Publications by authors named "Mia T Chandler"
Article Synopsis
- Racial and ethnic groups in the USA face significant inequities in COVID-19 infection and vaccine uptake, particularly among individuals with rheumatic conditions who are immunocompromised.
- A community-based trial is being conducted to evaluate the effectiveness of training trusted community leaders (POLs) to promote COVID-19 vaccination, using either a racial justice framework or a biomedical approach.
- The trial aims to increase vaccine uptake by having POLs educate their social networks about COVID-19 vaccines, assessing the impact on vaccination rates among those who have not received the latest vaccine.
Article Synopsis
- The study looks at kids with congenital heart disease (CHD) who also developed a serious condition called systemic juvenile idiopathic arthritis (sJIA).
- Researchers found 5 kids with both CHD and sJIA, who all had different heart issues but had surgery when they were babies.
- The kids showed typical signs of sJIA like fever and joint problems after their heart surgery, and some faced severe complications, highlighting the need to watch for sJIA in children with heart conditions.
Objective: We aimed to examine the feasibility of applying natural language processing (NLP) to unstructured electronic health record (EHR) documents to detect the presence of financial insecurity among patients with rheumatologic disease enrolled in an integrated care management program (iCMP).
Methods: We incorporated supervised, rule-based NLP and statistical methods to identify financial insecurity among patients with rheumatic conditions enrolled in an iCMP (n = 20,395) in a multihospital EHR system. We constructed a lexicon for financial insecurity using data from available knowledge sources and then reviewed EHR notes from 538 randomly selected individuals (training cohort n = 366, validation cohort n = 172).
Objective: Health disparities may be driven by hospital-level factors. We assessed whether racial and ethnic composition of populations hospitals serve explain or modify disparities in hospital outcomes of children with systemic lupus erythematosus (SLE).
Methods: In this retrospective cohort study of patients 5 to 26 years old with SLE at 47 children's hospitals in the Pediatric Health Information System (2006-2021), race and ethnicity were assessed at the patient level and hospital level (proportion of total admissions composed of Black or Hispanic patients, respectively).
Objective: Social determinants of health (SDoH), such as poverty, are associated with increased burden and severity of rheumatic and musculoskeletal diseases. This study was undertaken to study the prevalence and documentation of SDoH-related needs in electronic health records (EHRs) of individuals with these conditions.
Methods: We randomly selected individuals with ≥1 International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) code for a rheumatic/musculoskeletal condition enrolled in a multihospital integrated care management program that coordinates care for medically and/or psychosocially complex individuals.
Article Synopsis
- The study explores COVID-19 vaccine hesitancy among Black individuals with rheumatic conditions, emphasizing the need for community and physician insights to address disparities in vaccine uptake.
- Participants identified misinformation, mistrust, and historical injustices as key barriers to vaccination, stressing the influence of demographic factors like race and age.
- Effective strategies for improving vaccine acceptance involve empathetic, tailored communication and personal storytelling, highlighting the importance of addressing underlying social issues.
Objective: Although interleukin-1 (IL-1)/IL-6 inhibitors are effective therapies for systemic juvenile idiopathic arthritis (JIA), some patients develop eosinophilia and lung disease during treatment. This study was undertaken to retrospectively evaluate incidence and risk factors for eosinophilia and describe lung disease outcomes in IL-1/IL-6 inhibitor-exposed patients with systemic JIA.
Methods: Among JIA patients at our institution exposed to interleukin-1 (IL-1)/IL-6 inhibitors (1995-2022), we compared incidence rate of eosinophilia in systemic JIA compared to other JIA, stratified by medication class (IL-1/IL-6 inhibitors, other cytokine inhibitors, methotrexate).
Objective: Glucocorticoids ("steroids") are frequently used in systemic lupus erythematosus (SLE). Prolonged use may contribute to racial/ethnic disparities in avoidable adverse outcomes. We examined racial/ethnic differences in longitudinal patterns of steroid use and dose.
View Article and Find Full Text PDFObjective: To compare clinical outcomes in children with hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) who were managed before and after implementation of an evidence-based guideline (EBG).
Methods: A management algorithm for MAS-HLH was developed at our institution based on literature review, expert opinion, and consensus building across multiple pediatric subspecialties. An electronic medical record search retrospectively identified hospitalized patients with MAS-HLH in the pre-EBG (October 15, 2015, to December 4, 2017) and post-EBG (January 1, 2018, to January 21, 2020) time periods.
Objectives: Multisystem inflammatory syndrome in children (MIS-C) and e-cigarette or vaping product use-associated lung injury (EVALI) have significant overlap in clinical features, which can contribute to delay in identification and treatment. The objectives of this report were to identify and describe features that are common in both diagnoses and those that may help distinguish EVALI from MIS-C, and to highlight the diagnostic challenges observed at our tertiary medical center.
Methods: We identified adolescents diagnosed with MIS-C who had respiratory or gastrointestinal symptoms and patients diagnosed with EVALI during the same time period.