to item Cite

In-hospital resource use and medical costs in the last year of life by mode of death (from the HF-ACTION randomized controlled trial).

Journal Article Am J Cardiol · October 15, 2012 Patterns of medical resource use near the end of life may differ across modes of death. The aim of this study was to characterize patterns of inpatient resource use and direct costs for patients with heart failure (HF) who died of sudden cardiac death (SCD ... Full text Link to item Cite

Aerobic and resistance training effects on energy intake: the STRRIDE-AT/RT study.

Journal Article Med Sci Sports Exerc · October 2012 PURPOSE: Our study characterizes food and energy intake responses to long-term aerobic training (AT) and resistance training (RT) during a controlled 8-month trial. METHODS: In the STRRIDE-AT/RT trial, overweight/obese sedentary dyslipidemic men and women ... Full text Link to item Cite

Analyzing phase III studies in hospice/palliative care. a solution that sits between intention-to-treat and per protocol analyses: the palliative-modified ITT analysis.

Journal Article J Pain Symptom Manage · October 2012 Intention-to-treat (ITT) analyses are the standard way to evaluate randomized controlled trials (RCTs) to minimize Type I errors related to differential rates of noncompletion from one study arm. People in palliative care often die sooner than predicted as ... Full text Link to item Cite

Conflict of interest disclosure in off-label oncology clinical trials.

Journal Article J Oncol Pract · September 2012 PURPOSE: We sought to determine the prevalence, reliability, and predictors of conflict of interest (COI) and funding disclosure statements for studies of anticancer targeted therapies conducted in the off-label prescribing setting. METHODS: As a part of a ... Full text Link to item Cite

Effect of clinical decision-support systems: a systematic review.

Journal Article Ann Intern Med · July 3, 2012 BACKGROUND: Despite increasing emphasis on the role of clinical decision-support systems (CDSSs) for improving care and reducing costs, evidence to support widespread use is lacking. PURPOSE: To evaluate the effect of CDSSs on clinical outcomes, health car ... Full text Link to item Cite

Exercise effects on lipids in persons with varying dietary patterns-does diet matter if they exercise? Responses in Studies of a Targeted Risk Reduction Intervention through Defined Exercise I.

Journal Article Am Heart J · July 2012 BACKGROUND: The standard clinical approach for reducing cardiovascular disease risk due to dyslipidemia is to prescribe changes in diet and physical activity. The purpose of the current study was to determine if, across a range of dietary patterns, there w ... Full text Link to item Cite

Enabling health care decisionmaking through clinical decision support and knowledge management.

Journal Article Evid Rep Technol Assess (Full Rep) · April 2012 OBJECTIVES: To catalogue study designs used to assess the clinical effectiveness of CDSSs and KMSs, to identify features that impact the success of CDSSs/KMSs, to document the impact of CDSSs/KMSs on outcomes, and to identify knowledge types that can be in ... Link to item Cite

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

Journal Article Circ Cardiovasc Qual Outcomes · January 2012 BACKGROUND: Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions ... Full text Link to item Cite

An active learning approach to teach advanced multi-predictor modeling concepts to clinicians

Journal Article Journal of Statistics Education · January 1, 2012 Clinicians have characteristics - high scientific maturity, low tolerance for symbol manipulation and programming, limited time outside of class - that limit the effectiveness of traditional methods for teaching multi-predictor modeling. We describe an act ... Full text Cite

Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT.

Journal Article Am J Physiol Endocrinol Metab · November 2011 While the benefits of exercise are clear, many unresolved issues surround the optimal exercise prescription. Many organizations recommend aerobic training (AT) and resistance training (RT), yet few studies have compared their effects alone or in combinatio ... Full text Link to item Cite

Longitudinal patient-reported performance status assessment in the cancer clinic is feasible and prognostic.

Journal Article J Oncol Pract · November 2011 PURPOSE: Performance status is prognostic in oncology and palliative care settings. Traditionally clinician rated, it is often inconsistently collected, recorded, and measured, thereby limiting its utility. Patient-reported strategies are increasingly used ... Full text Link to item Cite

Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial.

Journal Article Arch Neurol · October 2011 OBJECTIVE: To perform a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, which tested the effect of treatment with atorvastatin in reducing stroke in subjects with a recent stroke or transient ischem ... Full text Link to item Cite

Quantitation of Candida CFU in initial positive blood cultures.

Journal Article J Clin Microbiol · August 2011 One potential limitation of DNA-based molecular diagnostic tests for Candida bloodstream infection (BSI) is organism burden, which is not sufficiently characterized. We hypothesized that the number of CFU per milliliter (CFU/ml) present in an episode of Ca ... Full text Link to item Cite

Symptomatic oxygen for non-hypoxaemic chronic obstructive pulmonary disease.

Journal Article Cochrane Database Syst Rev · June 15, 2011 BACKGROUND: Dyspnoea is a common symptom in chronic obstructive pulmonary disease (COPD). People who are hypoxaemic may be given long-term oxygen relief therapy (LTOT) to improve their life expectancy and quality of life. However, the symptomatic benefit o ... Full text Link to item Cite

Utility scores and treatment preferences for clinical early-stage cervical cancer.

Journal Article Value Health · June 2011 OBJECTIVES: To determine utility scores for health states relevant to the treatment of early-stage, high-risk cervical cancer. METHODS: Seven descriptive health states incorporating the physical and emotional aspects of medical treatment, recovery, and pro ... Full text Link to item Cite

Patient-care practices associated with an increased prevalence of hepatitis C virus infection among chronic hemodialysis patients.

Journal Article Infect Control Hosp Epidemiol · May 2011 OBJECTIVE: To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients. DESIGN: Survey. SETTING: Chronic hemodialysis facilities in the United States. PARTICIPANTS: Equal-pr ... Full text Link to item Cite

Physician characteristics as predictors of blood pressure control in patients enrolled in the hypertension improvement project (HIP).

Journal Article J Clin Hypertens (Greenwich) · February 2011 The authors sought to examine the relationship between physician characteristics and patient blood pressure (BP) in participants enrolled in the Hypertension Improvement Project (HIP). In this cross-sectional study using baseline data of HIP participants, ... Full text Link to item Cite

Exploration of a hypothesized independent association of a common 9p21.3 gene variant and ischemic stroke in patients with and without angiographic coronary artery disease.

Journal Article Cerebrovasc Dis · 2011 BACKGROUND: Single-nucleotide polymorphisms (SNPs) at the chromosome 9p21.3 locus are associated with coronary artery disease (CAD). An association of this genomic region with ischemic stroke independent of its effect on CAD could suggest an additional, st ... Full text Link to item Cite

Cost efficiency of anticoagulation with warfarin to prevent stroke in medicare beneficiaries with nonvalvular atrial fibrillation.

Journal Article Stroke · January 2011 BACKGROUND AND PURPOSE: in controlled trials, anticoagulation with warfarin reduces stroke risk by nearly two thirds, but the benefit has been less pronounced in clinical practice. This report describes the extent of warfarin use, its effectiveness, and it ... Full text Open Access Link to item Cite

Differential patterns of cognitive decline in anterior and posterior white matter hyperintensity progression.

Journal Article Stroke · September 2010 BACKGROUND AND PURPOSE: White matter hyperintensities (WMHs) found on brain MRI in elderly individuals are largely thought to be due to microvascular disease, and its progression has been associated with cognitive decline. The present study sought to deter ... Full text Link to item Cite

Hypertension improvement project: randomized trial of quality improvement for physicians and lifestyle modification for patients.

Journal Article Hypertension · December 2009 Despite widely publicized hypertension treatment guidelines for physicians and lifestyle recommendations for patients, blood pressure control rates remain low. In community-based primary care clinics, we performed a nested, 2 x 2 randomized, controlled tri ... Full text Link to item Cite

Hypertension Improvement Project (HIP): study protocol and implementation challenges.

Journal Article Trials · February 26, 2009 BACKGROUND: Hypertension affects 29% of the adult U.S. population and is a leading cause of heart disease, stroke, and kidney failure. Despite numerous effective treatments, only 53% of people with hypertension are at goal blood pressure. The chronic care ... Full text Open Access Link to item Cite

The headache management trial: a randomized study of coordinated care.

Journal Article Headache · October 2008 Featured Publication CONTEXT: Headache is a common, disabling disorder that is frequently not well managed in general clinical practice. OBJECTIVE: To determine if patients cared for in a coordinated headache management program would achieve reduced headache disability compare ... Full text Link to item Cite

Direct-to-patient expert system and home INR monitoring improves control of oral anticoagulation.

Journal Article J Thromb Thrombolysis · August 2008 BACKGROUND AND OBJECTIVE: Internet-based disease management programs have the potential to improve patient care. The objective of this study was to determine whether an interactive, internet-based system enabling supervised, patient self-management of oral ... Full text Link to item Cite

Impact of hormone replacement therapy on exercise training-induced improvements in insulin action in sedentary overweight adults.

Journal Article Metabolism · July 2008 Exercise training (ET) and hormone replacement therapy (HRT) are both recognized influences on insulin action, but the influence of HRT on responses to ET has not been examined. To determine if HRT use provided additive benefits for the response of insulin ... Full text Link to item Cite

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis.

