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  • 1
    Online Resource
    Online Resource
    Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide
    Elsevier BV ; 2023
    In:  The Lancet Oncology Vol. 24, No. 12 ( 2023-12), p. e472-e518
    Details
    In: The Lancet Oncology, Elsevier BV, Vol. 24, No. 12 ( 2023-12), p. e472-e518
    Type of Medium: Online Resource
    ISSN: 1470-2045
    URL: Article
    DOI: 10.1016/S1470-2045(23)00412-6
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2049730-1
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  • 2
    Online Resource
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    A Qualitative Study of Preclinical Medical Students Randomized to Patient-Partnered vs Traditional Clinical Experiences
    Aurora Health Care, Inc. ; 2022
    In:  Journal of Patient-Centered Research and Reviews Vol. 9, No. 4 ( 2022-10-18), p. 290-297
    Details
    In: Journal of Patient-Centered Research and Reviews, Aurora Health Care, Inc., Vol. 9, No. 4 ( 2022-10-18), p. 290-297
    Type of Medium: Online Resource
    ISSN: 2330-0698
    URL: Article
    DOI: 10.17294/2330-0698.1930
    Language: English
    Publisher: Aurora Health Care, Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 3022292-8
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  • 3
    Online Resource
    Online Resource
    Primary care physician involvement during hospitalisation: a qualitative analysis of perspectives from frequently hospitalised patients
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 12 ( 2021-12), p. e053784-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 12 ( 2021-12), p. e053784-
    Abstract: To explore frequently hospitalised patients’ experiences and preferences related to primary care physician (PCP) involvement during hospitalisation across two care models. Design Qualitative study embedded within a randomised controlled trial. Semistructured interviews were conducted with patients. Transcripts were analysed using qualitative template analysis. Setting In the Comprehensive Care Programme (CCP) Study, in Illinois, USA, Medicare patients at increased risk of hospitalisation are randomly assigned to: (1) care by a CCP physician who serves as a PCP across both inpatient and outpatient settings or (2) care by a PCP as outpatient and by hospitalists as inpatients (standard care). Participants Twelve standard care and 12 CCP patients were interviewed. Results Themes included: (1) Positive attitude towards PCP; (2) Longitudinal continuity with PCP valued; (3) Patient preference for PCP involvement in hospital care; (4) Potential for in-depth involvement of PCP during hospitalisation often unrealised (involvement rare in standard care; in CCP, frequent interaction with PCP fostered patient involvement in decision making); and (5) PCP collaboration with hospital-based providers frequently absent (no interaction for standard care patients; CCP patients emphasising PCP’s role in interdisciplinary coordination). Conclusion Frequently hospitalised patients value PCP involvement in the hospital setting. CCP patients highlighted how an established relationship with their PCP improved interdisciplinary coordination and engagement with decision making. Inpatient–outpatient relational continuity may be an important component of programmes for frequently hospitalised patients. Opportunities for enhancing PCP involvement during hospitalisation should be considered.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2021-053784
    DOI: 10.1136/bmjopen-2021-053784.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Design and implementation of a privacy preserving electronic health record linkage tool in Chicago
    Oxford University Press (OUP) ; 2015
    In:  Journal of the American Medical Informatics Association Vol. 22, No. 5 ( 2015-09-01), p. 1072-1080
    Details
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 22, No. 5 ( 2015-09-01), p. 1072-1080
    Abstract: Objective To design and implement a tool that creates a secure, privacy preserving linkage of electronic health record (EHR) data across multiple sites in a large metropolitan area in the United States (Chicago, IL), for use in clinical research. Methods The authors developed and distributed a software application that performs standardized data cleaning, preprocessing, and hashing of patient identifiers to remove all protected health information. The application creates seeded hash code combinations of patient identifiers using a Health Insurance Portability and Accountability Act compliant SHA-512 algorithm that minimizes re-identification risk. The authors subsequently linked individual records using a central honest broker with an algorithm that assigns weights to hash combinations in order to generate high specificity matches. Results The software application successfully linked and de-duplicated 7 million records across 6 institutions, resulting in a cohort of 5 million unique records. Using a manually reconciled set of 11 292 patients as a gold standard, the software achieved a sensitivity of 96% and a specificity of 100%, with a majority of the missed matches accounted for by patients with both a missing social security number and last name change. Using 3 disease examples, it is demonstrated that the software can reduce duplication of patient records across sites by as much as 28%. Conclusions Software that standardizes the assignment of a unique seeded hash identifier merged through an agreed upon third-party honest broker can enable large-scale secure linkage of EHR data for epidemiologic and public health research. The software algorithm can improve future epidemiologic research by providing more comprehensive data given that patients may make use of multiple healthcare systems.
