Clinical Research Oriented Workshop (CROW) Meeting: Jan 27, 2011

Present: Abby Crocker, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Connie van Eeghen

1. Check In:

a. Ben: Complex Systems’ journal club this morning reviewed recent Science article this month on Google Books, and meta-studies coming from 5 million books digitized and analyses of the words that appear in them, e.g.

i. Frequency of scientists’ names

ii. Evolution of verbs

iii. Lifeline of frequency of specific years and specific phrases

iv. Lifeline of historical epidemics

v. Identification of words not found in dictionaries: e.g. “aridification”

2. Abby – Analytical Plan

a. Teaching component of CTS program – on its way

b. Research question/idea: develop a predictive model to determine the presence of NAS and test it (“What predicts the occurrence of NAS?”); longitudinal health outcomes of children with NAS at perinatal, 1 year, and 5 year marks (“What are the outcomes over time?”). Develops expertise in area of high-risk children, a professional goal.

i. Will help with skill building

ii. Can be used to complete the Masters’ requirement (quasi-defense will be on March 11)

iii. Robust data base available, especially compared to what has been published so far

c. Research plan for question 1: What predicts the occurrence of NAS; gold standard is NAS score at delivery hourly for 24 hours, every four hours from 24 – 48 hours. (No studies exist re: when NAS manifests itself – another good question to study.)

i. Subjects: High risk babies delivered at FAHC from 2005-2011; n=350 (babies with NAS). 2005 is the start of formal documentation of NAS. 550 were identified as potentially having NAS, and 200 proved negative. “High risk” determined by opiate use by mother for any reason.

ii. Purpose of this study (why do it?): For those identified at risk for NAS, can NAS status be confirmed at time of delivery. Benefits may include reduced costs, improved family bonding, intervention started earlier, etc. Possible practical goals:

1. Precisely and accurately predict NAS (develop a point scoring system for providers involved in delivering high risk babies) NOT YET

2. Confirm a hypothesis

3. Understand/describe/explain the relationships among predictors THIS ONE

iii. Dependent variables: from registry, problem lists, medication lists, and other sources; could include delivery characteristics (ultrasound, medications prescribed to mother, social variables, height, weight, APGAR score...). Could also include the reason the mother used opiates (high risk criteria), maternal age, prematurity, delivery data, maternal meds, SES, diagnosis, prenatal care, prior use of health care resources (# nights in the hospital in the past year, SA admissions), PCP, presence of significant other and/or kids, employment, tobacco, ETOH, maternal labs/vitals/physical exam, glucose tolerance. Would be helpful to consider race relative to metabolism of opiates.

iv. Retrospective now; prospective when validating model in the future

v. Develop predictive model and compare prediction to actual results in retrospective analysis. The predictive model needs to be simple enough to be used at the time of delivery.

vi. Questions to explore:

1. When does NAS occur?

2. What explains NAS?

3. Can we predict NAS (is a useful way, whether at delivery or before discharge, depending on the outcome of question 1)?

4. Does the prediction rule help?

vii. Logistics:

1. Access to data (yes)

2. Clean data?

3. Process and time for chart review

viii. FINER checklist of 0 - 4

1. Feasibility: 4

2. Interesting: 4

3. Novel: there is a predictive model for NAS from Boston, smaller number of variables, included some things that might be useless; about the same sample size. Found that breast feeding intention or action was relevant: 3 (Consider journal clubbing that article with this group)

4. Ethical: could be used in a harmful way? Confidentiality? 3

5. Relevance: Could improve care, provide new interventions, new knowledge, 120 kids/year at $xx/day cost savings, and affect public health policy: 4

3. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. February 3: Connie – QI through Office System Analysis - Case 1 analysis

b. February 10: Rodger - discuss a research design for evaluating mental health contribution in BP PCMH practices; Craig Jones and Beth Tanzman (new member of his team) will be guests

c. February 17: Rodger & Connie’s draft paper for PPRP (No Amanda, Ben)

d. February 24: (no Amanda, Kairn, Connie, Ben – schools are on winter break)

e. March 3: (no Rodger)

f. March 10: (no Rodger)

g. March 17: John Senders - engineer and psychologist with deep expertise in human error and an international authority on medical errors; Ben as host

h. March 24: Rodger: NCQA survey data (no Amanda)

i. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)

Recorder: Connie van Eeghen

Link to CaringBridge

For those of you who wish to know more about my situation but don't wish to be intrusive during a difficult time: www.caringbridge.org/visit/montpeliersean (log in required) contains both general information and a detailed journal.
Kairn Stetler Kelley

Fwd: Martin Luther King speaker - Wed, Jan 26th ~ On Behalf of Assoc Dean Karen Richardson-Nassif

Martin Luther King Celebration 2011
Sponsored by the Colleges of Medicine and Nursing and Health Sciences

"The Health Disparities of Vermonters"
Tracy Dolan
Deputy Commissioner of Public Health

Wednesday, January 26th
6:00 p.m. - 7:00 p.m.

