Patient-Reported Experiences of Breast Cancer Screening, Diagnosis, and Treatment Delay, and Telemedicine Adoption during COVID-19.

Purpose: To evaluate and quantify potential sociodemographic disparities in breast cancer screening, diagnosis, and treatment due to the COVID-19 pandemic, and the use of telemedicine.

Methods: We fielded a 52-item web-based questionnaire from 14 May 2020 to 1 July 2020 in partnership with several U.S.

Can sharing clinic notes improve communication and promote self-management? A qualitative study of patients with COPD.

Objective: To understand the impact of sharing clinic notes on communication and self-management among patients with COPD and to develop recommendations for writing patient-centered notes.

Methods: Thirty patients with COPD participated in 'think-aloud' interviews in which they reviewed their COPD-specific clinic note. Interviews were coded using conventional content analysis, organized by the six-function communication framework.

Validation of an ICD-10-based algorithm to identify stillbirth in the Sentinel System.

Purpose: To develop and validate an International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)-based algorithm to identify cases of stillbirth using electronic healthcare data.

Methods: We conducted a retrospective study using claims data from three Data Partners (healthcare systems and insurers) in the Sentinel Distributed Database. Algorithms were developed using ICD-10-CM diagnosis codes to identify potential stillbirths among females aged 12-55 years between July 2016 and June 2018.

High-frequency hospital users: The tail that wags the readmissions dog.

Objective: To describe the characteristics of high-frequency hospital users (four or more hospitalizations in a year) and the consequences of including or excluding their data from a readmission-based measure.

Data Sources: 2015 and 2016 Massachusetts Medicaid data.

Study Design: We compare demographics, morbidity burden, and social risk factors for high- and low-frequency hospital users, and membership in 17 accountable care organizations.

How Communication "Failed" or "Saved the Day": Counterfactual Accounts of Medical Errors.

Communication breakdowns among clinicians, patients, and family members can lead to medical errors, yet effective communication may prevent such mistakes. This investigation examined patients' and family members' experiences where they believed communication failures contributed to medical errors or where effective communication prevented a medical error ("close calls"). The study conducted a thematic analysis of open-ended responses to an online survey of patients' and family members' past experiences with medical errors or close calls.

A cardiovascular disease risk prediction algorithm for use with the Medicare current beneficiary survey.

Objective: To develop a cardiovascular disease (CVD) risk score that can be used to quantify CVD risk in the Medicare Current Beneficiary Survey (MCBS).

Data Sources: We used 1999-2013 MCBS data.

Study Design: We used a backward stepwise approach and cox proportional hazards regressions to build and validate a new CVD risk score, similar to the Framingham Risk Score (FRS), using only information available in MCBS.

"You Leave There Feeling Part of Something": A Qualitative Study of Hospitalized COPD Patients' Perceptions of Pulmonary Rehabilitation.

Rationale: Current guidelines recommend that patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) initiate pulmonary rehabilitation (PR) shortly after discharge from the hospital. However, fewer than 2 percent of Medicare beneficiaries do so. Few studies have examined hospitalized patients' perceptions of the barriers and facilitators to enroll in PR.

Communicating with patients about breakdowns in care: a national randomised vignette-based survey.

Background: Many patients are reluctant to speak up about breakdowns in care, resulting in missed opportunities to respond to individual patients and improve the system. Effective approaches to encouraging patients to speak up and responding when they do are needed.

Objective: To identify factors which influence speaking up, and to examine the impact of apology when problems occur.

Positive deviance approaches to improving vaccination coverage rates within healthcare systems: a systematic review.

Our objective was to systematically review the use of the positive deviance approach to identify strategies to improve vaccination coverage rates. We searched English language articles in Medline, Embase, Cochrane Library, CINAHL and PsycINFO without any date restrictions on 4 October 2017. We compiled a list of all strategies and evaluated the quality of these studies using the QATSDD tool.

Designing Shared Decision-Making Interventions for Dissemination and Sustainment: Can Implementation Science Help Translate Shared Decision Making Into Routine Practice?

