A5051678130- Intensive Care Unit Cognitive Disorders
- Innovations in Medical Education
- Respiratory Support and Mechanisms
- Sepsis Diagnosis and Treatment
- Family and Patient Care in Intensive Care Units
- Cardiac Arrest and Resuscitation
- Simulation-Based Education in Healthcare
- Hemodynamic Monitoring and Therapy
- Healthcare Systems and Technology
- Interprofessional Education and Collaboration
- Ultrasound in Clinical Applications
- Patient Safety and Medication Errors
- Long-Term Effects of COVID-19
- Central Venous Catheters and Hemodialysis
- Patient-Provider Communication in Healthcare
- Hospital Admissions and Outcomes
- Emergency and Acute Care Studies
- Lung Cancer Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Surgical Simulation and Training
- Healthcare Decision-Making and Restraints
- Clinical Reasoning and Diagnostic Skills
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences Research and Education
- Radiology practices and education
University of Michigan
2017-2025
Michigan Medicine
2021-2025
Michigan United
2020-2025
National Heart Lung and Blood Institute
2023-2024
Rush Children's Hospital
2023
Rush University Medical Center
2023
A. Alfred Taubman Health Care Center
2018-2022
Pulmonary and Critical Care Associates
2014-2021
Ann Arbor Center for Independent Living
2021
VA Center for Clinical Management Research
2020
Abstract Background Acute hypoxemic respiratory failure (AHRF) and acute distress syndrome (ARDS) are associated with high in-hospital mortality. However, in cohorts of ARDS patients from the 1990s, more commonly died sepsis or multi-organ rather than refractory hypoxemia. Given increased attention to lung-protective ventilation treatment past 25 years, we hypothesized that causes death may be different among contemporary cohorts. These differences provide clinicians insight into targets for...
Acute respiratory distress syndrome (ARDS) is a common, but under-recognised, critical illness associated with high mortality. An important factor in its under-recognition the variability chest radiograph interpretation for ARDS. We sought to train deep convolutional neural network (CNN) detect ARDS findings on radiographs.CNNs were pretrained 595 506 radiographs from two centres identify common (eg, opacity and effusion), then trained 8072 annotated by multiple physicians using various...
The multifaceted long-term impairments resulting from critical illness and COVID-19 require interdisciplinary management approaches in the recovery phase of illness. Operational insights into structure process clinics (RCs) heterogeneous health systems are needed. This study describes characteristics existing newly implemented ICU-RCs COVID-RCs a subset large United States.Cross-sectional survey.Thirty-nine RCs, representing combined 156 hospitals within 29 participated.None.None.RC...
"What Is Post–Intensive Care Syndrome (PICS)?." American Journal of Respiratory and Critical Medicine, 201(8), pp. P15–P16
Rationale: Patients with severe coronavirus disease (COVID-19) meet clinical criteria for the acute respiratory distress syndrome (ARDS), yet early reports suggested they differ physiologically and clinically from patients non-COVID-19 ARDS, prompting treatment recommendations that deviate standard evidence-based practices ARDS. Objectives: To compare physiology, outcomes, extrapulmonary features of COVID-19 Methods: We performed a retrospective cohort study, comparing 130 consecutive...
Sepsis is a common cause of hospital mortality, as well new morbidity among survivors. Clinical practice guidelines recommend assessing goals care (GoC) during sepsis hospitalization to ensure goal-concordant provided. To determine how often GoC are assessed in routine practice. Cohort study adult patients hospitalized with community-onset at 66 hospitals (2020-2023) participating the Michigan Hospital Medicine Safety Consortium's initiative (HMS-sepsis). The primary outcomes were discussion...
Objective: The aim of this study was to develop and externally validate a machine-learning model that retrospectively identifies patients with acute respiratory distress syndrome (acute [ARDS]) using electronic health record (EHR) data. Design: In retrospective cohort study, ARDS identified via physician-adjudication in three cohorts hypoxemic failure (training, internal validation, external validation). Machine-learning models were trained classify vital signs, support, laboratory data,...
