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153. Association of Numeracy and Diabetes Control

Author

Cavanaugh, Kerri, Huizinga, Mary Margaret, Wallston, Kenneth A., Gebretsadik, Tebeb, Shintani, Ayumi, Davis, Dianne, Gregory, Rebecca Pratt, Fuchs, Lynn, Malone, Robb, Cherrington, Andrea, Pignone, Michael, DeWalt, Darren A., Elasy, Tom A., and Rothman, Russell L.

Published
2008

159. Significance of Medicare and Medicaid programs for the practice of medicine

Author

DeWalt, Darren A., Oberlander, Jonathan, Carey, Timothy S., and Roper, William L.

Subjects
United States. Centers for Medicare and Medicaid Services -- Laws, regulations and rules -- Forecasts and trends -- Case studies, Medicine -- Practice, Medical care -- Case studies -- United States, Government regulation, Market trend/market analysis, Business, Health care industry
Abstract

The 1965 legislation that established Medicare and Medicaid declared that the Federal Government would not interfere in clinical medicine. Despite the original intent, Medicare and Medicaid have had tremendous influence on medical practice. In this article, we focus on four policy areas that illustrate the influence of CMS (and its predecessor agencies) on medical practice. We discuss the implications of the relationship between CMS and clinical medicine and how this relationship has changed over time. We conclude with thoughts about potential future efforts at CMS., 'Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which [...]

Published
2005

167. Development of six PROMIS pediatrics proxy-report item banks

Author

Irwin Debra E, Gross Heather E, Stucky Brian D, Thissen David, DeWitt Esi, Lai Jin, Amtmann Dagmar, Khastou Leyla, Varni James W, and DeWalt Darren A

Subjects
PROMIS, HRQOL, PRO, Scale development, Parent Proxy, Pediatrics, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks. Methods The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Results Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6 months prior to the interview. The PROMIS proxy sample scored similar or better on the other proxy instruments compared to normative samples. Conclusions The initial calibration data was provided by a diverse set of caregivers of children with a variety of common chronic illnesses and racial/ethnic backgrounds. The PROMIS pediatric proxy-report item banks include physical function (mobility n = 23; upper extremity n = 29), emotional distress (anxiety n = 15; depressive symptoms n = 14; anger n = 5), social peer relationships (n = 15), fatigue (n = 34), pain interference (n = 13), and asthma impact (n = 17).

Published
2012
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171. Using PROMIS® to create clinically meaningful profiles of nephrotic syndrome patients.

Author

Troost, Jonathan P., primary, Gipson, Debbie S., additional, Carlozzi, Noelle E., additional, Reeve, Bryce B., additional, Nachman, Patrick H., additional, Gbadegesin, Rasheed, additional, Wang, Jichuan, additional, Modersitzki, Frank, additional, Massengill, Susan, additional, Mahan, John D., additional, Liu, Yang, additional, Trachtman, Howard, additional, Herreshoff, Emily G., additional, DeWalt, Darren A., additional, and Selewski, David T., additional

Published
2019
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172. Health-related quality of life in glomerular disease

