2022
Association of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65
Schonberger RB, Dai F, Michel G, Vaughn MT, Burg MM, Mathis M, Kheterpal S, Akhtar S, Shah N, Bardia A. Association of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65. Journal Of Clinical Anesthesia 2022, 80: 110846. PMID: 35489305, PMCID: PMC11150018, DOI: 10.1016/j.jclinane.2022.110846.Peer-Reviewed Original ResearchConceptsPropofol induction doseGeneral anesthetic inductionSevere hypotensionInduction doseBlood pressure measurementsYears of ageSurgical patientsEndotracheal intubationAnesthetic inductionInvasive blood pressure measurementsGeriatric surgical patientsNon-vascular surgeryDose of propofolNon-invasive blood pressure measurementBlood pressure dropSignificant independent associationPostoperative morbidityRetrospective observationalTotal patientsMulticenter cohortPrimary outcomeAnesthesia inductionPrimary exposureIndependent associationSurgical incision
2021
Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample
Bardia A, Treggiari MM, Michel G, Dai F, Tickoo M, Wai M, Schuster K, Mathis M, Shah N, Kheterpal S, Schonberger RB. Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample. JAMA Network Open 2021, 4: e2137296. PMID: 34905007, PMCID: PMC8672234, DOI: 10.1001/jamanetworkopen.2021.37296.Peer-Reviewed Original ResearchConceptsSurgical site infectionAntibiotic prophylaxis guidelinesWeight-adjusted dosingInfectious Diseases SocietyAntibiotic choiceProphylaxis guidelinesCohort studyDiseases SocietyOverall adherenceFuture quality improvement effortsStudy periodAntibiotic administration guidelinesPrimary end pointTiming of administrationGynecological surgical proceduresQuality improvement effortsIntraoperative antibioticsOverall nonadherenceNoncardiac surgeryAdult patientsEmergency surgeryFirst doseGuideline adherenceSurgical encountersAmerica guidelinesVariation in propofol induction doses administered to surgical patients over age 65
Schonberger RB, Bardia A, Dai F, Michel G, Yanez D, Curtis JP, Vaughn MT, Burg MM, Mathis M, Kheterpal S, Akhtar S, Shah N. Variation in propofol induction doses administered to surgical patients over age 65. Journal Of The American Geriatrics Society 2021, 69: 2195-2209. PMID: 33788251, PMCID: PMC8373684, DOI: 10.1111/jgs.17139.Peer-Reviewed Original ResearchConceptsPropofol induction dosesInduction dosesEndotracheal intubationGeneral anesthetic inductionPropofol induction dosePercent of patientsRetrospective observational studyLarge multicenter cohortSurgical patientsMulticenter cohortPropofol doseBolus doseGeneral anesthesiaInduction dosePropofol inductionPresent studyAnesthetic inductionDose administrationAdvanced agePatient variablesObservational studyProvider practicesAnaesthetic practiceClinical consequencesDosing decisions
2020
Prevalence of aberrant blood pressure readings across two automated intraoperative blood pressure monitoring systems among patients undergoing caesarean delivery.
