General Posters

Background/Significance:

Mechanical ventilation (MV) is lifesaving but requires consistent, evidence-based application to prevent patient harm. Despite international guidelines, global practice remains inconsistent, and skill gaps persist in areas such as waveform interpretation, patient–ventilator dyssynchrony, and ventilator liberation. In Ukraine, war-related system strain and variable access to standardized training may amplify gaps in MV practice.

Purpose:

To describe self-reported MV competence, perceived barriers, and preferred training formats among Ukrainian ICU clinicians to inform future MV education initiatives.

Methods:

We conducted a cross-sectional, anonymous web-based survey of clinicians caring for ventilated adults in Ukraine, distributed by the Ukrainian Society of Anesthesiology between September 20 and December 9, 2025. Survey items addressed clinician characteristics, MV competence (10 Likert-scale items), MV practices, perceived barriers, prior training, and preferred learning formats. Duplicate entries were removed; analyses were descriptive.

Results:

We analyzed 212 responses representing 16 regions/oblasts. Most respondents (98.1%) were Anesthesiologists/Intensivists. Over half of respondents reported more than 10 years of MV experience (57.5%) and half practiced in regional/district hospitals (50.0%). Highest confidence, utilizing a 5- point Likert scale, was reported for preventing ventilator-associated complications (80.6%) and applying lung-protective ventilation (77.8%). Confidence in mobilizing patients (55.5%) and troubleshooting ventilator technical issues (58.0%) were lower. Synchronized Intermittent Mandatory Ventilation (SIMV) was a commonly used mode of MV (75.9%); propofol (80.2%) and dexmedetomidine (73.6%) were frequently used sedatives. Key barriers included insufficient staffing/workload (69.2%), lack of clear institutional protocols (56.2%), and limited hands-on training (52.9%). Priority training topics focused on patient-specific ventilation strategies (77.4%), waveform interpretation/dyssynchrony (66.5%), and complication management (59.4%). Preferred formats included hands-on workshops (82.1%), bedside mentorship (55.2%), and simulation (50.9%).

Conclusion:Ukrainian intensivists report moderate MV confidence with specific gaps in troubleshooting, dyssynchrony management, and mobilization amid staffing and protocol barriers. Findings support a blended, competency-based curriculum emphasizing practical, simulation-supported, and mentored training.

Background/Significance:

The Inflammatory Bowel Disease Questionnaire (IBDQ), a 32-item survey published in 1989, evaluates health-related quality of life (QOL) in inflammatory bowel disease (IBD) across bowel, systemic, emotional, and social domains. Higher scores indicate better QOL. It remains widely used in clinical practice and trials. However, as therapies and patient expectations evolve, legacy instruments may not capture contemporary domains such as mental health burden, cultural factors, treatment complexity, extraintestinal manifestations, and cumulative therapy impact. Large language models (LLMs), increasingly used in clinical research, offer a systematic method to critique and refine patientreported outcome (PRO) tools. We aimed to determine whether LLMs identify meaningful gaps in the IBDQ and generate clinically relevant revisions compared with the original instrument.

Purpose:

To evaluate the IBDQ using multiple AI platforms, identify missing or underrepresented domains, generate revisions, and compare outputs through blinded expert review.

Methods:

The complete IBDQ and standardized prompts were provided to seven LLMs. Each generated a 1–10 global quality rating and structured critiques outlining strengths, limitations, redundancies, and proposed missing domains. An IBD-focused academic physician reviewed seven coded, randomized outputs under blind conditions. Overall quality, clinical appropriateness, and psychometric insight were assessed. Two 1–5 scales rated clinical applicability and comparative improvement versus the original IBDQ. Content analysis identified domains most frequently cited as underrepresented.

Results:

All LLMs rated the IBDQ favorably (7–8/10). Open Evidence retained the original structure. Copilot and Gemini reduced redundancy by consolidating items. ChatGPT expanded social consequence domains. Claude and Perplexity emphasized dietary impact, treatment burden, body image, cognitive function, and extraintestinal manifestations. Expert review found Copilot, Gemini, and Open Evidence revisions useful but inferior to the original. ChatGPT 4o and 5.1 revisions were considered improvements. Claude received the highest evaluation, with revisions viewed as potentially practice-changing.

Conclusion:

LLMs identified domains not fully captured in the IBDQ and proposed meaningful refinements. While outputs varied, many emphasized reducing questionnaire burden and improving clarity. LLMs may serve as scalable tools to modernize legacy PRO instruments, with expert oversight to ensure clinical rigor and relevance.

Background/Significance:

Bone health complications are a well-recognized but often under-monitored consequence of androgen deprivation therapy (ADT) and aromatase inhibitor (AI) therapy, which accelerate bone mineral density loss and increase fracture risk. Despite guideline recommendations from NCCN and ASCO for baseline and periodic DEXA screening, adherence remains low across multiple real-world studies. However, institution-specific adherence patterns, particularly potential sex-based disparities remain poorly characterized.

Purpose:

To evaluate adherence to guideline-recommended DEXA screening and assess sex-based differences among patients with non-metastatic breast or prostate cancer receiving hormone therapy within Advocate Health Midwest Wisconsin locations.

