A5061398003- Musculoskeletal pain and rehabilitation
- Spine and Intervertebral Disc Pathology
- Global Cancer Incidence and Screening
- Atrial Fibrillation Management and Outcomes
- Colorectal Cancer Screening and Detection
- Cervical Cancer and HPV Research
- Primary Care and Health Outcomes
- Cardiac Arrhythmias and Treatments
- Patient Satisfaction in Healthcare
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- Patient-Provider Communication in Healthcare
- Clinical practice guidelines implementation
- Cardiac electrophysiology and arrhythmias
- Chronic Disease Management Strategies
- Anesthesia and Pain Management
- Acute Ischemic Stroke Management
- Emergency and Acute Care Studies
- Food Security and Health in Diverse Populations
- Pain Management and Placebo Effect
- Spinal Fractures and Fixation Techniques
- Pneumonia and Respiratory Infections
- Diabetes Management and Research
- Cardiac, Anesthesia and Surgical Outcomes
- Pain Management and Opioid Use
Harvard University
2016-2025
Massachusetts General Hospital
2016-2025
Newton Wellesley Hospital
2024
University of York
2023
University of Maryland, College Park
2023
Bristol-Myers Squibb (United States)
2022
Dartmouth College
2009-2022
Decision Sciences (United States)
2022
James J. Peters VA Medical Center
2021
University of El Salvador
2021
Study Design This study analyzed health-related quality-of-life measures and other clinical questionnaire data obtained from the Maine Lumbar Spine Study, a prospective cohort of persons with low back problems. Objective For sciatica, pain-specific general were compared regard to internal consistency, construct validity, reproducibility, responsiveness in detecting small changes over 3-month period. Summary Background Data collected 427 participants sciatica. Baseline in-person interviews...
In Brief Study Design. A prospective observational cohort study. Objective. To assess long-term outcomes of patients with lumbar spinal stenosis treated surgically or nonsurgically. Summary Background Data. The relative benefit various treatments for is uncertain. Surgical treatment has been associated short-term improvement, but recurrence symptoms documented. Few studies have compared surgical and nonsurgical treatments. Methods. Patients recruited from the practices orthopaedic surgeons,...
In Brief Study Design. Clinical practice guideline. Objective. To develop evidence-based recommendations on use of interventional diagnostic tests and therapies, surgeries, interdisciplinary rehabilitation for low back pain any duration, with or without leg pain. Summary Background Data. Management patients persistent disabling remains a clinical challenge. A number therapies surgery are available their is increasing, but in some cases utility uncertain controversial. Interdisciplinary has...
In Brief Study Design. A prospective cohort study. Objective. To assess 10-year outcomes of patients with sciatica resulting from a lumbar disc herniation treated surgically or nonsurgically. Summary Background Data. There is little information comparing long-term surgical and conservative therapy in contemporary clinical practice. Prior studies suggest that these are similar. Methods. Patients recruited the practices orthopedic surgeons, neurosurgeons, occupational medicine physicians...
Study Design. A prospective cohort study of patients with lumbar spinal stenosis recruited from the practices orthopedic surgeons and neurosurgeons throughout Maine. Objective. To assess 4-year outcomes for treated surgically or nonsurgically. Summary Background Data. Surgery has increased dramatically despite lack randomized trials comparing surgical nonsurgical treatments. Long-term evaluation series documented deterioration in initial symptomatic improvement, but few studies have compared...
Systematic review and meta-analysis.To assess the efficacy of opioids in adults with chronic low back pain (CLBP).Opioids for CLBP has increased dramatically. However, benefits risks remain unclear.We updated a 2007 Cochrane Review through October 2012 randomized controlled trials from multiple databases. Use noninjectable at least 4 weeks was compared placebo or other treatments; comparisons different were excluded. Outcomes included function using standardized mean difference (SMD) risk...
Objective To determine which area‐based socioeconomic status ( SES ) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in primary network January 1, 2009 December 31, 2011. Study Design Cross‐sectional, comparing associations between indicators and patient outcomes. Collection Address data were geocoded construct at block group BG ), census tract CT ZIP code levels. on outcomes abstracted electronic...
