A5083403364- Anesthesia and Pain Management
- Opioid Use Disorder Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Pain Management and Opioid Use
- Colorectal Cancer Screening and Detection
- Innovations in Medical Education
- Colorectal Cancer Surgical Treatments
- Patient Satisfaction in Healthcare
- Healthcare cost, quality, practices
- Surgical site infection prevention
- Colorectal and Anal Carcinomas
- Gastric Cancer Management and Outcomes
- Genetic factors in colorectal cancer
- Esophageal Cancer Research and Treatment
- Healthcare professionals’ stress and burnout
- Radiology practices and education
- Health Systems, Economic Evaluations, Quality of Life
- Health and Medical Research Impacts
- Cancer survivorship and care
- Diversity and Career in Medicine
- Hernia repair and management
- Antibiotics Pharmacokinetics and Efficacy
- Prenatal Substance Exposure Effects
- Colorectal Cancer Treatments and Studies
- Surgical Simulation and Training
Temple University
2025
Temple University Health System
2025
Temple University Hospital
2023-2024
Cleveland Clinic
2022-2023
University of Michigan
2016-2021
Michigan Medicine
2018-2021
Michigan United
2019-2020
A. Alfred Taubman Health Care Center
2019
VA Ann Arbor Healthcare System
2018-2019
Ann Arbor Center for Independent Living
2019
<h3>Importance</h3> There is growing evidence that opioids are overprescribed following surgery. Improving prescribing requires understanding factors associated with opioid consumption. <h3>Objective</h3> To describe and consumption for a variety of surgical procedures determine after <h3>Design, Setting, Participants</h3> A retrospective, population-based analysis the quantity prescribed patient-reported across 33 health systems in Michigan, using sample adults 18 years older undergoing...
With improving survival from colorectal cancer, there is a growing population of patients undergoing surveillance. National accreditation organizations have increasingly endorsed formal survivorship care planning. To effectively design patient-centered programs, an understanding the prevalence unmet psychosocial and symptomatic needs required.
Breast cancer treatment can cause premature ovarian failure, yet the majority of young patients do not receive adequate education about effects before initiating chemotherapy. We studied impact an oncofertility program on access to fertility preservation.An was initiated foster collaboration between oncologists and reproductive endocrinologists, help increase preservation. Documented conversations concerns, specialist referrals, appointments, preservation procedures were compared breast from...
To measure the association between patient-reported satisfaction and regret clinical outcomes.Patient-reported outcomes are becoming an increasingly important marker of quality patient care. It is unclear however, how well adequately reflect care in surgical patients.Retrospective, population-based analysis adults ages 18 older undergoing surgery across 38 hospitals Michigan January 1, 2017 May 31, 2018.In this study, 9953 patients (mean age 56 years; 5634 women (57%)) underwent 1 16...
Objective: We sought to describe the differences in health care spending and utilization among patients who develop persistent postoperative opioid use. Summary of Background Data: Although use following surgery has garnered concern, its impact on costs remains unknown. Methods: examined insurance claims 133,439 opioid-naive adults undergoing surgery. Outcomes included 6-month spending; proportion attributable admission, readmission, ambulatory or emergency care; monthly 6 months before...
Objectives: The National Accreditation Program for Rectal Cancer (NAPRC) was established in 2017 to decrease rectal cancer treatment variation and improve oncologic outcomes. Initiating curative intent <60 days of first evaluation is one NAPRC standard. We evaluated whether outcomes improved with timely factors associated its receipt. Methods: Using the NCDB, we identified stage I III patients treated from 2004 2020 curative-intent surgery. Patients were stratified into 2 cohorts (timely...
BACKGROUND: The total mesorectal excision technique is associated with improved outcomes for rectal cancer, and grading the specimen recommended. We implemented a multimodal intervention in Michigan Surgical Quality Collaborative hospitals to increase grading. OBJECTIVE: To compare rates over time between that received early late study. DESIGN: Stepped wedge randomized controlled trial receive education or one year later. used generalized linear mixed model of groups, adjusting hospital...
Objective: We characterized patterns of preoperative opioid use in patients undergoing elective surgery to identify the relationship between and subsequent fill after surgery. Background: Preoperative is common, varies by dose, recency, duration, continuity fills. To date, there little evidence guide postoperative prescribing need based on prior use. Methods: analyzed claims data from Clinformatics DataMart Database for aged 18 64 years major minor 2008 2015. was defined as any prescription...
Objective: To determine the effect of nonchronic, periodic preoperative opioid use on prolonged fills after surgery. Background: Nonchronic, is common, but its postoperative not well understood. We hypothesize greater before surgery correlated with persistent use. Methods: used a national private insurance claims database, Optum's de-identifed Clinformatics Data Mart Database, to identify adults undergoing general, gynecologic, and urologic surgical procedures between 2008 2015 (N =...
represent an effective strategy to immediately affect the opioid crisis by reducing excessive prescribing after surgical operations.
Objective: To assess the association between preoperative opioid exposure and readmissions following common surgery. Summary Background Data: Preoperative use is common, but its effect on opioid-related, pain-related, respiratory-related, all-cause surgery unknown. Methods: We analyzed claims data from a 20% national Medicare sample of patients ages ≥ 65 with Part D undergoing January 1, 2009 November 30, 2016. grouped by dose, duration, recency, continuity prescription fills. used logistic...
Objective: The aim of this study was to determine whether older adults are at higher risk lasting functional and cognitive decline after surgery, the impact on survival healthcare use. Summary Background Data: Patient-centered outcomes surgery poorly characterized. Methods: Using data from Health Retirement Study linked with Medicare, we matched (≥65 years) who underwent one 163 high-risk elective operations (ie, inpatient mortality ≥1%) nonsurgical controls between 1992 2012. Functional...
Background Opioids are prescribed in excess after surgery. We leveraged our continuous quality improvement infrastructure to implement opioid prescribing guidelines and subsequently evaluate changes postoperative prescribing, consumption patient satisfaction/pain a statewide regional health system. Methods collected data regarding prescription size, patient-reported outcomes from February 2017 May 2019, 70-hospital surgical collaborative. Three iterations of were released. An interrupted...