Journal Article Br J Cancer · January 29, 2008 The aim of this study was to determine the efficacy of palliative oxygen for relief of dyspnoea in cancer patients. MEDLINE and EMBASE were searched for randomised controlled trials, comparing oxygen and medical air in cancer patients not qualifying for ho ... Full text Open Access Link to item Cite

Opportunities for improving management of advanced chronic kidney disease.

Journal Article Am J Med Qual · 2008 Evidence suggests that management of advanced chronic kidney disease affects patient outcomes. To identify clinical areas that demand attention from a quality improvement perspective, we sought to examine the extent of conformance to an advanced chronic ki ... Full text Link to item Cite

Systematic review: comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers for treating essential hypertension.

Journal Article Ann Intern Med · January 1, 2008 BACKGROUND: The relative effectiveness of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) for lowering blood pressure is unknown. PURPOSE: To compare the benefits and harms of ACE inhibitors versus ARBs for treati ... Full text Link to item Cite

Utility of the advanced chronic kidney disease patient management tools: case studies.

Journal Article Am J Med Qual · 2008 Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific manageme ... Full text Link to item Cite

Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise).

Journal Article Am J Cardiol · December 15, 2007 Although exercise improves individual risk factors for metabolic syndrome (MS), there is little research on the effect of exercise on MS as a whole. The objective of this study was to determine how much exercise is recommended to decrease the prevalence of ... Full text Link to item Cite

Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting.

Journal Article Anesth Analg · December 2007 The present guidelines were compiled by a multidisciplinary international panel of individuals with interest and expertise in postoperative nausea and vomiting (PONV) under the auspices of The Society of Ambulatory Anesthesia. The panel critically evaluate ... Full text Link to item Cite

Review of evidence for genetic testing for CYP450 polymorphisms in management of patients with nonpsychotic depression with selective serotonin reuptake inhibitors.

Journal Article Genet Med · December 2007 PURPOSE: Cytochrome P450 (CYP450) enzymes metabolize selective serotonin reuptake inhibitor (SSRI) drugs used in treatment of depression. Variants in these genes may impact treatment efficacy and tolerability. The purpose of this study was 2-fold: to syste ... Full text Link to item Cite

Assessing the quality of colorectal cancer care: do we have appropriate quality measures? (A systematic review of literature).

Journal Article J Eval Clin Pract · December 2007 RATIONALE, AIMS AND OBJECTIVES: The burden of illness from colorectal cancer (CRC) can be reduced by improving the quality of care. Identifying appropriate quality measures is the first step in this direction. We identified process measures currently avail ... Full text Link to item Cite

What is the impact of physician communication and patient understanding in the management of headache?

Journal Article Neuropsychiatr Dis Treat · December 2007 Migraine is a common and debilitating condition. Despite the burden of disease and increasing availability of effective treatment, migraine management is unsatisfactory. Evidence in other chronic conditions indicates that effective physician communication ... Full text Link to item Cite

Palliative oxygen for non-hypoxaemic chronic obstructive pulmonary disease

Journal Article Cochrane Database of Systematic Reviews · December 1, 2007 Full text Cite

Dietary carbohydrate intake and high-sensitivity C-reactive protein in at-risk women and men.

Journal Article Am Heart J · November 2007 BACKGROUND: The quality and quantity of dietary carbohydrate intake, measured as dietary glycemic load (GL), are associated with a number of cardiovascular disease (CVD) risk factors and, in healthy young women, are related to increased high-sensitivity C- ... Full text Link to item Cite

Less is not more: underutilization of headache medications in a university hospital emergency department.

Journal Article Headache · September 2007 OBJECTIVE: To gain knowledge of episodic headache patients who seek care at an urban university emergency department (ED), to evaluate the care they receive and to examine the impact of the ED on these headache patients. BACKGROUND: In the United States, 1 ... Full text Link to item Cite

Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia.

Journal Article Infect Control Hosp Epidemiol · July 2007 OBJECTIVE: Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumon ... Full text Link to item Cite

Advanced chronic kidney disease practice patterns among nephrologists and non-nephrologists: a database analysis.

Journal Article Clin J Am Soc Nephrol · March 2007 Chronic kidney disease (CKD) outcomes, including progression to end stage, is influenced by patient treatment and is known to be suboptimal. A commercial database was analyzed to assess practice patterns and conformance to clinical practice guidelines amon ... Full text Link to item Cite

Development, validation, and application of a microsimulation model to predict stroke and mortality in medically managed asymptomatic patients with significant carotid artery stenosis.

Journal Article Value Health · 2007 OBJECTIVE: To develop a model to predict stroke-free survival and mortality over a multiyear time frame for a trial-excluded population of medically managed asymptomatic patients with significant carotid artery stenosis. METHODS: We calibrated, validated, ... Full text Link to item Cite

Quality measures for the use of adjuvant chemotherapy and radiation therapy in patients with colorectal cancer: a systematic review.

Journal Article Cancer · November 15, 2006 BACKGROUND: Chemotherapy (CT) and radiation therapy (RT) are essential components of adjuvant (preoperative or postoperative) therapy for many patients with colorectal cancer (CRC); however, quality measures (QMs) of these critical aspects of CRC treatment ... Full text Link to item Cite

Response of high-sensitivity C-reactive protein to exercise training in an at-risk population.

Journal Article Am Heart J · October 2006 BACKGROUND: High-sensitivity C-reactive protein (hsCRP) is promoted as an independent predictor of atherosclerotic risk. In addition, cardiorespiratory fitness is inversely related to hsCRP in single-sex cross-sectional analyses. Our objective was to deter ... Full text Link to item Cite

Quality measures for the diagnosis and management of colorectal cancer.

Journal Article J Clin Oncol · June 20, 2006 16031 Background: The huge burden of illness from colorectal cancer (CRC) can be reduced by improving the quality of care for CRC patients. Identifying appropriate quality measures that can assess the processes of care is the first step in this process. Th ... Link to item Cite

Changing physician knowledge, attitudes, and beliefs about migraine: evaluation of a new educational intervention.

Journal Article Headache · May 2006 OBJECTIVE: Use a presurvey of primary care providers (PCPs) enrolled in a continuing medical education (CME) program on headache management to ascertain their existing knowledge, attitudes, and beliefs regarding migraine and use a postsurvey to determine t ... Full text Link to item Cite

Cancer care quality measures: diagnosis and treatment of colorectal cancer.

Journal Article Evid Rep Technol Assess (Full Rep) · May 2006 OBJECTIVES: To identify measures that are currently available to assess the quality of care provided to patients with colorectal cancer (CRC), and to assess the extent to which these measures have been developed and tested. DATA SOURCES: Published and unpu ... Link to item Cite

Facilitated process improvement: an approach to the seamless linkage between evidence and practice in CKD.

Journal Article Am J Kidney Dis · March 2006 Featured Publication BACKGROUND: Two common strategies for guideline implementation are preformed practice improvement tools, such as flowcharts, and process reengineering by total quality management (TQM) teams. Prespecified tools fail to accommodate local circumstances, TQM ... Full text Link to item Cite

Assessing weight-related quality of life in adolescents.

Journal Article Obesity (Silver Spring) · March 2006 OBJECTIVE: The development of a new weight-related measure to assess quality of life in adolescents [Impact of Weight on Quality of Life (IWQOL)-Kids] is described. RESEARCH METHODS AND PROCEDURES: Using a literature search, clinical experience, and consul ... Full text Link to item Cite

Point-of-care testing of the international normalized ratio in patients with antiphospholipid antibodies.

Journal Article Thromb Haemost · December 2005 Antiphospholipid antibodies can influence the results of clotting tests in a subset of patients, which can be a major obstacle in monitoring warfarin. The aim was to determine if point-of-care testing of the International Normalized Ratio (INR) is influenc ... Full text Link to item Cite

A cost-minimization analysis comparing azithromycin-based and levofloxacin-based protocols for the treatment of patients hospitalized with community-acquired pneumonia: results from the CAP-IN trial.

Journal Article Chest · November 2005 BACKGROUND: A randomized trial was performed comparing azithromycin and levofloxacin for treating moderately to severely ill patients hospitalized with community-acquired pneumonia. This is a cost-minimization analysis comparing those regimens. METHODS: Th ... Full text Link to item Cite

Burden of illness and satisfaction with care among patients with headache seen in a primary care setting.

Journal Article Headache · September 2005 OBJECTIVE: To assess the current level of headache burden and the headache management needs at three diverse clinical sites. BACKGROUND: Headache is a common disabling disorder that is costly for the patient and a management challenge for physicians. The d ... Full text Link to item Cite

Reply

Journal Article American Journal of Infection Control · September 2005 Full text Cite

Combining information from multiple data sources to create multivariable risk models: illustration and preliminary assessment of a new method.

Journal Article J Biomed Biotechnol · June 30, 2005 A common practice of metanalysis is combining the results of numerous studies on the effects of a risk factor on a disease outcome. If several of these composite relative risks are estimated from the medical literature for a specific disease, they cannot b ... Full text Link to item Cite

Dissemination of Evidence-based Practice Center reports.

