Implementing a Letter Template to Expedite Specialty Medication Appeal Letter Submission.

Background: Prior authorizations (PAs) for biologic medications, used to treat Inflammatory Bowel Disease (IBD), are often denied by Pharmacy Benefits Managers and can require a complex appeal process for patients to gain access to medication.

Objective: This quality improvement project evaluated the impact of implementing a standardized appeal letter template and customizable clinical rationale letter content on specialty pharmacist workflow and workload in an integrated Hospital Health System Specialty Pharmacy (HSSP) IBD clinic.

Practice Description: This initiative was conducted in an IBD outpatient clinic at a tertiary academic medical center with an integrated HSSP whose specialty pharmacists work collaboratively with providers to manage specialty medications.

Screening for Helicobacter pylori to Prevent Gastric Cancer: A Pragmatic Randomized Clinical Trial.

Importance: Effects of screening for Helicobacter pylori on gastric cancer incidence and mortality are unknown.

Objective: To evaluate the effects of an invitation to screen for H pylori on gastric cancer incidence and mortality.

Design, Setting, And Participants: A pragmatic randomized clinical trial of residents aged 50 to 69 years in Changhua County, Taiwan, eligible for biennial fecal immunochemical tests (FIT) for colon cancer screening.

Chronic pain after traumatic brain injury: a collaborative care approach.

Introduction: Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other non-pharmacological approaches for decreasing pain interference.

Disparities Based on Demographic Features in the Intensity and Treatment of Chronic Pain in US Patients With Spinal Cord Injury.

Objective: Informed by Minority Stress Theory, to investigate disparities in pain intensity, interference, and care in patients with spinal cord injuries (SCI) based on demographic features.

Design: Cross-sectional survey.

Setting: Outpatient SCI clinics in 2 academic medical centers in the northwestern United States.

Collaborative Care for Chronic Pain After Traumatic Brain Injury: A Randomized Clinical Trial.

Importance: Chronic pain after traumatic brain injury (TBI) is prevalent and associated with poor outcomes. By providing multidisciplinary care through expert consultation, a collaborative care (CC) treatment approach may reduce pain interference.

Objective: To compare CC with usual care (UC) in decreasing pain interference.

Patient and Caregiver Satisfaction With the Brain Injury Rehabilitation: Improving the Transition Experience (BRITE) Intervention.

Objective: To ascertain patient and caregiver satisfaction with an individualized case management intervention to improve transition from inpatient rehabilitation care to the community after traumatic brain injury (TBI).

Setting: Participants from 6 National Institute on Disability, Independent Living, and Rehabilitation Research-funded TBI Model Systems sites in the United States.

Participants: Adult, English-speaking patients with TBI who had moderate-to-severe TBI and were discharged from a TBI Model Systems site and who were in the intervention arm of the Brain Injury Rehabilitation: Improving the Transition Experience pragmatic clinical trial, as well as their caregivers.

Utility of in-session assessments during cognitive behavioral therapy for depression after traumatic brain injury: Results from a randomized controlled trial.

Background: The development of depression after moderate to severe traumatic brain injury (TBI) is common. Cognitive-behavioral therapy (CBT) can be used to treat post-TBI depression, but the symptoms response is poorly described.

Objective: This secondary analysis assessed: (1) the trajectory of depression symptoms up to 12 sessions of CBT, (2) which depressive symptom clusters were responsive to in-person and phone CBT, and (3) whether interim depression thresholds predict 16-week treatment response.

Insurance Approval Delay of Biologic Therapy Dose Escalation Associated with Disease Activity in Patients with Inflammatory Bowel Disease.

Background: Dose escalation of self-injectable biologic therapy for inflammatory bowel diseases may be required to counteract loss of response and/or low drug levels. Payors often require completion of a prior authorization (PA), which is a complex approval pathway before providing coverage. If the initial PA request is denied, clinic staff must complete a time and resource-intensive process to obtain medication approval.

Collaborative Care Versus Usual Care to Improve Quality of Life, Pain, Depression, and Physical Activity in Outpatients With Spinal Cord Injury: The SCI-CARE Randomized Controlled Clinical Trial.

Our goal was to test the effectiveness of collaborative care (CC) versus usual care (UC) to improve treatment of pain, depression, physical inactivity, and quality of life in outpatients with spinal cord injury (SCI). We conducted a single blind parallel group randomized controlled trial. The setting was two outpatient SCI rehabilitation clinics within a large academic medical center.

A Positive Distress Screen…Now What? An Updated Call for Integrated Psychosocial Care.

How can we move collaborative care from evidence-based practice to everyday practice for those living with cancer and distress?

Cost-Effectiveness Analysis of Personalized Hypertension Prevention.

Background: While a population-wide strategy involving lifestyle changes and a high-risk strategy involving pharmacological interventions have been described, the recently proposed personalized medicine approach combining both strategies for the prevention of hypertension has increasingly gained attention. However, a cost-effectiveness analysis has been hardly addressed. This study was set out to build a Markov analytical decision model with a variety of prevention strategies in order to conduct an economic analysis for tailored preventative methods.

NCCN Guidelines® Insights: Distress Management, Version 2.2023.

These NCCN Guidelines for Distress Management discuss the identification and treatment of psychosocial problems in patients with cancer. All patients experience some level of distress associated with a cancer diagnosis and the effects of the disease and its treatment regardless of the stage of disease. Clinically significant levels of distress occur in a subset of patients, and identification and treatment of distress are of utmost importance.