    Type of Medium: Online Resource
    ISSN: 1527-974X , 1067-5027
    URL: Article
    DOI: 10.1093/jamia/ocv038
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2018371-9
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  • 5
    Online Resource
    Online Resource
    How much diagnostic safety can we afford, and how should we decide? A health economics perspective
    BMJ ; 2013
    In:  BMJ Quality & Safety Vol. 22, No. Suppl 2 ( 2013-10), p. ii11-ii20
    Details
    In: BMJ Quality & Safety, BMJ, Vol. 22, No. Suppl 2 ( 2013-10), p. ii11-ii20
    Type of Medium: Online Resource
    ISSN: 2044-5415 , 2044-5423
    URL: Article
    DOI: 10.1136/bmjqs-2012-001616
    Language: English
    Publisher: BMJ
    Publication Date: 2013
    detail.hit.zdb_id: 2592912-4
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  • 6
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    Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model
    Oxford University Press (OUP) ; 2017
    In:  Journal of the American Medical Informatics Association Vol. 24, No. e1 ( 2017-04-01), p. e95-e102
    Details
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 24, No. e1 ( 2017-04-01), p. e95-e102
    Abstract: Objective: Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6%, are costly to treat, and result in Medicare reimbursement penalties. Medicare codes HAPUs according to Agency for Healthcare Research and Quality Patient-Safety Indicator 3 (PSI-03), but they are sometimes inappropriately coded. The objective is to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. Materials and Methods: We evaluated all hospitalized patient electronic medical records at an academic medical center data repository between 2011 and 2014. These data contained patient encounter level demographic variables, diagnoses, prescription drugs, and provider orders. HAPUs were defined by PSI-03: stages III, IV, or unstageable pressure ulcers not present on admission as a secondary diagnosis, excluding cases of paralysis. Random forests reduced data dimensionality. Multilevel logistic regression of patient encounters evaluated associations between covariates and HAPU incidence. Results: The approach produced a sample population of 21 153 patients with 1549 PSI-03 cases. The greatest odds ratio (OR) of HAPU incidence was among patients diagnosed with spinal cord injury (ICD-9 907.2: OR = 14.3; P  & lt; .001), and 71% of spinal cord injuries were not properly coded for paralysis, leading to a PSI-03 flag. Other high ORs included bed confinement (ICD-9 V49.84: OR = 3.1, P  & lt; .001) and provider-ordered pre-albumin lab (OR = 2.5, P  & lt; .001). Discussion: This analysis identifies spinal cord injuries as high risk for HAPUs and as being often inappropriately coded without paralysis, leading to PSI-03 flags. The resulting statistical model can be tested to predict HAPUs during hospitalization. Conclusion: Inappropriate coding of conditions leads to poor hospital performance measures and Medicare reimbursement penalties.
    Type of Medium: Online Resource
    ISSN: 1067-5027 , 1527-974X
    URL: Article
    DOI: 10.1093/jamia/ocw118
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2018371-9
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  • 7
    Online Resource
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    eHealth Literacy and Patient Portal Use and Attitudes: Cross-sectional Observational Study
    JMIR Publications Inc. ; 2023
    In:  JMIR Human Factors Vol. 10 ( 2023-1-27), p. e40105-
    Details
    In: JMIR Human Factors, JMIR Publications Inc., Vol. 10 ( 2023-1-27), p. e40105-
    Abstract: Throughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals. Objective The aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients. Methods Inpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P 〈 .006 (Bonferroni correction). Results Among 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P 〈 .001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P 〈 .001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P 〈 .001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81). Conclusions Low eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients’ eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.
