Opioid-Related Emergency Department Visits Before and During COVID-19: Association with Community-Level Factors.

Background: The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased.

Disciplinary Intersection of Medicine and Business: A Novel Population Health Management Premedical Pathway for Medicine and Other Health Care Professions.

Premedical students typically pursue undergraduate specialization in basic biological and other sciences, learning to understand living systems at a microscopic, genetic, or molecular level. However, curricula in the basic sciences do not traditionally include courses that enable students to learn about living systems at the macro level-understanding individuals within their environment, as well as understanding and managing the health of populations, especially those with underlying conditions or the underserved. This disconnect can be bridged by creating novel curricular programs intersecting medicine and business.

Disparities in Emergency Department Visits for Opioid and Stimulant Overdoses in Florida During COVID-19.

Emergency department (ED) visits for drug overdoses increased nationally during COVID-19 despite declines in all-cause ED visits. The study purpose was to compare characteristics of ED visits for opioid and stimulant overdoses before and during COVID-19 in Florida. This study tested for disparities in ED visits for opioid and stimulant overdoses by race/ethnicity, age, and insurance status.

Redesign of US Medical Schools: A Shift from Health Service to Population Health Management.

The integration of medical schools and clinical partners is effectively established through the formation of academic medical centers (AMCs). The tripartite mission of AMCs emphasizes the importance of providing critical clinical services, medical innovation through research, and the education of future health care leaders. Although AMCs represent only 5% of all hospitals, they contribute substantially to serving disadvantaged populations of patients, including an estimated 37% of all charity care and 26% of all Medicaid hospitalizations.

A Call to Action: Preventing Opioid and Substance Abuse in South Florida Youth.

Description The opioid crisis poses a substantial threat to youth throughout the nation. This crisis has been exacerbated by the COVID-19 pandemic, reversing some of the positive national trends in the fight against the opioid epidemic. Some risk factors for youth opioid use have been identified nationally.

Transitioning to Value-Based Diabetes Care: A Call for Action Derived from Primary Care Providers in South Florida.

Background: In Florida, 2.4 million people have diabetes and 5.8 million are pre-diabetic.

Management Principles to Drive the Creation of a 21st Century Medical School.

Introduction: There are currently no data, blueprints, best practices, or financial models available to guide the creation of a new medical school. Yet, the United States is experiencing unprecedented growth of new allopathic medical schools.

Findings: This article brings logic to the process.

Effects of web-based instruction and patient preferences on patient-reported outcomes and learning for women with advanced ovarian cancer: A randomized controlled trial.

A randomized controlled trial was conducted of a web-based intervention to improve advanced care planning in women with ovarian cancer. A secondary analysis of 35 randomized women focused on changes in distress and knowledge about ovarian cancer through distress monitoring and information tailored to patients' cognitive coping style (monitoring, blunting). Pre-/postresults indicated the Intervention group demonstrated lower distress (p = 0.

Designing an Educational Website to Improve Quality of Supportive Oncology Care for Women with Ovarian Cancer: An Expert Usability Review and Analysis.

A broad-based research team developed a Health Insurance Portability and Accountability Act (HIPAA)-compliant educational website for women with ovarian cancer to improve the quality of supportive oncology care. Prior to a randomized clinical trial of the website, initial usability testing was implemented to evaluate the website. The initial review found that 165/247 checklist items had sufficient information to allow for evaluation with the website achieving an overall score of 63%.

Cost-Effectiveness of Integrating a Clinical Decision Rule and Staged Imaging Protocol for Diagnosis of Appendicitis.

Objective: To evaluate the cost-effectiveness of a diagnostic protocol for appendicitis in children, the use of a validated clinical decision rule (CDR) and a staged imaging protocol, compared with usual care.

Methods: We estimated the cost-effectiveness of the three competing strategies using parameters from existing literature as well as a Markov model developed to simulate the effects of exposure to ionizing radiation from a single computed tomography (CT) study in the course of diagnosis. The simulation model was applied to a hypothetical cohort of 100,000 boys and girls, age 10 years, presenting with acute abdominal pain to emergency departments in the United States.

Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care.

Despite a shift from institutional services toward more home and community-based services (HCBS) for older adults who need long-term services and supports (LTSS), the effects of HCBS have yet to be adequately synthesized in the literature. This review of literature from 1995 to 2012 compares the outcome trajectories of older adults served through HCBS (including assisted living [AL]) and in nursing homes (NHs) for physical function, cognition, mental health, mortality, use of acute care, and associated harms (e.g.

