Long-Term Use of Hydrocodone vs. Oxycodone in Primary Care

Dec. 1, 2019

Rebecca Arden Harris, Henry R. Kranzler, Kyong-Mi Chang, Chyke A. Doubeni, Robert Gross

Abstract [from journal]

Background: Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown.

Methods: Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment


Observational Study of the Association between Participation in High School Football and Self-Rated Health, Obesity, and Pain in Adulthood

Mark D. Neuman, MD
Nov. 29, 2019

Timothy G. Gaulton, Sameer K. Deshpande, Dylan S. SmallMark D. Neuman

Abstract [from journal]

American football is the most popular high school sport yet its association with health in adulthood has not been widely studied. We investigated the association between high school football and self-rated health, obesity, and pain in adulthood using a retrospective cohort study of the Wisconsin Longitudinal Study from 1957 to 2004. We matched 925 high school males who played varsity football with 1,521 males who did not play football. After matching, playing football was not associated with poor or fair self-rated health (odds ratio [OR] 0.88, 95%


Pragmatic Health Assessment in Early Childhood: The PROMIS® of Developmentally Based Measurement for Pediatric Psychology

Christopher B. Forrest, MD, PhD
Nov. 27, 2019

Courtney K Blackwell, Lauren Wakschlag, Sheila Krogh-Jespersen, Kristin A Buss, Joan Luby, Katherine Bevans, Jin-Shei Lai, Christopher B Forrest, David Cella

Abstract [from journal]

Objective: To illustrate the integration of developmental considerations into person-reported outcome (PRO) measurement development for application in early childhood pediatric psychology.

Methods: Combining the state-of-the-science Patient-Reported Outcome Measurement Information System (PROMIS®) mixed-methods instrument development approach with considerations from developmental measurement science, we developed 12 PROMIS early childhood (PROMIS EC) parent report measures to evaluate common mental, social,


A Mixed Methods Study Examining Teamwork Shared Mental Models of Interprofessional Teams During Hospital Discharge

Nov. 27, 2019

Kirstin Manges, Patricia S Groves, Amany Farag, Ryan Peterson, Joanna Harton, Ryan Greysen

Abstract [from journal]

Background: Little is known about how team processes impact providers' abilities to prepare patients for a safe hospital discharge. Teamwork Shared Mental Models (teamwork-SMMs) are the teams' organised understanding of individual member's roles, interactions and behaviours needed to perform a task like hospital discharge. Teamwork-SMMs are linked to team effectiveness in other fields, but have not been readily investigated in healthcare. This study examines teamwork-SMMs to understand how interprofessional teams coordinate care when


The Association Between Newly Accredited Orthopedic Residency Programs and Teaching Hospital Complication Rates in Lower Extremity Total Joint Arthroplasty

Neil Sheth, MD
Nov. 27, 2019

Kevin Pirruccio, Samir Mehta, Neil P. Sheth

Abstract [from journal]

Objective: The influence of residency programs on teaching hospital outcomes in total joint arthroplasty (TJA) has recently been debated. This study investigates how complication and readmission rates for primary elective total hip (THA) and total knee arthroplasty (TKA) changed before and after new orthopedic surgery residency programs meeting ACGME accreditation requirements were introduced at hospitals.

Design: We conducted a retrospective cohort study using the CMS Hospital Compare database, which contains


Online Reviews of Specialized Drug Treatment Facilities—Identifying Potential Drivers of High and Low Patient Satisfaction

Nov. 21, 2019

Anish K. Agarwal, Vivien Wong, Arthur M. Pelullo, Sharath Guntuku, Daniel Polsky, David A. Asch, Jonathan Muruako, Raina M. Merchant

Background: Despite the importance of high-quality and patient-centered substance use disorder treatment, there are no standardized ratings of specialized drug treatment facilities and their services. Online platforms offer insights into potential drivers of high and low patient experience.

Objective: We sought to analyze publicly available online review content of specialized drug treatment facilities and identify themes within high and low ratings.



Association of an Active Choice Intervention in the Electronic Health Record Directed to Medical Assistants With Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening Tests

Nov. 15, 2019

Esther Y. Hsiang, Shivan J. Mehta, Dylan S. Small, Charles A. L. Rareshide, Christopher K. Snider, Susan C. Day, Mitesh S. Patel

Abstract [from journal]

Importance: Early cancer detection can lead to improved outcomes, but cancer screening tests are often underused.

Objective: To evaluate the association of an active choice intervention in the electronic health record directed to medical assistants with changes in clinician ordering and patient completion of breast and colorectal cancer screening tests.

Design, Setting, and Participants: A retrospective quality improvement study was conducted among 69 916 patients eligible for breast or


Neighborhood Physical Disorder and Adverse Pregnancy Outcomes Among Women in Chicago: A Cross-Sectional Analysis of Electronic Health Record Data

Nov. 14, 2019

Stephanie L. Mayne, Bernard F. Pellissier, Kiarri N. Kershaw

Abstract [from journal]

Adverse pregnancy outcomes increase infants' risk for mortality and future health problems. Neighborhood physical disorder may contribute to adverse pregnancy outcomes by increasing maternal chronic stress. Google Street View technology presents a novel method for assessing neighborhood physical disorder but has not been previously examined in the context of birth outcomes. In this cross-sectional study, trained raters used Google's Street View imagery to virtually audit a randomly sampled block within each Chicago census tract (n = 809) for nine


Combining Crowd-Sourcing and Automated Content Methods to Improve Estimates of Overall Media Coverage: Theme Mentions in E-cigarette and Other Tobacco Coverage

Nov. 13, 2019

Laura A. Gibson, Leeann Siegel, Elissa Kranzler, Allyson Volinsky, Matthew B. O’Donnell, Sharon Williams, Qinghua Yang, Yoonsang Kim, Steven Binns, Hy Tran, Veronica Maidel Epstein, Timothy Leffel, Michelle Jeong, Jiaying Liu, Stella Lee, Sherry Emery, Robert C. Hornik...