Journal Article Ann Intern Med · June 21, 2005 The Evidence-based Practice Center (EPC) program within the Agency for Healthcare Research and Quality (AHRQ) provides detailed evidence reports for partner organizations that they can translate into activities that improve patient care. A review of these ... Full text Link to item Cite

Quantitative myasthenia gravis score: assessment of responsiveness and longitudinal validity.

Journal Article Neurology · June 14, 2005 We prospectively tested the quantitative myasthenia gravis score (QMG) for responsiveness and longitudinal construct validity in 53 patients with myasthenia gravis. Index of responsiveness was high. Longitudinal construct validity was confirmed by the corr ... Full text Link to item Cite

Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions.

Journal Article Prev Med · May 2005 BACKGROUND: Individuals in the carpentry trade, due to lifestyle habits and occupational exposures, may be at above-average risk for colorectal cancer (CRC). Based on the literature which suggests that increasing perceived risk motivates behavior change, w ... Full text Link to item Cite

Cost of multiple sclerosis by level of disability: a review of literature.

Journal Article Mult Scler · April 2005 We performed a review of the economic literature to identify what is known about the relationship between Expanded Disability Status Scale (EDSS) categories and cost of multiple sclerosis (MS). We sought cohort studies of patients with multiple sclerosis t ... Full text Link to item Cite

Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses.

Journal Article Am J Infect Control · March 2005 BACKGROUND: Health care-associated infections most commonly result from person-to-person transmission via the hands of health care workers. METHODS: We studied the efficacy of hand hygiene agents (n = 14) following 10-second applications to reduce the leve ... Full text Link to item Cite

Cost-effectiveness of antiplatelet agents in secondary stroke prevention: the limits of certainty.

Journal Article Value Health · 2005 UNLABELLED: Which of the available antiplatelet therapies should be preferred for secondary prevention of recurrent ischemic stroke has been contentious. OBJECTIVE: We applied the Duke Stroke Policy Model (DSPM) to reconsider this issue, paying particular ... Full text Link to item Cite

Point of Care Monitoring of the International Normalized Ratio in Patients with Antiphospholipid Antibodies.

Conference Blood · November 16, 2004 AbstractWarfarin is effective in decreasing recurrent thrombosis in patients with antiphospholipid antibody syndrome (APS). Antiphospholipid antibodies (APAs) can influence the results of clotting tests in a ... Full text Cite

Gender and racial differences in lipoprotein subclass distributions: the STRRIDE study.

Journal Article Atherosclerosis · October 2004 Recent research has focused on the potential atherogenicity of various lipoprotein subclasses and their link to coronary heart disease (CHD) risk. This investigation seeks to identify differences in lipoprotein subclass distributions among a biracial, midd ... Full text Link to item Cite

Charlson Index comorbidity adjustment for ischemic stroke outcome studies.

Journal Article Stroke · August 2004 BACKGROUND AND PURPOSE: The Charlson Index is commonly used in outcome studies to adjust for patient comorbid conditions, but has not been specifically validated for use in studies of ischemic stroke. The purpose of the present study was to determine wheth ... Full text Link to item Cite

A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

Journal Article Health Qual Life Outcomes · May 6, 2004 BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of lif ... Full text Open Access Link to item Cite

How strong is the relationship between functional status and quality of life among persons with stroke?

Journal Article J Rehabil Res Dev · May 2004 The quantitative relationship between functional status and self-reported quality of life is relatively unexamined. As part of the 1-, 6-, and 12-month telephone follow-up of consecutive patients in an observational study of patients with stroke, we found ... Full text Link to item Cite

Alzheimer disease: operating characteristics of PET--a meta-analysis.

Journal Article Radiology · April 2004 PURPOSE: To assess the operating characteristics of positron emission tomography (PET) by using fluorine 18 fluorodeoxyglucose (FDG) in the diagnosis of Alzheimer disease. MATERIALS AND METHODS: Articles published between 1989 and 2003 were identified in t ... Full text Link to item Cite

Modifying attributions of colorectal cancer risk.

Journal Article Cancer Epidemiol Biomarkers Prev · April 2004 We report how a four-group risk communication intervention targeted to individuals in the carpentry trade affected their perceived causes (i.e., attributions) for increased colorectal cancer (CRC) risk. The intervention varied the amount of information pre ... Link to item Cite

Cost analysis of aprotinin for coronary artery bypass patients: analysis of the randomized trials.

Journal Article Ann Thorac Surg · February 2004 BACKGROUND: The full kallikrein-inhibiting dose of aprotinin has been shown to reduce blood loss, transfusion requirements, and the systemic inflammatory response associated with cardiopulmonary bypass graft surgery (CABG). A half-dose regimen, although ha ... Full text Link to item Cite

Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study.

Journal Article Arch Intern Med · January 12, 2004 BACKGROUND: Obesity is a major health problem due, in part, to physical inactivity. The amount of activity needed to prevent weight gain is unknown. OBJECTIVE: To determine the effects of different amounts and intensities of exercise training. DESIGN: Rand ... Full text Link to item Cite

Accuracy of self-reports of fecal occult blood tests and test results among individuals in the carpentry trade.

Journal Article Prev Med · November 2003 BACKGROUND: Inaccuracy in self-reports of colorectal cancer (CRC) screening procedures (e.g., over- or underreporting) may interfere with individuals adhering to appropriate screening intervals, and can blur the true effects of physician recommendations to ... Full text Link to item Cite

A clinical decision and economic analysis model of cancer pain management.

Journal Article Am J Manag Care · October 2003 OBJECTIVE: To design a model that educates clinical decision makers and healthcare professionals about the burden of cancer pain in their individual populations, and that assists them in weighing the effectiveness and cost of different cancer pain manageme ... Link to item Cite

Cancer incidence among union carpenters in New Jersey.

Journal Article J Occup Environ Med · October 2003 A cohort of 13,354 male union carpenters in New Jersey was linked to cancer registry data to investigate cancer incidence during 1979 through 2000. Surveillance, Epidemiology and End Results data were used to calculate standardized incidence ratios (SIRs). ... Full text Link to item Cite

VA Stroke Study: neurologist care is associated with increased testing but improved outcomes.

Journal Article Neurology · September 23, 2003 OBJECTIVE: VA Stroke Study (VASt) data were analyzed to determine whether neurologist management affected the process and outcome of care of patients with ischemic stroke. METHODS: VASt prospectively identified patients with stroke admitted to nine VA hosp ... Full text Link to item Cite

Cross-calibration of Stroke disability measures: Bayesian analysis of longitudinal ordinal categorical data using negative dependence

Journal Article Journal of the American Statistical Association · June 1, 2003 It is common to assess disability of stroke patients using standardized scales, such as the Rankin Stroke Outcome Scale (RS) and the Barthel Index (BI). The RS, which was designed for applications to stroke, is based on assessing directly the global condit ... Full text Cite

PNP14: COST OF MULTIPLE SCLEROSIS BY LEVEL OF DISABILITY

Journal Article Value in Health · May 2003 Full text Cite

Veterans Administration Acute Stroke (VASt) Study: lack of race/ethnic-based differences in utilization of stroke-related procedures or services.

Journal Article Stroke · April 2003 BACKGROUND AND PURPOSE: Race/ethnic-based disparities in the utilization of health-related services have been reported. Data collected as part of the Veterans Administration Acute Stroke Study (VASt) were analyzed to determine whether similar differences w ... Full text Link to item Cite

Racial differences in survival post cerebral infarction among the elderly.

Journal Article Neurology · January 28, 2003 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

VA stroke study (VASt study): Progressing stroke

Conference ANNALS OF NEUROLOGY · 2003 Cite

Headache management program improves outcome for chronic headache.

Journal Article Headache · 2003 OBJECTIVE: To determine the feasibility of developing a headache management program and to assess the outcomes of patients referred to the program for treatment of chronic headache. BACKGROUND: Effective headache treatment requires that the patient receive ... Full text Link to item Cite

When should functional neuroimaging techniques be used in the diagnosis and management of Alzheimer's dementia? A decision analysis.

Journal Article Value Health · 2003 BACKGROUND: Functional neuroimaging, including positron emission tomography (PET), has been proposed for use in diagnosing Alzheimer's disease-related dementia (AD). OBJECTIVE: The objective of this study was identify the circumstances under which PET scan ... 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

Effects of the amount and intensity of exercise on plasma lipoproteins.

Journal Article N Engl J Med · November 7, 2002 BACKGROUND: Increased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospe ... Full text Link to item Cite

Structure, process, and outcomes in stroke rehabilitation.

Journal Article Med Care · November 2002 BACKGROUND: The health services research framework of structure, process, and outcome is used commonly to examine quality of care, and it indicates that structure influences process, which in turn influences outcomes. However, little empirical work has bee ... Full text Link to item Cite

Which approach to anticoagulation management is best? Illustration of an interactive mathematical model to support informed decision making.

Journal Article J Thromb Thrombolysis · October 2002 Featured Publication BACKGROUND: Among patients with atrial fibrillation or mechanical heart valves, determining the best approach to oral anticoagulation largely depends on comparing the costs of anticoagulation management with the costs of events (thromboembolism and bleedin ... Full text Link to item Cite

Performance of a mail-administered version of a stroke-specific outcome measure, the Stroke Impact Scale.