Reliability and validity of a test designed to assess combat medics' readiness to perform life-saving procedures.

Objectives: Reducing preventable deaths because of uncontrolled hemorrhage, tension pneumothorax, and airway loss is a priority. As part of a research initiative comparing different training models, this study evaluated the reliability and validity of a test that assesses combat medic performance during a polytrauma scenario using live animal models.

Methods: Nine procedural checklists and seven global rating scales were piloted with four cohorts of soldiers (n = 94) at two U.

Validity and acceptability of a high-fidelity physical simulation model for training of laparoscopic pyeloplasty.

Purpose: The objective was to determine the acceptability and preliminary construct validity for a high-fidelity synthetic renal pelvis/ureter tissue analogue model for use as a simulation model for training of laparoscopic pyeloplasty.

Materials And Methods: The pyeloplasty model was designed with incorporated assessment lines for use in post-task Black Light Assessment of Surgical Technique (BLAST)™. Practicing urologists participating in the 2011 and 2012 American Urological Association Mentored Renal Laparoscopy courses performed a simulated laparoscopic pyeloplasty procedure and completed a post-task evaluation of the model.

Development and pilot of an advance care planning website for women with ovarian cancer: a randomized controlled trial.

Objective: Few available tools facilitate cancer patients and physicians' discussions of quality of life and end-of-life. Our objective was to develop a web-based tool to promote advance care planning for women with ovarian cancer.

Methods: Women with ovarian cancer, their families, clinicians and researchers met to identify ways to improve cancer care.

Linear regression metamodeling as a tool to summarize and present simulation model results.

Background / Objective: Modelers lack a tool to systematically and clearly present complex model results, including those from sensitivity analyses. The objective was to propose linear regression metamodeling as a tool to increase transparency of decision analytic models and better communicate their results.

Methods: We used a simplified cancer cure model to demonstrate our approach.

Comparing Bayesian and frequentist approaches for multiple outcome mixed treatment comparisons.

Objectives: Bayesian statistical methods are increasingly popular as a tool for meta-analysis of clinical trial data involving both direct and indirect treatment comparisons. However, appropriate selection of prior distributions for unknown model parameters and checking of consistency assumptions required for modeling remain particularly challenging. We compared Bayesian and traditional frequentist statistical methods for mixed treatment comparisons with multiple binary outcomes.

Adding decision models to systematic reviews: informing a framework for deciding when and how to do so.

Objective: Decision models are sometimes used alongside systematic reviews to synthesize evidence. Clarity, however, is lacking about when and how to conduct modeling studies in tandem with systematic reviews, as well as about how to evaluate and present model results. The objective of this study was to collect and analyze information from various sources to inform the development of a framework for deciding when and how a decision model should be added to a systematic review.

Benefits and harms of pharmacologic treatment for urinary incontinence in women: a systematic review.

Background: Urinary incontinence (UI) in women adversely affects quality of life.

Purpose: To conduct a systematic literature review of drugs for urgency UI in women.

Data Sources: MEDLINE, the Cochrane Central Register of Controlled Trials, SCIRUS, and Google Scholar were searched for articles published from 1966 to November 2011.

A framework and standardized methodology for developing minimum clinical datasets.

The concept of the minimum dataset (MDS) is taking on an increasingly important role in healthcare. In the current environment of health information exchange and universal implementation of electronic health records, work related to the development of one specific type of MDS, the minimum clinical dataset (MCDS), is beginning to permeate the literature. While there is currently no unified definition of either an MDS or an MCDS, an MDS is generally agreed to be a coherent set of explicitly defined data elements.

Introduction and validation of the American Urological Association Basic Laparoscopic Urologic Surgery skills curriculum.

Background And Purpose: The Fundamentals of Laparoscopic Surgery (FLS(™)) skills curriculum has validity evidence supporting use for assessing laparoscopic skills for general surgeons. As charged by the American Urological Association (AUA) Laparoscopy, Robotic, and New Surgical Technology Committee, we sought to develop and validate a urology-specific FLS, referred to as the Basic Laparoscopic Urologic Surgery (BLUS(©)) skills curriculum. The psychomotor component consists of three existing FLS tasks and one new clip-applying task.

Results availability from clinical research of female urinary incontinence.

Aims: To ascertain possible publication bias by examining the completeness and publication of studies on nonsurgical treatments for female urinary incontinence (UI).

Methods: We analyzed information about studies from several trial registries through May 2010. We searched Medline using study registration identifiers to determine publication status, and compared percentages of completed and published studies by study and subject characteristics.