2024
Peer Comparison or Guideline-Based Feedback and Postsurgery Opioid Prescriptions
Wagner Z, Kirkegaard A, Mariano L, Doctor J, Yan X, Persell S, Goldstein N, Fox C, Brummett C, Romanelli R, Bouskill K, Martinez M, Zanocco K, Meeker D, Mudiganti S, Waljee J, Watkins K. Peer Comparison or Guideline-Based Feedback and Postsurgery Opioid Prescriptions. JAMA Health Forum 2024, 5: e240077. PMID: 38488780, PMCID: PMC10943416, DOI: 10.1001/jamahealthforum.2024.0077.Peer-Reviewed Original ResearchConceptsCluster randomized clinical trialPeer comparison interventionOpioid prescribingEmail feedbackGuideline interventionComparison interventionIntervention periodHealth care delivery systemRandomized clinical trialsOpioid prescriptionsCare delivery systemPeer comparisonExcessive opioid prescribingSocial norm-based interventionsControl groupIntervention monthsMain OutcomesQuantity of opioidsClinical trialsDischarged patientsPeer surgeonsPrescribingOpioid misuseInterventionSurgical specialtiesUse of Telehealth Information for Early Detection: Insights From the COVID-19 Pandemic.
Haenchen S, McCabe B, Mack W, Doctor J, Linder J, Persell S, Tibbels J, Meeker D. Use of Telehealth Information for Early Detection: Insights From the COVID-19 Pandemic. American Journal Of Public Health 2024, 114: 218-225. PMID: 38335480, PMCID: PMC10862224, DOI: 10.2105/ajph.2023.307499.Peer-Reviewed Original ResearchConceptsTelehealth dataDistrict of ColumbiaNational Syndromic Surveillance ProgramSyndromic Surveillance ProgramTelemedicine encountersSurveillance infrastructureTelehealthModest improvementsObservational studyUS statesSurveillance programCOVID-19COVID-19 pandemicEarly detectionCase countsService providersForecasts of casesMortalityCOVID-19 casesEncountersStandard forecastForecastingProvidersTelemedicine
2023
Clinician Job Satisfaction After Peer Comparison Feedback
Doctor J, Goldstein N, Fox C, Linder J, Persell S, Stewart E, Knight T, Meeker D. Clinician Job Satisfaction After Peer Comparison Feedback. JAMA Network Open 2023, 6: e2317379. PMID: 37289454, PMCID: PMC10251208, DOI: 10.1001/jamanetworkopen.2023.17379.Peer-Reviewed Original ResearchConceptsClinician performanceInappropriate antibiotic prescribingSecondary null hypothesisRandomized clinical trialsMean job satisfactionPeer-comparison feedbackIndividual clinician performanceSocial norm feedbackClinician job satisfactionAntibiotic prescribingPrimary outcomeMean ageTrial interventionClinical trialsClinical significanceMonthly emailsMAIN OUTCOMENoninferiority analysisSecondary analysisInternal medicineSatisfaction scoresCliniciansClinicPeer comparisonInterventionSEnDAE: A resource for expanding research into social and environmental determinants of health
Kingsbury P, Abajian H, Abajian M, Angyan P, Espinoza J, MacDonald B, Meeker D, Wilson J, Bahroos N. SEnDAE: A resource for expanding research into social and environmental determinants of health. Computer Methods And Programs In Biomedicine 2023, 238: 107542. PMID: 37224727, DOI: 10.1016/j.cmpb.2023.107542.Peer-Reviewed Original Research
2022
Development and pilot testing of EHR-nudges to reduce overuse in older primary care patients
Rowe T, Brown T, Lee J, Linder J, Meeker D, Doctor J, Goldstein N, Fox C, Persell S. Development and pilot testing of EHR-nudges to reduce overuse in older primary care patients. Archives Of Gerontology And Geriatrics 2022, 104: 104794. PMID: 36115068, PMCID: PMC9682472, DOI: 10.1016/j.archger.2022.104794.Peer-Reviewed Original ResearchConceptsProstate-specific antigenUA/UCCDS alertsOlder adultsCommon conditionUnnecessary testingOlder primary care patientsClinical decision support alertsNon-specific reasonsOral hypoglycemic medicationsOvertreatment of diabetesPrimary care patientsPrimary care physiciansLarge health systemDecision support alertsHypoglycemic medicationsOveruse measuresCare patientsCare physiciansSignificant morbidityUrine cultureProstate cancerAmbulatory careClinical actionsAdult menA Qualitative Description of Clinician Free-Text Rationales Entered within Accountable Justification Interventions