Journal Article Clin Rehabil · August 2002 OBJECTIVE: To evaluate the feasibility and concurrent validity of a new, mail-administered, stroke-specific outcome measure, the Stroke Impact Scale (SIS). DESIGN: Observational cohort study. SETTING AND PATIENTS: Stroke patients who had lived independentl ... 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 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

Postacute stroke guideline compliance is associated with greater patient satisfaction.

Journal Article Arch Phys Med Rehabil · June 2002 OBJECTIVE: To determine if the structure of care or the process of stroke care, as measured by compliance with stroke guidelines published by the Agency for Healthcare Research and Quality (AHRQ), is associated with patient satisfaction. DESIGN: Prospectiv ... Full text Link to item Cite

Incorporating genetic susceptibility feedback into a smoking cessation program for African-American smokers with low income.

Journal Article Cancer Epidemiol Biomarkers Prev · June 2002 PURPOSE: Markers of genetic susceptibility to tobacco-related cancers could personalize harms of smoking and motivate cessation. Our objective was to assess whether a multicomponent intervention that included feedback about genetic susceptibility to lung c ... Link to item Cite

Effects of a mammography decision-making intervention at 12 and 24 months.

Journal Article Am J Prev Med · May 2002 BACKGROUND: Most women are not getting regular mammograms, and there is confusion about several mammography-related issues, including the age at which women should begin screening. Numerous groups have called for informed decision making about mammography, ... Full text Link to item Cite

Cost-effectiveness of ancrod treatment of acute ischaemic stroke: results from the Stroke Treatment with Ancrod Trial (STAT).

Journal Article J Eval Clin Pract · February 2002 RATIONALE, AIMS AND OBJECTIVES: This paper describes a recent randomized controlled trial in which 42% of patients receiving ancrod attained a favourable outcome in comparison with 34% of controls. Although the above effect size corresponds to a number nee ... Full text Link to item Cite

Exploring the association between perceived risks of smoking and benefits to quitting: who does not see the link?

Journal Article Addict Behav · 2002 This report explored associations between different measures of smokers' perceived risks of smoking and benefits to quitting and the extent to which these associations varied by demographic and other characteristics for 144 smokers. We hypothesized greater ... Full text Link to item Cite

Use of data from nonrandomized trial designs in evidence reports: an application to treatment of pulmonary disease following spinal cord injury.

Journal Article J Rehabil Res Dev · 2002 Evidence reports summarize the evidence pertaining to various health-related topics. Including evidence from nonrandomized studies into such reports involves a trade-off between availability and bias. We describe a general framework by which information fr ... Link to item Cite

Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke.

Journal Article Stroke · January 2002 BACKGROUND AND PURPOSE: The purpose of this study was to determine if compliance with poststroke rehabilitation guidelines was associated with better functional outcomes. METHODS: An inception cohort of 288 stroke patients in 11 Department of Veteran Affai ... Full text Link to item Cite

Studies of a targeted risk reduction intervention through defined exercise (STRRIDE).

Journal Article Med Sci Sports Exerc · October 2001 PURPOSE: The Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) trial is a randomized controlled clinical trial designed to study the effects of exercise training regimens differing in dose (kcal.wk-1) and/or intensity (re ... Full text Link to item Cite

Relationship between self-reported disability and caregiver hours.

Journal Article Am J Phys Med Rehabil · September 2001 OBJECTIVE: In a large, population-based cohort of patients with spinal cord dysfunction, we assessed the relationship between self-reported physical function and hours of care received. DESIGN: Data were obtained by a cross-sectional, self-administered sur ... Full text Link to item Cite

Effect of moderate weight loss on health-related quality of life: an analysis of combined data from 4 randomized trials of sibutramine vs placebo.

Journal Article Am J Manag Care · September 2001 OBJECTIVES: To determine whether (1) patients who experience greater weight loss also experience correspondingly greater improvements in health-related quality of life (HRQOL); (2) the improvement in HRQOL is noticeable for patients achieving moderate (5%- ... Link to item Cite

Reasons for quitting smoking among low-income African American smokers.

Journal Article Health Psychol · September 2001 The psychometric characteristics of the Reasons For Quitting scale (RFQ) were assessed among a sample of African American smokers with low income (N=487). The intrinsic and extrinsic scales and their respective subscales were replicated. As hypothesized, h ... Full text Link to item Cite

Improving headache care: Impact of a disease management program

Conference ANNALS OF NEUROLOGY · September 1, 2001 Link to item Cite

Treatment of pulmonary disease following cervical spinal cord injury.

Journal Article Evid Rep Technol Assess (Summ) · June 2001 Link to item Cite

The short-term impact of tailored mammography decision-making interventions.

Journal Article Patient Educ Couns · June 2001 BACKGROUND: We assessed the short-term impact of decision-making interventions on knowledge about mammography, accuracy of women's breast cancer risk perceptions, attitudes toward mammography, satisfaction with decisions, and mammography use since the inte ... Full text Link to item Cite

Hormone replacement therapy and ischemic stroke severity in women: a case-control study.

Journal Article Neurology · May 22, 2001 OBJECTIVE: To investigate whether ischemic stroke severity differed among women who were receiving hormone replacement therapy (HRT) as compared with those who were not receiving these drugs. BACKGROUND: Estrogen has a neuroprotective effect in animal mode ... Full text Link to item Cite

Have randomized controlled trials of neuroprotective drugs been underpowered? An illustration of three statistical principles.

Journal Article Stroke · March 2001 Featured Publication BACKGROUND AND PURPOSE: The results of phase III trials of neuroprotective drugs for acute ischemic stroke have been disappointing. We examine the question of whether these trials may have been underpowered. METHODS: Computer simulations were based on the ... Full text Link to item Cite

Differences in skeletal muscle between men and women with chronic heart failure.

Journal Article J Appl Physiol (1985) · January 2001 Men with chronic heart failure (CHF) have alterations in their skeletal muscle that are partially responsible for a decreased exercise tolerance. The purpose of this study was to investigate whether skeletal muscle alterations in women with CHF are similar ... Full text Link to item Cite

General performance on a numeracy scale among highly educated samples.

Journal Article Med Decis Making · 2001 BACKGROUND: Numeracy, how facile people are with basic probability and mathematical concepts, is associated with how people perceive health risks. Performance on simple numeracy problems has been poor among populations with little as well as more formal ed ... Full text Link to item Cite

Factors associated with repeat mammography screening.

Journal Article J Fam Pract · December 2000 BACKGROUND: Even organizations with differing mammography recommendations agree that regular repeat screening is required for mortality reduction. However, most studies have focused on one-time screening rather than repeat adherence. We compare trends in b ... Link to item Cite

New transient ischemic attack and stroke: outpatient management by primary care physicians.

Journal Article Arch Intern Med · October 23, 2000 BACKGROUND: Patients with transient ischemic attack (TIA) or stroke frequently first contact their primary care physician rather than seeking care at a hospital emergency department. The purpose of the present study was to identify a group of patients seen ... Full text Link to item Cite

Relationships among breast cancer perceived absolute risk, comparative risk, and worries.

Journal Article Cancer Epidemiol Biomarkers Prev · September 2000 When trying to predict breast cancer screening, it may be important to understand the relationships between perceived breast cancer risks and worries about getting breast cancer. This study examines the extent to which women's worries about breast cancer c ... Link to item Cite

Can continuous quality improvement be assessed using randomized trials? [see comment].

Journal Article Health Serv Res · August 2000 STUDY QUESTION: Continuous quality improvement (CQI) has been implemented at least to some degree in many health care settings, yet randomized controlled trials (RCTs) of CQI are rare. We ask whether, when, and how RCTs of CQI might be designed. STUDY DESI ... 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 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 of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities.

Journal Article Arch Intern Med · April 10, 2000 BACKGROUND: Most treatment of patients at risk for stroke is provided in the ambulatory setting. Although many studies have addressed the proportion of eligible patients with atrial fibrillation (AF) receiving warfarin sodium, few have addressed the qualit ... Full text Link to item Cite

Relationship between test frequency and outcomes of anticoagulation: a literature review and commentary with implications for the design of randomized trials of patient self-management.

Journal Article J Thromb Thrombolysis · April 2000 Featured Publication BACKGROUND: Patient self-management (PSM) of anticoagulation, which is primarily based upon the premise that more frequent testing will lead to tighter anticoagulation control and thus to improved clinical outcomes, is a promising model of care. The goals ... Full text Link to item Cite

Racial variation in treatment for transient ischemic attacks: impact of participation by neurologists.

Journal Article Health Serv Res · March 2000 OBJECTIVE: This study evaluates the role of neurologists in explaining African American-white differences in the use of diagnostic and therapeutic services for cerebrovascular disease. DATA SOURCES/STUDY SETTING: Medicare inpatient hospital records were us ... Link to item Cite

Disability fingerprints: patterns of disability in spinal cord injury and multiple sclerosis differ.

Journal Article J Gerontol A Biol Sci Med Sci · December 1999 BACKGROUND: Models for causation of functional disability differ as to whether different diseases lead to common expressions of disability versus producing unique "disability fingerprints." Multiple sclerosis (MS) and Spinal Cord Injury (SCI) both affect t ... Full text Link to item Cite

A comparison of three health status measures in primary care outpatients.