Author

Canetta, Pietro A., primary, Troost, Jonathan P., additional, Mahoney, Shannon, additional, Kogon, Amy J., additional, Carlozzi, Noelle, additional, Bartosh, Sharon M., additional, Cai, Yi, additional, Davis, T. Keefe, additional, Fernandez, Hilda, additional, Fornoni, Alessia, additional, Gbadegesin, Rasheed A., additional, Herreshoff, Emily, additional, Mahan, John D., additional, Nachman, Patrick H., additional, Selewski, David T., additional, Sethna, Christine B., additional, Srivastava, Tarak, additional, Tuttle, Katherine R., additional, Wang, Chia-shi, additional, Falk, Ronald J., additional, Gharavi, Ali G., additional, Gillespie, Brenda W., additional, Greenbaum, Larry A., additional, Holzman, Lawrence B., additional, Kretzler, Matthias, additional, Robinson, Bruce M., additional, Smoyer, William E., additional, Guay-Woodford, Lisa M., additional, Reeve, Bryce, additional, Gipson, Debbie S., additional, Ahn, Wooin, additional, Appel, Gerald B., additional, Babayev, Revekka, additional, Batal, Ibrahim, additional, Bomback, Andrew S., additional, Brown, Eric, additional, Campenot, Eric S., additional, Canetta, Pietro, additional, Carlassara, Lucrezia, additional, Chan, Brenda, additional, Chatterjee, Debanjana, additional, D’Agati, Vivette D., additional, Delbarba, Elisa, additional, Dogra, Samriti, additional, Foroncewicz, Bartosz, additional, Ghiggeri, Gian Marco, additional, Hines, William H., additional, Husain, S. Ali, additional, Jain, Namrata G., additional, Khairallah, Pascale, additional, Kil, Byum Hee, additional, Kiryluk, Krzysztof, additional, Jeyabalan, Anushya, additional, Lau, Wai L., additional, Lin, Fangming, additional, Lugani, Francesca, additional, Marasa, Maddalena, additional, Markowitz, Glen, additional, Mohan, Sumit, additional, Mu, Xueru, additional, Mucha, Krzysztof, additional, Nickolas, Thomas L., additional, Piva, Stacy, additional, Radhakrishnan, Jai, additional, Rao, Maya K., additional, Renu, Regunathan-Shenk, additional, Sanna-Cherchi, Simone, additional, Santoriello, Dominick, additional, Shirazian, Shayan, additional, Stokes, Michael B., additional, Uy, Natalie, additional, Valeri, Anthony M., additional, Al-Uzri, Amira, additional, Ambruzs, Josephine, additional, Ashoor, Isa, additional, Aviles, Diego, additional, Baracco, Rossana, additional, Barcia, John, additional, Bartosh, Sharon, additional, Belsha, Craig, additional, Bowers, Corinna, additional, Braun, Michael C., additional, Chernitskiy, Vladimir, additional, Chishti, Aftab, additional, Claes, Donna, additional, Clark, Kira, additional, Cramer, Carl, additional, Davis, Keefe, additional, Erkan, Elif, additional, Feig, Daniel, additional, Freundlich, Michael, additional, Gaut, Joseph, additional, Gbadegesin, Rasheed, additional, Hanna, Melisha, additional, Hidalgo, Guillermo, additional, Hooper, David, additional, Hunley, Tracy E., additional, Jain, Amrish, additional, Kallash, Mahmoud, additional, Kamel, Margo, additional, Khalid, Myda, additional, Klein, Jon B., additional, Kump, Theresa, additional, Lane, Jerome C., additional, Liapis, Helen, additional, Mahan, John, additional, Nester, Carla, additional, Pan, Cynthia, additional, Patterson, Larry, additional, Patel, Hiren, additional, Raad, Alice, additional, Revell, Adelaide, additional, Rheault, Michelle N., additional, Silva, Cynthia, additional, Sreedharan, Rajasree, additional, Steinke, Julia, additional, Sumner, Susan, additional, Twombley, Katherine, additional, Wenderfer, Scott E., additional, Vasylyeva, Tetyana L., additional, Weaver, Donald J., additional, Wong, Craig S., additional, Yin, Hong, additional, Achanti, Anand, additional, Almaani, Salem, additional, Ayoub, Isabelle, additional, Budisavljevic, Milos, additional, D’Angelo, Maggie, additional, Fatima, Huma, additional, Falk, Ronald, additional, Fogo, Agnes, additional, Gibson, Keisha, additional, Glenn, Dorey, additional, Hogan, Susan, additional, Jennette, J. Charles, additional, Julian, Bruce, additional, Kidd, Jason, additional, Laurin, Louis-Philippe, additional, Massey, H. Davis, additional, Mottl, Amy, additional, Murphy, Shannon, additional, Nachman, Patrick, additional, Nadasdy, Tibor, additional, Novak, Jan, additional, Parikh, Samir, additional, Poulton, Caroline, additional, Powell, Thomas Brian, additional, Renfrow, Matthew, additional, Reynolds, Monica, additional, Rizk, Dana, additional, Rovin, Brad, additional, Royal, Virginie, additional, Sanghani, Neil, additional, Self, Sally, additional, Adler, Sharon, additional, Alachkar, Nada, additional, Alpers, Charles, additional, Matar, Raed Bou, additional, Avila-Casado, Carmen, additional, Bagnasco, Serena, additional, Brede, Emily, additional, Brown, Elizabeth, additional, Cattran, Daniel, additional, Choi, Michael, additional, Dell, Katherine M., additional, Dewalt, Darren, additional, Denburg, Michelle, additional, Dukkipati, Ram, additional, Fervenza, Fernando C., additional, Gadegbeku, Crystal, additional, Gipson, Patrick, additional, Gonzalez-Zea, Anny, additional, Hasely, Leah, additional, Hendren, Elizabeth, additional, Hingorani, Sangeeta, additional, Hladunewich, Michelle, additional, Hogan, Jonathan, additional, Hou, Jean, additional, Jefferson, J. Ashley, additional, Jhaveri, Kenar, additional, Johnstone, Duncan B., additional, Kaskel, Frederick, additional, Kogan, Amy, additional, Kopp, Jeffrey, additional, Lafayette, Richard, additional, Lemley, Kevin V., additional, Malaga-Dieguez, Laura, additional, Meyers, Kevin, additional, Neu, Alicia, additional, O'Shaughnessy, Michelle Marie, additional, O’Toole, John F., additional, Oliverio, Andrea, additional, Palmer, Matthew, additional, Parekh, Rulan, additional, Pitter, Renee, additional, Reich, Heather, additional, Reidy, Kimberly, additional, Rondon, Helbert, additional, Sambandam, Kamalanathan K., additional, Sampson, Matthew, additional, Sedor, John R., additional, Schelling, Jeffrey, additional, Sperati, John C., additional, Swiatecka-Urban, Agnes, additional, Trachtman, Howard, additional, Waldman, Meryl, additional, Weisstuch, Joseph, additional, Wiggins, Roger, additional, Williams, David, additional, Winkler, Cheryl, additional, Vento, Suzanne, additional, Young, Eric, additional, Zhdanova, Olga, additional, Barisoni, Laura, additional, Beil, Charlotte, additional, Eikstadt, Richard, additional, Gillespie, Brenda, additional, Graff, John, additional, Hewitt, Stephen, additional, Hill-Callahan, Peg, additional, Helmuth, Margaret, additional, Lienczewski, Chrysta, additional, Mansfield, Sarah, additional, Mariani, Laura, additional, McCullough, Keith, additional, Moore, Nicholas, additional, Nast, Cynthia C., additional, Sexton, Melissa, additional, Troost, Jonathan, additional, Wladkowski, Matthew, additional, Zee, Jarcy, additional, and Zinsser, Dawn, additional

