Publications by authors named "Stuart Lipsitz"
Background: Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and healthcare access factors may be associated with adherence to recommended cancer screenings.
Methods: We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System.
Introduction: It is unclear if certain anatomic characteristics in patients with a right aortic arch with aberrant left subclavian artery (RAA ALSCA) are associated with undergoing surgical repair.
Methods: This was a single-center retrospective study of patients with RAA ALSCA and computed tomography or cardiovascular magnetic resonance from July 2013-September 2023. The size of the proximal ALSCA or diverticulum of Kommerell (DoK), thoracic inlet index, angle of the proximal ALSCA/DoK from the aortic arch, the position of descending aorta, location of the DoK, and tracheal size were compared between patients who did or did not undergo surgery.
Article Synopsis
- Patients with Alzheimer's Disease and related dementias (ADRD) experience worse outcomes after colorectal surgery compared to those without ADRD, as shown in a study analyzing Medicare data from 2017 to 2018.
- The study found that 8.3% of the colorectal surgery cohort had ADRD, and these patients were generally older, frailer, and had more comorbidities, leading to higher instances of complications and mortality.
- Additionally, ADRD patients required more hospital resources, including longer stays and more frequent discharges to higher-level care facilities.
Objectives: To estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned.
Design: Multicenter retrospective cohort study.
Setting: 11 US hospitals.
Objectives: The purpose of this study was to examine the impact of a contact-free continuous monitoring system on clinical outcomes including unplanned intensive care unit (ICU) transfer (primary), length of stay (LOS), code blue, and mortality. A secondary aim was to evaluate the return on investment associated with implementing the contact-free continuous monitoring program during the COVID public health emergency.
Methods: An interrupted time series evaluation was conducted to examine the association between the use of contact-free continuous monitoring and clinical outcomes.
Introduction: Benign prostatic obstruction (BPO) is one of the most common causes of male lower urinary tract symptoms. Some institutions routinely perform BPO surgeries in ambulatory setting, while others elect for overnight hospitalization. With the COVID-19 pandemic limiting resources and hospital space for elective surgery, we investigated the time trend of ambulatory BPO procedures performed around the COVID-19 outbreak.
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- A study investigates the clinical effectiveness of a new digital design method for creating custom transtibial prosthetic interfaces using MRI or CT scans of amputated limbs.
- The new design approach aims to enhance comfort and reduce pain compared to traditional methods, which often lack scientific backing and rely on standard sizes.
- Results show that the novel interfaces significantly lower pain during walking and reduce pressure at specific limb areas, although thermal differences and some pressure results were not statistically significant.
Article Synopsis
- E-cigarette use has risen notably among older individuals, raising questions about its impact on preventive health behaviors like prostate specific antigen (PSA) screening among smokers.
- A study analyzed data from men aged 50-69 to investigate the correlation between e-cigarette use and PSA screening rates, finding that 28.3% had received screening.
- Results indicated that e-cigarette smokers were significantly less likely to undergo PSA screening compared to both never-smokers and tobacco smokers, potentially due to fewer primary care visits.
Background: Adverse event surveillance approaches underestimate the prevalence of harmful diagnostic errors (DEs) related to hospital care.
Methods: We conducted a single-centre, retrospective cohort study of a stratified sample of patients hospitalised on general medicine using four criteria: transfer to intensive care unit (ICU), death within 90 days, complex clinical events, and none of the aforementioned high-risk criteria. Cases in higher-risk subgroups were over-sampled in predefined percentages.
Objective: Opioid use disorder (OUD) can be effectively treated with buprenorphine maintenance. Recent changes in federal policy have removed the requirement for physicians to complete additional training to apply for a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine. At that time, few primary care providers (PCPs) had completed the training for a DEA waiver to prescribe buprenorphine.
View Article and Find Full Text PDFBackground: Accurate identification of incident venous thromboembolism (VTE) for quality improvement and health services research is challenging. The purpose of this study was to evaluate the performance of a novel incident VTE phenotyping algorithm defined using standard terminologies, requiring three key indicators documented in the electronic health record (EHR): VTE diagnostic code, VTE-related imaging procedure code, and anticoagulant medication code.
Methods: Retrospective chart reviews were conducted to assess the performance of the algorithm using a random sample of phenotype(+) and phenotype(-) diagnostic encounters from primary care practices and acute care sites affiliated with five hospitals across a large integrated care delivery system in Massachusetts.