Carpenter Auditorium, Given Building

Reception immediately following in the Rowell Brickyard

Tracy Dolan was appointed in January, 2011 as the Deputy Commissioner of Public Health with
the Vermont Department of Health. She has been with the Department of Health for two years
and prior to this position she was the Director of Planning. Before coming to the
Department of Health, Tracy worked for 12 years in international public health primarily in
east and southern Africa focusing on maternal and child health, reproductive health,
HIV/AIDS and youth governance.  Tracy began her career in public health in northern British Columbia
working with the First Nations (indigenous population) on youth and reproductive health programs.

For more information, contact:
Karen Richardson-Nassif, Ph.D.
Associate Dean for Faculty and Staff Development and Diversity
656-4315, Karen.Richardson-Nassif@uvm.edu
or
M. Ahmad Chaudhry, PhD.
Interim Associate Dean for Research
656-0569, Muhammad.Chaudhry@uvm.edu

Clinical Research Oriented Workshop (CROW) Meeting: Jan 20, 2011

Present: Abby Crocker, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Rhonda Kost, Ben Littenberg, Connie van Eeghen

1. Round Table:

a. Welcome to Rhonda Kost, PhD student in Computer Science; also on staff at FAHC

2. Rodger: Review metrics paper r/t Collaborative Care Network

a. Building on pre-empirical work in integrating mental health services into primary care, put into various kinds of practice through the CCN

b. Focus is on Table (vs. Figure) 2: a figure is 150 words; is the same for a table? Sometimes the limit is on figures or tables… the editor or journal guideline is the authority, in all cases

c. Table (not figure) 2: can be looked at according to what is being measured (categorical definition), how to measure it, and where to find it

d. Purpose: an instrument for practices to identify deficiencies in their practice of care. Long term goal is to tie these characteristics to successful outcomes. This is one of three articles: research overview, lexicon, and (this article) a way to measure the elements in the lexicon by providing an algorithm for each element. This will be an example of how to use the lexicon and a proposal of how to evaluate a CC practice.

e. How to proceed: consider using the elements to create a checklist to design a CC practice; use this exercise to increase the precision of the description of how to deploy the lexicon.

f. Audiences: AHRQ, NIH folks interested in MH delivery in primary care, policy makers, practices and practitioners, and academics. Kissinger: “The tragedy of academic politics is that the stakes are so small.”

3. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. January 27: Abby – Present analytical plan

b. February 3: Connie – QI through Office System Analysis - Case 1 analysis

c. February 10: Rodger - discuss a research design for evaluating mental health contribution in BP PCMH practices; Craig Jones and Beth Tanzman (new member of his team) will be guests

d. February 17: Rodger: NCQA survey data (no Amanda)

e. February 24: (no Amanda, Kairn, Connie – schools are on winter break)

f. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)

Recorder: Connie van Eeghen

Caffeine and Snoring Research Study

Caffeine and Snoring Research Study

Does your snoring keep your partner awake? Do you drink coffee, soda, or other caffeinated drinks? The University of Vermont Department of Medicine is studying people who snore and use caffeine. We are looking for adults to stop using caffeine and who have a regular bed partner to report their snoring for four weeks. $25 compensation for participation. Information: 656-4560.

Informatics Grand Rounds - Tuesday, February 1st 4PM-5PM

INFORMATICS GRAND ROUNDS

"AUTOMATED USE OF CLINICAL LABORATORY RESULTS IN ADULTS"

Benjamin Littenberg, MD

Henry and Carleen Tufo Professor of Medicine and Professor of Nursing

University of Vermont

Date/Time:        

Tuesday, February 1st, 2011

4:00 PM – 5:00 PM

Location:    

Medical Education Center Room 300 (Reardon Classroom)

(Information about remote participation will be provided closer to the date)

Abstract:   

The aggregation of patient-level clinical data into registries has great potential to improve the quality and reduce the costs of health care. The Vermedx Diabetes Information System is a laboratory-based patient registry with clinical and public health applications developed with support from the National Institutes of Health. I will present the design, implementation and evaluation of the system and discuss its impact and current applications as well as prospects for the future of such registries.

