Trends And Updates On The Epidemiology Of Cancer Associated Thrombosis: A Systematic Review, Ang Li, Emily Zhou

Faculty, Staff and Students Publications

Introduction: Cancer associated thrombosis (CAT) is a significant complication for patients with cancer. This review summarizes an updated epidemiology of CAT in the past decade.

Methods: A systematic review was conducted on relevant population cohort studies published 2011-2024.

Results: The 12-month incidence of CAT among patients with unselected cancers is approximately 3-5% (9-fold increase vs. matched non-cancer population); although the risk increases to 6-8% in patients with advanced cancers requiring systemic therapy (20-fold increase vs. matched non-cancer population). Despite improvement in anticoagulation usage and adherence, recurrence risk remains high at 5-8% at 6 months and 7-15% at 12 months. Important …

Natural History Of Cancer-Associated Splanchnic Vein Thrombosis, Hanqing Shang, Jun Y Jiang, Danielle Guffey, Francisco Novoa, Raka Bandyo, Shengling Ma, Ang Li

Faculty, Staff and Students Publications

Background: There is uncertainty in the management of cancer-associated isolated splanchnic vein thrombosis (SpVT).

Objectives: To describe the natural history of SpVT by cancer type and thrombus composition and to review anticoagulation (AC) practices and associated rates of usual-site venous thromboembolism (VTE), major and clinically relevant nonmajor bleeding (MB/CRNMB), recanalization/progression, and mortality.

Methods: We performed a retrospective cohort study in patients with SpVT at 2 cancer care centers in Houston, Texas. We estimated the incidence of usual-site VTE and MB/CRNMB at 6 months using competing risk methods and examined venous patency in a subset of patients with repeat imaging. We …

Emerging Evidence For Glucagon-Like Peptide-1 Agonists In Slowing Chronic Kidney Disease Progression, Michael W Holliday, Livia Frost, Sankar D Navaneethan

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: Diabetic kidney disease continues to increase, and several novel therapeutic agents have been shown to slow the progression of chronic kidney disease in those with diabetes. This review summarizes more recent data on the role of glucagon-like peptide-1 (GLP-1) receptor agonists and kidney outcomes.

RECENT FINDINGS: Posthoc analysis of cardiovascular outcome trials, as well as several retrospective studies, demonstrate benefits of GLP-1 receptor agonist therapy for chronic kidney disease progression in diabetics. Although limited randomized clinical trials evidence assessing the effects of GLP-1 receptor agonists on kidney outcomes in diabetic chronic kidney disease patients have been published, …

Proteomic Biomarkers Of Quantitative Interstitial Abnormalities In Copdgene And Cardia Lung Study, Bina Choi, Gabrielle Y Liu, Quanhu Sheng, Kaushik Amancherla, Andrew Perry, Xiaoning Huang, Ruben San José Estépar, Samuel Y Ash, Weihua Guan, David R Jacobs, Fernando J Martinez, Ivan O Rosas, Russell P Bowler, Jonathan A Kropski, Nicholas E Banovich, Sadiya S Khan, Raúl San José Estépar, Ravi Shah, Bharat Thyagarajan, Ravi Kalhan, George R Washko

Faculty, Staff and Students Publications

Rationale: Quantitative interstitial abnormalities (QIAs) are early measures of lung injury automatically detected on chest computed tomography scans. QIAs are associated with impaired respiratory health and share features with advanced lung diseases, but their biological underpinnings are not well understood. Objectives: To identify novel protein biomarkers of QIAs using high-throughput plasma proteomic panels within two multicenter cohorts.