Schonberger RB, Gonzalez-Fiol A, Fardelmann KL, Bardia A, Michel G, Dai F, Banack T, Alian A. Prevalence of aberrant blood pressure readings across two automated intraoperative blood pressure monitoring systems among patients undergoing caesarean delivery. Blood Pressure Monitoring 2020, 26: 78-83. PMID: 33234814, PMCID: PMC8715608, DOI: 10.1097/mbp.0000000000000495.Peer-Reviewed Original ResearchConceptsBlood pressure readingsCaesarean deliveryBP readingsMultivariable logistic regression analysisPressure readingsCesarean delivery patientsComparable patient cohortsIntraoperative blood pressureRetrospective observational studySame surgical procedurePre-specified covariatesLogistic regression analysisBlood pressureDelivery patientsSimilar patientsPatient cohortSurgical centersBP measurementsBP monitoring systemObservational studyBP monitorInclusion criteriaSurgical proceduresRelative oddsPatientsAn Analysis of Anesthesia Induction Dosing in Female Older Adults
Chen EY, Michel G, Zhou B, Dai F, Akhtar S, Schonberger RB. An Analysis of Anesthesia Induction Dosing in Female Older Adults. Drugs & Aging 2020, 37: 435-446. PMID: 32300966, PMCID: PMC7359723, DOI: 10.1007/s40266-020-00760-3.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPostinduction hypotensionGeneral anesthesiaPresent cohortPostoperative acute kidney injuryLarge tertiary teaching hospitalOlder adultsFrailty of patientsGynecologic oncology surgeryImmediate hemodynamic effectsPropofol induction dosesPercentage of patientsRetrospective observational studyTertiary teaching hospitalPerioperative vital signsHigher propofol dosesFemale older adultsAKI associationInotrope administrationKidney injurySurgical populationHemodynamic effectsDose adjustmentPrimary outcomeFemale patients
2019
Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study
Hsiao B, Binder‐Finnema P, Nowell W, Michel G, Wiedmeyer C, Fraenkel L. Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study. Arthritis Care & Research 2019, 71: 629-637. PMID: 29953733, PMCID: PMC6310675, DOI: 10.1002/acr.23684.Peer-Reviewed Original ResearchConceptsDisease-modifying antirheumatic drugsNew disease-modifying antirheumatic drugsValues clarification toolPost-test visitsMore disease-modifying antirheumatic drugsTest visitsPretest/post-test studyAntirheumatic drugsMore patientsOutpatient visitsRheumatoid arthritisConcept studyPost-test studyPatientsPatient valuesSD lengthPost-test phaseVisitsActive RAVisit timeCarePretest phaseEscalation decisionsPreference phenotypesPhenotypeImpact of Information Presentation Format on Preference for Total Knee Replacement Surgery
Fraenkel L, Nowell WB, Stake CE, Venkatachalam S, Eyler R, Michel G, Peters E. Impact of Information Presentation Format on Preference for Total Knee Replacement Surgery. Arthritis Care & Research 2019, 71: 379-384. PMID: 29799668, PMCID: PMC6252282, DOI: 10.1002/acr.23605.Peer-Reviewed Original Research
2017
Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis
Fraenkel L, Nowell WB, Michel G, Wiedmeyer C. Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis. Annals Of The Rheumatic Diseases 2017, 77: 678. PMID: 29247126, PMCID: PMC5898982, DOI: 10.1136/annrheumdis-2017-212407.Peer-Reviewed Original ResearchConceptsBothersome side effectsRare side effectRheumatoid arthritisSide effectsSerious infectionsOnset of actionJanus kinase inhibitorPreferences of patientsMethotrexate monotherapyTriple therapyParenteral medicationsPoint of careTreatment preferencesGroup 2Patient valuesPatientsGroup 4Target strategyGroup 5Kinase inhibitorsConjoint analysis surveyLatent class analysisLarge groupArthritisMedications
2011
GEM at 10: a decade's experience with the Guideline Elements Model.
Hajizadeh N, Kashyap N, Michel G, Shiffman RN. GEM at 10: a decade's experience with the Guideline Elements Model. AMIA Annual Symposium Proceedings 2011, 2011: 520-8. PMID: 22195106, PMCID: PMC3243287.Peer-Reviewed Original Research
2010
How “should” we write guideline recommendations? Interpretation of deontic terminology in clinical practice guidelines: survey of the health services community
Lomotan EA, Michel G, Lin Z, Shiffman RN. How “should” we write guideline recommendations? Interpretation of deontic terminology in clinical practice guidelines: survey of the health services community. BMJ Quality & Safety 2010, 19: 509. PMID: 20702437, PMCID: PMC2982946, DOI: 10.1136/qshc.2009.032565.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesPractice guidelinesHealth services communityGuideline authorsCross-sectional electronic surveyGuideline recommendationsRecommendation strengthClinical scenariosGuideline developersHealthcare ResearchPractice recommendationsInterquartile rangeElectronic surveyGuidelinesUS AgencyLow levelsVariable levelsParticipantsHigh levels
2008
Developing a decision support system for tobacco use counselling using primary care physicians.
