The Impact of Within-Consultation and Preconsultation Decision Aids for Localized Prostate Cancer on Patient Knowledge: Results of a Patient-Level Randomized Trial.

Objective: To evaluate the role of timing (either before or during initial consultation) on the effectiveness of decision aids (DAs) to support shared-decision-making in a minority-enriched sample of patients with localized prostate cancer using a patient-level randomized controlled trial design.

Methods: We conducted a 3-arm, patient-level-randomized trial in urology and radiation oncology practices in Ohio, South Dakota, and Alaska, testing the effect of preconsultation and within-consultation DAs on patient knowledge elements deemed essential to make treatment decisions about localized prostate cancer, all measured immediately following the initial urology consultation using a 12-item Prostate Cancer Treatment Questionnaire (score range 0 [no questions correct] to 1 [all questions correct]), compared to usual care (no DAs).

Results: Between 2017 and 2018, 103 patients-including 16 Black/African American and 17 American Indian or Alaska Native men-were enrolled and randomly assigned to receive usual care (n = 33) or usual care and a DA before (n = 37) or during (n = 33) the consultation.

Effects of Smoking on SARS-CoV-2 Positivity: A Study of in Northern and Central California.

Introduction: COVID-19 continues to impact vulnerable populations disproportionally. Identifying modifiable risk factors could lead to targeted interventions to reduce infections. The purpose of this study is to identify risk factors for testing positive for SARS-CoV-2.

Colorectal Cancer Screening During the COVID-19 Pandemic.

Shared decision-making (SDM) can help patients make good decisions about preventive health interventions such as cancer screening. We illustrate the use of SDM in the case of a 53-year-old man who had a new patient visit with a primary care physician and had never been screened for colorectal cancer (CRC). The patient had recently recovered from a serious COVID-19 infection requiring weeks of mechanical ventilation.

Patient Preferences for Preventive Healthcare During the COVID-19 Pandemic in a Large Integrated Health System.

The COVID-19 pandemic caused healthcare systems and patients to cancel or postpone healthcare services, particularly preventive care. Many patients still have not received these services raising concerns about the potential for preventable morbidity and mortality. At Sutter Health, a large integrated healthcare system in Northern California, we conducted a population-based email survey in August 2020 to evaluate perceptions and preferences about where, when, and how healthcare is delivered during the COVID-19 pandemic.

Shared Decision-making in the U.S.: Evidence exists, but implementation science must now inform policy for real change to occur.

Shared decision making (SDM) is defined as an approach in which clinicians and patients share the best available evidence when faced with the task of making decisions, and in which patients are supported to consider options to achieve informed preferences [1]. Over the past decade, SDM has been increasingly recognized as a component of value-based care in the US. There is greater acceptance overall that SDM is a key strategy for achieving patient-centered care, enhancing patient safety, and achieving the triple aim of better health, better care, and lower costs [2].

Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty.

Background: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem.

Methods: Retrospective study of 798 primary total hip replacements by 1 surgeon performed using noncollared dual tapered femoral stems, including 457 implanted using hybrid rasp-impaction broaching and 341 implanted using impaction broaching.

Do Patients Continue to Use Video Visits? Factors Related to Continued Video Visit Use.

Many studies have assessed the factors associated with overall video visit use during the COVID-19 pandemic, but little is known about who is most likely to continue to use video visits and why. The authors combined a survey with electronic health record data to identify factors affecting the continued use of video visit. In August 2020, a stratified random sample of 20,000 active patients from a large health care system were invited to complete an email survey on health care seeking preferences during the COVID.

Decision aids for localized prostate cancer in diverse minority men: Primary outcome results from a multicenter cancer care delivery trial (Alliance A191402CD).

Background: Decision aids (DAs) can improve knowledge for prostate cancer treatment. However, the relative effects of DAs delivered within the clinical encounter and in more diverse patient populations are unknown. A multicenter cluster randomized controlled trial with a 2×2 factorial design was performed to test the effectiveness of within-visit and previsit DAs for localized prostate cancer, and minority men were oversampled.

Women, Younger Clinicians', and Caregivers' Experiences of Burnout and Well-being During COVID-19 in a US Healthcare System.

Background: The COVID-19 pandemic brought rapid changes to the work and personal lives of clinicians.

Objective: To assess clinician burnout and well-being during the COVID-19 pandemic and guide healthcare system improvement efforts.

Design: A survey asking about clinician burnout, well-being, and work experiences.

