Performance-based and patient-reported outcome measures for custom ankle-foot orthosis users: reliability, validity, and sensitivity evidence.

Purpose: To evaluate the psychometric properties of performance and patient-reported outcome measures (PROMs) for custom ankle-foot orthosis (AFOs) users.

Materials And Methods: Current AFO users completed two assessments one week apart; new AFO users completed an assessment before device delivery and at one- and two-months post-delivery.

Results: Seventy current and 31 new users consented and provided data.

Neighborhood Socioeconomic Status and Cardiovascular Events in Adults With CKD: The CRIC Study.

Rationale & Objective: In the general population, neighborhood socioeconomic status (SES) has been found to be associated with cardiovascular risk, but this relationship has not been well studied among patients with chronic kidney disease (CKD). This study seeked to evaluate the association between neighborhood SES and cardiovascular outcomes in a CKD cohort.

Study Design: Multicenter prospective cohort.

Telehealth for Goals of Care Conversations in Advanced CKD: A Mixed-Methods Pilot Study of US Veterans and Their Clinicians.

Rationale & Objective: Engaging patients with advanced chronic kidney disease (CKD) in goals of care (GOC) conversations is essential to align life-sustaining treatments with patient preferences. This pilot study described the feasibility of engaging older Veterans with advanced CKD in GOC conversations via telehealth by (1) comparing patient characteristics, including life-sustaining treatment note completion rates and preferences by visit modality, and (2) exploring Veteran and clinician perspectives surrounding telehealth GOC conversations.

Study Design: Mixed-method convergent design including a prospective, quantitative observational cohort analysis (n = 40) and qualitative, semi-structured interviews with 4 clinicians and 11 Veterans.

Anti-Amyloid Therapies for Alzheimer's Disease and Amyloid-Related Imaging Abnormalities: Implications for the Emergency Medicine Clinician.

Alzheimer's disease is the neurodegenerative disorder responsible for approximately 60% to 70% of all cases of dementia and is expected to affect 152 million by 2050. Recently, anti-amyloid therapies have been developed and approved by the Food and Drug Administration as disease-modifying treatments given as infusions every 2 to 5 weeks for Alzheimer's disease. Although this is an important milestone in mitigating Alzheimer's disease progression, it is critical for emergency medicine clinicians to understand what anti-amyloid therapies are and how they work to recognize, treat, and mitigate their adverse effects.

Veteran and healthcare team perspectives on the TeleWound Practice Program within the Veterans Health Administration.

Objective: The Veterans Health Administration (VHA) recently piloted the implementation of the TeleWound Practice Program (TWP), which provides interprofessional wound care to Veterans remotely. We assessed the perceptions of Veterans and healthcare team members (HCTMs), and their experiences with the TWP.

Method: We surveyed Veterans from four VHA medical centres who had received at least one TWP visit between 1 May 2020 and 31 May 2021, and HCTMs associated with any TWP encounter between 1 September 2019 and 31 March 2021.

Preventing Community-Acquired Pressure Injury in Spinal Cord Injury: Simulation for Registered Nurses.

Purpose: The study purpose was to develop and assess a simulation for registered nurses to apply knowledge, skills, and attitudes in conducting a focused assessment in the clinic setting to prevent community-acquired pressure injuries (CAPrIs) in individuals living with spinal cord injury (SCI).

Methods: Development, psychometric assessment, and pilot of a simulation for a nurse-patient clinic appointment to prevent CAPrIs at home. Evaluations were conducted via focus group.

Pain Coping Skills Training for Patients Receiving Hemodialysis: The HOPE Consortium Randomized Clinical Trial.

Importance: Chronic pain is common among individuals with dialysis-dependent kidney failure.

Objective: To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.

Design, Setting, And Participants: This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US.

Increasing financial incentives can lower the cost of trial recruitment.

Monetary incentives are commonly used to help recruit trial participants. Some studies have found greater recruitment with larger incentives, while others have found smaller incentives more cost-effective in terms of cost per participant. As part of an implementation study, we compared the impact of four approaches to recruitment, three of which involved phone recruitment with varying financial incentives.

Validation of Parkinson's Disease Ascertainment in the Veterans Administration Electronic Medical Record.

Background: Electronic medical record (EMR)-based studies hold great potential for epidemiologic investigations of Parkinson's disease (PD) causal factors and phenomenology, but diagnostic misclassification may obscure or bias inferences.

Objectives: The aims were to determine the validity of PD diagnostic codes in the Veterans Administration (VA) national electronic medical databases and develop recommendations for maximizing ascertainment accuracy.

Methods: We investigated a cohort of 146,776 veterans who utilized VA healthcare between 1999 and 2021.

Veteran patient perceptions of a universal gloving intervention for health care-associated infection prevention: A qualitative study.

