2,890 results match your criteria: "VA HSR&D Center for Innovations in Quality[Affiliation]"

Interval Advanced Adenomas and Neoplasia in Patients with Negative Colonoscopy Following Positive Stool-Based Colorectal Cancer Screening Test.

Dig Dis Sci

January 2025

Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, MS: BCM 285, Houston, TX, USA.

Background/aims: Fecal occult blood test (FOBT) and fecal immunohistochemical test (FIT) are used for colorectal cancer (CRC) screening. However, when no adenomas are found following a positive FOBT/FIT, the future risk of advanced adenomas or colorectal cancer (CRC) is unclear. We determined the incidence and determinants of advanced adenomas or CRC after a negative index colonoscopy following a positive FOBT/FIT.

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Patient-psychologist telemedicine interactions in an intensive care unit recovery clinic: Qualitative secondary analysis.

Intensive Crit Care Nurs

November 2024

School of Nursing, Vanderbilt University, Nashville, TN, USA; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address:

Objectives: We aimed to describe the content of patient-psychologist mental health related dialogues during a telemedicine intensive care unit recovery clinic visit.

Research Methodology/design: Qualitative descriptive study nested within a randomized controlled pilot trial to assess a telemedicine intensive care unit recovery clinic feasibility and preliminary efficacy. Participants included adults hospitalized with sepsis and/or respiratory failure.

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Background: The Veterans Health Administration (VA) recommends lung cancer screening (LCS), including shared decision making between clinicians and veteran patients. We sought to characterize 1) veteran conceptualization of lung cancer risk and 2) veteran and clinician accounts of shared decision-making discussions about LCS to assess whether they reflect veteran concerns.

Methods: We conducted qualitative interviews at 6 VA sites, with 48 clinicians and 34 veterans offered LCS in the previous 6 mo.

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Unlabelled: Mass media campaigns for public health often rely heavily on digital media and advertising tools that are customarily the domain of marketing professionals and primarily used for commercial purposes. Digital campaigns also generate a myriad of metrics, which can pose both a challenge and opportunity for scientists wishing to leverage these data for research and evaluation.

Objective: The aim of this article is to provide practical guidance for the evaluation of paid media campaigns, with a focus on analyzing digital data generated directly by the campaign.

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Background: Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S.

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Objective: To investigate provider and administrators' perspectives about the impact of the Department of Veterans Affairs' (VA) Community Care program on acute and residential mental health treatment of rural Veterans.

Data Sources And Study Setting: Primary data were collected from participants via interviews. Participants were employees of VA Healthcare Systems located in Northern New England, or employees of non-VA mental health treatment settings affiliated with VA in Northern New England.

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Objective: The COVID-19 pandemic had profound effects on society, including those living with chronic pain. This study sought to examine pandemic impacts on individuals enrolled in pragmatic clinical trials focused on nonpharmacological treatments for chronic pain.

Methods: We evaluated responses to a questionnaire on COVID-19 impacts that had been administered to participants (n=2024) during study enrollment in 3 pragmatic clinical trials for chronic pain treatment.

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Accessible, low-cost digital programmes are emerging as a means by which to address high rates of mental health problems. However, the development and assessment of scalable training programmes for effective use of digital interventions has lagged. This is particularly important, as coach-supported digital interventions provide benefits that substantially and consistently exceed those of programmes that are entirely self-guided.

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Article Synopsis
  • AI is transforming healthcare research, particularly in how qualitative data from expert discussions is summarized, as demonstrated by using ChatGPT to generate a draft manuscript from an expert panel on electronic health records (EHRs).
  • 15 implementation scientists provided insights on how EHRs can facilitate implementation strategies and outcomes, but the initial AI-generated summary required considerable editing for context and depth.
  • The study emphasizes the significant role of EHRs in implementation science but also highlights that using AI for research requires careful oversight to ensure accuracy and relevance.
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Article Synopsis
  • The Pain Management Collaboratory (PMC) was established in 2017 by key U.S. agencies to explore non-drug pain management strategies through practical clinical trials in military and veteran healthcare systems.
  • The current study examines the recruitment and retention methods used across PMC's trials, emphasizing strategies to diversify patient samples, revealing that 22% of participants were assigned female at birth and 34% identified as marginalized racial or ethnic groups.
  • Results indicated a limited definition of diversity among trialists and led to the development of 14 recommendations aimed at improving the inclusiveness of underrepresented social identity groups in clinical pain research.
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Cannabis legalization and changes in cannabis and tobacco/nicotine use and co-use in a national cohort of U.S. adults during 2017-2021.

