Tierney, Aaron A.
Research interests include equity in health information technology.
KP AIM-HI Program: Augmented Intelligence in Medicine and Healthcare Initiative
The Moore Foundation will fund a RFP for health system prospective evaluation of machine learning-based diagnostic decision support tools for…
Use and outcomes of intrapleural fibrinolytic therapy for complicated parapneumonic pleural effusion and empyema in Kaiser Permanente Northern California
This study will describe the variation in dosing regimens of intrapleural fibrinolytic medications administered within KPNC to adults hospitalized with…
Mogri, Murtaza
Murtaza Mogri, PhD, is a delivery science research fellow, focusing on clinical informatics and developing predictive models to guide clinical…
CT Use Reduction In Ostensive Ureteral Stone (CURIOUS)
Computed tomography (CT) is performed in over 90% of patients diagnosed with ureteral stones, but only 10% of patients presenting…
Association of Surgical Timing with Outcomes in Early Stage Lung Cancer
Optimal time to surgery for lung cancer is not well established. We aimed to assess whether time to surgery correlates…
Machine Learning Applied to EHR Data as a Means of Improving Biosurveillance and Diagnostic Excellence: A Pilot Project
We aim to develop and extend methods of probabilistic modeling of temporal electronic health record (EHR) data, using non-stationary Gaussian…
Development and validation of a prediction model of time to suicide attempt
Prediction models have the potential to transform targeted prevention strategies for suicide, a leading cause of death in the U.S.…
Pragmatic Clinical Trial of Continuous Glucose Monitoring-based Interventions for Safe Insulin Prescribing in High-Risk Older Patients with Type 2 Diabetes
This 3-arm randomized pragmatic clinical trial will test the efficacy of patient-focused continuous glucose monitoring (Arm 1 - "patient-only CGM")…
Performance of a Prediction Model of Suicide Attempts Across Race and Ethnicity
This study examines whether race disparities exist in the prediction of suicide attempts and if have they have detrimental effects…
Effects of COVID-19 shelter-in-place confinement on diabetes prevention health behaviors among US adults with prediabetes: A cross-sectional survey
The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant lifestyle changes due to shelter-in-place confinement orders. The study's purpose…
Telehealth Use, Care Continuity, and Quality: Diabetes and Hypertension Care in Community Health Centers Before and During the COVID-19 Pandemic.
BACKGROUND: Community health centers (CHCs) pivoted to using telehealth to deliver chronic care during the coronavirus COVID-19 pandemic. While care…
Development and Validation of a Diabetic Retinopathy Risk Stratification Algorithm
Although diabetic retinopathy is a leading cause of blindness worldwide, diabetes-related blindness can be prevented through effective screening, detection, and…
TRENDS IN SMOKING-SPECIFIC LUNG CANCER INCIDENCE RATES WITHIN A U.S. INTEGRATED HEALTH SYSTEM, 2007-2018
At least 10% of lung cancers arise in adults who have never smoked. Data remain inconclusive on whether lung cancer…
Identifying Predictors of Homelessness Among Adults in a Large Integrated Health System in Northern California
Introduction Homelessness contributes to worsening health and increased health care costs. There is little published research that leverages rich electronic…
Data-driven classification of health status of older adults with diabetes: The diabetes and aging study
We set out to identify empirically-derived health status classes of older adults with diabetes based on clusters of comorbid conditions…
Using Peer Support to Prevent Diabetes: Results of a Pragmatic RCT
High-contact structured diabetes prevention programs are effective in lowering weight and HbA1cs, yet their intensity level can create barriers to…
Telehealth During COVID-19 for Adults with Multiple Chronic Conditions: Associations with Self-Reported Food Insecurity and with Physical Limitations
Background: Adults with chronic medical conditions complicated by food insecurity or physical limitations may have higher barriers to accessing telehealth…
Associations of polygenic risk scores with posttraumatic stress symptom trajectories following combat deployment
Identification of genetic risk factors may inform the prevention and treatment of posttraumatic stress disorder (PTSD). This study evaluates the…
Testing a new population management model for hypoglycemia prevention in high-risk KPNC members
This study explores whether using a Hypoglycemia Champion to target high-risk patients with type 2 diabetes is a feasible and…
Antenatal pulmonary embolism diagnostics (APED) in the COVID-19 era
Our multispecialty team will utilize the Kaiser Permanente Northern California (KPNC) Perinatal Obstetrics Database to identify approximately 1,500 gravid patients…
Evaluation of the Emergency Severity Index in US Emergency Departments for the Rate of Mistriage
Accurate emergency department (ED) triage is essential to prioritize the most critically ill patients and distribute resources appropriately. The most…
Validation of a Hypoglycemia Risk Stratification Tool Using Data From Continuous Glucose Monitors
This cohort study uses data from continuous glucose monitoring to validate a hypoglycemia risk stratification tool.
Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation
Practice patterns and outcomes associated with the use of oral anticoagulation for arterial thromboembolism prevention following a hospitalization with new-onset…
Racial and Ethnic Differences in Medication Initiation Among Adults Newly Diagnosed with Type 2 Diabetes
Given persistent racial/ethnic differences in type 2 diabetes outcomes and the lasting benefits conferred by early glycemic control, we examined…
Among-Hospital Variation in ICU Admission Practices and Associated Outcomes for Patients with Acute Respiratory Failure
Rationale: We have previously shown that hospital strain is associated with intensive care unit (ICU) admission and that ICU admission,…
Development and Validation of an Electronic Health Record-based Score for Triage to Perioperative Medicine
To develop an electronic health record-based risk model for perioperative medicine (POM) triage and compare this model with legacy triage…
Sex- and ethnic-specific patterns in the incidence of hip fracture among older US Asian and non-Hispanic White adults
Asian and Pacific Islander (Asian/PI) adults have lower hip fracture incidence than non-Hispanic White (NHW) adults, but data regarding Asian/PI…
Hospital Strain and Variation in Sepsis ICU Admission Practices and Associated Outcomes
To understand how strain-process-outcome relationships in patients with sepsis may vary among hospitals. Retrospective cohort study using a validated hospital…
Posttraumatic stress disorder symptom trajectories in a 16-month COVID-19 pandemic period
COVID-19 pandemic presents an unheralded opportunity to better understand trajectories of posttraumatic stress disorder (PTSD) symptoms across a prolonged period…
Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
Telemedicine's dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with…
Risk of cardiac events after elective versus urgent or emergent noncardiac surgery: Implications for quality measurement and improvement
Patient populations differ for elective vs urgent and emergent surgery. The effect of this difference on surgical outcome is not…
Clinical Assessment of Residents: A Survey of Clinician Educators Regarding Resident Assessment Burden and Modifiable Factors.
BACKGROUND: A fundamental role of the clinician educator is to provide thoughtful assessments for resident development. A gap in the…
COVID-19 bacteremic co-infection is a major risk factor for mortality, ICU admission, and mechanical ventilation
Recent single-center reports have suggested that community-acquired bacteremic co-infection in the context of Coronavirus disease 2019 (COVID-19) may be an…
Associations between alcohol brief intervention in primary care and drinking and health outcomes in adults with hypertension and type 2 diabetes: a population-based observational study
To evaluate associations between alcohol brief intervention (BI) in primary care and 12-month drinking outcomes and 18-month health outcomes among…
The Safety of Inpatient Health Care
Adverse events during hospitalization are a major cause of patient harm, as documented in the 1991 Harvard Medical Practice Study.…
Cigarette Smoking and Risk of SARS-CoV-2 infection and Disease Severity Among Adults in an Integrated Health Care System in California
The relationship between tobacco smoking status and SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) severity is highly debated. We conducted…
Mortality Following Diagnosis of Nontraumatic Intracerebral Hemorrhage Within an Integrated “Hub-and-Spoke” Neuroscience Care Model: Is Spoke Presentation Noninferior to Hub Presentation?
Practice guidelines recommend that patients with intracerebral hemorrhage (ICH) be treated in units with acute neuroscience care experience. However, most…
Trends in Outpatient Visits and Hospital and Intensive Care Unit Admissions of Adults With COVID-19 in an Integrated US Health Care System, March 2020 to January 2022
This cohort study of patients at a single integrated health system examines trends in COVID-19–related treatment location and mortality.
Primary care video and telephone telemedicine during the COVID-19 pandemic: treatment and follow-up health care utilization
Telemedicine use expanded greatly during the COVID-19 pandemic, and broad use of telemedicine is expected to persist beyond the pandemic.…
Risk of hospitalization in a sample of COVID-19 patients with and without chronic obstructive pulmonary disease
Patients with chronic obstructive pulmonary disease (COPD) may have worse coronavirus disease-2019 (COVID-19)-related outcomes. We compared COVID-19 hospitalization risk in…
The intensity of anticoagulant dosing in hospitalized patients with COVID-19: An observational, comparative effectiveness study
The question of anticoagulant dosing in hospitalized patients with coronavirus disease-2019 (COVID-19) is unresolved, with randomized trials showing mixed results…
Anakinra or high-dose corticosteroids in COVID-19 pneumonia patients who deteriorate on low-dose dexamethasone: An observational study of comparative effectiveness
To assess whether escalating to high-dose corticosteroids or anakinra compared with continuing low-dose corticosteroids reduced mortality in patients with severe…
Association between anaemia and hospital readmissions in patients undergoing major surgery requiring postoperative intensive care
Anaemia is a common sequela of surgery, although its relationship with patient recovery is unclear. The goal of this investigation…
Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions
Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and…
Cardiovascular Disease Risk Factors Among Middle-Aged and Older Adult Vietnamese American Members of a Northern California Health Plan
There is increasing recognition that cardiovascular disease (CVD) risk factors vary by Asian subgroups. We examined CVD risk factor prevalence…
Incidence and Medical Hospitalization Rates of Patients With Pediatric Eating Disorders
Objective Eating disorders typically onset in preadolescence and adolescence and cause negative mental and physical health sequelae over the life…
Team is brain: leveraging EHR audit log data for new insights into acute care processes
To determine whether novel measures of contextual factors from multi-site electronic health record (EHR) audit log data can explain variation…
Persistent Steroid Exposure Before Coronavirus Disease 2019 Diagnosis and Risk of Hospitalization in Patients With Chronic Obstructive Pulmonary Disease
It is unclear whether persistent inhaled steroid exposure in chronic obstructive pulmonary disease (COPD) patients before coronavirus disease 2019 (COVID-19)…
High-dose corticosteroids in patients hospitalized for COVID-19 pneumonia: an observational study of comparative effectiveness
To assess whether high- compared with low-dose corticosteroids started upon hospitalization reduce mortality in patients with severe COVID-19 pneumonia or…
Characterizing Equity of Intensive Care Unit Admissions for Sepsis and Acute Respiratory Failure
Rationale: Patients who identify as from racial or ethnic minority groups who have sepsis or acute respiratory failure (ARF) experience…
Bariatric Surgery and Risk of Death in Persons with Chronic Kidney Disease
A retrospective cohort study investigated the association between having surgery and risk of mortality for up to 5 years and…
Telemedicine implementation and use in community health centers during COVID-19: Clinic personnel and patient perspectives.
In March 2020, federal and state telehealth policy changes catalyzed telemedicine adoption and use in community health centers. There is…
Vinson, David
David R. Vinson, MD, is an adjunct investigator at the Kaiser Permanente Division of Research and a practicing emergency physician…
Sax, Dana
Dana Sax, MD, is senior physician with The Permanente Medical Group (TPMG), practicing emergency medicine at the Oakland, Richmond, and…
Papini, Santiago
Research interests include predictive modeling in behavioral health.
Casey, Scott
Research efforts encompass optimizing healthcare delivery for emergency department patients with acute pulmonary embolism or heart failure.
Myers, Laura
Dr. Myers’ research focuses on care delivery and policy for patients with chronic obstructive pulmonary disease.
Rodriguez, Luis
Research interests include type 2 diabetes and cardiometabolic disease prevention, and reducing health disparities
Adams, Alyce S.
Research interests include health care services among disparities populations.
Fohner, Alison
Research interests include clinical informatics and electronic decision support.
Reed, Mary E.
Research interests include health information technology.
Schmittdiel, Julie
Research interests are focused on organizational theory and behavior.
Liu, Vincent
Research interests include health services research and health information technology
Marshall, Cassondra (Cassie)
Research interests include preconception care and health care disparities.
Gopalan, Anjali
Research interests include patient-provider communication and behavioral economics
Gordon, Nancy P.
Research interests include health and eHealth disparities, social determinants of health, and surveys.
Grant, Richard W.
Research interests include diabetes and health services research
Herrinton, Lisa J.
Research interests include inflammatory bowel disease epidemiology.
Karter, Andrew J.
Research interests include epidemiology and health services research in diabetes.
The association between video or telephone telemedicine visit type and orders in primary care
Telemedicine is increasingly relied upon for care delivery in primary care, but the impact of visit type on clinical ordering…
Prevalence of sleep-related problems and risks in a community-dwelling older adult population: a cross-sectional survey-based study
Despite evidence of adverse health consequences of inadequate restorative sleep for older adults, assessment of sleep quantity, quality, and use…
Association Between Preoperative Hemodialysis Timing and Postoperative Mortality in Patients With End-stage Kidney Disease
For patients with end-stage kidney disease treated with hemodialysis, the optimal timing of hemodialysis prior to elective surgical procedures is…
Assessing the Long-term Impact of COVID-induced Telemedicine Expansion on Dementia Care
The major goal of this project is to generate robust evidence on the impact of the COVID-induced shift to telemedicine…
Relaxed Glycemic Control and the Risk of Infections in Older Adults with Type 2 Diabetes
Older adults with poorly controlled type 2 diabetes (T2D) have a higher risk of infection than patients with good glycemic…
Health Economic Analysis of Automated Insulin Delivery Systems
Safely administering insulin to manage blood glucose is challenging for people with type 1 diabetes (T1D). Artificial pancreas or automated…
Trends and Risk Factors for Venous Thromboembolism Among Hospitalized Medical Patients
While hospital-associated venous thromboembolism (HA-VTE) is a known complication of hospitalization, contemporary incidence and outcomes data are scarce and methodologically…
Use of Cannabidiol (CBD) oil in the treatment of PTSD: Study design and rationale for a placebo-controlled randomized clinical trial
The burden of illness for PTSD is staggering and confers significant interference in work, social functioning, as well as increased…
Covid-19 Vaccination and the Timing of Surgery Following Covid-19 Infection
To evaluate whether COVID-19 vaccination status or mode of anesthesia modified the temporal harms associated with surgery following coronavirus disease-2019…
Telemedicine implementation trends in surgical specialties before and after COVID-19 shelter in place: Adjusting to a changing landscape
The COVID-19 pandemic caused a shift from in-person care to telemedicine, providing a unique opportunity to evaluate trends and efficiency…
Management and Outcomes of Adults Diagnosed with Acute Pulmonary Embolism in Primary Care: Community-Based Retrospective Cohort Study
The management and outcomes of patients diagnosed with acute pulmonary embolism in primary care have not been characterized. To describe…
Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study
Asian adults develop Type 2 diabetes at a lower body mass index (BMI) compared to other racial/ethnic groups. We examined…
Quantifying the breadth of antibiotic exposure in sepsis and suspected infection using spectrum scores
A retrospective cohort study. Studies to quantify the breadth of antibiotic exposure across populations remain limited. Therefore, we applied a…
Barriers and Opportunities Regarding Implementation of a Machine Learning-Based Acute Heart Failure Risk Stratification Tool in the Emergency Department
Hospital admissions for patients with acute heart failure (AHF) remain high. There is an opportunity to improve alignment between patient…
Comparing the effectiveness of a brief intervention to reduce unhealthy alcohol use among adult primary care patients with and without depression: A machine learning approach with augmented inverse probability weighting
The combination of unhealthy alcohol use and depression is associated with adverse outcomes including higher rates of alcohol use disorder…
Identifying modifiable obesogenic behaviors among Latino adolescents in primary pediatric care.
Latino adolescents engage in more obesogenic behaviors, including sedentary behaviors and sugary drink consumption, than White adolescents. However, it is…
Unsupervised probabilistic models for sequential Electronic Health Records
We develop an unsupervised probabilistic model for heterogeneous Electronic Health Record (EHR) data. Utilizing a mixture model formulation, our approach…
Current Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement
Emergency department (ED) providers play a critical role in the stabilization and diagnostic evaluation of patients presenting with acute heart…
Trends in Diabetes Screening, Risk Factors and Incidence Before and After the SARS-CoV-2 Pandemic Between the California Medi-Cal and Commercially-Insured Populations
Using quasi-experimental research methods, this study is assessing the extent to which disparities in type 2 diabetes prevention and outcomes…
Strategies Facilitating Video Visit Implementation by a Medical Group Serving a Diverse Population
IntroductionVideo visits have created new opportunities to enhance access to care, but limited information exists on strategies medical groups can…
Improving outcomes in malignant pleural mesothelioma in an integrated health care system
Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor that should be managed by an experienced surgical and multidisciplinary…
Primary Care Visits Are Timelier When Patients Choose Telemedicine: A Cross-Sectional Observational Study
Introduction: Telemedicine could increase timely access to primary care-a key dimension of care quality. Methods: Among patient-scheduled appointments with their…
Ovarian Cystadenomas: Growth Rate and Reliability of Imaging Measurements
To evaluate the growth rate of benign ovarian cystadenomas and the degree of variability in ultrasound measurements. Two independent retrospective…
Risk of severe COVID-19 infection among adults with prior exposure to children
Susceptibility and severity of COVID-19 infection vary widely. Prior exposure to endemic coronaviruses, common in young children, may protect against…
Post-acute sequelae of SARS-CoV-2 infection (PASC) in adult KPNC members
This study will establish a cohort of adult KPNC members with prior SARS-CoV-2 infection and identify those with a confirmed…
Do health and health care indicators differ by preferred language in Latinx and Chinese Adults? A health and health care disparities study.
