Disparities Associated with Decision to Undergo Oncologic Surgery: A Prospective Mixed-Methods Analysis.

Background: Underrepresented minority patients with surgical malignancies experience disparities in outcomes. The impact of provider-based factors, including communication, trust, and cultural competency, on outcomes is not well understood. This study examines modifiable provider-based barriers to care experienced by patients with surgical malignancies.

Andragogy in Practice: Applying a Theoretical Framework to Team Science Training in Biomedical Research.

This study is the first to apply the theoretical principles of Malcolm Knowles' theory of andragogy to evaluate data collected from learners who participated in team science training workshops in a biomedical research setting. Briefly, andragogy includes six principles: the learner's self-concept, the role of experience, readiness to learn, orientation to learning, the learner's need to know, and intrinsic motivation. Using an embedded study design, the primary focus was on qualitative data, with quantitative data complementing the qualitative findings.

Lung cancer screening utilization rate varies based on patient, provider, and hospital factors.

Objective: Low-dose computed tomography has been proven to reduce mortality, yet utilization remains low. The purpose of this study is to identify factors that impact the utilization of lung cancer screening.

Methods: We performed a retrospective review of our institution's primary care network from November 2012 to June 2022 to identify patients who were eligible for lung cancer screening.

COVID-19 Vaccine Hesitancy: A Critical Time Period Analysis.

The COVID-19 pandemic has been a devastating, global public health crisis. Public health systems in the United States heavily focused on getting people to adhere to preventive behaviors, and later, to get vaccinated. January through May of 2021 was a critical and volatile time period for COVID-19 cases, deaths, and expanding vaccination programs coinciding with important political and social events which will have a lasting impact on how the public views science, places trust in our government, and views individual rights.

Racial and sex differences in optimizing anticoagulation therapy for patients with atrial fibrillation.

Study Objective: Atrial fibrillation (AF) is the most common cardiac rhythm disorder, responsible for 15 % of strokes in the United States. Studies continue to document underuse of anticoagulation therapy in minority populations and women. Our objective was to compare the proportion of AF patients by race and sex who were receiving non-optimal anticoagulation as determined by an Atrial Fibrillation Decision Support Tool (AFDST).

Electronic health record-embedded decision support to reduce stroke risk in patients with atrial fibrillation - Study protocol.

Background: Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder and is a powerful common risk factor for stroke. Randomized trials have demonstrated that anticoagulation can reduce the risk of stroke in patients with AF. Yet, there continues to be widespread underutilization of this therapy.

Atrial fibrillation decision support tool: Population perspective.

Background: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients.

Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

Background: Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT.

Impact of an Atrial Fibrillation Decision Support Tool on thromboprophylaxis for atrial fibrillation.

Background: Appropriate thromboprophylaxis for patients with atrial fibrillation (AF) remains a national challenge.

Methods: We hypothesized that provision of decision support in the form of an Atrial Fibrillation Decision Support Tool (AFDST) would improve thromboprophylaxis for AF patients. We conducted a cluster randomized trial involving 15 primary care practices and 1,493 adults with nonvalvular AF in an integrated health care system between April 2014 and February 2015.

Dissemination of Evidence From Systematic Reviews Through Academic CME Providers: A Feasibility Study.

Introduction: Although systematic reviews represent a source of best evidence to support clinical decision-making, reviews are underutilized by clinicians. Barriers include lack of awareness, familiarity, and access. Efforts to promote utilization have focused on reaching practicing clinicians, leaving unexplored the roles of continuing medical education (CME) directors and faculty in promoting systematic review use.

Using an Atrial Fibrillation Decision Support Tool for Thromboprophylaxis in Atrial Fibrillation: Effect of Sex and Age.

Objectives: To assess the appropriateness of oral anticoagulant therapy (OAT) in women and elderly adults, looking for patterns of undertreatment or unnecessary treatment.

Design: Retrospective cohort study.

Setting: Primary care practices of an academic healthcare system.

Developing an Atrial Fibrillation Guideline Support Tool (AFGuST) for shared decision making.

