Publications by authors named "Greevy R"
Incidence of Pulmonary Hypertension in the Echocardiography Referral Population.
Ann Am Thorac Soc
December 2024
Rationale: Incidence rates for pulmonary hypertension using diagnostic data in patients with cardiopulmonary disease are not known.
Objectives: To determine incidence rates of, risk factors for, and mortality hazard associated with pulmonary hypertension among patients referred for transthoracic echocardiography.
Methods: Retrospective cohort study using data from the Veterans Health Administration (1999-2020) and Vanderbilt University Medical Center (1994-2020).
Background: Observationally, family and social support are important for optimal diabetes self-management; however, interventions targeting family/social support have not consistently been effective. A novel, diabetes-specific family functioning typology offers the opportunity to classify types of baseline family functioning to determine for whom family interventions may be effective.
Purpose: We examined the effects of an intervention by baseline type of family functioning post hoc, to inform differential benefit from interventions.
Background: Continuous glucose monitor (CGM) use is increasing rapidly among people with type 2 diabetes, although little is known about predictors of CGM use beyond clinical and demographic information available in electronic medical records. Behavioral and psychosocial characteristics may also predict CGM use.
Objective: We examined clinical, psychosocial, and behavioral characteristics that may predict CGM use in adults with type 2 diabetes.
Health Mindset and One Year Outcomes in Adult Peritoneal Dialysis (PD) Patients.
SM J Nephrol Kidney Dis
August 2024
Background: Many patients who start peritoneal dialysis (PD) transition to hemodialysis (HD) after a PD-related complication. Patient psychological factors may influence clinical outcomes. One possible factor is health mindset, or patient belief that their health knowledge and ability can change.
View Article and Find Full Text PDFRationale: Incidence rates for pulmonary hypertension using diagnostic data in patients with cardiopulmonary disease are not known.
Objectives: To determine incidence rates of, risk factors for, and mortality hazard associated with pulmonary hypertension among patients referred for transthoracic echocardiography Methods: Retrospective cohort study using data from the Veterans Health Administration (1999-2020) and Vanderbilt University Medical Center (1994-2020). Pulmonary hypertension was defined as pulmonary artery systolic pressure >35mmHg with prevalent cases excluded.
Article Synopsis
- - The study investigates the link between altered sense of smell and protein-energy wasting (PEW) in patients with chronic kidney disease (CKD), particularly focusing on those with moderate-to-advanced stages and those undergoing maintenance hemodialysis (MHD).
- - Researchers tested the smell abilities of 139 individuals using an odor identification test and assessed their nutritional status with a malnutrition inflammation score (MIS); results showed CKD patients had poorer odor scores and higher inflammation indicators compared to healthy controls.
- - Although advanced CKD patients had significantly impaired olfactory function, the study found no strong statistical connection between their smell abilities and the severity of PEW, indicating that while both issues are prevalent, they may not directly impact each other
Background And Aims: There are limited contemporary population-based data on epidemiology and outcomes in the United States. Our primary aim was to create a validated cohort of veterans with testing or treatment using Veterans Health Administration data.
Methods: Using Veterans Health Administration structured and unstructured data, we developed and validated 4 algorithms for infection (3 algorithms) and treatment status (1 algorithm).
Article Synopsis
- Acute kidney injury (AKI) is a serious issue in hospitalized patients, prompting a study that analyzed genetic factors in a large cohort from the Million Veteran Program and Vanderbilt University Medical Center.
- The study included 54,488 patients with AKI and 138,051 without, identifying two significant genetic loci associated with AKI: one near the FTO gene related to obesity and another near SHROOM3 linked to kidney function.
- The research suggests that genetics may play a role in the risk of developing AKI, with factors like body mass index and diabetes potentially influencing the association with the FTO locus.
Introduction: Acute kidney injury (AKI) is associated with increased risk of heart failure (HF). Determining the type of HF experienced by AKI survivors (heart failure with preserved or reduced ejection fraction, HFpEF or HFrEF) could suggest potential mechanisms underlying the association and opportunities for improving post-AKI care.
Methods: In this retrospective study of adults within the Vanderbilt University health system with a diagnosis of HF, we tested whether AKI events in the two years preceding incident HF associated more with HFpEF or HFrEF while controlling for known predictors.
Purpose: is the most common cause of infection-associated cancer worldwide. We aimed to evaluate the impact of H. pylori infection and treatment on colorectal cancer (CRC) incidence and mortality.
View Article and Find Full Text PDFArticle Synopsis
- Mobile health (mHealth) has the potential to enhance health behaviors, but there is limited understanding on how to effectively engage users, particularly regarding cognitive reflection on the content.
- This study focused on the balance between response and reflection burdens in mHealth messaging, examining how these factors influence user engagement in a diabetes management intervention.
- The research involved 148 participants receiving different versions of text messages over two years, measuring response rates to determine the optimal level of cognitive effort versus information requested for effective engagement.