Methods:

We conducted a retrospective review of patients diagnosed with stage I–III breast or stage I-IVA prostate cancer treated within Advocate Health Midwest Wisconsin locations between 2019–2023 who received ADT or AI therapy. We excluded metastatic disease and coding inaccuracies. Adherence was defined as documentation of baseline or interval DEXA screening consistent with guideline recommendations. We summarized data using counts and frequencies and tested for associations using the Chi-square test with p < 0.05 considered statistically significant.

Results:

Ninety-two patients met inclusion criteria [45 women (all breast), 47 men (all prostate)]. Baseline screening prior to therapy (48.9% vs 21.3%, p < 0.01), DEXA screening ordered (80.0% vs 30.2%, p < 0.01) and documentation of newly identified osteopenia or osteoporosis after therapy (35.6 vs 15.6%, p = 0.09) was higher in women vs. men.

Conclusion:

Significant disparities exist in adherence to bone density screening guidelines between men and women receiving hormone therapy for cancer. Under-screening among men on ADT may reflect lower awareness of osteoporosis risk, fewer standardized screening workflows, and differences in provider perception of fracture risk. These findings identify a modifiable quality gap and support targeted interventions such as EMR prompts, standardized order sets, and provider education to improve adherence and optimize skeletal outcomes. This represents a readily addressable care gap within oncology survivorship management. Larger datasets and prospective studies are needed to validate these findings and guide institutional quality improvement efforts.

Background/Significance:

Sickle cell disease (SCD) often results in vaso-occlusive pain crises (VOC), leading to recurrent emergency department visits and hospital admissions. American Society of Hematology (ASH) guidelines recommend rapid initiation of intravenous opioid therapy—within one hour of ED arrival— and standardized management pathways. Despite these recommendations, individuals with SCD remain under-recognized and under-treated in community hospitals. Practice variability may contribute to delayed analgesia, inconsistent patient-controlled analgesia (PCA) use, stigmatizing documentation, and prolonged hospital length of stay (LOS). Institutional review found inpatient VOC care processes and documentation as key targets for quality improvement.

Purpose:

To evaluate provider-group variation in LOS, PCA use, and timeliness to first IV opioid for inpatient VOC at two community hospitals, and to assess clinician documentation.

Methods:

This descriptive quality-improvement project occurred at Aurora Sinai Medical Center (230 beds) and St. Luke’s Medical Center (938 beds) and included adults ≥18 years admitted between 2020–2025 with VOC based on ICD-10 criteria, per an approved QI protocol. Comparative analyses included the Aurora Medical Group (AMG) hospitalist service and the Internal Medicine Teaching Service (IMTS); the Family Medicine Teaching Service was excluded due to low volume. Chart audits were performed, and chi-square and Wilcoxon tests were used with significance set at p<0.05.

Results:

73/81 admissions met inclusion criteria (AMG n=43; IMTS n=30). Genotypes included HbSS 84.9%, HbSC 6.8%, and unknown 8.2%. Door-to-IV opioid time was available for 70/73 admissions (median [IQR] 1.2 hours [0.7–2.1]). PCA was used in 35.7% of encounters, and 86.3% received IV fluids within 6 hours. No significant differences were seen between AMG and IMTS in median LOS (3.7 vs 3.0 days, p=0.075), PCA (y/n) use (35.7% vs 35.7%, p>0.999), or IV opioid choice (predominantly hydromorphone; p=0.115). However, AMA discharges differed significantly (7.0% vs 25.0%, p=0.032), with higher rates in the IMTS group. Chart audits found recurring documentation referencing opioid tolerance, prior pain regimens, and frequent admissions.

Conclusion:

Provider-group comparisons showed similar LOS, PCA use, and IV opioid selection, with higher AMA discharges in the IMTS group. Findings highlight opportunities for standardized VOC management, non-stigmatizing documentation, and future study of individualized inpatient pain plans.

Background/Significance:

The Nulliparous, Term, Singleton, Vertex (NTSV) cesarean birth rate was developed as a quality metric to provide a standardized way of evaluating rates between hospitals with the aim of reducing primary cesarean rates. Currently, in the United States NTSV cesareans account for ~25.6% of births (national benchmark 23.6%). Labor arrest disorders, including failed induction of labor, arrest of cervical dilation, and arrest of fetal descent, account for ~18-35% of primary deliveries, making them one of the more common indications for NTSV cesareans. However, there has been limited evaluation of adherence to American College of Obstetricians and Gynecologists (ACOG) Safe Prevention of the Primary Cesarean Delivery diagnostic criteria for arrest disorders among NTSV cesareans.

Purpose:

To evaluate adherence to established diagnostic criteria for labor arrest disorders among NTSV cesareans.

Methods:

We conducted a quality improvement project within one urban teaching hospital among patients ≥ 37 weeks’ gestation who presented with a singleton, vertex pregnancy and their first live birth between 6/1/2021-6/1/2022. A subgroup of patients who were identified as having a NTSV cesarean and a labor arrest disorder as a documented cause for delivery were further reviewed to determine adherence to the ACOG diagnostic criteria for labor arrest disorders. Neonatal outcomes were also reviewed within this subpopulation. Basic descriptive statistics were computed.

