A5017987589- Colorectal Cancer Screening and Detection
- Gastric Cancer Management and Outcomes
- Genetic factors in colorectal cancer
- Healthcare Operations and Scheduling Optimization
- Global Cancer Incidence and Screening
- Gastroesophageal reflux and treatments
- Helicobacter pylori-related gastroenterology studies
- Healthcare cost, quality, practices
- Hepatitis C virus research
- Microscopic Colitis
- Colorectal Cancer Surgical Treatments
- Esophageal and GI Pathology
- Clinical practice guidelines implementation
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Patient Satisfaction in Healthcare
- Hospital Admissions and Outcomes
- Eosinophilic Esophagitis
- Liver Disease and Transplantation
- Cardiac, Anesthesia and Surgical Outcomes
- Mobile Health and mHealth Applications
- Esophageal Cancer Research and Treatment
- Colorectal Cancer Treatments and Studies
- COVID-19 and healthcare impacts
- Liver Disease Diagnosis and Treatment
Duke University
2013-2023
Durham VA Health Care System
2015-2023
Duke Medical Center
2010-2023
Durham VA Medical Center
2012-2022
Duke University Hospital
2010-2020
Clinical Research Institute
2012-2020
University of North Carolina at Chapel Hill
2010
Veterans Health Administration
2010
University Gastroenterology
2007
Haverford College
2000
The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis presented the U.S. delivery system with unprecedented challenges, catalyzed rapid adoption of telehealth, or entire spectrum activities used to deliver care at a distance. Using examples reported by organizations, including ours, we describe role that telehealth played in transforming during 3 phases COVID-19 pandemic: (1) stay-at-home outpatient care, (2) initial...
Heartburn that persists despite proton-pump inhibitor (PPI) treatment is a frequent clinical problem with multiple potential causes. Treatments for PPI-refractory heartburn are of unproven efficacy and focus on controlling gastroesophageal reflux reflux-reducing medication (e.g., baclofen) or antireflux surgery dampening visceral hypersensitivity neuromodulators desipramine).
The coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid expansion of telehealth services hepatology. However, known racial and socioeconomic disparities internet access potentially translate into barriers for the use telehealth, particularly video technology. specific aim this study was to determine if race or status exist among patients utilizing visits during COVID-19. We performed retrospective cohort all adult evaluated hepatology clinics at Duke University Health System....
Existing cross-sectional quality measures for colorectal cancer (CRC) screening do not assess longitudinal adherence and thus may overestimate the of care. Our goal was to evaluate repeated yearly fecal occult blood tests (FOBTs) in order better understand extent which impact quality.This a retrospective cohort analysis 1,122,645 patients aged 50-75 years seen at any 136 Department Veterans Affairs medical centers across United States 2000 followed through 2005. The primary outcome receipt...
Abstract Objective As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed ability derive a score for no-showing clinic visit. Methods Using from 2 264 235 outpatient appointments performance of models built across 14 different specialties and 55 clinics. We used regularized logistic regression fit assess health system, specialty, levels. evaluated fits based their discrimination calibration. Results Overall,...
Purpose The Veterans Affairs (VA) healthcare system treats approximately 3% of patients with cancer in the United States each year. We measured quality nonmetastatic colorectal (CRC) care VA as indicated by concordance National Comprehensive Cancer Network practice guidelines (six indicators) and timeliness (three indicators). Patients Methods A retrospective medical record abstraction was done for 2,492 incident stages I to III CRC diagnosed between October 1, 2003, March 31, 2006, who...
Clostridium difficile-associated diarrhea (CDAD) has a wide spectrum of disease severity. Studies have implicated immunosuppressants as risk factor for severe disease. We hypothesized that solid organ transplant (SOT) patients with CDAD would be at greater because their profound immunosuppression. Adult SOT seen Duke University Medical Center between 1999 and 2003 were compared reference group non-transplant CDAD. The primary outcome was the development complicated colitis defined death,...
OBJECTIVES: Withdrawal time (WT) has been proposed as a quality indicator for colonoscopy based on evidence that it is directly related to the rate of adenoma detection. Our objective was test hypothesis baseline WT inversely associated with risk finding neoplasia at interval colonoscopy. METHODS: In all, 3,121 subjects, aged 50–75 years, had screening between 1994 and 1997 13 Veteran Affairs Medical Centers. 1,193 subjects returned by protocol surveillance within 5.5 years. 304 patients...
ManageMySurgery (MMS) is a digital health application (app) for patients undergoing surgery, including Transcatheter Aortic Valve Replacement (TAVR). Patients using MMS review procedure-specific education, view FAQs, and report patient-reported outcomes. This study assessed the impact of app use on postoperative
OBJECTIVES: We investigated physician beliefs and behaviors regarding diminutive colorectal polyps the contribution of these to variable detection rates. METHODS: One hundred sixty-seven members American College Gastroenterology took a Web-based survey. compared respondents nonrespondents using demographic practice information from Medical Association Physician Masterfile. RESULTS: Respondents varied in their definition polyps. acknowledged leaving place during colonoscopy various scenarios....
Clinical practice guidelines can be used to help develop measures of quality cancer care. This article describes the use a Cancer Care Quality Measurement System (CCQMS) monitor these for colorectal in Veterans Health Administration (VHA). The CCQMS assessed guideline concordance primarily based on colon (14 indicators) and rectal (11 care NCCN. Indicators were developed with input from VHA stakeholders goal examining continuum diagnosis, neoadjuvant therapy, surgery, adjuvant survivorship...
Contemporary breast cancer surgery often requires hospital stays of 1 day or less, presenting challenges to delivery high-quality care. Without sufficient time for proper education and guidance, patients may delay seeking care, experience anxiety, seek unnecessary leading poorer outcomes increased costs. To address this, we evaluated the feasibility a planning-, outcomes-, analytics-based mobile health application called Manage My Surgery (MMS) undergoing elective surgery.Patients at an...