Importance: Inadequate communication between caregivers and clinicians at hospital discharge contributes to medication dosing errors in children. Health literacy-informed communication strategies during medication counseling can reduce dosing errors but have not been tested in the pediatric hospital setting.
Objective: To test a health literacy-informed communication intervention to decrease liquid medication dosing errors compared with standard counseling in hospitalized children.
Background: Lung cancer risk attributable to smoking is dose dependent, yet few studies examining a polygenic risk score (PRS) by smoking interaction have included comprehensive lifetime pack-years smoked.
Methods: We analyzed data from participants of European ancestry in the Framingham Heart Study Original (n = 454) and Offspring (n = 2,470) cohorts enrolled in 1954 and 1971, respectively, and followed through 2018. We built a PRS for lung cancer using participant genotyping data and genome-wide association study summary statistics from a recent study in the OncoArray Consortium.
Aims: Family/friend Activation to Motivate Self-care (FAMS) is a self-care support intervention delivered via mobile phones. We evaluated FAMS' effects on hemoglobin A1c (HbA1c) and intervention targets among adults with type 2 diabetes in a 15-month RCT.
Methods: Persons with diabetes (PWDs) were randomized to FAMS or control with their support person (family/friend, optional).
Objectives: Dyadic interventions, involving two persons with a preexisting close relationship, offer the opportunity to activate support persons (SPs) to improve health for adults with chronic conditions. Requiring SP coparticipation can challenge recruitment and bias samples; however, the associations between voluntary SP coparticipation and recruitment outcomes across patient characteristics are unknown.
Methods: The Family/Friend Activation to Motivate Self-care 2.
Aims: Family/friends Activation to Motivate Self-care (FAMS) is a self-care support intervention delivered via mobile phones. We evaluated FAMS effects on hemoglobin A1c (HbA1c) and intervention targets among adults with type 2 diabetes in a 15-month RCT.
Methods: Persons with diabetes (PWDs) and their support persons (family/friend, optional) were randomized to FAMS or control.
Aims: Type 2 diabetes self-management occurs within social contexts. We sought to test the effects of Family/friends Activation to Motivate Self-care (FAMS), a self-care support intervention delivered via mobile phones, on psychosocial outcomes for persons with diabetes (PWDs) and their support persons.
Methods: PWDs had the option to enroll with a friend/family member as a support person in a 15-month RCT to evaluate FAMS versus enhanced usual care.
Aims: Type 2 diabetes self-management occurs within social contexts. We sought to test the effects of Family/friend Activation to Motivate Self-care (FAMS), a self-care support intervention delivered via mobile phones, on psychosocial outcomes for persons with diabetes (PWDs) and their support persons.
Methods: PWDs had the option to enroll with a friend/family member as a support person in a 15-month RCT to evaluate FAMS versus enhanced usual care.
Objective: We validated longitudinally a typology of diabetes-specific family functioning (named Collaborative and Helpful, Satisfied with Low Involvement, Want More Involvement, and Critically Involved) in adults with type 2 diabetes.
Research Design And Methods: We conducted k-means cluster analyses with nine dimensions to determine if the typology replicated in a diverse sample and if type assignment was robust to variations in sampling and included dimensions. In a subsample with repeated assessments over 9 months, we examined the stability and validity of the typology.
Bile Acid Sequestrant Use and Gastric Cancer: A National Retrospective Cohort Analysis.
Clin Transl Gastroenterol
December 2023
Introduction: Bile acids have been implicated in gastric carcinogenesis. We hypothesized that bile acid sequestrant medication (BAM) use is associated with a lower gastric cancer (GC) incidence.
Methods: We assembled a cohort of veterans receiving longitudinal care within the Veterans Health Administration between 2000 and 2020 who completed testing for Helicobacterpylori .
Covariate-adjusted randomization (CAR) can reduce the risk of covariate imbalance and, when accounted for in analysis, increase the power of a trial. Despite CAR advances, stratified randomization remains the most common CAR method. Matched randomization (MR) randomizes treatment assignment within optimally identified matched pairs based on covariates and a distance matrix.
View Article and Find Full Text PDFObjective: To validate an algorithm that identifies fractures using billing codes from the International Classification of Diseases Ninth Revision (ICD-9) and Tenth Revision (ICD-10) for inpatient, outpatient, and emergency department visits in a population of patients.
Methods: We identified and reviewed a random sample of 543 encounters for adults receiving care within a single Veterans Health Administration healthcare system and had a first fracture episode between 2010 and 2019. To determine if an encounter represented a true incident fracture, we performed chart abstraction and assessed the type of fracture and mechanism.
Key Points: The adjustments made by the dialysis units during the peak of the pandemic were effective in maneuvering the challenges faced by our patients during the COVID-19 pandemic. Patients who remained on PD were satisfied with the quality of care, felt supported by the unit staff, and did not report feeling anxious or depressed.
Background: During the coronavirus disease 2019 (COVID-19) pandemic, adjustments were made to peritoneal dialysis (PD) practices in the outpatient units.