Published
2019
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173. Development of a proxy-reported pulmonary outcome scale for preterm infants with bronchopulmonary dysplasia

Author

Laughon Matthew M, DeWalt Darren A, Tolleson-Rinehart Sue, Massie Sara E, Powell Leslie M, and Price Wayne A

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background To develop an accurate, proxy-reported bedside measurement tool for assessment of the severity of bronchopulmonary dysplasia (also called chronic lung disease) in preterm infants to supplement providers' current biometric measurements of the disease. Methods We adapted Patient-Reported Outcomes Measurement Information System (PROMIS) methodology to develop the Proxy-Reported Pulmonary Outcomes Scale (PRPOS). A multidisciplinary group of registered nurses, nurse practitioners, neonatologists, developmental specialists, and feeding specialists at five academic medical centers participated in the PRPOS development, which included five phases: (1) identification of domains, items, and responses; (2) item classification and selection using a modified Delphi process; (3) focus group exploration of items and response options; (4) cognitive interviews on a preliminary scale; and (5) final revision before field testing. Results Each phase of the process helped us to identify, classify, review, and revise possible domains, questions, and response options. The final items for field testing include 26 questions or observations that a nurse assesses before, during, and after routine care time and feeding. Conclusions We successfully created a prototype scale using modified PROMIS methodology. This process can serve as a model for the development of proxy-reported outcomes scales in other pediatric populations.

Published
2011
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175. Use of serum electrolyte panels in gastroenteritis

Author

Steiner, Michael J., DeWalt, Darren A., Byerley, Julie S., Rhee, Kyung E., Silverstein, Michael, Tarini, Beth A., Mendoza, Jason A., Wathen, Joe, and Bothner, Joan

Abstract

To the Editor.-- Wathen et al (1) studied the use of serum electrolyte panels (SEPs) for children needing intravenous fluid (IVF) for gastroenteritis. All children enrolled had obligatory SEPs drawn, [...]

