Technology developed through the study and application of living systems, important for medical advances in areas such as prosthetics.

Personal Health Information Management Among Healthy Older Adults: Varying Needs And Approaches

George Demiris, Penn Nursing School
Aug. 22, 2020

Anne M. Turner, Jean O. Taylor, Andrea L. Hartzler, Katie P. Osterhage, Alyssa L. Bosold, Ian S. PainterGeorge Demiris

Abstract [from journal]

Objective: With age, older adults experience a greater number of chronic diseases and medical visits, and an increased need to manage their health information. Technological advances in consumer health information technologies (HITs) help patients gather, track, and organize their health information within and outside of clinical settings. However, HITs have not focused on the needs of older adults and their caregivers. The goal of the SOARING (Studying Older Adults and Researching their Information Needs and Goals)


The Contemporary Landscape Of Genetic Testing And Breast Cancer: Emerging Issues

Jul. 20, 2020

Payal D. Shah, Susan M. Domchek

Abstract [from journal]

The landscape of genetic testing for breast cancer susceptibility has transformed dramatically over the last decade and a half. Traditionally, the process of genetic testing resided fully within a medical infrastructure, from identification of appropriate testing candidates to gene selection to risk mitigation recommendations. More recently, decreasing costs, advancing technology, and a growing understanding of therapeutic implications of certain genetic test results have led to more widespread uptake of testing that increasingly


Variation in the Utilization of Robotic Surgical Operations

Sep. 27, 2019

Jennifer H. Fieber, Lindsay E. Kuo, Chris Wirtalla, Rachel R. Kelz

Abstract [from journal]

The appropriate use of the robot in surgery continues to evolve. Robotic operations (RO) are particularly advantageous for deep pelvic and retroperitoneal procedures, but the implementation of RO is unknown. We aimed to examine regional variation for the most commonly performed RO in general, gynecologic, and urologic surgery. A three-state inpatient database from 2008 to 2011 was used. Nine common robotic inpatient general, gynecologic and urologic surgery procedures were analyzed. States were divided into hospital service areas (HSAs). The percentage of...

A Machine Learning Algorithm to Predict Severe Sepsis and Septic Shock: Development, Implementation, and Impact on Clinical Practice

Craig A. Umscheid, MD, MSCE
Aug. 5, 2019

Heather Giannini, Jennifer Ginestra, Corey Chivers, Michael Draugelis, Asaf Hanish, William Schweickert, Barry Fuchs, Laurie Meadows, Michael Lynch, Patrick Donnelly, Kimberly Pavan, Neil Fishman, C. Hanson, Craig Umscheid

Abstract [from journal]

Objectives: Develop and implement a machine learning algorithm to predict severe sepsis and septic shock and evaluate the impact on clinical practice and patient outcomes.

Design: Retrospective cohort for algorithm derivation and validation, pre-post impact evaluation.

Setting: Tertiary teaching hospital system in Philadelphia, PA.

Patients: All non-ICU admissions; algorithm derivation July 2011 to June 2014 (n = 162,212); algorithm validation October to December


Music Versus Midazolam During Preoperative Nerve Block Placements: a Prospective Randomized Controlled Study

Jul. 18, 2019

Veena Graff, Lu Cai, Ignacio Badiola, Nabil M Elkassabany

Abstract [from journal]

Background and objectives: Music medicine is a non-pharmacologic intervention that is virtually harm-free, relatively inexpensive and has been shown to significantly decrease preoperative anxiety. In this study we aim to compare the use of music to midazolam as a preoperative anxiolytic prior to the administration of an ultrasound-guided single-injection peripheral nerve block.

Methods: In this randomized controlled study we compared the anxiolytic effects of


Conflict of Interest for Patient-Advocacy Organizations

Jun. 29, 2017

Matthew S. McCoy, Micahel Carniol, Katherine Chockley, John W. Urwin, Ezekiel J. Emanuel, and Harald Schmidt

In the New England Journal of Medicine, Matthew McCoy and colleagues, including Ezekiel Emanuel, examine conflicts of interest arising from the presence of industry executives on the boards of patient-advocacy organizations. Previous research has raised concern that the presence of industry leaders on the boards of these non-profit organizations may lead to advocacy for questionable reforms that do not always benefit the organizations’ constituents. The authors analyzed tax records, annual reports, and websites of 104 of the largest U.S patient-advocacy organizations to understand...

Association of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality

Jun. 28, 2017

Marina Serper, Tamar H. Taddei, Rajni Mehta, Kathryn D'Addeo, Feng Dei, Ayse Ayatman, Michelle Baytarian, Rena Fox, Kristel Hunt, David S. Goldberg, Adriana Valderrama

In Gastroenterology, Marina Serper and colleagues, including David Goldberg, assess how various health care system factors affect survival rates in hepatocellular carcinoma (HCC). These factors included uptake of historically underutilized curative therapies, access to a hepatologist, and presentation of the case to a multidisciplinary tumor board. The authors found that, while curative treatments of HCC increased survival rates, only 25% of newly diagnosed HCC patients received treatment intended to cure the disease. Additionally, those who received care from only...

Clinician-Targeted Mobile Apps in Palliative Care: A Systematic Review

Jun. 21, 2017

Salimah H. Meghani, Meredith A. MacKenzie, Brianna Morgan, Youjeong Kang, Anum Wasim, and Saleem Sayani


In Journal of Palliative Medicine, Salimah Meghani and colleagues identify and review available palliative care-related smartphone applications for clinicians. The authors assess growth in development of these apps, and review them for purpose, target audience, and number of downloads. They found that the number of palliative care apps targeting clinicians has increased eight-fold over the past five years. Of the 46 applications identified, nine were designed to assist clinicians with goals of advance care planning, seven provide training materials for palliative care, 17 present...

Biomarker-Defined Subsets of Common Diseases: Policy and Economic Implications of Orphan Drug Act Coverage

Jan. 20, 2017

Aaron S. Kesselheim, Carolyn L. Treasure, Steven Joffe

In PLOS Medicine, Aaron Kesselheim and colleagues, including LDI senior fellow Steven Joffe, investigate the policy and economic implications of the Orphan Drug Act of 1983, and examine the circumstances surrounding a drug’s discovery and development, secondary approvals, off label uses, subsequent revenues, and the reported monthly cost of biomarker-defined disease subsets. The Orphan Drug Act of 1983 was intended to incentivize the development of pharmaceutical products for rare diseases by providing manufacturers with the opportunity to earn grants, tax credits, free waivers,...

Using Genomic Information to Improve Public Health

Aug. 11, 2015
What exactly is precision medicine? When the human genome was sequenced more than a decade ago, it began a new era of medicine that is now known as precision medicine. Initially, it was called personalized medicine; however, the word “personalized” was replaced with “precision” because it caused confusion and was misinterpreted. The goal of precision medicine is not to develop preventions and treatments that are unique for each individual. The National Research Council defines precision medicine as a medical model that focuses on “identifying which approaches will be effective for which...