Article
Anesthesiology
Stephen L. Luther, Dezon K. Finch, Lina Bouayad, James McCart, Ling Han, Steven K. Dobscha, Melissa Skanderson, Samah J. Fodeh, Bridget Hahm, Allison Lee, Joseph L. Goulet, Cynthia A. Brandt, Robert D. Kerns
Summary: This study used rule-based natural language processing algorithms to extract pain care quality indicators from documents of Veterans Health Administration primary care providers. The patterns and frequency of these indicators were described. The study found that the most commonly documented indicators were pain presence, etiology or source, and pain site, while the least commonly documented were sensation, pain's impact, and pain relief factors. The study also calculated a PCQ indicator score for each visit and found the scores to be highly stable across patient characteristics and healthcare facilities.
Article
Health Care Sciences & Services
Aimee Kroll-Desrosiers, Laurel A. Copeland, Michelle A. Mengeling, Kristin M. Mattocks
Summary: By analyzing the infertility diagnoses and treatments among Veterans using the Veterans Health Administration (VHA) healthcare system from 2018 to 2020, it was found that the infertility rate was lower in male Veterans and higher in female Veterans compared to a recent study of active duty servicemembers. Further research is needed to investigate military exposures and circumstances that may lead to infertility. Enhancing communications between the Department of Defense and VHA systems is essential to help more men and women benefit from infertility care during military service or as Veterans.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Health Care Sciences & Services
Kara Zivin, Tony Van, Katerine Osatuke, Matt Boden, Paul N. Pfeiffer, Rebecca K. Sripada, Kristen M. Abraham, Jennifer Burgess, Hyungjin Myra Kim
Summary: While many studies have examined the predictors of provider burnout, there is limited evidence on the impact of burnout on patient outcomes, especially among behavioral health providers. This study aimed to assess the impact of burnout among psychiatrists, psychologists, and social workers on access-related quality measures in the Veterans Health Administration.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Health Care Sciences & Services
Conor Walsh, Caitlin Sullivan, Hayden B. Bosworth, Sarah Wilson, Jennifer M. Gierisch, Kaitlyn B. Goodwin, Felicia Mccant, Helen Hoenig, Leonie Heyworth, Donna M. Zulman, Carolyn Turvey, Ernest Moy, Allison A. Lewinski
Summary: The Covid-19 pandemic led to a significant increase in the use of virtual care, but there are inequities in access and utilization between audio-only and video-based virtual care. This study identified priorities for achieving equitable implementation of virtual care within the Veterans Health Administration (VHA) through a Think Tank involving clinicians, researchers, and operational partners.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Medicine, General & Internal
Michael E. Ohl, Kelly Richardson Miell, Brice F. Beck, Bradley Mecham, George Bailey, Michelle Mengeling, Mary Vaughan-Sarrazin
Summary: This study found that most veterans who were hospitalized for COVID-19 chose community hospitals over VHA hospitals, and veterans in community hospitals had higher mortality rates compared to those in VHA hospitals. The VHA needs to understand the reasons behind the mortality difference in order to plan appropriate care for veterans during future COVID-19 surges and the next pandemic.
Article
Public, Environmental & Occupational Health
Jessica Luo, Sujee Jeyapalina, Gregory J. Stoddard, Alvin C. Kwok, Jayant P. Agarwal
Summary: This analysis examines the demographics, infection, mortality, and case-fatality rates of COVID-19 patients in the veteran population from March 4th to June 23rd, 2020. The findings indicate that elderly veterans (>= 65yo) and veterans with a history of cardiovascular disease are significantly impacted, with black veterans showing higher mortality rates but lower case fatality rates compared to white veterans.
ANNALS OF EPIDEMIOLOGY
(2021)
Article
Health Care Sciences & Services
Amy K. Rosen, Erin E. Beilstein-Wedel, Alex H. S. Harris, Michael Shwartz, Megan E. Vanneman, Todd H. Wagner, Nicholas J. Giori
Summary: This study compared the rates of hospital readmissions following TKAs performed in VA versus those purchased through CC, and found that nationally, the risk of readmission was significantly lower for TKAs performed in VA. Most VA facilities performed similarly to their corresponding CC providers, but there were a few VA facilities that performed worse.
Editorial Material
Medicine, General & Internal
Baligh R. Yehia, Stephan D. Fihn
Summary: To respond to declining numbers of veterans and impending budget constraints, the VA health care system can accelerate the transition to value-based care, optimize infrastructure, and strengthen engagement with employees and the public.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Oncology
Kallisse R. Dent, Benjamin R. Szymanski, Michael J. Kelley, Ira R. Katz, John F. McCarthy
Summary: This study found that Veterans receiving VHA care have an increased risk of suicide following new cancer diagnoses, especially within the first three months. Additional screening and suicide prevention efforts are needed to protect newly diagnosed Veterans with cancer.
