Volume 4, Issue 3 (2017)

From the Editor

Original Research


Influence of Differential Calcification in the Descending Thoracic Aorta on Aortic Pulse Pressure
Mirza Mujadil Ahmad, Syed Haris Ahmed Pir, Mustafa Noor Muhammad, Sharmeen Hussaini, Immad Arif Kiani, Mirza Nubair Ahmad, Imaad Razzaque, Muhammad Nabeel Syed, Rafath Ullah, Suhail Allaqaband, Anjan Gupta, Steven C. Port, and Khawaja Afzal Ammar


Teen, Parent, and Clinician Expectations About Obesity and Related Conditions During the Annual Well-Child Visit
Andrew S. Bossick, Charles Barone, Gwen L. Alexander, Heather A. Olden, Tanya Troy, and Andrea E. Cassidy-Bushrow


Maternal Intuition of Fetal Gender
Michael McFadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, and Joe Grundle

Brief Report


Multiple Myeloma Baseline Immunoglobulin G Level and Pneumococcal Vaccination Antibody Response
Michael A. Thompson, Martin K. Oaks, Maharaj Singh, Karen M. Michel, Michael P. Mullane, Husam S. Tarawneh, Angi Kraut, and Kayla J. Hamm

Patient-Centered Essay/Creative Writing


Every Word, Every Gesture
Dennis J. Baumgardner



Multimorbidity Profile of Urologic Patients in a Large, Integrated Health Care Delivery System
Tullika Garg, Amanda Young, Korey Kost, and H. Lester Kirchner


Outcomes of an Embedded Resource and Education Program for Patients and Families With Memory Loss
Leah Hanson, Anna Forsberg, Avis Thomas, Jean Crow, Heidi Haley-Franklin, and Terry Barclay


Research Priorities to Advance the Science of Multiple Chronic Conditions in Older Adults From the AGING Initiative Steering and Advisory Committees
Mayra Tisminetzky, Kathryn Anzuoni, Ben Shirley, Jay Magaziner, Elizabeth Bayliss, and Jerry Gurwitz


Lung Cancer Screening: A Qualitative Study Exploring the Decision to Opt Out of Screening
Lisa Carter-Harris, Susan Brandzel, Karen Wernli, Joshua Roth, and Diana Buist


Diabetes Treatment and Risks of Adverse Breast Cancer Outcomes Among Elderly Breast Cancer Patients: A SEER-Medicare Analysis
Lu Chen, Jessica Chubak, Denise Boudreau, William Barlow, Noel Weiss, and Christopher Li


Reasons for Never and Intermittent Completion of Colorectal Cancer Screening After Receiving Multiple Rounds of Mailed Fecal Tests
Beverly Green, June BlueSpruce, Leah Tuzzio, Sally Vernon, L. Aubree Shay, and Sheryl Catz


Systems of Support to Increase Colorectal Cancer (CRC) Screening –– A Randomized Trial to Increase Long-Term Adherence to CRC Screening: Time in Compliance Over 5 Years
Beverly Green, Melissa Anderson, Jessica Chubak, Andrea Cook, Sharon Fuller, Richard Meenan, and Sally Vernon


Can Thyroid Cancer Overdiagnosis, Overtreatment, and Costs Be Reduced by Following Guidelines?
Dina Hassen, Susan R. Snyder, Steven Chang, Jing Hao, Michael Singer, and Arti Bhan


External Validity of Electronic Health Record Studies of Cancer Patients
Anqi Jin, Scarlett Gomez, Harold Luft, Daphne Lichtensztajn, and Caroline Thompson


Establishing a Population-Based Cohort of Nonmuscle Invasive Bladder Cancer Cases to Improve Care by Enhancing Surveillance and Risk Stratification
Carmit McMullen, Maureen O'Keeffe-Rosetti, Sheila Weinmann, Michael Leo, and Matthew Nielsen


