Medical Specialties Commons^™

Concussion Knowledge And Prior Concussion Experience Of Theater Personnel, Brooke Daniell, Jeffery A. Russell

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

In Volume 3, Issue 1 of the JSMAHS you will find Professional research abstracts, as well as Under Graduate student research abstracts, case reports, and critically appraised topics.

Thank you for viewing this 3^rd Annual OATA Special Edition.

The Relationship Of Gymnastics Experience And Hand Placement Technique On Peak Ground Reaction Forces Through The Elbow, Saskia Richter

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

This Research was supported by a grant from the Ohio Athletic Trainers Association.

In Volume 3, Issue 1 of the JSMAHS you will find Professional research abstracts, as well as Under Graduate student research abstracts, case reports, and critically appraised topics.

Thank you for viewing this 3^rd Annual OATA Special Edition.

Breast Cancer Patient Preparedness For Transition To Survivorship: Individualized Survivorship Care Plans, Kimberly Beringer

Master's Projects and Capstones

Purpose. For breast cancer survivors, after-effects of surgery, radiation and chemotherapy can be substantial, and recurrence is a concern requiring constant surveillance. National healthcare organizations have promulgated guidelines that include providing individualized survivorship care plans (SCP’s). At a northern California oncology department, SCP’s will be prepared for breast cancer patients and delivered in-person by the oncology nurse navigator (ONN).

Method. The author worked with the ONN to develop the format and content requirements for the SCP’s. The ONN prepared individualized plans for patients and scheduled in-person appointments to deliver the SCP’s. A feedback survey to assess preliminary impact was then …

Hybrid Peripheral Nerve Sheath Tumors: Report Of Five Cases And Detailed Review Of Literature, Nasir Ud Din, Zubair Ahmad, Jamshid Abdul Ghafar, Rashida Ahmed

Department of Pathology and Laboratory Medicine

BACKGROUND: Hybrid peripheral nerve sheath tumors (PNSTs) have been recognized recently and were first included in the 4th edition of World Health Organization (WHO) Classification of Tumors of Soft tissue and Bone, published in 2013. These tumors show combined features of more than one type of conventional benign peripheral nerve sheath tumors. The most common combinations are those of schwannoma/perineurioma followed by combinations of neurofibroma/schwannoma and neurofibroma/perineurioma. A detailed literature review of published cases is presented. We have discussed the types and etiology, epidemiology and sites of localization, gross and microscopic appearances and immunohistochemical features of hybrid PNSTs and association …

A Randomized Controlled Trial Of Individual Versus Group-Format Exercise And Self-Management In Individuals With Parkinson's Disease And Comorbid Depression, Martha Sajatovic, Ellen M. Walter, Curtis M. Tatsuoka, Steven A. Gunzler, Christina M. Whitney, Benjamin L. Walter

Faculty Scholarship

Background: Depression is common in people with Parkinson’s disease (PD), and exercise is known to improve depression and PD. However, lack of motivation and low self-efficacy can make exercise difficult for people with PD and comorbid depression (PD-Dep). A combined group exercise and chronic disease self-management (CDSM) program may improve the likelihood that individuals will engage in exercise and will show a reduction in depression symptoms. The purpose of this study was to compare changes in depression in PD-Dep between individual versus group exercise plus CDSM and to examine participant adherence and perception of the interventions. Methods: Participants (N=30) were …

The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough

Master's Theses

In this thesis, I will expand upon each step in the process of acquiring and analyzing electroencephalogram (EEG) for the classification of benign childhood epilepsy with centrotemporal spikes. Despite huge advancements in the field of health informatics—natural language processing, machine learning, predictive modeling—there are significant barriers to the access of clinical data. These barriers include information blocking, privacy policy concerns, and a lack of stakeholder support. We will see that these roadblocks are all responsible for stunting biomedical research in some way, including my own experiences in acquiring the data for the second chapter of this thesis.

This second chapter …

Ethical Concerns For Assisted Reproductive Technologies, Olga Najera

Dialogue & Nexus

The development of assisted reproductive technologies has provided new options for infertile couples in their pursuit of parenthood. As a result of the successful implementation of in vitro fertilization (IVF), gestational surrogacy is now an alternative. Other technology, such as genetic enhancement, could potentially become available for human beings soon; however, numerous ethical concerns have been raised by the fact that it requires germline engineering. The concerns brought about by these new reproductive technologies will be addressed in light of the teachings of the Roman Catholic Church and of the following ethical theories: Kantian, evolutionary, utilitarian, and virtue ethics.

