A5086632845- Menopause: Health Impacts and Treatments
- Phytoestrogen effects and research
- Estrogen and related hormone effects
- Pelvic floor disorders treatments
- Cancer Risks and Factors
- Gut microbiota and health
- Gestational Diabetes Research and Management
- Menstrual Health and Disorders
- Sleep and related disorders
- Endometriosis Research and Treatment
- Diabetes Treatment and Management
- Diabetes Management and Research
- Pregnancy and preeclampsia studies
- Nutritional Studies and Diet
- Global Cancer Incidence and Screening
- Endometrial and Cervical Cancer Treatments
- Sexual function and dysfunction studies
- Diabetes Management and Education
- Genetic Associations and Epidemiology
- Chronic Disease Management Strategies
- Circadian rhythm and melatonin
- Anorectal Disease Treatments and Outcomes
- Urinary Tract Infections Management
- Dental Health and Care Utilization
- Oral microbiology and periodontitis research
New College of Florida
2022
Kaiser Permanente Washington Health Research Institute
2011-2020
Seattle University
2006-2020
University of Washington
2009-2018
Group Health Cooperative
2008-2018
Kaiser Permanente
2008-2018
Mater Dei Hospital
2018
University Hospitals Sussex NHS Foundation Trust
2018
Society for Maternal-Fetal Medicine
2018
Swedish Medical Center
2018
OBJECTIVE: To determine the incidence of foot ulcers in a large cohort patients with diabetes, risk developing serious complications after diagnosis, and attributable cost care compared that without ulcers. RESEARCH DESIGN AND METHODS: Retrospective study diabetes staff-model health maintenance organization from 1993 to 1995. Patients were identified by algorithm using administrative, laboratory, pharmacy records. The data used calculate ulcers, osteomyelitis, amputation, death diagnosis...
Background At the request of researchers in UK, we conducted a case-control study to explore relation between use postmenopausal oestrogen hormone replacement therapy (HRT) and idiopathic venous thromboembolism (VTE). Methods The was based on information derived from Group Health Cooperative Puget Sound for period 1980 1994. Women aged 50–74 years admitted hospital VTE were identified records. diagnosis validated clinical record. who had medical conditions predisposing (a history or cancer,...
Because of the additional costs associated with improving diabetes management, there is interest in whether improved glycemic control leads to reductions health care costs, and, if so, when such cost savings occur.To determine sustained improvements hemoglobin A(1c) (HbA(1c)) levels among diabetic patients are followed by utilization and costs.Historical cohort study conducted 1992-1997 a staff-model maintenance organization (HMO) western Washington State.All aged 18 years or older who were...
Genetic studies require precise phenotype definitions, but electronic medical record (EMR) data are recorded inconsistently and in a variety of formats.To present lessons learned about validation EMR-based phenotypes from the Electronic Medical Records Genomics (eMERGE) studies.The eMERGE network created validated 13 EMR-derived algorithms. Network sites Group Health, Marshfield Clinic, Mayo Northwestern University, Vanderbilt University.By validating we that: (1) multisite improves...
Clinical data captured in electronic medical records accurately identify cases and controls for genome-wide association studies.
Genome-wide association studies (GWAS) require high specificity and large numbers of subjects to identify genotype-phenotype correlations accurately. The aim this study was type 2 diabetes (T2D) cases controls for a GWAS, using data captured through routine clinical care across five institutions different electronic medical record (EMR) systems.An algorithm developed T2D based on combination diagnoses, medications, laboratory results. performance the validated at three participating compared...
Background: Herbal supplements are widely used for vasomotor symptoms. Objective: To test the efficacy of 3 herbal regimens and hormone therapy relief symptoms compared with placebo. Design: 1-year randomized, double-blind, placebo-controlled trial conducted from May 2001 to September 2004. Setting: Group Health, Washington State. Participants: 351 women age 45 55 years 2 or more per day; 52% were in menopausal transition 48% postmenopausal. Measurements: Rate intensity (1 = mild severe),...
