Health Information Technology Commons^™

Population-Level Trends In Self-Reported Healthcare Utilization Among Older Adults In Mexico With And Without Cognitive Impairment, José Eduardo Cabrero Castro, Rebeca Wong, Rafael Samper Ternent, Brian Downer

Faculty, Staff and Student Publications

BACKGROUND: Older adults with cognitive impairment exhibit different patterns of healthcare utilization compared to their cognitively healthy counterparts. Despite extensive research in high-income countries, similar studies in low- and middle-income countries are lacking. This study aims to investigate the population-level patterns in healthcare utilization among older adults with and without cognitive impairment in Mexico.

METHODS: Data came from five waves (2001-2018) of the Mexican Health and Aging Study. We used self-reported measures for one or more over-night hospital stays, doctor visits, visits to homeopathic doctors, and dental visits in the past year; seeing a pharmacist in the past year; and …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Evidence-Based Prostate Cancer Screening Interventions For Black Men: A Systematic Review, Abigail Lopez, Jared T. Bailey, Dorothy Galloway, Leanne Woods-Burnham, Susanne B. Montgomery, Rick Kittles, Dede K. Teteh-Brooks

Health Sciences and Kinesiology Faculty Articles

Abstract

Prostate cancer is the second leading cause of death for men in the U.S. and Black men are twice as likely to die from the disease. However, prostate cancer, if diagnosed at an earlier stage, is curable. The purpose of this review is to identify prostate cancer screening clinical trials that evaluate screening decision-making processes of Black men.

Methods

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used …

Hampton's Hump- A Rare Radiographic Finding In Pulmonary Embolism, Tanshi Anand

Digital Journal of Clinical Medicine

Background- Pulmonary embolism is a condition that is characterized by occlusion of the pulmonary circulation, usually originating from deep vein thrombosis in the lower extremities. This condition is difficult to diagnose as it can present with a wide spectrum of nonspecific symptoms, making it a life-threatening illness.

Case Description- A 50-year-old man with a medical history of deep vein thrombosis, ischemic heart disease, dilated cardiomyopathy with left ventricular dysfunction, diabetes, hypertension, and COPD presented with fever, cough with expectoration, orthopnea, and exertional dyspnea. A routine X-ray was done and revealed Hampton’s hump, a rare radiographic finding persistent with possible …

Call Me Dr Ishmael: Trends In Electronic Health Record Notes Available At Emergency Department Visits And Admissions, Brian W Patterson, Daniel J Hekman, Frank J Liao, Azita G Hamedani, Manish N Shah, Majid Afshar

Faculty, Staff and Student Publications

OBJECTIVES: Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in the EHR, trended over the time since EHR establishment.

MATERIALS AND METHODS: We conducted a retrospective analysis of EHR data from a large healthcare system, examining the number of notes and a corresponding number of total words and total tokens across all notes available to physicians during patient encounters in the emergency department (ED). We assessed the change in these metrics over a 17-year period between 2006 and …

Reliable Detection Of Generalized Convulsive Seizures Using An Off-The-Shelf Digital Watch: A Multisite Phase 2 Study, Yash Shashank Vakilna, Xiaojin Li, Jaison S Hampson, Yan Huang, John C Mosher, Yuri Dabaghian, Xi Luo, Blanca Talavera, Sandipan Pati, Masel Todd, Ryan Hays, Charles Akos Szabo, Guo-Qiang Zhang, Samden D Lhatoo

Faculty, Staff and Student Publications

Objective: The aim of this study was to develop a machine learning algorithm using an off-the-shelf digital watch, the Samsung watch (SM-R800), and evaluate its effectiveness for the detection of generalized convulsive seizures (GCS) in persons with epilepsy.

Methods: This multisite epilepsy monitoring unit (EMU) phase 2 study included 36 adult patients. Each patient wore a Samsung watch that contained accelerometer, gyroscope, and photoplethysmographic sensors. Sixty-eight time and frequency domain features were extracted from the sensor data and were used to train a random forest algorithm. A testing framework was developed that would better reflect the EMU setting, consisting of …

An Electronic Health Record Model For Predicting Risk Of Hepatic Fibrosis In Primary Care Patients, Aaron P Thrift, Theresa H Nguyen Wenker, Kyler Godwin, Maya Balakrishnan, Hao T Duong, Rohit Loomba, Fasiha Kanwal, Hashem B El-Serag

Faculty, Staff and Students Publications

BACKGROUND: One challenge for primary care providers caring for patients with nonalcoholic fatty liver disease is to identify those at the highest risk for clinically significant liver disease.

AIM: To derive a risk stratification tool using variables from structured electronic health record (EHR) data for use in populations which are disproportionately affected with obesity and diabetes.