Journal Article J Gen Intern Med · December 1999 Our objective was to compare a brief, relatively new global health status measure, the Health Utilities Index Mark II (HUI), to two commonly applied health status measures (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] and the Sickness Jg ... Full text Link to item Cite

Incidence and occurrence of total (first-ever and recurrent) stroke.

Journal Article Stroke · December 1999 BACKGROUND AND PURPOSE: It has recently been hypothesized that the figure of approximately half a million strokes substantially underestimates the actual annual stroke burden for the United States. The majority of previously reported studies on the epidemi ... Full text Link to item Cite

The role of evidence reports in evidence-based medicine: a mechanism for linking scientific evidence and practice improvement.

Journal Article Jt Comm J Qual Improv · October 1999 STUDY QUESTIONS: In this article two related questions are considered: (1) Why isn't evidence-based medicine (EBM) more consistently implemented? and (2) Using the EBM paradigm, by what mechanism can we link evidence reports to concrete practice improvemen ... Full text Link to item Cite

Using outcomes data to identify best medical practice: The role of policy models

Journal Article Hepatology · June 9, 1999 Increasingly, physicians are attempting to incorporate best evidence into their clinical decision making. However, best evidence takes a variety of forms, including clinical trials, cohort studies, administrative data, and patient preference data. Incorpor ... Cite

Using outcomes data to identify best medical practice: the role of policy models.

Journal Article Hepatology · June 1999 Increasingly, physicians are attempting to incorporate best evidence into their clinical decision making. However, best evidence takes a variety of forms, including clinical trials, cohort studies, administrative data, and patient preference data. Incorpor ... Link to item Cite

Performing cost-effectiveness analysis by integrating randomized trial data with a comprehensive decision model: application to treatment of acute ischemic stroke.

Journal Article J Clin Epidemiol · March 1999 A recent national panel on cost-effectiveness in health and medicine has recommended that cost-effectiveness analysis (CEA) of randomized controlled trials (RCTs) should reflect the effect of treatments on long-term outcomes. Because the follow-up period o ... Full text Link to item Cite

Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II.

Journal Article Pharmacoeconomics · February 1999 The objective of this article was to describe and illustrate a comprehensive approach for estimating clinically important differences (CIDs) in health-related quality-of-life (HR-QOL). A literature review and pilot study were conducted to determine whether ... Full text Link to item Cite

Epidemiology of recurrent cerebral infarction: a medicare claims-based comparison of first and recurrent strokes on 2-year survival and cost.

Journal Article Stroke · February 1999 BACKGROUND AND PURPOSE: Because recurrent strokes will tend to leave patients with greater disability than first strokes, patients with recurrent strokes should have poorer outcomes on average than those with first strokes. The extent of this difference ha ... Full text Link to item Cite

Utilities for major stroke: results from a survey of preferences among persons at increased risk for stroke.

Journal Article Am Heart J · October 1998 BACKGROUND: Patient beliefs, values, and preferences are crucial to decisions involving health care. In a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke. METHODS AND RESULTS: Respondents were ob ... Full text Link to item Cite

Race, treatment, and survival among colorectal carcinoma patients in an equal-access medical system.

Journal Article Cancer · June 15, 1998 BACKGROUND: The aim of this study was to assess the influence of race on the treatment and survival of patients with colorectal carcinoma. METHODS: This retrospective cohort study included all white or black male veterans given a new diagnosis of colorecta ... 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

The cost-effectiveness of a clinical pharmacist intervention among elderly outpatients

Journal Article Pharmacotherapy · March 1, 1998 We estimated the cost and cost-effectiveness of a clinical pharmacist intervention known to improve the appropriateness of drug prescribing. Elderly veteran outpatients prescribed at least five drugs were randomized to an intervention (105 patients) or con ... Cite

Developing a national registry of veterans with spinal cord dysfunction: experiences and implications.

Journal Article Spinal Cord · January 1998 We describe the development of a registry of veterans with spinal cord dysfunction who have been treated within the Department of Veterans Affairs health care facilities. The registry departs from the function and structure of traditional registries by a m ... Full text Link to item Cite

Physician-reported readiness to change stroke prevention practices.

Journal Article J Stroke Cerebrovasc Dis · 1998 There are a series of possible impediments to the incorporation of new treatment modalities into clinical practice, and any intervention intended to alter practice must consider physicians' motivation and readiness to change. As part of a national survey i ... Full text Link to item Cite

Carotid endarterectomy trends in the patterns and outcomes of care at academic medical centers, 1990 through 1995.

Journal Article Arch Neurol · January 1998 OBJECTIVE: To evaluate whether the patterns of inpatient care and patient characteristics have changed for patients undergoing a carotid endarterectomy across a group of academic medical centers from 1990 through 1995. If changes occurred, we investigated ... Full text Link to item Cite

The cost-effectiveness of a clinical pharmacist intervention among elderly outpatients.

Journal Article Pharmacotherapy · 1998 We estimated the cost and cost-effectiveness of a clinical pharmacist intervention known to improve the appropriateness of drug prescribing. Elderly veteran outpatients prescribed at least five drugs were randomized to an intervention (105 patients) or con ... Link to item Cite

Predicting the cost of illness: a comparison of alternative models applied to stroke.

Journal Article Med Decis Making · 1998 Predictions of cost over well-defined time horizons are frequently required in the analysis of clinical trials and social experiments, for decision models investigating the cost-effectiveness of interventions, and for macro-level estimates of the resource ... Full text Link to item Cite

Adverse events after discontinuing medications in elderly outpatients.

Journal Article Arch Intern Med · October 27, 1997 BACKGROUND: Discontinuation of drug therapy is an important intervention in elderly outpatients receiving multiple medications, but it may be associated with adverse drug withdrawal events (ADWEs). OBJECTIVE: To determine the frequency, types, timing, seve ... Link to item Cite

The Stroke Prevention Policy Model: linking evidence and clinical decisions.

Journal Article Ann Intern Med · October 15, 1997 Simulation models that support decision and cost-effectiveness analysis can further the goals of evidence-based medicine by facilitating the synthesis of information from several sources into a single comprehensive structure. The Stroke Prevention Policy M ... Full text Link to item Cite

Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease.

Journal Article Neurology · September 1997 In administrative databases the International Classification of Diseases, Version 9, Clinical Modification (ICD-9-CM) is often used to identify patients with specific diagnoses. However, certain conditions may not be accurately reflected by the ICD-9 codes ... Full text Link to item Cite

Adverse drug events in high risk older outpatients.

Journal Article J Am Geriatr Soc · August 1997 OBJECTIVE: To describe the prevalence, types, and consequences of adverse drug events (ADEs) in older outpatients with polypharmacy. DESIGN: A cohort study. SETTING: General Medicine Clinic at the Durham Veterans Affairs Medical Center. PATIENTS: A total o ... Full text 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

Knowledge of risk among patients at increased risk for stroke.

Journal Article Stroke · May 1997 BACKGROUND AND PURPOSE: Patients who recognize their increased risk for stroke are more likely to engage in (and comply with) stroke prevention practices than those who do not. We describe perceived risk of stroke among a nationally diverse sample of patie ... Full text Link to item Cite

Inappropriate prescribing and health outcomes in elderly veteran outpatients.

Journal Article Ann Pharmacother · May 1997 OBJECTIVE: To determine the relationship of inappropriate prescribing in the elderly to health outcomes. SETTING: General Medical Clinic of the Durham Veterans Affairs Medical Center. PATIENTS: A total of 208 veterans more than 65 years old who were each t ... Full text Link to item Cite

Reliability of drug utilization evaluation as an assessment of medication appropriateness.

Journal Article Ann Pharmacother · May 1997 OBJECTIVE: To test the reliability of drug utilization evaluation (DUE) applied to medications commonly used by the ambulatory elderly. METHODS: A DUE model was developed for four domains: (1) justification for use, (2) critical process indicators, (3) com ... Full text Link to item Cite

Health status of individuals with mild stroke.

Journal Article Stroke · April 1997 BACKGROUND AND PURPOSE: Diminished quality of life and limitations in higher levels of physical functioning are often underestimated in stroke and are not fully captured by measures such as the Barthel Index and the Rankin Outcome Scale. This study used ad ... Full text Link to item Cite

Should we just let the anticoagulation service do it?

Journal Article J Gen Intern Med · April 1997 Link to item Cite

Reliability of the National Institutes of Health Stroke Scale. Extension to non-neurologists in the context of a clinical trial.

Journal Article Stroke · February 1997 BACKGROUND AND PURPOSE: The reliability of the National Institutes of Health Stroke Scale (NIHSS) has been established through testing its use in live and videotaped patients. This reliability testing has primarily focused on the use of the scale by neurol ... Full text Link to item Cite

Assessing uncertainty in cost-effectiveness analyses: application to a complex decision model.

Journal Article Med Decis Making · 1997 A framework for quantifying uncertainty about costs, effectiveness measures, and marginal cost-effectiveness ratios in complex decision models is presented. This type of application requires special techniques because of the multiple sources of information ... Full text Link to item Cite

The relative importance of strength and balance in chair rise by functionally impaired older individuals.

