Risk Communication

The exchange of information about the probability and consequences of adverse events, and how these risks are perceived and managed.

Timing and Efficacy of Mifepristone Pretreatment for Medical Management of Early Pregnancy Loss

Jan. 18, 2021

Anne N. Flynn, Andrea H. Roe, Nathanael Koelper, Arden McAllister, Mary D. Sammel, Courtney A. Schreiber

Abstract [from journal]

Objectives: To determine the time interval between mifepristone and misoprostol administration associated with the most efficacious early pregnancy loss (EPL) management.

Study design: We performed a secondary analysis of a randomized trial. Participants with EPL were instructed to take 200 mg oral mifepristone followed by 800 mcg vaginal misoprostol 24 hours later. The primary outcome was gestational sac expulsion at the first follow-up visit (1-4 days after misoprostol use) after a single


Black-White Disparities in Maternal In-Hospital Mortality According to Teaching and Black-Serving Hospital Status

Jan. 13, 2021

Heather H. Burris, Molly Passarella, Sara C. HandleySindhu K. SrinivasScott A. Lorch

Abstract [from journal]

Background: Maternal mortality is higher among Black compared to White people in the United States. Whether Black-White disparities in maternal in-hospital mortality during the delivery hospitalization vary across hospital types (Black-serving vs. non-Black-serving and teaching vs. non-teaching) and whether overall maternal mortality differs across hospital types is not known.

Objectives: 1) Determine whether risk-adjusted Black-White disparities in maternal mortality during the delivery


Prior Sexually Transmitted Infection and Human Immunodeficiency Virus Risk Perception in a Diverse At-Risk Population of Men Who Have Sex with Men and Transgender Individuals

Jan. 4, 2021

Daniel Resnick, Knashawn Morales, Robert Gross, Danielle Petsis, Danielle Fiore, Annet Davis-Vogel, David Metzger, Ian Frank, Sarah Wood

Abstract [from journal]

Prior sexually transmitted infections (STIs) are associated with higher rates of subsequent human immunodeficiency virus (HIV) infection, but the influence of prior STIs on perceived vulnerability to HIV remains unclear. We aimed to assess this relationship, hypothesizing that a prior STI diagnosis is associated with higher self-assessed vulnerability to HIV. We performed a cross-sectional study of men and transgender individuals who have sex with men screening for HIV prevention trials in Philadelphia. An unadjusted regression


Identifying Adolescent Suicide Risk via Depression Screening in Pediatric Primary Care: An Electronic Health Record Review

Dec. 18, 2020

Molly Davis, Victoria Rio, Alyssa M. Farley, Morgan L. Bush, Rinad S. Beidas, Jami F. Young

Abstract [from journal]

Objective: The authors evaluated suicide risk rates detected via a depression screener administered within a large pediatric primary care system and examined 1-year follow-up care after adolescents' endorsement of suicide risk.

Methods: Retrospective electronic health record data were extracted to examine both suicide risk rates from items endorsed on the Patient Health Questionnaire-Modified for Teens (PHQ-9-M) and primary care providers' (PCPs') follow-up suicide risk assessments on the day


Association of Gun Violence With Emergency Department Visits for Stress-Responsive Complaints

Dec. 17, 2020

Eugenia C. South, Kaytlena Stillman, David G. Buckler, Douglas Wiebe

Abstract [from journal]

Study objective: We evaluate the association between living near a neighborhood shooting and emergency department (ED) utilization for stress-responsive complaints.

Methods: In this location-based before-and-after neighborhood study, we examined variability in ED encounter volume for stress-responsive complaints after neighborhood shooting incidents around 2 academic hospitals. We included patients residing within 1/8- and 1/2-mile-diameter buffers around a shooting (place) if their ED


Prescription Requirements and Patient Autonomy: Considering an Over-the-Counter Default

Holly Fernandez Lynch 160
Dec. 14, 2020

Madison KilbrideSteven JoffeHolly Fernandez Lynch

Abstract [from journal]

When new drugs are approved by the Food and Drug Administration, the default assumption is that they will be available by prescription only, safe for use exclusively under clinical supervision. The paternalism underlying this default must be interrogated in order to ensure appropriate respect for patient autonomy. Upon closer inspection, prescription requirements are justified when nonprescription status would risk harm to third parties and when a large segment of the population would struggle to exercise their autonomy in using a


What Can COVID-19 Teach Us About Using AI in Pandemics?

Dec. 1, 2020

Krzysztof LaudanskiGregory Shea, Matthew DiMeglio, Mariana Rastrepo, Cassie Solomon

Abstract [from journal]

The COVID-19 pandemic put significant strain on societies and their resources, with the healthcare system and workers being particularly affected. Artificial Intelligence (AI) offers the unique possibility of improving the response to a pandemic as it emerges and evolves. Here, we utilize the WHO framework of a pandemic evolution to analyze the various AI applications. Specifically, we analyzed AI from the perspective of all five domains of the WHO pandemic response. To effectively review the current scattered literature, we


Beyond Survival: The Broader Consequences of Prehospital Transport by Police for Penetrating Trauma

Nov. 26, 2020

Sara F. JacobyCharles C. BranasDaniel N. HolenaElinore J. Kaufman

Abstract [from journal]

Background: Time to definitive hemorrhage control is a primary driver of survival after penetrating injury. For these injuries, mortality outcomes after prehospital transport by police and emergency medical service (EMS) providers are comparable. In this study we identify patient and geographic predictors of police transport relative to EMS transport and describe perceptions of police transport elicited from key stakeholders.

Methods: This mixed methods study was conducted in Philadelphia,


Better Nurse Staffing is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests

Nov. 16, 2020

Margo Brooks CarthonHeather BromMatthew McHugh, Douglas M. Sloane, Robert Berg, Raina Merchant, Saket Girotra, Linda H. Aiken

Abstract [from journal]

Background: Racial disparities in survival among patients who had an in-hospital cardiac arrest (IHCA) have been linked to hospital-level factors.

Objectives: To determine whether nurse staffing is associated with survival disparities after IHCA.

Research design: Cross-sectional data from (1) the American Heart Association's Get With the Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and Patient Safety


Predictors of Mental Health During the COVID-19 Pandemic in the U.S.: Role Of Economic Concerns, Health Worries and Social Distancing

Nov. 11, 2020

Fabrice Kämpfen, Iliana V. Kohler, Alberto Ciancio, Wändi Bruine de Bruin, Jürgen Maurer, Hans-Peter Kohler

Abstract [from journal]

Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative "Understanding America Study" (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:


Opioid Prescription For Pain After Osmotic Dilator Placement In Abortion Care: A Randomized Controlled Trial

Nov. 5, 2020

Divyah NagendraSarita Sonalkar, Danielle Schurr, Arden McAllister, Andrea Hsu Roe, Jade M. Shorter, Mary D. Sammel, Courtney A. Schreiber

Abstract [from journal]

Objective: To compare the overnight maximum pain scores after osmotic dilator placement prior to a dilation and evacuation (D&E) procedure in participants assigned to a prescription for ibuprofen alone or to ibuprofen plus oxycodone.

Study design: We conducted a non-blinded pragmatic, randomized controlled trial to evaluate pain management among women undergoing osmotic dilator placement prior to D&E. We randomly assigned 70 participants at 12 weeks 6 days to 23 weeks 6 days gestation