Methods: We measured the plasma proteomics of 4,383 participants in an older, ever-smoker cohort (COPDGene [Genetic Epidemiology of Chronic Obstructive Pulmonary Disease]) and 2,925 participants in a younger population cohort (CARDIA [Coronary Artery Disease Risk in Young Adults]) using the SomaLogic SomaScan assays. …

Mechanisms Driving Fasting-Induced Protection From Genotoxic Injury In The Small Intestine, Kali Deans-Fielder, Timothy Wu, Thanh Nguyen, Sarah To, Yang-Zhe Huang, Steven J Bark, Jason C Mills, Noah F Shroyer

Faculty, Staff and Students Publications

Genotoxic agents such as doxorubicin (DXR) can cause damage to the intestines that can be ameliorated by fasting. How fasting is protective and the optimal timing of fasting and refeeding remain unclear. Here, our analysis of fasting/refeeding-induced global intestinal transcriptional changes revealed metabolic shifts and implicated the cellular energetic hub mechanistic target of rapamycin complex 1 (mTORC1) in protecting from DXR-induced DNA damage. Our analysis of specific transcripts and proteins in intestinal tissue and tissue extracts showed that fasting followed by refeeding at the time of DXR administration reduced damage and caused a spike in mTORC1 activity. However, continued fasting …

Engineering Small-Molecule And Protein Drugs For Targeting Bone Tumors, Yixian Wang, Chenhang Wang, Meng Xia, Zeru Tian, Joseph Zhou, Julian Meyer Berger, Xiang H-F Zhang, Han Xiao

Faculty, Staff and Students Publications

Bone cancer is common and severe. Both primary (e.g., osteosarcoma, Ewing sarcoma) and secondary (e.g., metastatic) bone cancers lead to significant health problems and death. Currently, treatments such as chemotherapy, hormone therapy, and radiation therapy are used to treat bone cancer, but they often only shrink or slow tumor growth and do not eliminate cancer completely. The bone microenvironment contributes unique signals that influence cancer growth, immunogenicity, and metastasis. Traditional cancer therapies have limited effectiveness due to off-target effects and poor distribution on bones. As a result, therapies with improved specificity and efficacy for treating bone tumors are highly needed. …

Angiogenic Gene Therapy For Refractory Angina: Results Of The Exact Phase 2 Trial, Kenta Nakamura, Timothy D Henry, Jay H Traverse, David A Latter, Nahush A Mokadam, Geoffrey A Answini, Adam R Williams, Benjamin C Sun, Christopher R Burke, Faisal G Bakaeen, Marcelo F Dicarli, Bernard R Chaitman, Mark W Peterson, Dawn G Byrnes, E Magnus Ohman, Carl J Pepine, Ronald G Crystal, Todd K Rosengart, Elaine Kowalewski, Gary G Koch, Howard C Dittrich, Thomas J Povsic, Exact Trial Investigators

Faculty, Staff and Students Publications

Background: XC001 is a novel adenoviral-5 vector designed to express multiple isoforms of VEGF (vascular endothelial growth factor) and more safely and potently induce angiogenesis. The EXACT trial (Epicardial Delivery of XC001 Gene Therapy for Refractory Angina Coronary Treatment) assessed the safety and preliminary efficacy of XC001 in patients with no option refractory angina.

Methods: In this single-arm, multicenter, open-label trial, 32 patients with no option refractory angina received a single treatment of XC001 (1×1011 viral particles) via transepicardial delivery.

Results: There were no severe adverse events attributed to the study drug. Twenty expected severe adverse events in 13 patients …

An Assessment Of The Current State Of Nursing Homes In The United States, Southern Region, And Tennessee, Nicole Galler

Electronic Theses and Dissertations

Introduction: Nursing homes throughout the U.S. have faced unprecedented challenges in recent years because of staffing shortages, and under-investment, especially since the COVID-19 pandemic. To gain insight into the current state of nursing homes, this study examined nursing home characteristics, quality, and accessibility from a national, regional and state perspective.

Methods: This cross-sectional study used secondary data from the Centers for Medicare and Medicaid Services, American Community Survey, Medicare Beneficiary, and the Tennessee Department of Health. Nursing home characteristics and quality were assessed through bivariate and multivariate regression in the U.S. Assessment of HHS Region 4 nursing home characteristics and …

Healthcare Providers’ Screening And Counseling For Tobacco Use Among Youth In The United States: Prevalence, Practices, And Providers’ Perspectives, Adeola Omolade Ayo

Electronic Theses and Dissertations

Youth tobacco use is a public health concern in the United States (U.S.) with about 2.8 million middle and high school youth reporting current tobacco use in 2023. Healthcare providers (HCPs) can play a crucial role in addressing youth tobacco use through screening and counseling, yet rates of these interventions are suboptimal. Tennessee has a high prevalence of youth tobacco use and not much is known about these interventions in Northeast Tennessee. This study has several objectives: 1) conduct a scoping review of available evidence on screening and counseling for youth tobacco use and identify related gaps; 2) assess youth …

The Association Between Prenatal Care And Postpartum Depression: Current State And Future Directions, Esther Adebayo-Abikoye

Electronic Theses and Dissertations

Background

Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.

