A5086611319- Atrial Fibrillation Management and Outcomes
- Emergency and Acute Care Studies
- Nonmelanoma Skin Cancer Studies
- Diabetes Management and Research
- Obesity, Physical Activity, Diet
- Polyomavirus and related diseases
- Trauma and Emergency Care Studies
- Health disparities and outcomes
- Diabetes Treatment and Management
- Telemedicine and Telehealth Implementation
- Cardiac Arrhythmias and Treatments
- Cutaneous Melanoma Detection and Management
- Medication Adherence and Compliance
- Appendicitis Diagnosis and Management
- Cardiovascular Syncope and Autonomic Disorders
- Nutritional Studies and Diet
- Antenna Design and Analysis
- Radiation Dose and Imaging
- Health Systems, Economic Evaluations, Quality of Life
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Healthcare professionals’ stress and burnout
- Cutaneous lymphoproliferative disorders research
- Full-Duplex Wireless Communications
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Patient-Provider Communication in Healthcare
Kaiser Permanente
2016-2025
Kaiser Permanente San Rafael Medical Center
2018
Kaiser Permanente Roseville Medical Center
2018
HealthPartners
2018
University of California, Davis
2016
National Institutes of Health
2013
National Cancer Institute
2013
Stanford University
2012
A significant proportion of US Latinos with diabetes have limited English proficiency (LEP). Whether language barriers in health care contribute to poor glycemic control is unknown.To assess the association between (LEP) and whether this modified by having a language-concordant physician.Cross-sectional, observational study using data from 2005-2006 Diabetes Study Northern California (DISTANCE). Patients received managed setting interpreter services self-reported their ability Spanish...
Poor medication refill adherence contributes to poor cardiometabolic control and diabetes outcomes. Studies linking communication between patients health care providers often use self-reported have not explored differences across domains or therapeutic indications.To investigate associations patient ratings adherence, we conducted a cross-sectional analysis of 9377 in the Diabetes Study Northern California (DISTANCE), race-stratified, random sample Kaiser Permanente survey respondents....
We examined the association between HbA1c level and self-reported severe hypoglycemia in patients with type 2 diabetes.Type diabetic a large, integrated healthcare system, who were 30-77 years of age treated glucose-lowering therapy, asked about requiring assistance year prior to Diabetes Study Northern California survey conducted 2005-2006 (62% response rate). The main exposure interest was last collected preceding observation period. Poisson regression models adjusted for selected...
The incidence of non-melanoma skin cancers (NMSCs), including basal cell (BCC) or squamous carcinoma (SCC), is not well documented among HIV-positive (HIV+) individuals. We identified 6560 HIV+ and 36 821 HIV-negative (HIV−) non-Hispanic white adults who were enrolled followed up in Kaiser Permanente Northern California from 1996 to 2008. first biopsy-proven NMSCs diagnosed during follow-up pathology records. Poisson models estimated rate ratios that compared (overall stratified by recent...
Importance Accurate emergency department (ED) triage is essential to prioritize the most critically ill patients and distribute resources appropriately. The used system in US Emergency Severity Index (ESI). Objectives To derive validate an algorithm assess rate of mistriage identify characteristics associated with mistriage. Design, Setting, Participants This retrospective cohort study created operational definitions for each ESI level that use ED visit electronic health record data classify...
Hypoglycemia-related emergency department (ED) or hospital use among patients with type 2 diabetes (T2D) is clinically significant and possibly preventable.To develop validate a tool to categorize risk of hypoglycemic-related utilization in T2D.Using recursive partitioning split-sample design, we created classification tree based on potential predictors hypoglycemia-related ED use. The resulting model was transcribed into for practical application tested 1 internal fully independent,...
Importance Emergency department (ED) triage may impact timeliness of care for high-risk conditions. Objective To determine the association ED undertriage with delays in patients subarachnoid hemorrhage (SAH), aortic dissection (AD), and ST-elevation myocardial infarction (STEMI). Design, Setting, Participants This retrospective cohort study included adult diagnosed SAH, AD, or STEMI from January 1, 2016, to December 31, 2020, a multicenter, community-based health delivery system. Data...
Merkel cell carcinoma (MCC) is a rare, aggressive, neuroendocrine-derived skin cancer with high rates of recurrence and associated mortality. Few published studies have used comprehensive patient data long-term follow-up to examine factors that predict MCC outcomes.To characterize in large defined-population cohort analyze predictors disease survival.Retrospective study 218 patients from the registry Kaiser Permanente Northern California, integrated health care delivery system. Patients were...
Intratumoral CD8+ lymphocytes (IT-CD8s) have shown promise as a prognostic indicator for Merkel cell carcinoma (MCC). We tested whether IT-CD8s predict survival among population-based MCC cohort.One hundred thirty-seven cases that had not previously been analyzed were studied.Three-year MCC-specific rates 56%, 72%, and 100% patients with absent (n = 46), low 85), moderate or strong 6) IT-CD8s, respectively. Increased associated improved in multivariate competing risk-regression analysis...
In screening pharmaceuticals for possible carcinogenic effects we noted an association between lip cancer risk and the photosensitizing antihypertensive drugs hydrochlorothiazide nifedipine. this study, further characterized of associated with these other commonly used drugs.In a comprehensive medical care program, evaluated prescriptions dispensed occurrence from August 1, 1994, to February 29, 2008. We identified 712 patients (cases) 22,904 comparison individuals (controls) matched age,...
<h3>Importance</h3> The increasing use of electronic communications has enhanced access to physicians for patients and clinical staff. Primary care (PCPs) have anecdotally identified inbox management as a new source work-related stress. <h3>Objectives</h3> To describe PCPs' experiences managing their inboxes characterize the array strategies developed by individual practice groups. <h3>Design, Setting, Participants</h3> This qualitative study was conducted in 8 medical centers large group...
Abstract Objectives Electronic health record systems are increasingly used to send messages physicians, but research on physicians’ inbox use patterns is limited. This study’s aims were (1) quantify the time primary care physicians (PCPs) spend managing inboxes; (2) describe daily of use; (3) investigate which types consume most time; and (4) identify factors associated with work duration. Materials Methods We analyzed 1 month electronic data for 1275 PCPs in a large medical group linked...
Objective Bariatric surgery is the most effective therapy for severe obesity. People with bipolar disorder have increased risk of obesity, yet are sometimes considered ineligible bariatric due to their diagnosis. This study aimed determine if alters psychiatric course among stable patients disorder. Methods A matched cohort (2006–2009) mean follow‐up 2.17 years was conducted within Kaiser Permanente Northern California, a group practice integrated health services delivery organization that...
Background Increased work through electronic health record (EHR) messaging is frequently cited as a factor of physician burnout. However, studies to date have relied on anecdotal or self-reported measures, which limit the ability match EHR use patterns with continuous stress throughout day. Objective The aim this study collect and physiologic data unobtrusive means that provide objective cluster distinct inbox work, identify physicians’ daily patterns, evaluate association between stress....
It is unknown whether any association between neighborhood food environment and obesity varies according to individual income and/or race/ethnicity. The objectives of this study were test there was an environments among adults with diabetes relationship differed or race/ethnicity.Subjects (n = 16,057) participants in the Diabetes Study Northern California survey. Kernel density estimation used create a score for each individual's residence address that reflected mix healthful unhealthful...