Limited English proficiency may be an important social determinant of health and health care access. This study will use electronic…
The Kaiser Permanente Northern California Advance Alert Monitor Program: An Automated Early Warning System for Adults at Risk for In-Hospital Clinical Deterioration
In-hospital deterioration among ward patients is associated with substantially increased adverse outcome rates. In 2013 Kaiser Permanente Northern California (KPNC)…
Associations Between Different Self-reported Social Risks and Neighborhood-level Resources in Medicaid Patients
Adverse social conditions are a key contributor to health disparities. Improved understanding of how social risk factors interact with each…
Impact of cannabidiol-rich hemp extract oil on reconsolidation disruption of naturalistic interoceptive aversive memory in humans: Protocol for a randomized clinical trial
Preclinical experiments with rodents demonstrate that cannabidiol (CBD), the non-psychotomimetic constituent of the Cannabis sativa plant, disrupts reconsolidation of aversive…
Temporal Trends in Antimicrobial Prescribing During Hospitalization for Potential Infection and Sepsis
Some experts have cautioned that national and health system emphasis on rapid administration of antimicrobials for sepsis may increase overall…
Adults hospitalized with breakthrough COVID-19 have lower mortality than matched unvaccinated adults
Coronavirus disease 2019 (COVID-19) breakthrough infections are common. Evaluate in-hospital mortality of patients with COVID-19 by vaccination status using retrospective…
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial
Patients with gestational diabetes mellitus and from racial/ethnic minority groups face disproportionate risk for type 2 diabetes. Lifestyle interventions, if…
New complementary perspectives for inpatient physical function assessment: matched clinician-report and patient-report short form measures from the PROMIS adult physical function item bank
To develop two item content-matched, precise, score-level targeted inpatient physical function (PF) short form (SF) measures: one clinician-reported, one patient-reported.…
Red Blood Cell Transfusion at a Hemoglobin Threshold of Seven g/dL in Critically Ill Patients: A Regression Discontinuity Study
Rationale: In critically ill patients, a hemoglobin transfusion threshold of
Validation of Respiratory Rate-Oxygenation Index in Patients With COVID-19-Related Respiratory Failure
The respiratory rate-oxygenation (ROX) index is a fraction of oxygen saturation, Fio2, and respiratory rate that has been validated to…
Address Changes Are Associated With Unmet Glycemic Targets: Opportunities to Improve Processes and Outcomes of Care Among People With Type 2 Diabetes
Introduction The objective of this study was to identify and operationalize measures of potential housing insecurity within existing electronic health…
Detection and Mitigation of Algorithmic Bias in Predictive Models of Suicide Risk
This project will assess the potential impact of algorithmic bias on the allocation of preventive care for suicide and compare…
Predictive modeling of adverse mental health outcomes following acute hospitalizations for serious illness: A machine learning approach with natural language processing
This study addresses predicting risk of post-traumatic stress disorder and other mental health conditions following hospitalization for life-threatening conditions. We…
Opioid safety initiative associated with decreased emergency department opioid prescribing
The opioid abuse epidemic has focused attention on efforts to decrease opioid prescribing. Although education and feedback interventions are potential…
Psychosocial and diabetes risk factors among racially/ethnically diverse adults with prediabetes
Psychosocial factors such as self-efficacy may be important in helping high-risk adults prevent diabetes. We aimed to describe psychosocial and…
Risk adjusted 30-day mortality and serious adverse event rates among a large, multi-center cohort of emergency department patients with acute heart failure
Admission rates for emergency department (ED) patients with acute heart failure (AHF) remain elevated. Use of a risk stratification tool…
Higher intensity of 72-hour non-invasive cardiac test referral does not improve short-term outcomes among emergency department patients with chest pain
It is unclear whether referral for cardiac noninvasive testing (NIT) following emergency department (ED) chest pain encounters improves short-term outcomes.…
Exploratory analysis of novel electronic health record variables for quantification of healthcare delivery strain, prediction of mortality, and prediction of imminent discharge
To explore the relationship between novel, time-varying predictors for healthcare delivery strain (eg, counts of patient orders per hour) and…
Sustainability of a Clinical Decision Support Intervention for Outpatient Care for Emergency Department Patients With Acute Pulmonary Embolism
Physicians commonly hospitalize patients presenting to the emergency department (ED) with acute pulmonary embolism (PE), despite eligibility for safe outpatient…
Association Between High-Deductible Health Plans and Engagement in Routine Medical Care for Type 2 Diabetes in a Privately Insured Population: A Propensity Score-Matched Study
High-deductible health plans (HDHPs) are increasingly more common but can be challenging for patients to navigate and may negatively affect…
Comparison of Electronic Frailty Metrics for Prediction of Adverse Outcomes of Abdominal Surgery
Electronic frailty metrics have been developed for automated frailty assessment and include the Hospital Frailty Risk Score (HFRS), the Electronic…
Perinatal Complications in Individuals in California With or Without SARS-CoV-2 Infection During Pregnancy
Additional research from population-based studies is needed to inform the treatment of SARS-CoV-2 infection during pregnancy and to provide health…
Continuous Glucose Monitor Use Prevents Glycemic Deterioration in Insulin-Treated Patients with Type 2 Diabetes
Continuous glucose monitoring (CGM) is indicated in poorly controlled insulin-treated patients with type 2 diabetes (T2D) to improve glycemic control…
Video Telehealth Access and Changes in HbA1c Among People With Diabetes
Video telehealth can offer people convenient, real-time access to clinicians without arranging transportation or time off work. Among people with…
Association of Low-Density Lipoprotein Testing after an Atherosclerotic Cardiovascular Event with Subsequent Statin Adherence and Intensification
This study aimed to evaluate associations between outpatient low-density lipoprotein cholesterol (LDL-C) testing and subsequent statin adherence and intensification in…
Evaluation of Incident 7-Day Infection and Sepsis Hospitalizations in an Integrated Health System
Rationale: Prehospital opportunities to predict infection and sepsis hospitalization may exist, but little is known about their incidence following common…
Prospective evaluation of social risks, physical function, and cognitive function in prediction of non-elective rehospitalization and post-discharge mortality
Increasing evidence suggests that social factors and problems with physical and cognitive function may contribute to patients' rehospitalization risk. Understanding…
Social Risk Screening and Social Risk Prediction: Research Consultation and Planning
Kaiser Permanente has set a national goal to increase social health screening among members. Dr. Grant and his DOR Complex…
A Social Needs Network for Evaluation and Translation (SONNET): Addressing the Social, Economic and Behavioral Needs of Kaiser Permanente Members
Social Needs Network for Evaluation and Translation (SONNET) is a national network of applied researchers who help design, evaluate, and…
Economic analysis of automated insulin delivery (AID) systems
Our aim is to determine if automated insulin delivery (AID) systems provide good value compared with standard insulin delivery. We…
Association of standardized radiology reporting and management of abdominal CT and MRI with diagnosis of pancreatic cancer
Follow-up of abdominal computed tomography (CT) and magnetic resonance imaging (MRI) findings suspicious for pancreatic cancer may be delayed if…
Developing a shared sepsis data infrastructure: a systematic review and concept map to FHIR
The development of a shared data infrastructure across health systems could improve research, clinical care, and health policy across a…
Prognostic Accuracy of Presepsis and Intrasepsis Characteristics for Prediction of Cardiovascular Events After a Sepsis Hospitalization
Sepsis survivors face increased risk for cardiovascular complications; however, the contribution of intrasepsis events to cardiovascular risk profiles is unclear.…
Evaluation of Outcomes Following Hospital-Wide Implementation of a Subcutaneous Insulin Protocol for Diabetic Ketoacidosis
Standard diabetic ketoacidosis care in the US includes intravenous insulin treatment in the intensive care unit. Subcutaneous (SQ) insulin could…
Accounting for Social Risk Does not Eliminate Race/Ethnic Disparities in COVID-19 Infection Among Insured Adults: a Cohort Study
Communities of color have been disproportionately impacted by the COVID-19 epidemic in the USA. To examine the relationship of self-reported…
Primary care telemedicine during the COVID-19 pandemic: patient’s choice of video versus telephone visit
The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated…
Differences in Health Characteristics of Geographic Subgroups of Arab Americans in a Northern California Health Plan
Arab Americans are a diverse ethnic group originating from a large geographic area in the Middle East and North Africa…
All in the Family: A Qualitative Study of the Early Experiences of Adults with Younger Onset Type 2 Diabetes
Adults with type 2 diabetes diagnosed at a younger age are at increased risk for poor outcomes. We examined life…
Future of Teleoncology: Trends and Disparities in Telehealth and Secure Message Utilization in the COVID-19 Era
The COVID-19 pandemic created an imperative to re-examine the role of telehealth in oncology. We studied trends and disparities in…
Comparison of cognitive function in older adults with type 1 diabetes, type 2 diabetes, and no diabetes: results from the Study of Longevity in Diabetes (SOLID)
The incidence of both type 1 diabetes (T1D) and type 2 diabetes (T2D) is increasing. Life expectancy is improving in…
Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality
The Patient Protection and Affordable Care Act eliminated cost sharing for preventive services, including colorectal cancer screening for individuals aged…
Association of Intensive Care Unit Admission and Outcomes in Sepsis and Acute Respiratory Failure
Rationale: Many decisions to admit patients to the ICU are not grounded in evidence regarding who benefits from such triage,…
Patient Experience and Satisfaction with Immediate Sequential and Delayed Sequential Bilateral Cataract Surgery
In bilaterally pseudophakic patients who received immediate or delayed sequential bilateral cataract surgery (ISBCS or DSBCS), we sought to determine…
Evaluation of Risk-Based Predictive Models to Inform the Efficiency of Perioperative Systems
We previously developed an automated electronic health record-based risk stratification tool, called the Comorbidity Assessment and Surgical Triage (CAST) score,…
Turning back the clock on sepsis: Defining the epidemiology and opportunities of pre-sepsis
We intend to determine the epidemiology of pre-sepsis, including ambulatory and prehospital care settings, to identify modifiable care delays, opportunities…
Quantifying Racial/ethnic Differences in the Relationship Between Glucose Concentrations and Hemoglobin A1c
Physicians rely on hemoglobin A1c (A1C), an integrated measure of glycemia (blood glucose), to make treatment decisions for patients with…
Comparative effectiveness of intermittently scanned continuous glucose monitors among patients with basal-bolus insulin-treated type 2 diabetes
This study will characterize patients selected by their providers for intermittently-scanned, continuous glucose monitor (isCGM) initiation and estimate the effect…
Social Risk Prediction Working Group
Our DOR Complex Care Team is working with Dr. Anand Shah and his team in a consultative role to address…
Tailoring initial type 2 diabetes care to meet the needs of younger Latinx adults: A randomized pilot study
Our goal is to evaluate the effectiveness of a proactive, tailored care intervention in improving early outcomes for Latinx individuals…
Outcomes After Implementation of a Benzodiazepine-Sparing Alcohol Withdrawal Order Set in an Integrated Health Care System
Alcohol withdrawal syndrome (AWS) is a common inpatient diagnosis managed primarily with benzodiazepines. Concerns about the adverse effects associated with…
Connecting Research and Practice: Implementation of Suicide Prevention Strategies in Learning Health Care Systems
The health care systems affiliated with the Mental Health Research Network strive to be learning health care systems that identify…
Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities
Cardiovascular disease (CVD) continues to be a leading cause of morbidity in the U.S. Managing CVD risk factors, such as…
Did the 2015 USPSTF Abnormal Blood Glucose Recommendations Change Clinician Attitudes or Behaviors? A Mixed-Method Assessment
In 2015, the US Preventive Services Task Force (USPSTF) revised clinical recommendations to more broadly recommend abnormal blood glucose screening…
Oral Health Care: A Missing Pillar of Total Health Care?
Oral health is an important component of overall health, and preventive dental care is essential for maintaining good oral health.…
Hospital-specific Template Matching for Benchmarking Performance in a Diverse Multihospital System
Hospital-specific template matching is a newer method of hospital performance measurement that may be fairer than regression-based benchmarking. However, it…
Prior Immunosuppressive Therapy and Severe Illness Among Patients Diagnosed with SARS-CoV-2: a Community-Based Study
An estimated 10 million people in the USA are immunocompromised, a risk factor for severe COVID-19. Data informing whether immune-mediated…
Volume Matters: Longitudinal Retrospective Cohort Study of Outcomes Following Consultation and Standardization of Adrenal Surgery
Subspecialization of adrenal surgery through regionalization has not been adequately evaluated. We assessed implementation of subspecialization and the association of regionalization with adrenalectomy outcomes in a community-based setting.…
Weight Outcomes of Sleeve Gastrectomy and Gastric Bypass Compared to Nonsurgical Treatment
To investigate weight trajectories among patients with severe obesity undergoing sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and nonsurgical treatment.…
Computed Tomography Use in Children With Minor Head Trauma Presenting to 21 Community Emergency Departments Within an Integrated Health-Care System
Decreasing unnecessary cranial computed tomography (CT) use in pediatric head trauma patients remains important for emergency departments (EDs) across the…
Graded Coronary Risk Stratification for Emergency Department Patients With Chest Pain: A Controlled Cohort Study
Background Resource utilization among emergency department (ED) patients with possible coronary chest pain is highly variable. Methods and Results Controlled…
Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR)
The Diabetes Research for Equity through Advanced Multilevel Science Center for Diabetes Translational Research(DREAMS-CDTR) supports diabetes translational research through mentoring…
Barriers and Facilitators to TracFone/CareLink Implementation in Two Kaiser Permanente Regions
This study will evaluate TracFone/CareLink program within Kaiser Permanente (KP) Digital Health Equity portfolio. It will involve engaging local leaders,…
Tailoring care to meet the needs of younger Latinx adults with newly diagnosed type 2 diabetes
We will evaluate a culturally responsive community health worker (CHW) intervention targeting younger-onset Latinx individuals with a new type 2…
Women’s Multi-Ethnic Health and Lifestyle Survey
We propose to survey White, Black, Latina, Filipina, Chinese, South Asian, Vietnamese, and Japanese women aged 35-79 to characterize and…
A Pragmatic Randomized Controlled Trial of a Bundled, Pharmacist-Led Hyperpolypharmacy Deprescribing Intervention
This randomized controlled trial study is testing an intervention to reduce unsafe medication use in patients aged 75 years and…
Does NAFLD Mediate the Relationship Between Obesity and Type 2 Diabetes Risk? Evidence from the Multi-Ethnic Study of Atherosclerosis (MESA)
To estimate the effect of obesity on type 2 diabetes (T2DM) risk and evaluate to what extent non-alcoholic fatty liver…
Attitudes and Perceptions of Multidisciplinary Cancer Care Clinicians Toward Telehealth and Secure Messages
Telehealth use including secure messages has rapidly expanded since the COVID-19 pandemic, including for multidisciplinary aspects of cancer care. Recent…
Treatment and Follow-up Care Associated With Patient-Scheduled Primary Care Telemedicine and In-Person Visits in a Large Integrated Health System
Telemedicine visits can offer patients convenient access to a clinician, but it is unclear whether treatment differs from that with…
Clinical Outcomes Following Regionalization of Gastric Cancer Care in a US Integrated Health Care System
In 2016, Kaiser Permanente Northern California regionalized gastric cancer care, introducing a regional comprehensive multidisciplinary care team, standardizing staging and…
Aligning care with the personal values of patients with complex care needs
To identify opportunities to align care with the personal values of patients from three distinct groups with complex medical, behavioral,…
Adjusting for selection bias due to missing data in electronic health records-based research
While electronic health records data provide unique opportunities for research, numerous methodological issues must be considered. Among these, selection bias…
Algorithmic prognostication in critical care: a promising but unproven technology for supporting difficult decisions
Patients, surrogate decision makers, and clinicians face weighty and urgent decisions under uncertainty in the ICU, which could be aided…
Ultrasound characteristics of early stage high-grade serous ovarian cancer
Survival from ovarian cancer is strongly dependent on the stage at diagnosis. Therefore, when confronted with a woman with an…
Outcomes following interventions to sustain body weight in esophageal cancer patients starting preoperative therapy: a retrospective cohort study
To improve nutritional status and dysphagia, esophageal cancer patients starting neoadjuvant therapy in advance of curative-intent surgery may receive a…
Association of Cardiovascular Outcomes and Mortality With Sustained Long-Acting Insulin Only vs Long-Acting Plus Short-Acting Insulin Treatment
Cardiovascular events and mortality are the principal causes of excess mortality and health care costs for people with type 2…
Temporal Trends and Hospital Variation in Time-to-Antibiotics Among Veterans Hospitalized With Sepsis
It is unclear whether antimicrobial timing for sepsis has changed outside of performance incentive initiatives. To examine temporal trends and…
Association Between Troponin I Levels During Sepsis and Post-Sepsis Cardiovascular Complications
Rationale: Sepsis commonly results in elevated serum troponin levels and increased risk for postsepsis cardiovascular complications; however, the association between…
Reducing Readmissions for Chronic Obstructive Pulmonary Disease in Response to the Hospital Readmissions Reduction Program
Rationale: In August 2013, the Hospital Readmission Reduction Program announced financial penalties on hospitals with higher than expected risk-adjusted 30-day…
Validation of Postpartum Hemorrhage Admission Risk Factor Stratification in a Large Obstetrics Population
This study aimed to evaluate the performance of the California Maternal Quality Care Collaborative (CMQCC) admission risk criteria for stratifying…
Examining the Relationship Between the Lean Management System and Quality Improvement Care Management Processes.
BACKGROUND AND OBJECTIVES: The United States has an underperforming health care system on both cost and quality criteria in comparison…
Exploratory and Confirmatory Bayesian Networks Identify the Central Role of Non-judging in Symptoms of Depression.
OBJECTIVES: Depression is a highly heterogeneous disorder, and meta-analyses of mindfulness-based interventions show moderate efficacy for reducing depressive symptoms. However,…
Reduction in Long-term Mortality after Sleeve Gastrectomy and Gastric Bypass Compared to Non-surgical Patients with Severe Obesity
To separately compare the long-term risk of mortality among bariatric surgical patients undergoing either RYGB or SG to large, matched,…
Evaluation of an intervention targeted with predictive analytics to prevent readmissions in an integrated health system: observational study
To determine the associations between a care coordination intervention (the Transitions Program) targeted to patients after hospital discharge and 30…
Distinct trajectories of depression symptoms in early and middle adolescence: Preliminary evidence from longitudinal network analysis.