Objective: Patient values and preferences are an important component to decision making when tradeoffs exist that impact quality of life, such as tradeoffs between stroke prevention and hemorrhage in patients with atrial fibrillation (AF) contemplating anticoagulant therapy. Our objective is to describe the development of an Atrial Fibrillation Guideline Support Tool (AFGuST) to assist the process of integrating patients' preferences into this decision.

Materials And Methods: CHA2DS2VASc and HAS-BLED were used to calculate risks for stroke and hemorrhage.

Integrating real-time clinical information to provide estimates of net clinical benefit of antithrombotic therapy for patients with atrial fibrillation.

Background: Guidelines for anticoagulant therapy in patients with atrial fibrillation are based on stroke risk as calculated by either the CHADS2 or the CHA2DS2VASc scores and do not integrate bleeding risk in an explicit, quantitative manner. Our objective was to quantify the net clinical benefit resulting from improved decision making about antithrombotic therapy.

Methods And Results: This study is a retrospective cohort study of 1876 adults with nonvalvular atrial fibrillation or flutter seen in primary care settings of an integrated healthcare delivery system between December 2012 and January 2014.

The long-term impact of a performance improvement continuing medical education intervention on osteoporosis screening.

Introduction: The purpose of this study is to determine whether a performance improvement continuing medical education (PI CME) initiative that utilizes quality improvement (QI) principles is effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis.

Methodology: A health care center participated in a PI CME program designed to increase appropriate osteoporosis screening. There were eight 1-hour educational sessions for this activity over a 9-month period.

Community physician education in geriatrics: applying the assessing care of vulnerable elders model with a multisite primary care group.

Providing practicing physicians with effective education that leads to better patient outcomes remains challenging. In 2003, the University of Cincinnati College of Medicine developed a comprehensive program to enhance practicing physician geriatric medicine education based on the Assessing the Care of Vulnerable Elders model. The program was implemented with a large, multisite primary care group based in the greater Cincinnati area and was designed to increase physicians' clinical skills and assist them in implementing new office and system strategies that could improve the quality of care for their older patients.

Effectiveness of a geriatric medical student scholars program: a qualitative assessment.

In 2003, the University of Cincinnati College of Medicine initiated a 4-year Geriatric Medical Student Scholars (GMSS) program in which a selected group of 14 medical students participated in a variety of extracurricular geriatrics-related activities such as one-on-one mentoring and discussion groups. These students were also required to compose journal entries describing GMSS program-related activities using a semistructured on-line computer program designed specifically for this purpose. The reflective journals, in combination with the American Geriatrics Society (AGS) competencies, were used to evaluate the degree to which the GMSS program achieved its goal of enhancing students' understanding of the complex health and social challenges facing older adults.

Integrated advanced information management systems: a twenty-year history at the University of Cincinnati.

The University of Cincinnati (UC) has been active in the National Library of Medicine's Integrated Advanced Information Management Systems (IAIMS) program since IAIMS' inception in 1984. UC received IAIMS planning and modeling grants in the 1980s, spent the 1990s practicing its own form of "iaims" and refining its vision, and, in May 2003, received an IAIMS operations grant in the first round of awards under "the next generation" program. This paper discusses the history of IAIMS at UC and describes the goals, methods, and strategies of the current IAIMS program.

Integrating mobile technology into a health professions curriculum: using flexible technology to meet expectations.

The diverse needs of students, faculty, administrators, and the curriculum itself, create formidable challenges when attempting to integrate mobile technology into a health professions curriculum. Single technology solutions often fail in this environment because they cannot meet user needs. Multiple platform and device agnostic solutions can provide the flexibility to address curricular needs without significantly adding technological complexity.

Moods that predict coming migraine headaches.

The relationship between mood change and migraine headache has often been reported anecdotally, but these observations have not been followed up empirically. In this study 17 migraine sufferers recorded headache occurrence and intensity using 10 mood indicators 3 times daily for periods ranging from 21 to 75 days. Headaches were correlated with mood states during the headache and for periods ranging from 12 to 36 h prior to the headache.