Risk Factors For Heart Failure In Patients With Chronic Kidney Disease: The Cric (Chronic Renal Insufficiency Cohort) Study., Jiang He, Michael Shlipak, Amanda Anderson, Jason A Roy, Harold I Feldman, Radhakrishna Reddy Kallem, Radhika Kanthety, John W Kusek, Akinlolu Ojo, Mahboob Rahman, Ana C Ricardo, Elsayed Z Soliman, Myles Wolf, Xiaoming Zhang, Dominic Raj, Lee Hamm

Medicine Faculty Publications

Background Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study.

Methods and Results Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin …

Bendablesound: An Elastic Multisensory Surface Using Touch-Based Interactions To Assist Children With Severe Autism During Music Therapy, Franceli L. Cibrian, Oscar Peña, Deysi Ortega, Monica Tentori

Engineering Faculty Articles and Research

Neurological Music Therapy uses live music to improve the sensorimotor regulation of children with severe autism. However, they often lack musical training and their impairments limit their interactions with musical instruments. In this paper, we present our co-design work that led to the BendableSound prototype: an elastic multisensory surface encouraging users to practice coordination movements when touching a fabric to play sounds. We present the results of a formative study conducted with 18 teachers showing BendableSound was perceived as “usable” and “attractive”. Then, we present a deployment study with 24 children with severe autism showing BendableSound is “easy to use” …

Whole Genome Analysis Of A Schistosomiasis-Transmitting Freshwater Snail., Coen M Adema, Ladeana W Hillier, Catherine S Jones, Eric S Loker, Matty Knight, Patrick Minx, +Several Additional Authors

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Biomphalaria snails are instrumental in transmission of the human blood fluke Schistosoma mansoni. With the World Health Organization's goal to eliminate schistosomiasis as a global health problem by 2025, there is now renewed emphasis on snail control. Here, we characterize the genome of Biomphalaria glabrata, a lophotrochozoan protostome, and provide timely and important information on snail biology. We describe aspects of phero-perception, stress responses, immune function and regulation of gene expression that support the persistence of B. glabrata in the field and may define this species as a suitable snail host for S. mansoni. We identify …

Effect Of Oral Iron Repletion On Exercise Capacity In Patients With Heart Failure With Reduced Ejection Fraction And Iron Deficiency: The Ironout Hf Randomized Clinical Trial., Gregory D Lewis, Rajeev Malhotra, Adrian F Hernandez, Steven E Mcnulty, Andrew Smith, G Michael Felker, W H Wilson Tang, Shane J Larue, Margaret M Redfield, Marc J Semigran, Michael M Givertz, Peter Van Buren, David J Whellan, Kevin J Anstrom, Monica R Shah, Patrice Desvigne-Nickens, Javed Butler, Eugene Braunwald

Department of Medicine Faculty Papers

Importance: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpensive readily available oral iron supplementation in heart failure is unknown.

Objective: To test whether therapy with oral iron improves peak exercise capacity in patients with HFrEF and iron deficiency.

Design, Setting, and Participants: Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with HFrEF (

Interventions: Oral iron polysaccharide (n = 111) or placebo (n = 114), 150 mg twice daily for 16 weeks. …

Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study., Anna M Gorczyca, Charles B Eaton, Michael J Lamonte, Joann E Manson, Jeanne D Johnston, Aurelian Bidulescu, Molly E Waring, Todd Manini, Lisa W Martin, Marcia L Stefanick, Ka He, Andrea K Chomistek

Medicine Faculty Publications

Background

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown.

Methods and Results

Participants included postmenopausal women in the Women's Health Initiative‐Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self‐reported at baseline, year 3, and year 6. Self‐reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as the …

Exploring Autonomy Support In Shared Decision Making And Patient Activation Of Diabetes Self-Care Behaviors, Carol Mahler Hamersky

Seton Hall University Dissertations and Theses (ETDs)

Introduction:

Chronic disease places a different set of demands on an individual and family. Self-care behaviors and daily decision making is an integral part of diabetes management. According to the CDC (2014), the prevalence of Diabetes is estimated at 29.1 million and an alarming 86 million Americans have Pre-diabetes. Despite a plethora of evidence on the importance of diabetes self-care behaviors on clinical outcomes, studies have highlighted the current disconnect of patients not able to follow self-care behavior recommendations and not asking for help from their health care providers. There is no literature on the impact of an autonomy supported …

Temperature Induces Significant Changes In Both Glycolytic Reserve And Mitochondrial Spare Respiratory Capacity In Colorectal Cancer Cell Lines, Mihail I. Mitov, Jennifer W. Harris, Michael Alstott, Yekaterina Y. Zaytseva, B. Mark Evers, D. Allan Butterfield

Markey Cancer Center Faculty Publications

Thermotherapy, as a method of treating cancer, has recently attracted considerable attention from basic and clinical investigators. A number of studies and clinical trials have shown that thermotherapy can be successfully used as a therapeutic approach for various cancers. However, the effects of temperature on cancer bioenergetics have not been studied in detail with a real time, in a microplate, label-free detection approach.