Results:

Of NTSV cesarean deliveries (N=127), 20.5% (N=26) had documentation of labor arrest disorder. Patients were of median age 22.0 years, and were predominately Black, non-Hispanic (48.8%) with a median gestational age of 39w3d. Gestational hypertension was present in 30.0% of patients. Labor was induced in 73.1% of patients and 92.3% had Pitocin augmentation. Only 61.5% (N=16) met ACOG criteria for labor arrest: 50.0% (N=8) criteria for arrest of dilation, 43.8% (N=7) arrest of descent, or 6.3% (N=1) failed induction of labor. Neonates born within this subpopulation had a median 5-min APGAR of 9.0; 19.2% were admitted to the NICU.

Conclusion:

More than one-third of NTSV cesarean deliveries performed for a labor arrest disorder did not meet established ACOG diagnostic criteria, indicating inconsistencies in guideline-concordant labor management. This finding reveals an important opportunity for future targeted quality improvement efforts aimed at strengthening adherence to evidence-based labor arrest criteria.

Background/Significance:

Perceived unprofessional behavior (PUB) poses a significant challenge in medical education (ME), as research demonstrates its adverse impact on patient care, teamwork, and learning. But what if professionalism is reframed as trust consistent with ME’s entrusted professional activities (EPA)? Agreement on which behaviors adversely affect trust can provide educators with a different approach to illuminate PUB.

Purpose:

To develop and conduct a needs assessment to assess the degree to which selected professionalism-related behaviors are linked to trust.

Methods:

Key ME stakeholders (i.e., learners, faculty, ME leaders/staff) submitted brief, de-identified unprofessional behaviors that they had experienced/witnessed exhibited in practice. Behaviors were categorized into 1 of 4 Feltman trust categories: reliability, competence (with humility), sincerity, or caring. 5 items were selected for each category (to represent an array of behaviors, settings, professional roles) yielding a 20-item assessment tool. ME stakeholders rated items on the degree to which they would trust this person as a professional (4-point Likert scale with unable to judge option). Protected time was provided in existing forums to complete the voluntary needs assessment using Survey Monkey to minimize anonymity concerns.

Results:

265 responses were received (July-October 2025) from residents/fellows (37%), medical students (18%), faculty (15%), ME staff (17%), and ME Leaders (12%) with average completion time < 4.5 minutes. Cronback’s Alpha = .84. Greater than 70% of respondents expressed a lack of trust (rating “No, Probably Not" or "No, Definitely Not" trust) on 75% of the items [e.g., being unresponsive to feedback (94%), senior trainee repeatedly late to service (92%); heavy cell phone in front of patients (86%)]. 15% of items had < 50% consensus [e.g., lack of progressive autonomy (49%); rarely asking for help/feedback (45%)]. When items were examined by trust categories, “sincerity” related items had the highest not trustworthy agreement (range: 78%-86%) while “competence with humility” related items had the lowest agreement (range: 44%-94%).

Conclusion:

Conducting a reliable needs assessment focused on unprofessional behaviors reframed as trust revealed common ground and a few areas of disagreement that will be used to foster candid conversations about professionalism and appropriate conduct.

Background/Significance:

Long COVID is characterized by persistent, heterogeneous symptoms that often lack timely recognition, contributing to delayed diagnosis and fragmented care. Understanding patient experiences with diagnosis and care pathways is critical to determining whether and how receiving a Long COVID diagnosis influences access to care, patient well-being, and perceptions of validation within the healthcare system. This study aimed to explore patient experiences with a Long COVID diagnosis and care navigation within the Advocate Health system, with a focus on identifying barriers to diagnostic equity and opportunities to improve clinical pathways.

Purpose:

The purpose of this study was to understand diagnostic challenges, identify barriers to equitable Long COVID care, and inform improvements in clinical processes that support earlier recognition and coordinated management.

Methods:

We conducted a qualitative study using semi-structured virtual interviews with adults (≥18 years) who had received a Long COVID diagnosis at Advocate Health. Participants were identified through electronic health record review and contacted by phone and via MyChart outreach. Interviews were audio-recorded, transcribed verbatim, de-identified, and analyzed using the RADaR (Rapid and Rigorous Qualitative Data Analysis) technique. Patient quotes were organized in Excel and coded, reduced, and synthesized into themes.

Results:

Thirteen patients were interviewed, ages 25–76; most were African American women insured through Blue Cross and Blue Shield. Preliminary analyses revealed several recurring themes: persistent diagnostic uncertainty, delays in symptom recognition, difficulty navigating referrals and specialty care, fragmented communication across providers, and the substantial self-advocacy required to obtain appropriate evaluation. Patients also described relief and validation once Long COVID was formally acknowledged. Ongoing RADaR analysis will further clarify how earlier diagnosis and consistent referral pathways may reduce navigation burdens and support more equitable care.

Conclusion:Patient experiences highlight the need for systematic approaches, such as clinical symptom screening tools, to promote timely diagnosis of Long COVID and to improve equity, coordination, and patient-centered care.