Background: Universal gloving by health care workers (HCW) for all patient care activities (beyond isolation and standard precautions) has been proposed to reduce health care-associated infection transmission, but patient perceptions of this approach are unclear. We interviewed patients who experienced a universal gloving intervention by HCW within Veterans Affairs inpatient acute care units to understand their perceptions of universal gloving.

Methods: We conducted interviews with 15 patients across 5 Veterans Affairs hospitals.

Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study.

Study Objective: The primary objective of our study was to compare the effectiveness of oral cephalosporins versus fluroquinolones and trimethoprim/sulfamethoxazole (TMP-SMX) for the treatment of pyelonephritis in patients discharged home from the emergency department (ED).

Methods: This was a multicenter, retrospective, observational cohort study of 11 geographically diverse US EDs. Patients aged ≥18 years diagnosed with pyelonephritis and discharged home from the ED between January 1, 2021 and October 31, 2023 were included.

A cross-sectional survey of Department of Veterans Affairs laboratory practices for identification of carbapenem-resistant and .

Control of carbapenem-resistant and spread in healthcare settings begins with timely and accurate laboratory testing practices. Survey results show most Veterans Affairs facilities are performing recommended tests to identify these organisms. Most facilities report sufficient resources to perform testing, though medium-complexity facilities report some perceived barriers.

Trends in and predictors of patient pharmacogenomic test uptake in a national health care system.

Purpose: Better understanding patient uptake of pharmacogenomic (PGx) testing may inform its implementation and maximize the benefits that such testing can confer. This study examined patient and provider factors associated with PGx test ordering in a national health care system in which panel-based testing was implemented as part of routine care.

Methods: We used a retrospective matched cohort design and data from the Veterans Health Administration Corporate Data Warehouse.

Social Disadvantage and Disparities in Chronic Liver Disease: A Systematic Review.

Introduction: Social determinants of health (SDOH) may impact chronic liver disease (CLD) outcomes but are not clearly understood. We conducted a systematic review to describe the associations of SDOH with mortality, hospitalizations, and readmissions among patients with CLD.

Methods: This review was registered (PROSPERO ID: CRD42022346654) and identified articles through MEDLINE, Embase, Cochrane Library, and Scopus databases.

High Hospitalization Rates and Risk Factors Among Frail Patients With Cirrhosis: A 10-year Population-based Cohort Study.

Background & Aims: Cirrhosis-related inpatient hospitalizations have increased dramatically over the past decade. We used a longitudinal dataset capturing a large metropolitan area in the United States from 2011 to 2021 to evaluate contemporary hospitalization rates and risk factors among frail patients with cirrhosis.

Methods: We conducted a retrospective, longitudinal cohort study using the Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN) database, an electronic health record repository that aggregates de-duplicated data across 7 health care systems in the Chicago metropolitan area, from 2011 to 2021.

Veteran Preferences and Willingness to Share Patient-Generated Health Data.

Background: Technologies, including mobile health applications (apps) and wearables, offer new potential for gathering patient-generated health data (PGHD) from patients; however, little is known about patient preferences for and willingness to collect and share PGHD with their providers and healthcare systems.

Objective: Describe how patients use their PGHD and factors important to patients when deciding whether to share PGHD with a healthcare system.

Design: Cross-sectional mailed longitudinal survey supplemented with administrative data within the Veterans Health Administration (VHA).

Race, Social Determinants of Health, and the Quality of Diabetic Eye Care.

Importance: Besides race, little is known about how other social determinants of health (SDOH) affect quality of diabetic eye care.

Objective: To evaluate the association between multiple SDOH and monitoring for diabetic retinopathy (DR) in accordance with clinical practice guidelines (CPGs).

Design, Setting, And Participants: This cohort study was conducted in 11 US medical centers and included adult patients (18-75 years old) with diabetes.

Antibiotic utilization trends in Veterans Affairs patients with bloodstream infections.

Objective: is a multidrug-resistant gram-negative bacillus that can cause serious infections but has limited treatment options. This study aims to establish trends in the treatment of bloodstream infections (BSI) across the United States in Department of Veterans Affairs (VA) facilities.

Methods: Data was evaluated over a 10-year timeframe (2012 to 2021) in this retrospective cohort study.

Ceftazidime/avibactam alone or in combination with an aminoglycoside for treatment of carbapenem-resistant Enterobacterales infections: A retrospective cohort study.

Background: Ceftazidime/avibactam is one of the preferred treatment options for carbapenem-resistant Enterobacterales (CRE). However, the benefit of combining ceftazidime/avibactam with another antibiotic remains unclear.

Objectives: To identify variables associated with treatment failure during the use of ceftazidime/avibactam for CRE infections and assess the effect of combining an aminoglycoside with ceftazidime/avibactam.