Speaker Bio:

Dr. Littenberg is the Henry and Carleen Tufo Professor of Medicine as well as Professor of Nursing, Director of General Internal Medicine, and Associate Director of the Center for Clinical and Translational Science at the University of Vermont. He received his medical degree from Case Western Reserve University and trained in internal medicine at Hartford (Connecticut) Hospital. He was a Robert Wood Johnson Clinical Scholar at Stanford University before becoming Assistant Professor of Medicine at Dartmouth. Following an appointment as Associate Professor of Medicine at Washington University in St. Louis, he assumed his present position in 1999.

He also founded and serves as Chief Medical Officer of Vermedx, Inc., a privately-held company whose NIH clinical trial-validated chronic disease decision support tools for providers and patients is being utilized in primary care environments in New England, New York, California, and Texas.

Dr. Littenberg's research centers on technology assessment and quality improvement. Recent projects include new ways to measure quality of care in chronic disease, novel strategies for reporting test results to patients, the effect of the built environment on health outcomes, safety improvements in outpatient prescriptions, and strategies to address health literacy. In Vermont, Dr. Littenberg has developed statewide registry-based approaches to quality and safety improvement with the Vermont Breast Cancer Surveillance System and as Principal Investigator of the Vermont Diabetes Information System. He serves on the Association of University Radiologists GE-AUR Radiology Research Academic Fellowship (GERRAF) Advisory Board, the Brookings Institution High Value Health Care Project Expert Panel for Lab Data Integration for Diabetes Care Improvement, the National Quality Forum's Cancer Care Performance Measures Cancer Technical Panel, and the New York City Department of Health A1C Registry Advisory Board.

Informatics Grand Rounds is a joint initiative between the University of Vermont (Center for Clinical and Translational Science Biomedical Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont.

http://ccts.uvm.edu/web/informatics/grandrounds

Fwd: Apply Now for the 2011 UVM Student Research Conference!

2011 UVM Student Research Conference

Co-sponsored by the Honors College, the Office of the Vice President for Research, and the Graduate College
Tuesday, April 26, 2011
8:00am - 4:00pm, Davis Student Center, 4th Floor

On-Line Application Forms Now Available @ uvm.edu/~uvmsrc

Applications and Abstracts Due:  5:00 PM Friday, February 18, 2011

Eligibility:  All students working on a research or creative project with a UVM faculty member are eligible to present some aspect of their research at this forum. Research and creative projects at any stage of completion are welcome. The event also serves as a resource for students who are not yet involved with research but wish to learn about how to engage in research pursuits.

Abstract Workshops for Students:  Your application form requires submission of an abstract. If you need help, UVM will be holding two abstract writing workshops specifically designed to support student SRC applications.   Please click on dates below to register for a workshop and/or get additional registration information:

   * SRC Abstract Workshop on Wednesday, February 9th, 12:45PM-1:45PM

   * SRC Abstract Workshop on Thursday, February 10th, 1:00PM-2:00PM

The workshops will:

    * help you learn more about the April conference and how you can participate
    * show you how to write a brief, yet compelling and comprehensive, proposal
    * provide hands-on help from Writing Center staff to help you get started

Workshops are co-sponsored by the UVM Writing in the Disciplines Program, Bailey/Howe Library and the Center for Teaching and Learning.  

If you have any questions about the 2011 SRC, please send an e-mail to uvmsrc@uvm.edu or call Andrea Elledge at 6-8867.

We Look Forward to Your Participation!

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The 2011 Student Research Conference is co-sponsored by the Office of the Vice President for Research, the Graduate College, and the Honors College. 

Additional sponsors are Center for Teaching and Learning, Graduate Student Senate, James M. Jeffords Center, McNair Scholars Program, Transportation Research Center, and UVM Libraries

Please visit  uvm.edu/~uvmsrc to become a 2011 SRC contributor!

Clinical Research Oriented Workshop (CROW) Meeting: Jan 13, 2011

Present: Kairn Kelley, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Connie van Eeghen

1. Round Table:

a. Atul Gawande “On Point” from a 2011 NPR broadcast is available on loan from Connie. Karin brought in “How to Change when Change is Hard,” also available in the future.