Background/Significance:

Esophagectomy is a cornerstone of esophageal cancer treatment. Open esophagectomy has potential for complications and difficult recovery. Transhiatal Endoscopic Esophageal Mobilization (TEEM) is a novel minimally invasive method of esophagectomy that decreases morbidity and length of procedure via a dual-team approach from the abdomen and neck.

Purpose:

The objective of this study was to evaluate the oncologic and perioperative outcomes of TEEM esophagectomy over a 10-year period.

Methods:

We retrospectively reviewed patients who underwent TEEM esophagectomy between January 1, 2015- December 31, 2024 at our institution using the STS database. Patients without esophageal cancer were excluded. Demographics, intraoperative data, post-operative, and pathologic results were collected for descriptive analysis.

Results:

Overall, 146 patients received TEEM. Mean age was 65.3 years (range 36-84). Average procedure time was 202 minutes. Procedure time trended lower over time with average OR time during the first 3.5 years of 244 minutes, OR time during the middle 3 years of 192 minutes, and OR time during the final 3.5 years of 188 minutes. Initially all patients were admitted to ICU after surgery, but at the end of data collection patients were admitted to the floor after surgery in most cases. Esophageal tumors were located in the lower third (57%, n=83), the gastroesophageal junction (35%, n=51), and middle third (8%, n=12). Mena lymphadenectomy included 15 LN (15.43 ± 5.47 SD). 95.2% of patients had R0 resection (n=139). 30-day and 90-day mortality were equivalent at 1.3% (n=2). One year mortality was 15%. 54 patients experienced post-operative events. The most frequent complications were pulmonary (pulmonary embolism, respiratory failure, pneumonia, pleural effusion, pneumothorax, acute respiratory distress syndrome, reintubation, trach, atelectasis, n=47). Additional complications included cardiac (arrythmias/myocardial infraction, n=24), recurrent laryngeal nerve injury (n=13), anastomotic leak (n=9), surgical site infection (n=3). 14.38% (n=21) of patients were readmitted within 30 days.

Conclusion:

TEEM esophagectomy is a feasible approach for surgical resection of esophageal cancers from mid esophagus to gastroesophageal junction. This technique is efficient and provides adequate lymphadenectomy and R0 resection rates. Further study is needed to compare TEEM approach to standard esophagectomy to discern any approach specific benefit.

Background/Significance:

The management of children with aortic regurgitation (AR) remains controversial. Adult surgical criteria are frequently applied to pediatric patients, yet normalization of left ventricular (LV) size and function postoperatively is not always achieved. We sought to identify preoperative imaging parameters that predict postoperative LV recovery in pediatric and young adult patients undergoing aortic valve intervention for chronic AR.

Purpose:

Defining imaging markers that distinguish reversible from irreversible remodeling is critical to prevent lifelong cardiac dysfunction.

Methods:

We retrospectively studied patients <30 years from 2020-2024 with at least moderate AR who underwent aortic valve surgery and had preoperative and>6–12-month postoperative imaging. We divided the cohort into two groups based on if LV recovery was achieved, which was defined as meeting ≥3 criteria of normalization of LV size and function on postoperative imaging. Preoperative imaging variables were compared between recovery and non-recovery groups. Logistic regression identified predictors of LV recovery.

Results:

Overall, 22 patients (mean age 16 years) were included; 91% demonstrated improvement in LV size postoperatively, but only 77% achieved LV recovery. On preoperative echocardiograms, smaller systolic volumes (LVESV 61.0 mL vs 132.8 mL, p=0.017) and better systolic function were associated with LV recovery. This trend was similar via cardiac MRI, but not statistically significant given a small sample size. Impaired preoperative strain parameters by MRI were significantly associated with failure of LV recovery. When compared to adult volumetric thresholds associated with increased mortality (LVESVi ≥45 mL/m2), 86% of patients with normal function still achieved LV recovery.

Conclusion:

Most of our cohort achieved LV recovery despite large ventricular volumes. Systolic LV volumes and function parameters such as MRI derived strain provide prognostic value and may better guide surgical timing. Adult-based volumetric criteria alone did not reliably predict who achieved LV recovery and suggest different reverse remodeling capabilities of pediatric patients. This highlights the need for pediatric-based surgical guidelines to prevent irreversible myocardial injury. We are currently developing a larger, multi-center project to further investigate.

Background/Significance:

Maternal complications during delivery may predispose neonates to early clinical instability. Identifying specific maternal risk factors can help stratify neonatal risk and guide early postnatal care.

Purpose:

To assess the relationship between maternal complications and early neonatal illness severity using a composite clinical illness score.

Methods:

This retrospective cohort study included neonates admitted to a level IV NICU. Maternal factors analyzed included chorioamnionitis, fever, PPROM, preeclampsia, and intrapartum antibiotic exposure. Neonatal illness severity was defined using a 5-point composite score incorporating hypotension, need for hydrocortisone, elevated CRP, presence of multiple central lines, and ≥5 days of central line use. Linear regression models were used to assess associations between maternal factors and illness score, adjusting for gestational age and birthweight.

Results:

Among the maternal factors analyzed, maternal fever (p = 0.021) and PPROM (p = 0.038) were independently associated with higher neonatal illness scores. Chorioamnionitis and preeclampsia were not significantly associated after adjustment.