Adolescent depression is a clinically relevant concern that has major implications for mental and physical health. The trajectory of depressive…
Evaluation of Vaccination Strategies to Compare Efficient and Equitable Vaccine Allocation by Race and Ethnicity Across Time
Identifying the most efficient COVID-19 vaccine allocation strategy may substantially reduce hospitalizations and save lives while ensuring an equitable vaccine…
Clinical characteristics of COVID-19 patients evaluated in the emergency department: A retrospective cohort study of 801 cases
Coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has extracted devastating tolls. Despite…
Race/ethnicity moderates associations between depressive symptoms and diet composition among U.S. adults
Although depression is associated with poorer overall diet quality, few studies have examined its association with levels of particular macronutrients,…
Epidemiologic Analysis of Chilblains Cohorts Before and During the COVID-19 Pandemic
Beginning in March 2020, case reports and case series linked the COVID-19 pandemic with an increased occurrence of chilblains, but…
Pediatric Surgeons’ Adoption of an Innovative Laparoscopic Technique for Inguinal Hernia Repair: A Mixed Methods Study
Purpose: We studied adoption of an innovative laparoscopic technique for pediatric inguinal hernia repair by pediatric surgeons and pediatric urologists…
Outcomes among acute heart failure emergency department patients by preserved vs. reduced ejection fraction
This study aimed to assess short-term outcomes among emergency department (ED) patients with acute heart failure (AHF) by preserved (≥50%)…
The Delivery Science Targeted Analysis Program: A Partnership between the Division of Research and The Permanente Medical Group-Project 3
The Delivery Science Rapid Analysis Program will create a mechanism to solicit, prioritize, and address rapidly researchable analytic questions with…
Using predictive analytics to tailor care for patients with newly diagnosed type 2 diabetes
In a population of adults newly diagnosed with type 2 diabetes (T2D) from 2010-2015 and followed for 5 years this…
Reducing Variation in Hospitalization and Processes of Care in Emergency Department Patients with Atrial Fibrillation: A Stepped Wedge Cluster Randomized Trial
This stepped-wedge cluster randomized trial will stagger implementation of a clinical decision support system (CDSS) across 13 KPNC emergency departments…
Standardized ultrasound-based risk stratification for detection of ovarian cancer
This project, initiated in 2014, led to the development and large-scale implementation of a system for risk stratifying ovarian abnormalities…
Implementation of large-scale HPV self-testing for cervical cancer screening
The goal of this project is to determine the best strategy for integrating a home-testing option for cervical cancer screening.…
COVID-19: Antecedents to Hospitalization and Deterioration
This study will characterize and compare antecedents to hospitalization and in-hospital deterioration among patients with COVID-19 and comparator patients with…
Development of a healthcare system COVID Hotspotting Score in California: an observational study with prospective validation
To examine the value of health systems data as indicators of emerging COVID-19 activity. Observational study of health system indicators…
Singular and combined effects of transcranial infrared laser stimulation and exposure therapy on pathological fear: a randomized clinical trial.
BACKGROUND: Preclinical findings suggest that transcranial infrared laser stimulation (TILS) improves fear extinction learning and cognitive function by enhancing prefrontal…
Equitably Allocating Resources During Crises: Racial Differences in Mortality Prediction Models
Rationale: Crisis standards of care (CSCs) guide critical care resource allocation during crises. Most recommend ranking patients on the basis…
Linking racism and homonegativity to healthcare system distrust among young men of color who have sex with men: Evidence from the Healthy Young Men’s (HYM) study
Experiences with racism predict healthcare system distrust among people of color, but Black and Latino young men who have sex…
Retrospective Cohort Study Comparing Infliximab-dyyb and Infliximab in Biologic-Naive Patients With Inflammatory Bowel Disease in the United States
Real-world assessments of biosimilars are needed to understand their effectiveness and safety in practice settings that may differ from those…
The Role of Community-Based Organizations in Improving Chronic Care for Safety-Net Populations
Social determinants of health (SDoH) influence health outcomes and contribute to disparities in chronic disease in vulnerable populations. To inform…
Endophthalmitis prophylaxis failures in patients injected with intracameral antibiotic during cataract surgery
To estimate the association of cefuroxime and moxifloxacin in relation to the occurrence of endophthalmitis following phacoemulsification cataract surgery. Retrospective…
Developing and Testing Automatic Models of Patient Communicative Health Literacy Using Linguistic Features: Findings from the ECLIPPSE study
Patients with diabetes and limited health literacy (HL) may have suboptimal communication exchange with their health care providers and be…
Racial/ethnic, gender, and age group differences in cardiometabolic risks among adults in a Northern California health plan: a cross-sectional study
In the U.S., the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than…
Community-based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial.
BACKGROUND AND AIMS: People with anxiety disorders are more likely to smoke and less likely to succeed when they try…
Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study
The substantial expansion of secure messaging (SM) via the patient portal in the last decade suggests that it is becoming…
Association of Real-time Continuous Glucose Monitoring With Glycemic Control and Acute Metabolic Events Among Patients With Insulin-Treated Diabetes
Continuous glucose monitoring (CGM) is recommended for patients with type 1 diabetes; observational evidence for CGM in patients with insulin-treated…
Understanding differences within ethnic group designation: comparing risk factors and health indicators between Iranian and Arab Americans in Northern California
The Middle Eastern and North African (MENA) ethnic group is a diverse group composed of two primary subsets in the…
Association of Type 1 Diabetes and Hypoglycemic and Hyperglycemic Events and Risk of Dementia
To determine whether severe hypoglycemic and hyperglycemic events are associated with longitudinal dementia risk in older adults with type 1…
Association of Positive Fluid Balance at Discharge After Sepsis Management With 30-Day Readmission
Although early fluid administration has been shown to lower sepsis mortality, positive fluid balance has been associated with adverse outcomes.…
Racial Disparities in COVID-19 Testing and Outcomes : Retrospective Cohort Study in an Integrated Health System
Racial disparities exist in outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To evaluate the contribution of race/ethnicity…
Disclosure of New Type 2 Diabetes Diagnoses to Younger Adults: a Qualitative Study
Adults diagnosed with type 2 diabetes at a younger age are at increased risk for poor outcomes. Yet, little is…
Three Learning Organizations in Cataract Surgery: The Example of Intracameral Antibiotic Injection
The recent systematic adoption of intracameral antibiotic injection during cataract surgery in Sweden, India, and the US serves as a…
Effectiveness and safety of treatments for hospitalized patients with COVID-19
Examine the safety and effectiveness of current treatments for hospitalized patients with COVID-19 and identify patient characteristics and time periods…
Validity of a Computational Linguistics-Derived Automated Health Literacy Measure Across Race/Ethnicity: Findings from The ECLIPPSE Project
Limited health literacy (HL) partially mediates health disparities. Measurement constraints, including lack of validity assessment across racial/ethnic groups and administration…
Regionalization of Acute Myeloid Leukemia Treatment in a Community-Based Population: Implementation and Early Results
Regionalization of care for acute myeloid leukemia (AML) has not been described for community-based settings. In 2015, we shifted AML…
Visit Content Analysis: Doctor-Patient Communication in Patients with Type 2 Diabetes
The primary care visit is an important opportunity to discuss and modify diabetes management. To gain insight into doctor-patient communication…
Nonstationary Multivariate Gaussian Processes for Electronic Health Records
Advances in the modeling and analysis of electronic health records (EHR) have the potential to improve patient risk stratification, leading…
Sepsis Subclasses: A Framework for Development and Interpretation
Sepsis is defined as a dysregulated host response to infection that leads to life-threatening acute organ dysfunction. It afflicts approximately…
Investigating Bias from Missing Data in an Electronic Health Records-Based Study of Weight Loss After Bariatric Surgery
Missing data is common in electronic health records (EHR)-based obesity research. To avoid bias, it is critical to understand mechanisms…
Physician Stress During Electronic Health Record Inbox Work: In Situ Measurement With Wearable Sensors
Increased work through electronic health record (EHR) messaging is frequently cited as a factor of physician burnout. However, studies to…
Physicians’ electronic inbox work patterns and factors associated with high inbox work duration
Electronic health record systems are increasingly used to send messages to physicians, but research on physicians' inbox use patterns is…
Influence of patient immigrant status on physician trainee diabetes treatment decisions: a virtual patient experimental study
To determine the effect of patient immigrant status on physician trainees' diabetes treatment decisions. Participants were 140 physician trainees ('providers').…
Prospective Validation and Comparative Analysis of Coronary Risk Stratification Strategies Among Emergency Department Patients With Chest Pain
Background Coronary risk stratification is recommended for emergency department patients with chest pain. Many protocols are designed as "rule-out" binary…
Acute Kidney Injury After CT in Emergency Patients with Chronic Kidney Disease: A Propensity Score-matched Analysis
Acute kidney injury (AKI) after intravenous contrast administration for computed tomography (CT) occurs infrequently, but certain patients may be susceptible.…
Measurement of Sepsis in a National Cohort Using Three Different Methods to Define Baseline Organ Function
Rationale: In 2017, the U.S. Centers for Disease Control and Prevention (CDC) developed a new surveillance definition of sepsis, the…
Five-year Longitudinal Cohort Study of Reinterventions After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
To compare the long-term risks of reintervention following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in a large surgical…
Smoking cessation treatment for individuals with comorbid diabetes and serious mental illness in an integrated health care delivery system
Smoking is a significant modifiable risk factor for mortality for persons with serious mental illness (SMI), who have a life…
The Presentation, Pace, and Profile of Infection and Sepsis Patients Hospitalized Through the Emergency Department: An Exploratory Analysis
To characterize the signs and symptoms of sepsis, compare them with those from simple infection and other emergent conditions and…
Characteristics and Outcomes of Clinic Visits Immediately Preceding Sepsis Hospitalization
Existing sepsis quality improvement initiatives focus on recognition and treatment of sepsis upon hospital admission. Yet many patients are evaluated…
SARS-CoV-2 Clinical Outcomes in Patients with Cancer in a Large Integrated Health Care System in Northern California
The SARS-CoV-2 (COVID-19) pandemic continues to affect many lives globally. Patients with cancer undergoing potentially immunosuppressive therapies appear to be…
Preventing COPD readmissions under the Hospital Readmissions Reduction Program: How far have we come?
The Hospital Readmissions Reduction Program (HRRP) was developed and implemented by the Centers for Medicare & Medicaid Services to curb…
Building an Evidence Case for Capturing Educational Attainment in the EHR as a Social Determinant of Health
Educational attainment is an important social determinant of health, but it is not included in the electronic health records of…
Tools for Outpatient and Population Management of SARS-COV-2 Infection (TOPS2)
This project aims to improve The Permanente Medical Group's capability for outpatient and population management of adults with COVID-19. It…
Predictors of Acute Atrial Fibrillation and Flutter Hospitalization across 7 U.S. Emergency Departments: A Prospective Study
International rates of hospitalization for atrial fibrillation and flutter (AFF) from the emergency department (ED) vary widely without clear evidence…
Implementation of a Multidisciplinary Expert Testicular Cancer Tumor Board Across a Large Integrated Healthcare Delivery System Via Early Case Ascertainment
In 2016, Kaiser Permanente Northern California began regionalizing testicular cancer care using population-based tumor board review. This mixed methods evaluation…
Use of Machine Learning to Develop a Risk-Stratification Tool for Emergency Department Patients With Acute Heart Failure
We use variables from a recently derived acute heart failure risk-stratification rule (STRATIFY) as a basis to develop and optimize…
Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study
To develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing. With…
Predicting Non-Alcoholic Fatty Liver Disease for Adults Using Practical Clinical Measures: Evidence from the Multi-ethnic Study of Atherosclerosis.
BACKGROUND: Many adults have risk factors for non-alcoholic fatty liver disease (NAFLD). Screening all adults with risk factors for NAFLD…
Evaluation of Attention Switching and Duration of Electronic Inbox Work Among Primary Care Physicians
Primary care physicians (PCPs) report multitasking during workdays while processing electronic inbox messages, but scant systematic information exists on attention…
Frustrative nonreward and cannabinoid receptors: Chronic (but not acute) WIN 55,212-2 treatment increased resistance to change in two reward downshift tasks.
Assessing the role of cannabinoid (CB) receptors in behavior is relevant given the trend toward the legalization of medicinal and…
Development and Validation of an Obstetric Comorbidity Risk Score for Clinical Use
Background: A comorbidity summary score may support early and systematic identification of women at high risk for adverse obstetric outcomes.…
Health Risks and Chronic Health Conditions among Arab American and White Adults in Northern California
To characterize the prevalence of chronic cardiovascular conditions and risk factors among Arab American adults stratified by sex and compare…
Challenges and solutions to employing natural language processing and machine learning to measure patients’ health literacy and physician writing complexity: The ECLIPPSE study
In the National Library of Medicine funded ECLIPPSE Project (Employing Computational Linguistics to Improve Patient-Provider Secure Emails exchange), we attempted…
A Randomized Encouragement Trial to Increase Mail Order Pharmacy Use and Medication Adherence in Patients with Diabetes
Mail order pharmacy (MOP) use has been linked to improved medication adherence and health outcomes among patients with diabetes. However,…
Outpatient Mastectomy: Factors Influencing Patient Selection and Predictors of Return to Care
After implementation of the Surgical Home Recovery (SHR) initiative for mastectomy within a large, integrated health delivery system, most patients…
Use of Latent Class Analysis and k-Means Clustering to Identify Complex Patient Profiles
Medically complex patients are a heterogeneous group that contribute to a substantial proportion of health care costs. Coordinated efforts to…
Predicting preventable hospital readmissions with causal machine learning
To assess both the feasibility and potential impact of predicting preventable hospital readmissions using causal machine learning applied to data…
60-day major adverse cardiac events in emergency department patients with non-low modified HEART scores
A low (0-3) History, Electrocardiogram, Age, Risk factors and Troponin (HEART) score reliably identifies ED chest pain patients who are…
Automated Identification of Adults at Risk for In-Hospital Clinical Deterioration
Hospitalized adults whose condition deteriorates while they are in wards (outside the intensive care unit [ICU]) have considerable morbidity and…
Expanding Post-discharge Readmission Metrics in Patients with Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a common and costly reason for hospitalization and rehospitalization. The Hospital Readmissions Reduction Program…
Association of a Novel Index of Hospital Capacity Strain with Admission to Intensive Care Units
Rationale: Prior approaches to measuring healthcare capacity strain have been constrained by using individual care units, limited metrics of strain,…
Clinical Trial of Expanded Advance Care Planning to Address Regimen Intensity in Older Patients at High Risk for Treatment-Induced Hypoglycemia
The goal of this study is to apply the patient-centered advance care planning paradigm of values elicitation and decision-making and…
Smoking cessation treatment for individuals with comorbid diabetes and serious mental illness in an integrated health care delivery system
Smoking is a significant modifiable risk factor for mortality for persons with serious mental illness (SMI), who have a life…
Network analysis reveals the associations of past quit experiences on current smoking behavior and motivation to quit.
INTRODUCTION: Smoking is a leading cause of morbidity and mortality in the United States. While most smokers endorse a desire…
The impact of prior and ongoing threat on the false alarm threshold for facial discrimination.
BACKGROUND AND OBJECTIVES: Perceptual adaptations that facilitate rapid responses to threats can also lead to false alarms, or the failure…
Inpatient-outpatient shared electronic health records: telemedicine and laboratory follow-up after hospital discharge
Continuity of patient information across settings can improve transitions after hospital discharge, but outpatient clinicians often have limited access to…
Assessment of Value of Neighborhood Socioeconomic Status in Models That Use Electronic Health Record Data to Predict Health Care Use Rates and Mortality
Prediction models are widely used in health care as a way of risk stratifying populations for targeted intervention. Most risk…
Automated retrospective calculation of the EDACS and HEART scores in a multicenter prospective cohort of emergency department chest pain patients
Coronary risk scores are commonly applied to emergency department patients with undifferentiated chest pain. Two prominent risk score-based protocols are…
Evaluation of automated computed tomography segmentation to assess body composition and mortality associations in cancer patients
Body composition from computed tomography (CT) scans is associated with cancer outcomes including surgical complications, chemotoxicity, and survival. Most studies…
Examining if the relationship between BMI and incident type 2 diabetes among middle-older aged adults varies by race/ethnicity: evidence from the Multi-Ethnic Study of Atherosclerosis (MESA).
AIMS: Disparities persist on the prevalence of undiagnosed type 2 diabetes in racial/ethnic minorities in the USA. This study evaluated…
Associations of CYP2C9 and CYP2C19 pharmacogenetic variation with phenytoin-induced cutaneous adverse drug reactions
The role of cytochrome P450 (CYP)2C9 and CYP2C19 genetic variation in risk for phenytoin-induced cutaneous adverse drug events is not…
Diagnostic Performance of Emergency Physician Gestalt for Predicting Acute Appendicitis in Patients Age 5 to 20 Years
Pediatric appendicitis remains a challenging diagnosis in the emergency department (ED). Available risk prediction algorithms may contribute to excessive ED…
Patient experiences with Value-Based Insurance Designs (VBID) in Kaiser Permanente: Plan Knowledge and Medication Behavior
The study will examine patient knowledge and experience in a Value-based insurance designs plan by surveying 1,000 patients newly enrolling…
Age- and race/ethnic-based disparities in diabetes outcomes among younger adults with newly diagnosed Type 2 Diabetes
This study will conduct focus groups with KPNC members (age 45) with newly diagnosed Type 2 diabetes to learn about…
Prevalence of Social Risks and Association of Social Risks with Health and Well-Being Among Non-Safety Net Middle-Aged and Older Adult Members in Kaiser Permanente Northern California
This study will gather data to estimate the prevalence of several different social and financial risk factors among adults aged…
Diagnostic Reclassification by a High-Sensitivity Cardiac Troponin Assay.
STUDY OBJECTIVE: Our objective is to describe the rates of diagnostic reclassification between conventional cardiac troponin I (cTnI) and high-sensitivity…
Study protocol: Using peer support to aid in prevention and treatment in prediabetes (UPSTART)
There is an urgent need to develop and evaluate effective and scalable interventions to prevent or delay the onset of…
A Transparent and Adaptable Method to Extract Colonoscopy and Pathology Data Using Natural Language Processing
Key variables recorded as text in colonoscopy and pathology reports have been extracted using natural language processing (NLP) tools that…
Impact of the COVID Pandemic on KP Members with Complex Medical and Social Needs
The COVID epidemic has exposed the fragility of the social network that supports our most complex and vulnerable members. We…
Hospitalization is less common in ambulatory patients with acute pulmonary embolism diagnosed before emergency department referral than after arrival
Emergency department (ED) patients with acute pulmonary embolism (PE) may undergo diagnostic pulmonary imaging as an outpatient before referral to…
Can Patient-Provider Interpersonal Interventions Achieve the Quadruple Aim of Healthcare? A Systematic Review.
BACKGROUND: Human connection is at the heart of medical care, but questions remain as to the effectiveness of interpersonal interventions.…
Design of a cluster-randomized trial of the effectiveness and cost-effectiveness of metformin on prevention of type 2 diabetes among prediabetic Mexican adults (the PRuDENTE initiative of Mexico City).
INTRODUCTION: Type 2 diabetes (T2D) is a global epidemic, and nations are struggling to implement effective healthcare strategies to reduce…
Developing a template matching algorithm for benchmarking hospital performance in a diverse, integrated healthcare system
Template matching is a proposed approach for hospital benchmarking, which measures performance based on matching a subset of comparable patient…
Differences in Diet Quality among Multiple US Racial/Ethnic Groups from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA).
BACKGROUND: Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known…
Dose Timing of D-Cycloserine to Augment Exposure Therapy for Social Anxiety Disorder: A Randomized Clinical Trial.