It is unclear if helping patients meet resource needs, such as difficulty affording food, housing, or medications, improves clinical outcomes.To determine the effectiveness of Health Leads program on improvement in systolic and diastolic blood pressure (SBP DBP, respectively), low-density lipoprotein cholesterol (LDL-C) level, hemoglobin A1c (HbA1c) level.A difference-in-difference evaluation was conducted from October 1, 2012, through September 30, 2015, at 3 academic primary care...
Increasing access to care may be insufficient improve the health of patients with diabetes mellitus and unmet basic needs (hereinafter referred as material need insecurities). How specific insecurities relate clinical outcomes use resources in a setting near-universal is unclear.To determine association food insecurity, cost-related medication underuse, housing instability, energy insecurity control resources.Cross-sectional data were collected from June 1, 2012, through October 31, 2013, at...
Morbidity from undiagnosed atrial fibrillation (AF) may be preventable with early detection. Many consumer wearables contain optical photoplethysmography (PPG) sensors to measure pulse rate. PPG-based software algorithms that detect irregular heart rhythms identify AF in large populations using wearables, but minimizing false-positive detections is essential.We performed a prospective remote clinical trial examine novel algorithm for detecting range of wrist-worn devices. Adults aged ≥22...
Background: Undiagnosed atrial fibrillation (AF) may cause preventable strokes. Guidelines differ regarding AF screening recommendations. We tested whether point-of-care with a handheld single-lead ECG at primary care practice visits increases diagnoses of AF. Methods: randomized 16 clinics 1:1 to using (AliveCor KardiaMobile) during vital sign assessments, or usual care. Patients included were ages ≥65 years. Screening results provided clinicians the encounter. All confirmatory diagnostic...
Study Design The Maine Lumbar Spine is a prospective cohort study of patients recruited from the practices orthopedic surgeons, neurosurgeons, and occupational medicine physicians throughout Maine. Objective To assess 1-year outcomes with sciatica believed to be due herniated lumbar disc treated surgically or nonsurgically. Summary Background Data spine surgery rates vary by geographic region may reflect uncertainty about optimal clinical use. Methods Eligible consenting participated in...
Study Design A prospective cohort study of patients with lumbar spinal stenosis recruited from the practices orthopedic surgeons and neurosurgeons throughout Maine. Objective To assess 1-year outcomes treated surgically or nonsurgically. Summary Background Data No randomized trials few nonexperimental studies have compared surgical nonsurgical treatment stenosis. The authors' goal was to Methods Eligible, consenting participated in baseline interviews were then mailed follow-up...
A prospective cohort study.To assess 5-year outcomes for patients with sciatica caused by a lumbar disc herniation treated surgically or nonsurgically.There is limited knowledge about long-term treatment of herniation, particularly the relative benefits surgical and conservative therapy in contemporary clinical practice.Eligible, consenting recruited from practices orthopedic surgeons, neurosurgeons, occupational medicine physicians throughout Maine had baseline interviews mailed follow-up...
Background: Patients with community-acquired pneumonia who are at low risk for short-term mortality can be identified using a validated prediction rule, the Pneumonia Severity Index.Such patients should candidates outpatient treatment, yet many hospitalized.Objective: To assess program to safely increase proportion of low-risk treated home. Methods:The intervention provided physicians Index score and corresponding eligible offered enhanced visiting nurse services antibiotic...
Background: Patients with complex health needs are increasingly the focus of system redesign. Objective: To characterize patients, as defined by their primary care physicians (PCPs), and to compare this definition other commonly used algorithms. Design: Cohort study. Setting: 1 hospital-based practice, 4 community centers, 7 private practices in a network United States. Participants: 40 who reviewed random sample 120 own patients. Measurements: After excluding patients for whom they were not...
Background: Valid measurement of physician performance requires accurate identification patients for whom a is responsible. Among all seen by physician, some will be more strongly connected to their than others, but the effect connectedness on measures not known. Objective: To determine whether patient–physician affects clinical performance. Design: Population-based cohort study. Setting: Academic network 4 community health centers and 9 hospital-affiliated primary care practices. Patients:...
OBJECTIVE Both food insecurity (limited access owing to cost) and living in areas with low physical nutritious foods are public health concerns, but their relative contribution diabetes management is poorly understood. RESEARCH DESIGN AND METHODS This was a prospective cohort study. A random sample of patients primary care network completed assessment 2013. Low at the census tract level defined as no supermarket within 1 mile urban 10 miles rural areas. HbA1c measurements were obtained from...