Brown T, Zelch B, Lee J, Doctor J, Linder J, Sullivan M, Goldstein N, Rowe T, Meeker D, Knight T, Friedberg M, Persell S. A Qualitative Description of Clinician Free-Text Rationales Entered within Accountable Justification Interventions. Applied Clinical Informatics 2022, 13: 820-827. PMID: 36070799, PMCID: PMC9451951, DOI: 10.1055/s-0042-1756366.Peer-Reviewed Original ResearchConceptsClinical content areasClinical appropriatenessClinical decision support alertsPrimary care physiciansDecision support alertsAppropriate clinical decisionsUnique cliniciansOpioid prescribingCare physiciansClinical detailsAccountable justificationCDS alertsPilot interventionClinical decisionClinical casesCliniciansParticular diagnosisOlder adultsInterventionPhysiciansDelphi techniquePolypharmacyPrescribingPatientsSymptomsThe protocol of improving safe antibiotic prescribing in telehealth: A randomized trial
McCabe B, Linder J, Doctor J, Friedberg M, Fox C, Goldstein N, Knight T, Kaiser K, Tibbels J, Haenchen S, Persell S, Warberg R, Meeker D. The protocol of improving safe antibiotic prescribing in telehealth: A randomized trial. Contemporary Clinical Trials 2022, 119: 106834. PMID: 35724841, DOI: 10.1016/j.cct.2022.106834.Peer-Reviewed Original ResearchConceptsAcute respiratory infectionsInappropriate antibiotic prescribingAntibiotic prescribing ratesAntibiotic prescribingPrescribing ratesRandomized quality improvement trialAntibiotic stewardship interventionsInappropriate antibiotic prescriptionsUrgent care visitsPrevious randomized trialsPrimary care clinicsQuality improvement trialEffective antibiotic useElectronic health recordsARI visitsInappropriate prescribingAntibiotic prescriptionsCare visitsSecondary outcomesPrimary outcomeRespiratory infectionsCare clinicsRandomized trialsStewardship interventionsAntibiotic useExtracting Patient-level Social Determinants of Health into the OMOP Common Data Model.
Phuong J, Zampino E, Dobbins N, Espinoza J, Meeker D, Spratt H, Madlock-Brown C, Weiskopf N, Wilcox A. Extracting Patient-level Social Determinants of Health into the OMOP Common Data Model. AMIA Annual Symposium Proceedings 2022, 2021: 989-998. PMID: 35308947, PMCID: PMC8861735.Peer-Reviewed Original ResearchDevelopment of High-Risk Geriatric Polypharmacy Electronic Clinical Quality Measures and a Pilot Test of EHR Nudges Based on These Measures
Persell S, Brown T, Doctor J, Fox C, Goldstein N, Handler S, Hanlon J, Lee J, Linder J, Meeker D, Rowe T, Sullivan M, Friedberg M. Development of High-Risk Geriatric Polypharmacy Electronic Clinical Quality Measures and a Pilot Test of EHR Nudges Based on These Measures. Journal Of General Internal Medicine 2022, 37: 2777-2785. PMID: 34993860, PMCID: PMC9411452, DOI: 10.1007/s11606-021-07296-1.Peer-Reviewed Original ResearchConceptsHigh-risk criteriaNon-dihydropyridine calcium channel blockersMore high-risk criteriaSingle large health systemThree-arm pilotChronic kidney diseaseHigh-risk medicationsCalcium channel blockersLarge health systemDrug-drug interactionsClinical quality measuresElectronic health recordsEHR alertMain MeasuresRatesMore medicationsPatients 65Older patientsHeart failureKey ResultsAmongKidney diseaseNovel electronic health recordPolypharmacyChannel blockersFall historyPatients
2021
The protocol of the Application of Economics & Social psychology to improve Opioid Prescribing Safety trial 2 (AESOPS-2): Availability of opioid harm
Kelley M, Persell S, Linder J, Friedberg M, Meeker D, Fox C, Goldstein N, Knight T, Zein D, Sullivan M, Doctor J. The protocol of the Application of Economics & Social psychology to improve Opioid Prescribing Safety trial 2 (AESOPS-2): Availability of opioid harm. Contemporary Clinical Trials 2021, 112: 106650. PMID: 34896295, PMCID: PMC8869359, DOI: 10.1016/j.cct.2021.106650.Peer-Reviewed Original ResearchConceptsProportion of patientsOpioid-related overdosesOpioid prescribingOpioid-related harmsOpioid use disorderTrial 2Mixed effects regression modelsHarmful patient outcomesDaily MMEMorphine equivalentsPatient overdoseUsual careOpioid usePrimary outcomePrescriber awarenessOpioid harmsPrescribing SafetyPrevention recommendationsIntervention groupPatient outcomesOpioid overdosesUse disordersTreat differencesDisease controlAdditional outcomesDesign of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): A pragmatic cluster randomized controlled trial