Choice of Intensive Lifestyle Change and/or Metformin after Shared Decision Making for Diabetes Prevention: Results from the Prediabetes Informed Decisions and Education (PRIDE) Study.

Introduction: While the Diabetes Prevention Program Study demonstrated that intensive lifestyle change and metformin both reduce type 2 diabetes incidence, there are little data on patient preferences in real-world, clinical settings.

Methods: The Prediabetes Informed Decisions and Education (PRIDE) study was a cluster-randomized trial of shared decision making (SDM) for diabetes prevention. In PRIDE, pharmacists engaged patients with prediabetes in SDM using a decision aid with information about both evidence-based options.

Revaccination management of a large cohort of pediatric patients following a potential lapse in cold storage.

Introduction: In a pediatric clinic in California (US), 3823 patients were vaccinated with potentially-compromised vaccines following lapses in cold storage chain management between February 2014 and April 2015. A revaccination program was initiated in May 2015. Families were contacted by mail and encouraged to discuss follow-up options with their care team, namely: revaccination, serological testing and/or revaccination, or no further action.

Engaging patients and stakeholders in preresearch: findings from the Pipeline to Proposal Awards Initiative.

The Patient-Centered Outcomes Research Institute Pipeline to Proposal (P2P) Awards Initiative funded 177 awardees to engage patients and stakeholder partners in preresearch. Based on P2P, we described engagement strategies; outcomes; facilitators; and challenges to inform research funders and stakeholders participating in preresearch. We used a qualitative approach based on content analysis of program data and interviews with P2P awardees and partners.

Patient-Centric Scheduling With the Implementation of Health Information Technology to Improve the Patient Experience and Access to Care: Retrospective Case-Control Analysis.

Background: Cancellations and rescheduling of doctor's appointments are common. An automated rescheduling system has the potential to facilitate the rescheduling process so that newly opened slots are promptly filled by patients who need and can take the slot. Building on an existing online patient portal, a large health care system adopted an automated rescheduling system, Fast Pass, that sends out an earlier appointment offer to patients via email or SMS text messaging and allows patients to reschedule their appointment through the online portal.

Perioperative Complications Stratified by Body Mass Index for the Direct Anterior Approach to Total Hip Arthroplasty.

Background: Previous studies have addressed the increased risk of perioperative complications in the obese and morbidly obese populations undergoing total hip arthroplasty. Over the last 15 years, the direct anterior approach has increased in popularity. The purpose of this study is to compare the 90-day perioperative complication rate of total hip arthroplasty performed through the direct anterior approach stratified by body mass index (BMI).

Development of a patient decision aid for the management of superficial basal cell carcinoma (BCC) in adults with a limited life expectancy.

Background: Basal cell carcinoma (BCC) is a slow-growing, rarely lethal skin cancer that affects people 65 years or older. A range of treatment options exist for BCC, but there is little evidence available to guide patients and providers in selecting the best treatment options.

Objectives: This study outlines the development of a patient decision aid (PDA) for low-risk BCC that can be used by patients and providers to assist in shared decision-making.

The Relationship Between Primary Care Physician Burnout and Patient-Reported Care Experiences: a Cross-sectional Study.

Background: Primary care physician (PCP) burnout is prevalent and on the rise. Physician burnout may negatively affect patient experience of care.

Objective: To identify the direct impact of PCP burnout on patient experience in various domains of care.

Shared Decision Making for Syncope in the Emergency Department: A Randomized Controlled Feasibility Trial.

Objectives: Significant practice variation is seen in the management of syncope in the emergency department (ED). We sought to evaluate the feasibility of performing a randomized controlled trial of a shared decision making (SDM) tool for low-to-intermediate-risk syncope patients presenting to the ED.

Methods: We performed a randomized controlled trial of adults (≥30 years) with unexplained syncope who presented to an academic ED in the United States.

Assessment of Accuracy and Usability of a Fee Estimator for Ambulatory Care in an Integrated Health Care Delivery Network.

Importance: Given increased enrollment in high-deductible health insurance plans and mandates from the Patient Protection and Affordable Care Act, individualized price transparency tools are needed.

Objective: To assess accuracy and initial user experience of a cost estimation tool for ambulatory procedures delivered via an online patient portal and informed by real-time data feeds from third-party payers.

Design, Setting, And Participants: This quality improvement study included patients aged 18 years and older at an integrated health care system in Northern California.