Patterns of Repeat Colorectal Cancer Screening and Follow-Up of Abnormal Results in an Integrated Safety-Net Health Care System
Caitlin Murphy, Amit Singal, Joanne Sanders, Sandi Pruitt, Simon Craddock Lee, Ethan Halm, and Celette Sugg Skinner


Predictors of Colorectal Cancer Screening Prior to Implementation of a Large Pragmatic Trial in Federally Qualified Health Care Centers
Amanda Petrik, Thuy Le, Erin Keast, Jennifer Rivelli, Keshia Bigler, Beverly Green, William Vollmer, and Gloria Coronado


Choosing Reports Wisely: Considerations in Reporting for Clinical Improvement
Sharon Fuller, Matt Handley, Angela Sparks, and Kimberly Wicklund


Primary Care Provider Use Rates of a Clinical Decision Support Tool and Change in Diabetes Performance Measures
JoAnn Sperl-Hillen, Stephen Asche, Darin Ruanpeng, Heidi Ekstrom, and Patrick O'Connor


Impact of Improving Diabetes Care on Quality-Adjusted Life Expectancy and Costs: A 40-Year Perspective
Patrick O'Connor, Todd Gilmer, JoAnn Sperl-Hillen, Heidi Ekstrom, and Lauren Crain


Clinical Decision Support Impact on Overuse and Underuse of Aspirin for Primary Prevention of Cardiovascular Events
Patrick O'Connor, JoAnn Sperl-Hillen, Karen Margolis, Lauren Crain, and Heidi Ekstrom


Can Prioritized Clinical Decision Support in Primary Care Reduce Cardiovascular Risk?
Patrick O'Connor, JoAnn Sperl-Hillen, Karen Margolis, Lauren Crain, William Rush, Heidi Ekstrom, Jerry Amundson, Rashmi Sharma, and Deepika Appana


Taking Action on Overuse: Implementing an Action-Planning Framework to Engage Providers
Michael Parchman, Nora Henrikson, Paula Blasi, Diana Buist, Brian Austin, and Robert Penfold


System-Level Barriers to Follow-up Colonoscopy Completion After Positive Fecal Test: Interviews With Gastroenterologists and Staff
Jennifer Schneider, Jennifer Rivelli, Basak Gokcora, Keshia Bigler, Amanda Petrik, Beverly Green, and Gloria Coronado


Reducing Opioid Exposure Following Hip and Knee Surgery: Results of a Randomized, Pragmatic, Pharmacist-Led Intervention
David Smith, Jennifer Kuntz, Eric Johnson, Jennifer Schneider, Xiuhai Yang, and Lynn DeBar


A Clinical Decision Support System Promotes Shared Decision-Making and Cardiovascular Risk Factor Management
JoAnn Sperl-Hillen, Lauren Crain, Heidi Ekstrom, and Karen Margolis


Aspirin for Primary Prevention of Atherosclerotic Cardiovascular Disease: Challenges to Appropriate Use
JoAnn Sperl-Hillen, Patrick O'Connor, Jay Desai, Karen Margolis, Heidi Ekstrom, and Lauren Crain


Results of a Cluster-Randomized Trial Testing the Effects of TeenBP, an Electronic Health Record-Based Clinical Decision Support Tool, on Recognition of Adolescent Hypertension
Elyse Kharbanda, Stephen Asche, James Nordin, Alan Sinaiko, Heidi Ekstrom, Nancy Sherwood, Patricia Fontaine, Steven Dehmer, Jerry Amundson, Deepika Appana, and Patrick O'Connor


Development and Validation of a Risk Equation for Appendicitis in Children Presenting With Abdominal Pain
Gabriela Vazquez-Benitez, Elyse Kharbanda, Dustin Ballard, David Vinson, Richard Bachur, Uli Chettipally, Mamata Kene, Patrick O'Connor, Steven Dehmer, Heidi Ekstrom, Peter Dayan, Nathan Kuppermann, and Anupam Kharbanda


Bisphosphonates Use and Risk of Hip Fractures
Sarah Sharman Moser, Inbal Goldshtein, Jingbo Yu, Clara Weil, Sophia Ish-Shalom, Vanessa Rouach, Varda Shalev, and Gabriel Chodick


