Medicine and Health Sciences Commons^™

The Validity Of Medicare Claims-Based Codes To Identify Nontuberculous Mycobacterial Infection In Patients With Bronchiectasis, Jennifer Ku

OHSU-PSU School of Public Health Annual Conference

Background: Nontuberculous mycobacteria (NTM) is a disease of increasing incidence, causing permanent airway damage leading to destructive pulmonary disease. Medicare claims-based codes have been used to identify NTM infection and to evaluate trends in diagnosis and disease outcomes. However, claims-based codes to identify NTM infection have not been validated.

Methods: We linked patients with a bronchiectasis diagnosis (ICD-9-CM 494.0 or 494.1) excluding cystic fibrosis from the national 2006-2014 Centers for Medicare and Medicaid (Medicare) data to the U.S. Bronchiectasis Research Registry (BRR). The BRR is a national prospective cohort of patients with bronchiectasis, that collects detailed clinical, laboratory, microbiology and …

Heart Transplant: Donation After Circulatory Death, Saifullah Hasan, Castigliano Bhamidipati

OHSU-PSU School of Public Health Annual Conference

Donation after circulatory death (DCD) is a potential avenue to narrow the gap between demand for donor hearts and their limited supply. DCD was abandoned after 1970 where donation of organs after brain death became the standard, however DCD has made a recent resurgence for organ donation, predominantly for lung transplants which has shown much success. Heart transplant donors primarily source from brain dead donors. Benefits of DCD for heart transplants include an expanded donor pool to address the drastic shortage of supply and reduced onerous financial burden. Drawbacks of heart DCD include substantial ischemia reperfusion injury (IRI) and inflammation …

Ex Vivo Heart Perfusion, Saifullah Hasan, Castigliano Bhamidipati

OHSU-PSU School of Public Health Annual Conference

Heart transplantation offers the best prognostic results for patients with end stage heart failure. However, there is a much greater demand for donor hearts than there is adequate supply. Cold static storage (CSS) is the current standard protocol for donor heart procurement. CSS has excellent prognosis but subjects the organ to ischemic reperfusion injury (IRI) and induces tissue inflammation due to anoxic conditions and oxidative stress. Hearts from older donors or patients that have a history of previous heart disease can’t withstand the anoxic stressors and make for poor donor candidates with the CSS protocol since they are associated with …

Comparison Of Administratively Collected (Icd-10) Vs. Prospectively Collected Adverse Event Data, Joseph G. O'Sullivan

OHSU-PSU School of Public Health Annual Conference

Background: Accurate adverse event reporting is vital for analyzing outcomes and implementing the proper systemic efforts to improve them. Complication reporting and tracking has implications in medical practice, billing, and ultimately patient safety.

Objectives: To determine accuracy of complications reported in administrative data compared to prospectively obtained data.

Methods: A total of 1,213 patients undergoing spine surgery were followed over a two-year period (January 2011 to December 2012) sampled at a single institution. All patients undergoing spine surgery were eligible for inclusion in the study. Prospective data collection of adverse events was accomplished using OrthoSAVES, a standardized …

Quantifying The Invisible: A Literature Review And History Of Research On The Health Effects Of Wildfire Smoke, Lily A. Cook Ma

OHSU-PSU School of Public Health Annual Conference

The objective of this scoping review is to provide an overview of issues affecting the results of studies on the health effects of non-occupational wildfire exposure. Although it is well established that wildfire smoke is harmful to people with chronic respiratory conditions, research on other health impacts have often found inconsistent results or small effect sizes. These results are often misinterpreted to mean that wildfire smoke has a negligible effect on non-respiratory outcomes such as cardiovascular health or mortality. However, what these results actually reflect is the complexity of determining public exposure to wildfire smoke, as well as variations in …

A Data Collection Program For Reducing Ipv In Lgbtq+ Communities, Alexandra Michel, Nicholas Cheke, Lourdes Gonzalez, Rachel Greim

OHSU-PSU School of Public Health Annual Conference

Sexual and gender minority populations are not currently being accurately tracked or counted in most domestic violence (DV) and intimate partner violence (IPV) surveillance programs in Oregon. However, research indicates that LGBTQ+ populations experience IPV at rates comparable or even higher than heterosexual populations. Additionally, distrust of law enforcement and services designed around heterosexual experiences of IPV further reduce the ability of LGBTQ+ populations, particularly transgender women, to access IPV services. We propose that through the use of a PRECEED-PROCEED model, a program could be developed to more accurately collect sexual orientation and gender identity data by IPV service providers …