Methods

A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used …

Travel-Time Disparities In Access To Proton Beam Therapy For Cancer Treatment, Todd Burus, Alexander Vanhelene, Michael Rooney, Krystle Lang Kuhs, W. Jay Christian, Christopher Mcnair, Sanjay Mishra, Arnold Paulino, Grace Smith, Steven Frank, Jeremy Warner

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

IMPORTANCE: Proton beam therapy is an emerging radiotherapy treatment for patients with cancer that may produce similar outcomes as traditional photon-based therapy for many cancers while delivering lower amounts of toxic radiation to surrounding tissue. Geographic proximity to a proton facility is a critical component of ensuring equitable access both for indicated diagnoses and ongoing clinical trials.

OBJECTIVE: To characterize the distribution of proton facilities in the US, quantify drive-time access for the population, and investigate the likelihood of long commutes for certain population subgroups.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study analyzed travel times to proton facilities in …

Risk Evaluation In Occupational Safety And Health Research: Results From A Benchmarking Exercise Of Federal And Academic Irbs, Sarah A Felknor, Jessica M K Streit, Angela M Morley, John D Piacentino

Faculty, Staff and Student Publications

OBJECTIVE: Research involving working populations can pose unique ethical and risk evaluation challenges. The purpose of this benchmarking project was to assess how federal agencies and academic institutions approach the interpretation and application of key risk evaluation concepts in research involving workers in their places of employment.

METHODS: Key informant interviews were conducted to ascertain current practices related to assessing soundness of research design, determining risk reasonableness and research relatedness of risks, and evaluating the risk of noninvasive clinical tests in occupational settings.

RESULTS: There were noteworthy commonalities among the approaches described to review and address critical aspects of risk …

Examining Current Capacity Of Healthcare Systems: Identifying Potential Adaptations For Children And Youth With Special Healthcare Needs, Caitlin Koob

All Dissertations

Children and youth with special healthcare needs (CYSHCN) are a growing proportion of the pediatric population, accounting for 23% of children in South Carolina (SC). Children with medical complexity (CMC) are a subgroup of CYSHCN who experience the most complex conditions and comprise

This dissertation investigates equitable healthcare access, service quality, and health and well-being among CYSHCN and their families, within the context of SC’s healthcare system. Three studies make up this dissertation, focusing on various aspects of healthcare access and experiences of CYSHCN and their families.

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience: Master of Public Health

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Institutionalized Stigmas: Hiv Stigma, Racism And Heterosexism Among Medical Students In The Southern United States, Krishen D. Samuel

Graduate Theses and Dissertations

Background: Intersecting and related forms of stigma, including HIV-related stigma, racism, and heterosexism, disproportionately impact both communities vulnerable to acquiring HIV and people living with HIV (PLHIV), ultimately impacting more distal outcomes related to HIV prevention, treatment, and epidemiological patterns in the United States (US). The Southern US is the region most impacted by new HIV diagnoses, mainly among Black men who have sex with men (MSM). However, there is a paucity of research on medical students, specifically those in the Southern US, regarding stigmatizing attitudes they may hold towards PLHIV, and how these associate with racism and heterosexism. This …

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

Observational Analysis For Predicting Initial Spikes In Testing Volume Of Cohorts Inside And Outside Of A Regional Covid-19 Screening Program, Adam M. Franks, Seth Bergeron, Tammy Bannister, Justin Spradling, Tamara Lowe, Paris Johnson, Rajan Lamichhane, Stephen M. Petrany

Marshall Journal of Medicine

BACKGROUND Containing the highly contagious SARs-CoV-2 pathogen requires a safe and effective screening program. The aim of this observational cohort study is to analyze a regional testing center and identify factors predicting testing rates that direct supply and staffing needs.

