A5020220729- Colorectal Cancer Screening and Detection
- Economic and Financial Impacts of Cancer
- Health Systems, Economic Evaluations, Quality of Life
- Gastric Cancer Management and Outcomes
- BRCA gene mutations in cancer
- Urban Transport and Accessibility
- Hepatitis C virus research
- Hepatitis B Virus Studies
- Health disparities and outcomes
- Liver Disease Diagnosis and Treatment
- Global Cancer Incidence and Screening
- Chronic Disease Management Strategies
- Diverticular Disease and Complications
- Food Security and Health in Diverse Populations
- Noise Effects and Management
- Multiple and Secondary Primary Cancers
- Genomics and Rare Diseases
- Ethics in Clinical Research
- Central Venous Catheters and Hemodialysis
- Healthcare Policy and Management
- Prenatal Screening and Diagnostics
- Urban Green Space and Health
- Genetic factors in colorectal cancer
- Dental Health and Care Utilization
- Burn Injury Management and Outcomes
Kaiser Permanente Center for Health Research
2016-2025
University of Colorado Denver
2023
Denver Health Medical Center
2023
Education Northwest
2022
University of Minnesota System
2021
Kaiser Permanente
2010-2019
Centers for Disease Control and Prevention
2014
Kaiser Permanente Washington Health Research Institute
2013
Henry Ford Health System
2013
Virginia Commonwealth University
2013
Background. Liver biopsy remains critical for staging liver disease in hepatitis C virus (HCV)–infected persons, but is a bottleneck to evaluation, follow-up, and treatment of HCV. Our analysis sought validate APRI (aspartate aminotransferase [AST]–to-platelet ratio index) FIB-4, an index from serum fibrosis markers (alanine [ALT], AST, platelets plus patient age) stage disease. Methods. Biopsy results HCV patients the Chronic Hepatitis Cohort Study were mapped F0–F4 equivalent scale; FIB-4...
The number of deaths in hepatitis C virus (HCV)-infected persons recorded on US death certificates has been increasing, but actual rates and causes these individuals have not well elucidated.Disease-specific, liver-related, non-liver-related mortality data for HCV-infected patients an observational cohort study, the Chronic Hepatitis Cohort Study (CHeCS) at 4 healthcare systems, were compared with multiple cause (MCOD) 12 million 2006-2010. Premortem diagnoses, liver biopsies, FIB-4 scores...
<h3>Importance</h3> Approximately 24 million US individuals receive care at federally qualified health centers, which historically have low rates of colorectal cancer screening. The Preventive Services Task Force recommends routine screening for aged 50 to 75 years. <h3>Objective</h3> To determine the effectiveness an electronic record (EHR)-embedded mailed fecal immunochemical test (FIT) outreach program implemented in centers as part standard care. <h3>Design, Setting, and...
A key question in care of patients with chronic hepatitis C virus (HCV) infection is beginning treatment immediately vs delaying treatment. Risks mortality and disease progression "real world" settings are important to assess the implications HCV treatment.This was a cohort study identified from 4 integrated health systems United States who had liver biopsies during 2001-2012. The probabilities death hepatocellular carcinoma, hepatic decompensation (hepatic encephalopathy, esophageal...
The Community Preventive Services Task Force recommends multi-component interventions, including patient reminders, to improve uptake of colorectal cancer screening. We sought compare the effectiveness different forms reminders for a direct-mail fecal immunochemical test (FIT) program. Patient-randomized controlled trial. 2772 adults aged 50–75, not up date with screening recommendations, clinic visit in previous year at any four participating health center clinics. Participants were mailed...
Abstract Among 2338 chronic hepatitis B patients followed during 2006–2013 in the Chronic Hepatitis Cohort Study, 78% had ≥1 alanine aminotransferase and 37% virus DNA level assessed annually. cirrhotic patients, 46% never hepatic imaging. Patients this cohort were insufficiently monitored for disease activity hepatocellular carcinoma.
While electronic health records (EHRs) play a key role in increasing colorectal cancer (CRC) screening by identifying individuals who are overdue, important shortfalls remain. As part of the Strategies and Opportunities to STOP Colon Cancer (STOP CRC) study, we assessed accuracy EHR codes patients eligible for CRC screening. We selected stratified random sample 800 study participants from 26 participating clinics, Pacific Northwest region USA. compared data obtained through conduct manual...