Article
Gastroenterology & Hepatology
Vera Yakovchenko, Timothy R. Morgan, Edward J. Miech, Brittney Neely, Carolyn Lamorte, Sandra Gibson, Lauren A. Beste, Heather McCurdy, Dawn Scott, Rachel Gonzalez, Angela M. Park, Byron J. Powell, Jasmohan S. Bajaj, Jason A. Dominitz, Maggie Chartier, David B. Ross, Matthew J. Chinman, Shari S. Rogal
Summary: This study identified and specified implementation strategies for improving cirrhosis care through surveys, analysis, and qualitative interviews. The findings can be applied to other implementation challenges in hepatology.
Article
Health Care Sciences & Services
Heather Davila, Amy K. Rosen, Erin Beilstein-Wedel, Michael Shwartz, Leslie Chatelain, Deborah Gurewich
Summary: The study found that rural Veterans rated community care (CC) the same or better compared to urban Veterans, but there was still a gap in primary care experiences. Rural Veterans' experiences with CC and VA care improved between 2016 and 2019, with greater improvements in CC.
Article
Medicine, General & Internal
Lucinda B. Leung, Karen Chu, Danielle Rose, Susan Stockdale, Edward P. Post, Kenneth B. Wells, Lisa Rubenstein
Summary: This study aimed to investigate adherence to guidelines for follow-up and treatment among primary care patients with depression in the Veterans Health Administration. The study found that while most patients completed at least minimal treatment, only a minority received timely follow-up after screening positive and being identified as having depression.
Article
Public, Environmental & Occupational Health
Eduardo R. Nunez, Christopher G. Slatore, Nichole T. Tanner, Anne C. Melzer, Kristina A. Crothers, Jennifer A. Lewis, Angela E. Fabbrini, James K. Brown, Renda S. Wiener
Summary: This study aimed to compare the utilization of key components in centralized, hybrid, and decentralized lung cancer screening programs. The results showed that centralized programs were more likely to implement practices that support lung cancer screening before the initial screening, while hybrid and decentralized programs were less likely to do so.
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
(2023)
Article
Oncology
Leah L. Zullig, Whitney Raska, Gina McWhirter, Scott E. Sherman, Danil Makarov, Daniel Becker, Heather A. King, John Pura, Amy S. Jeffreys, Susanne Danus, Vida Passero, Karen M. Goldstein, Michael J. Kelley
Summary: As the largest integrated health care system in the United States, the VA provides telehealth-delivered cancer care to ensure access to specialized treatment for Veterans, especially those in rural areas with limited local resources. The National TeleOncology Service connects VA oncologists from across the country to provide care to patients at smaller spoke sites, as well as larger facilities with limited subspecialties. This model has the potential to revolutionize cancer care delivery and improve the experience of Veterans.
JCO ONCOLOGY PRACTICE
(2023)
Article
Health Care Sciences & Services
Ryan A. Sterling, Chuan-Fen Liu, Paul L. Hebert, John C. Fortney, Kaylyn E. Swankoski, Jodie G. Katon, Edwin S. Wong
Summary: This study examined the choice of veterans between VA and VCCP providers and found that veterans who had the option continued to use VA for most of their outpatient care in the initial years after the 2014 VCCP expansion. There were modest declines in reliance for PC and MH, and a more significant decline for SC.
Editorial Material
Gastroenterology & Hepatology
Sneha Chebrolu, Meaghan Phipps, Frederick Yao, Jennifer Lai, Elizabeth Verna, Marina Serper, Giuseppe Cullaro, Sumeet K. Asrani, Lisa B. VanWagner
LIVER TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
Marina Serper, Elliot B. B. Tapper, David E. E. Kaplan, Tamar H. H. Taddei, Nadim Mahmud
Summary: We examined the impact of the COVID-19 pandemic on mortality, outpatient, and inpatient care for cirrhosis patients. HCC surveillance rates initially dropped but have rebounded, although still below pre-pandemic levels. The use of population-based strategies and specialty care were associated with higher completion of HCC surveillance.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Gres Karim, Dewan Giri, Tatyana Kushner, Nancy Reau
Summary: Liver disease in pregnancy encompasses a wide range of liver conditions that need to be identified early to provide appropriate care. Evaluation should include careful testing to rule out chronic liver disease, coincidental liver injury, and pregnancy-specific liver injury. Early recognition and management of liver disease in pregnancy are crucial for optimizing outcomes for both mother and baby, and for facilitating referrals to liver specialists and postnatal care if necessary.
CLINICS IN LIVER DISEASE
(2023)
Review
Gastroenterology & Hepatology
Ani Kardashian, Marina Serper, Norah Terrault, Lauren D. Nephew
Summary: The syndemic of hazardous alcohol consumption, opioid use, and obesity has led to important changes in liver disease epidemiology that have exacerbated health disparities. Understanding how social and structural factors cause health disparities and affect chronic liver disease outcomes is crucial for improving liver health outcomes.
Article
Gastroenterology & Hepatology
Marina Serper, David E. Kaplan, Tamar H. Taddei, Elliot B. Tapper, Jordana B. Cohen, Nadim Mahmud
Summary: This study investigated the effectiveness of nonselective beta blockers in preventing hepatic decompensation and liver-related mortality. The results suggest that carvedilol may reduce the risk of hepatic decompensation and composite outcome of hepatic decompensation/liver-related mortality, especially in specific subgroups.