Abstract [from journal]

Exposure to media content can shape public opinions about tobacco. Accurately describing content is a first step to showing such effects. Historically, content analyses have hand-coded tobacco-focused texts from a few media sources which ignored passing mention coverage and social media sources, and could not reliably capture over-time variation. By using a combination of crowd-sourced and automated coding, we labeled the population of all e-cigarette and other tobacco-related (including cigarettes, hookah, cigars, etc.) 'long-form texts' (focused and


Dissatisfaction with Medical and Surgical Residency Training Is Consistently Higher for Women than for Men

Nov. 11, 2019

C. Jessica Dine, Manqing Liu, David A. Asch, Lisa M. Bellini, Karl Y. Bilimoria, Sanjay V. Desai, Judy A. Shea

Abstract [from journal]

In an attempt to balance service and education, there is a renewed focus on trainee work experiences and job satisfaction. Overall measures of dissatisfaction likely disguise differences across defined subgroups, particularly men and women, known to experience job satisfaction and burnout differently across professions. A previous study showed gender differences in satisfaction during surgical residency training. The objective of this study was to determine gender differences in dissatisfaction with specific aspects of the institutional environment and with...

Clustering of Unhealthy Behaviors in a Nationally Representative Sample of U.S. Children and Adolescents

Alexander G. Fiks, MD, MSCE
Nov. 9, 2019

Stephanie L. Mayne, Senbagam Virudachalam, Alexander G. Fiks

Abstract [from journal]

Poor diet, low physical activity, sedentary behavior and smoking are modifiable risk factors for chronic diseases that often develop early in life. An improved understanding of how unhealthy behaviors co-occur within individual children across childhood and adolescence could inform the development of more effective prevention approaches. Using data from the 2011-2016 National Health and Nutrition Examination Survey, we calculated weighted prevalence of five unhealthy behaviors - excessive screen time, poor diet quality, low physical activity, fast


When Patients Take Charge of Opioids: Self-Management Concerns and Practices Among Cancer Outpatients in the Context of Opioid Crisis

Nov. 8, 2019

Salimah H. Meghani, Jesse Wool, Jessica Davis, Katherine A. Yeager, Jun J. Mao, Frances K. Barg

Abstract [from journal]

Context: With concerns about opioid prescribing practices prominent in the professional and lay literature, there is less focus on patients’ self-management of opioids for cancer pain and potential safety risks.

Objectives: To investigate reports of opioid self-management practices and concerns among patients undergoing active cancer treatments—a group excluded from the scope of most policy initiatives on prescription opioids


Modification of Everyday Activities and its Association with Self-Awareness in Cognitively Diverse Older Adults

Jason Karlawish, MD of Penn Medicine
Nov. 7, 2019

Danielle Shaked, Preeti Sunderaraman, Jennifer Piscitello, Sarah Cines, Christiane Hale, Davangere Devanand, Jason Karlawish, Stephanie Cosentino

Abstract [from journal]

Cognitive impairment (CI) in older adults is frequently accompanied by difficulty performing complex everyday activities (e.g., managing finances). However, it is unclear if and how older adults with CI modify their activities (i.e., Do individuals continue, monitor, seek help with, change their approach to, or stop different activities?). In the current study, we examined if older adults with CI are concerned about their ability to carry out complex activities, if and how they modify activities based on their concern, and the factors associated with


Failure to Rescue as an Outcome Metric for Pediatric and Congenital Cardiac Catheterization Laboratory Programs: Analysis of Data From the IMPACT Registry

Nov. 5, 2019

Michael L. O'Byrne, Kevin F. Kennedy, Natalie Jayaram, Lisa J. Bergersen, Matthew J. Gillespie, Yoav Dori, Jeffrey H. Silber, Steven M. Kawut, Jonathan J. Rome, Andrew C. Glatz

Abstract [form journal]

Background: Risk-adjusted adverse event (AE) rates have been used to measure the quality of pediatric and congenital cardiac catheterization laboratories. In other settings, failure to rescue (FTR) has demonstrated utility as a quality metric.

Methods and Results: A multicenter retrospective cohort study was performed using data from the IMPACT (Improving Adult and Congenital Treatment) Registry between January 2010 and December 2016. A modified FTR metric was developed for pediatric and congenital cardiac


Patient Experiences With Miscarriage Management in the Emergency and Ambulatory Settings

Nov. 4, 2019

Carolyn Miller, Andrea Roe, Arden McAllister, Zachary Meisel, Nathanael Koelper, Courtney Schreiber

Abstract [from journal]

Objective: To quantitatively and qualitatively describe the patient experience for clinically stable patients presenting with miscarriage to the emergency department (ED) or ambulatory clinics.

Methods: We present a subanalysis of a mixed-methods study from 2016 on factors that influence miscarriage treatment decision-making among clinically stable patients. Fifty-four patients were evaluated based on location of miscarriage care (ED or ambulatory-only), and novel parameters were assessed including timeline (