A Novel Automated Algorithm to Identify Lung Cancer Screening from Free Text of Radiology Orders.

Background: Lung cancer screening (LCS) is recommended for asymptomatic patients. Administrative codes for LCS may capture tests prompted by signs/symptoms.

Objective: To validate an automated algorithm that identifies LCS among asymptomatic patients.

National cross-sectional survey of US adults to assess the reliability of current and lifetime cannabis smoking.

Objective: The objective is to examine the test-retest reliability and internal reliability of six self-report questions assessing both current (past 30 days) and lifetime cannabis smoking in an internet survey in the adult US population.

Design: Cross-sectional national survey.

Participants: Out of 957 US adults who completed a national 2020 survey administered through Ipsos KnowledgePanel, 557 completed a second survey ('reliability survey') aimed at assessing the test-retest and internal reliability of questions asking about current and lifetime cannabis smoking.

The Heart and Cannabis (THC) Cohort: Differences in Baseline Health and Behaviors by Cannabis Use.

Background: Evidence on the cardiovascular health effects of cannabis use is limited. We designed a prospective cohort study of older Veterans (66 to 68 years) with coronary artery disease (CAD) to understand the cardiovascular consequences of cannabis use. We describe the cohort construction, baseline characteristics, and health behaviors that were associated with smoking cannabis.

Examining the Interfacility Variation of Social Determinants of Health in the Veterans Health Administration.

Introduction: Recently, numerous studies have linked social determinants of health (SDoH) with clinical outcomes. While this association is well known, the interfacility variability of these risk favors within the Veterans Health Administration (VHA) is not known. Such information could be useful to the VHA for resource and funding allocation.

Development of a Cannabis Assessment Tool (CAT-1) to measure current and lifetime marijuana use among older Veterans.

Objective: To develop a tool to assess current (past 30 days) and lifetime marijuana use in older Veterans.

Setting: US Veteran's Affairs Healthcare System.

Participants: 704 older Veterans were screened, 339 completed the initial survey, 100 completed the follow-up.

Differences in Opinions About Marijuana Use and Prevalence of Use by State Legalization Status.

Objective: Beliefs about marijuana use and prevalence of use may be associated with the legalization status of the state of residence. We examined differences in views and rates of use of marijuana among residents in recreationally legal, medically legal, and nonlegal states.

Methods: We surveyed a nationally representative online panel of US adults (N = 16,280) and stratified results by marijuana legalization status of states.

Sources of Information and Beliefs About the Health Effects of Marijuana.

Background: Marijuana is currently legal for recreational use in 10 states and Washington DC while a total of 34 states have implemented varying degrees of medical marijuana. The commercialization of marijuana has been accompanied by a proliferation of false claims regarding the therapeutic potential of marijuana, which are popularized by several different information sources. To date, no study has examined where US adults get their information regarding marijuana.

Substitution of marijuana for opioids in a national survey of US adults.

Opioid prescriptions for chronic pain and subsequent opioid-related complications have risen dramatically in the US. Recent data suggest that medical marijuana laws have been associated with lower state-level opioid overdose mortality. In a national survey, we examined the prevalence of substitution of marijuana for opioids among US adults taking opioids for pain.

Moonstone: a novel natural language processing system for inferring social risk from clinical narratives.

Background: Social risk factors are important dimensions of health and are linked to access to care, quality of life, health outcomes and life expectancy. However, in the Electronic Health Record, data related to many social risk factors are primarily recorded in free-text clinical notes, rather than as more readily computable structured data, and hence cannot currently be easily incorporated into automated assessments of health. In this paper, we present Moonstone, a new, highly configurable rule-based clinical natural language processing system designed to automatically extract information that requires inferencing from clinical notes.

Examining the Utility of 30-day Readmission Rates and Hospital Profiling in the Veterans Health Administration.

Background: The Veterans Health Administration (VA) reports hospital-specific 30-day risk-standardized readmission rates (RSRRs) using CMS-derived models.

Objective: The aim of this study was to examine and describe the interfacility variability of 30-day RSRRs for acute myocardial infarction (AMI), heart failure (HF), and pneumonia as a means to assess its utility for VA quality improvement and hospital comparison.

Research Design: A retrospective analysis of VA and Medicare claims data using one-year (2012) and three-year (2010-2012) data given their use for quality improvement or for hospital comparison, respectively.

Risks and Benefits of Marijuana Use: A National Survey of U.S. Adults.

Background: Despite insufficient evidence regarding its risks and benefits, marijuana is increasingly available and is aggressively marketed to the public.

Objective: To understand the public's views on the risks and benefits of marijuana use.

Design: Probability-based online survey.

Marijuana Use, Respiratory Symptoms, and Pulmonary Function: A Systematic Review and Meta-analysis.

Background: The health effects of smoking marijuana are not well-understood.

Purpose: To examine the association between marijuana use and respiratory symptoms, pulmonary function, and obstructive lung disease among adolescents and adults.

Data Sources: PubMed, Embase, PsycINFO, MEDLINE, and the Cochrane Library from 1 January 1973 to 30 April 2018.

A search algorithm for identifying likely users and non-users of marijuana from the free text of the electronic medical record.

Background: The harmful effects of marijuana on health and in particular cardiovascular health are understudied. To develop such knowledge, an efficient method of developing an informative cohort of marijuana users and non-users is needed.

Methods: We identified patients with a diagnosis of coronary artery disease using ICD-9 codes who were seen in the San Francisco VA in 2015.

Guideline concordance of new statin prescriptions: who got a statin?

Objectives: Statins are recommended to reduce serum cholesterol in patients at risk for atherosclerotic cardiovascular disease. Despite the prevalence of statin use, little is known about the indications for new prescriptions. We assessed the concordance of new statin prescriptions in the Veterans Health Administration (VHA) compared with the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III) guidelines (the guidelines in force in 2012) and the American College of Cardiology (ACC)-American Heart Association (AHA) 2013 guidelines.

Molecular subgroups of medulloblastoma identification using noninvasive magnetic resonance spectroscopy.

Background: Medulloblastomas in children can be categorized into 4 molecular subgroups with differing clinical characteristics, such that subgroup determination aids in prognostication and risk-adaptive treatment strategies. Magnetic resonance spectroscopy (MRS) is a widely available, noninvasive tool that is used to determine the metabolic characteristics of tumors and provide diagnostic information without the need for tumor tissue. In this study, we investigated the hypothesis that metabolite concentrations measured by MRS would differ between molecular subgroups of medulloblastoma and allow accurate subgroup determination.

Tumor-associated macrophages in SHH subgroup of medulloblastomas.

Purpose: Medulloblastoma in children can be categorized into at least four molecular subgroups, offering the potential for targeted therapeutic approaches to reduce treatment-related morbidities. Little is known about the role of tumor microenvironment in medulloblastoma or its contribution to these molecular subgroups. Tumor microenvironment has been shown to be an important source for therapeutic targets in both adult and pediatric neoplasms.

Copy number variation signature to predict human ancestry.

Background: Copy number variations (CNVs) are genomic structural variants that are found in healthy populations and have been observed to be associated with disease susceptibility. Existing methods for CNV detection are often performed on a sample-by-sample basis, which is not ideal for large datasets where common CNVs must be estimated by comparing the frequency of CNVs in the individual samples. Here we describe a simple and novel approach to locate genome-wide CNVs common to a specific population, using human ancestry as the phenotype.