Importance: Findings suggest that the efficacy of D-cycloserine (DCS) for enhancing exposure therapy may be strongest when administered after sessions…
Behavioural and psychosocial factors associated with 5-year weight trajectories within the PORTAL Overweight/Obesity Cohort
The purpose of this study was to model weight trajectories over a 5-year time period (2012-2016) and their association with…
Patient Characteristics Associated With Choosing a Telemedicine Visit vs Office Visit With the Same Primary Care Clinicians
Video or telephone telemedicine can offer patients access to a clinician without arranging for transportation or spending time in a…
Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes
Diabetic ketoacidosis (DKA) is a serious complication of diabetes. DKA is associated with poorer cognition in children with type 1…
Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study
To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west…
Complex Patients: DOR Research Team
My team has been working collaboration with The Permanente Medical Group and Kaiser Foundation Health Plan to implement and evaluate…
Reducing Treatment Risk in Older Patients with Diabetes: Comparative Effectiveness of Academic Detailing with and without Pre-Visit Patient Preparation
This pragmatic, randomized clinical trial will compare the effect of primary care physician academic detailing with or without patient pre-visit…
Hospital Alternatives (HALT)
The SRI team will (a) assess results of previous internal and external deployments of alternatives to hospitalization, (b) define strategies…
The Impact of Step-Down Unit Care on Patient Outcomes After ICU Discharge
To examine whether and how step-down unit admission after ICU discharge affects patient outcomes. Retrospective study using an instrumental variable…
Comparison of Early Warning Scoring Systems for Hospitalized Patients With and Without Infection at Risk for In-Hospital Mortality and Transfer to the Intensive Care Unit
Risk scores used in early warning systems exist for general inpatients and patients with suspected infection outside the intensive care…
Racial and Ethnic Disparities in Diabetes Care Quality among Women of Reproductive Age in an Integrated Delivery System
Diabetes is increasingly prevalent among women of reproductive age, yet little is known about quality of diabetes care for this…
Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes
The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a…
Response-to-Treatment for Comorbid Post-Traumatic Stress and Substance Use Disorders: The Value of Combining Person- and Variable-Centered Approaches.
Optimizing treatment for co-occurring post-traumatic stress disorder and substance use disorder (PTSD+SUD) is critically important. Whereas treatments have been designed…
Isradipine enhancement of virtual reality cue exposure for smoking cessation: Rationale and study protocol for a double-blind randomized controlled trial.
Cigarette smoking remains a leading cause of preventable death in the United States, contributing to over 480,000 deaths each year.…
Exploiting nonsystematic covariate monitoring to broaden the scope of evidence about the causal effects of adaptive treatment strategies
In studies based on electronic health records (EHR), the frequency of covariate monitoring can vary by covariate type, across patients,…
Presyncope Is Associated with Intensive Care Unit Admission in Emergency Department Patients with Acute Pulmonary Embolism
Syncope is common among emergency department (ED) patients with acute pulmonary embolism (PE) and indicates a higher acuity and worse…
Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review
The Patient Protection and Affordable Care Act increases healthcare access and includes provisions that directly impact access to and cost…
Red blood cell transfusions for emergency department patients with gastrointestinal bleeding within an integrated health system
To assess trends over time in red blood cell (RBC) transfusion practice among emergency department (ED) patients with gastrointestinal (GI)…
Advancing Evidence Synthesis from Effectiveness to Implementation: Integration of Implementation Measures into Evidence Reviews.
BACKGROUND: In order to close the gap between discoveries that could improve health, and widespread impact on routine health care…
Diabetes and cardiovascular disease mortality among a population-based cohort of women with and without breast cancer.
PURPOSE: We investigated whether the relationship between diabetes and all-cause and CVD-related mortality differed between women with and without breast…
Testing patient-informed approaches for visually depicting the hemoglobin A1c value to patients with poorly controlled diabetes: a randomized, controlled trial
Patients' understanding of the hemoglobin A1c (HbA1c) has been linked to better diabetes care outcomes (glycemic control, self-care). This is…
Assessment of Electronic Health Record Search Patterns and Practices by Practitioners in a Large Integrated Health Care System
The electronic health record (EHR) is a source of practitioner dissatisfaction in part because of challenges with information retrieval. To…
Cytological sampling of fallopian tubes using a hysteroscopic catheter: A multi-center study
To assess the feasibility of a novel hysteroscopic catheter to collect fallopian tube cytologic samples and to correlate cytologic findings…
Educational Program for Physiologic Monitor Use and Alarm Systems Safety: A Toolkit
Clinical alarm systems safety is a national healthcare concern in the United States. Physiologic monitors are the medical devices associated…
Severe Hypoglycemia and Cognitive Function in Older Adults With Type 1 Diabetes: The Study of Longevity in Diabetes (SOLID)
In children with type 1 diabetes (T1D), severe hypoglycemia (SH) is associated with poorer cognition, but the association of SH…
What Do We Do After the Pilot Is Done? Implementation of a Hospital Early Warning System at Scale
Adults who deteriorate outside the ICU have high mortality. Most rapid response systems (RRSs) have employed manual detection processes that…
Association of Mobile Patient Portal Access With Diabetes Medication Adherence and Glycemic Levels Among Adults With Diabetes
Online patient portals support self-management, and mobile devices expand portal access, but whether this translates to improvements in diabetes outcomes…
The Association Between the Supply of Nonpharmacologic Providers, Use of Nonpharmacologic Pain Treatments and High-risk Opioid Prescription Patterns Among Medicare Beneficiaries With Persistent Musculoskeletal Pain
Opioids are prescribed more frequently than nonpharmacologic treatments for persistent musculoskeletal pain (MSP). We estimate the association between the supply…
Pretreatment Posttraumatic Stress Disorder Symptom Network Metrics Predict the Strength of the Association Between Node Change and Network Change During Treatment.
Network analysis has been increasingly applied in an effort to understand complex interactions among symptoms in posttraumatic stress disorder (PTSD).…
Risk of Cardiovascular Events in Statin-Treated Patients with Type 2 Diabetes and Metabolic Dyslipidemia without Prevalent Atherosclerotic Cardiovascular Disease
The relationship between achieved low-density lipoprotein cholesterol (LDL-C) levels and risk of incident atherosclerotic cardiovascular disease events among patients with…
Enhancing panic and smoking reduction treatment with D-Cycloserine: A pilot randomized clinical trial.
In this placebo-controlled randomized clinical trial, we examined the efficacy of 250 mg d-cycloserine (DCS) for enhancing the effects of…
Use of Digital Information Technologies and Health Information Resources by Limited English Proficient Latino and Chinese Adult Members
The goal of this research is to learn about use of digital information technologies (DIT) and the kp.org website and…
Understanding and Informing Early Hospital Antibiotic Prescribing for Potential Infection
The goals of this study are to (1) examine temporal trends in early hospital antibiotic prescribing patterns over the past…
Sepsis on FHIR
Overall goal is to define and refine the current epidemiology, clinical characteristics, and treatment practices in respiratory failure in late…
Comparative Effectiveness of Real-Time Continuous Glucose Monitoring (CGM) Among Insulin-Treated Diabetes Patients from Kaiser Permanente Northern California
This study will characterize type 1 and type 2 diabetes patients initiating newly prescribed continuous glucose monitors and evaluate the…
Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians
The goal of this project is to assist with measure development and testing for the Hospital-Wide Mortality (HWM) hybrid and…
Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter.
IMPORTANCE: Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical…
Goldilocks, the Three Bears and Intensive Care Unit Utilization: Delivering Enough Intensive Care But Not Too Much. A Narrative Review
Professional societies have developed recommendations for patient triage protocols, but wide variations in triage patterns for many acute conditions exist…
Comparison of Mortality and Major Cardiovascular Events Among Adults With Type 2 Diabetes Using Human vs Analogue Insulins
The comparative cardiovascular safety of analogue and human insulins in adults with type 2 diabetes who initiate insulin therapy in…
Predicting the readability of physicians’ secure messages to improve health communication using novel linguistic features: Findings from the ECLIPPSE study
Low literacy skills impact important aspects of communication, including health-related information exchanges. Unsuccessful communication on the part of physician or…
Context is Key: Using the Audit Log to Capture Contextual Factors Affecting Stroke Care Processes
High quality patient care through timely, precise and efficacious management depends not only on the clinical presentation of a patient,…
Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan
Social determinants of health (SDoHs) and social risks (SRs) have been associated with adverse health and healthcare utilization and racial/ethnic…
Association Between Peripheral Blood Oxygen Saturation (SpO2)/Fraction of Inspired Oxygen (FiO2) Ratio Time at Risk and Hospital Mortality in Mechanically Ventilated Patients
Acute respiratory failure requiring mechanical ventilation is a leading cause of mortality in the intensive care unit. Although single peripheral…
Sleep Quality and Cognitive Function in Type 1 Diabetes: Findings From the Study of Longevity in Diabetes (SOLID)
The objective was to examine the association between sleep quality and global and domain-specific cognitive function among older individuals with…
ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.
OBJECTIVES: We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU.DESIGN: Retrospective…
The Hospital Readmissions Reduction Program and Readmissions for Chronic Obstructive Pulmonary Disease, 2006-2015.
RATIONALE: In October 2012, the initial phase of the Hospital Readmission Reduction Program (HRRP) imposed financial penalties on hospitals with…
An Examination of Medical Malpractice Claims Involving Physician Trainees.
PURPOSE: To identify patient-, provider- and claim-related factors of medical malpractice claims in which physician trainees were directly involved in…
Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management
Background Despite the success of current cardiovascular disease (CVD) management programs, many patients do not achieve optimal control of CVD-related…
Primary Care Physicians’ Experiences With and Strategies for Managing Electronic Messages
The increasing use of electronic communications has enhanced access to physicians for patients and clinical staff. Primary care physicians (PCPs)…
Multiyear Rehospitalization Rates and Hospital Outcomes in an Integrated Health Care System
Since the introduction of the rehospitalization rate as a quality measure, multiple changes have taken place in the US health…
Use and Discontinuation of Insulin Treatment Among Adults Aged 75 to 79 Years With Type 2 Diabetes
Among older individuals with type 2 diabetes, those with poor health have greater risk and derive less benefit from tight…
Assessing clinical heterogeneity in sepsis through treatment patterns and machine learning
To use unsupervised topic modeling to evaluate heterogeneity in sepsis treatment patterns contained within granular data of electronic health records.…
The number needed to benefit: estimating the value of predictive analytics in healthcare
Predictive analytics in health care has generated increasing enthusiasm recently, as reflected in a rapidly growing body of predictive models…
Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study
Few large cohort studies have examined the prevalence of diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), obesity, and…
Metformin Initiation and Early Adherence among Kaiser Permanente Northern California Members with Newly Diagnosed Type 2 Diabetes
Aim 1: Identify patient-level predictors of metformin treatment during the year following type 2 diabetes diagnosis. Examined factors will include:…
“They were just waiting for me to mess up”: A critical discourse analysis of immigrant Latinx teens’ perceptions of power dynamics.
This paper explores Latinx adolescents' perceptions of power dynamics with authority around them. We seek to inform how community-based professionals…
Comorbid Diabetes and Severe Mental Illness: Outcomes in an Integrated Health Care Delivery System
Diabetes prevalence is twice as high among people with severe mental illness (SMI) when compared to the general population. Despite…
What is clinician presence? A qualitative interview study comparing physician and non-physician insights about practices of human connection.
OBJECTIVE: We sought to investigate the concept and practices of 'clinician presence', exploring how physicians and professionals create connection, engage…
Detection of early stage ovarian cancer in a large community cohort
Although detecting ovarian cancer at early stage is a highly meaningful clinical goal, no studies have evaluated early stage disease…
Proton Pump Inhibitors, H2 Blocker Use, and Risk of Inflammatory Bowel Disease in Children
Evidence suggests use of proton pump inhibitors (PPIs) and H2 blockers may provoke disease flares in individuals with established inflammatory…
Secure Messaging with Physicians by Proxies for Patients with Diabetes: Findings from the ECLIPPSE Study
Little is known about patients who have caregiver proxies communicate with healthcare providers via portal secure messaging (SM). Since proxy…
Text message alerts to emergency physicians identifying potential study candidates increase clinical trial enrollment
Prospective enrollment of research subjects in the fast-paced emergency department (ED) is challenging. We sought to develop a software application…
Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder.
Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention…
Assessing the clinical impact of CYP2C9 pharmacogenetic variation on phenytoin prescribing practice and patient response in an integrated health system
To assess the impact of CYP2C9 variation on phenytoin patient response and clinician prescribing practice where genotype was unknown during…
Portal Use Among Patients With Chronic Conditions: Patient-reported Care Experiences
Personal health records offer patients access to view their own health information and to manage their care online through secure…
Validation of the Pediatric Appendicitis Risk Calculator (pARC) in a Community Emergency Department Setting
The pediatric Appendicitis Risk Calculator (pARC) is a validated clinical tool for assessing a child's probability of appendicitis. Our objective…
Understanding Non-Adherence with Hydroxychloroquine Therapy in Systemic Lupus Erythematosus
Hydroxychloroquine (HCQ) is a cornerstone to managing systemic lupus erythematosus (SLE), yet adherence to medication is poor. We sought to…
Care System Analytics to Support Primary Care Patients with Complex Medical and Social Needs
This study will leverage the rich electronic data sources within Kaiser Permanente to create pragmatic tools for improving health and…
Drug Benefit Design and Adherence Disparities in Older Adults
Our prior study examined the impact of one aspect of Medicare Part D, the removal of limits on the number…
Effect of donor, component and recipient characteristics on hemoglobin increments following red blood cell transfusion
Significant research has focused individually on blood donors, product preparation and storage, and optimal transfusion practice. To better understand the…
Simple Adnexal Cysts: SRU Consensus Conference Update on Follow-up and Reporting.
This multidisciplinary consensus update aligns prior Society of Radiologists in Ultrasound (SRU) guidelines on simple adnexal cysts with recent large…
Optimizing Medical Decision-Making for Older Patients with Type 2 Diabetes
Medicare-age patients with type 2 diabetes are projected to double in the next 25 years and have high rates of…
Improving Outcomes and Care Experience among Dual-Eligible Members
This study will be one of the first to examine the relationship between health-system factors across the continuum of care…
Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery: A Quality Improvement Initiative
To evaluate implementation of an enhanced recovery after surgery (ERAS) program for patients undergoing elective cesarean delivery by comparing opioid…
Do no harm: a roadmap for responsible machine learning for health care
Interest in machine-learning applications within medicine has been growing, but few studies have progressed to deployment in patient care. We…
Characteristics of New Opioid Use Among Medicare Beneficiaries: Identifying High-Risk Patterns
Opioid prescription patterns, including long-term use, multiple prescribers, and high opioid doses, increase the risk for adverse outcomes; however, previous…
Identifying Common Predictors of Multiple Adverse Outcomes Among Elderly Adults With Type-2 Diabetes
As part of a multidisciplinary team managing patients with type-2 diabetes, pharmacists need a consistent approach of identifying and prioritizing…
Association of Anxiety With High-Cost Health Care Use Among Individuals With Type 2 Diabetes
People with type 2 diabetes vary greatly in their use of high-cost health care resources. We examined the association of…
Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study
There is an unmet clinical need to better understand the impact of lifestyle choices with respect to diet and nutrition…
Health Outcomes of Interest Validation of Serious Infections Among an Immunocompromised Population
Kaiser Permanente Northern California will participate with the FDA Sentinel to validate the diagnosis of health outcomes of interest.
A Seat at the Table: Strategic Engagement in Service Activities for Early Career Faculty From Underrepresented Groups in the Academy
Many academic institutions strive to promote more diverse and inclusive campuses for faculty, staff, and students. As part of this…
High-Need Patients’ Goals and Goal Progress in a Veterans Affairs Intensive Outpatient Care Program.
BACKGROUND: Healthcare systems nationwide are implementing intensive outpatient care programs to optimize care for high-need patients; however, little is known…
Targeted learning with daily EHR data
Electronic health records (EHR) data provide a cost- and time-effective opportunity to conduct cohort studies of the effects of multiple…
Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns
Primary care providers (PCPs) are often challenged to address multiple patient concerns during time-limited visits. The need for PCPs to…
Transdisciplinary Strategies for Physician Wellness: Qualitative Insights from Diverse Fields.
BACKGROUND: While barriers to physician wellness have been well detailed, concrete solutions are lacking. n OBJECTIVE: We looked to professionals…
Opportunities to encourage mail order pharmacy delivery service use for diabetes prescriptions: a qualitative study
Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of…
Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial
Most patients with diabetes do not meet all evidence-based goals of care, and many patients report poor communication and lack…
Use of financial incentives and text message feedback to increase healthy food purchases in a grocery store cash back program: a randomized controlled trial
The HealthyFood (HF) program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled…
Medical Malpractice Involving Pulmonary/Critical Care Physicians.