2. Kairn’s application for a F Series Grant: PA10-108

a. April 8 due date for start in September 2011

b. New electronic format that makes submission easy; UVM Grant department has a role to complete some portions. “Info Ed” has a tutorial to work through but it is fairly self-explanatory. Dayna LeDuc is the contact person for General Medicine.

c. Steps

i. Choose your area – which later in the session produced a compelling argument to move from auditory processing to the connection to AHDH dis-regulation of behavior. Either way, it’s about how to know what auditory assessment is measuring and what the standards are. Example research question: how do the error patterns in auditory spectrum differ for children on the ADHD spectrum. What are the differences in scoring between ADHD and Ochenbach children?

ii. Choose your funding source and opportunity

1. Figure out the budget well ahead of grant submission

2. Develop the body of the application (research and training)

3. Supporting stuff (letters, animal welfare number, facilities & admin page)

iii. Info Ed

iv. Submission

d. One rule: follow the instructions to the letter as well as the standard conventions, or you will get kicked out promptly

i. Get a copy of Gabe’s recently funded application (CTS student)

ii. Contact the program officer as soon as possible (see page on website)

e. UVM wants at least 2 weeks, ideally, to process (shoot for third week of March, around the 20^th)

i. Presubmission review (internally) in early March. Make sure the pre-review study section includes people that have no familiarity with your study area

ii. Therefore, send out draft around February 21^st, and get started on budget

iii. Get letters of recommendation by early February

f. Review of application instructions:

i. Must have a sponsor from the field of study (can be external). Grantee must be full time student.

ii. Sponsor must be currently funded for independent research: Ben provided us with an ad hoc search process and found a funded UVM researcher with a link to auditory processing. This is promising but may change the above schedule significantly.

3. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. January 20: Rodger – Review survey distributions for NCQA? Or metrics for CCN.

b. January 27: Abby – Present analytical plan

c. February 3: (Connie may be out)

d. February 10:

e. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)

Recorder: Connie van Eeghen

Fwd: Call for Nominations for Jeffords Graduate Fellowship Program

James M. Jeffords Center

 

TO:                  All UVM Graduate Students and Faculty

 

FROM:             H. Bud Meyers, Director, James M. Jeffords Center at UVM

 

DATE:             January 3, 2011

 

RE:                  Call for Nominations for Jeffords Graduate Fellowship Program

 

The James M. Jeffords Center for Policy Research at the University of Vermont is pleased to invite nominations and applications for the James M. Jeffords Graduate Fellowship Program for the academic year 2011-2012.

The Jeffords Center Graduate Fellowship Program provides funding for graduate students conducting high-quality policy research related to education, health care, the environment, and effective government.  Students may not apply directly, but must be nominated by their Department Chair, Program Director, or faculty advisor.

Application Deadline:  February 7, 2011

The Jeffords Fellowship provides support for one year, and includes a $20,000 stipend for the academic year, and a tuition scholarship of 20 credits.

 

The goal of the Jeffords Center Fellowship Program is to support highly talented graduate students whose studies are directed toward the development of effective solutions to policy challenges in education, health care, environment and effective government.  Preference will be given to applicants whose research, 1) is aligned with a faculty member who has received a Jeffords Center Signature Award; 2) is aligned with a faculty member who is developing a proposal for a Jeffords Center Signature Award; or 3) crosses disciplines and addresses more than one of the Jeffords Center Signature Areas of research. 

 

Application guidelines and a program overview are attached, and can also be found on our website www.uvm.edu/jeffordscenter.  Nominations and completed applications should be submitted electronically in either .pdf, .docx, or .doc format to Jeffordscenter@uvm.edu.

 

Questions may be directed to Laurie.Eddy@uvm.edu, or 802-656-3161.

Farrell Hall 210 Colchester Avenue Burlington, VT  05405 Phone:  (802)656-3161

 E-mail: jeffordscenter@uvm.edu           website:  uvm.edu/jeffordscenter

--

Informatics Grand Rounds - Spring 2011 Schedule

Happy New Year!