Published
2005

176. Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS) study

Author

DeWalt Darren A, Yeatts Karin, Varni James W, and Irwin Debra E

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background The evaluation of patient-reported outcomes (PROs) in health care has seen greater use in recent years, and methods to improve the reliability and validity of PRO instruments are advancing. This paper discusses the cognitive interviewing procedures employed by the Patient Reported Outcomes Measurement Information System (PROMIS) pediatrics group for the purpose of developing a dynamic, electronic item bank for field testing with children and adolescents using novel computer technology. The primary objective of this study was to conduct cognitive interviews with children and adolescents to gain feedback on items measuring physical functioning, emotional health, social health, fatigue, pain, and asthma-specific symptoms. Methods A total of 88 cognitive interviews were conducted with 77 children and adolescents across two sites on 318 items. From this initial item bank, 25 items were deleted and 35 were revised and underwent a second round of cognitive interviews. A total of 293 items were retained for field testing. Results Children as young as 8 years of age were able to comprehend the majority of items, response options, directions, recall period, and identify problems with language that was difficult for them to understand. Cognitive interviews indicated issues with item comprehension on several items which led to alternative wording for these items. Conclusion Children ages 8–17 years were able to comprehend most item stems and response options in the present study. Field testing with the resulting items and response options is presently being conducted as part of the PROMIS Pediatric Item Bank development process.

Published
2009
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179. Development and validation of the Diabetes Numeracy Test (DNT)

Author

Fuchs Lynn S, Gregory Rebecca P, Davis Dianne, Cavanaugh Kerri, Wallston Kenneth A, Elasy Tom A, Huizinga Mary, Malone Robert, Cherrington Andrea, DeWalt Darren A, Buse John, Pignone Michael, and Rothman Russell L

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Low literacy and numeracy skills are common. Adequate numeracy skills are crucial in the management of diabetes. Diabetes patients use numeracy skills to interpret glucose meters, administer medications, follow dietary guidelines and other tasks. Existing literacy scales may not be adequate to assess numeracy skills. This paper describes the development and psychometric properties of the Diabetes Numeracy Test (DNT), the first scale to specifically measure numeracy skills used in diabetes. Methods The items of the DNT were developed by an expert panel and refined using cognitive response interviews with potential respondents. The final version of the DNT (43 items) and other relevant measures were administered to a convenience sample of 398 patients with diabetes. Internal reliability was determined by the Kuder-Richardson coefficient (KR-20). An a priori hypothetical model was developed to determine construct validity. A shortened 15-item version, the DNT15, was created through split sample analysis. Results The DNT had excellent internal reliability (KR-20 = 0.95). The DNT was significantly correlated (p < 0.05) with education, income, literacy and math skills, and diabetes knowledge, supporting excellent construct validity. The mean score on the DNT was 61% and took an average of 33 minutes to complete. The DNT15 also had good internal reliability (KR-20 = 0.90 and 0.89). In split sample analysis, correlations of the DNT-15 with the full DNT in both sub-samples was high (rho = 0.96 and 0.97, respectively). Conclusion The DNT is a reliable and valid measure of diabetes related numeracy skills. An equally adequate but more time-efficient version of the DNT, the DNT15, can be used for research and clinical purposes to evaluate diabetes related numeracy.

Published
2008
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180. A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

Author

Malone Robert M, Perhac J Stephen, Miller Thomas M, Prakken Steven D, Felix Katherine M, Ives Timothy J, Chelminski Paul R, Bryant Mary E, DeWalt Darren A, and Pignone Michael P

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. Methods Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. Results Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). Conclusions A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up.

Published
2005
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181. CureGN Study Rationale, Design, and Methods: Establishing a Large Prospective Observational Study of Glomerular Disease