To describe self-reported prevalence of the use alternative therapies for menopause symptoms and subject characteristics associated with their use.A telephone survey 886 women aged 45-65 years (87.2% response rate) was conducted at Group Health Cooperative in Washington state. Women were asked about eight symptoms.The proportion who used each therapy 76.1% any therapy, 43.1% stress management, 37.0% over-the-counter remedies, 31.6% chiropractic, 29.5% massage 22.9% dietary soy, 10.4%...
In Brief OBJECTIVE: We sought to examine prescribing patterns (prevalence and rates of initiation discontinuation) for estrogen plus progestin (hormone therapy [HT] alone [ET]) in the United States 2 years before published results Women's Health Initiative's (WHI) HT trial's early termination 5 months after their release. METHODS: conducted an observational cohort study 169,586 women aged 40–80 who were enrolled health maintenance organizations estimate prevalence ET discontinuation between...
In Brief Objective: Research has shown an association between urinary incontinence and depression. Studies that use community-based samples major depressive disorder diagnostic criteria are needed. The objective of this study was to estimate the prevalence factors associated with depression in women incontinence. Methods: We conducted age-stratified postal survey 6,000 aged 30–90 years. Subjects were randomly selected from enrollees a large health maintenance organization Washington state....
Estrogen therapy is the gold standard treatment for hot flashes and night sweats, but some women are unable or unwilling to use it because of associated risks. The serotonin-norepinephrine reuptake inhibitor venlafaxine hydrochloride used widely as a nonhormonal treatment. While clinical impression that inhibitors less effective than estrogen, these medications have not been simultaneously evaluated in one trial date.To determine efficacy tolerability low-dose oral 17β-estradiol extended...
Nearly half of postmenopausal women report bothersome vulvovaginal symptoms, but few data support the efficacy 2 commonly recommended treatments.To compare a low-dose vaginal estradiol tablet and moisturizer, each vs placebo, for treatment moderate-to-severe symptoms.This 12-week multicenter randomized clinical trial enrolled with moderate to severe symptoms itching, pain, dryness, irritation, or pain penetration.Vaginal 10-μg (daily weeks, then twice weekly) plus placebo gel (3 times week)...
Objective This study aims to determine the efficacy of exercise training for alleviating vasomotor and other menopausal symptoms. Methods Late perimenopausal postmenopausal sedentary women with frequent symptoms (VMS) participated in a randomized controlled trial conducted three sites: 106 142 usual activity. The intervention consisted individual facility-based aerobic times per week 12 weeks. VMS frequency bother were recorded on daily diaries at baseline weeks 6 12. Intent-to-treat...
The objective of this study was to identify the number people with diabetes from a DataLink developed as part SUPREME-DM (SUrveillance, PREvention, and ManagEment Diabetes Mellitus) project, consortium 11 integrated health systems that use comprehensive EHR data for research.
Effective, practical, nonpharmacologic therapies are needed to treat menopause-related insomnia symptoms in primary and women's specialty care settings.To evaluate the efficacy of telephone-based cognitive behavioral therapy for (CBT-I) vs menopause education control (MEC).A single-site, randomized clinical trial was conducted from September 1, 2013, August 31, 2015, western Washington State among 106 perimenopausal or postmenopausal women aged 40 65 years with moderate (Insomnia Severity...
An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium 11 integrated health-care delivery systems with electronic health records in 10 US states. Among nearly 7 million adults aged 20 years or older, we estimated annual diabetes incidence per 1,000 persons overall by age, sex, race/ethnicity, body mass index. We identified 289,050 incident cases diabetes. Age- sex-adjusted population stable...
This study aims to determine the efficacy of yoga in alleviating vasomotor symptoms (VMS) frequency and bother.
OBJECTIVE The objective of this study was to assess the incidence major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes or without CV disease (CVD) associated inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), blood pressure (BP), current smoking. RESEARCH DESIGN AND METHODS Study subjects included 859,617 enrolled for more than 6 months during 2005–2011 in a network 11 U.S. integrated health care organizations....
The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network conducted three randomized clinical trials (RCTs) testing six interventions treating vasomotor symptoms (VMS), also collected self-reported sleep outcomes. A fourth RCT assessed an intervention insomnia among women with VMS. We describe these seven interventions' effects relative to control in comparably severe