Publications by authors named "Elizabeth Stevens"

Introduction: Failure to document colonoscopy follow-up needs postpolypectomy can lead to delayed detection of colorectal cancer (CRC). Automating the update of a unified follow-up date in the electronic health record (EHR) may increase the number of patients with guideline-concordant CRC follow-up screening.

Methods: Prospective pre-post design study of an automated rules engine-based tool using colonoscopy pathology results to automate updates to documented CRC screening due dates was performed as an operational initiative, deployed enterprise-wide May 2023.

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Highly effective antiobesity and diabetes medications such as glucagon-like peptide 1 (GLP-1) agonists and glucose-dependent insulinotropic polypeptide/GLP-1 (dual) receptor agonists (RAs) have ushered in a new era of treatment of these highly prevalent, morbid conditions that have increased across the globe. However, the rapidly escalating use of GLP-1/dual RA medications is poised to overwhelm an already overburdened health care provider workforce and health care delivery system, stifling its potentially dramatic benefits. Relying on existing systems and resources to address the oncoming rise in GLP-1/dual RA use will be insufficient.

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Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder of the blood vessels that leads to the formation of telangiectasias and arteriovenous malformations (AVMs). HHT affects ∼1/5,000 people, but this varies significantly by geography and ancestry. The Curaçao criteria for HHT consist of four diagnostic criteria: spontaneous epistaxis, first-degree relative with HHT, AVMs in characteristic location (liver, lung, brain), and telangiectasias.

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Introduction: Six hospitals within the New York City public hospital system implemented the Consult for Addiction Treatment and Care in Hospitals (CATCH) program, an interprofessional addiction consult service. A stepped-wedge cluster randomized controlled trial tested the effectiveness of CATCH for increasing initiation and engagement in post-discharge medication for opioid use disorder (MOUD) treatment among hospital patients with opioid use disorder (OUD). The objective of this study was to identify facility characteristics that were associated with stronger performance of CATCH.

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Introduction: Depressive symptoms are linked with pain, anxiety, and substance use. Research estimating whether a reduction in depressive symptoms is linked to subsequent reductions in pain and anxiety symptoms and substance use is limited.

Methods: Using data from the Veterans Aging Cohort Study, a multisite observational study of U.

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Objective: Both diabetes and smoking significantly increase the risk of cardiovascular disease (CVD). Understanding whether a diagnosis of diabetes can be leveraged to promote smoking cessation is a gap in the literature.

Methods: We used data from the US National Health Interview Survey, 2006 to 2018, to investigate the relationship between self-report of diagnosis of diabetes and subsequent smoking abstinence among 142,884 respondents who reported regular smoking at baseline.

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Article Synopsis
  • Engaging researchers effectively in research practices is crucial for developing relevant methods and maximizing participation.
  • A study used a 2 factorial experiment to evaluate how different recruitment strategies influenced participants' likelihood of opening and completing a survey, testing factors like monetary incentives and messaging approaches.
  • Results indicated that altruistic messaging significantly increased the likelihood of opening the survey, while egoistic messaging reduced it; however, egoistic messaging improved completion rates once the survey was opened, suggesting complex interactions between different recruitment strategies.
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Importance: Virtual patient-physician communications have increased since 2020 and negatively impacted primary care physician (PCP) well-being. Generative artificial intelligence (GenAI) drafts of patient messages could potentially reduce health care professional (HCP) workload and improve communication quality, but only if the drafts are considered useful.

Objectives: To assess PCPs' perceptions of GenAI drafts and to examine linguistic characteristics associated with equity and perceived empathy.

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Article Synopsis
  • E-cigarettes (ECs) could be a potential harm reduction method for individuals with chronic conditions like COPD, asthma, and heart diseases who currently smoke combustible cigarettes (CCs).
  • In a pilot study, patients were randomized to use either ECs or nicotine replacement therapy (NRT) combined with counseling, and outcomes such as cigarette use and symptom improvement were measured over six months.
  • Results showed both groups reduced their cigarette use significantly, with the EC group showing notable satisfaction and improvement in respiratory symptoms, indicating ECs may be a safer alternative to CCs for these patients.
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We have entered a new age of health informatics—applied health informatics—where digital health innovation cannot be pursued without considering operational needs. In this new digital health era, creating an integrated applied health informatics system will be essential for health systems to achieve informatics healthcare goals. Integration of information technology (IT) and health informatics does not naturally occur without a deliberate and intentional shift towards unification.