BACKGROUND: Medical malpractice data can be leveraged to understand specialty-specific risk.METHODS: Malpractice claims were examined from the Comparative Benchmarking System…
Association of Social and Behavioral Risk Factors With Earlier Onset of Adult Hypertension and Diabetes
The National Academy of Medicine has recommended incorporating information on social and behavioral factors associated with health, such as educational…
Translating/Creating a Culturally Responsive Spanish-Language Mobile App for Visit Preparation: Case Study of “Trans-Creation”
Health information technology (IT) tools are increasingly used to improve patient care. However, implementation of English-only health IT tools could…
Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions
Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with…
Association between Inpatient Delirium and Hospital Readmission in Patients ≥ 65 Years of Age: A Retrospective Cohort Study
Delirium affects more than seven million hospitalized adults in the United States annually. However, its impact on postdischarge healthcare utilization…
The Impact of Pharmacy-specific Predictors on the Performance of 30-Day Readmission Risk Prediction Models
Pharmacists are an expensive and limited resource in the hospital and outpatient setting. A pharmacist can spend up to 25%…
Visual outcomes after cataract surgery in patients with type 2 diabetes
To assess the relation between diabetic retinopathy (DR) severity, duration of diabetes, insulin dependence, and preoperative hemoglobin A1c (HbA1c) with…
Association of Medical Scribes in Primary Care With Physician Workflow and Patient Experience
Widespread adoption of electronic health records (EHRs) in medical care has resulted in increased physician documentation workload and decreased interaction…
Building Toward a Population-Based Approach to Diabetes Screening and Prevention for US Adults
Evidence-based treatments for prediabetes can prevent and delay the development of type 2 diabetes in adults. In this review, we…
Prevalence and Factors Influencing Use of Internet and Electronic Health Resources by Middle-Aged and Older Adults in a US Health Plan Population: Cross-Sectional Survey Study
Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange health information and advice (HIA). There…
Visit Planning Using a Waiting Room Health IT Tool: The Aligning Patients and Providers Randomized Controlled Trial
Time during primary care visits is limited. We tested the hypothesis that a waiting room health information technology (IT) tool…
Statistical Modeling and Aggregate-Weighted Scoring Systems in Prediction of Mortality and ICU Transfer: A Systematic Review
The clinical deterioration of patientsin general hospital wards is an important safety issue. Aggregate-weighted early warning systems (EWSs) may not…
The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (the Diabetes & Aging Study)
To examine for a legacy effect of early glycemic control on diabetic complications and death. This cohort study of managed…
Long-term follow-up of pediatric open and laparoscopic inguinal hernia repair
Pediatric laparoscopic inguinal hernia repair is not widely accepted. Children 0-14 years who underwent inguinal hernia repair during 2010-2016 at Kaiser…
Sexual Orientation Disparities in Physical Activity: Results From Insured Adults in California
The majority of adults in the United States fail to meet the Centers for Disease Control and Prevention (CDC) physical…
Pill, patch, or ring? A mixed methods analysis of provider counseling about combined hormonal contraception
In this study we aimed to investigate the content and process of contraceptive counseling surrounding combined hormonal contraceptive (CHC) methods…
Understanding Housing Insecurity and Risk for Homelessness in the Kaiser Permanente Northern California Member Population
This project will examine patient and community-level correlates of housing instability and homelessness using observational data sources. These formative analyses…
Assessing and Optimizing the Impact of an Electronic Clinical Decision Support Tool for Chest Pain Risk Stratification in the Emergency Department STEWARD Project (Phase 3)
Conducted with co-investigator Dustin G. Mark, MD, this study helps emergency physicians with estimates of individual patient risk for patients…
Using EHR Audit Logs to Capture Diagnostic Pathways and Time to Diagnosis
Rapid expansions in the use of electronic health record (EHR) systems also contribute to large expansions in the availability of…
Targeting Cardiovascular Events to Improve Patient Outcomes After Sepsis
Sepsis is the most common illness leading to hospitalization in the United States, affecting more than 1 million Americans each…
Comparative Effectiveness of Virtual Care in Dermatology for Diagnosing Rash
The benefit of teledermatology for triaging skin rashes is not adequately understood. The study will assess how implementation of teledermatology…
Automated Early Detection of Obstetric Complications: Theoretical and Methodological Considerations
Compared to adults admitted to general medical-surgical wards, women admitted to labor and delivery services are at much lower risk…
Long-Term Outcomes Among Patients Discharged From the Hospital With Moderate Anemia: A Retrospective Cohort Study
Randomized clinical trial findings support decreased red blood cell (RBC) transfusion and short-term tolerance of in-hospital anemia. However, long-term outcomes…
Motivational Determinants of Postpartum Lifestyle Behaviors, Weight Retention, and Metabolic Syndrome – DUPLICATED DO NOT ACTIVATE
The Pregnancy Environment and Lifestyle Study-2 (PETALS-2) aims to identify psychosocial influences on healthy lifestyle behaviors — such as healthy…
Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal
For patients with diabetes, many with multiple complex chronic conditions, using a patient portal can support self-management and coordination of…
Diagnostic thresholds for pregnancy hyperglycemia, maternal weight status and the risk of childhood obesity in a diverse Northern California cohort using health care delivery system data
To estimate the risk of childhood obesity associated with the various criteria proposed for diagnosis of gestational diabetes (GDM), and…
Clinical Response to Real-Time Patient-Reported Diabetic Peripheral Neuropathy Symptoms
To assess clinician response to real-time patient-reported data about diabetic peripheral neuropathy (DPN) symptoms, we analyzed DPN diagnosis and treatment…
Sociodemographic Determinants of Health and Well-Being Among Adults Residing in the Combined Kaiser Permanente Regions
Kaiser Permanente commissioned a health and well-being (HWB) survey of adult members and nonmembers in its 8 Regions. To estimate…
Knowing How to Ask Good Questions: Comparing Latinos and Non-Latino Whites Enrolled in a Cardiovascular Disease Prevention Study
Latinos face unique challenges engaging with their health care providers for risk management of cardiovascular disease (CVD). To better understand…
Healthcare Effectiveness Data and Information Set (HEDIS) measures of alcohol and drug treatment initiation and engagement among people living with the human immunodeficiency virus (HIV) and patients without an HIV diagnosis
Background: Problematic use of alcohol and other drugs (AOD) is highly prevalent among people living with the human immunodeficiency virus…
Patient characteristics associated with treatment initiation and engagement among individuals diagnosed with alcohol and other drug use disorders in emergency department and primary care settings
Background: Treatment initiation and engagement rates for alcohol and other drug (AOD) use disorders differ depending on where the AOD…
Using natural language processing and machine learning to classify health literacy from secure messages: The ECLIPPSE study
Limited health literacy is a barrier to optimal healthcare delivery and outcomes. Current measures requiring patients to self-report limitations are…
The association between medical comorbidity and Healthcare Effectiveness Data and Information Set (HEDIS) measures of treatment initiation and engagement for alcohol and other drug use disorders
Background: Medical comorbidity may influence treatment initiation and engagement for alcohol and other drug (AOD) use disorders. We examined the…
Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014-2015
Background: Only 10% of patients with alcohol and other drug (AOD) disorders receive treatment. The AOD Initiation and Engagement in…
The prevalence of Healthcare Effectiveness Data and Information Set (HEDIS) initiation and engagement in treatment among patients with cannabis use disorders in 7 US health systems
Background: Cannabis use disorders (CUDs) have increased with more individuals using cannabis, yet few receive treatment. Health systems have adopted…
Psychiatric comorbidity and Healthcare Effectiveness Data and Information Set (HEDIS) measures of alcohol and other drug treatment initiation and engagement across 7 health care systems
Background: Psychiatric comorbidity is common among patients with alcohol and other drug (AOD) use disorders. To better understand how psychiatric…
Predictors of Healthcare Effectiveness Data and Information Set (HEDIS) treatment initiation and engagement among patients with opioid use disorder across 7 health systems
Background: The prevalence of opioid use disorder (OUD) has increased rapidly in the United States and improving treatment access is…
Inpatient electronic health record maintenance from 2010 to 2015
To describe the scale and scope of inpatient electronic health record (EHR) maintenance following initial implementation. A retrospective study reviewing EHR…
The health information technology special issue: new real-world evidence and practical lessons
As technology applications in healthcare continue to grow, electronic health records are maturing, interoperability is developing, and patient-facing technology use…
Shake Rattle & Roll – Design and rationale for a pragmatic trial to improve blood pressure control among blacks with persistent hypertension
In Kaiser Permanente Northern California (KPNC), members had similar access to care and a very high overall rate of hypertension…
Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial
To evaluate the effectiveness of automated symptom and side effect monitoring on quality of life among individuals with symptomatic diabetic…
Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial.
Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and…
Increasing Safe Outpatient Management of Emergency Department Patients With Pulmonary Embolism: A Controlled Pragmatic Trial
Many low-risk patients with acute pulmonary embolism (PE) in the emergency department (ED) are eligible for outpatient care but are…
Optimizing a Scalable Intervention to Maximize Guideline-recommended Diabetes Testing after Gestational Diabetes Mellitus
Guideline-recommended postpartum screening is a critical step toward diabetes prevention after a diagnosis of gestational diabetes mellitus (GDM). However, patient…
Vegetarian Diets Are Associated with Selected Cardiometabolic Risk Factors among Middle-Older Aged South Asians in the United States.
Background: Following a vegetarian diet is considered to be beneficial for overall health and is associated with a lower risk…
Tele-Triage Outcomes For Patients With Chest Pain: Comparing Physicians And Registered Nurses
We took advantage of a change in protocol in an integrated delivery system's telephone consultation service-routing callers complaining of chest…
Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer
To investigate the implications of a cancer diagnosis on medication adherence for pre-existing comorbid conditions, we explored statin adherence patterns…
Characteristics of patients with substance use disorder before and after the Affordable Care Act
The Affordable Care Act (ACA) offered an unprecedented opportunity to expand insurance coverage to patients with substance use disorders (SUDs).…
Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study
To examine the prevalence and person-level predictors of undiagnosed Type 2 diabetes among adults with elevated HbA1c values. We identified…
Central Obesity Increases the Risk of Gestational Diabetes Partially Through Increasing Insulin Resistance
This study examined the associations of central obesity measures, waist to hip ratio (WHR) and waist circumference (WC), in early…
Advancing Health Policy and Program Research in Diabetes: Findings from the Natural Experiments for Translation in Diabetes (NEXT-D) Network
To advance our understanding of the impacts of policies and programs aimed at improving detection, engagement, prevention, and clinical diabetes…
Bias-contingent attention bias modification and attention control training in treatment of PTSD: a randomized control trial.
BACKGROUND: Randomized control trials (RCTs) comparing attention control training (ACT) and attention bias modification (ABM) in posttraumatic stress disorder (PTSD)…
Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members
To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage…
Exploring how patients understand and assess their diabetes control
Poor understanding of diabetes management targets is associated with worse disease outcomes. Patients may use different information than providers to…
Emergency Department Patient Satisfaction with Treatment of Low-risk Pulmonary Embolism
Many emergency department (ED) patients with acute pulmonary embolism (PE) who meet low-risk criteria may be eligible for a short…
Prospective Validation of a Standardized Ultrasonography-Based Ovarian Cancer Risk Assessment System
To evaluate the performance of a system that standardizes ovarian cancer risk assessment and reporting on ultrasonography. We conducted a…
Evaluating the Impact of Eliminating Copayments for Tobacco Cessation Pharmacotherapy
We examined the impact of the Affordable Care Act-mandated elimination of tobacco cessation pharmacotherapy (TCP) copayments on patient use of…
Associations of ICU Capacity Strain with Disposition and Outcomes of Patients with Sepsis Presenting to the Emergency Department
Intensive care unit (ICU) capacity strain refers to the potential limits placed on an ICU's ability to provide high-quality care…
The Initial Care of Younger Adults with Newly Diagnosed Type 2 Diabetes
In a population of adults with newly diagnosed, early onset type 2 diabetes, this study will identify patient-, provider-, and…
Similarities and Differences in Health Indicators and Health Care Use Among Asian Ethnic Groups
This study will examine whether significant differences across Asian ethnic groups in prevalence of chronic diseases, behavioral/psychosocial risk factors, preventive…
Benchmarking Hospital Quality – Template Matching
In this study, Kaiser Permanente Northern California researchers will serve as consultants for U.S. Department of Veterans Affairs (VA) researchers…
Predicting Successful Onboarding in the Medi-Cal Population
The purpose of this project is to examine quality indicators for key chronic conditions such as diabetes and asthma for…
Supplement to T32 Training Program in Diabetes Translational Research
This administrative supplement solicited by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) will provide two to…
T32 Training Program in Diabetes Translational Research
Diabetes remains a leading cause of morbidity and mortality, and it is a significant burden to the U.S. health care…
CORAL Meaningful Outcomes & Missed Opportunities
A relatively small proportion of patients with complex needs represent a major source of cost and utilization. The fundamental principle…
Identifying Pre-Sepsis Opportunities for Early, Targeted Intervention
Early evidence suggests there will be ongoing waves of COVID-19 outbreak that can be mitigated through effective community-level prediction models…
Predicting and Reducing Future Health Disparities for U.S. Adults with Diabetes
The clinical and financial impact of diabetes-related interventions and policies may not be quantifiable without the use of simulation models…
It Takes a Network: A Network Science- and Command Center-Based Approach to Hospital Error Detection, Prevention, and Mitigation
This project aims to develop a set of algorithms for generic error detection, prevention, and mitigation in the hospital setting.…
Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative
The Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative was initiated in 2014 to bridge the Health Care Systems Research…
Ensemble machine learning prediction of posttraumatic stress disorder screening status after emergency room hospitalization.
Posttraumatic stress disorder (PTSD) develops in a substantial minority of emergency room admits. Inexpensive and accurate person-level assessment of PTSD…
Mobile-accessible personal health records increase the frequency and timeliness of PHR use for patients with diabetes
Personal health records (PHRs) offer patients a portal to view lab results, communicate with their doctors, and refill medications. Expanding…
Understanding functional and social risk characteristics of frail older adults: a cross-sectional survey study
Frailty is a condition of increasing importance, given the aging adult population. With an anticipated shortage of geriatricians, primary care…
Prevalence of infant bronchiolitis-coded healthcare encounters attributable to RSV
We sought to determine the proportion of bronchiolitis episodes attributable to respiratory syncytial virus (RSV) among ICD-9 coded infant bronchiolitis…
Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention.
OBJECTIVE: To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraumatic stress disorder (PTSD) and substance use disorder…
Reducing risk of Clostridium difficile infection and overall use of antibiotic in the outpatient treatment of urinary tract infection
Risk of community-acquired Clostridium difficile infection (CA-CDI) following antibiotic treatment specifically for urinary tract infection (UTI) has not been evaluated.…
Association between Inhaled Corticosteroid Use and Pulmonary Nontuberculous Mycobacterial Infection
Nontuberculous mycobacterial (NTM) pulmonary disease prevalence is increasing. To determine the association between the use of inhaled corticosteroids and the…
Review of Metformin Use for Type 2 Diabetes Prevention
Prediabetes is prevalent and significantly increases lifetime risk of progression to type 2 diabetes. This review summarizes the evidence surrounding…
The Implementation of Performance Management Systems in U.S. Physician Organizations
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that…
Traumatic brain injury associated with dementia risk among people with type 1 diabetes
To examine the association between traumatic brain injury (TBI) and dementia risk among a cohort of middle-aged and elderly individuals…
Exposure-based therapy changes amygdala and hippocampus resting-state functional connectivity in patients with posttraumatic stress disorder.
BACKGROUND: Recent research suggests that posttraumatic stress disorder (PTSD) is associated with altered amygdala and hippocampal resting-state functional connectivity (rsFC).…
Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes
Individuals with type 1 diabetes have experienced an increase in life expectancy; yet, it is unknown what level of glycemic…
The Effect of Age and Comorbidities on the Association Between the Medicare STAR Oral Antihyperglycemic Adherence Metric and Glycemic Control
The Medicare STAR program for Medicare Advantage Plans that include drug benefits provides monetary incentives for health plans to achieve…
Language barriers and LDL-C/SBP control among Latinos with diabetes
Language barriers in healthcare are associated with worse glycemic control among Latino patients with limited English proficiency and diabetes. We…
Risk of Incident Atherosclerotic Cardiovascular Disease Events by Achieved Atherogenic Lipid Levels Among 62,428 Statin-Treated Individuals With Diabetes Mellitus
The relevance of low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C) goals for primary prevention of atherosclerotic cardiovascular disease…
Association of behavioral health factors and social determinants of health with high and persistently high healthcare costs
A high proportion of U.S. health care costs are attributable to a relatively small proportion of patients. Understanding behavioral and…
Which Complex Patients Should Be Referred for Intensive Care Management? A Mixed-Methods Analysis
A large and increasing proportion of health care costs are spent caring for a small segment of medically and socially…
Collaborative research and actions on both sides of the US-Mexico border to counteract type 2 diabetes in people of Mexican origin.
BACKGROUND: Type 2 Diabetes (T2D) is now a massive epidemic in both California and Mexico, with serious consequences for social…
Diagnosis-based cohort augmentation using laboratory results data: The case of chronic kidney disease
In this report, we use data from FDA's Sentinel System to focus on how augmenting a diagnosis-based chronic kidney disease…
Immediate sequential bilateral cataract surgery: surgeon preferences and concerns
We surveyed cataract surgeons to gain insight into their perceptions of and attitudes about immediate sequential bilateral cataract surgery (ISBCS).…
Eating with others and meal location are differentially associated with nutrient intake by sex: The Diabetes Study of Northern California (DISTANCE)
Though eating with others is often a social behavior, relationships between social contexts of eating and nutrient intake have been…
Social and Functional Predictors of Rehospitalization: YCLS and PROMIS (SDH2)
This project aims to determine whether fields included in the National Institutes of Health’s Patient Reported Outcomes Measurement System (PROMIS)…
Evaluation of the Effectiveness and Implementation of Regionalized Care of Testicular Cancer
This study has three primary aims: 1) to evaluate the effectiveness of Testicular Cancer Redesign on rates of use of…
Association of Initiation of Basal Insulin Analogs vs Neutral Protamine Hagedorn Insulin With Hypoglycemia-Related Emergency Department Visits or Hospital Admissions and With Glycemic Control in Patients With Type 2 Diabetes
In clinical trials of patients with type 2 diabetes, long-acting insulin analogs modestly reduced the risk of nocturnal hypoglycemia compared…
Influence of a New Diabetes Diagnosis on the Health Behaviors of the Patient’s Partner
When a person is given a diagnosis of diabetes, the changes in his or her health behaviors may influence the…
Risk Adjustment for Hospital Characteristics Reduces Unexplained Hospital Variation in Pressure Injury Risk
Research investigating risk factors for hospital-acquired pressure injury (HAPI) has primarily focused on the characteristics of patients and nursing staff.…
The Relationship Between Prescription Copayments and Contraceptive Adherence in a New-user Cohort
Contraceptive nonadherence is an important contributor to unintended pregnancy in the United States. While the elimination of patient cost sharing…
Outpatient Management of Emergency Department Patients With Acute Pulmonary Embolism: Variation, Patient Characteristics, and Outcomes
Outpatient management of emergency department (ED) patients with acute pulmonary embolism is uncommon. We seek to evaluate the facility-level variation…
Adherence to Cardio-protective Medications Prescribed for Secondary Prevention after an Acute Coronary Syndrome Hospitalization Compared to Usual Care
Secondary prevention after an acute coronary syndrome (ACS) hospitalization is critical to prevent additional morbidity and mortality. While poor adherence…
Does Information about Members’ Social Determinants of Health Improve Prediction of Risk for Hospitalization, Emergency Department Visits, and Outpatient Utilization?
The new Kaiser Permanente Your Current Life Situation (YCLS) screening questionnaire will be mailed to a random sample of 7,000…
Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial.
Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and…
Improved Cardiovascular Risk Factors Control Associated with a Large-Scale Population Management Program Among Diabetes Patients
Optimal cardiovascular risk factors control among individuals with diabetes remains a challenge. We evaluated changes in glucose, lipid, and blood…
Food Insecurity, Food “Deserts,” and Glycemic Control in Patients With Diabetes: A Longitudinal Analysis
Both food insecurity (limited food access owing to cost) and living in areas with low physical access to nutritious foods…
The Impact of Acute Organ Dysfunction on Long-Term Survival in Sepsis
To estimate the impact of each of six types of acute organ dysfunction (hepatic, renal, coagulation, neurologic, cardiac, and respiratory)…
A Two-Step Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems
To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). Third National…
Social and Functional Predictors of Rehospitalization: YCLS and PROMIS
This study aims to determine whether specific items from two questionnaires currently in use at Kaiser Permanente Northern California (the…
Characterizing and Predicting Adverse Drug Events Outside the Hospital
This study aims to employ machine learning methods to develop predictive models for adverse drug events, or ADEs, that result…
Add-On Antihypertensive Medications to Angiotensin-Aldosterone System Blockers in Diabetes: A Comparative Effectiveness Study
In individuals with diabetes, the comparative effectiveness of add-on antihypertensive medications added to an angiotensin-converting enzyme inhibitor or angiotensin II…
Impact of emergency physician-provided patient education about alternative care venues
Interventions that focus on educating patients appear to be the most effective in directing healthcare utilization to more appropriate venues.…
Acute Pulmonary Embolism in Emergency Department Patients Despite Therapeutic Anticoagulation
Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered…
Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data
Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department…
Large-Scale Implementation of Structured Reporting of Adnexal Masses on Ultrasound
The aim of this article is to describe the development and implementation of structured reporting of adnexal mass findings on…
Mortality Measures to Profile Hospital Performance for Patients With Septic Shock
Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of…
Depression in type 1 diabetes and risk of dementia
Depression afflicts 14% of individuals with type 1 diabetes (T1D). Depression is a robust risk factor for dementia but it…
Healthcare Utilization and Infection in the Week Prior to Sepsis Hospitalization
To quantify healthcare utilization in the week preceding sepsis hospitalization to identify potential opportunities to improve the recognition and treatment…
Accuracy of international classification of diseases, ninth revision, codes for postpartum hemorrhage among women undergoing cesarean delivery
Determining the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) codes for postpartum hemorrhage (PPH) is vital…
Effect of Out-of-Pocket Cost on Medication Initiation, Adherence, and Persistence among Patients with Type 2 Diabetes: The Diabetes Study of Northern California (DISTANCE)
To estimate the effect of out-of-pocket (OOP) cost on nonadherence to classes of cardiometabolic medications among patients with diabetes. Electronic…
Association of Inflammatory Markers with Disease Progression in Patients with Metastatic Melanoma Treated with Immune Checkpoint Inhibitors
We investigated the effect of inflammatory biomarkers (neutrophil, platelet, and lymphocyte counts) on risk of progression in patients with metastatic…
Older adults’ readiness to engage with eHealth patient education and self-care resources: a cross-sectional survey
This study examined access to digital technologies, skills and experience, and preferences for using web-based and other digital technologies to…
The Role of Bariatric Surgery in the Management of Nonalcoholic Fatty Liver Disease
This project is proposed by University of California, San Francisco (UCSF) gastroenterology fellow Suzanne Sharpton, who is also earning an…
FY16 Sentinel Infrastructure, Methods and Surveillance
This project consists of tasks required for data partners in the Food and Drug Administration’s Sentinel Initiative under the initiative’s…
Effect of cognitive bias modification-memory on depressive symptoms and autobiographical memory bias: two independent studies in high-ruminating and dysphoric samples.
Memory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative…
Pre-Visit Prioritization for Complex Primary Care Patients with Diabetes
Patients with type 2 diabetes are increasingly living with multiple concurrent conditions and complicated medical regimens. For these patients, diabetes…
Does Combining Asians Into One Group Mask Important Ethnic Group Differences in Health and Health Care Use?
This study will examine whether significant differences across Asian ethnic groups in prevalence of chronic diseases, behavioral and psychosocial risk…
Sex, race, and insurance status differences in hospital treatment and outcomes following out-of-hospital cardiac arrest.
BACKGROUND: Sex, race, and insurance status are associated with treatment and outcomes in several cardiovascular diseases. These disparities, however, have…
Thromboprophylaxis for Patients with High-risk Atrial Fibrillation and Flutter Discharged from the Emergency Department
Many patients with atrial fibrillation or atrial flutter (AF/FL) who are high risk for ischemic stroke are not receiving evidence-based…
Exploring young women’s decisional needs for contraceptive method choice: A qualitative study
Assisting women with choosing contraceptive methods that meet their needs and preferences is essential to providing patient-centered care, but research…
Incorporating Longitudinal Comorbidity and Acute Physiology Data in Template Matching for Assessing Hospital Quality: An Exploratory Study in an Integrated Health Care Delivery System
We sought to build on the template-matching methodology by incorporating longitudinal comorbidities and acute physiology to audit hospital quality. Patients…
Performance of Coronary Risk Scores Among Patients With Chest Pain in the Emergency Department
Both the modified History, Electrocardiogram, Age, Risk factors and Troponin (HEART) score and the Emergency Department Assessment of Chest pain…
Flexible, Cluster-Based Analysis of the Electronic Medical Record of Sepsis with Composite Mixture Models
The widespread adoption of electronic medical records (EMRs) in healthcare has provided vast new amounts of data for statistical machine…
A systematic review of care management interventions targeting multimorbidity and high care utilization
Evidence supporting the effectiveness of care management programs for complex patients has been inconclusive. However, past reviews have not focused…
Early Detection of Obstetric Complications: Development of Predictive Models Suitable for Real-Time Surveillance During Labor, Delivery, and the Postpartum Period
This is a feasibility study to determine whether data from Kaiser Permanente HealthConnect® can be harnessed to predict obstetric complications…
Recovery or Disability? Trajectories After Pneumonia: Integrating 12 Months of Frequent Patient-Reported Measures with EMR Data
This is a pilot study to determine the feasibility of conducting a prospective study that aims to characterize longitudinal trajectories…
Effectiveness of Respiratory Syncytial Virus Immunoprophylaxis on Bronchiolitis Hospitalizations among High-risk Infants
We sought to determine the real-world effectiveness of respiratory syncytial virus (RSV) immunoprophylaxis in a population-based cohort to inform policy.…
‘The Hand on the Doorknob’: Visit Agenda Setting by Complex Patients and Their Primary Care Physicians
Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex…
Using Neighborhood-Level Census Data to Predict Diabetes Progression in Patients with Laboratory-Defined Prediabetes
Research on predictors of clinical outcomes usually focuses on the impact of individual patient factors, despite known relationships between neighborhood…
Liver Enzymes in Early to Mid-pregnancy, Insulin Resistance, and Gestational Diabetes Risk: A Longitudinal Analysis
Background: Liver enzymes may be implicated in glucose homeostasis; liver enzymes progressively change during pregnancy but longitudinal data during pregnancy…
An Observational Study of Cardiovascular Risks Associated with Rheumatoid Arthritis Therapies: A Comparison of Two Analytical Approaches
Comparative safety studies typically use hierarchical treatment categories that lump monotherapy and combination therapy. The consequence of this approach on…
Improving the quality of care and patient experience of care during the diagnosis of lupus: a qualitative study of primary care
Purpose To better understand diagnostic delay and doctor-patient communication during the diagnosis of systemic lupus erythematous in patients without malar…
Patient-reported adherence to statin therapy, barriers to adherence, and perceptions of cardiovascular risk
Patient reports of their adherence behaviors, concerns about statins, and perceptions of atherosclerotic cardiovascular disease (ASCVD) risk could inform approaches…
Diabetes Screening among Antipsychotic-Treated Adults with Severe Mental Illness in an Integrated Delivery System: A Retrospective Cohort Study
Severe mental illness (SMI) is associated with increased risk for type 2 diabetes, partly due to adverse metabolic effects of…
Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System
Although healthcare organizations have decreased hospital-acquired pressure injury (HAPI) rates, HAPIs are not eliminated, driving further examination in both nursing…
Rectal Cancer Survivors’ Participation in Productive Activities
Rectal cancer and its treatment impair survivors' productivity. To assess determinants of market and nonmarket employment, job search, volunteering, and…
Benefits of Intensive Care Unit Admission for Patients with Acute Respiratory Failure or Sepsis
Ideal and optimally efficient use of intensive care unit (ICU) resources would create benefits across the health care system. Ideal…
Using Peer Support To Aid in PRevention and Treatment in Prediabetes (UPSTART)
This intervention trial has three specific aims: 1) To implement and test the effectiveness of a peer support model to…
CREATE Wellness: A multi-component behavioral intervention for patients not responding to traditional Cardiovascular disease management
Cardiovascular disease (CVD) is the leading cause of death in the US. Many patients do not benefit from traditional disease…
Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer
To evaluate the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments…
Overcoming barriers to diabetic polyneuropathy management in primary care
Diabetic polyneuropathy is a highly prevalent and costly complication of diabetes that is frequently underdiagnosed and undertreated in primary care…
Barriers to Health Care in a Latino Population with Autism Spectrum Disorder
This study will identify barriers to the use of recommended assessment, diagnostic, and treatment services among Latino children and adolescents…
Does Free Medicines Coverage Improve Diabetes Self-Care and Outcomes for Diverse Populations?
A quasi-experimental longitudinal study to evaluate the impact of KPHI WellRx -- a program intended to engage patients more effectively…
Predictive Modeling to Aid Clinical Decision-Making and Improve Diabetic Peripheral Neuropathy Outcomes
This 18-month research project will bring together a multidisciplinary team of scientists and clinicians from four Kaiser Permanente regions (Kaiser…
Physical activity, bowel function, and quality of life among rectal cancer survivors
Physical activity (PA) is positively associated with numerous health benefits among cancer survivors. This study examined insufficiently investigated relationships among…
Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis
Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is…
Opportunities to Reduce Diabetes Risk in Women of Reproductive Age: Assessment and Treatment of Prediabetes within a Large Integrated Delivery System
Preventing diabetes before pregnancy may be important to improve maternal and infant outcomes. Although the preconception period is a crucial…
Emotion dysregulation moderates the effect of cognitive behavior therapy with prolonged exposure for co-occurring PTSD and substance use disorders.
A goal of clinical trials is to identify unique baseline characteristics that can inform treatment planning. One such target is…
Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration
This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us…
The Delivery Science Rapid Analysis Program: A Research and Operational Partnership at Kaiser Permanente Northern California
Health care researchers and delivery system leaders share a common mission to improve health care quality and outcomes. However, differing…
The Incidence and Prevalence of Systemic Lupus Erythematosus in San Francisco County, California: The California Lupus Surveillance Project
Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of…
Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use
Hypoglycemia-related emergency department (ED) or hospital use among patients with type 2 diabetes (T2D) is clinically significant and possibly preventable.…
Identifying Distinct Subgroups of ICU Patients: A Machine Learning Approach
Identifying subgroups of ICU patients with similar clinical needs and trajectories may provide a framework for more efficient ICU care…
The Timing of Early Antibiotics and Hospital Mortality in Sepsis
Prior sepsis studies evaluating antibiotic timing have shown mixed results. To evaluate the association between antibiotic timing and mortality among…
Ibutilide Effectiveness and Safety in the Cardioversion of Atrial Fibrillation and Flutter in the Community Emergency Department
Little is known about the use of ibutilide for cardioversion in atrial fibrillation and flutter outside of clinical trials. We…
A randomized controlled study of power posing before public speaking exposure for social anxiety disorder: No evidence for augmentative effects.
This manuscript details a randomized controlled study designed to test the efficacy of power posing (i.e., briefly holding postures associated…
Navigating the research-clinical interface in genomic medicine: analysis from the CSER Consortium
PurposeThe Clinical Sequencing Exploratory Research (CSER) Consortium encompasses nine National Institutes of Health-funded U-award projects investigating translation of genomic sequencing…
Prediction of Recurrent Clostridium Difficile Infection Using Comprehensive Electronic Medical Records in an Integrated Healthcare Delivery System
BACKGROUND Predicting recurrent Clostridium difficile infection (rCDI) remains difficult. We employed a retrospective cohort design. Granular electronic medical record (EMR)…
Incidence of diabetes after a partner’s diagnosis
People socially connected with each other often share health risks, possibly due to shared environments and behaviors. In a cohort…
Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model.
OBJECTIVES: Excessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary…
Adaptation of the Acute Organ Failure Score for Use in a Medicare Population
Without widely available physiologic data, a need exists for ICU risk adjustment methods that can be applied to administrative data.…
Individual and health system variation in rehospitalizations the year after pneumonia
Little is known about variation in patterns of recovery among patients discharged alive from hospitalizations for pneumonia.The aim of the…
Immediate Sequential vs. Delayed Sequential Bilateral Cataract Surgery: Retrospective Comparison of Postoperative Visual Outcomes
We conducted a retrospective comparative-effectiveness study of best-corrected visual acuity (BCVA) and refractive error (RE) after immediate sequential (ISBCS) and…
Relationships Between Medication Adherence and Cardiovascular Disease Risk Factor Control in Elderly Patients With Diabetes
The Centers for Medicare and Medicaid Services (CMS) Medicare Star program provides incentives to health plans when their patients with…
Innovation and Technology: Electronic Intensive Care Unit Diaries
Hospitalization in the intensive care unit can be a stressful time for patients and their family members. Patients' family members…
Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System
Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical…
Pathogens and antibiotic sensitivities in endophthalmitis
Antibiotic prophylaxis in cataract surgery is intended to minimize endophthalmitis. We describe pathogenic organisms, antibiotic sensitivities and antibiotic prophylaxis in…
A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina.
INTRODUCTION: Diabetes Prevention Programs (DPPs) have shown that healthy eating and moderate physical activity are effective ways of delaying and…
Hypoglycemia Patients and Transport by EMS in Alameda County, 2013-15
To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency…
Association Between Neighborhood Supermarket Presence and Glycated Hemoglobin Levels Among Patients With Type 2 Diabetes Mellitus
We estimated associations between neighborhood supermarket gain or loss and glycemic control (assessed by glycated hemoglobin (HbA1c) values) in patients…
Effects of acute exercise on fear extinction in rats and exposure therapy in humans: Null findings from five experiments.
BACKGROUND: Exposure therapy is an established learning-based intervention for the treatment of anxiety disorders with an average response rate of…
The Diabetes Strengths and Resilience Measure for Adolescents With Type 1 Diabetes (DSTAR-Teen): Validation of a New, Brief Self-Report Measure.
OBJECTIVE: Despite the challenges of managing type 1 diabetes, many adolescents achieve optimal outcomes. A validated measure of diabetes-specific strengths is…
Concurrent Treatment with Prolonged Exposure for Co-Occurring Full or Subthreshold Posttraumatic Stress Disorder and Substance Use Disorders: A Randomized Clinical Trial.
BACKGROUND: To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress disorder (PTSD) symptoms effectively in individuals…
Making a difference in medical trainees’ attitudes toward Latino patients: A pilot study of an intervention to modify implicit and explicit attitudes.
Negative attitudes and discrimination against Latinos exist in the dominant U.S. culture and in healthcare systems, contributing to ongoing health…
Food Environment and Weight Change: Does Residential Mobility Matter?: The Diabetes Study of Northern California (DISTANCE)
Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects…
Population Health Management for Diabetes: Health Care System-Level Approaches for Improving Quality and Addressing Disparities
Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity.…
High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network
Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population…
Association of the Affordable Care Act With Smoking and Tobacco Treatment Utilization Among Adults Newly Enrolled in Health Care
To examine rates of smoking and tobacco treatment utilization by insurance coverage status (Medicaid, commercial, exchange) among newly enrolled patients…
Shared decision making in contraceptive counseling
Shared decision making (SDM) is a potentially valuable but underexplored approach to contraceptive counseling. We determined the correlation between patient…
Emergency Department Pain Management Following Implementation of a Geriatric Hip Fracture Program.
INTRODUCTION: Over 300,000 patients in the United States sustain low-trauma fragility hip fractures annually. Multidisciplinary geriatric fracture programs (GFP) including…
A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis
Current algorithms for management of neonatal early-onset sepsis (EOS) result in medical intervention for large numbers of uninfected infants. We…
Primary care visit preparation and communication for patients with poorly controlled diabetes: A qualitative study of patients and physicians
The purpose of this study was to examine how patients with diabetes and their primary care physicians identify and discuss…
Natural language processing to ascertain two key variables from operative reports in ophthalmology
Antibiotic prophylaxis is critical to ophthalmology and other surgical specialties. We performed natural language processing (NLP) of 743 838 operative notes…
Predicting Final Visual Acuity Following Cataract Surgery
The objective of this study is to predict visual acuity and incidence rates of complications after cataract surgery.
Beyond the Great Recession: Was the Foreclosure Crisis Harmful to the Health of Individuals With Diabetes?
The housing foreclosure crisis was harmful to the financial well-being of many households. In the present study, we investigated the…
Racial-Ethnic Differences in Fall Prevalence among Older Women: A Cross-Sectional Survey Study
Falls are the leading cause of hip fracture in older women, with important public health implications. Fall risk increases with…
The association between physician turnover (the “July Effect”) and survival after in-hospital cardiac arrest.
IMPORTANCE: The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in…
Identifying attendance patterns in a smoking cessation treatment and their relationships with quit success.
BACKGROUND: While important for substance use outcomes, knowledge about treatment attendance patterns, and their relation with clinical outcomes is limited.…
Defining Team Effort Involved in Patient Care from the Primary Care Physician’s Perspective
A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and…
Improvements in access and care through the Affordable Care Act
To examine the impact of enrolling in a healthcare plan through the Affordable Care Act (ACA) healthcare exchanges on self-reported…
Failure Modes and Effects Analysis of bilateral same-day cataract surgery
To systematically analyze potential process failures related to bilateral same-day cataract surgery toward the goal of improving patient safety. Twenty-one…
Value-Based Insurance Design Benefit Offsets Reductions In Medication Adherence Associated With Switch To Deductible Plan
Enrollment in high-deductible health plans is increasing out-of-pocket spending. But innovative plans that pair deductibles with value-based insurance designs can…
Adherence to Newly Prescribed Diabetes Medications Among Insured Latino and White Patients With Diabetes
Medication adherence is essential to diabetes care. Patient-physician language barriers may affect medication adherence among Latino individuals. To determine the…
Association of Patient-Physician Language Concordance and Glycemic Control for Limited-English Proficiency Latinos With Type 2 Diabetes
Providing culturally competent care to the growing number of limited-English proficiency (LEP) Latinos with diabetes in the United States is…
Telephone-Based Coaching: A Comparison of Tobacco Cessation Programs in an Integrated Health Care System
Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation…
CTSI Institutional Career Development Core
The Clinical and Translational Science Institute (CTSI) facilitates the rapid translation of research to improvements in patient and community health.…
Health Delivery Systems Center for Diabetes Translational Research
The Health Delivery Systems Center for Diabetes Translational Research (CDTR) supports diabetes translational research through mentoring and supporting junior faculty,…
Health Delivery Systems Center for Diabetes Translational Research Pilot
The aims of this study are to: 1) support two pilot and feasibility studies in each year of the HDS-CDTR…
Developing and Disseminating Programs to Build Sustainable Lupus Awareness, Knowledge, Skills and Partnerships
This program, with funding through Lupus Foundation of America, is a new initiative to improve health outcomes and health-related quality…
Preferences, Management and Outcomes in the Oldest Patients with Diabetes
The aim of this study is to develop, pilot and conduct a survey among older diabetes patients (75 years of…
Mentored Research to Improve Care for Complex Patients With Diabetes
K24 Midcareer Investigator Awards in Patient-Oriented Research are designed to support established scientists with a track record of mentoring to…
Respiratory Syncytial Virus Infection in Preterm Infants: Six Seasons; Experience in an Integrated Health Care Delivery System
We will study the impact of the change in the American Academy of Pediatrics's palivizumab recommendations in a large cohort…
Long-term Benefits and Risks of Bariatric Surgery in Integrated Care Systems
The objective of this study is to provide surveillance of bariatric surgery outcomes and safety.