Conclusion:

Maternal fever and PPROM are independently associated with increased early neonatal illness severity, even after accounting for gestational age and birthweight. These findings support targeted surveillance and management strategies for neonates exposed to these maternal complications.

Background/Significance:

Various gaps persist across communities due to barriers that prevent patients from accessing their healthcare needs. Aurora St. Luke’s Family Practice Clinic, which serves a diverse and underserved population, developed an interdisciplinary outreach model called “Pop Spotting”

Purpose:

We aim to create a model that allows the clinic team to identify patients who have multiple care gaps and have been lost to follow up. By reaching out to these patients and scheduling visits, we hope to meet health care needs efficiently and improve patient outcomes.

Methods:

This project utilizes Population Health Indicator (PHI) scores to identify established clinic patients with four or more outstanding care gaps and compiling a list of 12 patients per week who met the PHI criteria. This then resulted in outreach calls to offer in-clinic or home visits to address the healthcare gaps. The data collected included monthly PHI scores, outreach call metrics, scheduled and completed visits (both in clinic and home visits).

Results:

Between April 2024 and December 2025, 1080, patients were targeted for outreach, with 660 successful contacts, resulting in 140 clinic appointments, 42 home visits, and 40 patient panel removals due to transfer of care, relocation, etc.

Conclusion:

Initially, there were obstacles to the model with staffing turnover, which were addressed to improve accountability and interdisciplinary collaboration. Overall, the outreach allowed for a combined total of 182 additional clinic and home visits, possibly indicating “Pop Spotting” as a model to improve care access to high-risk patients and reduce healthcare disparities in underserved and vulnerable populations. Opportunities for growth include implementing this model at additional clinic sites, such as the FCC, and reinforcing the key take-away that interdisciplinary collaboration and coordinated teamwork are essential to this project’s success and delivery of high-quality patient care.

Background/Significance:

According to the GOULD registry, the median low-density lipoprotein (LDL) after coronary revascularization is 99mg/dL. Similarly, a large-scale New York City health system cohort (2018-2023) reports 52% of those who underwent revascularization had a median follow-up LDL<70 mg>/dL.

Purpose:

Our retrospective study assesses the current practices of cholesterol-lowering therapy and secondary risk reduction strategies for patients who have undergone percutaneous intervention or coronary artery bypass grafting from September 2011 to September 2023 across all 25 Advocate Aurora Health medical centers in Wisconsin and Illinois.

Methods:

Among the 42,561 identified patients, 20,501 were excluded because of incomplete data. The primary outcome was LDL characteristics after revascularization in male (Group A) and female (Group B) cohorts. Secondary analysis included patient demographics, medical conditions associated with increased cardiovascular risk, and prevalence of non-statin therapy usage. The Chi-square test or Fisher’s exact test was used to compare the groups for categorical variables, and the Wilcoxon Rank Sum test was used to compare the groups for numerical variables. Confidence intervals (95%) were also used with descriptive statistics to describe the characteristics of the cohorts.

Results:

Eligible for the study were 15,311 males with a median age of 68 years old and 6,749 females with a median age of 70 years old. Most individuals were White (80%) and had a BMI >29 across both groups. Compared with their male counterparts, a heightened prevalence of cardiovascular risk factors was identified amongst the women, including history of myocardial infarction, congestive heart failure, diabetes, hypertension, stroke, peripheral arterial disease, chronic obstructive pulmonary disease, and chronic kidney disease. Key risk factors more prevalent in men included atrial fibrillation and cancer. Both groups had 95% statin utilization after coronary revascularization and achieved post-revascularization LDL levels of 61mg/dL and 67 mg/dL in males and females, respectively.

Conclusion:

The study’s findings suggest that healthcare systems can successfully implement secondary prevention strategies to achieve LDL levels <70 after coronary revascularization for both male and female patients at very high risk of developing future cardiovascular>events.

Background/Significance:

The Tyrer-Cuzick (T-C) score is a risk prediction tool used to provide a quantitative estimate of an individual's lifetime risk of developing breast cancer and can be used to guide screening practices. A high score may lead to recommendations for earlier breast imaging, lifestyle modifications, genetic testing, risk reducing medications or surgery. Given updated recommendations by professional organizations such as the American Academy of Breast Surgeons, Advocate Health developed Primary Care and Radiology workflow processes to attempt to standardize breast cancer risk assessment. Since initiating this workflow in July 2023, there has been a disproportionate number of patients screened by Radiology compared to Primary Care. Since Primary Care clinicians see patients prior to the start of routine mammogram screening at age 40, there is an opportunity to begin breast cancer risk assessment at much earlier ages. Currently, the Aurora Family Medicine Residency Program is under-utilizing the T-C score because of a lack of knowledge of the score and formal policy regarding breast cancer risk assessment.

Purpose:

This project was conducted to improve the systematic process our clinics utilize to assess patients’ breast cancer risk.