Editorial Material
Gastroenterology & Hepatology
Andrew J. Groff, Marina Serper, Sunny Y. Tao, Pamela M. Bloomer, Michael A. Dunn, Andres Duarte-Rojo
LIVER TRANSPLANTATION
(2023)
Article
Surgery
Sasha Deutsch-Link, Therese Bittermann, Lauren Nephew, Katherine Ross-Driscoll, Ethan M. Weinberg, Robert M. Weinrieb, Kim M. Olthoff, Senayish Addis, Marina Serper
Summary: This study aimed to investigate racial and ethnic inequities in liver transplantation (LT) waitlisting for medical and psychosocial reasons. The findings showed that Black race and Hispanic/Latinx ethnicity were associated with not being waitlisted for psychosocial reasons. Health systems and LT centers should develop programs to address these disparities and promote equity in LT access.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Review
Gastroenterology & Hepatology
Tatyana Kushner
Summary: Delta Hepatitis, the most severe form of hepatitis, has varying prevalence, genotype distribution, and risk factors worldwide. Limited knowledge exists about its global epidemiology due to inconsistent screening practices for HDV. This article summarizes the current understanding of testing prevalence and HDV positivity globally.
JOURNAL OF VIRAL HEPATITIS
(2023)
Article
Immunology
Tatyana Kushner, Custon T. Nyabanga, Scott J. Cotler, Ohad Etzion, Harel Dahari
Summary: Treating hepatitis C virus (HCV) during pregnancy can address HCV during prenatal care and potentially reduce the risk of vertical transmission. Response-guided therapy provides a way to customize and shorten HCV treatment duration during pregnancy. Data from a 27-year-old woman showed that HCV was stable before treatment and dropped in a biphasic manner during sofosbuvir/velpatasvir therapy, reaching undetectable levels at delivery-16 days after starting therapy. Mathematical modeling predicted that a cure could have been achieved after 7 weeks of sofosbuvir/velpatasvir, reducing the therapy duration by 5 weeks.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Article
Obstetrics & Gynecology
Farrah Naz Hussain, Emma Rosenbluth, Kristina Martimucci Feldman, Tirtza Spiegel Strauss, Emily Schneider, Emily Schmidt-Beauchat, Clara Rodriguez-Rivas, Lois Brustman, Tatyana Kushner
Summary: The aim of this study was to assess the prevalence of elevated liver stiffness and steatosis immediately postpartum and to determine whether there were differences in rates of metabolic disorders of pregnancy and pre-pregnancy conditions in those with elevated liver stiffness/liver steatosis.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
(2023)
Letter
Gastroenterology & Hepatology
Helen Tang, Christopher Shi, Sara Chapin, Sarjukumar Panchal, Xiaoling Yu, Lisa B. B. VanWagner, Marina Serper, Nadim Mahmud
LIVER TRANSPLANTATION
(2023)
Review
Gastroenterology & Hepatology
Marcia Lange, Devika Nadkarni, Lily Martin, Carolyn Newberry, Sonal Kumar, Tatyana Kushner
Summary: Despite the lack of FDA-approved treatments for NAFLD, intermittent fasting shows promising results in improving hepatic endpoints and promoting weight loss in adults with NAFLD. However, further large-scale randomized controlled studies are needed to validate these findings.
HEPATOLOGY COMMUNICATIONS
(2023)
Article
Gastroenterology & Hepatology
Mara Sophie Vell, Arunkumar Krishnan, Kirk Wangensteen, Marina Serper, Katharina Sophie Seeling, Leonida Hehl, Miriam Daphne Rendel, Inuk Zandvakili, Marijana Vujkovic, Eleonora Scorletti, Kate Townsend Creasy, Christian Trautwein, Daniel James Rader, Saleh Alqahtani, Kai Markus Schneider, Carolin Victoria Schneider
Summary: Regular aspirin use is associated with a reduced risk of liver disease in men without an elevated risk of gastrointestinal bleeding or ulcers. The protective effect of aspirin appears to be dependent on the duration of intake, and there may be sex-related differences in its effects.
HEPATOLOGY COMMUNICATIONS
(2023)
Article
Pediatrics
Aliza Gross, Marcia Lange, Emma Rosenbluth, Carin Carroll, Rhoda Sperling, Courtney Juliano, Keith Sigel, Scott L. Friedman, Pamela A. Argiriadi, Jaime Chu, Tatyana Kushner
Summary: This study found that maternal nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of very premature delivery before 32 weeks and neonatal jaundice. However, it does not have a significant impact on infant growth and weight over the first 2 years of life.
EUROPEAN JOURNAL OF PEDIATRICS
(2023)
Article
Gastroenterology & Hepatology
Catherine Mezzacappa, Nadim Mahmud, Marina Serper, Binu V. John, Tamar H. Taddei, David E. Kaplan
Summary: Diabetes is associated with hepatocellular carcinoma (HCC) in patients with cirrhosis, and inadequate long-term blood glucose control is consistently associated with a higher risk of HCC.
HEPATOLOGY COMMUNICATIONS
(2023)