Below is the Spring 2011 Schedule for Informatics Grand Rounds. This schedule as well as videos of the three Fall 2010 presentations can be found on the Web site at:

http://ccts.uvm.edu/web/informatics/grandrounds

Spring 2011 Schedule

Date/Time: Tuesday, February 1st, 2011 4:00 PM - 5:00 PM
Location: Medical Education Center Room 300 (Reardon Classroom)
Speaker: Benjamin Littenberg, MD (Division of General Internal Medicine, Department of Medicine, University of Vermont)
 
Date/Time: Tuesday, March 15th, 2011 4:00 PM - 5:00 PM
Location: Medical Education Center Room 300 (Reardon Classroom)
Speaker: Richard C. Wasserman, MD, MPH (Department of Pediatrics, University of Vermont; Pediatric Research in Office Settings (PROS) Network, American Academy of Pediatrics)
 
Date/Time: Tuesday, April 12th, 2011 4:00 PM - 5:00 PM
Location: Medical Education Center Room 300 (Reardon Classroom)
Speaker: Dian Kahn, MPA (Analysis and Data Management, Vermont Department of Banking, Insurance, Securities and Health Care Administration [BISHCA])

Date/Time: Tuesday, May 10th, 2010 4:00 PM - 5:00 PM
Location: Medical Education Center Room 300 (Reardon Classroom)
Speakers: Indra Neil Sarkar, PhD, MLIS (Biomedical Informatics Unit, Center for Clinical and Translational Science, University of Vermont)

Another way to think about our personal technology

This is a seven minute excerpt from a cyborg anthropologist - no, not a joke. Take a minute to look if you want an alternative to thinking of oneself as a victim of technology. Connie

http://www.ted.com/talks/amber_case_we_are_all_cyborgs_now.html

2011 NIH Mobile Health (mHealth) Summer Institute

2011 NIH Mobile Health (mHealth) Summer Institute - Accepting Applications Now

Enhancing health through the use of mobile technologies Using mobile technologies to more rapidly and accurately assess and modify behavior, biological states and contextual variables has great potential to transform medical research. Recent advances in mobile technologies and the ubiquitous nature of these technologies in daily life (e.g., smart phones, sensors) have created opportunities for research applications that were not previously possible (e.g., simultaneously assessing behavioral, physiological, and psychological states in the real world and in real-time). The use of mobile technology affords numerous methodological advantages over traditional methods, including reduced memory bias, the ability to capture time-intensive longitudinal data, date- and time-stamped data, and the potential for personalizing information in real-time. However, challenges in mobile health (or mHealth) research exist. Importantly, much of the work being done in mHealth arises from single disciplines without integration of the behavioral, social sciences and clinical research fields. Without integration, mobile technologies will not be maximally effective. is unlikely in other discipline or trade-specific venues. The mHealth Summer Institute is designed to provide early career investigators with an opportunity to learn about mHealth research in a collaborative team environment with mentorship from leaders in the fields of engineering, medicine and the behavioral and social sciences. The week-long Institute provides participants with an overview of the engineering, behavioral sciences and clinical aspects of mobile and wireless research. Participants will spend their mornings in dyadic sessions with experts from across the mHealth spectrum and the afternoons in development of a team project. The week with conclude with a review of team concept projects by multi-disciplinary experts. Candidate Requirements: Hold a doctoral level degree (PhD, ScD, MD, DVM, etc.), in any of the following: Social and Behavioral sciences Medical and Health sciences Biological, Physical or Earth sciences Computational sciences and Mathematics Engineering disciplines (applicants with a MS in engineering and three or more years of post-degree professional experience also qualify). Early career investigators: have received a terminal degree within the past five years, except applicants with a MS in engineering who can apply within 3-8 years of their terminal degree, and have not been tenured. Interest in the multidisciplinary science of mobile and wireless technologies Applicants are NOT required to be citizens, permanent residents, or non-citizen nationals of the United States. HOWEVER, expenses will only be paid for domestic (within the U.S.) travel. Preference will be given to applicants who plan to use the training to inform research on health problems.

The complete application can be found at:

http://obssr.od.nih.gov/training_and_education/mhealth/index.aspx

 

Clinical Research Oriented Workshop (CROW) Meeting: Jan 6, 2011

Present: Abby Crocker, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Ben Littenberg, Connie van Eeghen

1. Round Table:

a. New spring schedule has started: Thursdays from 2:30 – 4:00.