Statistical Methods for Recurrent Event Data in RSV Immunoprophylaxis Studies
This is a methodological study that will utilize our established PRIMA cohort to develop statistical methods for (a) quantifying and…
Development and Validation of a Novel Coding Algorithm for Identification of Severe Hypoglycemic Events in Ambulance Records
Severe hypoglycemia (SH) is one of the most prevalent diabetes complications and a critical public health concern; 25% of hospitalizations…
Severe Hypoglycemia: Ascertainment, Surveillance and Pharmacovigalence
Diabetes medications are commonly used to reduce high blood sugar, but their use can sometimes lead to dangerously low blood…
Pragmatic Risk Score to Identify Patients at Risk of Severe Hypoglycemia
A two-year study to develop and validate a pragmatic risk scoring tool to predict severe hypoglycemic (SH) events among patients…
Default Palliative Care Consultation for Seriously Ill Hospitalized Patients
This project aims to test the impact of changing the default mode for palliative care consultation in hospitalized patients from…
Synch and Swim: Establishing Infrastructure for Collaborative Nursing Research in California
This project aims to lay the groundwork for collaborative nursing research effort involving both Kaiser Permanente California regions. Its initial…
The Next Frontier in Diabetes Communication: Promoting Health Literacy in the Era of Secure Messaging
In this study, we will examine how diabetes patients with limited health literacy interact with their healthcare providers via secure…
CESR Regional Data Infrastructure Support and Website Maintenance
The Regional Data Infrastructure Support (RDIS) Budget covers the costs associated with a number of Virtual Data Warehouse (VDW) tasks,…
Accelerating Access through Call Centers (AACC) Study
To examine the association between patient calls to a provider-led call center and emergency department visits.
Advance Alert Monitor Operations
The Systems Research Initiative will provide project management and operational consultation for the spread of the Advance Alert Monitor within…
The Safety and Effectiveness of Diabetes Quality Metrics in Elderly Patients
Improving health care quality for seniors with complex chronic conditions is a critical issue for health services and health policy…
Development, Reevaluation and Implementation of Outcome/Efficiency Measures
This project aims to test the feasibility of employing clinical data from comprehensive electronic medical record systems (such as the…
Delivery Science Rapid Analysis Program II
The purpose of the Delivery Science Rapid Analysis Program is to create a mechanism that will solicit, prioritize and address…
Early Detection, Prevention and Mitigation of Impending Physiologic Deterioration in Hospitalized Patients Outside the ICU: A Pilot Project
An electronic alert system targeting adult patients in 3 hospital units (ward, telemetry, and transitional care unit) will be deployed…
Diabetes Screening and Care Received by the Mentally Ill in an Integrated System
This observational study will examine the level of fasting plasma glucose (FPG) and A1c testing in patients with severe mental…
Encouraging Mail Order Pharmacy Use to Improve Outcomes and Reduce Disparities
Previous research has shown that mail order pharmacy use is associated with improved adherence to cardiometabolic medications, and better LDL-C…
Data-Driven Precision Medicine in Sepsis
Sepsis is a common and costly disease which contributes to nearly 1 in 2 hospital deaths in our healthcare system.…
Cardiovascular Benefits and Safety of Glucose-Lowering Therapies in Adults with Diabetes
Cardiovascular (CV) events are the most common cause of death among adults with type 2 diabetes. While the benefits and…
Balancing Treatment Outcomes and Medication Burden among Patients with Symptomatic Diabetic Peripheral Neuropathy
This project is a continuation of a study we recently conducted to identify and prioritize treatment outcomes of relevance to…
RSV immunoprophylaxis impact on RSV Morbidity and Asthma in Healthy Preterm Infants
The goal of this project is to conduct simulation analyses using an existing dataset (from our AHRQ-funded PRIMA study) to…
Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders.
BACKGROUND: Research has demonstrated a strong link between trauma, posttraumatic stress disorder PTSD and substance use disorders (SUDs) in general…
Evaluating Frameworks That Provide Value Measures for Health Care Interventions
The recent acceleration of scientific discovery has led to greater choices in health care. New technologies, diagnostic tests, and pharmaceuticals…
The impact of telephonic wellness coaching on weight loss: A “Natural Experiments for Translation in Diabetes (NEXT-D)” study
To evaluate the impact of a population-based telephonic wellness coaching program on weight loss. Individual-level segmented regression analysis of interrupted…
Provider self-disclosure during contraceptive counseling
Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized…
Center for Transdisciplinary ELSI Research in Translational Genomics
The aims of this application are to: (1) develop an Exploratory Center of Excellence in ethical, legal, and social implications…
Pre-Visit Prioritization for Complex Primary Care Patients with Diabetes – DUPLICATED DO NOT ACTIVATE
Patients with type 2 diabetes are increasingly living with multiple concurrent conditions and complicated medical regimens. For these patients, diabetes…
Comparative Effectiveness of Prophylaxis in Cataract Surgery
To conduct a CE study to assess whether differences in abx prophx for infection (during cataract surgery) result in different…
CAREER: Managing Patient Flows with Congestion Effects
This project will employ simulation methods to analyze emergency department, hospital, and ICU data, including physiologic markers of severity of…
Development of Predictive Models for Recurrent Clostridium Difficile Infection (rCDI)
This project will examine predictors of and outcomes after recurrent Clostridium difficile infection in adults. Predictors will include age, sex,…
Carnitine palmitoyltransferase 1A P479L and infant death: policy implications of emerging data.
Carnitine palmitoyltransferase 1 isoform A (CPT1A) is a crucial enzyme for the transport of long-chain fatty acids into the mitochondria.…
Multi-Component Behavioral Intervention for Complex Patients with CVD Risk
Disease management programs have had success in CVD risk factor control among uncomplicated patients but often fall short in more…
Postpartum Hemorrhage and Anemia: Epidemiologic and Cost-Effectiveness Analyses
This project, a collaboration with Dr. Alex Butwick at Stanford University, aims to investigate the prevalence and incidence of early…
Are Diabetes Risk and Preventive Behaviors Shared in Households?
While considerable efforts have focused on care and outcomes associated with the individual affected by diabetes, much less is known…
Pre-Visit Prioritization for Complex Primary Care Patients with Diabetes – DUPLICATED DO NOT ACTIVATE
Patients with type 2 diabetes are increasingly living with multiple concurrent conditions and complicated medical regimens. For these patients, diabetes…
Interactive Personal Health Records: Use of a Web-Portal by Patients with Complex Chronic Conditions
Patient use of health IT tools to interact with healthcare providers and delivery systems, including exchanging secure messages with their…
Aligning the Visit Priorities of Complex Patients and their Primary Care Providers
The primary care visit is a key opportunity for catalyzing changes in care for complex patients with multiple heath issues.…
Center for Transdisciplinary ELSI Research in Translational Genomics
The aims of this application are to: (1) develop an Exploratory Center of Excellence in ethical, legal, and social implications…
Impact of Integrated Patient-Facing Health IT Tools on Quality and Resource Use for Patients with Diabetes
This is a quasi-experimental study of the effect of Health IT use on the quality and efficiency of outpatient care…
Genome-Wide Association Study Identifies African-Specific Susceptibility Loci in African Americans With Inflammatory Bowel Disease
The inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Crohn's disease (CD) cause significant morbidity and are increasing in prevalence…
Utilization of Health Services Among Adults With Recurrent Clostridium difficile Infection: A 12-Year Population-Based Study
BACKGROUND Considerable efforts have been dedicated to developing strategies to prevent and treat recurrent Clostridium difficile infection (rCDI); however, evidence…
The Kaiser Permanente Northern California Enhanced Recovery After Surgery Program: Design, Development, and Implementation
Complications are common after surgery, highlighting the need for innovations that reduce postsurgical morbidity and mortality. In this report, we…
Influence of Language and Culture in the Primary Care of Spanish-Speaking Latino Adults with Poorly Controlled Diabetes: A Qualitative Study
We examined the role of language and culture in the interactions between Spanish-speaking Latino patients with poorly controlled diabetes -…
Depressive symptoms and adherence to cardiometabolic therapies across phases of treatment among adults with diabetes: the Diabetes Study of Northern California (DISTANCE)
Among adults with diabetes, depression is associated with poorer adherence to cardiometabolic medications in ongoing users; however, it is unknown…
The Next Frontier in Communication and the ECLIPPSE Study: Bridging the Linguistic Divide in Secure Messaging
Health systems are heavily promoting patient portals. However, limited health literacy (HL) can restrict online communication via secure messaging (SM)…
Missing laboratory results data in electronic health databases: implications for monitoring diabetes risk
Laboratory test (lab) results may be useful to detect incident diabetes in electronic health record and claims-based studies. Using the…
Nearly One-Third Of Enrollees In California’s Individual Market Missed Opportunities To Receive Financial Assistance
The Affordable Care Act includes financial assistance that reduces both premiums and cost-sharing amounts for lower-income Americans, to increase the…
Patterns and predictors of severe postpartum anemia after Cesarean section
Postpartum anemia is associated with maternal and perinatal morbidity. Population-level data may inform guideline development for postpartum anemia screening. Our…
Changes in Medication Use After Dementia Diagnosis in an Observational Cohort of Individuals with Diabetes Mellitus
To assess changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. Difference-in-differences analysis…
Ten-year hemoglobin A1c trajectories and outcomes in type 2 diabetes mellitus: The Diabetes & Aging Study
To classify trajectories of long term HbA1c values in patients after diagnosis of type 2 diabetes and examine each trajectory's…
Altered resting state functional connectivity of fear and reward circuitry in comorbid PTSD and major depression.
BACKGROUND: Individuals with comorbid posttraumatic stress disorder and major depressive disorder (PTSD-MDD) often exhibit greater functional impairment and poorer treatment…
A cross species study of heterogeneity in fear extinction learning in relation to FKBP5 variation and expression: Implications for the acute treatment of posttraumatic stress disorder.
Deficits in fear extinction learning are hypothesized to underlie the development of posttraumatic stress disorder (PTSD). Such deficits may, in…
Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey
This study assessed the effect of acculturation on type 2 diabetes and whether health literacy may mediate this association. The…
Randomised controlled trial of alternative messages to increase enrolment in a healthy food programme among individuals with diabetes
We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes.…
Prospective Case-Control Study of Abnormal Bleeding after Outpatient Corticosteroid Injection
This study is aimed at evaluating the incidence of bleeding among women having outpatient corticosteroid injection compared to matched controls,…
Chronic cannabis use is associated with impaired fear extinction in humans.
The use of fear conditioning and extinction paradigms to examine intermediate phenotypes of anxiety and stress-related disorders has facilitated the…
Incorporating an Early Detection System Into Routine Clinical Practice in Two Community Hospitals
Efforts to improve outcomes of patients who deteriorate outside the intensive care unit have included the use of rapid response…
Implementation of a multicenter performance improvement program for early detection and treatment of severe sepsis in general medical-surgical wards
Sepsis is a leading cause of in-hospital death, and evidence suggests a higher mortality in patients presenting with sepsis on…
Piloting electronic medical record-based early detection of inpatient deterioration in community hospitals
Patients who deteriorate in the hospital outside the intensive care unit (ICU) have higher mortality and morbidity than those admitted…
Early detection, prevention, and mitigation of critical illness outside intensive care settings
Patients who deteriorate outside the intensive care unit (ICU) are known to have elevated mortality and morbidity. Rapid response teams…
Data that drive: Closing the loop in the learning hospital system
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture…
Early detection of critical illness outside the intensive care unit: Clarifying treatment plans and honoring goals of care using a supportive care team
Given the high mortality experienced by patients who deteriorate outside the intensive care unit, issues related to patient preferences around…
Self-reported depression and perceived financial burden among long-term rectal cancer survivors
Types of surgery for rectal cancer (RC), including permanent ostomy (PO) or temporary ostomy followed by anastomosis (TO) or initial…
Identifying Spanish Language Competent Physicians: The Diabetes Study of Northern California (DISTANCE)
Language barriers negatively impact health care access and quality for US immigrants. Latinos are the second largest immigrant group and…
Increasing Minority Enrollment Onto Clinical Trials: Practical Strategies and Challenges Emerge From the NRG Oncology Accrual Workshop
Racial and ethnic diversity has historically been difficult to achieve in National Cancer Institute-sponsored clinical trials, even while as many…
Neural changes in extinction recall following prolonged exposure treatment for PTSD: A longitudinal fMRI study.
BACKGROUND: Neurobiological models of posttraumatic stress disorder (PTSD) implicate fear processing impairments in the maintenance of the disorder. Specific deficits…
Dietary quality and household food insecurity among Mexican children and adolescents.
Seventy percent of Mexican households experience some level of food insecurity (FI). Studies have shown positive associations between FI and…
Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes: the Diabetes Study of Northern California (DISTANCE)
While stress has been linked to poor health outcomes, little is known about the impact of objective measures of neighborhood…
Optimizing Clinical Decision Support in the Electronic Health Record. Clinical Characteristics Associated with the Use of a Decision Tool for Disposition of ED Patients with Pulmonary Embolism
Adoption of clinical decision support (CDS) tools by clinicians is often limited by workflow barriers. We sought to assess characteristics…
Development and Validation of an Electronic Medical Record-Based Alert Score for Detection of Inpatient Deterioration Outside the ICU
Patients in general medical-surgical wards who experience unplanned transfer to the intensive care unit (ICU) show evidence of physiologic derangement…
Harms, benefits, and the nature of interventions in pragmatic clinical trials
To produce evidence capable of informing healthcare decision making at all critical levels, pragmatic clinical trials are diverse both in…
Conversations for Providers Caring for Patients With Rectal Cancer: Comparison of Long-Term Patient-Centered Outcomes for Patients With Low Rectal Cancer Facing Ostomy or Sphincter-Sparing Surgery
For some patients with low rectal cancer, ostomy (with elimination into a pouch) may be the only realistic surgical option.…
A Learning Behavioral Health Care System: Opportunities to Enhance Research
Sweeping changes in health care financing combined with the increased use of technology across health care systems are making it…
Risk of Serious Infection for Patients with Systemic Lupus Erythematosus Starting Glucocorticoids with or without Antimalarials
To compare serious infection risk for systemic lupus erythematosus (SLE) patients starting glucocorticoids (GC), antimalarials (AM), or their combination. We…
The Digital Divide and Patient Portals: Internet Access Explained Differences in Patient Portal Use for Secure Messaging by Age, Race, and Income
Online access to health records and the ability to exchange secure messages with physicians can improve patient engagement and outcomes;…
Acceptance of flexible sigmoidoscopy screening for colorectal cancer
This study was conducted in the Kaiser Permanente Medical Care Program of Northern California to identify patient characteristics that explain…
Participation of Asian-American women in cancer treatment research: a pilot study
Few Asian-American women participate in cancer treatment trials. In a pilot study to assess barriers to participation, we mailed surveys…
Breast and cervical cancer screening: clinicians’ views on health plan guidelines and implementation efforts
BACKGROUND: Optimizing breast and cervical cancer screening rates within health plans requires clinician support for screening guidelines, an awareness of…
Women’s decision making about whether or not to use breast cancer chemoprevention
BACKGROUND: Minimal research is available that examines how women at high risk for breast cancer make choices about chemoprevention. We…
In-hospital mortality following treatment with red blood cell transfusion or inotropic therapy during early goal-directed therapy for septic shock: a retrospective propensity-adjusted analysis
We sought to investigate whether treatment of subnormal (
Towards Smarter Lumping and Smarter Splitting: Rethinking Strategies for Sepsis and ARDS Clinical Trial Design
Both quality improvement and clinical research efforts over the past few decades have focused on consensus definition of sepsis and…
Trans-ethnic Meta-Analysis and Functional Annotation Illuminates the Genetic Architecture of Fasting Glucose and Insulin
Knowledge of the genetic basis of the type 2 diabetes (T2D)-related quantitative traits fasting glucose (FG) and insulin (FI) in…
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected
Our purpose was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods.…
Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors
Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can…
Is a reduction in distance to nearest supermarket associated with BMI change among type 2 diabetes patients?
We examined whether residing within 2 miles of a new supermarket opening was longitudinally associated with a change in body…
Big data in health care: using analytics to identify and manage high-risk and high-cost patients
The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data…
Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey
More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in…
Rationale and Design of the Randomized Evaluation of Default Access to Palliative Services (REDAPS) Trial
The substantial nationwide investment in inpatient palliative care services stems from their great promise to improve patient-centered outcomes and reduce…
Association Among ICU Congestion, ICU Admission Decision, and Patient Outcomes
To employ automated bed data to examine whether ICU occupancy influences ICU admission decisions and patient outcomes. Retrospective study using…
The Diabetes Telephone Study: Design and challenges of a pragmatic cluster randomized trial to improve diabetic peripheral neuropathy treatment
Challenges to effective pharmacologic management of symptomatic diabetic peripheral neuropathy include the limited effectiveness of available medicines, frequent side effects,…
Medicare Payment Policy Creates Incentives For Long-Term Care Hospitals To Time Discharges For Maximum Reimbursement
Long-term care hospitals are postacute care facilities for patients requiring extended hospital-level care. These facilities are reimbursed by Medicare under…
Multicenter Implementation of a Treatment Bundle for Sepsis Patients with Intermediate Lactate Values
Treatments for patients with sepsis with intermediate lactate values (?2 and
Developing a framework for implementing intensive care unit diaries: a focused review of the literature
Intensive care unit diaries have been shown to improve post-critical illness recovery, however, prior reports of diary implementation are heterogeneous.…
Greater hippocampal volume is associated with PTSD treatment response.