A New Method For Assessing Smoking Behavior In Orthopaedic Patients, David Gallacher

OHSU-PSU School of Public Health Annual Conference

“A New Method for Assessing Smoking Behavior in Orthopaedic Patients”

Background:Tobacco use is associated with post-operative complications and self-reporting often introduces a bias that underestimates the true exposure. Traditional tobacco testing methods, including serum cotinine are associated with issues of specificity, as they do not differentiate active smokers from those on nicotine replacement therapies (NRTs). This study intends to evaluate the effectiveness of point-of-care carbon monoxide (CO) breathalyzer test to assess patient smoking status and to differentiate active smokers from those using NRTs.

Methods:Eligible patients will be >18 years old and indicated for joint or fracture surgery at …

Validity Of An Atopic Dermatitis Outcome Measure For Real-World Clinical Practice, Christina Topham, Dylan Haynes, Molly Brazil, Eric Simpson

OHSU-PSU School of Public Health Annual Conference

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the United States. AD is associated with reduced quality of life and substantial financial costs, making it burdensome at an individual and population level. Disease severity outcome measures are validated tools to assess severity and therapeutic response. Recent consensus statements have identified gold-standard outcome measures for AD in clinical trials, but further work is needed evaluating outcome measures feasible for clinical practice.

Objective: To investigate the validity and feasibility of the product of investigator global assessment and body surface area (IGA x BSA) as an outcome measure …

Take Control: A Proposed Mental Health Treatment Program To Be Implemented In Youth Correctional Facilities Around Oregon Based On The Evidence-Based Target Program, Zoey S. Rochefort

OHSU-PSU School of Public Health Annual Conference

70% of youth in state and local juvenile justice systems exhibit symptoms of one or more mental health disorders and are not receiving adequate treatment. Currently, in Oregon, there is no mental health-screening requirement for youth admitted into detention centers or correctional facilities. Though this doesn’t mean kids never get diagnosed, it does mean there is a large delay in time before treatment begins where they could be receiving care. The Take Control program is working to mitigate wasted time and improve mental health treatment for youth inmates through a seven-step treatment program that provides youth with steps and strategies …

Improving Access To Rare Disease Clinical Trials Through Telemedicine, Dylan Haynes, Christina Topham, Teri Greiling

OHSU-PSU School of Public Health Annual Conference

Introduction: Rare diseases affect nearly 400 million individuals worldwide. The geographic density of any single disease, however, can prohibit access to care and research efforts. Telemedicine has improved access barriers in the clinical setting, though its application in rare disease trials has not been evaluated.

Objective: To assess the impact on access to care of videoconferencing in a rare disease clinical trial.

Materials and Methods: Preliminary analysis was performed on the first five participants to complete our ongoing trial (NCT03485976) evaluating the efficacy of ixekizumab for the treatment of pityriasis rubra pilaris. Participants were required to travel to Oregon Health …

A Visual Exploration Of Walking In Mild Traumatic Brain Injury (Mtbi), Bryana Popa

OHSU-PSU School of Public Health Annual Conference

Visual exploration of the environment is vital for safe and effective walking, and is influenced by cognitive load. Eye movement deficits can occur following mTBI and may impact visual exploration when walking, leading to issues with mobility. This study aims to examine visual exploration when walking under single and dual-task in mTBI and controls.

Sixteen people with mTBI (Age: 30.1±12.8 yrs, days since injury: 39.5±21.7) and 10 healthy controls (Age: 26.3±5.2 yrs) walked for 1 minute while wearing a mobile eye tracker under single and dual-task conditions. The primary outcome was visual exploration measured by saccade frequency (sacc/sec). Secondary outcomes …

Preventing Infectious Hematopoietic Necrosis In Salmonid Fish Along The Columbia River Basin, Whitney L. Wright

OHSU-PSU School of Public Health Annual Conference

Infectious hematopoietic necrosis virus (IHNV) is a member of the Rhabdoviridae family and causes infectious hematopoietic necrosis (IHN) disease in many salmonid species during the juvenile or “fry” stage of life. IHNV is endemic to Western North America and occurs in the Columbia River Basin, where Steelhead and Chinook salmon are the most abundant IHNV-vulnerable species. IHNV can cause an epidemic in wild or farmed stocks, killing 90-95 percent of the fish it infects. Transmission is currently understood to occur by direct exposure through the gills, and the virus is shed typically from asymptomatic or clinically ill carrier adults at …