A5101637997- Dementia and Cognitive Impairment Research
- Genetic Associations and Epidemiology
- BRCA gene mutations in cancer
- Genomics and Rare Diseases
- Health Systems, Economic Evaluations, Quality of Life
- Health, Environment, Cognitive Aging
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Chronic Disease Management Strategies
- Alzheimer's disease research and treatments
- Nutrition, Genetics, and Disease
- Ethics in Clinical Research
- Geriatric Care and Nursing Homes
- Healthcare cost, quality, practices
- Frailty in Older Adults
- Health disparities and outcomes
- Traumatic Brain Injury Research
- Cancer Genomics and Diagnostics
- Retinal Imaging and Analysis
- Bioinformatics and Genomic Networks
- Lipoproteins and Cardiovascular Health
- Neuroinflammation and Neurodegeneration Mechanisms
- Blood Pressure and Hypertension Studies
- Physical Activity and Health
- Genetic factors in colorectal cancer
Kaiser Permanente Washington Health Research Institute
2016-2025
University of Washington
2016-2025
The University of Texas Health Science Center at Houston
2024
Kaiser Permanente
2019-2023
Milwaukee VA Medical Center
2023
Children's Hospital of Philadelphia
2022
Children's Hospital & Medical Center
2022
Boston Children's Hospital
2022
Cincinnati Children's Hospital Medical Center
2022
Seattle University
1990-2021
As the patient-centered medical home model emerges as a key vehicle to improve quality of health care and control costs, experience Seattle-based Group Health Cooperative with its pilot takes on added importance. This paper examines effects prototype patients' experiences, quality, burnout clinicians, total costs at twenty-one twenty-four months after implementation. The results show improvements in clinician through two years. Compared other clinics, patients experienced 29 percent fewer...
Declines in heart disease and stroke mortality rates are conventionally attributed to reductions cigarette smoking, recognition treatment of hypertension diabetes, effective medications improve serum lipid levels reduce clot formation, general lifestyle improvements. Recent evidence implicates these other cerebrovascular factors the development a substantial proportion dementia cases. Analyses were undertaken determine whether corresponding declines age-specific prevalence incidence for...
Clinicians and health systems are facing widespread challenges, including changes in care delivery, escalating costs, the need to keep up with rapid scientific discovery. Reorganizing U.S. changing its practices render better, more affordable requires transformation how generate apply knowledge. The “rapid-learning system”—posited as a conceptual strategy spur such transformation—leverages recent developments information technology growing data infrastructure access evidence real time, while...
<b>Objective</b> To determine whether higher cumulative use of benzodiazepines is associated with a risk dementia or more rapid cognitive decline. <b>Design</b> Prospective population based cohort. <b>Setting</b> Integrated healthcare delivery system, Seattle, Washington. <b>Participants</b> 3434 participants aged ≥65 without at study entry. There were two rounds recruitment (1994-96 and 2000-03) followed by continuous enrollment beginning in 2004. <b>Main outcomes...
Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk.To determine whether extraction associated with reduced risk of among adults.This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based randomly selected, cognitively normal members Kaiser Permanente Washington. Study participants were 65 years age or and free at enrollment followed up...
A gap exists between patients' desire to be told about medical errors and present practice. Little is known how physicians approach disclosure. The objective of the study was describe disclose patients.Mailed survey 2637 surgical in United States (Missouri Washington) Canada (national sample). Participants received 1 4 scenarios depicting serious that varied by specialty (medical scenarios) obvious error would patient if not disclosed (more apparent vs less apparent). Five questions measured...
OBJECTIVES: To test the effects of walking, light exposure, and a combination intervention (walking, light, sleep education) on persons with Alzheimer's disease (AD). DESIGN: Randomized, controlled trial blinded assessors. SETTING: Independent community living. PARTICIPANTS: One hundred thirty‐two people AD their in‐home caregivers. INTERVENTIONS: Participants were randomly assigned to one three active treatments treatment) or contact control received six visits. MEASUREMENTS: Primary...
<h3>Importance</h3> Large-scale DNA sequencing identifies incidental rare variants in established Mendelian disease genes, but the frequency of related clinical phenotypes unselected patient populations is not well established. Phenotype data from electronic medical records (EMRs) may provide a resource to assess relevance variants. <h3>Objective</h3> To determine EMRs for individuals with designated as pathogenic by expert review arrhythmia susceptibility genes. <h3>Design, Setting, and...
Late-life depression is associated with increased risk of dementia, but the temporal relationship between and development dementia remains unclear.To examine association baseline depressive symptoms; history depression, particularly early-life (<50 years) vs late-life (≥50 years); individual domains Center for Epidemiologic Studies Depression Scale.A large cohort initially nondemented participants was followed up biennially to 15 years. Baseline symptoms were assessed using 11-item version...
To examine automobile crash risk associated with cognition in older drivers without dementia.
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...
Purpose To measure trainees' attitudes and experiences regarding medical error disclosure. Method In 2003, the authors carried out a cross-sectional survey of 629 students (320 in their second year, 309 fourth year), 226 interns (159 medicine, 67 surgery), 283 residents (211 72 total 1,138 trainees at two U.S. academic health centers. Results The response rate was 78% (889/1,138). Most (74%; 652/881) agreed that is among most serious care problems. Nearly all (99%; 875/884) errors should be...
No consensus exists about when researchers need additional participant consent (reconsent) to submit existing data the federal database of Genotypes and Phenotypes (dbGaP). Re-consent for submission their dbGaP was sought from 1,340 study participants, 1,159 (86%) whom agreed. We invited first 400 those who agreed complete a telephone survey reasoning decision satisfaction with reconsent process; 365 participants completed survey. Respondents reported that it very (69%) or somewhat (21%)...
Non-alcoholic fatty liver disease (NAFLD) is a common chronic illness with genetically heterogeneous background that can be accompanied by considerable morbidity and attendant health care costs. The pathogenesis progression of NAFLD complex many unanswered questions. We conducted genome-wide association studies (GWASs) using both adult pediatric participants from the Electronic Medical Records Genomics (eMERGE) Network to identify novel genetic contributors this condition.First, natural...
Electronic health records (EHRs) are increasingly used for clinical and translational research through the creation of phenotype algorithms. Currently, algorithms most commonly represented as noncomputable descriptive documents knowledge artifacts that detail protocols querying diagnoses, symptoms, procedures, medications, and/or text-driven medical concepts, primarily meant human comprehension. We present desiderata developing a computable representation model (PheRM).A team clinicians...