Default Bulk Ordering and Text Messaging to Enhance Outreach for Lipid Screening: A Randomized Clinical Trial.

Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.

Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.

Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.

Tumour size is associated with growth rates of >0.5 cm/year and delayed intervention in small renal masses in patients on active surveillance.

Objective: To evaluate the association between tumour size and the growth rate (GR) of small renal masses (SRMs) in patients managed by active surveillance (AS).

Materials And Methods: We queried the prospective, multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry for patients on AS with an imaging interval of ≥6 months, identifying 456 patients. We tracked tumour size over time; a GR >0.

Medicare Resource Use Differs by English Reading Proficiency.

Background And Objectives: Medicare coverage decisions are complex. The Centers for Medicare & Medicaid Services (CMS) provides a hotline, handbook, and website to help Medicare beneficiaries understand their benefits and coverage options, yet it is unclear what factors affect beneficiary use of these resources. We examined limited English speaking and English reading proficiency status as predictors of CMS Medicare informational resource use in a nationally representative sample of Medicare beneficiaries.

Automated Integration of AI Results into Radiology Reports Using Common Data Elements.

Integration of artificial intelligence (AI) into radiology practice can create opportunities to improve diagnostic accuracy, workflow efficiency, and patient outcomes. Integration demands the ability to seamlessly incorporate AI-derived measurements into radiology reports. Common data elements (CDEs) define standardized, interoperable units of information.

A Pilot Study on the Freelisting Method Among Adolescents with Chronic Musculoskeletal Pain: Feasibility, Acceptability and Study Findings.

: To assess the feasibility and acceptability of freelisting for adolescents with chronic musculoskeletal pain (CMP) and use freelisting to identify how adolescents with CMP cope with pain. : This was a mixed-methods cross-sectional single-center study of patients 12-18 years old, diagnosed with CMP. Twenty-seven subjects participated in an interview which included the freelisting exercise, probing questions, Connor-Davidson Resilience Scale 10-item, and semi-structured interview.

Cost-effectiveness Analysis of Uterus Transplantation versus Gestational Carrier for Treatment of Absolute Uterine Factor Infertility.

Importance: Patients with uterine factor infertility (UFI) have few options for family building. Uterus transplant is a feasible treatment for some patients; however, cost remains a significant concern.

Objective: To compare the cost effectiveness of treatment for patients with absolute uterine factor infertility to achieve 1-2 singleton births by gestational carrier or uterus transplant DESIGN: Decision analysis from the United States healthcare sector perspective, with time horizons to achieve one or two singleton births.

Types and cost of wellness services provided by a neighborhood-based academic nursing center.

Background: Despite increased insurance coverage since 2010, racial and ethnic minorities in the United States still receive less medical care than White counterparts. The Johns Hopkins School of Nursing's Center for Community Programs, Innovation, and Scholarship (COMPASS Center) provides free wellness services, aiming to address healthcare disparities in the neighborhoods.

Objective: To delineate the types and cost of wellness services provided by the COMPASS Center.

Racial/ethnic differences in post-acute sequelae of SARS-CoV-2 in children and adolescents in the United States.

Racial/ethnic differences are associated with the symptoms and conditions of post-acute sequelae SARS-CoV-2 infection (PASC) in adults. These differences may exist among children and warrant further exploration. We conducted a retrospective cohort study with difference-in-differences analyzes to assess these differences in children and adolescents under the age of 21.

Endoscopy and Anesthesia Outcomes Associated with Glucagon-Like Peptide-1 Receptor Agonist use in Patients Undergoing Outpatient Upper Endoscopy.

Background And Aims: Glucagon-like peptide-1 receptor agonists (GLP1RAs) can cause delayed gastric emptying, raising concern for retained gastric contents (RGCs) during endoscopy and adverse anesthesia events. We aimed to determine associations between GLP1RA and endoscopy and anesthesia outcomes.

Methods: This single-center retrospective cohort study examined patients prescribed GLP1RA who underwent outpatient endoscopy stratified by exposure at the time of endoscopy.

The Complete Inpatient Record Using Comprehensive Electronic Data (CIRCE) project: A team-based approach to clinically validated, research-ready electronic health record data.

Introduction: The rapid adoption of electronic health record (EHR) systems has resulted in extensive archives of data relevant to clinical research, hospital operations, and the development of learning health systems. However, EHR data are not frequently available, cleaned, standardized, validated, and ready for use by stakeholders. We describe an in-progress effort to overcome these challenges with cooperative, systematic data extraction and validation.

Designing an intervention to improve cognitive evaluations in primary care.

