Publications by authors named "Scott Koeneman"
Article Synopsis
- The study aimed to analyze how Medicaid expansion impacted the receipt of adjuvant chemotherapy among eligible cancer patients using a national database.
- Researchers reviewed data from nearly 10,000 patients treated in states that expanded Medicaid, finding a significant increase in chemotherapy receipt post-expansion (70.2% vs. 62.3%).
- The results suggest that Medicaid expansion improved access to care and potentially led to better survival outcomes for patients receiving adjuvant therapy.
Background: Deep hypothermic circulatory arrest (DHCA) in patients undergoing descending thoracic (DTAA) or thoracoabdominal aortic aneurysm (TAAA) repair is associated with increased morbidity and mortality. We present our outcomes after open DTAA and TAAA repair with and without DHCA.
Methods: From 1999 to 2022, 81 (38.
Introduction: Lung cancer resection has largely focused on perioperative outcomes (eg, mortality) to benchmark performance. While variations in perioperative outcomes and in utilization of services (eg, ambulatory procedures, hospitalization) have been independently demonstrated, there has been limited evaluation of associations between these outcomes. We evaluated the association between perioperative outcomes and utilization of services to evaluate provider performance across a broader context of care.
View Article and Find Full Text PDFBackground: Hiatal hernia is a common surgical pathology. Such hernias can be found incidentally and patients may opt for an initial nonoperative approach though many will pursue surgery after symptom progression. Data on the effects of age on the outcomes of hiatal hernia repair may help inform this decision-making process.
View Article and Find Full Text PDFBackground: We aimed to investigate the incidence of extrapulmonary findings identified on low-dose computed tomography (CT) that may warrant evaluation by cardiothoracic surgeons and describe their management and referral patterns at our institution.
Methods: We conducted a retrospective cohort study of patients who underwent low-dose CT through a centralized Lung Cancer Screening Program at Thomas Jefferson University Hospital between January 2018 and December 2022. An electronic medical record review was performed for patients with incidental findings.
Article Synopsis
- Fevers are traditionally used to screen for diseases, but individual variations in body temperature can complicate their detection, making diagnosis harder.
- Using millions of temperature recordings, researchers evaluated how body temperature patterns vary by time of day, sex, and age, noting significant differences among these groups.
- The study highlights that detecting a fever depends not only on the individual's characteristics but also on the time of day, suggesting that follow-up temperature readings are crucial for accurate diagnosis of infections.
Background: The incidence of diagnostic delays is unknown for many diseases and specific healthcare settings. Many existing methods to identify diagnostic delays are resource intensive or difficult to apply to different diseases or settings. Administrative and other real-world data sources may offer the ability to better identify and study diagnostic delays for a range of diseases.
View Article and Find Full Text PDFObjectives: A first step in studying diagnostic delays is to select the signs, symptoms and alternative diseases that represent missed diagnostic opportunities. Because this step is labor intensive requiring exhaustive literature reviews, we developed machine learning approaches to mine administrative data sources and recommend conditions for consideration. We propose a methodological approach to find diagnostic codes that exhibit known patterns of diagnostic delays and apply this to the diseases of tuberculosis and appendicitis.
View Article and Find Full Text PDFPurpose: The purpose of this paper was to investigate patterns of health care utilization leading up to diagnosis of necrotizing soft tissue infections of the genitalia and to identify risk factors associated with potential diagnostic delay.
Materials And Methods: IBM MarketScan Research Databases (2001-2020) were used to identify index cases of necrotizing soft tissue infections of the genitalia. We identified health care visits for symptomatically similar diagnoses (eg, penile swelling, cellulitis) that occurred prior to necrotizing soft tissue infections of the genitalia diagnosis.
Histoplasmosis is often confused with other diseases leading to diagnostic delays. We estimated the incidence, length of, and risk factors for, diagnostic delays associated with histoplasmosis. Using data from IBM Marketscan, 2001-2017, we found all patients with a histoplasmosis diagnosis.
View Article and Find Full Text PDFBackground: Delays in diagnosing herpes simplex encephalitis (HSE) are associated with increased morbidity and mortality. The purpose of this paper is to determine the frequency and duration of diagnostic delays for HSE and risk factors for diagnostic delays.
Methods: Using data from the IBM Marketscan Databases, 2001-2017, we performed a retrospective cohort study of patients with HSE.
Objectives: Missed opportunities to diagnose tuberculosis are costly to patients and society. In this study, we (1) estimate the frequency and duration of diagnostic delays among patients with active pulmonary tuberculosis and (2) determine the risk factors for experiencing a diagnostic delay.
Design: A retrospective cohort study of patients with tuberculosis using longitudinal healthcare encounters prior to diagnosis.