Postdeployment Mental Health Status and Obesity Among a Multigenerational Sample of U.S. Veterans
Johanna Hyacinthe, Stuart Hoffman, Thomas Urosevich, H. Lester Kirchner, Richard Adams, Charles Figley, and Joseph Boscarino


Assessing the Association Between Exercise Status and Poor Glycemic Control
David Mosen, Harry Glauber, Ashley Stoneburner, Adrianne Feldstein, and Steve Fortmann


Loop Diuretic Use in the Months and Years Preceding a Heart Failure Diagnosis: A Case-Control Study
David Knorek, Steven Steinhubl, Christopher deFilippi, Kenney Ng, Roy Byrd, Zahar Daar, and Walter Stewart


Patterns of Prednisone Use During Pregnancy: Daily and Cumulative Dose
Kristin Palmsten, Matthieu Rolland, Mary F. Hebert, Megan E.B. Clowse, Michael Schatz, Ronghui Xu, and Christina D. Chambers


Patient Experience-of-Care Is Associated With Adherence/Persistence to Cardiometabolic Disease Medications in an Ambulatory Setting
Robert Romanelli, Vani Nimbal, Qiwen Huang, Wang Xiang, Joyce LaMori, Dilesh Doshi, and Sukyung Chung


What Factors Facilitate Weight Loss Among Medicaid Beneficiaries Participating in the Diabetes Prevention Program?
Gabriela Vazquez-Benitez, Jay Desai, Gretchen Taylor, Sara Vine, Julie Anderson, Joyce Garrett, Todd Gilmer, Houa Vue-Her, Jeff Schiff, Sarah Rinn, Katelyn Engel, Amy Michael, Mary Becker, and Patrick O'Connor


Long-Term Outcomes of a Cluster-Randomized Trial Testing the Effects of Blood Pressure Telemonitoring and Pharmacist Management
Stephen Asche, Anna Bergdall, Steven Dehmer, Beverly Green, JoAnn Sperl-Hillen, Patrick O'Connor, Rachel Nyboer, Pamala A. Pawloski, Michael Maciosek, Nicole Trower, and Karen Margolis


Exploring Prevalence of Discussions of e-Cigarettes Use During Tobacco Cessation Counseling and Smokers’ Understanding of e-Cigarette Use
Amy S.L. Tan, Gwen L. Alexander, Kathleen Mazor, Amanda Holm, and Kasisomayajula Viswanath


Evolving Dashboards: Honing Metrics by Engaging Stakeholders
Sarah Robinson, Theresa Schrider, Julie Anne Miller, Anjali Franco, Nicole Oehmke, Kristen Azar, and Alice Pressman


Retrieving Medical Records Within FDA’s Sentinel Distributed Network: Lessons Learned During a Protocol-Based Assessment Involving 13 Data Partners
Crystal Garcia, Candace Fuller, Madelyn Pimentel, Eric Ammann, Elizabeth Chrischilles, and Scott Winiecki


Leveraging the Virtual Data Warehouse to Support Implementation of Precision Medicine for Oncology at Catholic Health Initiatives
John Weeks, Jan Lowery, David Bailey, Elizabeth Evans, Penne Perry, and Lela McFarland


Validation of a Prediction Model Used at Kaiser Permanente Northwest in Collaboration With Operations
Ning Smith, Xiuhai Yang, Amanda Petrik, Yvonne Rice, Keith Crowland, Delilah Moore, and Eric Johnson


PreManage ED™ Evaluation in Hospitals of Alameda County, California
Xiangyi Xu, Franco Anjali, Kristen Azar, Nicole Oehmke, Nasiera Byrd, and Alice Pressman


Payer Decision-Making for Pharmacogenetic Tests: Preliminary Results
Christine Lu, Stephanie Treadwell, Rachel Ceccarelli, Kathleen Mazor, and Ann Wu