Brown T, Rowe T, Lee J, Petito L, Chmiel R, Ciolino J, Doctor J, Fox C, Goldstein N, Kaiser D, Linder J, Meeker D, Peprah Y, Persell S. Design of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): A pragmatic cluster randomized controlled trial. Contemporary Clinical Trials 2021, 112: 106649. PMID: 34896294, PMCID: PMC8724916, DOI: 10.1016/j.cct.2021.106649.Peer-Reviewed Original ResearchConceptsPrimary care clinicsProstate-specific antigenCo-primary outcomesElectronic health recordsCare clinicsOlder adultsClinician educationParallel armsPragmatic cluster-randomized trialNon-specific reasonsOvertreatment of diabetesClinical decision support interventionHealth recordsPrimary care cliniciansChoosing Wisely campaignLarge regional health systemCluster-randomized trialDecision support interventionsPragmatic clusterRegional health systemOlder patientsStudy armsCare cliniciansDiabetes measuresUrine testingEstablishing a research informatics program in a public healthcare system: a case report with model documents
Meeker D, Fu P, Garcia G, Dyer I, Yadav K, Fleishman R, Yee H. Establishing a research informatics program in a public healthcare system: a case report with model documents. Journal Of The American Medical Informatics Association 2021, 29: 694-700. PMID: 35289368, PMCID: PMC8922175, DOI: 10.1093/jamia/ocab226.Peer-Reviewed Original ResearchConceptsHealth systemLos Angeles County DepartmentClinical Translational Science InstituteAcademic medical centerCounty health systemPublic health systemCancer CenterPublic healthcare systemCase reportTranslational Science InstituteMedical CenterHealth servicesInformatics programsCounty DepartmentHealthcare systemHealth ITResearch Governance FrameworkEffect of Peer Benchmarking on Specialist Electronic Consult Performance in a Los Angeles Safety-Net: a Cluster Randomized Trial
Meeker D, Friedberg M, Knight T, Doctor J, Zein D, Cayasso-McIntosh N, Goldstein N, Fox C, Linder J, Persell S, Dea S, Giboney P, Yee H. Effect of Peer Benchmarking on Specialist Electronic Consult Performance in a Los Angeles Safety-Net: a Cluster Randomized Trial. Journal Of General Internal Medicine 2021, 37: 1400-1407. PMID: 34505234, PMCID: PMC8428492, DOI: 10.1007/s11606-021-07002-1.Peer-Reviewed Original ResearchPrivacy-protecting, reliable response data discovery using COVID-19 patient observations
Kim J, Neumann L, Paul P, Day M, Aratow M, Bell D, Doctor J, Hinske L, Jiang X, Kim K, Matheny M, Meeker D, Pletcher M, Schilling L, SooHoo S, Xu H, Zheng K, Ohno-Machado L, Anderson D, Anderson N, Balacha C, Bath T, Baxter S, Becker-Pennrich A, Bernstam E, Carter W, Chau N, Choi Y, Covington S, DuVall S, El-Kareh R, Florian R, Follett R, Geisler B, Ghigi A, Gottlieb A, Hu Z, Ir D, Knight T, Koola J, Kuo T, Lee N, Mansmann U, Mou Z, Murphy R, Neumann L, Nguyen N, Niedermayer S, Park E, Perkins A, Post K, Rieder C, Scherer C, Soares A, Soysal E, Tep B, Toy B, Wang B, Wu Z, Zhou Y, Zucker R. Privacy-protecting, reliable response data discovery using COVID-19 patient observations. Journal Of The American Medical Informatics Association 2021, 28: 1765-1776. PMID: 34051088, PMCID: PMC8194878, DOI: 10.1093/jamia/ocab054.Peer-Reviewed Original ResearchThe protocol of the Application of Economics & Social psychology to improve Opioid Prescribing Safety Trial 1 (AESOPS-1): Electronic health record nudges
Kelley M, Persell S, Linder J, Friedberg M, Meeker D, Fox C, Goldstein N, Knight T, Zein D, Rowe T, Sullivan M, Doctor J. The protocol of the Application of Economics & Social psychology to improve Opioid Prescribing Safety Trial 1 (AESOPS-1): Electronic health record nudges. Contemporary Clinical Trials 2021, 103: 106329. PMID: 33636344, PMCID: PMC8089040, DOI: 10.1016/j.cct.2021.106329.Peer-Reviewed Original ResearchConceptsEHR-based interventionsElectronic health recordsPrimary careLong-term opioid useHigh-risk prescriptionsProportion of patientsPrimary care clinicsTrial 1Mixed-effects regression modelsPersistence of effectsDaily MMEMorphine equivalentsNoncancer painLack of evidenceOpioid prescribingOpioid useSecondary outcomesDaily dosePrimary outcomeCare clinicsIntervention armPrescribing SafetyClinical guidelinesControl armIntervention period
2020
Details matter: predicting when nudging clinicians will succeed or fail
Fox C, Doctor J, Goldstein N, Meeker D, Persell S, Linder J. Details matter: predicting when nudging clinicians will succeed or fail. The BMJ 2020, 370: m3256. PMID: 32933926, DOI: 10.1136/bmj.m3256.Peer-Reviewed Original ResearchEngaging heart failure patients from a clinical data research network: A survey on willingness to participate in different types of research.