Background: Early diagnosis is crucial to the optimal management of patients with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias. For some patients, early detection of cognitive impairment enables access to disease-modifying therapies. For all patients, it allows access to psychosocial supports.

Real-World Effectiveness of Long-Acting Injectable and Oral Antipsychotic Agents in US Medicare Patients with Schizophrenia.

Introduction: Daily oral antipsychotics (OAPs) are the mainstay of schizophrenia treatment; however, long-acting injectable antipsychotics (LAIs) are associated with better treatment adherence and improved outcomes.

Methods: This study assessed the real-world comparative effectiveness of LAIs and daily OAPs using claims data from a nationally representative sample of fee-for-service Medicare beneficiaries with schizophrenia. Antipsychotic discontinuation, psychiatric hospitalization, and treatment failure were compared relative to different reference groups using within-individual Cox regression models.

A qualitative study exploring the feasibility and acceptability of embedding an overdose prevention sites in a U.S. hospital.

Introduction: Community-based overdose prevention sites (OPS) are recognized for reducing overdose deaths and the spread of HIV and hepatitis C among people who use drugs (PWUD). While some hospitals in Europe and Canada have successfully integrated OPS into their facilities, such integration remains illegal in the United States. This study explores the feasibility and acceptability of implementing an OPS at the Hospital of the University of Pennsylvania (HUP), situated in an urban area with high rates of overdose.

Development and External Validation of a Machine Learning Model to Predict Restriction from Spirometry.

Background: Though European Respiratory Society and American Thoracic Society (ERS/ATS) guidelines for pulmonary function test (PFT) interpretation recommend the use of the forced vital capacity (FVC) lower limit of normal (LLN) to exclude restriction, recent data suggest that the negative predictive value (NPV) of the FVC LLN is lower than has been accepted, particularly among non-Hispanic Black patients. We sought to develop and externally validate a machine learning (ML) model to predict restriction from spirometry and determine whether its use may improve the accuracy and equity of PFT interpretation.

Methods: We included PFTs with both static and dynamic lung volume measurements for patients between 18 and 80 years of age who were tested at pulmonary diagnostic labs within two health systems.

Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language.

Background And Methods: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020).

Delayed or forgone medical care associated with increased resource utilization and health care expenditures among patients with peripheral artery disease in the United States.

Background: PAD affects >12 million Americans and poses significant financial burdens on patients, but the relationship between delayed/forgone (D/F) care and resource use in this population is unknown. We sought to assess the relationship between D/F care, resource use, and health care expenditures among patients with PAD.

Methods: Adults with PAD in the US were identified in the Medical Expenditure Panel Survey for years 2007-2017.

Child Maltreatment Evaluations Following Out-of-Hospital Cardiac Arrests.

Objectives: In children admitted after an out-of-hospital cardiac arrest (OHCA), this study 1) determines the proportion that undergo: physical abuse and toxin exposure evaluation, child protection team (CPT) consultation, and child protective services (CPS) referral, and 2) evaluates the association between demographic, social, clinical characteristics with CPT consultation and CPS referral.

Methods: Retrospective chart review was conducted of children < 4 years old admitted following an OHCA between November 2012 and February 2023. Associations between demographics, caregiver social risk factors, and clinical characteristics with CPT consultation and CPS referral were examined using logistic regression.

Prioritizing attributes of approaches to analyzing patient-centered outcomes that are truncated due to death in critical care clinical trials: a Delphi study.

Background: A key challenge for many critical care clinical trials is that some patients will die before their outcome is fully measured. This is referred to as "truncation due to death" and must be accounted for in both the treatment effect definition (i.e.

Association Between Hospital Efficiency and Quality of Care Among Fee-for-Service Medicare Beneficiaries with Prostate Cancer: A Retrospective Cohort Study.

Background: Technical efficiency evaluates a hospital's economic performance and plays an important role in variations in quality of care and outcomes. The study objective was to examine the association between hospital efficiency and quality of care among fee-for-service Medicare beneficiaries with prostate cancer and to assess if race moderates this association.

Design: Retrospective study using Surveillance, Epidemiological, and End Results-Medicare (SEER-Medicare) data from 1998 to 2016 for prostate cancer patients aged ≥ 66.

The association of telomere length and religiosity: A systematic review.

Objective: Religiosity is a complex construct comprised observance, intrinsic beliefs, meditative practice, and communal elements. Religiosity has been associated with reduced mortality and improved overall health, but understanding the underlying biological associations is evolving. As increased telomere length has been associated with increased longevity, this project presents a systematic review of studies investigating the relationship between religiosity and telomere length.