Patient Views on the Use of Personal Health Information and Biological Samples for Biobank Research
Katherine Gillespie, Harold Luft, Yasmin Hernandez, Sandra Lee, Mildred Cho, and Christina Craft


Access and Reimbursement for Cancer-Related Pharmacogenetic Tests and Medications
Ann Wu, Kathleen Mazor, Rachel Ceccarelli, and Christine Lu


Health Care Systems Research Network Twin Cohort and its Potential Utility
Scott Hebbring, Joseph Boscarino, Nora Henrikson, Sharon Fuller, and Mara Epstein


Interactive Visualization of a Patient’s Electronic Health Information to Assist Manual Chart Review Using Tableau® Software
David Carrell, Ladia Albertson-Junkans, Arvind Ramaprasan, Andrew Baer, and David Cronkite


Developing and Validating a Kaiser Permanente Electronic Health Record Data Transfer to External Research Partner Using Software Designed for Health Data Interoperability
Suzanne Gillespie, Mary Ann McBurnie, Vincent Malanga, Kelly Kirk, Michael Thornton, Phillip Crawford, Weiming Hu, Renee Petrie, Mike Stockemer, Kourtney Davis, and Richard Mularski


Population Insight Tool: A Novel Visual Interactive Query Interface to Virtual Data Warehouse
Ketan Mane, Dimitri Buzkov, Jackie Blank, Jamila Gul, Tracy Lieu, and Michael Horberg


Crusade for Cancer Data: How a Non-SEER Site Populated the Virtual Data Warehouse Tumor Table
Pamala A. Pawloski, Jody Jackson, Amy Butani, Terese DeFor, and Sheryl Kane


Adherence and Persistence With Therapy Among Newly Prescribed Fibromyalgia Patients in Israel
Dahlia Weitzman, Dana Ben-Ami Shor, Varda Shalev, Howard Amital, and Gabriel Chodick


Emergency Department Use in a U.S. Health Care System Before and After Implementation of the Coverage Provisions of the Affordable Care Act
Lisa Dean-Gilley, Anjali Franco, Lydia Xu, Jessica Liu, Sarah Robinson, and Alice Pressman


Correlates of High Performance After Implementing Lean Redesigns in Primary Care
Dorothy Hung, Su-Ying Liang, Caroline Gray, Meghan Martinez, Michael Harrison, and Harold Luft


Sustainment of Lean Redesigns in Primary Care Clinics
Dorothy Hung, Caroline Gray, Su-Ying Liang, Meghan Martinez, and Michael Harrison


Evaluating Unwarranted Variation in Treatment Patterns Using Unblinded Data
Satish Mudiganti, Michael van Duren, Sylvia Sudat, and Walter Stewart


Development of an Algorithm to Prospectively Identify Palliative Care-Eligible Patients From the Electronic Health Record
Sylvia Sudat, Kathy Blanton, Jessica Hanserd, Kenneth Rosenfeld, Anjali Franco, Shruti Vaidya, and Alice Pressman


Fidelity Evaluation of a Care Coordination Solution for Integrative Medicine: Usage and User Acceptance
Shruti Vaidya, Ridhima Nerlekar, Chelsea Lunders, Margot Markman, and Alice Pressman


Racial/Ethnic Disparities in Completion of the Routine Immunization Series by Age Two
James Nordin, Gabriela Vazquez-Benitez, and Elyse Kharbanda


Lessons Learned in Developing and Implementing the ED-PACT Tool: An Innovation Supporting Communication of Care Needs After Emergency Department Visits
Kristina M. Cordasco, Hemen N. Saifu, Mana Khafaf, Jonie J. Hsiao, Brian J. Doyle, and David A. Ganz


Two Models for Improving Colorectal Cancer Screening Rates in Health Plan Populations
Jennifer Coury, Jennifer Schneider, Laura-Mae Baldwin, Gloria Coronado, Beverly Green, Amanda Petrik, Keshia Bigler, and Malaika Schwartz


