Association of an Automated Blood Pressure Measurement Quality Improvement Program With Terminal Digit Preference and Recorded Mean Blood Pressure in 11 Clinics.

Importance: Terminal digit preference has been shown to be associated with inaccurate blood pressure (BP) recording.

Objective: To evaluate whether converting from manual BP measurement with aneroid sphygmomanometers to automated BP measurement was associated with terminal digit preference, mean levels of recorded BP, and the rate at which hypertension was diagnosed.

Design, Setting, And Participants: This quality improvement study was conducted from May 9, 2021, to March 24, 2022, using interrupted time series analysis of medical record data from 11 primary care clinics in a single health care system from April 2008 to April 2015.

Providers' perceived barriers to sexually transmitted disease care in 2 large health maintenance organizations.

Goal: To identify providers' perceived barriers to sexually transmitted disease (STD) care in 2 health plans and plan-, clinician-, and patient-level factors that were associated with these barriers in order to inform quality improvement interventions.

Study Design: Surveys were mailed to a stratified sample of 1000 physicians, physician assistants, and nurse practitioners at 2 large health plans in 1999-2000. Of the 743 (82%) providers who received questionnaires and responded, data were analyzed from 699 with complete specialty information.

Evaluation of clinician-reported adherence to Centers for Disease Control and Prevention guidelines for the treatment of Chlamydia trachomatis in two U.S. health plans.

Objective: The objective of this study was to assess clinician adherence to Centers for Disease Control and Prevention-recommended treatments for Chlamydia trachomatis (CT) in two health plans.

Study Design: Using hypothetical scenarios, a 1999-2000 mail survey questioned clinicians about how they would treat a cervicitis patient (CT and gonorrhea treatment recommended) and two patients with laboratory-confirmed CT: an injection drug user (single-dose azithromycin promotes adherence) and a pregnant patient (nonteratogenic drugs recommended).

Results: Seven hundred forty-three (82%) of the 907 nonretired clinicians receiving the survey completed it.

Diabetes: how are we diagnosing and initially managing it?

Purpose: We undertook this study to examine the symptoms, clinical events, and types of health care encounters that preceded the diagnosis of diabetes mellitus in adults, and to examine changes in glycemic control and cardiovascular risk factors in the first year after a diabetes diagnosis.

Methods: We conducted a historical cohort study of patients in a large multispecialty medical group in Minnesota. Among 55,121 adults who were continuously enrolled in the health plan and receiving care at the study medical group from January 1, 1993, to December 31, 1996, we identified 504 who received a new diagnosis of diabetes in 1995 or 1996.

Incompleteness of reporting of laboratory-confirmed chlamydial infection by providers affiliated with a managed care organization, 1997-1999.

Background: Surveillance for sexually transmitted diseases (STDs) depends on the receipt of positive STD test results from laboratories or reports of STD diagnoses from clinicians to local or state health departments.

Goal: The goal of this study was to evaluate incompleteness of reporting of chlamydial infection in a large staff-model managed care organization (MCO) using laboratory data and provider-based reports.

Methods: All cases of chlamydial infection in 2 databases, one from the MCO during January 1997 through June 1999 and the other from the state STD registry, were compared by using a standard algorithm alone that included patient's name, sex, and date of specimen collection, and by using the standard algorithm together with the patient's medical record number.

Adherence to CDC STD guideline recommendations for the treatment of Chlamydia trachomatis infection in two managed care organizations.

Background: The extent of adherence to the Centers for Disease Control and Prevention (CDC) STD guidelines by clinicians practicing in managed care settings is unknown. GOAL The goal was to assess adherence to the CDC guideline recommendations for the treatment of genital chlamydial infection, by clinicians at two group model managed care organizations.

Design: Retrospective cohort study of men and women with laboratory-confirmed chlamydial infection.

Household composition and risk of fatal child maltreatment.

Objective: Approximately 2000 children die annually in the United States from maltreatment. Although maternal and child risk factors for child abuse have been identified, the role of household composition has not been well-established. Our objective was to evaluate household composition as a risk factor for fatal child maltreatment.