Author

Mariani, Laura H., primary, Bomback, Andrew S., additional, Canetta, Pietro A., additional, Flessner, Michael F., additional, Helmuth, Margaret, additional, Hladunewich, Michelle A., additional, Hogan, Jonathan J., additional, Kiryluk, Krzysztof, additional, Nachman, Patrick H., additional, Nast, Cynthia C., additional, Rheault, Michelle N., additional, Rizk, Dana V., additional, Trachtman, Howard, additional, Wenderfer, Scott E., additional, Bowers, Corinna, additional, Hill-Callahan, Peg, additional, Marasa, Maddalena, additional, Poulton, Caroline J., additional, Revell, Adelaide, additional, Vento, Suzanne, additional, Barisoni, Laura, additional, Cattran, Dan, additional, D’Agati, Vivette, additional, Jennette, J. Charles, additional, Klein, Jon B., additional, Laurin, Louis-Philippe, additional, Twombley, Katherine, additional, Falk, Ronald J., additional, Gharavi, Ali G., additional, Gillespie, Brenda W., additional, Gipson, Debbie S., additional, Greenbaum, Larry A., additional, Holzman, Lawrence B., additional, Kretzler, Matthias, additional, Robinson, Bruce, additional, Smoyer, William E., additional, Guay-Woodford, Lisa M., additional, Ahn, Wooin, additional, Appel, Gerald B., additional, Babayev, Revekka, additional, Batal, Ibrahim, additional, Brown, Eric, additional, Campenot, Eric S., additional, Canetta, Pietro, additional, Carlassara, Lucrezia, additional, Chan, Brenda, additional, Chatterjee, Debanjana, additional, D’Agati, Vivette D., additional, Delbarba, Elisa, additional, Dogra, Samriti, additional, Fernandez, Hilda, additional, Foroncewicz, Bartosz, additional, Ghiggeri, Gian Marco, additional, Hines, William H., additional, Ali Husain, S., additional, Jain, Namrata G., additional, Khairallah, Pascale, additional, Kil, Byum Hee, additional, Jeyabalan, Anushya, additional, Lau, Wai L., additional, Lin, Fangming, additional, Lugani, Francesca, additional, Markowitz, Glen, additional, Mohan, Sumit, additional, Mu, Xueru, additional, Mucha, Krzysztof, additional, Nickolas, Thomas L., additional, Piva, Stacy, additional, Radhakrishnan, Jai, additional, Rao, Maya K., additional, Regunathan-Shenk, Renu, additional, Sanna-Cherchi, Simone, additional, Santoriello, Dominick, additional, Shirazian, Shayan, additional, Stokes, Michael B., additional, Yu, Natalie, additional, Valeri, Anthony M., additional, Zviti, Ronald, additional, Al-Uzri, Amira, additional, Ambruzs, Josephine, additional, Ashoor, Isa, additional, Aviles, Diego, additional, Baracco, Rossana, additional, Barcia, John, additional, Bartosh, Sharon, additional, Belsha, Craig, additional, Braun, Michael C., additional, Cai, Yi, additional, Chernitskiy, Vladimir, additional, Chishti, Aftab, additional, Claes, Donna, additional, Clark, Kira, additional, Cramer, Carl, additional, Davis, Keefe, additional, Dutcher, Amy, additional, Erkan, Elif, additional, Feig, Daniel, additional, Freundlich, Michael, additional, Gaut, Joseph, additional, Gbadegesin, Rasheed, additional, Hanna, Melisha, additional, Hidalgo, Guillermo, additional, Hooper, David, additional, Hunley, Tracy E., additional, Jain, Amrish, additional, Kallash, Mahmoud, additional, Kamel, Margo, additional, Khalid, Myda, additional, Kump, Theresa, additional, Lane, Jerome C., additional, Liapis, Helen, additional, Mahan, John, additional, Mathews, Nisha, additional, Nester, Carla, additional, Pan, Cynthia, additional, Patterson, Larry, additional, Patel, Hiren, additional, Raad, Alice, additional, Silva, Cynthia, additional, Sreedharan, Rajasree, additional, Srivastava, Tarak, additional, Steinke, Julia, additional, Sumner, Susan, additional, Vasylyeva, Tetyana L., additional, Wang, Chia-shi, additional, Weaver, Donald J., additional, Wong, Craig S., additional, Yin, Hong, additional, Achanti, Anand, additional, Almaani, Salem, additional, Ayoub, Isabelle, additional, Budisavljevic, Milos, additional, D'Angelo, Maggie, additional, Derebail, Vimal, additional, Fatima, Huma, additional, Falk, Ronald, additional, Fogo, Agnes, additional, Gibson, Keisha, additional, Glenn, Dorey, additional, Hogan, Susan, additional, Jain, Koyal, additional, Julian, Bruce, additional, Kidd, Jason, additional, Massey, H. Davis, additional, Mottl, Amy, additional, Murphy, Shannon, additional, Nadasdy, Tibor, additional, Novak, Jan, additional, Parikh, Samir, additional, Poulton, Caroline, additional, Powell, Thomas Brian, additional, Reeve, Bryce, additional, Renfrow, Matthew, additional, Reynolds, Monica, additional, Rizk, Dana, additional, Rovin, Brad, additional, Royal, Virginie, additional, Saha, Manish, additional, Sanghani, Neil, additional, Self, Sally, additional, Adler, Sharon, additional, Alachkar, Nada, additional, Alpers, Charles, additional, Matar, Raed Bou, additional, Avila-Casado, Carmen, additional, Bagnasco, Serena, additional, Brede, Emily, additional, Brown, Elizabeth, additional, Cattran, Daniel, additional, Choi, Michael, additional, Contreras, Gabriel, additional, Dell, Katherine M., additional, Dewalt, Darren, additional, Denburg, Michelle, additional, Dukkipati, Ram, additional, Fervenza, Fernando C., additional, Fornoni, Alessia, additional, Gadegbeku, Crystal, additional, Gipson, Patrick, additional, Gonzalez-Zea, Anny, additional, Hasely, Leah, additional, Hendren, Elizabeth, additional, Hingorani, Sangeeta, additional, Hladunewich, Michelle, additional, Hogan, Jonathan, additional, Hou, Jean, additional, Jefferson, J. Ashley, additional, Jhaveri, Kenar, additional, Johnstone, Duncan B., additional, Kaskel, Frederick, additional, Kogan, Amy, additional, Kopp, Jeffrey, additional, Lafayette, Richard, additional, Lemley, Kevin V., additional, Malaga-Dieguez, Laura, additional, Meyers, Kevin, additional, Neu, Alicia, additional, O'Shaughnessy, Michelle Marie, additional, O’Toole, John F., additional, Oliverio, Andrea, additional, Palmer, Matthew, additional, Parekh, Rulan, additional, Pitter, Renee, additional, Reich, Heather, additional, Reidy, Kimberly, additional, Rondon, Helbert, additional, Sambandam, Kamalanathan K., additional, Sampson, Matthew, additional, Sedor, John R., additional, Selewski, David T., additional, Sethna, Christine B., additional, Schelling, Jeffrey, additional, Sperati, John C., additional, Swiatecka-Urban, Agnes, additional, Tuttle, Katherine R., additional, Waldman, Meryl, additional, Weisstuch, Joseph, additional, Wiggins, Roger, additional, Williams, David, additional, Winkler, Cheryl, additional, Young, Eric, additional, Zhdanova, Olga, additional, Beil, Charlotte, additional, Eikstadt, Richard, additional, Gillespie, Brenda, additional, Graff, John, additional, Hewitt, Stephen, additional, Herreshoff, Emily, additional, Lienczewski, Chrysta, additional, Mansfield, Sarah, additional, Mariani, Laura, additional, McCullough, Keith, additional, Moore, Nicholas, additional, Robinson, Bruce M., additional, Sexton, Melissa, additional, Troost, Jonathan, additional, Wladkowski, Matthew, additional, Zee, Jarcy, additional, and Zinsser, Dawn, additional