Journal Article J Am Geriatr Soc · December 1996 OBJECTIVE: The ability to stand independently and safely from the seated position is essential for independent function. This investigation determined the relative contributions of measures of lower extremity strength and measures of balance control in exp ... Full text Link to item Cite

What role do neurologists play in determining the costs and outcomes of stroke patients?

Journal Article Stroke · November 1996 BACKGROUND AND PURPOSE: Despite growing concern over the large numbers of specialists in the United States, little information is available on how stroke treatment varies by the specialty of the attending physician. This study compares the costs and outcom ... Full text Link to item Cite

Inpatient hospital utilization among veterans with traumatic spinal cord injury.

Journal Article Arch Phys Med Rehabil · October 1996 OBJECTIVE: To describe the pattern of inpatient hospital utilization, up to 15 years after injury, among a cohort of veterans with service-connected traumatic spinal cord injury (SCI). PATIENTS: A cohort of 1,250 male veterans, with traumatic SCI occurring ... Full text Link to item Cite

US National Survey of Physician Practices for the Secondary and Tertiary Prevention of Ischemic Stroke. Medical therapy in patients with carotid artery stenosis.

Journal Article Stroke · September 1996 BACKGROUND AND PURPOSE: Aspirin or other platelet antiaggregants and anticoagulants are commonly used in many types of patients at elevated stroke risk. However, relatively little is known concerning how practicing physicians use these medications in their ... Full text Link to item Cite

Sampling distributions of p(pos) and p(neg).

Journal Article J Clin Epidemiol · August 1996 In the absence of a gold standard, assessment of clinimetric properties of dichotomous variables should include reporting of the proportions of positive agreement (ppos) and negative agreement (pneg). For example, for a patient considering whether or not t ... Full text Link to item Cite

Using physician claims to identify postoperative complications of carotid endarterectomy.

Journal Article Health Serv Res · June 1996 OBJECTIVE: This study develops a methodology for identifying complications following carotid endarterectomy, using physician claims data. DATA SOURCES/STUDY SETTING: We selected a random 20 percent sample of Medicare patients undergoing carotid endarterect ... Link to item Cite

US National Survey of Physician Practices for the Secondary and Tertiary Prevention of Ischemic Stroke. Carotid endarterectomy.

Journal Article Stroke · May 1996 BACKGROUND AND PURPOSE: Data from several randomized clinical trials concerning the efficacy of carotid endarterectomy (CE) in patients with symptomatic and asymptomatic stenoses of the extracranial carotid artery are now available. Yet, there are few data ... Full text Link to item Cite

A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy.

Journal Article Am J Med · April 1996 PURPOSE: To evaluate the effect of sustained clinical pharmacist interventions involving elderly outpatients with polypharmacy and their primary physicians. PATIENTS AND METHODS: Randomized, controlled trial of 208 patients aged 65 years or older with poly ... Full text Link to item Cite

Inpatient costs of specific cerebrovascular events at five academic medical centers.

Journal Article Neurology · March 1996 We estimated the hospital costs for patients with different cerebrovascular events and applied patient and administrative variables to explain the variance of the cost estimates with particular attention to the relationship between patient age and cost. Th ... 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

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

Late withdrawal of cyclosporine in stable renal transplant recipients.

Journal Article Am J Kidney Dis · September 1995 The use of cyclosporine (CsA) in renal transplantation has been associated with an improvement in 1-year graft survival, but has not changed the rate of late graft loss. We sought to determine whether the intent to withdraw CsA late after renal transplanta ... Full text Link to item Cite

ADVERSE EVENTS AFTER DISCONTINUING MEDICATIONS IN ELDERLY OUTPATIENTS

Journal Article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · September 1, 1995 Link to item Cite

Accuracy and reliability of apical S3 gallop detection.

Journal Article J Gen Intern Med · August 1995 This study assessed physician performance in detecting the apical S3 gallop using a cardiology patient simulator. Six physicians (two cardiology fellows, two medicine residents, and two attending physicians) performed two sets of 24 cardiac examinations th ... Full text Link to item Cite

Malignant mesothelioma associated with low pulmonary tissue asbestos burdens: a light and scanning electron microscopic analysis of 18 cases.

Journal Article Mod Pathol · August 1995 Most malignant mesothelioma cases are associated with pulmonary asbestos body (AB) counts significantly greater than those of the general population. However, the question remains whether malignant mesothelioma cases associated with "normal" AB counts (i.e ... Link to item Cite

Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis.

Journal Article JAMA · April 5, 1995 OBJECTIVE: To compare 14-day outcomes and relapse and recurrence rates among patients with acute maxillary sinusitis randomized to 3-day (3D) vs 10-day (10D) treatment with trimethoprim/sulfamethoxazole (TMP/SMX). SETTING: University-affiliated Veterans Af ... Link to item Cite

Physician attitudes about anticoagulation for nonvalvular atrial fibrillation in the elderly.

Journal Article Arch Intern Med · February 13, 1995 BACKGROUND: Our goal was to determine whether patient age affects a physician's reported likelihood of using anticoagulant therapy or the intensity of anticoagulant therapy for patients with nonvalvular atrial fibrillation. METHODS: We surveyed a nationwid ... Link to item Cite

A nurse-coordinated intervention for primary care patients with non-insulin-dependent diabetes mellitus: impact on glycemic control and health-related quality of life.

Journal Article J Gen Intern Med · February 1995 OBJECTIVE: To examine the impact of a nurse-coordinated intervention delivered to patients with non-insulin-dependent diabetes mellitus between office visits to primary care physicians. DESIGN: Randomized, controlled trial. SETTING: Veterans Affairs genera ... Full text Link to item Cite

Assessing health-related quality of life in elderly outpatients: telephone versus face-to-face administration.

Journal Article J Am Geriatr Soc · December 1994 OBJECTIVE: While health-related quality of life (HRQOL) is increasingly being used as an outcome in clinical trials, it is unknown whether HRQOL assessments are influenced by the method of administration. Within the context of a randomized, controlled tria ... Full text Link to item Cite

The relationship between glycemic control and health-related quality of life in patients with non-insulin-dependent diabetes mellitus.

Journal Article Med Care · December 1994 The relationship between glycemic control and health-related quality of life was examined in patients with non-insulin-dependent diabetes mellitus (NIDDM). Within the context of a randomized controlled trial, 275 patients with NIDDM receiving primary care ... Full text Link to item Cite

Appropriateness of medication prescribing in ambulatory elderly patients.

Journal Article J Am Geriatr Soc · December 1994 OBJECTIVE: To assess the quality of medication prescribing in ambulatory elderly patients on multiple medications using the Medication Appropriateness Index (MAI). DESIGN: Cross-sectional study. SETTING: General Medical Clinic of the Durham VA Medical Cent ... Full text 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

A telephone-delivered intervention for patients with NIDDM. Effect on coronary risk factors.

Journal Article Diabetes Care · August 1994 OBJECTIVE: To examine whether a telephone-delivered intervention (TDI), designed to improve glycemic control in patients with non-insulin-dependent diabetes mellitus (NIDDM), improved coronary risk factors in high-risk patients. RESEARCH DESIGN AND METHODS ... Full text Link to item Cite

A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity.

Journal Article J Clin Epidemiol · August 1994 Inappropriate medication prescribing is an important problem in the elderly, but is difficult to measure. As part of a randomized controlled trial to evaluate the effectiveness of a pharmacist intervention among elderly veterans using many medications, we ... Full text 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

Similar motor recovery of upper and lower extremities after stroke.

Journal Article Stroke · June 1994 BACKGROUND AND PURPOSE: This study examined the validity of the clinical tenet that poststroke recovery of the upper extremity is less rapid and complete than poststroke recovery of the lower extremity. Previous studies comparing upper and lower extremity ... Full text Link to item Cite

Predicting falls: the role of mobility and nonphysical factors.

Journal Article J Am Geriatr Soc · March 1994 OBJECTIVE: Our purpose was to test a four-domain predictive model of recurrent falls developed for this study. In this model, limited mobility is considered a necessary but not sufficient element in risk of recurrent falls. Three other domains, attitudinal ... Full text Link to item Cite

Response

Journal Article Stroke · January 1, 1994 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

X-Linked hypophosphatemic rickets: a disease often unknown to affected patients.

Journal Article Bone Miner · January 1994 X-Linked hypophosphatemic rickets (XLH) is an X-linked dominant disorder that is secondary to renal phosphate wasting. Affected individuals frequently present the following characteristics: short stature, lower-extremity deformity, bone pain, dental absces ... Full text Link to item Cite

Compliance With Recommendations From an Outpatient Geriatric Consultation Team

Journal Article The Journal of Applied Gerontology · January 1, 1994 For outpatient geriatric consultation to be effective, it is necessary, although n t sufficient, that recommendations made to patients are followed. This prospective cohort study describes the nature of, types of, and compliance with, recommendations made ... Full text Cite

The Stroke Prevention Patient Outcomes Research Team. Goals and methods.

Journal Article Stroke · December 1993 BACKGROUND AND PURPOSE: The aim of the present study, based at Duke University and involving 14 other institutions, is to identify the most appropriate and cost-effective clinical strategies for prevention of ischemic (thrombotic or embolic) stroke in high ... Full text 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

Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level.

