Changes in Healthcare Professionals' Practice Behaviors Through an Educational Intervention Targeting Weight Bias.

Objective: Weight bias is pervasive in healthcare and leads to worse patient outcomes. A uniquely designed 4-h continuing medical education (CME) intervention was assessed for changing healthcare professionals' (HCPs') weight biases and clinical practice behaviors.

Design: The intervention used a (1) pre/post design examining CME attendees' self-reported weight bias at baseline, after, and 4- and 12-month follow-up, and (2) post/post design examining obesity practice behaviors 12 months after intervention in attendees and non-attendees.

Comparing In-Person, Telephonic, and Video-Based Treatment of Depression in Adult Primary Care During the COVID-19 Pandemic.

Introduction: The COVID-19 pandemic forced a rapid shift toward virtual modalities for the treatment of depression in primary care.

Methods: Participants were adults 18 years and older with a new episode of depression diagnosed in primary care between March 1, 2020, and May 21, 2021, and moderate-to-severe symptoms of depression at the time of diagnosis (N = 9619). Outcomes were 1) antidepressant medications prescribed and dispensed (referred to as received), as well as adherence to those medications; 2) referrals made to depression-related services and the receipt of those services; and 3) a follow-up visit completed with the diagnosing practitioner regardless of treatment actions.

Importance of variables from different time frames for predicting self-harm using health system data.

Objective: Self-harm risk prediction models developed using health system data (electronic health records and insurance claims information) often use patient information from up to several years prior to the index visit when the prediction is made. Measurements from some time periods may not be available for all patients. Using the framework of algorithm-agnostic variable importance, we study the predictive potential of variables corresponding to different time horizons prior to the index visit and demonstrate the application of variable importance techniques in the biomedical informatics setting.

Importance of variables from different time frames for predicting self-harm using health system data.

Objective: Self-harm risk prediction models developed using health system data (electronic health records and insurance claims information) often use patient information from up to several years prior to the index visit when the prediction is made. Measurements from some time periods may not be available for all patients. Using the framework of algorithm-agnostic variable importance, we study the predictive potential of variables corresponding to different time horizons prior to the index visit and demonstrate the application of variable importance techniques in the biomedical informatics setting.

Influenza and COVID-19 Vaccine Uptake Among Individuals With Versus Without Diagnosed Psychiatric Disorders.

Objective: The authors sought to examine influenza and COVID-19 vaccine uptake among individuals diagnosed as having psychiatric disorders compared with those without such diagnoses and to examine variations in vaccine uptake by sociodemographic and clinical characteristics.

Methods: The study was conducted in the Kaiser Permanente Georgia, Washington, and Southern California health care systems. Individuals with psychiatric conditions had at least one diagnosis of any psychiatric disorder during a 12-month study period; individuals in the control group had no psychiatric disorder diagnoses during this period, and the two groups were matched on age and sex.

Health Expenditures After Bariatric Surgery: A Retrospective Cohort Study.

Objective: To compare expenditures between surgical and matched nonsurgical patients in a retrospective cohort study.

Background: Bariatric surgery leads to substantial improvements in weight and weight-related conditions, but prior literature on postsurgical health expenditures is equivocal.

Methods: In a retrospective study, total outpatient, inpatient, and medication expenditures 3 years before and 5.

Bariatric Surgery and the Long-Term Risk of Venous Thromboembolism: A Population-Based Cohort Study.

Purpose: Bariatric surgery is associated with a greater venous thromboembolism (VTE) risk in the weeks following surgery, but the long-term risk of VTE is incompletely characterized. We evaluated bariatric surgery in relation to long-term VTE risk.

Materials And Methods: This population-based retrospective matched cohort study within three United States-based integrated health care systems included adults with body mass index (BMI) ≥ 35 kg/m who underwent bariatric surgery between January 2005 and September 2015 (n = 30,171), matched to nonsurgical patients on site, age, sex, BMI, diabetes, insulin use, race/ethnicity, comorbidity score, and health care utilization (n = 218,961).