Marcy TW, Kaplan B, Connolly SW, Michel G, Shiffman RN, Flynn BS. Developing a decision support system for tobacco use counselling using primary care physicians. BMJ Health & Care Informatics Online 2008, 16: 101-9. PMID: 18713526, PMCID: PMC2706833, DOI: 10.14236/jhi.v16i2.681.Peer-Reviewed Original ResearchConceptsClinical decision support systemDecision support systemPrimary care physiciansPrimary care clinicsCDSS prototypeCare physiciansSupport systemPrototype clinical decision support systemCare clinicsClinical testingIterative design changesRoutine patient visitsUsability testingMultiple evaluation methodsDesign flawsComplex environmentsCessation interventionsClinical environmentClinical trialsPatient visitsAmbulatory clinicsIndividual patientsPhysician preferencePhysiciansClinic managers
2005
The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation
Shiffman RN, Dixon J, Brandt C, Essaihi A, Hsiao A, Michel G, O'Connell R. The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation. BMC Medical Informatics And Decision Making 2005, 5: 23. PMID: 16048653, PMCID: PMC1190181, DOI: 10.1186/1472-6947-5-23.Peer-Reviewed Original ResearchConceptsGuideLine Implementability AppraisalGuideline implementationBackgroundClinical practice guidelinesProcess of careDraft guidelinesClinical guidelinesPractice guidelinesNational professional societiesGuideline developersHealth outcomesClinician behaviorFurther evaluationContent validityConstruct validityImplementable recommendationsImplementable guidelinesPreliminary supportGuidelinesOutcomesExpert reviewProfessional societiesPotential benefitsMeasurable outcomesImplementation strategiesA wireless, handheld decision support system to promote smoking cessation in primary care.
Michel G, Marcy T, Shiffman RN. A wireless, handheld decision support system to promote smoking cessation in primary care. AMIA Annual Symposium Proceedings 2005, 2005: 530-4. PMID: 16779096, PMCID: PMC1560449.Peer-Reviewed Original ResearchConceptsTobacco useTreatment guideline recommendationsPrimary care settingClinical decision support systemGuideline recommendationsSmoking cessationPrimary careClinical guidelinesCare settingsDaily careHandheld decision-support systemCareTreatmentManagement service modelGuidelinesPatientsDiseasePhysiciansCessation
2004
Bridging the Guideline Implementation Gap: A Systematic, Document-Centered Approach to Guideline Implementation
Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the Guideline Implementation Gap: A Systematic, Document-Centered Approach to Guideline Implementation. Journal Of The American Medical Informatics Association 2004, 11: 418-426. PMID: 15187061, PMCID: PMC516249, DOI: 10.1197/jamia.m1444.Peer-Reviewed Original ResearchConceptsDecision support systemGuideline Elements ModelSupport systemVerification of rulesClinical decision support systemGuideline implementationElectronic health record systemsHealth record systemsBlood Institute guidelinesRequirements specificationClinical practice guidelinesDomain knowledgeInterface componentsComputable formatImplementation tasksKnowledge sourcesGuideline textExecutable statementsClinical workflowChronic asthmaNational HeartRecord systemOverall complexityPractice guidelinesInstitute guidelinesUsing a guideline-centered approach for the design of a clinical decision support system to promote smoking cessation.
Shiffman RN, Michel G, Essaihi A, Marcy TW. Using a guideline-centered approach for the design of a clinical decision support system to promote smoking cessation. 2004, 101: 152-6. PMID: 15537219.Peer-Reviewed Original Research
2003
Comprehensive categorization of guideline recommendations: creating an action palette for implementers.
Essaihi A, Michel G, Shiffman RN. Comprehensive categorization of guideline recommendations: creating an action palette for implementers. AMIA Annual Symposium Proceedings 2003, 2003: 220-4. PMID: 14728166, PMCID: PMC1480124.Peer-Reviewed Original ResearchConceptsGuideline recommendationsNational Guideline ClearinghouseClinical decision support systemGuideline implementationClinical guidelinesComputerized decision support systemClinical information systemsTherapeutic proceduresUnanticipated actionsValidation setGuidelinesRelative frequencyRecommendationsConsultsActivity