Published
2019
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184. Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study.

Author

Halladay, Jacqueline R., Weiner, Bryan J., In Kim, Jung, DeWalt, Darren A., Pierson, Stephanie, Fine, Jason, Lefebvre, Ann, Mackey, Monique, Bergmire, Dawn, Cené, Crystal, Henderson, Kamal, and Cykert, Samuel

Subjects
MEDICALLY underserved areas, OUTPATIENT medical care, RESOURCE allocation, PRIMARY care
Abstract

Background: Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation.Methods: One hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative's NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator's experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement.Results: Among our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24-57.19), [0.00], and practice location in a MUA 7.25 (1.8-29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement.Conclusions: Our analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services. [ABSTRACT FROM AUTHOR]

Published
2020
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185. Determining a transitional scoring link between PROMIS® pediatric and adult physical health measures

Author

Tulsky, David S., primary, Kisala, Pamela A., additional, Boulton, Aaron J., additional, Jette, Alan M., additional, Thissen, David, additional, Ni, Pengsheng, additional, DeWalt, Darren A., additional, Huang, I-Chan, additional, Liu, Yang, additional, Mulcahey, M. J., additional, Slavin, Mary, additional, Magnus, Brooke, additional, Crump, Holly, additional, Hanks, Robin, additional, Charlifue, Susan, additional, and Reeve, Bryce B., additional

Published
2018
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188. Recruiting for a pragmatic trial using the electronic health record and patient portal: successes and lessons learned