Methods:

A pre-survey was distributed to residents and faculty to assess baseline usage and knowledge of the T-C Score with 72.5% of responses demonstrating poor understanding and utilization of the T-C score, indicating a need for intervention. Following survey distribution, an education session was held at a Resident Faculty Meeting, and a summary of the session was emailed to our program. T-C score completion data was continuously collected with monthly updates sent to residents and faculty.

Results:

Prior to our intervention, a total of 100 patients had been screened at our Family Medicine residency clinics from 07/2024-07/2025. After our intervention, a total of 323 patients had been screened from 08/2025-02/2026. The number of patients screened tripled in a 6-month period after our intervention. We anticipate that our screening rate will continue to improve over time.

Conclusion:

As a result of this intervention, Primary Care has been better able to perform breast cancer risk assessments, which will positively impact patients’ ability to receive appropriate care sooner for their designated breast cancer risk stratification category.

Background/Significance:

Point of Care Ultrasound (POCUS) is a useful diagnostic and therapeutic tool in the inpatient and emergency department settings. Pediatric residency programs across the United States have failed to incorporate POCUS training into their curricula despite strong resident interest.

Purpose:

Currently, pediatric residents at Advocate Children’s Hospital – Park Ridge does not receive POCUS training. Thus, we sought to institute a POCUS curriculum to address that training gap.

Methods:

Residents took a 15-question examination via Google Forms to assess baseline knowledge of POCUS. Over the course of 4 weeks, residents received four separate lectures given by POCUS trained pediatric residents. Topics covered included (1) basics of bedside ultrasound, (2) how to perform a FAST exam, (3) the use of bedside ultrasound in the inpatient setting to evaluate soft-tissue structures, and (4) the use of bedside ultrasound for IV placement. After completion of the lectures, residents were tested using the same 15-question examination. Pre-curriculum and post-curriculum examinations were scored, and percent difference between averages were compared for effectiveness of curriculum in improving knowledge of POCUS.

Results:

46 surveys (23 individual respondents) were included in the final analysis. The average score of the pre-curriculum examination was 62.3% ±5.8%. The average score of the post-curriculum examination was 72.5% ± 4.9%. The difference in score averages between pre-curriculum and post-curriculum examination was approximately 10%.

Conclusion:

POCUS education continues to lag in many residency programs despite its increased use and prevalence in the medical community. The results of this study demonstrate a need for an effective ultrasound curriculum at Advocate Children’s Hospital - Park Ridge. Final exam results will demonstrate that the developed curriculum was effective in increasing resident knowledge.

Background/Significance:

Many new treatment options for ulcerative colitis (UC) have become available in recent years, including dual-mechanism strategies and single-agent approaches. Among available treatments, JAK– STAT inhibitors carry an increased risk of herpes zoster (HZ) with an associated FDA Black Box warning.

Purpose:

This study aims to compare FDA-approved UC therapies and their relative association with HZ using reported data from the FDA Adverse Event Reporting System database (FAERS).

Methods:

The FAERS database consists of voluntarily reported post-marketing adverse drug reactions (ADRs). 32,229,802 total reports from Jan 1968 to September 2025 were evaluated. Reports of ADRs of all FDA approved UC therapies including mesalamine, sulfasalazine, balsalazide, olsalazine, methotrexate, azathioprine, 6-mercaptopurine, infliximab, adalimumab, certolizumab, folimumab, vedolizumab, ustekunumab, mirikizumab, risankizumab, guselkumab, ozanimod, etrasimod, tofacitinib, and upadacitnib along with combination infliximab with methotrexate, infliximab with azathioprine, adalimumab with azathioprine, and golimumab with azathioprine were reviewed. Cases of reported HZ in the treatment of UC were collected and only medications with documented reports were included in this study. Using the OpenVigil program, signals for these ADRs were determined using reporter odds ratios (RORs) calculated with the following formula: ROR = (a/c)/(b/d) (a: drug with ADR, b: all drugs with ADR, c: all ADRs for the drug, d: other drugs with other ADRs.) A ROR >1 indicates that an ADR frequency is not occurring by chance alone, suggesting a significant post-marketing signal.

Results:

The JAK-STAT inhibitor tofacitinib showed increased risk of HZ with 58 total reports (ROR 2.79). In addition, methotrexate (ROR 1.83), azathioprine (ROR 1.74), 6-mercaptopurine (ROR 2.4), infliximab (ROR 2.49), and combination therapies of infliximab with methotrexate (ROR 2.61) and infliximab with azathioprine (ROR 2.91) demonstrated increased risk. Alternatively, there is a statistically significant decreased risk of HZ with treatment of adalimumab (ROR 0.61) and vedolizumab (ROR 0.54).

Conclusion:

Tofacitinib was shown to have an increased risk of HZ in our study. No other medications used in the treatment of UC also demonstrated an increased risk. Of interest, adalimumab and vedolizumab demonstrated a protective association with HZ.

Background/Significance:

Detection of radiographically occult metastatic disease (ROMD) in pancreatic ductal adenocarcinoma (PDAC) remains vital for staging. There is no standardized approach, but borderline resectable or locally advanced disease, CA 19-9 > 394, location in the pancreatic body or tail, and no neoadjuvant therapy are predictive of ROMD and often used to select patients for staging laparoscopy. Peritoneal washings have been used at the time of laparoscopy to further detect occult disease, with positive cytology considered by NCCN guidelines to be metastatic (M1) disease.