Pre-surgical factors related to latent trajectories of 5-year weight loss for a diverse bariatric surgery population.

Background: Analyzing trajectories of weight loss may address how particular groups of patients respond to metabolic and bariatric surgery.

Objectives: The Bariatric Experience Long Term (BELONG) study was designed to use a theoretical model to examine determinants of weight loss and recurrence.

Setting: Large integrated health system in Southern California with 11 surgical practices and 23 surgeons.

Short report: Transition to International Classification of Diseases, 10th Revision and the prevalence of autism in a cohort of healthcare systems.

Currently, the prevalence of autism spectrum disorder (henceforth "autism") is 1 in 36, an increasing trend from previous estimates. In 2015, the United States adopted a new version (International Classification of Diseases, 10th Revision) of the World Health Organization coding system, a standard for classifying medical conditions. Our goal was to examine how the transition to this new coding system impacted autism diagnoses in 10 healthcare systems.

Beyond clinical outcomes: Case control study of the role of race in disruptive life events for people with serious mental illness.

Objective: To understand how race and serious mental illness (SMI) interact for disruptive life events defined as financial (bankruptcy and judgement filings), and non-financial (arrests).

Methods: Patients were adults with schizophrenia (SCZ; N = 16,159) or bipolar I disorder (BPI; N = 30,008) matched 1:1 to patients without SMI (non-SMI) from health systems in Michigan and Southern California during 1/1/2007 through 12/31/2018. The main exposure was self-reported race, and the outcome was disruptive life events aggregated by Transunion.

Baseline Psychosocial, Environmental, Health, and Behavioral Correlates of 1- and 3-Year Weight Loss After Bariatric Surgery.

Purpose: Weight loss surgery is an effective, long-term treatment for severe obesity but individual response to surgery varies widely. The purpose of this study was to test a comprehensive theoretical model of factors that may be correlated with the greatest surgical weight loss at 1-3 years following surgery. Such a model would help determine what predictive factors to measure when patients are preparing for surgery that may ensure the best weight outcomes.

Research data warehouse: using electronic health records to conduct population-based observational studies.

Background: Electronic health records and many legacy systems contain rich longitudinal data that can be used for research; however, they typically are not readily available.

Materials And Methods: At Kaiser Permanente Southern California (KPSC), a research data warehouse (RDW) has been developed and maintained since the late 1990s and widely extended in 2006, aggregating and standardizing data collected from internal and a few external sources. This article provides a high-level overview of the RDW and discusses challenges common to data warehouses or repositories for research use.

Assessment of Disruptive Life Events for Individuals Diagnosed With Schizophrenia or Bipolar I Disorder Using Data From a Consumer Credit Reporting Agency.

Importance: There is a dearth of population-level data on major disruptive life events (defined here as arrests by a legal authority, address changes, bankruptcy, lien, and judgment filings) for patients with bipolar I disorder (BPI) or schizophrenia, which has limited studies on mental health and treatment outcomes.

Objective: To conduct a population-level study on disruptive life events by using publicly available data on disruptive life events, aggregated by a consumer credit reporting agency in conjunction with electronic health record (EHR) data.

Design, Setting, And Participants: This study used EHR data from 2 large, integrated health care systems, Kaiser Permanente Southern California and Henry Ford Health.

Remission and Relapse of Hypertension After Bariatric Surgery: A Retrospective Study on Long-Term Outcomes.

Unlabelled: To compare hypertension remission and relapse after bariatric surgery compared with usual care.

Background: The effect of Roux-en-Y gastric bypass and sleeve gastrectomy on hypertension remission and relapse has not been studied in large, multicenter studies over long periods and using clinical blood pressure (BP) measurements.

Methods: This retrospective cohort study was set in Kaiser Permanente Washington, Northern California, and Southern California.