Clinical Research Oriented Workshop (CROW) Meeting: May 21, 2020

Present:   Levi Bonnell, Marianne Burke, Jessica Clifton, Juvena Hitt, Ben Littenberg, Jen Oshita, Gail Rose, Connie van Eeghen, Adam Sprouse-Blum, Mariana Wingood

1.                   Warm Up: Zoom meeting and the importance of having a group of peers to share and drive your work – and have fun

2.                   Jessica: Differences in occupational burnout among primary care professionals

a.       Journal: consider Journal of the American Board of Family Medicine or Annals of Family Medicine

b.       Abstract: Add to discussion; lighten up conclusion; use consistent terminology; eliminate unused abbreviations

c.       Methods: reference the IBH-PC methods paper sooner; say less about this

                                                   i.      Is “burn out” appropriate for a manuscript? Use as a noun, not as a verb.

                                                 ii.      Add “abbreviated” to first use of the aMBI tool

d.       Results

                                                   i.      Review of Table 1, with modifications

1.       Consider a Chi^2 for Moderate or severe % for the 3 domains

e.       Discussion

                                                   i.      What is it about BHPs that they don’t get as burned out?

1.       We may not believe that there is a relationship with personality but we may need to say so

                                                 ii.      PCPs are experiencing more burnout than others

                                               iii.      There is a lot of burnout in healthcare (”All” in Table 2)

1.       Although PCPs may be carrying a higher load, they do not have more in some domains

2.       We need a solution that helps everyone

3.                   5/28: Jen’s comps preview (comps committee: Rich, Abby, and Alan)

a.       6/4: Diagnostic testing theory by Ben, per Amanda Kennedy’s request, chalk talk

b.       Future topics: Jessica’s article in the Cone of Silence

Recorded by: CvE

New pub by Spouse-Blum

Adam Sprouse-Blum, MD, Assistant Professor of Neurology and CTS PhD candidate, just published this work with a panel from the American Headache Society:

Minen MT, Robbins MS, Loder E, et al. Addressing the Crisis of Diagnosis and Management of Migraine in Primary Care: A Summary of the American Headache Society FrontLine Primary Care Advisory Board. Headache. 2020;60(5):1000‐1004. doi:10.1111/head.13797

(Link here)

^{Congratulations, Adam!} 

New publication from Bonnell and company

Congrats to Levi Bonnell (CTS PhD candidate), Ben Littenberg (Professor of Medicine), Safwan Wshah (Assistant Professor of Computer Science), and Gail Rose (Assistant Professor of Psychology) for this recent analysis stemming from Gail's NIH grant.

A Machine Learning Approach to Identification of Unhealthy Drinking. Levi N. Bonnell, Benjamin Littenberg, Safwan R. Wshah and Gail L. Rose. J Am Board Fam Med May/June 2020; 33:397-406; doi:10.3122/jabfm.2020.03.190421 http://www.jabfm.org/content/33/3/397.abstract

Abstract

Introduction: Unhealthy drinking is prevalent in the United States, and yet it is underidentified and undertreated. Identifying unhealthy drinkers can be time-consuming and uncomfortable for primary care providers. An automated rule for identification would focus attention on patients most likely to need care and, therefore, increase efficiency and effectiveness. The objective of this study was to build a clinical prediction tool for unhealthy drinking based on routinely available demographic and laboratory data.

Methods: We obtained 38 demographic and laboratory variables from the National Health and Nutrition Examination Survey (1999 to 2016) on 43,545 nationally representative adults who had information on alcohol use available as a reference standard. Logistic regression, support vector machines, k-nearest neighbor, neural networks, decision trees, and random forests were used to build clinical prediction models. The model with the largest area under the receiver operator curve was selected to build the prediction tool.

Results: A random forest model with 15 variables produced the largest area under the receiver operator curve (0.78) in the test set. The most influential predictors were age, current smoker, hemoglobin, sex, and high-density lipoprotein. The optimum operating point had a sensitivity of 0.50, specificity of 0.86, positive predictive value of 0.55, and negative predictive value of 0.83. Application of the tool resulted in a much smaller target sample (75% reduced).

Conclusion: Using commonly available data, a decision tool can identify a subset of patients who seem to warrant clinical attention for unhealthy drinking, potentially increasing the efficiency and reach of screening.

It's extra nice that The Journal of the American Board of Family Medicine is open-source, no fee to authors, and widely respected for all things primary care.

Levi Bonnell has been appointed to the NAPCRG training committee

Congrats to Levi Bonnell, MPH, who was recently appointed to the North American Primary Care Research Group's Training Committee.  Nice going!

Professor Amanda Kennedy

There are not words enough to express my pride and happiness at learning that Amanda Kennedy, PharmD, has been promoted by the University of Vermont to Professor of Medicine effective July 1.

Congratulations, Amanda!

Today's mantra...

"It is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence." -William Kingdon Clifford (1845-1879)

FW: Join Us May 5th for a Webinar on the 2017 – 2018 NHANES Data Release

April 30, 2020   NHANES Webinar Announcement Join the National Center for Health Statistics in this timely presentation on the latest data release and reports from the National Health and Nutrition Examination Survey (NHANES). This webinar, open to the public, will focus on the 2017 – 2018 NHANES data release and recent data briefs on obesity, hepatitis B, hypertension, and cholesterol. Researchers, students, policymakers, and health programmers will learn about NHANES, the latest data and reports, and what to expect in the future.    Webinar Details   Tuesday May 5th from 2:00-3:00 pm EDT. Participants can join via Skype or by telephone. Learn more and connect at: https://www.cdc.gov/nchs/nhanes/nhanes-webinar.htm     National Center for Health Statistics 3311 Toledo Rd   Hyattsville, MD 20782     Centers for Disease Control and Prevention 1600 Clifton Rd   Atlanta, GA 30329   1-800-CDC-INFO (800-232-4636)   TTY: 888-232-6348 Questions or Problems  |  Unsubscribe