Objectives: This study aimed to pilot an application-based patient diagnostic questionnaire (PDQ) and assess the concordance of the admission diagnosis reported by the patient and entered by the clinician.
Methods: Eligible patients completed the PDQ assessing patients' understanding of and confidence in the diagnosis 24 hours into hospitalization either independently or with assistance. Demographic data, the hospital principal problem upon admission, and International Classification of Diseases 10th Revision (ICD-10) codes were retrieved from the electronic health record (EHR).
Background: Focal therapy, a minimally invasive procedure, offers targeted treatment for kidney and prostate cancer using image guidance. However, the current institutional landscape of its adoption in localized prostate and kidney cancer remains less understood. This analysis compares its usage between the 2 cancers to discern health system determinants affecting the adoption of these treatments.
View Article and Find Full Text PDFBackground: This study evaluated the accuracy, clinical concordance, and readability of the chatbot interface generative pretrained transformer (ChatGPT) 3.5 as a source of breast cancer information for patients.
Methods: Twenty questions that patients are likely to ask ChatGPT were identified by breast cancer advocates.
Background: Respectful maternity care includes shared decision-making (SDM). However, research on SDM is lacking from the intrapartum period and instruments to measure it have only recently been developed. TeamBirth is a quality improvement initiative that uses team huddles to improve SDM during labor and birth.
View Article and Find Full Text PDFBackground: The rise in advanced prostate cancer has coincided with increased use of Magnetic Resonance Imaging (MRI), leading to the hypothesis that this increase in surveillance registries is an artifact of more sensitive imaging tools. We assessed the association between regional variation in prostate MRI and advanced prostate cancer diagnoses.
Methods: We utilized SEER-Medicare data (2004-2015), including men > 65 diagnosed with localized prostate cancer.
Objectives: Post-discharge adverse events (AEs) are common and heralded by new and worsening symptoms (NWS). We evaluated the effect of electronic health record (EHR)-integrated digital tools designed to promote quality and safety in hospitalized patients on NWS and AEs after discharge.
Materials And Methods: Adult general medicine patients at a community hospital were enrolled.
Article Synopsis
- This study aimed to evaluate if unsupervised machine learning can differentiate patients with Fontan circulation from healthy individuals based on heart function metrics derived from cardiovascular magnetic resonance (CMR) imaging.
- By analyzing 503 CMR studies from Fontan patients and 42 from controls, researchers identified four distinct patient clusters with different risks for adverse outcomes like heart failure or transplantation.
- The highest-risk group, characterized by specific heart shapes and poor functioning, showed significantly greater health risks compared to the lowest-risk group, suggesting that machine learning can help target distinct patient subgroups for better clinical management.
While many experts in pediatric cardiology have emphasized the importance of palliative care involvement, very few studies have assessed the influence of specialty pediatric palliative care (SPPC) involvement for children with heart disease. We conducted a systematic review using keywords related to palliative care, quality of life and care-satisfaction, and heart disease. We searched PubMed, EMBASE, CINAHL, CENTRAL and Web of Science in December 2023.
View Article and Find Full Text PDFImportance: The decision for surgical vs nonsurgical treatment for hip fracture can be complicated among community-dwelling people living with dementia.
Objective: To compare outcomes of community-dwelling people living with dementia treated surgically and nonsurgically for hip fracture.
Design, Setting, And Participants: This retrospective cross-sectional study undertook a population-based analysis of national Medicare fee-for-service data.
Background: The objective of this study was to quantify disparities in cancer treatment delivery between minority-serving hospitals (MSHs) and non-MSHs for breast, prostate, nonsmall cell lung, and colon cancers from 2010 to 2019 and to estimate the impact of improving care at MSHs on national disparities.
Methods: Data from the National Cancer Database (2010-2019) identified patients who were eligible for definitive treatments for the specified cancers. Hospitals in the top decile by minority patient proportion were classified as MSHs.
Importance: Time on the electronic health record (EHR) is associated with burnout among physicians. Newer virtual scribe models, which enable support from either a real-time or asynchronous scribe, have the potential to reduce the burden of the EHR and EHR-related documentation.
Objective: To characterize the association of use of virtual scribes with changes in physicians' EHR time and note and order composition and to identify the physician, scribe, and scribe response factors associated with changes in EHR time upon virtual scribe use.