Medical Technology

Advances in drugs, devices, and biological products that change the way health care is delivered. LDI Senior Fellows study the adoption and diffusion of medical technologies and assesses their impact on costs and quality of care.

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

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Effect Of Behavioral Economic Incentives For Colorectal Cancer Screening In A Randomized Trial

Shivan J. Mehta, MD, MBA
Jul. 2, 2020

Shivan J. Mehta, Catherine Reitz, Tess Niewood, Kevin G. VolppDavid A. Asch

Abstract [from journal]

Background & aims: Financial incentives might increase participation in prevention such as screening colonoscopy. We studied whether incentives informed by behavioral economics increase participation in risk assessment for colorectal cancer (CRC) and completion of colonoscopy for eligible adults.

Methods: Employees of a large academic health system (50-64 y old; n=1977) were randomly assigned to groups that underwent risk assessment for CRC screening and direct access colonoscopy scheduling

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Suprapubic Versus Urethral Catheter For Urinary Drainage After Robot-Assisted Radical Prostatectomy

Leilei Xia
Jun. 6, 2020

Leilei Xia, Thomas J Guzzo, Phillip Mucksavage, Daniel J. Lee 

Abstract [from journal]

Purpose of review: To review the evidence regarding the usage of suprapubic tube (SPT) versus indwelling urethral catheter (IUC) after robot-assisted radical prostatectomy (RARP).

Recent findings: Available data on the use of SPT for urinary drainage after RARP is somewhat limited mostly because of the variations of study designs and non-standardized outcomes. Although it may provide some mild benefit in terms of catheter-related pain and discomfort, the benefit seems not to be clinically

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Association of Demographic, Clinical, and Hospital-Related Factors With Use of Robotic Hysterectomy for Benign Indications: A National Database Study

Anna Jo Smith
Apr. 10, 2020

Anna Jo B. Smith, Abdelrahman AlAshqar, Kate F. Chaves, Mostafa A. Borahay

Abstract [from journal]

Background: We examined the association of patient factors, gynecologic diagnoses, and hospital characteristics with utilization of the robotic approach for benign hysterectomy.

Methods: We performed cross‐sectional study of women (n = 725 050) undergoing hysterectomies in the 2012 to 2014 National Inpatient Sample.

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Efficacy Of A Mobile Behavioral Intervention For Workers With Insomnia

Judith McKenzie, MD, MPH
Feb. 29, 2020

Chinyere Omeogu, Frances Shofer, Philip Gehrman, Judith Green-McKenzie

Abstract [from journal]

Objective: Insomnia is often unrecognized in the workplace despite a 10% prevalence. Cognitive behavioral therapy for insomnia (CBTi) is efficacious but often not available. This study assessed the efficacy of the self-guided CBTi Coach mobile app.

Methods: Using a pre/post design, the CBTi Coach was evaluated prospectively in hospital nurses with insomnia. The primary outcome measured was the Insomnia Severity Index (ISI) at 0, 3, and 6 weeks.

Results: Thirteen of 17 (76%) female nurses who...

Association Between Mobile Telephone Interruptions and Medication Administration Errors in a Pediatric Intensive Care Unit

Christopher Bonafide, MD
Dec. 20, 2019

Christopher P. Bonafide, Jeffrey M. Miller, A. Russell Localio, Amina Khan, Adam C. Dziorny, Mark Mai, MD, Shannon Stemler, Wanxin Chen, John H. Holmes, Vinay M. Nadkarni, Ron Keren

Abstract [from journal]

Importance: Incoming text messages and calls on nurses’ mobile telephones may interrupt medication administration, but whether such interruptions are associated with errors has not been established.
 

Objective: To assess whether a temporal association exists between mobile telephone interruptions and subsequent errors by pediatric intensive care unit (PICU) nurses during medication administration.

Design, Setting, and Participants: A retrospective cohort study was...

Can Machine Learning Improve Cancer Care?

Oct. 25, 2019

“How long do I have?”

It is the first question many patients ask after a cancer diagnosis. It is also among the hardest to answer. For decades, predicting cancer survival was more art than science. But now, unprecedented computing power and access to digital health information offer a tantalizing opportunity: can machine learning (ML) algorithms succeed where others fail?

Electronic Pill Bottles or Bidirectional Text Messaging to Improve Hypertension Medication Adherence (Way 2 Text): a Randomized Clinical Trial

Shivan J. Mehta, MD, MBA
Aug. 8, 2019

Shivan J. Mehta, Kevin G. Volpp, Andrea B. Troxel, Susan C. Day, Raymond Lim, Noora Marcus, Laurie Norton, Sophia Anderson, David A. Asch

Abstract [from journal]

Background: Poor medication adherence contributes to inadequate control of hypertension. However, the value of adherence monitoring is unknown.

Objective: To evaluate the impact of monitoring adherence with electronic pill bottles or bidirectional text messaging on improving hypertension control.

Design: Three-arm pragmatic randomized controlled trial.

Patients: One hundred forty-nine primary care patients aged 18-75 with hypertension and text messaging capabilities who

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Rise of the Machines in Health Care?

Feb. 22, 2019

Artificial intelligence (AI) is moving fast and breaking things everywhere. It is built into multinational supply chains, web-based services, cars, and, slowly, health care. Although the adoption of AI in health care has been bumpy, it continues unabated. Last year, the U.S.

Does Bad News Travel Faster? On the Determinants of Medical Technology Abandonment

Dec. 20, 2018

Julie Berez, Guy David, David H. Howard, Mark D. Neuman

ABSTRACT [FROM JOURNAL]

This paper studies the abandonment of technology in reaction to information shocks. While the diffusion of new technologies has been widely researched, the factors driving abandonment are not well understood. This is particularly important in the health care sector, where curbing overuse of low-value technologies is a priority. Using the abandonment of pulmonary artery catheters (PACs) as an empirical application, we aim to understand patterns of human behavior when information that a technology is ineffective becomes available. This study focuses on the...

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