2. Rodger’s draft: Effects on mental health treatment initiation of incorporating mental health services into primary care practice. This is a draft following edits based on reviewers’ and fellows’ feedback.

a. Second draft includes new data set from a different practice. The Berlin data show who signed up and came (for behavioral health visit), but not who received a referral. In the Aesculapius data set, all three variables are known: referral, appointment, and visit. Therefore, the two data sets are not equivalent. This is a given; there is no ability to add to the data. Results will be re-organized to present data more clearly.

b. Writing has been reduced and, with the use of a single table, conveys its primary message more simply.

c. Eschew obfuscation (see www.SaveTheWords.org) and consider whether site identification is necessary.

3. Other Topics:

a. Rodger will invite Craig Jones to discuss a proposal with the Vermont Blueprint as part of a future Workshop.

b. Reviewed the CTS student roster; Ben’s four mentored students/fellows are part of this group (that includes all participants here today), the rest are invited to attend as available. It may be practically difficult for others to attend but they will always be included if they appear.

c. Round table review:

i. Connie: Amended her most recent protocol to include the substudy she ran under Chuck Hulce’s, as his study is about to terminate. Needs to finish re-planning her analytical approach and do the work. Needs to plan how to get objective confirmation of how data were coded and interpreted. Needs to plan presentation to first case study group. Wants help to evaluate whether such a thing as an “anecdotal control case” is a viable part of the discussion section.

ii. Abby: Continued with VCHIP last semester but ends on Jan 15; needs a new supervisor with FAHC affiliation -> Ben. Amanda and Abby are working on setting up a work group to study academic detailing, with Charlie and others. Also meeting with policy faculty and legislators for increased understanding and advice. Meeting with OB research people Jan 18; clarification of research boundaries underway.

iii. Kairn: Looking at new source for grant funding/fellowship application. Balancing her academic needs with her resources.

iv. Ben: brief review of model on how to have a policy impact: marketing effort, supported by two stories: 1) problem description that motivates change and 2) specific intervention. FBBE: Features, benefits, barriers, and enablers are elements of the problem description. Both the problem and the intervention require a narrative, a language that all parties have access to, and data that support the narrative.

4. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. January 13: Kairn – Start up fellowship application form (Connie late; no Charlie)

b. January 20: Rodger – Review survey distributions for NCQA

c. January 27: Abby – Present analytical plan

d. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)

5. Fellows document – to be reviewed in the future.

a. Past meetings: Scheduled in Wednesdays in 2009 and moved to Mondays from May – August 2009; then to Fridays from Sept 2009 – April 2010. Then switched back to Wednesdays, which started May 5, 2010 and continued until August 25, 2010. We returned to Friday meetings on Sept 3, 2010, which continued to Dec 17, 2010. We moved to Thursday meetings on Jan 6, 2011.

Recorder: Connie van Eeghen

Evaluation of a modified prescription form to address prescribing errors

Here's a nice way to start off the new year: an original research publication in the leading journal in your field. Congratulations to Principal Investigator and first author Amanda Kennedy

Evaluation of a modified prescription form to address prescribing errors
Amanda G. Kennedy, Benjamin Littenberg, Peter W. Callas, and Jan K. Carney
Am J Health Syst Pharm 2011;68 151-157
http://www.ajhp.org/cgi/content/abstract/68/2/151

Purpose. The impact of a modified paper prescription form on the occurrence of prescribing errors was evaluated.

Methods. Rural primary care providers practicing in the United States who wrote paper prescriptions in English were eligible for study participation. The prescribers agreed to use only the prescription pads provided to them during the study. The study prescription pads contained 50 prescription forms, each with a duplicate. Each prescription and duplicate contained a unique serial number for data identification purposes. When a prescriber wrote a prescription, the original was provided to the patient per usual practice, and the duplicate was retained as the study data. Two prescription pads contained modified forms and two prescription pads were similar to the prescription pads the prescriber had been using. Providers completed 100 standard and 100 modified prescriptions. Pharmacist consultants reviewed each prescription for the presence or absence of errors. The primary outcome measure was the number of errors. Secondary outcomes were risk differences between standard and modified prescription forms for various error types.

Results. Of the 327 prescribers who were eligible and expressed interest in the study, 111 started the study and 84 completed the study. A total of 16,061 prescriptions were eligible for analysis. Pharmacists identified at least one prescribing problem in 987 prescriptions (6.1%). Modified prescription forms were associated with significantly more prescribing problems than standard prescription forms (odds ratio, 1.85; 95% confidence interval, 1.5–2.2; p < 0.001).

Conclusion. Modified prescription forms were associated with more errors than were standard prescription forms in a sample of rural prescribers.