Purpose:

We sought to study characteristics of patients undergoing laparoscopy with or without washings to inform a future protocol at our institution.

Methods:

This was a single-institution retrospective chart review of all adult patients (>18) undergoing staging laparoscopy for known or suspected PDAC (ICD C25-9) from Jan 1, 2020 – Dec 31, 2024. Patients with known metastatic disease were excluded. Descriptive statistics were calculated. Unpaired t-tests were used for normally distributed continuous variables, and Mann-Whitney u-test for nonparametric data. Fischer’s exact test was used for comparison of categorical values with small sample sizes.

Results:

98 patients underwent staging laparoscopy for PDAC. Washings were performed in 55/98 patients (56%). Preoperative characteristics related to ROMD identified at laparoscopy were analyzed. Positive or atypical cytology was found in 7/55 cases (12.7%). One patient (1/55) had positive washings with no gross metastatic disease. In this sample, median CA 19-9, BMI, and tumor location were not associated with ROMD at laparoscopy. Fifty percent (10/20) of patients with ROMD had upfront resectable disease vs. only 41% (32/78) in the no metastasis group (p = 0.01). Cytology results were associated with diagnosis of biopsy proven metastatic disease at laparoscopy (p = 0.003).

Conclusion:

Staging laparoscopy remains crucial to the workup for PDAC to inform treatment decisions and set patient expectations, particularly in the setting of routine neoadjuvant treatment. In our sample, many factors typically associated with ROMD were not significant, and an unusually high proportion of resectable patients presented with occult metastatic disease. This suggests the need to consider routine staging laparoscopy, and further study is indicated to determine the role of washing.

Background/Significance:

Chlamydia trachomatis (CT) remains one of the most reported bacterial sexually transmitted infections in the United States, disproportionately affecting young women. National guidelines recommend annual screening of sexually active women under the age of 25 to reduce risks of pelvic inflammatory disease and comparable conditions. However, operationalizing risk-based screening within the Electronic Health Record (EHR) proves challenging when sexual activity is not comprehensively documented. During a period without active EHR prompts in Aurora St. Luke’s integrated health system, baseline CT screening patterns were evaluated to inform future workflow and quality initiatives.

Purpose:

To characterize age-specific CT screening and positivity rates and examine variations of these two rates by provider specialty and social vulnerability.

Methods:

A retrospective analysis of EHR data from April 20, 2022, to April 19, 2023, was conducted. Female patients aged 12 years and older, with at least one provider encounter in the prior 12 months were included. Testing rates, positivity, and population prevalence were calculated by age. Screening at wellness visits was stratified by specialty (pediatrics, family medicine, obstetrics/gynecology). Social Vulnerability Index quartiles were compared to assess socioeconomic gradients in testing and positivity.

Results:

Among 1,971,826 active female patients aged ≥12 years, 106,414 (5.4%) underwent chlamydia testing, with 4,968 positive results (4.7% positivity; population prevalence 0.3%). Testing increased with age, from 0.4% among ages 12–14 to 16.0% among ages 21–24, yet overall results remained below estimated sexual activity prevalence. Test positivity among those screened was high across adolescence (≈13–14% at ages 15–20), declining to 9.0% at ages 21–24. At wellness visits, screening differed by specialty across all ages (p<10⁻2⁰), with higher testing in family medicine and obstetrics/gynecology than pediatrics. Patients from high Social Vulnerability Index neighborhoods had greater testing uptake and higher odds of infection.

Conclusion:

Without EHR prompts, CT screening was below guideline recommendations despite high positivity once testing occurred. Population prevalence increased with age due to greater testing, not rising infection risk. Specialty and social vulnerability influenced screening and disease burden, supporting standardized, opt-out screening to improve equity.

Background/Significance:

Patient safety in hospice care requires balancing traditional safety metrics with individualized, comfort-focused goals at the end of life. Inpatient hospice units manage complex symptoms, high-risk medications, and dynamic family preferences, yet limited literature characterizing safety events in this setting. Despite routine event reporting, no comprehensive evaluation of safety incidents has been conducted at Zilber Family Hospice (ZFH).

Purpose:

The purpose of this project was to characterize and analyze patient safety incidents at ZFH to identify patterns, clarify event categorization, and inform hospice-specific safety practices and staff education that support comfort and harm reduction.

Methods:

Safety incidents at ZFH reported on the Origami platform in 2024 were reviewed. Extracted data included patient MRN, date, event category, and description; data were supplemented with review of electronic medical records and unit logs. Events were categorized by Origami classification, and thematic analysis refined subcategories for greater specificity. Aggregate 2024 hospice-wide data (n=975 patients) was used for comparison. Descriptive statistics and Chi-squared tests are used as appropriate.

Results:

Of 102 reported events, exclusions for prior-year events, duplicates, and non-admitted patients yielded 92 unique events. Eighty-three (90%) were patient-related, and 72 included a patient with MRN representing 64 patients. Median patient age was lower than the whole-hospice median (69 years (IQR 60–79) vs. 76 years). Racial/ethnic distribution differed significantly (p<0.0001). Thirty-nine percent of safety events occurred on the day of admission and 83% within 7 days of admission. The most common event categories were Care Related (35%) and Medication Event (24%). Review of Care Related events showed 38% were miscategorized; the remaining 62% were subcategorized into groups such as “unsafe transfer” and “missing order” for greater detail.