Objectives The subspecialty consultation represents a potentially powerful opportunity for resident learning, but barriers may limit the educational exchanges between fellows (subspecialty registrars) and residents (house officers). We conducted focus group study of internal medicine (IM) to determine against factors facilitating resident–fellow teaching interactions on wards, identify opportunities maximising learning. Methods four groups IM (n = 18) 16) at two academic medical centres in...
Rationale: Quantifying acute respiratory disease syndrome (ARDS) severity is essential for prognostic enrichment to stratify patients invasive or higher-risk treatments; however, the comparative performance of many ARDS measures unknown.Objectives: To validate their ability predict hospital mortality and an ARDS-specific outcome (defined as death from pulmonary dysfunction need extracorporeal membrane oxygenation [ECMO] therapy).Methods: We compared five individual including ratio arterial...
COVID-19 has led to an unprecedented strain on health care facilities across the United States. Accurately identifying patients at increased risk of deterioration may help hospitals manage their resources while improving quality patient care. Here, we present results analytical model, Predicting Intensive Care Transfers and Other Unforeseen Events (PICTURE), identify high for imminent intensive unit transfer, respiratory failure, or death, with intention improve prediction due COVID-19.This...
Fellows are expected to educate trainees, peers, and patients, during long after fellowship. However, there has been relatively little emphasis on the acquisition of teaching skills in fellowship programs. Challenges by fellows subspecialty training include demanding clinical duties, their limited knowledge base field, brief contact time with learners consultative roles, and, for new fellows, personal unfamiliarity hospital culture. Fellows' can be improved formal curricula addressing...
Cognition is the act of knowing, perceiving and processing information specifically in relation to brain functioning mental processes.Thus cognitive learning about using thinking learn, where such may be affected by external internal factors.
To prospectively describe 1-year outcomes, with a focus on functional outcome, cognitive and the burden of anxiety, depression, post-traumatic stress disorder, in coronavirus disease 2019 patients managed extracorporeal membrane oxygenation.Prospective case series.Tertiary oxygenation center United States.Adult acute respiratory distress syndrome March 1, 2020, to July 31, 2020.Baseline variables, treatment measures, short-term outcomes were obtained from medical record. Survivors...
To describe patient characteristics, symptoms, patterns of care and outcomes for patients hospitalised with COVID-19 in Michigan.
To determine whether a postoperative venous thromboembolism (VTE) is associated with worse prognosis and/or more advanced cancer stage and to evaluate the association between VTE cancer-specific survival when known prognostic factors, such as age, stage, type, type of surgery, are controlled.It unknown oncology patients who develop after complete curative resection at same disadvantage spontaneous VTE.A retrospective case control study was conducted Memorial Sloan-Kettering Cancer Center....
ABSTRACT Background Subspecialty consultation in inpatient care is increasing. Teaching by subspecialty fellows a setting may be an important source of work-based learning for students and residents. However, teaching evaluation learners this context challenging due to personal systems-based barriers. Objective We developed evaluated framework designed overcome barriers improve fellow skills during consultation. Methods The PARTNER (Partner with resident, Assess the learner, Reinforce...
Enhancing rheumatology fellows' teaching skills in the setting of inpatient consultation may have a broad positive impact. Such efforts improve clinical and overall patient care. Most importantly, effective resident-fellow interactions not only increase residents' knowledge but influence their career choice. However, number barriers to interaction been identified, including skills. We developed Fellow As Clinical Teacher (FACT) curriculum order enhance during consultation.The FACT was...
Because the Berlin definition of acute respiratory distress syndrome (ARDS) has only moderate reliability, physicians disagree about diagnosis ARDS in some patients. Understanding clinical differences between patients with agreement and disagreement may provide insight into epidemiology pathophysiology this syndrome, inform strategies to improve reliability diagnosis.
Patients who survive critical illness endure complex physical and mental health conditions, referred to as post-intensive care syndrome (PICS). The University of Michigan's cardiac outpatient long-term outreach (PICCOLO) clinic is designed for patients recently admitted the coronary unit (CCU). goal this understand post-CCU patients' needs design targeted interventions reduce their morbidity mortality post-discharge. As a first step toward goal, we aimed define post-discharge CCU survivors....