Implementing a Program to Encourage Patients to Report Breakdowns in Care: Do We Really Want to Know?
Kimberly Fisher, Kelly Smith, Thomas Gallagher, and Kathleen Mazor


Implementation of a New Kiosk Technology for Blood Pressure Management in a Community-Based Primary Care Clinic
Beverly Green, Chai-Fung Chung, Sean A. Munson, Matthew J. Thompson, Laura-Mae Baldwin, Jeffrey Kaplan, and Randall Cline


Designing for Impact: Multidisciplinary Program to Identify Novel Interventions in Support of Recovery After Major Cancer Surgery
Carmit McMullen, Matthew Nielsen, Alison Firemark, Denise Nakatani, Jean Tuthill, Ruth McMyn, Anobel Odisho, Michael Meyers, David Shibata, and Scott Gilbert


Fidelity Evaluation of the Cardiometabolic Solution, CM-SHARE: Usage and User Acceptance
Ridhima Nerlekar, Jake Reimer, Hannah Husby, Alice Pressman, and J.B. Jones


Geisinger’s Use of Clinical CarePaths: Impact of a Psoriasis CarePath on Process, Clinical, and Economic Outcomes
Rebecca Pulk, Laney Jones, Joseph Chronowski, Howard Pride, Eric Wright, and Michael Evans


Using Novel Multimodal Reminders for a Direct-Mail Fecal Testing Program: Findings From STOP CRC
Jennifer Rivelli, Gloria Coronado, Amanda Petrik, Sara Barker, Emily Topalanchik, Erin Keast, Keshia Bigler, and Ricardo Jimenez


Using Natural Language Processing to Enable Quality Improvement and Future Research for Patients at Risk of Suicide
Jennifer M. Boggs, J. David Powers, LeeAnn M. Rohm, Steve Hochberg, and Arne Beck


Alcohol Misuse Among Formerly Deployed U.S. Service Members Seen in Non-VA Facilities: Results From the Veterans' Cohort Study
Joseph Boscarino, Stuart Hoffman, Thomas Urosevich, H. Lester Kirchner, Johanna Hyacinthe, Richard Adams, and Charles Figley


Differences in Adult PHQ9 Administration at KP Northwest by Demographic and Census Factors
Phillip Crawford, Frances Lynch, Greg Clarke, and Greg Simon


Opioid Prescribing During Pregnancy: Eight-Year Secular Trends at HealthPartners Medical Group
Thomas E. Elliott, Caitlin K. Frail, Pamala A. Pawloski, Avis J. Thomas, Ann M. Werner, and Rebecca C. Rossom


Treating Behavioral Health Conditions: What Worries Pediatric Residents?
Ilene Ladd, Paul Kettlewell, Jeffrey Shahidullah, Kathy Dehart, Tyler Bogaczyck, and Sharon Larson


Population-Based Outreach Versus Usual Care to Prevent Suicide Attempt: Study Protocol for a Randomized Clinical Trial
Rebecca C. Rossom, Greg Simon, Arne Beck, Julie Richards, Beth Kirlin, Deborah King, Lisa Shulman, Evette Ludman, Ron Penfold, Susan Shortreed, and Ursula Whiteside


Adolescent SBIRT in Pediatric Primary Care: Patient Outcomes From a Randomized Trial in an Integrated Health Care System
Stacy Sterling, Andrea Kline-Simon, Ashley Jones, Anna Wong, Derek Satre, and Constance Weisner


Health Care Service Utilization Among Anxious and Nonanxious Youth
V. Robin Weersing, Argero Zerr Zerr, John Dickerson, Frances Lynch, Phillip Crawford, and Kate Conover


Expanding the VA Women’s Health Practice-Based Research Network: Increasing Capacity for Equitable Representation of Women in VA Research
Diane Carney, Susan Frayne, Ruth Klap, Lori Bastian, Bevanne Bean-Mayberry, Anne Sadler, Alyssa Pomernacki, Ciaran Phibbs, Fay Saechao, Vidhya Balasubramanian, Yasmin Romodan, and Elizabeth Yano