Conclusion:

Safety events occurred predominantly early in admission and were most often care-related or medication-related. The patients experiencing events differed from the broader hospice population, including a significantly different racial and ethnic distribution. Misclassification within the reporting system highlights the need for refined hospice-specific categories. These findings support targeted education and focused attention on admission of workflows to better align safety practices with equitable, patient-centered end-of-life care.

Background/Significance:

Traumatic brain injury (TBI) affects around 1.7 million individuals annually in the United States and is associated with detrimental complications including seizures. Anticonvulsants are used prophylactically, with the 2024 Neurocritical Care Society Clinical Practice Guideline recommending levetiracetam as the preferred agent. However, no standardized dosing strategies currently exist, resulting in variability in both loading and maintenance of dose regimens across institutions and among providers. The aim of this project is to identify the most appropriate dosing strategy of levetiracetam to reduce seizure incidence in patients with TBI.

Purpose:

This project aimed to identify the most appropriate dosing strategy of levetiracetam to reduce seizure incidence in patients with TBI.

Methods:

This retrospective chart review compared different dosing strategies of levetiracetam for seizure prophylaxis at two institutions. It included patients admitted from 11/1/2020 through 8/1/2025 with a diagnosis of TBI who received levetiracetam during the initial 7 days following the injury. Those with history of seizures, prehospital use of anticonvulsants, seizure onset prior to medication administration, aneurysmal subarachnoid hemorrhage, or catastrophic brain injury with death within 48 hours were excluded from the study. The primary outcome was the incidence of seizures following TBI. Secondary outcomes included hospital and intensive care unit length of stay, need for rescue therapy due to seizures, and discontinuation rates due to adverse drug reactions. Data collected included the mechanism of injury, severity of brain injury, seizure type and method of diagnosis, dose of levetiracetam, duration of therapy, use of additional antiseizure drugs, adverse drug reactions, and disposition at discharge. This study was approved by the Institutional Review Board.

Results:

Out of the 3,718 patients screened, 825 met the inclusion criteria. Patients were divided into three groups based on loading doses: >20 mg/kg (n=276), <20 mg>/kg (n=209), or no loading dose (n=152). The incidence of seizures was 39 (14.1%), 54 (25.8%), and 19 (12.5%) respectively in these groups (p=0.001), with a higher incidence of early onset seizures in all groups. A subgroup analysis of maintenance dosing was performed and found that doses of 500 mg every 12 hours were associated with a higher incidence of seizure compared to higher doses (p=0.018).

Conclusion:

The results of this study support the use of higher loading and maintenance doses in patients presenting with TBI to reduce the incidence of posttraumatic seizures. Further studies are needed with stratification for injury severity and type of intracranial hemorrhage.

Background/Significance:

Cardioversions in the emergency department (ED) allow for a controlled shock to be delivered to the heart to restore normal sinus rhythm in dysrhythmic states such as atrial fibrillation and supraventricular tachycardia. Sedation used during this procedure helps to reduce anxiety, pain, and discomfort. There are several general anesthetics available, and those with a quick onset and recovery time with minimal side effects are favorable. Current data is limited, with one retrospective review by Bauer and colleagues comparing methohexital to propofol and etomidate for procedural sedation in ED cardioversions finding no statistically significant difference in the time from first dose of the agent to clinical recovery.

Purpose:

The purpose of this study was to compare the pharmacodynamic profiles of etomidate, methohexital, and propofol in emergency cardioversions.

Methods:

This retrospective review looked at adult patients that had undergone electrical cardioversion with either methohexital, etomidate, or propofol in the ED. There were 255 patients screened between November 2019 and September 2025 with 194 meeting the inclusion criteria.105 received etomidate, 47 received methohexital, and 42 received propofol. Patients were excluded if they received an alternative agent prior to the study of drug, had incomplete documentation, or underwent a noncardiac procedure. Descriptive statistics were performed for all continuous and categorical data using Wilcoxon Rank Sum and Fisher’s exact tests.

Results:

There was no difference seen in our primary outcome of time (min) from sedative administration to procedure end time between etomidate, methohexital, and propofol (9 versus 7 versus 9.4, p=0.20). The etomidate group required less additional doses (p=0.06) and received more concomitant analgesia with fentanyl (p≤0.01). Dosing was found to be on the lower end of the dosing range for methohexital (0.51 mg/kg) and propofol (0.53 mg/kg). Differences in systolic blood pressure were statistically significant but as expected for propofol and methohexital (p≤0.01).

Conclusion:

Despite etomidate requiring fewer additional doses, all three agents appear to be similar in terms of efficacy and safety. Although medication selection did not make a difference with procedure times, we did not evaluate patient comfort with pain and sedation endpoints. Looking forward, it could be beneficial to do a prospective study, compare sedatives for other procedures, and evaluate the use of concomitant analgesics for procedures.