    Type of Medium: Online Resource
    ISSN: 2292-9495
    URL: Article
    DOI: 10.2196/40105
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2023
    detail.hit.zdb_id: 2874187-0
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  • 8
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    A Peer-Led Social Media Intervention to Improve Interest in Research Careers Among Urban Youth: Mixed Methods Study
    JMIR Publications Inc. ; 2020
    In:  JMIR Medical Education Vol. 6, No. 1 ( 2020-5-14), p. e16392-
    Details
    In: JMIR Medical Education, JMIR Publications Inc., Vol. 6, No. 1 ( 2020-5-14), p. e16392-
    Abstract: Novel methods to boost interest in scientific research careers among minority youth are largely unexplored. Social media offers a unique avenue toward influencing teen behavior and attitudes, and can therefore be utilized to stimulate interest in clinical research. Objective The aim of this study was to engage high-achieving minority youth enrolled in a science pipeline program to develop a targeted social media marketing campaign for boosting interest in clinical research careers among their peers. Methods Students enrolled in the Training Early Achievers for Careers in Health program conducted focus groups in their communities to inform themes that best promote clinical research. They then scripted, storyboarded, and filmed a short video to share on social media with a campaign hashtag. Additionally, each student enrolled peers from their social circle to be subjects of the study. Subjects were sent a Career Orientation Survey at baseline to assess preliminary interest in clinical research careers and again after the campaign to assess how they saw the video, their perceptions of the video, and interest in clinical research careers after watching the video. Subjects who did not see the video through the online campaign were invited to watch the video via a link on the postsurvey. Interest change scores were calculated using differences in Likert-scale responses to the question “how interested are you in a career in clinical research?” An ordinal logistic regression model was used to test the association between watching a peer-shared video, perception of entertainment, and interest change score controlling for underrepresented minorities in medicine status (Black, American Indian/Alaska Native, Native Hawaiian, or Pacific Islander), gender, and baseline interest in medical or clinical research careers. Results From 2014 to 2017, 325 subjects were enrolled as part of 4 distinct campaigns: #WhereScienceMeetsReality, #RedefiningResearch, #DoYourResearch, and #LifeWithoutResearch. Over half (n=180) of the subjects watched the video via the campaign, 227/295 (76.9%) found the video entertaining, and 92/325 (28.3%) demonstrated baseline interest in clinical research. The ordinal logistic regression model showed that subjects who viewed the video from a peer (odds ratio [OR] 1.56, 95% CI 1.00-2.44, P=.05) or found the video entertaining (OR 1.36, 95% CI 1.01-1.82, P=.04) had greater odds of increasing interest in a clinic al research career. Subjects with a higher baseline interest in medicine (OR 1.55, 95% CI 1.28-1.87, P 〈 .001) also had greater odds of increasing their interest in clinical research. Conclusions The spread of authentic and relevant peer-created messages via social media can increase interest in clinical research careers among diverse teens. Peer-driven social media campaigns should be explored as a way to effectively recruit minority youth into scientific research careers.
    Type of Medium: Online Resource
    ISSN: 2369-3762
    URL: Article
    DOI: 10.2196/16392
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2874582-6
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  • 9
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    Describing Variability of Inpatient Consultation Practices: Physician, Patient, and Admission Factors
    Wiley ; 2020
    In:  Journal of Hospital Medicine Vol. 15, No. 3 ( 2020-03), p. 164-168
    Details
    In: Journal of Hospital Medicine, Wiley, Vol. 15, No. 3 ( 2020-03), p. 164-168
    Abstract: Appropriate use of consultation can improve patient outcomes, but inappropriate use may cause harm. Factors affecting the variability of inpatient consultation are poorly understood. We aimed to describe physician‐, patient‐, and admission‐level factors influencing the variability of inpatient consultations on general medicine services. We conducted a retrospective study of patients hospitalized from 2011 to 2016 and enrolled in the University of Chicago Hospitalist Project, which included 6,153 admissions of 4,772 patients under 69 attendings. Consultation use varied widely; a 5.7‐fold difference existed between the lowest (mean, 0.613) and highest (mean, 3.47) quartiles of use ( P 〈 .01). In mixed‐effect Poisson regression, consultations decreased over time, with 45% fewer consultations for admissions in 2015 than in 2011 ( P 〈 .01). Patients on nonteaching hospitalist teams received 9% more consultations than did those on teaching services ( P =.02). Significant variability exists in inpatient consultation use. Further understanding may help to identify groups at high‐risk for underuse/overuse and aid in the development of interventions to improve high‐value care.
    Type of Medium: Online Resource
    ISSN: 1553-5592 , 1553-5606
    URL: Article
    DOI: 10.12788/jhm.3355
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2221544-X
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  • 10
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    The Chronic Effects of COVID‐19 Hospitalizations: Learning How Patients Can Get “Back to Normal”
    Wiley ; 2021
    In:  Journal of Hospital Medicine Vol. 16, No. 9 ( 2021-09), p. 575-575
    Details
    In: Journal of Hospital Medicine, Wiley, Vol. 16, No. 9 ( 2021-09), p. 575-575
    Type of Medium: Online Resource
    ISSN: 1553-5592 , 1553-5606
    URL: Article
    DOI: 10.12788/jhm.3679
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2221544-X
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