Predictors of Treatment Response to a Psychoeducational Intervention for Anger in Chronic Moderate-Severe Traumatic Brain Injury.

Objective: The investigators examined predictors of treatment response to anger self-management training (ASMT) among patients with chronic moderate-severe traumatic brain injury (TBI).

Methods: A multicenter randomized clinical trial comprising 90 participants with moderate-severe TBI was conducted. Fifty-four participants who were randomly assigned to receive active treatment and provided complete data were included in the current secondary analysis.

Virtual Surgical Skills Training in a High School Summer Program.

Background: The COVID-19 pandemic has disrupted components of traditional education with shifts toward virtual platforms. This report describes the virtual approach to basic surgical skills training during a high school program in the summers of 2020 and 2021.

Methods: Two 2-week sessions were held by Zoom (Zoom Video Communications) with 99 students in 2020 and 198 students in 2021.

Breast cancers originating from the terminal ductal lobular units: In situ and invasive acinar adenocarcinoma of the breast, AAB.

Purpose: To use mammographic tumour features (imaging biomarkers) to identify and investigate breast cancers originating from the terminal ductal lobular units (TDLUs) of the breast in order to overcome the confusion arising from the current histopathology terminology, which calls cancers arising from the TDLUs either "ductal" or "lobular".

Method: Prospectively collected data from a randomized controlled mammography screening trial with more than four decades of follow up, and data from the subsequent population-based service screening program in Dalarna County, Sweden, provided the database necessary for studying nonpalpable, primarily screen-detected breast cancer cases in their earliest detectable phases. Large format thick (subgross) and thin section histopathologic images of breast cancers originating from the TDLUs were correlated with their mammographic tumour features (imaging biomarkers) and long-term patient outcome.

History of Surgery for Mitral Stenosis: John Mayow to Charles Bailey.

Mitral stenosis was first described in 1674 by Englishman John Mayow, but surgical intervention for mitral stenosis was proposed over 2 centuries later in 1898. Mitral valve surgery was undertaken in the 1920s with varying success; after 2 decades of staggered progress, mitral valvuloplasty and commissurotomy would be rediscovered by Americans Horace Smithy, Charles Bailey, and Dwight Harken. The evolution of open surgery for mitral stenosis suggests the troubled triumph of humanity over disease while also underlining surgeons' inability to successfully disseminate their pioneering ideas to a community critical of innovation.

Community-based multiple screening for metabolic syndrome by innovative theory: A longitudinal study.

The purpose of this research is to elucidate whether metabolic syndrome affects the rate of adoption of a new multiple cancer screening programme, based on the Diffusion of Innovation theory. The time to attend the screening programme, conducted in Keelung, Taiwan, within 10 years was assessed by innovativeness (innovators, early adaptors, early majority, late majority and laggard) using data from 79,303 residents, with the information on metabolic syndrome accrued from routine adult health check-ups. The median time of adopting the programme and the relative rates of early adoption by metabolic syndrome and its severity score were estimated.

Treatment of Psychiatric Problems After Traumatic Brain Injury.

Psychiatric sequelae of traumatic brain injury (TBI) can cause significant and often chronic impairment in functioning and quality of life; however, their phenomenological and mechanistic complexities continue to present significant treatment challenges. The clinical presentation is often an amalgam of syndromes and co-occurring symptoms that require a highly nuanced and systematic approach to treatment. Although few randomized controlled trials have tested treatments for psychiatric problems after TBI and the synthesis of results continues to be compromised by the heterogeneity of study populations, small samples, and differing inclusion criteria and outcome measures, an increasing body of literature supports evidence-based treatment strategies.

The Impact of Opioid Medications on Sleep Architecture and Nocturnal Respiration During Acute Recovery From Moderate to Severe Traumatic Brain Injury: A TBI Model Systems Study.

Objectives: To describe patient and clinical characteristics associated with receipt of opioid medications and identify differences in sleep quality, architecture, and sleep-related respiration between those receiving and not receiving opioid medications.

Setting: Acute inpatient rehabilitation care for moderate to severe traumatic brain injury (TBI).

Participants: A total of 248 consecutive admissions for inpatient rehabilitation care following moderate to severe TBI (average age of 43.

American Association for Thoracic Surgery Summer Intern Scholarship-Over a decade of experience.

Objective: The study objective was to evaluate the experience of previous American Association for Thoracic Surgery Summer Intern Scholarship recipients.

Methods: A database of recipients of the American Association for Thoracic Surgery Summer Intern Scholarship in Cardiothoracic Surgery provided by the American Association for Thoracic Surgery was analyzed. A questionnaire was sent via email to recipients with 10 questions within the survey to assess the types of exposure during the internship, the impact of the internship on career choices, the current career setting, and any additional thoughts regarding the internship.

Estimating global burden of COVID-19 with disability-adjusted life years and value of statistical life metrics.

Background: Global burden of COVID-19 has not been well studied, disability-adjusted life years (DALYs) and value of statistical life (VSL) metrics were therefore proposed to quantify its impacts on health and economic loss globally.

Methods: The life expectancy, cases, and death numbers of COVID-19 until 30th April 2021 were retrieved from open data to derive the epidemiological profiles and DALYs (including years of life lost (YLL) and years loss due to disability (YLD)) by four periods. The VSL estimates were estimated by using hedonic wage method (HWM) and contingent valuation method (CVM).