Shared decision making (SDM) is not widely practiced in routine care due to a variety of organizational, provider, patient, and contextual factors. This article explores how implementation science-which encourages attention to the multilevel contextual factors that influence the adoption, implementation, and sustainment of health care practices-can provide useful insights for increasing SDM use in routine practice. We engaged with stakeholders representing different organizations and geographic locations over three phases: 1) multidisciplinary workgroup meeting comprising researchers and clinicians ( = 11); 2) survey among a purposive sample of 47 patient advocates, clinicians, health care system leaders, funders, policymakers, and researchers; and 3) working session among diverse stakeholders ( = 30).

We want to know: patient comfort speaking up about breakdowns in care and patient experience.

Objective: To assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up.

Design: Cross-sectional study.

Setting: Eight hospitals in Maryland and Washington, District of Columbia.

Encouraging Patients to Speak up About Problems in Cancer Care.

Objectives: Many patients with cancer believe that something has gone wrong in their care but are reluctant to speak up. This pilot study sought to evaluate the impact of an intervention of active outreach to patients undergoing cancer treatment, wherein patients were encouraged to speak up if they had concerns about their care and to describe the types of concerns patients reported.

Methods: Patients receiving cancer care at two sites were randomly assigned to an intervention or control group.

Data Management for Applications of Patient Reported Outcomes.

Context: Patient reported outcomes (PROs) are one means of systematically gathering meaningful subjective information for patient care, population health, and patient centered outcomes research. However, optimal data management for effective PRO applications is unclear.

Case Description: Delivery systems associated with the Health Care Systems Research Network (HCSRN) have implemented PRO data collection as part of the Medicare annual Health Risk Assessment (HRA).

Insurance Coverage Policies for Pharmacogenomic and Multi-Gene Testing for Cancer.

Insurance coverage policies are a major determinant of patient access to genomic tests. The objective of this study was to examine differences in coverage policies for guideline-recommended pharmacogenomic tests that inform cancer treatment. We analyzed coverage policies from eight Medicare contractors and 10 private payers for 23 biomarkers (e.

Access to Guideline-Recommended Pharmacogenomic Tests for Cancer Treatments: Experience of Providers and Patients.

Genomic tests are the fastest growing sector in medicine and medical science, yet there remains a dearth of research on access to pharmacogenomic tests and medications. The objective of this study is to explore providers' and patients' experiences and views on test access as well as strategies used for gaining access. We interviewed clinicians who prescribed medications that should be guided by pharmacogenomic testing and patients who received those prescriptions.

Use of Risk Models to Predict Death in the Next Year Among Individual Ambulatory Patients With Heart Failure.

Importance: The clinical practice guidelines for heart failure recommend the use of validated risk models to estimate prognosis. Understanding how well models identify individuals who will die in the next year informs decision making for advanced treatments and hospice.

Objective: To quantify how risk models calculated in routine practice estimate more than 50% 1-year mortality among ambulatory patients with heart failure who die in the subsequent year.

Knowledge of and perceived need for evidence-based education about antipsychotic medications among nursing home leadership and staff.

Background/objectives: Antipsychotic use is common in US nursing homes, despite evidence of increased risk of morbidity and mortality, and limited efficacy in older adults with dementia. Knowledge, attitudes, and beliefs regarding antipsychotic use among nursing home staff are unclear. The study aim was to describe nursing home leadership and direct care staff members' knowledge of antipsychotic risks, beliefs and attitudes about the effectiveness of antipsychotics and nonpharmacologic management of dementia-related behaviors, and perceived need for evidence-based training about antipsychotic medication safety.

Effects of transitioning from conventional methods to liquid-based methods on unsatisfactory Papanicolaou tests: results from a multicenter US study.

Background: Papanicolaou (Pap) testing has transitioned from conventional preparations (CPs) to liquid-based preparations (LBPs) because of the perceived superiority of LBPs. Many studies conclude that LBPs reduce unsatisfactory Pap tests; however, some believe that the evidence substantiating this claim is weak. The authors studied the effect of the transition from CPs to LBPs on the proportion of unsatisfactory Pap tests in 4 health care systems in the United States participating in the National Institutes of Health-funded Screening Effectiveness and Research in Community-Based Healthcare (SEARCH) project.