METHODS: We used data from 344 participants who underwent Fibroscan examination to measure liver fat and liver stiffness measurement [LSM]. Using two approaches, multivariable logistic regression and random forest classification, we assessed risk factors for any hepatic fibrosis (LSM > 7 kPa) and significant hepatic …

What Are The Lessons Learned From A Survivorship Trial During The Pandemic?, Alanna J. Horowitz, Sharneet J. Sandhu, Sherry J. Guo, Gabriel Barreto-D'Silva, Leonardo Barreto-D'Silva, Krishna Gunturu

The Lahey Journal

Purpose: The American Cancer Society (ACS) has acknowledged the importance of maintaining a healthy diet and engaging in regular physical activity for cancer survivors. While studies have found that adherence to these guidelines improves long-term quality of life, several studies showed that up to 70% of cancer survivors do not meet the standards. The purpose of this pilot study is to determine the effectiveness of a multi-disciplinary survivorship clinic (MDSC) in helping patients adhere to the ACS survivorship guidelines and its impacts on quality of life (QOL).

Methods: Primary objective of the study is to encourage cancer patients to adhere …

Enhancing Foot Care Education And Support Strategies In Adults With Type 2 Diabetes, Hsiao-Hui Ju, Madelene Ottosen, Jeffery Alford, Jed Jularbal, Constance Johnson

Faculty, Staff and Student Publications

BACKGROUND: People with diabetes are susceptible to serious and disabling foot complications, which increase their morbidity and mortality rates. Examining the perspectives of people with diabetes on their foot care routines could help elucidate their beliefs and offer practical ways to prevent foot problems.

PURPOSE: We explored the perspectives of adults with diabetes on their foot care practices to identify and enhance foot care education and support strategies.

METHODOLOGY: Using the Zoom platform, 29 adults with diabetes completed a 3-month telehealth educational program, during which interviews were conducted. This article reports the results of thematic content analysis of the qualitative …

Us Filipino Adults Have Elevated Prevalence Of Hypertension Across The Adult Lifespan: Findings From A Cross-Sectional Electronic Health Record Study, Nancy P Gordon, Irvin C Lien, Jamal S Rana, Joan C Lo

Faculty, Staff and Student Publications

INTRODUCTION: The prevalence of hypertension increases with age and differs by race and ethnicity. Among U.S. Asian adults, prevalence is higher for Filipino adults than for other major Asian subgroups, but whether this disparity exists across the adult lifespan is unknown. This study examined hypertension prevalence by age decade, comparing Filipino adults with South Asian, Chinese, Black, Hispanic, and White adults.

METHODS: This cross-sectional study used 2015-2016 electronic health record data from a Northern California integrated healthcare delivery system for 1,839,603 adults aged 30-79 years, including 128,124 Filipino adults. Hypertension was defined by diagnosis codes. Sex-specific prevalence was calculated by …

Desvenlafaxine Induced Acute Angle-Closure Glaucoma - Case Report, Venkatesh Babu Dr, Priyankha Kothandaraman Dr, Megha Sadashiv Dr., Kishor M

Digital Journal of Clinical Medicine

The World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India's National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians_[1].

SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Investigation Of The Utility Of A Ptsd Coaching Mobile App To Address Mental Health Services Demand In A Primary Care Clinic: Analysis Of Caps-5 Measures, Sindhura Nemani, Danielle Rae Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

The COVID-19 pandemic affected countless people globally, resulting in a greater need for mental health professionals and resources¹. The demand for mental health care is soaring yet the limitation of resources has strained the healthcare system, making it challenging to help patients in a timely manner². This poster represents a snapshot of a larger project that is striving to investigate an intervention to help bridge the gap between patient need and prompt referral through a warm handoff approach and use of the PTSD Coach mobile application as well as exploring patients’ satisfaction^3,4,5,6,8,9. In this …

Unveiling The Potential: The Role Of Ai-Enhanced Ecg In Cardiovascular Disease Detection, Alisha Vincent

Rowan-Virtua Research Day

Background: The Electrocardiogram (ECG) is a widely utilized, non-invasive, cost-effective cardiac test. Its integration with Artificial Intelligence (AI) has empowered it to become a potent screening tool and a predictor for various cardiovascular diseases, especially in asymptomatic individuals. Objective: This review investigates the utility of AI-powered ECG in early detection of cardiac conditions, focusing on conditions such as low ejection fraction (LEF), atrial fibrillation (AF), aortic valve stenosis (AVS), and cardiac amyloidosis (CA). Methods: A literature review spanning 2018 to 2024 was conducted, analyzing 10 articles - 3 on AF, 3 on AVS, 3 on LEF, and …

Effects Of Obesity On Patients Undergoing Cardiomems Procedure: Retrospective Cohort Study, Tony Elias, Mena Elmalh, Priya Brahmbhatt, Kyrillos Girgis, Taha Syed, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

★ Remote hemodynamic monitoring (CardioMEMs) is becoming increasingly important for management of chronic heart failure patients.

★ There is limited data looking specifically for obese patients who undergo CardioMEMs implantation.

