A5061809927- Spine and Intervertebral Disc Pathology
- Musculoskeletal pain and rehabilitation
- Health Systems, Economic Evaluations, Quality of Life
- Spinal Fractures and Fixation Techniques
- Medical Imaging and Analysis
- Radiation Dose and Imaging
- Pelvic and Acetabular Injuries
- Clinical practice guidelines implementation
- Radiology practices and education
- Anesthesia and Pain Management
- Hip and Femur Fractures
- Meta-analysis and systematic reviews
- Orthopedic Surgery and Rehabilitation
- Genomics and Rare Diseases
- Peripheral Nerve Disorders
- Trauma and Emergency Care Studies
- Shoulder Injury and Treatment
- Radiomics and Machine Learning in Medical Imaging
- Primary Care and Health Outcomes
- Genetics and Neurodevelopmental Disorders
- Health Policy Implementation Science
- Traumatic Brain Injury and Neurovascular Disturbances
- Healthcare cost, quality, practices
- Opioid Use Disorder Treatment
- Medical Imaging Techniques and Applications
University of Washington
2016-2025
Neurological Surgery
2015-2024
Washington Center
2021-2024
Seattle University
1996-2023
Howard Hughes Medical Institute
2023
Harvard University
2017-2023
Boston Children's Hospital
2023
Seattle Children's Hospital
2021-2023
Associated Radiologists
2023
University of California System
2022
Vertebroplasty is commonly used to treat painful, osteoporotic vertebral compression fractures.In this multicenter trial, we randomly assigned 131 patients who had one three painful fractures undergo either vertebroplasty or a simulated procedure without cement (control group). The primary outcomes were scores on the modified Roland-Morris Disability Questionnaire (RDQ) (on scale of 0 23, with higher indicating greater disability) and patients' ratings average pain intensity during preceding...
Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis, a common cause pain and disability in older adults. However, rigorous data lacking regarding the effectiveness safety these injections.In double-blind, multisite trial, we randomly assigned 400 patients who had central stenosis moderate-to-severe leg receive epidural glucocorticoids plus lidocaine or alone. The received one two before primary outcome evaluation, performed 6 weeks after...
Context Faster magnetic resonance imaging (MRI) scanning has made MRI a potential cost-effective replacement for radiographs patients with low back pain. However, whether rapid results in better patient outcomes than radiographic evaluation or alternative is unknown. Objective To determine the clinical and economic consequences of replacing spine primary care patients. Design, Setting, Patients Randomized controlled trial 380 aged 18 years older whose physicians had ordered that their pain...
Prospective cohort study of randomly selected Veterans Affairs out-patients without baseline low back pain (LBP).To determine predictors new LBP as well the 3-year incidence magnetic resonance imaging (MRI) findings.Few prospective studies have examined clinical and anatomic risk factors for development LBP, or findings their relationship to onset.We 148 (aged 35 70) in past 4 months. We compared lumbar spine MRI. Using data collected every months, we developed a prediction model pain-free...
Most analyses of intravenous tissue plasminogen activator (IV tPA) use for acute stroke in routine practice have been limited by sample size and generally restricted to patients treated large academic medical facilities. In the present study, we sought estimate among community hospitals IV tPA identify factors associated with inpatient mortality.We evaluated a retrospective cohort 23 058 ischemic from 137 hospitals.Three hundred sixty-two (1.6%) were tPA, 9.9% those died during...
An analysis of revertants missense mutants in phage P22 has shown: (i) New temperature-sensitive (TS) and cold-sensitive (CS) phenotypes are often acquired concomitant with reversion. (ii) In many cases, these new due to second-site mutations (suppressors) that correct the original defect. (iii) Sometimes suppressor mutation is not same gene as mutation. (iv) Extragenic suppressors almost always genes whose products known interact physically products. (v) The typically retain their TS or CS...
Objective: To assess the safety and efficacy of memantine, an uncompetitive antagonist N-methyl-D-aspartate receptor as treatment HIV-associated cognitive impairment. Methods: This was a Phase II randomized, double-blind, placebo-controlled, multicenter trial within Adult AIDS Clinical Trials Group. One-hundred forty HIV-infected adults with mild to severe dementia complex receiving stable antiretroviral therapy were enrolled. Memantine initiated at 10 mg daily escalated 40 daily, or up...
Background: For carefully selected patients with lumbar stenosis, decompression surgery is more efficacious than nonoperative treatment. However, some undergo repeat surgery, often because of complications, the failure to achieve solid fusion following arthrodesis procedures, or persistent symptoms. We assessed probability operations for treatment stenosis and examined its association patient age, comorbidity, previous type surgical procedure. Methods: performed a retrospective cohort...
The clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; currently involves use of labor-intensive parallel systems that are separate from care. emergence pragmatic trials (PCTs) poses possible solution: these large-scale embedded within routine care often involve cluster randomization hospitals, clinics, primary providers, etc. Interventions can be implemented by health system personnel through usual communication...
Prior studies that have concluded disk degeneration uniformly precedes facet been based on convenience samples of individuals with low back pain. We conducted a study to examine whether the view spinal begins anterior structures is supported by epidemiologic observations in community-based population. 361 participants from Framingham Heart Study were included this study. The prevalences vertebral structure (disk height loss) and posterior (facet joint osteoarthritis) characterized CT...
In contrast to the recommendations for younger adults, many guidelines allow older adults with back pain undergo imaging without waiting 4 6 weeks. However, early may precipitate interventions that do not improve outcomes.To compare function and at 12-month follow-up visit among who received those did receive after a new primary care radiculopathy.Prospective cohort of 5239 patients 65 years or (2011-2013) in 3 US health systems. We matched controls 1:1 using propensity score matching...
Purpose To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with screening alone, among women dense breasts. Materials Methods An established, discrete-event breast cancer simulation model was used to estimate comparative clinical cost-effectiveness both versus alone U.S. aged 50–74 years breasts from a federal payer perspective lifetime horizon. Input values were estimated for test performance, costs, health state utilities National...
This analysis of the lumbar epidural steroid injections for spinal stenosis multicenter randomized controlled trial data identifies degree and risk factors cortisol suppression after in older adults with stenosis. Four hundred patients aged 50 years back or leg pain central completed baseline demographic psychosocial measures. Morning serum levels were measured at 3 weeks initial injection. Patients to receive either local anesthetic corticosteroid (n = 200) only 200). The specific was...
<b><i>Objectives: </i></b> To evaluate the reliability and diagnostic accuracy of high-resolution MRI median nerve in a prospectively assembled cohort subjects with clinically suspected carpal tunnel syndrome (CTS). <b><i>Methods: The authors identified 120 CTS from five Seattle-area clinics. All completed hand-pain diagram underwent standardized conduction study (NCS). reference standard for determining status was classic or probable hand pain NCS difference >0.3 ms between 8-cm ulnar...