Social isolation among individuals ages 65 years and older is associated with poor health outcomes. However, little known about care utilization patterns of socially isolated individuals. This retrospective, observational study evaluated associations between social hospital emergency department (ED) Medicare patients older. In a cohort 18,557 members age at Kaiser Permanente Northwest, the authors compared rates hospitalization ED visits in 12 months following baseline survey respondents who...
<h3>Importance</h3> Whether guideline-concordant lung nodule evaluations lead to better outcomes remains unknown. <h3>Objective</h3> To examine the association between intensity of diagnostic and outcomes, safety, health expenditures. <h3>Design, Setting, Participants</h3> This comparative effectiveness research study analyzed plan enrollees at Kaiser Permanente Washington in Seattle, Washington, Marshfield Clinic Marshfield, Wisconsin, with an incidental detected January 1, 2005, December...
Evidence connecting health care expenditures with physical activity and built environment is rare. We examined how detailed urban form relates to mode specific moderate-to-vigorous (MVPA) costs—controlling for transit access, residential choices/preferences, sociodemographic factors. harness high resolution data 476 participants in the Rails Health study on costs, MVPA, parcel-level environment, neighborhood perception surveys. To account dependencies among outcomes, structural equation...
Abstract Background There is an urgent need for evidence on how interventions can prevent or mitigate cancer-related financial hardship. Our objectives are to compare self-reported hardship, quality of life, and health services use between patients receiving a navigation intervention versus comparison group at 12 months follow-up, assess patient-level factors associated with dose received intervention. Methods The Cancer Financial Experience (CAFÉ) study multi-site randomized controlled...
This study assessed neighbourhood walkability for older adults in eight neighbourhoods of Vancouver, British Columbia and Portland Oregon, utilizing the newly developed environmental audit tool 'SWEAT-R'. The discrete variable based data are complemented with qualitative observation data. Findings indicate that has a 95% or higher inter-rater reliability more than 80% items. Neighbourhood suggest Vancouver region have urban design features supportive walking behaviour. Sidewalk street life...
A test for hepatitis C virus (HCV) RNA is essential to identify persons with active, or current, HCV infection. We assessed trends in testing following a positive antibody result among 4 large healthcare organizations.Data collected from adults ≥2 clinical encounters during 2003-2010 were analyzed determine the frequency of, interval between, and factors associated having an after first test.From 2003-2010, 5860 had test, of whom 3570 (60.9%) follow-up test. During this period, annual...
Identifying and addressing social needs is important to improve health for older adults with type 2 diabetes mellitus (T2DM). However, few studies have examined the association between T2DM-related outcomes among populations within integrated care systems. This study DM-related T2DM receiving at Kaiser Permanente Northwest. From a cohort of 1954 Medicare members ages 65 who completed questionnaire, we 5 dichotomous (yes vs no) measures (financial strain, food insecurity, housing instability,...
In Brief Objective: Although estrogen may be linked to biological pathways that maintain higher physical function, the evidence is derived mostly from observational epidemiology and therefore has numerous limitations. We examined whether hormone therapy affected function in women 65 79 years of age at enrollment. Methods: This study involves an analysis Women's Health Initiative randomized controlled trials which 922 nondisabled who had previous hysterectomies were receive or a placebo 1,458...
Medicare data represent 75% of aged and permanently disabled beneficiaries enrolled in the fee-for-service (FFS) indemnity option, but omit 25% Advantage health maintenance organizations (HMOs). Little research has examined how longitudinal patterns utilization differ between HMOs FFS. The Burden Cancer Study developed implemented an algorithm to assign standardized relative costs HMO FFS consistently across time place. uses 15 payment systems reimburse providers for covered services....
Objective With increasing use electronic health records (EHR) in the USA, we looked at predictive values of International Classification Diseases, 9th revision (ICD-9) coding system for surveillance chronic hepatitis B virus (HBV) infection.
Abstract Annual fecal immunochemical testing (FIT) is cost‐effective for colorectal cancer (CRC) screening. However, FIT positivity rates and positive predictive value (PPV) can vary substantially, with false‐positive (FP) results adding to colonoscopy burden without improving detection. Our objective was describe PPV the factors associated FP among patients undergoing CRC In an ongoing pragmatic clinical trial of mailed‐FIT outreach, clinics delivered one three brands (InSure, OC‐Micro,...
A critical step in access to genetic testing for hereditary cancer syndromes is referral counseling assess personal and family risk. Individuals meeting guidelines have the greatest need be evaluated. However, referrals genetics are underutilized US patients with syndromes, especially within traditionally underserved populations, including racial ethnic minorities, low-income, non-English speaking patients.We studied existing processes evaluation risk identify areas of potential improvement...