METHODS A drive-through SAR-CoV-2 regional testing facility was created. Number of tests and positive results were collected for eighteen months. Data for testing demand was compared to positive results, percent positive rates (PPR), known external factors, and county PPR. Dissimilarities were contrasted with dynamic time warp and a detailed agreement analysis. The Grainger’s test was utilized to assess the degree …

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

Ensuring Equitable Application Of Interventions To Vulnerable Subpopulations In The Kentucky Consortium For Accountable Health Communities (Kc-Ahc), Jing Li, Jessica M. Clouser, Akosua Adu, Aiko Weverka, Nikita Vundi, Terry D. Stratton, Mark V. Williams

Journal of Appalachian Health

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women.

Methods: Twenty-eight primary …

Factors Predicting Work Ability Among Community Healthcare Providers In Yangon, Myanmar, Phyu Nyein Wai, Naw Clara

Makara Journal of Health Research

Background: In healthcare organizations, a high level of work ability is necessary for workers to perform their tasks under different working conditions. This study aimed to describe the quality of work life, work environment, and work ability and examine predictors of the work ability of community healthcare providers.

Methods: A cross-sectional descriptive study was conducted from May 2020 to July 2020. The study enrolled 284 registered nurses and midwives from 38 public health departments in Yangon, Myanmar. Data were collected using the work-related quality of life scale (WRQoL) 2, work environment impact scale (WEIS-SR), and work ability index …

Perception Of Lean Adoption Among Emergency Department Personnel In Public Hospitals In Selangor, Malaysia, Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Makara Journal of Health Research

Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions.

Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals.

Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = …

Assessment Of Sociodemographic Status, Self-Awareness, And Risk Factors Affecting Patients With Prediabetes In Bangladesh: Cross-Sectional Study, Farhana Sultana, Muhammed Mohibul Islam, Aparajita Das, Md Hasan Shahriar Rahman, Nandita Islam Pia, Md Kayes Mahmud, Md. Saqline Mostaq, Saadullah Saadullah, Md. Saddam Hossain, Saikat Fakir, Mohammad Nurul Amin

Makara Journal of Health Research

Background: Poor glycemic control and high diabetes and prediabetes incidence are influenced by socioeconomic disparity. Raising awareness and ensuring that people with prediabetes are receiving medication, maintaining their glycemic control, and getting the proper care they need despite their socioeconomic situation are crucial in the fight against diabetes. This study aims to assess the sociodemographic status, self-awareness, and risk factors associated with prediabetes in Bangladesh.

Methods: A cross-sectional survey was carried out among 500 participants aged >18 years to evaluate and summarize their demographic data, socioeconomic status, and responses to various questionnaires about their conditions related to prediabetes …

Refining Successful Implementation Strategies For The Surgical Safety Checklist In High-Income Contexts: Results Of An International Mixed Methods Study, Meagan E. Elam, Christopher J. Louis, Jonathan Woodson, Nathan Turley, Denisa Urban, Mary E. Brindle, Jacey A. Greece

Patient Experience Journal

The WHO Surgical Safety Checklist (SSC) continues to show inconsistent success in reducing surgical complications in high-income settings. Previous implementation research identified potential barriers and facilitators to success, but it primarily consists of qualitative studies with small sample sizes in limited geographic areas. We conducted a multi-country mixed-methods study of barriers and facilitators to SSC implementation to better inform policies and practices for improving SSC buy-in and use to maximize its impact. This convergent parallel mixed-methods study utilized survey and interview data from surgical team members practicing in five countries. Survey data were analyzed using χ² analysis or Fisher’s …

Feasibility And Acceptability Of A Community Health Worker Administered Behavioral Activation Intervention For Postpartum Depression: A Single Arm Pilot Study From India, Amy Szajna, Bheemsain Tekkalaki, Veereshkumar Nandagaon, Gururaj Udapi, Manjunath Sogalad, Shweta Dandagi, Uma Kole, Sushma Patil, Sudha Raddi, Vanessa Short, Patricia Kelly