This study investigate how changes in temperature affect the bioenergetics characteristics (mitochondrial function and glycolysis) of three colorectal cancer (CRC) cell lines utilizing the Seahorse XF96 technology. Experiments were performed at 32°C, 37°C and 42°C using assay …

Laboratory Tests In Patients Treated With Isotretinoin: Occurrence Of Liver And Muscle Abnormalities And Failure Of Ast And Alt To Predict Liver Abnormality., Guy F. Webster, Timothy G. Webster, Lorraine R. Grimes

Department of Dermatology and Cutaneous Biology Faculty Papers

Current laboratory monitoring may not be optimal. A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients had an elevated AST and 35 of these had an elevated CK; 32 had an elevated ALT and 11 of these had an elevated CK. Thirteen patients had an elevated GGT; in 5 this was the only abnormality, whereas 8 had a GGT elevation accompanied by an elevated AST or ALT. Two had an elevated GGT …

Hemodynamic And Metabolic Responses During Self-Paced And Ramp Graded Exercise Testing Treadmill Protocols, Nicholas Mark Beltz

Health, Exercise, and Sports Sciences ETDs

Purpose: To investigate: 1) if a self-paced (SP) graded exercise testing protocol elicits similar and reliable maximal oxygen uptake (VO_2max) responses compared to a ramp (RAMP) treadmill protocol; 2) the impact of SP on cardiac output (Q), stroke volume (SV), and arteriovenous oxygen difference (a-vO_2diff); and 3) the metabolic response during SP through blood lactate (BLa^-) accumulation and ventilatory threshold (VT) attainment. Methods: Sixteen recreationally trained men (23.7±3.0 yrs) completed two separate treadmill graded exercise testing protocols. SP consisted of five 2-min stages (10 min total) of increasing speed based on the Borg …

Single-Trait And Multi-Trait Genome-Wide Association Analyses Identify Novel Loci For Blood Pressure In African-Ancestry Populations., Jingjing Liang, Thu H Le, Digna R Velez Edwards, Bamidele O Tayo, Kyle J Gaulton, Jennifer A Smith, Lisa W Martin, +Several Additional Authors

Medicine Faculty Publications

Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25×10−8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH/TMBIM4) …

Safety And Immunogenicity Of An Inactivated Whole Cell Tuberculosis Vaccine Booster In Adults Primed With Bcg: A Randomized, Controlled Trial Of Dar-901, C. Fordham Von Reyn, Timothy Lahey, Robert D. Arbeit, Bernard Landry, Leway Kailani, Lisa Adams, Brenda Haynes, Todd Mackenzie, Wendy Wieland-Alter, Ruth Connor, Sue Tvaroha, David Hokey, Ann Ginsberg, Richard Waddell

Dartmouth Scholarship

Development of a tuberculosis vaccine to boost BCG is a major international health priority. SRL172, an inactivated whole cell booster derived from a non-tuberculous mycobacterium, is the only new vaccine against tuberculosis to have demonstrated efficacy in a Phase 3 trial. In the present study we sought to determine if a three-dose series of DAR-901 manufactured from the SRL172 master cell bank by a new, scalable method was safe and immunogenic.

Research Brief: "The National Veteran Sleep Disorder Study: Descriptive Epidemiology And Secular Trends, 2000–2010", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relation between sleep disorder diagnosis and cardiovascular disease, cancer, and mental health disorders among veterans. In policy and practice, physicians should familiarize themselves with signs of and screenings for sleep disorders and should discuss factors that affect sleep with their veteran patients; the VHA should continue recommending policies that help veterans receive a prompt diagnosis and treatment of their sleep disorders, policymakers should fund early intervention programs to help veterans learn how to cope with reintegration, and the VHA should create a database on sleep disorders in veterans. Suggestions for future research include studying veterans …