Journal Article Am J Ophthalmol · November 15, 1993 Fifty-eight healthy, normolipidemic adult men participated in a prospective, masked, randomized crossover study designed to compare the effects of two topical nonselective beta-adrenergic antagonists, carteolol and timolol, on plasma high-density lipoprote ... Full text Link to item Cite

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

Journal Article Am J Med · October 1993 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

Long-term survival of veterans with traumatic spinal cord injury.

Journal Article Arch Neurol · September 1993 OBJECTIVE: To investigate the long-term survival of veterans with traumatic spinal cord injury (SCI). DESIGN: Survival in a retrospective inception cohort of veterans suffering service-connected traumatic SCI is compared with survival among veterans disabl ... 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

Preliminary evidence on retention rates of primary care physicians in rural and urban areas.

Journal Article Med Care · July 1993 The primary study objectives were to 1) determine how many physicians entered primary care practice in rural and urban counties of North Carolina in the 1981 to 1989 period and 2) estimate their length of tenure in these areas. The secondary objective was ... Full text Link to item Cite

Aclacinomycin A in the treatment of experimental proliferative vitreoretinopathy. Efficacy and toxicity in the rabbit eye.

Journal Article Invest Ophthalmol Vis Sci · April 1993 PURPOSE: Aclacinomycin A is an oligosaccharide anthracycline that, by contrast with daunomycin, lacks carcinogenicity. The authors evaluated the efficacy of aclacinomycin A in prevention of experimental proliferative vitreoretinopathy (PVR) and its toxicit ... Link to item Cite

TOPICAL BETA-BLOCKERS AND PLASMA-LIPIDS - CARTEOLOL VS TIMOLOL

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · March 15, 1993 Link to item Cite

Role perceptions of divorcing parents.

Journal Article Health Care Women Int · 1993 Using interview data from a convenience sample of 101 divorcing parents, we examined the gender roles of parents during the transition from marriage to divorce. We found that the women, who most often initiated divorce, were changing their roles and that t ... Full text Link to item Cite

Likelihood ratios for continuous test results--making the clinicians' job easier or harder?

Journal Article J Clin Epidemiol · January 1993 Clinicians' paradigms for considering diagnostic test results require decisions based on the actual test value. However, when the test result is reported on a continuous scale each possible outcome may not result in unique actions. To simplify decision mak ... Full text Link to item Cite

Predictors of two-year post-hospitalization mortality among elderly veterans in a study evaluating a geriatric consultation team.

Journal Article J Am Geriatr Soc · December 1992 OBJECTIVE: To determine predictors of 2-year post-hospitalization mortality in a cohort of elderly hospitalized patients originally assembled to assess the impact of a Geriatric Consultation Team (GCT). DESIGN: Two-year follow-up of an inception cohort. SE ... Full text Link to item Cite

Physician-related barriers to breast cancer screening in older women.

Journal Article J Gerontol · November 1992 Despite evidence that annual mammographic screening in women 50 years and older reduces mortality, surveys of physicians and patients have repeatedly demonstrated that annual screening mammography is not performed. The fundamental question addressed in thi ... Link to item Cite

Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination.

Journal Article Ann Intern Med · November 1, 1992 OBJECTIVE: To identify the most useful clinical examination findings for the diagnosis of acute and subacute sinusitis. DESIGN: Prospective comparison of clinical findings with radiographs. SETTING: General medicine clinics at a university-affiliated Veter ... Full text Link to item Cite

A method for assessing drug therapy appropriateness.

Journal Article J Clin Epidemiol · October 1992 This study evaluated the reliability of a new medication appropriateness index. Using the index, independent assessments were made of chronic medications taken by 10 ambulatory, elderly male patients by a clinical pharmacist and an internist-geriatrician. ... Full text Link to item Cite

Criteria for the use of Sartwell's incubation period model to study chronic diseases with uncertain etiology.

Journal Article J Clin Epidemiol · October 1992 This study explores the conditions under which Sartwell's incubation period model may be appropriate for identifying a primary time period of etiologic risk for chronic diseases with uncertain etiology. The investigation begins with a description of the ev ... Full text Link to item Cite

Blood pressure measurements in the nursing home: are they accurate?

Journal Article Gerontologist · August 1992 To examine the accuracy of blood pressure (BP) measurements in the nursing home, a trained observer (physician) and nursing home staff (NHS) measured BP for 146 nursing home residents on two separate occasions. Using the physician as the reference standard ... Full text Link to item Cite

Relative frequency of nosocomial pathogens at a university hospital during the decade 1980 to 1989.

Journal Article Am J Infect Control · August 1992 BACKGROUND: We compared the relative frequency of pathogens isolated from 1985 to 1989 (N = 4358) with those isolated from 1980 to 1984 (N = 5290) in a university hospital to determine trends in the relative importance of pathogens causing nosocomial infec ... Full text Link to item Cite

FREQUENT MISDIAGNOSIS OF X-LINKED HYPOPHOS-PHATEMIC RICKETS

Journal Article JOURNAL OF BONE AND MINERAL RESEARCH · August 1, 1992 Link to item Cite

Physicians' attitudes and practices regarding treatment of HIV-infected patients.

Journal Article South Med J · July 1992 We conducted a statewide survey to identify physicians' experiences, attitudes, and practices related to HIV-infected patients. A random sample, stratified by medical specialty (primary care, surgery, emergency medicine), was drawn. Physicians were concern ... Full text Link to item Cite

Comparing proxy and patients' perceptions of patients' functional status: results from an outpatient geriatric clinic.

Journal Article J Am Geriatr Soc · June 1992 OBJECTIVE: To compare ratings of patients referred for geriatric evaluation and their proxies with respect to patients' ability to perform activities of daily living. DESIGN: Retrospective chart audit. SETTING: University-based Outpatient Geriatric Clinic. ... Full text Link to item Cite

The effect of combined daunorubicin and triamcinolone acetonide treatment on a refined experimental model of proliferative vitreoretinopathy.

Journal Article Invest Ophthalmol Vis Sci · June 1992 Prior studies have shown that intravitreal daunorubicin (9-15 nmol) and triamcinolone acetonide (2 mg) are effective individually in preventing retinal detachment in experimental proliferative vitreoretinopathy. This report compares the efficacy of the com ... Link to item Cite

Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks.

Journal Article JAMA · April 15, 1992 OBJECTIVE: To obtain a quantitative estimate of the impact on infectious complications of using transparent dressings with intravenous catheters. DATA SOURCES: Meta-analysis of all studies published in the English literature, including abstracts, letters, ... Link to item Cite

Generic versus disease specific health status measures: comparing the sickness impact profile and the arthritis impact measurement scales.

Journal Article J Rheumatol · April 1992 Health services researchers frequently must choose between a generic health status measure, such as the Sickness Impact Profile (SIP) and a disease specific health status measure, such as the Arthritis Impact Measurement Scales (AIMS). In a longitudinal st ... Link to item Cite

Factors associated with veterans' decisions about living wills.

Journal Article Arch Intern Med · February 1992 Most states have adopted legislation that allows patients to designate by advance directives the type of health care they would like to receive if they should become incompetent while suffering from a terminal illness. The living will is one of the most co ... Link to item Cite

Risk factors for nosocomial pneumonia in the elderly.

Journal Article Am J Med · February 1992 PURPOSE: Elderly patients have a disproportionate incidence of nosocomial pneumonia (NP) and a higher mortality rate, yet few studies have focused on this high-risk population. We undertook a study to examine risk factors for NP in elderly inpatients and t ... Full text Link to item Cite

TRANSPARENT POLYURETHANE FILM AS A CATHETER DRESSING - REPLY

Journal Article JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION · 1992 Full text Cite

Transparent polyurethane-film catheter dressings: A meta-analysis

Journal Article Annals of Internal Medicine · January 1, 1992 Cite

Resolution of a Regression Paradox in Pretestā€Posttest Designs

Journal Article Journal of Educational Measurement · January 1, 1992 Regression to the mean (RTM) of individuals is the tendency for extreme individuals to become less extreme on remeasurement; RTM of group means describes this same tendency among group means. Under the classical test model, in pretestā€posttest designs wher ... Full text Cite

Nosocomial infection rate as a function of human immunodeficiency virus type 1 status in hemophiliacs

Journal Article American Journal of Medicine · December 1, 1991 As part of a prospective cohort study initiated in 1983, the human immunodeficiency virus type 1 (HIV-1) status has been periodically determined for patients with clotting disorders (hemophilia A or B, von Willebrand's disease, miscellaneous). The Universi ... Cite

Two-year trends in physical performance following supervised exercise among community-dwelling older veterans.

Journal Article J Am Geriatr Soc · October 1991 The extent to which exercise can delay the normal decline in physical performance associated with aging is unknown. We examined the impact of 2 years of supervised exercise on cardiovascular fitness, flexibility, and strength in a group of elderly (age 65- ... Full text Link to item Cite

Nosocomial infection rate as a function of human immunodeficiency virus type 1 status in hemophiliacs.