Choi Y, López J, Meeker D, Ohno-Machado L, Kim K. Engaging heart failure patients from a clinical data research network: A survey on willingness to participate in different types of research. AMIA Annual Symposium Proceedings 2020, 2019: 305-312. PMID: 32308823, PMCID: PMC7153117.Peer-Reviewed Original ResearchConceptsClinical Data Research NetworkHeart failure patientsLarge cohort studyResearch participationResearch NetworkCohort studyFailure patientsOne-time surveyPatient cohortObservational studyPatient motivationWeight controlSignificant associationClinical researchPatientsPrecision medicineHealth dataRecruitment effortsNational effortsActivity interestsSurgeryCohortClinician-Level Variation in Three Measures Representing Overuse Based on the American Geriatrics Society Choosing Wisely Statement
Rowe T, Brown T, Lee J, Linder J, Friedberg M, Doctor J, Meeker D, Ciolino J, Persell S. Clinician-Level Variation in Three Measures Representing Overuse Based on the American Geriatrics Society Choosing Wisely Statement. Journal Of General Internal Medicine 2020, 35: 1797-1802. PMID: 32128687, PMCID: PMC7280408, DOI: 10.1007/s11606-020-05748-8.Peer-Reviewed Original ResearchConceptsDiabetes measuresPSA measuresUrine cultureOlder adultsUrinalysis/urine cultureProstate-specific antigen (PSA) testingHealth systemNon-specific reasonsOral hypoglycemic medicationsOveruse of testingInappropriate useSame health systemMedical servicesIntermediate outcome measuresClinical quality measuresDesignRetrospective analysisHypoglycemic medicationsElderly patientsAntigen testingDiabetes mellitusCare cliniciansHighest quartileOffice visitsOdds ratioOutcome measures
2019
Patient Commitment to Health (PACT-Health) in the Heart Failure Population: A Focus Group Study of an Active Communication Framework for Patient-Centered Health Behavior Change
Meeker D, Goldberg J, Kim K, Peneva D, De Oliveira Campos H, Maclean R, Selby V, Doctor J. Patient Commitment to Health (PACT-Health) in the Heart Failure Population: A Focus Group Study of an Active Communication Framework for Patient-Centered Health Behavior Change. Journal Of Medical Internet Research 2019, 21: e12483. PMID: 31389339, PMCID: PMC6701162, DOI: 10.2196/12483.Peer-Reviewed Original ResearchConceptsHeart failure populationHeart failureFailure populationHealth coachingDietary habitsMedication adherence barriersPatient-centered themesChronic heart failurePatient focus groupsHealth behavior changeRegimen complexityAdherence barriersMedication adherenceExercise regimensDisease progressionExercise habitsLocal cardiologistsLifestyle changesPatient commitmentCare providersFocus groupsSide effectsSemistructured interview toolPatientsAppropriate exerciseSimulation-based training is associated with lower risk-adjusted mortality in ACS pediatric TQIP centers.
Jensen A, McLaughlin C, Subacius H, McAuliff K, Nathens A, Wong C, Meeker D, Burd R, Ford H, Upperman J. Simulation-based training is associated with lower risk-adjusted mortality in ACS pediatric TQIP centers. Journal Of Trauma And Acute Care Surgery 2019, 87: 841-848. PMID: 31589193, PMCID: PMC6785206, DOI: 10.1097/ta.0000000000002433.Peer-Reviewed Original ResearchConceptsRisk-adjusted mortalityTrauma Quality Improvement ProgramPatient outcomesPediatric Trauma Quality Improvement ProgramMultivariable hierarchical logistic regressionLower risk-adjusted mortalityRisk-adjusted oddsPediatric trauma resuscitationQuality Improvement ProgramSimulation-based trainingLow-volume trainingHierarchical logistic regressionSurvey nonrespondersHigh-volume trainingSurvey response rateTrauma centerClinical dataAmerican CollegeResuscitation qualityCare managementResponse rateTrauma resuscitationLevel IIIMortalitySimulation-based team training