Impact Of Ibrutinib Dose Adherence On Therapeutic Efficacy In Patients With Previously Treated Cll/Sll., Paul M Barr, Jennifer R Brown, Peter Hillmen, Susan O'Brien, Jacqueline C Barrientos, Nishitha M Reddy, Steven Coutre, Stephen P Mulligan, Ulrich Jaeger, Richard R Furman, Florence Cymbalista, Marco Montillo, Claire Dearden, Tadeusz Robak, Carol Moreno, John M Pagel, Jan A Burger, Samuel Suzuki, Juthamas Sukbuntherng, George Cole, Danelle F James, John C Byrd

Articles, Abstracts, and Reports

Ibrutinib, an oral inhibitor of Bruton's tyrosine kinase (BTK), at a once-daily dose of 420 mg achieved BTK active-site occupancy in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) that was maintained at 24 hours. It is unknown if intermittent interruption of ibrutinib therapy contributes to altered clinical outcomes. We therefore evaluated the effect of ibrutinib dose adherence on patient outcomes in the phase 3 RESONATE trial. The overall mean dose intensity (DI) was 95% with median treatment duration of ∼9 months. Pharmacokinetic assessment of ibrutinib exposure at 420-mg dose suggested similar exposure regardless of patient weight or age. …

Exploring The Burnout Experience Of Radiology Physician Executives Working In An Academic Medical Institution: A Mixed Methods Approach, Julie Chapman-Greene

Seton Hall University Dissertations and Theses (ETDs)

Radiology Physician Executives (Radiology PEs) perform administrative duties and they have frequent and prolonged contact with patients, residents, fellows, faculty and staff. This study, using the Maslach Burnout Inventory Human Services Survey to measure burnout in a convenient sample of Radiology PEs working in accredited academic medical institutions, is the first one to evaluate burnout in this group. The purpose of this study was to explore the burnout experience of Radiology PEs by investigating their burnout rate, understanding their burnout experience and explore a theory on how Radiology PEs think about, perceive, experience and manage burnout. The study describes the …

The Clinical Impact Of Copy Number Variants In Inherited Bone Marrow Failure Syndromes, Nicolas Waespe, Santhosh Dhanraj, Manju Wahala, Elena Tsangaris, Tom Enbar, Bozana Zlateska, Hongbing Li, Robert J Klaassen, Conrad V Fernandez, Geoff D E Cuvelier, John K Wu, Yves D Pastore, Mariana Silva, Jeffrey H Lipton, Joseé Brossard, Bruno Michon, Sharon Abish, Macgregor Steele, Roona Sinha, Mark J Belletrutti, Vicky R Breakey, Lawrence Jardine, Lisa Goodyear, Liat Kofler, Michaela Cada, Lillian Sung, Mary Shago, Stephen W Scherer, Yigal Dror

Paediatrics Publications

Inherited bone marrow failure syndromes (IBMFSs) comprise a genetically heterogeneous group of diseases with hematopoietic failure and a wide array of physical malformations. Copy number variants (CNVs) were reported in some IBMFSs. It is unclear what impact CNVs play in patients evaluated for a suspected diagnosis of IBMFS. Clinical and genetic data of 323 patients from the Canadian Inherited Marrow Failure Registry from 2001 to 2014, who had a documented genetic work-up, were analyzed. Cases with pathogenic CNVs (at least 1 kilobasepairs) were compared to cases with other mutations. Genotype-phenotype correlations were performed to assess the impact of CNVs. Pathogenic …

Structure Activity Relationship Studies Of Novel Diarylpentanoid Analogs Targeting The Androgen Receptor In Prostate Cancer Cells, Haili Coffin, Marco Bisoffi

Student Scholar Symposium Abstracts and Posters

The development of prostate cancer (PCa) relies strongly on the activation of the androgen receptor (AR) signaling pathway by its natural ligand dihydrotestosterone. Furthermore, PCa progression to metastatic disease represents oncogene addiction to AR activity. Androgen ablation therapy is thus a mainstay therapy against this disease, but the development of ligand-independent AR activation and persisting AR expression eventually leads to castration resistant PCa (CRPC). Therefore, down-regulation of AR expression in PCa cells may be an effective therapeutic modality. The diarylpentanoid ca27 has previously been shown to down-regulate AR expression by an unknown mechanism of action. The present work represents a …

Adenocarcinoma In A Koff Urinary Ileal Diversion., Bradley Sherman, Frederick Taylor

Oncology Articles

The use of an ileal conduit as a means of treatment for bladder cancer or dysfunction is widely used and understood. However, long term surveillance of that conduit has not been strongly established and set forth as a means of screening. We present a 76yo female with a history of neurogenic bladder secondary to paraplegia who underwent the formation of a "Koff" pouch as a conduit. Nineteen years later she presents with hematuria and was found to have adenocarcinoma originating in her conduit.