Journal Article Am J Med · September 16, 1991 As part of a prospective cohort study initiated in 1983, the human immunodeficiency virus type 1 (HIV-1) status has been periodically determined for patients with clotting disorders (hemophilia A or B, von Willebrand's disease, miscellaneous). The Universi ... Full text Link to item Cite

An evaluation of a brief health status measure in elderly veterans.

Journal Article J Am Geriatr Soc · July 1991 OBJECTIVE: To examine the feasibility of a brief 36-item health status measure in elderly male veterans, by comparing it with the 136-item Sickness Impact Profile. DESIGN: Cross-sectional study in which all subjects completed both measures in a random orde ... Full text Link to item Cite

Use of antimicrobial drugs in adults before and after removal of a restriction policy.

Journal Article Am J Hosp Pharm · June 1991 The effects on the quantity and quality of antimicrobial drug use of removing an antimicrobial restriction policy are reported. Monthly totals for the number of courses of antimicrobial therapy and expenditures based on grams used were obtained from pharma ... Link to item Cite

A PREDICTIVE MODEL OF PREOPERATIVE LENGTH OF STAY

Journal Article CLINICAL RESEARCH · April 1, 1991 Link to item Cite

Predicting the outcomes of electrophysiologic studies of patients with unexplained syncope: preliminary validation of a derived model.

Journal Article J Gen Intern Med · 1991 PURPOSE: To develop and validate a predictive model that would allow clinicians to determine whether an electrophysiologic (EP) study is likely to result in useful diagnostic information for a patient who has unexplained syncope. PATIENTS: One hundred seve ... Full text Link to item Cite

Bacterial indicators of risk of diarrhoeal disease from drinking-water in the Philippines.

Journal Article Bull World Health Organ · 1991 Inadequate measures of water quality have been used in many studies of the health effects associated with water supplies in developing countries. The present 1-year epidemiological-microbiological study evaluated four bacterial indicators of tropical drink ... Link to item Cite

Observer variability of Osler's maneuver in detection of pseudohypertension.

Journal Article J Clin Epidemiol · 1991 Pseudohypertension in the elderly occurs when blood pressure is overestimated because of inelastic, sclerotic arteries. Osler's maneuver (OM), the palpability of a pulseless artery, is recommended as a non-invasive test to detect pseudohypertension, despit ... Full text Link to item Cite

Breast cancer screening in older women: practices and barriers reported by primary care physicians.

Journal Article J Am Geriatr Soc · January 1991 Annual mammography, in combination with clinical breast examinations, can reduce mortality from breast cancer. However, surveys of both patients and physicians suggest that mammography is underutilized. This study examined whether physicians' reported brea ... Full text Link to item Cite

Likelihood ratios with confidence: sample size estimation for diagnostic test studies.

Journal Article J Clin Epidemiol · 1991 Confidence intervals are important summary measures that provide useful information from clinical investigations, especially when comparing data from different populations or sites. Studies of a diagnostic test should include both point estimates and confi ... Full text Link to item Cite

X-linked hypophosphatemic rickets without "rickets".

Journal Article Skeletal Radiol · 1991 Wrist and knee radiographs from children with X-linked hypophosphatemic rickets were analyzed and compared with those from normal children and children with established rickets to assess whether radiographically apparent rickets is a consistent abnormality ... Full text Link to item Cite

Nosocomial infection rate as a function of human immunodeficiency virus type 1 status in hemophiliacs

Journal Article The American Journal of Medicine · 1991 As part of a prospective cohort study initiated in 1983, the human immunodeficiency virus type 1 (HIV-1) status has been periodically determined for patients with clotting disorders (hemophilia A or B, von Willebrand's disease, miscellaneous). The Universi ... Cite

A PREDICTIVE MODEL OF PREOPERATIVE LENGTH OF STAY

Journal Article CLINICAL RESEARCH · December 1, 1990 Link to item Cite

Endotracheal tube confirmation with colorimetric CO2 detectors (Reply)

Journal Article Anesthesia and Analgesia · November 29, 1990 Full text Cite

Atypical metaplasia and incidence of bronchogenic carcinoma.

Journal Article Am J Epidemiol · May 1990 The prognostic implication of atypical squamous metaplasia of the respiratory tract has been uncertain, especially for mild atypia. The relation between degree of severity of atypical metaplasia as detected by sputum cytology and incidence of bronchogenic ... Full text Link to item Cite

MAMMOGRAPHIC SCREENING PRACTICES OF PRIMARY CARE PHYSICIANS

Journal Article CLINICAL RESEARCH · April 1, 1990 Link to item Cite

Epidemiology of tuberculosis in North Carolina, 1966 to 1986: analysis of demographic features, geographic variation, AIDS, migrant workers, and site of infection.

Journal Article South Med J · October 1989 We analyzed all cases of tuberculosis reported in North Carolina between 1966 and 1986, and related the incidence rate of tuberculosis (per 100,000 population) to age (0 to 4 years, 7.59; 5 to 14 years, 3.44; 15 to 24 years, 6.30; 25 to 44 years, 15.92; 45 ... Full text Link to item Cite

Multiple nosocomial infections. An incidence study.

Journal Article Am J Epidemiol · October 1989 Prospective surveillance for nosocomial infections was performed for a five-year admission cohort (1980-1984) at North Carolina Memorial Hospital. One or more nosocomial infections developed in 2,662 patients (2.6%) from 102,206 patients at risk; greater t ... Full text Link to item Cite

Do nursing diagnoses affect functional status?

Journal Article J Gerontol Nurs · October 1989 1. Nurses in this study often made diagnoses pertaining to physiological or physical problems rather than psychosocial problems. One diagnostic category, "impaired home maintenance management," was consistently used incorrectly, suggesting a need for caref ... Full text Link to item Cite

Management of infectious waste by US hospitals.

Journal Article JAMA · September 22, 1989 In July 1987 and January 1988, forty-six percent (441/955) of randomly selected US hospitals responded to a questionnaire intended to identify their waste disposal practices. Survey responses were received from hospitals in 48 states. United States hospita ... Link to item Cite

Accuracy of nurses in performing capillary blood glucose monitoring.

Journal Article Diabetes Care · April 1989 The accuracy and outcome of capillary blood glucose (CBG) monitoring as routinely performed by nursing staff were assessed. The sample consisted of 160 readings conducted by 93 nursing staff members in four hospitals; 19% of the readings deviated from simu ... Full text Link to item Cite

Nosocomial infections in the elderly. Increased risk per hospital day.

Journal Article Am J Med · April 1988 Elderly patients have been shown to have an increased risk of acquiring nosocomial infection per hospital admission. To determine if the length of stay accounts for this risk, daily infection rates were computed per decade of life and rates for patients ov ... Full text Link to item Cite

Disinfectant testing using a modified use-dilution method: collaborative study.

Journal Article J Assoc Off Anal Chem · 1988 An initial collaborative study of the AOAC use-dilution method (UDM), used for bactericidal disinfectant efficacy testing, demonstrated extreme variability of test results among the 18 laboratories testing identical hospital disinfectants. In an effort to ... Link to item Cite

Schwann cell vulnerability to demyelination is associated with internodal length in tellurium neuropathy.

Journal Article J Neuropathol Exp Neurol · January 1988 The frequency of demyelinated fibers in mixed nerve and cutaneous nerve and the relationship of the frequency of demyelination to internodal length were assessed in a model of tellurium neuropathy in the rat. Twenty-day-old Long-Evans rats were fed chow co ... Full text Link to item Cite

Impact of air filtration on nosocomial Aspergillus infections. Unique risk of bone marrow transplant recipients.

Journal Article Am J Med · October 1987 Bone marrow transplant recipients were found to have a 10-fold greater incidence of nosocomial Aspergillus infection than other immunocompromised patient populations (p less than 0.001) when housed outside of a high-efficiency particulate air (HEPA) filter ... Full text Link to item Cite

Tuberculosis in hospital personnel.

Journal Article Infect Control · March 1987 Tuberculosis (TB) skin testing practices and the prevalence and inherent risk of TB infection among hospital employees in 167 North Carolina (NC) hospitals were determined from a 79% (132/167) response to a tuberculosis screening questionnaire. Preemployme ... Full text Link to item Cite

Standardization of bacterial numbers of penicylinders used in disinfectant testing: interlaboratory study.

Journal Article J Assoc Off Anal Chem · 1987 An interlaboratory study was conducted to evaluate a method of standardizing bacterial numbers on penicylinders used in the AOAC use-dilution method (4.007-4.015) of disinfectant testing. Eight participating laboratories followed a broth adjustment method ... Link to item Cite

Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine.

Journal Article JAMA · December 13, 1985 Factors associated with lack of antibody response to the hepatitis B virus plasma vaccine were retrospectively evaluated by means of a logistic regression in 194 previously seronegative staff members of a community hospital. All subjects had received three ... Link to item Cite

Response

Journal Article AJIC: American Journal of Infection Control · January 1, 1982 Full text Open Access Cite

Biochemical and cytochemical comparison of surface membranes from normal and dystrophic chickens.

Journal Article Am J Pathol · December 1981 Cytochemical and biochemical characteristics of the surface membrane components of avian dystrophic muscle were examined. A Mg2+- or Ca2+-activated ("basic") adenosine triphosphate (ATPase) was localized cytochemically in fixed, intact dystrophic muscle sl ... Link to item Cite