Previous research associates smaller hippocampal volume with posttraumatic stress disorder (PTSD). It is unclear, however, whether treatment affects hippocampal volume…
The Natural History of Changes in Preferences for Life-Sustaining Treatments and Implications for Inpatient Mortality in Younger and Older Hospitalized Adults
To compare changes in preferences for life-sustaining treatments (LSTs) and subsequent mortality of younger and older inpatients. Retrospective cohort study.…
Communication Barriers and the Clinical Recognition of Diabetic Peripheral Neuropathy in a Diverse Cohort of Adults: The DISTANCE Study
The purpose of this study was to explore communication barriers as independent predictors and potential mediators of variation in clinical…
Associations of perceived neighborhood safety and crime with cardiometabolic risk factors among a population with type 2 diabetes
Little is known about how neighborhood crime may relate to health in diabetes patients. We examined associations between individuals' perceptions…
Financial Strain and Medication Adherence among Diabetes Patients in an Integrated Health Care Delivery System: The Diabetes Study of Northern California (DISTANCE)
To examine self-reported financial strain in relation to pharmacy utilization adherence data. Survey, administrative, and electronic medical data from Kaiser…
Refilling medications through an online patient portal: consistent improvements in adherence across racial/ethnic groups
Online patient portals are being widely implemented; however, no studies have examined whether portals influence health behaviors or outcomes similarly…
Diabetes and Prior Coronary Heart Disease are Not Necessarily Risk Equivalent for Future Coronary Heart Disease Events
For more than a decade, the presence of diabetes has been considered a coronary heart disease (CHD) "risk equivalent". The…
Acceptance of Lean redesigns in primary care: A contextual analysis
Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term…
Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005-2012.
OBJECTIVE: To examine the association between added sugar intake and metabolic syndrome among adolescents. DESIGN: Dietary, serum biomarker, anthropometric and…
Severe Hypoglycemia Requiring Medical Intervention in a Large Cohort of Adults With Diabetes Receiving Care in U.S. Integrated Health Care Delivery Systems: 2005-2011
Appropriate glycemic control is fundamental to diabetes care, but aggressive glucose targets and intensive therapy may unintentionally increase episodes of…
Pre-visit prioritization for complex patients with Diabetes: Randomized Trial Design and Implementation within an Integrated Health Care system
Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control.…
Evaluation Following Staggered Implementation of the “Rethinking Critical Care” ICU Care Bundle in a Multicenter Community Setting
To evaluate process metrics and outcomes after implementation of the "Rethinking Critical Care" ICU care bundle in a community setting.…
Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation…
Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to…
PTSD REMISSION AFTER PROLONGED EXPOSURE TREATMENT IS ASSOCIATED WITH ANTERIOR CINGULATE CORTEX THINNING AND VOLUME REDUCTION.
BACKGROUND: Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome…
The Value of Ultrasound Monitoring of Adnexal Masses for Early Detection of Ovarian Cancer
Although ultrasound has so far been found to be ineffective as a screening tool for ovarian cancer, it is commonly…
Medication Adherence Does Not Explain Black-White Differences in Cardiometabolic Risk Factor Control among Insured Patients with Diabetes
Among patients with diabetes, racial differences in cardiometabolic risk factor control are common. The extent to which differences in medication…
Comparative Effectiveness of Antibiotic Prophylaxis in Cataract Surgery
Intracameral injection is an effective method for preventing infection, but no controlled study has been published in the United States.…
Comparative Effectiveness of Etanercept and Adalimumab in Patient Reported Outcomes and Injection-Related Tolerability
To describe patient preferences in selecting specific biologics and compare clinical response using patient reported outcomes (PROs) among patients with…
No Spillover Effect of the Foreclosure Crisis on Weight Change: The Diabetes Study of Northern California (DISTANCE)
The emerging body of research suggests the unprecedented increase in housing foreclosures and unemployment between 2007 and 2009 had detrimental…
Differences in Access to and Preferences for Using Patient Portals and Other eHealth Technologies Based on Race, Ethnicity, and Age: A Database and Survey Study of Seniors in a Large Health Plan
Patients are being encouraged to go online to obtain health information and interact with their health care systems. However, a…
User-Centered Design of a Tablet Waiting Room Tool for Complex Patients to Prioritize Discussion Topics for Primary Care Visits
Complex patients with multiple chronic conditions often face significant challenges communicating and coordinating with their primary care physicians. These challenges…
The Kaiser Permanente Northern California Adult Member Health Survey
The Kaiser Permanente Northern California (KPNC) Member Health Survey (MHS) is used to describe sociodemographic and health-related characteristics of the…
Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting
Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings.…
The Patient Outcomes Research To Advance Learning (PORTAL) Network Adult Overweight and Obesity Cohort: Development and Description
The Patient-Centered Outcomes Research Institute (PCORI) created a new national network infrastructure to enable large-scale observational comparative effectiveness research across…
Treatment of Alcohol Withdrawal Syndrome with and without Dexmedetomidine
Studies suggest that dexmedetomidine-an intravenous central-acting ?2-adrenergic agonist that effectively reduces anxiety among critically ill patients-is being used in patients…
Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges
The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive…
Population Variations in Rheumatoid Arthritis Treatment and Outcomes, Northern California, 1998-2009
To assess variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009. The study used…
Parental Views on Expanded Newborn Screening Using Whole-Genome Sequencing
The potential application of whole-genome sequencing (WGS) to state-mandated standard newborn screening (NBS) challenges the traditional public health approach to…
Genetics, Diet, and Season Are Associated with Serum 25-Hydroxycholecalciferol Concentration in a Yup’ik Study Population from Southwestern Alaska.
BACKGROUND:Low blood vitamin D concentration is a concern for people living in circumpolar regions, where sunlight is insufficient for vitamin…
Patient-initiated e-mails to providers: associations with out-of-pocket visit costs, and impact on care-seeking and health
To understand when patients use secure e-mail messaging with healthcare providers across several types of questions or concerns, associations between…
Emergency Department Management of Atrial Fibrillation and Flutter and Patient Quality of Life at One Month Postvisit
We identify characteristics of patients with atrial fibrillation or flutter associated with favorable assessments of emergency department (ED) effectiveness and…
Evaluating a Model to Predict Primary Care Physician-Defined Complexity in a Large Academic Primary Care Practice-Based Research Network
Improving the ability to risk-stratify patients is critical for efficiently allocating resources within healthcare systems. The purpose of this study…
Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors
Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors'…
Implementation of Computerized Physician Order Entry Is Associated With Increased Thrombolytic Administration for Emergency Department Patients With Acute Ischemic Stroke
Electronic health record systems with computerized physician order entry and condition-specific order sets are intended to standardize patient management and…
Metabolic Dyslipidemia and Risk of Coronary Heart Disease in 28,318 Adults With Diabetes Mellitus and Low-Density Lipoprotein Cholesterol <100 mg/dl
The risk of future coronary heart disease (CHD) in subjects with diabetes and "metabolic dyslipidemia" (high triglyceride [TGs] and low…
Comparative Effectiveness of Three Prophylactic Strategies to Prevent Clinical Macular Edema after Phacoemulsification Surgery
To study the relationship of chemoprophylaxis and other factors with the occurrence of acute, clinical, postoperative macular edema. Retrospective cohort…
Health IT-assisted population-based preventive cancer screening: a cost analysis
Novel health information technology (IT)-based strategies harnessing patient registry data seek to improve care at a population level. We analyzed…
The impact of electronic health records and teamwork on diabetes care quality
Evidence of the impact electronic health records (EHRs) have on clinical outcomes remains mixed. The impact of EHRs likely depends…
Patient reported outcomes for diabetic peripheral neuropathy
Multiple patient-reported outcomes (PROs) have been used to assess symptoms among patients with Diabetic Peripheral Neuropathy (DPN). However, there is…
Variation in the Contents of Sepsis Bundles and Quality Measures: A Systematic Review
Sepsis contributes to one in every two to three inpatient hospital deaths. Early recognition and treatment are instrumental in reducing…
Nonelective Rehospitalizations and Postdischarge Mortality: Predictive Models Suitable for Use in Real Time
Hospital discharge planning has been hampered by the lack of predictive models. To develop predictive models for nonelective rehospitalization and…
Employer-Based Screening for Diabetes and Prediabetes in an Integrated Health Care Delivery System: A Natural Experiment for Translation in Diabetes (NEXT-D) Study
This study evaluates an employer-based diabetes/prediabetes screening intervention that invited at-risk employees via letters, secure e-mails, and automated voice messages…
Does well-child care have a future in pediatrics?
The most common adult chronic diseases affect 1 in 3 adults and account for more than three-quarters of US health…
Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review.
BACKGROUND: In the United States, people of color face disparities in access to health care, the quality of care received,…
Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses
The management of women with asymptomatic adnexal masses should aim to balance potential benefit with potential harm. While masses with…
Who Must We Target Now to Minimize Future Cardiovascular Events and Total Mortality? Lessons From the SUPREME-DM Cohort Study
Examining trends in cardiovascular events and mortality in US health systems can guide the design of targeted clinical and public…
An algorithm to identify medication nonpersistence using electronic pharmacy databases
Identifying patients who are medication nonpersistent (fail to refill in a timely manner) is important for healthcare operations and research.…
Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active
To identify the predictors and clinical effects among inactive patients with diabetes who become physically active, in the setting of…
Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes: The Diabetes and Aging Study
The aim of this study was to evaluate ethnic differences in burden of prevalent geriatric conditions and diabetic complications among…
Reach and Validity of an Objective Medication Adherence Measure Among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study
With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using…
Why the C-statistic is not informative to evaluate early warning scores and what metrics to use
Metrics typically used to report the performance of an early warning score (EWS), such as the area under the receiver…
Variation in genes controlling warfarin disposition and response in American Indian and Alaska Native people: CYP2C9, VKORC1, CYP4F2, CYP4F11, GGCX.
OBJECTIVES:Pharmacogenetic testing is projected to improve health outcomes and reduce the cost of care by increasing therapeutic efficacy and minimizing…
Building Equity Improvement into Quality Improvement: Reducing Socioeconomic Disparities in Colorectal Cancer Screening as Part of Population Health Management
Improving colorectal cancer (CRC) screening rates for patients from socioeconomically disadvantaged backgrounds is a recognized public health priority. Our aim…
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011
Diabetes is a leading cause of chronic kidney disease (CKD). Different methods of CKD ascertainment may impact prevalence estimates. We…
Outreach to diversify clinical trial participation: A randomized recruitment study
Racial and ethnic minorities remain underrepresented in clinical research, yet few recruitment strategies have been rigorously evaluated. We experimentally tested…
Evaluating diabetes health policies using natural experiments: the natural experiments for translation in diabetes study
The high prevalence and costs of type 2 diabetes makes it a rapidly evolving focus of policy action. Health systems,…
Methods for engaging stakeholders in comparative effectiveness research: A patient-centered approach to improving diabetes care
Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience. Online…
Electronic Health Records and the Evolution of Diabetes Care: A Narrative Review
Adoption of electronic health records (EHRs) has increased dramatically since the 2009 implementation of the Health Information Technology for Economic…
Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism
Studies of adults presenting to the emergency department (ED) with acute pulmonary embolism (PE) suggest that those who are low…
Randomized Trial of a Health IT Tool to Support Between-Visit-Based Laboratory Monitoring for Chronic Disease Medication Prescriptions
Lack of timely medication intensification and inadequate medication safety monitoring are two prevalent and potentially modifiable barriers to effective and…
Does Food Vendor Density Mediate the Association Between Neighborhood Deprivation and BMI?: A G-computation Mediation Analysis
In previous research, neighborhood deprivation was positively associated with body mass index (BMI) among adults with diabetes. We assessed whether…
Preventable Major Cardiovascular Events Associated With Uncontrolled Glucose, Blood Pressure, and Lipids and Active Smoking in Adults With Diabetes With and Without Cardiovascular Disease: A Contemporary Analysis
The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among…
Determinants of Adherence to Diabetes Medications: Findings From a Large Pharmacy Claims Database
Adults with diabetes typically take multiple medications for hyperglycemia, diabetes-associated conditions, and other comorbidities. Medication adherence is associated with improved…
Health Care System-level Factors Associated With Performance on Medicare STAR Adherence Metrics in a Large, Integrated Delivery System
The Centers for Medicare and Medicaid Services provide significant incentives to health plans that score well on Medicare STAR metrics…
Impact of a Pharmacy Benefit Change on New Use of Mail Order Pharmacy among Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)
To assess the impact of a pharmacy benefit change on mail order pharmacy (MOP) uptake. Race-stratified, random sample of diabetes…
Stakeholder engagement in policy development: challenges and opportunities for human genomics
Along with rapid advances in human genomics, policies governing genomic data and clinical technologies have proliferated. Stakeholder engagement is widely…
Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.
INTRODUCTION AND AIMS: Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress…
Effects of Eliminating Drug Caps on Racial Differences in Antidepressant Use Among Dual Enrollees With Diabetes and Depression
Black patients with diabetes are at greater risk of underuse of antidepressants even when they have equal access to health…
Patients who self-monitor blood glucose and their unused testing results
To investigate the prevalence, predictors, and costs associated with unused results from self-monitoring of blood glucose (SMBG). Observational cohort study.…
Combining seeking safety with sertraline for PTSD and alcohol use disorders: A randomized controlled trial.
OBJECTIVE: The current study marks the first randomized controlled trial to test the benefit of combining Seeking Safety (SS), a…
Low-frequency and rare exome chip variants associate with fasting glucose and type 2 diabetes susceptibility
Fasting glucose and insulin are intermediate traits for type 2 diabetes. Here we explore the role of coding variation on…
Wellness Coaching for People With Prediabetes: A Randomized Encouragement Trial to Evaluate Outreach Methods at Kaiser Permanente, Northern California, 2013
Health coaching can improve lifestyle behaviors known to prevent or manage chronic conditions. Little is known about effective ways to…
Accuracy of parent-reported information for estimating prevalence of overweight and obesity in a race-ethnically diverse pediatric clinic population aged 3 to 12
There is conflicting evidence about the accuracy of estimates of childhood obesity based on parent-reported data. We assessed accuracy of…
Big Data, Miniregistries: A Rapid-Turnaround Solution to Get Quality Improvement Data into the Hands of Medical Specialists
The cost to build and to maintain traditional registries for many dire, complex, low-frequency conditions is prohibitive. The authors used…
Functional Limitations, Medication Support, and Responses to Drug Costs among Medicare Beneficiaries
Standard Medicare Part D prescription drug benefits include substantial and complex cost-sharing. Many beneficiaries also have functional limitations that could…
The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente
Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However,…
Factors associated with use and non-use of the Fecal Immunochemical Test (FIT) kit for Colorectal Cancer Screening in Response to a 2012 outreach screening program: a survey study
The one-sample fecal immunochemical test (FIT) is gaining popularity for colorectal cancer (CRC) screening of average-risk people. However, uptake and…
Trends in Diabetes Incidence Among 7 Million Insured Adults, 2006-2011: The SUPREME-DM Project
An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of…
Bringing patients’ social context into the examination room: an investigation of the discussion of social influence during contraceptive counseling
Although social networks are an increasingly recognized influence on contraceptive use, little is known about if and how social influences…
Timing of Discharge Follow-up for Acute Pulmonary Embolism: Retrospective Cohort Study
Historically, emergency department (ED) patients with pulmonary embolism (PE) have been admitted for several days of inpatient care. Growing evidence…
Pneumothorax is a rare complication of thoracic central venous catheterization in community EDs
The rate of iatrogenic pneumothorax associated with thoracic central venous catheterization in community emergency departments (EDs) is poorly described, although…
The Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH): Design of a pharmacogenetic Resource for Type 2 Diabetes
Genome-wide association studies have uncovered a large number of genetic variants associated with type 2 diabetes or related phenotypes. In…
An Innovative Approach to Informing Research: Gathering Perspectives on Diabetes Care Challenges From an Online Patient Community
Funding agencies and researchers increasingly recognize the importance of patient stakeholder engagement in research. Despite calls for greater patient engagement,…
Creating patient-centered health care systems to improve outcomes and reduce disparities
Health care delivery systems that are designed to understand and meet patient preferences for care have the potential to improve…
The Accuracy of an Electronic Pulmonary Embolism Severity Index Auto-Populated from the Electronic Health Record: Setting the stage for computerized clinical decision support
The Pulmonary Embolism (PE) Severity Index identifies emergency department (ED) patients with acute PE that can be safely managed without…
Infections Requiring Hospitalization as Predictors of Pediatric-Onset Crohn’s Disease and Ulcerative Colitis
Objectives. To assess the relationship between infections and the risk of pediatric-onset inflammatory bowel disease (IBD). Methods. We conducted a…
Linguistic characteristics in a non-trauma-related narrative task are associated with PTSD diagnosis and symptom severity.
Linguistic characteristics of trauma narratives have been linked to the development and severity of posttraumatic stress disorder (PTSD). However, it…
Randomized Trial of Telephone Outreach to Improve Medication Adherence and Metabolic Control in Adults With Diabetes
Medication nonadherence is a major obstacle to better control of glucose, blood pressure (BP), and LDL cholesterol in adults with…
Medicare Star excludes diabetes patients with poor CVD risk factor control
CMS recently added medication adherence to antihypertensives, antihyperlipidemics, and oral antihyperglycemics to its Medicare Star quality measures. These CMS metrics…
The Next Step Towards Making Use Meaningful: Electronic Information Exchange and Care Coordination Across Clinicians and Delivery Sites
Care for patients with chronic conditions often requires coordination between multiple physicians and delivery sites. Electronic Health Record (EHR) use…
Outcomes from ultrasound follow-up of small complex adnexal masses in women over 50
The discovery of a complex adnexal mass in an older woman often raises concern for cancer. We evaluate outcomes for…
Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)
In chronic illness self-care, social support may influence some health behaviors more than others. Examine social support's association with seven…
Reliability and validity of a survey to measure bowel function and quality of life in long-term rectal cancer survivors
Examination of reliability and validity of a specialized health-related quality of life questionnaire for rectal cancer (RC) survivors (?5 years…
Incidence of Remission in Adults With Type 2 Diabetes: The Diabetes & Aging Study
To estimate the incidence of remission in adults with type 2 diabetes not treated with bariatric surgery and to identify…
Comparative Effectiveness of Laparoscopic Adjustable Gastric Banding vs Laparoscopic Gastric Bypass
Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (AGB) are 2 of the most commonly performed bariatric procedures…
Toward a translational approach to targeting the endocannabinoid system in posttraumatic stress disorder: a critical review of preclinical research.
Despite the lack of clinical research, marijuana and synthetic cannabinoids have been approved to treat posttraumatic stress disorder (PTSD) in…
At the crossroads: the intersection of substance use disorders, anxiety disorders, and posttraumatic stress disorder.
The co-occurrence of substance use disorders with anxiety disorders and/or posttraumatic stress disorder has been widely documented and when compared…
Non-viral opportunistic infections in new users of tumour necrosis factor inhibitor therapy: results of the SAfety Assessment of Biologic ThERapy (SABER) Study
To determine among patients with autoimmune diseases in the USA whether the risk of non-viral opportunistic infections (OI) was increased…
Lack of improved outcomes with increased use of targeted temperature management following out-of-hospital cardiac arrest: A multicenter retrospective cohort study
To assess whether increased use of targeted temperature management (TTM) within an integrated healthcare delivery system resulted in improved rates…
Trends in Elective Labor Induction for Six United States Health Plans, 2001-2007
To describe trends in labor induction, including elective induction, from 2001 to 2007 for six U.S. health plans and to…