Injury mechanism, epidemiology, and Hospital trends of scapula fractures: A 10-year retrospective study of the National Trauma Data Bank.

Background: This 10 year retrospective study of the NTDB is the first to describe trends in scapula fracture diagnosis frequency, epidemiology, injury mechanisms and the type of hospital where the condition is treated.

Methods: Demographics, ISS scores, hospital data, mechanism of injury, complications, and hospital length of stay were recorded for patients with diagnosed scapula fractures (ICD-9, 811.0) recorded in the NTDB, v7.

The Challenges of Collecting and Using Patient Care Data From Diverse Care Systems: Lessons From COMPASS.

The ability to aggregate clinical data across multiple diverse organizations and to use it for performance measurement, quality improvement, evaluation, and research is rapidly becoming a national necessity, but there are few examples of how to do that. This article uses lessons from a national effort to implement the collaborative care management model for patients with both depression and diabetes or heart disease across 8 partner organizations, 18 medical groups, and more than 170 clinics in 8 states to identify the challenges and provide experience-based recommendations for those tasks. The challenges are divided into those needed for (1) collecting similar data, (2) aggregating those data across care systems, and (3) using the data to both improve and evaluate care.

A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression.

Background: Little is known about the reach and impact of collaborative care for depression outside of clinical trials.

Objective: The objective of this study was to examine the effect of a collaborative care intervention for depression on the rates of depression diagnosis, use of specific depression codes, and treatment intensification.

Research Design: Evaluation of a staggered, multiple baseline implementation initiative.

Missed opportunities for pregnancy prevention among insured adolescents.

Importance: Birth to a teenaged mother is associated with adverse health and social outcomes. Adolescents at risk for pregnancy may not receive needed reproductive health services at primary care visits.

Objective: To review services provided at outpatient visits in the year prior to pregnancy among adolescents in a US Midwestern integrated health care delivery system.

Safety of the yellow Fever vaccine: a retrospective study.

Background: Yellow fever (YF) vaccine is considered safe; however, severe illness and death following vaccination have been reported.

Methods: Vaccine Safety Datalink (VSD) and US Department of Defense (DoD) data were used to identify adverse reactions following YF vaccination. Within the VSD, YF-vaccine-exposed subjects were compared to age-, site-, and gender-matched unexposed subjects.

Assessing the safety of influenza immunization during pregnancy: the Vaccine Safety Datalink.

The influenza vaccine can reduce maternal and neonatal morbidity and mortality and thus is recommended for all pregnant women. However, concerns regarding safety of influenza vaccine remain a barrier to vaccination. We describe ongoing analyses of influenza vaccine safety during pregnancy within the Vaccine Safety Datalink that includes the evaluation of acute events, adverse pregnancy and birth outcomes, and congenital anomalies.

Designing and implementing research on a statewide quality improvement initiative: the DIAMOND study and initiative.

Objective: To demonstrate a rigorous methodology that optimally balanced internal validity with generalizability to evaluate a statewide collaborative that implemented an evidence-based, collaborative care model for depression management in primary care.

Study Design And Setting: Several operational features of the DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) Initiative suggested that the DIAMOND Study use a staggered implementation design with repeated cross-sections of patients across clinical settings. A multilevel recruitment strategy elicited virtually complete study participation from the medical groups, clinics, and health plans that coordinated efforts to deliver and reimburse DIAMOND care.

Tobacco-use prevalence in special populations taking advantage of electronic medical records.

Background: It is difficult and expensive to use surveys to obtain the repeatable information that is needed to understand and monitor tobacco prevalence rates and to evaluate cessation interventions among various subgroups of the population. Therefore, the electronic medical record database of a large medical group in Minnesota was used to demonstrate the potential value of that approach to accomplish those goals.

Methods: The relevant variables for all medical group patients aged 18 and over were extracted from the record from a 1-year period.