College of Nursing Faculty Papers & Presentations

INTRODUCTION: Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral …

Blastomas Of The Digestive System In Adults: A Review, Yu Liu, Tony El Jabbour, Jonathan Somma, Yukihiro Nakanishi, Saverio Ligato, Hwajeong Lee, Zhi-Yan Fu

School of Medicine Faculty Publications

Blastomas, characterized by a mixture of mesenchymal, epithelial, and undifferentiated blastematous components, are rare malignant neoplasms originating from precursor blast cells. This review focuses on digestive system blastomas in adult patients, including gastroblastoma, hepatoblastoma, and pancreatoblastoma. Gastroblastoma is a biphasic, epitheliomesenchymal tumor, with only sixteen cases reported to date. In addition to the characteristic histology, metastasis-associated lung adenocarcinoma transcript 1 - glioma-associated oncogene homolog 1 gene fusion is typical, although recently novel ewing sarcoma breakpoint region 1 - c-terminal binding protein 1 and patched 1 - glioma-associated oncogene homolog 2 fusions have been described. Hepatoblastoma is exceptionally rare in adults …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Targeting Idh2r140q And Other Neoantigens In Acute Myeloid Leukemia, Wingchi K Leung, Alejandro G Torres Chavez, Matthew French-Kim, Paul Shafer, Maksim Mamonkin, Laquisa C Hill, Manik Kuvalekar, Yovana Velazquez, Ayumi Watanabe, Norihiro Watanabe, Valentina Hoyos, Premal Lulla, Ann M Leen

Faculty, Staff and Students Publications

For patients with high-risk or relapsed/refractory acute myeloid leukemia (AML), allogeneic stem cell transplantation (allo-HSCT) and the graft-versus-leukemia effect mediated by donor T cells, offer the best chance of long-term remission. However, the concurrent transfer of alloreactive T cells can lead to graft-versus-host disease that is associated with transplant-related morbidity and mortality. Furthermore, ∼60% of patients will ultimately relapse after allo-HSCT, thus, underscoring the need for novel therapeutic strategies that are safe and effective. In this study, we explored the feasibility of immunotherapeutically targeting neoantigens, which arise from recurrent nonsynonymous mutations in AML and thus represent attractive targets because they …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

Centralized Interactive Phenomics Resource: An Integrated Online Phenomics Knowledgebase For Health Data Users, Jacqueline Honerlaw, Yuk-Lam Ho, Francesca Fontin, Michael Murray, Ashley Galloway, David Heise, Keith Connatser, Laura Davies, Jeffrey Gosian, Monika Maripuri, John Russo, Rahul Sangar, Vidisha Tanukonda, Edward Zielinski, Maureen Dubreuil, Andrew J Zimolzak, Vidul A Panickan, Su-Chun Cheng, Stacey B Whitbourne, David R Gagnon, Tianxi Cai, Katherine P Liao, Rachel B Ramoni, J Michael Gaziano, Sumitra Muralidhar, Kelly Cho

Faculty, Staff and Students Publications

Objective: Development of clinical phenotypes from electronic health records (EHRs) can be resource intensive. Several phenotype libraries have been created to facilitate reuse of definitions. However, these platforms vary in target audience and utility. We describe the development of the Centralized Interactive Phenomics Resource (CIPHER) knowledgebase, a comprehensive public-facing phenotype library, which aims to facilitate clinical and health services research.

Materials and methods: The platform was designed to collect and catalog EHR-based computable phenotype algorithms from any healthcare system, scale metadata management, facilitate phenotype discovery, and allow for integration of tools and user workflows. Phenomics experts were engaged in the …

Impact Of Ehr On Security Check And Patient Outcomes, Arun Kumar Marumudi

Harrisburg University Dissertations and Theses

This study aims to explore patient perspectives on how electronic health record (EHR) security protocols influence care quality and outcomes. In the context of methodology, an online survey was conducted in March 2024 with 10 participants from the USA who provided informed consent. Questions assessed experience with EHRs, security concerns, perceptions of authentication impacts, satisfaction with balancing priorities, and open-ended feedback. Descriptive analysis was used to identify key themes.

Most respondents had direct EHR exposure, which validated their viewpoints. Universal concerns co-existed with preferring digital records due to facilitated sharing when regulated appropriately. One-third reported occasional access issues correlating with …