Publications by authors named "J Kupersmith"
Article Synopsis
- - The study investigated how well veterans receiving opioid therapy followed clinical guidelines, comparing those who used only VA services (mono users) to those who also used community care (dual-system users).
- - High overall adherence rates (over 90%) to guidelines were found in both groups, although specific recommendations, like urine drug screening, were less consistently followed (8.9% for mono users, 11.2% for dual users).
- - The study indicated no clear trend in adherence between the two user types but noted an increase in overall guideline adherence from 2015 to 2019, suggesting a need for further research into coordination among dual-system users.
Opioid use disorder is known to be under-coded as a diagnosis, yet problematic opioid use can be documented in clinical notes, which are included in electronic health records. We sought to identify problematic opioid use from a full range of clinical notes and compare the demographic and clinical characteristics of patients identified as having problematic opioid use exclusively in clinical notes to patients documented through ICD opioid use disorder diagnostic codes. We developed and applied a natural language processing (NLP) tool that combines rule-based pattern analysis and a trained support vector machine to the clinical notes of a patient cohort (n = 222,371) from two Veteran Affairs service regions to identify patients with problematic opioid use.
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- Some patients get opioids from more than one source, making it harder to follow guidelines for safe use.
- The study looked at veterans who received care from both Veterans Administration (VA) services and outside community services to see if they got more prescriptions and were more likely to have opioid use problems.
- It found that those using both sources were younger, more likely to be women, and had higher chances of getting new prescriptions, continuing prescriptions, and being diagnosed with opioid use disorder.
Diffusion changes as determined by diffusion tensor imaging are potential indicators of microstructural lesions in people with mild cognitive impairment (MCI), prodromal Alzheimer's disease (AD), and AD dementia. Here we extended the scope of analysis toward subjective cognitive complaints as a pre-MCI at risk stage of AD. In a cohort of 271 participants of the prospective DELCODE study, including 93 healthy controls and 98 subjective cognitive decline (SCD), 45 MCI, and 35 AD dementia cases, we found reductions of fiber tract integrity in limbic and association fiber tracts in MCI and AD dementia compared with controls in a tract-based analysis (p < 0.
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