Health Services Research Commons^™

Feasibility And Validity Of Asking Patients To Define Individual Levels Of Meaningful Change On Patient-Reported Outcomes, Salene M.W. Jones, Yuxian Du, Ari Bell-Brown, Kaylin Bolt, Joseph M. Unger

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcomes (PROs) are frequently used in clinical care to monitor treatment response. However, most guidelines on PRO use treat all patients the same. This study tested the feasibility and validity of a method for determining individually meaningful change in PRO measures.

Methods: Participants (n = 398) completed 12 pain and distress questions to define individually meaningful change. This mixed-methods study used both quantitative and qualitative analyses, including descriptive statistics, inferential statistics, and content analysis.

Results: Two-thirds (67%) of the sample reported at least one medical condition, including depression and back pain. Most participants (70%–90%) were able to answer …

A 12-Lead Electrocardiogram Database For Arrhythmia Research Covering More Than 10,000 Patients, Jianwei Zhang, Jianming Zhang, Sidy Daniako, Hai Yao, Hangyuan Guo, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

This newly inaugurated research database for 12-lead electrocardiogram signals was created under the auspices of Chapman University and Shaoxing People’s Hospital (Shaoxing Hospital Zhejiang University School of Medicine) and aims to enable the scientific community in conducting new studies on arrhythmia and other cardiovascular conditions. Certain types of arrhythmias, such as atrial fibrillation, have a pronounced negative impact on public health, quality of life, and medical expenditures. As a non-invasive test, long term ECG monitoring is a major and vital diagnostic tool for detecting these conditions. This practice, however, generates large amounts of data, the analysis of which requires considerable …

Listening To The Patient: A Typology Of Contextual Red Flags In Disease Management Encounters, Amy E. Binns-Calvey, Gunjan Sharma, Naomi Ashley, Brendan Kelly, Frances M. Weaver, Saul J. Weiner

Journal of Patient-Centered Research and Reviews

Purpose: Patients send clues, often unwittingly, when they are grappling with a life challenge that complicates their care. For instance, a patient may lose control of a previously well-managed chronic condition or start missing appointments. When explored, these clues help clinicians uncover the life circumstance impacting the individual’s ability to manage their health and health care. Such clues are termed “contextual red flags.” Effective care requires recognizing them, asking about them, and customizing the care plan where feasible. We sought to develop a typology of contextual red flags by analyzing audio recordings along with the medical records of encounters between …

Surgeons’ Views On Shared Decision-Making, Suraj Kannan, Jayhyun Seo, Kevin R. Riggs, Gail Geller, Emily F. Boss, Zackary D. Berger

Journal of Patient-Centered Research and Reviews

Purpose: Shared decision-making (SDM) has a significant role in surgical encounters, where decisions are influenced by both clinician and patient preferences. Herein, we sought to explore surgeons’ practices and beliefs about SDM.

Methods: We performed a qualitative study consisting of semi-structured individual interviews with 18 surgeons from private practice and academic surgery practices in Baltimore, Maryland. We purposively sampled participants to maximize diversity of practice type (academic vs private), surgical specialty, gender, and experience level. Interview topics included benefits and challenges to patient involvement in decision-making, communicating uncertainty to patients, and use of decision aids. Interviews were audio-recorded and transcribed. …

Epilepsy Risk Among Survivors Of Intensive Care Unit Hospitalization For Sepsis, Tresah C. Antaya, Britney N. Allen, Lucie Richard, Salimah Z. Shariff, Gustavo Saposnik, Jorge Burneo

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• 407 (0.28%) patients developed epilepsy within 2 years of their ICU discharge, 103 (25.3%) of whom were exposed to sepsis.
• Sepsis survivors were significantly more likely to develop epilepsy, relative to non-septic ICU survivors.
• Among sepsis survivors, epilepsy risk increased with age and was higher among those with chronic kidney disease.