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This study reports a secondary analysis from a quasi-experimental design study (N = 13 schools) to examine the effects of aligned Tier 1 (T1) and Tier 2 (T2) instruction for a subsample of fourth graders with inattention and reading difficulties. Of this sample (N = 63 students), 100% received free- or reduced-price lunch, 92% identified as Hispanic, and 22% received special education services. T1 instruction focused on implementing practices to support reading comprehension and content learning during social studies instruction.

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Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitative analysis of audio-recorded patient-provider interactions supplemented by quantitative description.

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Background: Up to 50% of antibiotic prescriptions for upper respiratory infections (URIs) are inappropriate. Clinical decision support (CDS) systems to mitigate unnecessary antibiotic prescriptions have been implemented into electronic health records, but their use by providers has been limited.

Objective: As a delegation protocol, we adapted a validated electronic health record-integrated clinical prediction rule (iCPR) CDS-based intervention for registered nurses (RNs), consisting of triage to identify patients with low-acuity URI followed by CDS-guided RN visits.

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Background: Meta-research in which researchers are the study subjects can illuminate how to better support researchers and enhance the development of research capacity. Comprehensively compiling the literature in this area can help define best practices for research capacity development and reveal gaps in the literature. However, there are challenges to assessing and synthesizing the breadth of the meta-research literature produced.

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Objectives: To evaluate demographic biases in diagnostic accuracy and health advice between generative artificial intelligence (AI) (ChatGPT GPT-4) and traditional symptom checkers like WebMD.

Materials And Methods: Combination symptom and demographic vignettes were developed for 27 most common symptom complaints. Standardized prompts, written from a patient perspective, with varying demographic permutations of age, sex, and race/ethnicity were entered into ChatGPT (GPT-4) between July and August 2023.

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Background: We assessed longitudinal effects of e-cigarette use on respiratory symptoms in a nationally representative sample of US adults by combustible tobacco smoking status.

Methods: We analyzed Waves 4-5 public-use data from the Population Assessment of Tobacco and Health Study. Study sample included adult respondents who reported no diagnosis of respiratory diseases at Wave 4, and completed Waves 4-5 surveys with no missing data on analytic variables (N = 15,291).

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Article Synopsis
  • The study focused on the prevalence of secondhand smoke (SHS) exposure among pregnant women in Cairo, Egypt, and explored their attitudes and knowledge regarding SHS.
  • It involved a survey of 200 pregnant women in their third trimester, revealing that two-thirds had smoking husbands and a significant portion were exposed to SHS, particularly in rural areas.
  • Despite high levels of SHS exposure, many participants underestimated the risks to themselves and their unborn children, highlighting the need for better education and awareness campaigns.
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Background: Ecological momentary assessment (EMA) is an increasingly used tool for data collection in behavioral research, including smoking cessation studies. As previous addiction research suggests, EMA has the potential to elicit cue reactivity by triggering craving and increasing behavioral awareness. However, there has been limited evaluation of its potential influence on behavior.

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Objectives: The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long-term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.

Methods: Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.

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Background: Overprescribing of antibiotics for acute respiratory infections (ARIs) remains a major issue in outpatient settings. Use of clinical prediction rules (CPRs) can reduce inappropriate antibiotic prescribing but they remain underutilized by physicians and advanced practice providers. A registered nurse (RN)-led model of an electronic health record-integrated CPR (iCPR) for low-acuity ARIs may be an effective alternative to address the barriers to a physician-driven model.

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Meta-research is a bourgeoning field studying topics with significant relevance to health sciences librarianship, such as research reproducibility, peer review, and open access. As a discipline that studies research itself and the practices of researchers, meta-research spans disciplines and encompasses a broad spectrum of topics and methods. The breadth of meta-research presents a significant challenge for identifying published meta-research studies.

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Indiscriminate use of predictive models incorporating race can reinforce biases present in source data and lead to an exacerbation of health disparities. In some countries, such as the United States, there is therefore a push to remove race from prediction models; however, there are still many prediction models that use race as an input. Biomedical informaticists who are given the responsibility of using these predictive models in healthcare environments are likely to be faced with questions like how to deal with race covariates in these models.

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