Author

Pfaff, Emily, primary, Lee, Adam, additional, Bradford, Robert, additional, Pae, Jinhee, additional, Potter, Clarence, additional, Blue, Paul, additional, Knoepp, Patricia, additional, Thompson, Kristie, additional, Roumie, Christianne L, additional, Crenshaw, David, additional, Servis, Remy, additional, and DeWalt, Darren A, additional

Published
2018
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189. Race-Specific Patterns of Treatment Intensification Among Hypertensive Patients Using Home Blood Pressure Monitoring: Analysis Using Defined Daily Doses in the Heart Healthy Lenoir Study

Author

Cummings, Doyle M., primary, Adams, Alyssa, additional, Halladay, Jacquie, additional, Hinderliter, Alan, additional, Donahue, Katrina E., additional, Cene, Crystal W., additional, Li, Quefeng, additional, Miller, Cassandra, additional, Garcia, Beverly, additional, Tillman, Jim, additional, Little, Edwin, additional, and DeWalt, Darren, additional

Published
2018
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191. Health Literacy and Power

Author

Paasche-Orlow, Michael K., primary, Schillinger, Dean, additional, Weiss, Barry D., additional, Bickmore, Timothy, additional, Cabral, Howard, additional, Chang, Peter, additional, Bailey, Stacy C., additional, Dewalt, Darren A., additional, Fernandez, Alicia, additional, Fransen, Mirjam, additional, Leung, Angela, additional, McCaffery, Kirsten, additional, Meade, Cathy D., additional, McCormack, Lauren A., additional, Protheroe, Joanne, additional, Parker, Ruth, additional, Rothman, Russell, additional, Rubin, Don, additional, Rudd, Rima, additional, Sørensen, Kristine, additional, Von Wagner, Christian, additional, Wolf, Michael S., additional, Yin, H. Shonna, additional, and Ownby, Raymond L., additional

Published
2018
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194. Applicability of Precision Medicine Approaches to Managing Hypertension in Rural Populations

Author

Halladay, Jacqueline, primary, Lenhart, Kaitlin, additional, Robasky, Kimberly, additional, Jones, Wendell, additional, Homan, Wayne, additional, Cummings, Doyle, additional, Cené, Crystal, additional, Hinderliter, Alan, additional, Miller, Cassandra, additional, Donahue, Katrina, additional, Garcia, Beverly, additional, Keyserling, Thomas, additional, Ammerman, Alice, additional, Patterson, Cam, additional, DeWalt, Darren, additional, Johnston, Larry, additional, Willis, Monte, additional, and Schisler, Jonathan, additional

Published
2018
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199. How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.

Author

Fried, Aaron J., Gladman, Christine, and DeWalt, Darren A.

Subjects
*MEDICAL personnel, *PATIENT experience, *EMERGENCY medicine, *FAMILY medicine, *PATIENTS' attitudes
Abstract

Background: Approximately 25% of patients that present to the emergency department (ED) do so after contact with a healthcare professional. Many of these patients could be effectively managed in non-ED ambulatory settings. Aligning patients with safe and appropriate outpatient care has the potential to improve ED overcrowding, patient experience, outcomes, and costs. Little is understood about how healthcare providers approach triage decision-making and what factors influence their choices. Objectives: To evaluate how providers think about patient triage, and what factors influence their decision-making when triaging patient calls. Design: Cross-sectional survey-based study in which participants make triage decisions for hypothetical clinical scenarios. Participants: Healthcare providers in the specialties of internal medicine, family medicine, or emergency medicine within a large integrated healthcare system in the Southeast. Main Measures: Differences in individual training and practice characteristics were used to compare observed differences in triage outcomes. Free-response data were evaluated to identify themes and factors affecting triage decisions. Key Results: Out of 72 total participants, substantial variability in triage decision-making was observed among all patient cases. Attending physicians triaged 1.4 fewer cases to ED care compared with resident physicians (p < 0.001, 95% CI 0.62–2.1). Academic attendings demonstrated a trend toward fewer cases to ED care compared with community attendings (0.61, p = 0.188, 95% CI − 0.31–1.5). Qualitative data highlighted the complex considerations in provider triage and led to the development of a novel conceptual model to describe the cognitive triage process and the main influencing factors. Conclusions: Triage decision-making for healthcare providers is influenced by many factors related to clinical resources, care coordination, patient factors, and clinician factors. The complex considerations involved yield variability in triage decisions that is largely unexplained by descriptive physician factors. [ABSTRACT FROM AUTHOR]

Published
2024
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