Impact of a Clinical Decision Support System on Guideline Adherence of Surveillance Recommendations for Colonoscopy After Polypectomy.

Surveillance colonoscopy is required in patients with polyps due to an elevated colorectal cancer (CRC) risk; however, studies suggest substantial overuse and underuse of surveillance colonoscopy. The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). We performed a retrospective cohort study of patients who underwent colonoscopy with polypectomy at a safety-net healthcare system before (n=1,822) and after (n=1,320) implementation of CoRS in December 2013.

Cervical Cancer Burden and Opportunities for Prevention in a Safety-Net Healthcare System.

Background: The high prevalence of cervical cancer at safety-net health systems requires careful analysis to best inform prevention and quality improvement efforts. We characterized cervical cancer burden and identified opportunities for prevention in a U.S.

Cervical cancer screening among HIV-infected women in an urban, United States safety-net healthcare system.

Objective: Little is known about cervical cancer screening and results patterns among HIV-infected (HIV+) women in real-world healthcare settings. We characterized two periods of screening opportunity.

Design: Retrospective cohort.

Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices.

Objective: To explore the potential impact of worker hygiene by determining the prevalence of radiographic changes consistent with asbestos exposure among household contacts of workers exposed to Libby vermiculite that contained amphibole fibers.

Methods: Workers and household contacts had chest radiographs and completed questionnaires regarding hygiene and potential exposure pathways.

Results: Participants included 191 household contacts of 118 workers.

Biopersistence of refractory ceramic fiber in human lung tissue and a 20-year follow-up of radiographic pleural changes in workers.

Objective: The biopersistence of refractory ceramic fiber (RCF) in human lung tissue is unknown and may contribute to an association between cumulative fiber exposure and radiographic changes.

Methods: Lung tissue fiber was analyzed for a case series of 10 RCF workers and a 20-year longitudinal chest radiograph study of 1323 workers was conducted.

Results: Within lung tissue, RCF comprised 14% to 100% of fibers 5 μm or more in length and was identified up to 20 years after RCF employment.

Exposure estimates for workers in a facility expanding Libby vermiculite: updated values and comparison with original 1980 values.

Objective: Low cumulative fiber exposure (CFE) has been associated with health effects in a cohort exposed to Libby vermiculite. This study refines the original 1980 exposure estimates and compares the CFE results.

Methods: Cumulative fiber exposure estimates were developed using three times more industrial hygiene measurements and long-term workers' input.

A long term study of pulmonary function among US refractory ceramic fibre workers.

Background: Cross-sectional studies have shown declines in lung function among refractory ceramic fibre (RCF) workers with increasing fibre exposure. This study followed current and former workers (n=1396) for up to 17 years and collected 5243 pulmonary function tests.

Methods: Cumulative fibre exposure and production years were categorised into exposure levels at five manufacturing locations.

Exposures to refractory ceramic fibers in manufacturing and related operations: a 10-year update.

Refractory ceramic fiber (RCF) is a man-made vitreous fiber used for its insulating properties. Since 1987, the work environment of approximately 800 persons employed in fiber manufacture or production operations directly related to manufacturing has been monitored to evaluate exposure levels. Samples were collected quarterly from the breathing zones of randomly selected workers.