Patient Activation Among Diverse Populations: A Systematic Review, Megan Kenney

Student Scholar Symposium Abstracts and Posters

The purpose of this article was to review the current research regarding patient activation among diverse populations. Patient activation is defined as an individual’s knowledge, skill, and confidence in managing his or her own health and health care. A total of 62 articles were used in this review (54 primary research articles, six retrospective analyses, and two systematic reviews). Articles were obtained using the EBSCO search engine through the Leatherby Libraries at Chapman University. Preliminary and secondary searches were conducted using the keywords “patient activation.” Only articles published within the last ten years (2007 to 2017) were included to ensure …

The Skin Cancer Health Crisis And Recommended Intervention Methods, Blaire Brooks

Senior Theses

Despite the increasing research connecting UVR exposures to skin cancer, rates of skin cancer are rising. Skin cancer is now the most common form of cancer and there are significant health care costs associated with treating the cases (Balk et al., 2013). As a result, the United States needs greater initiatives to increase educational programs, physician counseling, and political action regarding ultraviolet exposure and incidence of skin cancer. Evaluation of the types of skin cancer, perceptions of tanning, and current regulations and recommendations are required in order to form the initiatives to combat the growth of skin cancer.

Pharmacological Threat To Lungs: A Case Series And Literature Review, Omar Irfan, Jaleed A. Gilani, Abeel Irshad, Babar Irfan, Javaid A. Khan

Section of Pulmonary & Critical Care

Drug-induced organ damage stands as a prevalent yet much-neglected issue globally. Keeping in view it's rising frequency, health care providers stand obliged to be well versed with the de-merits of the agents they prescribe. Drug therapies causing damage present with a non-specific clinical presentation, histological findings or radiology, which further elaborates on the necessity of a conscientious diagnosis. Pulmonary architecture ranging from the airways, lung parenchyma, mediastinum, pleura, pulmonary vasculature or the neuromuscular system, all can fall victim to the dreaded outcomes of this menace. In order to establish successful diagnosis, the definite temporal relation between initiation of drug therapy …

Ccr4 Is A Determinant Of Melanoma Brain Metastasis., Anat Klein, Orit Sagi-Assif, Tsipi Meshel, Alona Telerman, Sivan Izraely, Shlomit Ben-Menachem, Jagadeesh Bayry, Diego M Marzese, Shuichi Ohe, Dave S B Hoon, Neta Erez, Isaac P Witz

Articles, Abstracts, and Reports

We previously identified the chemokine receptor CCR4 as part of the molecular signature of melanoma brain metastasis. The aim of this study was to determine the functional significance of CCR4 in melanoma brain metastasis. We show that CCR4 is more highly expressed by brain metastasizing melanoma cells than by local cutaneous cells from the same melanoma. Moreover, we found that the expression of CCR4 is significantly higher in paired clinical specimens of melanoma metastases than in samples of primary tumors from the same patients. Notably, the expression of the CCR4 ligands, Ccl22 and Ccl17 is upregulated at the earliest stages …

Evidence-Based Treatment Options In Recurrent And/Or Metastatic Squamous Cell Carcinoma Of The Head And Neck., Athanassios Argiris, Kevin J. Harrington, Makoto Tahara, Jeltje Schulten, Pauline Chomette, Ana Ferreira Castro, Lisa Licitra

Department of Medical Oncology Faculty Papers

The major development of the past decade in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) was the introduction of cetuximab in combination with platinum plus 5-fluorouracil chemotherapy (CT), followed by maintenance cetuximab (the "EXTREME" regimen). This regimen is supported by a phase 3 randomized trial and subsequent observational studies, and it confers well-documented survival benefits, with median survival ranging between approximately 10 and 14 months, overall response rates between 36 and 44%, and disease control rates of over 80%. Furthermore, as indicated by patient-reported outcome measures, the addition of cetuximab …

Relationship Of Patient Self-Administered Copd Assessment Test (Cat) To Physician Standard Assessment Of Copd In A Family Medicine Residency Training Program, Leigh Johnson, Jessica Burchette, Ivy A. Click, Sandra Alicia Williams

ETSU Faculty Works

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. COPD is of particular concern in certain sectors of the country, including Central Appalachia where our clinic is located. Assessing patients with COPD presents many challenges as symptoms range from those considered "typical" such as shortness of breath and sputum production to those less often identified like anxiety and social isolation. We conducted a pilot study comparing physician standard assessment of COPD to patient self-assessment using the COPD Assessment Test (CAT). The CAT is an eight-item questionnaire that measures the impact COPD has …