★ We sought to examine the national inpatient sample database to describe in-hospital outcomes for this demographic

Translating Motivational Interviewing For The Hpv Vaccine Into A Computable Ontology Model For Automated Ai Conversational Interaction, Nicole Moore, Muhammad Amith, Ana C Neumann, Jane Hamilton, Lu Tang, Lara S Savas, Cui Tao

Faculty, Staff and Student Publications

Human papillomavirus (HPV) vaccinations are lower than expected. To protect the onset of head and neck cancers, innovative strategies to improve the rates are needed. Artificial intelligence may offer some solutions, specifically conversational agents to perform counseling methods. We present our efforts in developing a dialogue model for automating motivational interviewing (MI) to encourage HPV vaccination. We developed a formalized dialogue model for MI using an existing ontology-based framework to manifest a computable representation using OWL2. New utterance classifications were identified along with the ontology that encodes the dialogue model. Our work is available on GitHub under the GPL v.3. …

Perspectives From Patients With Chronic Lung Disease On A Telehealth-Facilitated Integrated Palliative Care Model: A Qualitative Content Analysis Study, Jeannette Kates, Carrie Tompkins Stricker, Kristin L. Rising, Alexzandra Gentsch, Ellen Solomon, Victoria Powers, Venise J. Salcedo, Brooke Worster

Department of Medicine Faculty Papers

BACKGROUND: Chronic lung disease affects nearly 37 million Americans and often results in significant quality of life impairment and healthcare burden. Despite guidelines calling for palliative care (PC) integration into pulmonary care as a vital part of chronic lung disease management, existing PC models have limited access and lack scalability. Use of telehealth to provide PC offers a potential solution to these barriers. This study explored perceptions of patients with chronic lung disease regarding a telehealth integrated palliative care (TIPC) model, with plans to use findings to inform development of an intervention protocol for future testing.

METHODS: For this qualitative …

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Using Implementation Science To Understand Barriers To Telemedicine Use For Burn Care During A Crisis, Amanda Bettencourt, Jeffrey E. Carter, Theresa M. Davis, Katherine R. Buhikire, Joseph Rhodes, Subhash Aryal, Gary Vercruysse, Deena Kelly-Costa, Colleen M. Ryan

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Effects Of Family Dignity Interventions Combined With Standard Palliative Care On Family Adaptability, Cohesion, And Anticipatory Grief In Adult Advanced Cancer Survivors And Their Family Caregivers: A Randomized Controlled Trial, Nannan Wang, Kun Wang, Xinyu Lu, Shuyu Zhang, Xuhan Sun, Yuxi Zhang

Faculty, Staff and Student Publications

BACKGROUND: Family involvement and comfort are equally important in palliative care. Dignity undertook a new meaning and novel challenges as a result of restrictions on visits and companionship during the pandemic. Family-centered family dignity interventions have been shown to be effective in increasing patients' sense of dignity, increasing levels of hope, and reducing psychological distress; however, the effectiveness in enhancing family adaptability and intimacy in the survivor-caregiver binary and reducing expected grief have been inconclusive.

OBJECTIVES: The primary objective of this study was to assess the efficacy of family dignity interventions on family adaptability and cohesion. The secondary objective was …

The Future Role Of Cytologists Regarding Telecytology And Rapid On-Site Evaluation (Rose), A Meta-Narrative Review, James Jeffery Fretwell, Liam Patrick Farley, Melissa Perez, Mary Coolbaugh-Murphy Phd, Denise Juroske Short Phd

Research Methods Poster Session 2024

The use of Telecytology in conjunction with rapid on-site evaluation (ROSE) is currently at the forefront of discussion among cytologists and cytopathologists. In this meta-narrative review, the advancements of Telecytology and ROSE within the discipline of Cytology are discussed. Advancements in telecytology and ROSE enable off-site cytology slide evaluation and diagnosis through digital image transfer. ROSE allows for preliminary cytological assessment during image-guided biopsy procedures to determine specimen adequacy. The meta-narrative review concluded that the combination of these two technologies increases the efficacy of patient diagnosis without sacrificing the quality of patient care.

Improved communication between the presiding technician, the …

Dysexecutive Difficulty And Subtle Everyday Functional Disabilities: The Digital Trail Making Test, David J Libon, Rod Swenson, Sean Tobyne, Ali Jannati, Daniel Schulman, Catherine C Price, Melissa Lamar, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Digital neuropsychological tests reliably capture real-time, process-based behavior that traditional paper/pencil tests cannot detect, enabling earlier detection of neurodegenerative illness. We assessed relations between informant-based subtle and mild functional decline and process-based features extracted from the digital Trail Making Test-Part B (dTMT-B).

METHODS: A total of 321 community-dwelling participants (56.0% female) were assessed with the Functional Activities Questionnaire (FAQ) and the dTMT-B. Three FAQ groups were constructed: FAQ = 0 (unimpaired); FAQ = 1-4 (subtle impairment); FAQ = 5-8 (mild impairment).

Results: Compared to the FAQ-unimpaired group, other groups required longer pauses inside target circles (p < 0.050) and produced more total pen strokes to complete the test (p < 0.016). FAQ-subtle participants required more time to complete the entire test (p …