Organizational Learning in an Integrated Health System: Informing Operations for a Learning Health Care System
Deserae Clarke, Gloria Gerrity, Rebecca Stametz, Amanda Young, and Daniel Davis


Stakeholder Engagement in a Patient‐Activation Behavioral Intervention for Prescription Opioid Patients (ACTIVATE)
Monique Does, Andrea Kline-Simon, Nancy Charvat Aguilar, Catherine Marino, and Cynthia Campbell


Acculturation and Patient-Reported Experience With Health Care: An In-Depth Examination Using CG-CAHPS Surveys, Electronic Health Records, and Patient Surveys
Shuting (Lily) Liang, Sukyung Chung, Katie Gillespie, Lu Wah Hung, Yasmin Hernandez, and Meghan Halley


Are Asians Harder to Please? A Mixed-Methods Study of Racial/Ethnic Differences in Expectations and Evaluation of Health Care Experiences
Shuting (Lily) Liang, Sukyung Chung, Katie Gillespie, Lu Wah Hung, Yasmin Hernandez, and Meghan Halley


Towards Culturally Competent Care: Perspectives From Both Physicians and Patients
Shuting (Lily) Liang, Lu Wah Hung, Yasmin Hernandez, Katie Gillespie, Meghan Halley, and Sukyung Chung


Response to Survey Solicitation to Patient Portal Members Differs by Age, Race, and Health Care Utilization
Cathryn Peltz-Rauchman, George Divine, Daniel McLaren, Ko Un Park, Ilan Rubinfeld, Michelle Schreiber, David Allard, and Christine Cole Johnson


Preference for Immediate Release of Test Results Through a Patient Portal Differs by Demographics and Type of Results
Cathryn Peltz-Rauchman, George Divine, Daniel McLaren, Ko Un Park, Ilan Rubinfeld, Michelle Schreiber, Christine Cole Johnson, and David Allard


Feasibility of Collecting Patient-Reported Outcomes After Major Cancer Surgery: A Survey of Kaiser Permanente Members Six Months After Cystectomy for Bladder Cancer
Joanna Bulkley, Maureen O'Keeffe-Rosetti, Christopher Wendel, James Davis, Michael Leo, Sheila Weinmann, Julie Munneke, Teresa Harrison, Marilyn Kwan, Kim Danforth, and Carmit McMullen


Enrolling Patients in the Sutter Health Biobank: Lessons Learned From Testing Different Recruitment Methods
Katherine Gillespie, Yasmin Hernandez, Lu Wah Hung, and Harold Luft


Identification of Migraine at Sutter Health: An Application of an EHR-Based Algorithm
Alice Jacobson, Heather Law, Andrew Avins, Sylvia Sudat, Jessica Liu, Lisa Dean, and Alice Pressman


Fidelity Measurement of a Mindfulness-Based Stress Reduction Intervention in a Randomized Controlled Feasibility Trial for Migraine Patients
Heather Law, Bob Stahl, Andrew Avins, Sylvia Sudat, Alice Jacobson, Jessica Liu, Marina Dolginsky, Lisa Dean, and Alice Pressman


Stakeholders’ Views on Data Sharing and Multisite Research
Kathleen Mazor, Marsha Raebel, David Arterburn, Allison Richards, Mia Gallagher, W. Benjamin Nowell, and Darren Toh


Direct Adjustment of Obesity Estimates in the Colorado BMI Monitoring System
Liza Reifler, Eric Bell, David Tabano, Jennifer Barrow, LeeAnn Rohm, Rickey Tolliver, and Matthew Daley


Sleep Deprivation in Hospitalized Patients Over the Age of 60: An Approach to Recruitment Challenges in an Inpatient Setting
Ariana Ruiz, Alice Pressman, Katie Stone, Lisa Dean, Sarah Robinson, and Phillip Yu


Identification of Incident Uterine Fibroids Using Electronic Medical Record Data
Onchee Yu, Renate Schulze-Rath, Susan Reed, Jane Grafton, Kelly Hansen, and Delia Scholes