Int J Drug Policy

December 2024

Center for Data to Discovery and Delivery Innovation, San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States; School of Medicine, University of California San Francisco, 4150 Clement Street, San Francisco, CA 94121 (111A1), United States.

Background: Little is known about whether cannabis legalization impacts cannabis use uptake or has spillover effects on co-use of cannabis and tobacco/nicotine (using both in the past 30 days). We determined associations of cannabis legalization with self-reported (1) current (past 30-day) cannabis use; (2) current ("now") tobacco/nicotine use (smoking or electronic cigarette use); and (3) current co-use of cannabis and tobacco/nicotine and how prevalence is changing over time.

Methods: In this longitudinal study, a web-based survey was administered to a nationally representative, population-based panel of US adults in 2017, 2020, and 2021.

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Effects of Buprenorphine, Methadone, and Substance-Use on COVID-19 Morbidity and Mortality.

J Addict Med

October 2024

From the Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT (NC); Department of Psychiatry, Yale School of Medicine, New Haven, CT (RR); VA Connecticut Healthcare System, West Haven, CT (NC, RR); and Department of Biostatistics, Yale School of Public Health, New Haven, CT (XZ).

Objectives: Substance use disorder has been associated with increased morbidity in COVID-19 infection. However, less is known about the impact of active substance use and medications for opioid use disorder (MOUD) on COVID-19 outcomes. We conducted a retrospective cohort study to evaluate the impact of substance use, namely, cannabis, cocaine, alcohol, sedative and opioid use; and buprenorphine or methadone on COVID-19 morbidity and mortality.

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Background: Advance Care Planning via Group Visits (ACP-GV) is a patient-centered intervention facilitated by a clinician using a group modality to promote healthcare decision-making among veterans. Participants in the group document a "Next Step" to use in planning for their future care needs. The next step may include documentation of preferences in an advance directive, discussing plans with family, or anything else to fulfill their ACP needs.

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The translation-to-policy learning cycle to improve public health.

Learn Health Syst

October 2024

Office of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs Washington DC USA.

Objective: Learning Health Systems (LHSs) have not directly informed evidence-based policymaking. The Translation-to-Policy (T2P) Learning Cycle aligns scientists, end-users, and policymakers to support a repeatable roadmap of innovation and quality improvement to optimize effective policies toward a common public health goal. We describe T2P learning cycle components and provide examples of their application.

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Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.

Am J Geriatr Psychiatry

September 2024

Department of Population Health Sciences (LZ, MSB, SNH), Duke University School of Medicine, Durham, NC; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (SW, MSB, SNH), Durham VA Medical Center, Durham, NC; Division of Geriatrics (SNH), Duke University School of Medicine, Durham, NC.

Objectives: Adults with dementia are frequently prescribed antipsychotic medications despite concerns that risks outweigh benefits. Understanding conditions where antipsychotics are initially prescribed, such as hospitalization, may offer insights into reducing inappropriate use.

Design, Setting, Participants: Retrospective cohort study of community-dwelling veterans with dementia aged ≥68 with VA hospitalizations in 2014, using Veterans Health Administration (VA) and Medicare data.

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Novel Radiopharmaceuticals and Future of Theranostics in Genitourinary Cancers.

Eur Urol

February 2025

Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.

Background And Objective: This review aims to provide an overview of novel diagnostic and therapeutic radiopharmaceuticals tested recently or used currently in genitourinary cancers within prospective phase 1-2 clinical trials, summarizing progresses and future directions.

Methods: A systematic search was conducted using the PubMed/MEDLINE and ClinicalTrials.gov databases for original prospective research studies following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

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Background: Despite widespread use of higher levels of care in treating eating disorders in adolescents, research supporting the use of these treatments remains limited by small sample sizes and a predominant focus on anorexia nervosa. Further, existing data regarding predictors of outcome have yielded mixed findings. In the current study, we evaluated treatment outcomes and predictors of outcome among a large sample of adolescents with eating disorders presenting to inpatient, residential, partial hospitalization programs, and intensive outpatient programs across the United States.

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Article Synopsis
  • * An 18-month pilot intervention was conducted at eight VA medical centers, with CWOs overseeing implementation and monitoring progress through surveys and qualitative interviews.
  • * Results indicated that not formally hiring CWOs limited their effectiveness, but some positive changes in workplace culture and readiness for change were noted, emphasizing the need for a structured CWO role and comprehensive interventions to better support workforce well-being.
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Objective: To evaluate whether having previously disenrolled from Medicare Advantage (MA) is associated with lower hazards of future MA enrollment.

Data Sources And Study Setting: Secondary data from Medicare.

Study Design: We examined beneficiaries with baseline FFS enrollment from 2017-2019 using a 20% sample of Medicare claims.

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