A5079788238- Palliative Care and End-of-Life Issues
- Cardiac, Anesthesia and Surgical Outcomes
- Patient-Provider Communication in Healthcare
- Acute Kidney Injury Research
- Economic and Financial Impacts of Cancer
- Heart Failure Treatment and Management
- Galectins and Cancer Biology
- Macrophage Migration Inhibitory Factor
- Patient Dignity and Privacy
- Childhood Cancer Survivors' Quality of Life
- Cardiac Ischemia and Reperfusion
- Chronic Kidney Disease and Diabetes
- Health Literacy and Information Accessibility
- Cancer survivorship and care
- Antiplatelet Therapy and Cardiovascular Diseases
- Digital Mental Health Interventions
- Attachment and Relationship Dynamics
- Cancer Risks and Factors
- Reproductive Health and Technologies
- Pharmaceutical industry and healthcare
- BRCA gene mutations in cancer
- Testicular diseases and treatments
- Renal and Vascular Pathologies
- Multiple and Secondary Primary Cancers
- Mechanical Circulatory Support Devices
Pharmaceutical Product Development (United States)
2020-2021
Dartmouth Institute for Health Policy and Clinical Practice
2016-2021
Dartmouth College
2016-2021
Johns Hopkins University
2019
Johns Hopkins Medicine
2019
Dartmouth–Hitchcock Medical Center
2018
Radboud University Nijmegen
2017
Queen's University Belfast
2010-2011
Scottish National Blood Transfusion Service
2011
Royal Victoria Hospital
2011
Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was develop test the usability, acceptability accessibility a pictorial encounter aid targeted at women SES cancer.Community-based participatory research (CBPR) using think-aloud protocols (phases 1 2) semistructured interviews (phase...
<h3>Importance</h3> Early discussion of end-of-life (EOL) care preferences improves clinical outcomes and goal-concordant care. However, most EOL discussions occur approximately 1 month before death, despite patients desiring information earlier. <h3>Objective</h3> To describe successful navigation missed opportunities for (eg, advance planning, palliative care, discontinuation disease-directed treatment, hospice after-death wishes) between oncologists outpatients with advanced cancer....
Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve outcomes potentially reduce healthcare disparities. Our goal was evaluate the acceptability feasibility (Option Grid, Comic Option Picture Grid) adapted for a low-SES low-literacy population.We used multi-phase,...
Abstract Background We calculated the performance of National Cancer Institute (NCI)/National Comprehensive Network (NCCN) cancer centers’ end‐of‐life (EOL) quality metrics among minority and white decedents to explore center‐attributable sources EOL disparities. Methods conducted a retrospective cohort study Medicare beneficiaries with poor‐prognosis cancers who died between April 1, 2016 December 31, had any inpatient services in last 6 months life. attributed patients’ treatment center at...
Current preoperative models use clinical risk factors alone in estimating of in-hospital mortality following cardiac surgery. However, novel biomarkers now exist to potentially improve prediction models. An assessment Galectin-3, N-terminal pro b-type natriuretic peptide (NT-ProBNP), and soluble ST2 the predictive ability an existing model may our capacity risk-stratify patients before
Previous research suggests that novel biomarkers may be used to identify patients at increased risk of acute kidney injury following cardiac surgery. The purpose this study was evaluate the relationship between preoperative levels circulating Galectin-3 (Gal-3) and after Preoperative serum Gal-3 measured in 1498 who underwent coronary artery bypass graft (CABG) surgery and/or valve as part Northern New England Biomarker Study 2004 2007. were using multiplex assays grouped into terciles....
Is the level of shared decision-making (SDM) higher after introduction a SDM package (including encounter decision aids on treatment options for heavy menstrual bleeding and training clinicians) than before?. This before-after study, performed in OB-GYN practice, compared consultations before package. The target sample size was 25 patients per group. Women seeking were eligible. After their appointments, filled out three-item patient-reported measure. Treatment discussions audio-recorded...
Cardiac surgery results in a multifactorial systemic inflammatory response with cytokines, such as interleukin-10 and 6 (IL-10 IL-6), shown to have potential the prediction of adverse outcomes including readmission or mortality. This study sought measure association between IL-6 IL-10 levels 1-year hospital mortality following cardiac surgery. Plasma biomarkers were measured 1,047 patients discharged alive after isolated coronary artery bypass graft from eight medical centers participating...
Cardiac surgery results in a multifactorial systemic inflammatory response with cytokines, such as interleukin-10 and 6 (IL-10 IL-6), shown to have potential the prediction of adverse outcomes including readmission or mortality. This study sought measure association between IL-6 IL-10 levels 1-year hospital mortality following cardiac surgery. Plasma biomarkers were measured 1,047 patients discharged alive after isolated coronary artery bypass graft from eight medical centers participating...
Abstract Background A critical barrier to improving the quality of end-of-life (EOL) cancer care is our lack understanding mechanisms underlying variation in EOL treatment intensity. This study aims fill this gap by identifying 1) organizational and provider practice norms at major US centers, 2) how these influence decision making heuristics patient expectations for care, particularly minority patients with advanced cancer. Methods a multi-center, qualitative case six National Comprehensive...
Abstract Background Rates of recommending percutaneous coronary intervention (PCI) and artery bypass grafting (CABG) vary across clinicians. Whether clinicians agree on preferred treatment options for multivessel disease patients has not been well studied. Methods results We distributed a survey to 104 from the Northern New England Cardiovascular Study Group through email at regional meeting with 88 (84.6%) responses. The described three clinical vignettes patients. For each patient vignette...
INTRODUCTION: Heavy menstrual bleeding impacts women’s quality of life and can be treated in a variety ways. Shared decision-making (SDM) requires providing tailored information to the patient about options eliciting integrating preferences as treatments are selected. decision aids used during clinical encounter may facilitate SDM. We evaluated impact introducing for women presenting with heavy or fibroids on level METHODS: A before-after study was conducted general OB-GYN practice an...
6507 Background: Higher EOL treatment intensity is burdensome and has been defined as low-quality care. We explored cancer centers’ quality outcomes among minority white patients evaluated whether minority-serving centers had systematically lower quality. Methods: conducted a retrospective cohort study of Medicare beneficiaries with poor-prognosis cancers who died between April 1, 2016 December 31 2016. attributed patients’ to the center where they received preponderance inpatient services...