CROW NOTES 4/26/18

CROW 4/26/18

Attendees: Marianne, Levi, Kairn, Dr. Littenberg, Koela, Justine

Presenter:  Kairn

·        Research on process markers is okay in the eyes of Dr. Littenberg and CTS but DON’T Forget about the outcomes.

o   Medication can have unintended effects, good or bad.

§  Statins -> improve longevity in patients with low cholesterol through unintended and not fully understood anti-inflammatory pathway.

§  Drug for PVC -> increased in death rates. Not fully studied before being approved.

·         DON’T FORGET ABOUT THE OUTCOMES!!!

·         Process marker: Communication

·         Why solve communication problem -> stop bad things from happening?

·         What are the possible adverse outcomes

o   Mortality

o   Morbidity

§  Function

§  Symptoms

o   Costs

o   Non-adherence

o   Mis-adventures or medical errors

o   Patient engagement or lack thereof

FINER Research question:

Solving communication problems between providers and patients who are hard of hearing: Do personal amplifiers help improve patient/provider communication and patient comprehension?

UVMMC

·         Settlement with deaf patient that didn’t have the proper services at UVMMC

·         Tasked with improving services for patient communication among hearing impaired patients  

o   Roll out of personal amplifiers

o   Kairn has the option to help. Should she?

§  Clean slate but research + make hospital happy == not likely.  

American speech and hearing grant $10k

·         Should she apply? Due in a week.

o   Probably not but maybe in the near future.

Next workshop meetings: Thursdays @ 11 AM. Given Courtyard South Level 4

·        May 3: Hendrika Maltby, Qualitative methods

Notes from CROW 4/19

  CROW 4/19/18 Notes

    Start Up:  Davis FD. Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Quarterly. 1989; 13(3):319-40

·         Seminal paper in technology acceptance model (TAM)

  o     Purpose: Create a valid measurement for acceptance of computers

  o   Perceived usefulness/ease of use associated with anticipated usage?   

   ·         Cited over 38,000 times.

   ·         Definitions

   ·         Usefulness

  o   Does the technology benefit your work?

   ·         Ease of use 

  o   “…free of effort”

·          Validity

  o   Does the instrument reflect the construct

§  In this case the constructs are usefulness & ease of use

   ·          Discussion/review on precision, accuracy, validity: visualized on the white board

  o   Measures can be

§  Not precise or accurate (valid)

§  Precise but not accurate (or valid)

§  Valid but suffering from lack of precision (still accurate)

·         Perhaps increase sample size or improve measurement

§  Valid with good precision and accuracy

   ·         Discussion on types of validity with the group

  o   Face validity

§  The degree to which a procedure appears effective in …

·         Astrology: Not so much.

  o   Construct validity

§  Does the instrument what we want it to measure?

·         Does BMI measure obesity? Decently.

  o   Convergent validity

§  Measuring same thing with different devices/tools and you get the same/more precise answer

·         Measure height with yardstick, then laser then … All going to converge to my height

·         If they don’t converge then at least one device/tool is wrong

  o   Divergent validity

§  Tests that the measurements that are not supposed to be related are actually unrelated.

  o   Factorial validity

§  Factor analysis on all items/questions

·         A question asked 5 different ways will all be grouped by factor analysis

·         A way to shorten survey

o   Gain: time, less annoying, increase response/decrease missingness

o   Lose: precision within subject (power in study)

  o          Criterion validity

§  Gold standard, benchmark

§  But what if there is no criterion validity? What if there is no prior measurement of usefulness and ease of use of technology?

·         You create it! Become the gold standard

·         The meter

·         Temperature

·         PIP example-> how well do primary care offices get behavioral health delivered?

·         Kairn auditory -> auditory processing disorder.

o   No agreed upon definition -> no construct or criterion validity.

                Next Workshop Meeting(s): Thursdays @ 11AM at Given Courtyard South Level 4.

                April 26: Kairn Kelley

     May 3: Hendrika Maltby, Qualitative methods 

Emily Tarleton's Magnesium Trial featured on UVM Med Center Blog

The UVM Med Center recently featured the work of Emily Tarleton, PhD. Magnesium: UVM Study Shows It’s a Safe, Effective, Low-Cost Treatment for Depression includes an interview with Emily and a discussion of her thesis work.

Congrats, Emily!

-Ben Littenberg

Justine Dee presentations

Justine Dee, PT, Associate Professor of Movement Science and CTS graduate student, has two new presentations. Both relate to her graduate work.

Dee J. Klotz S, Matos V, Nason J, Ninh C, Oziemina J. Initial experience with a novel approach to treatment of chronic pain in survivors of trauma. APTA Combined Sections Meeting, New Orleans, Louisiana, February 22-24, 2018.

Dee J, Littenberg B. Did clarification of Medicare guidelines effect Physical and Occupational Usage? A retrospective analysis. Center on Health Services Training and Research 2018 Institute on Health Services Research, Boston, Massachusetts, April 4-5, 2018.

Congratulations, Justine!

-Ben Littenberg

Webinar series on Health System Transformation

Betty Rambur, RN, PhD (former Chair of Nursing at UVM and now Professor of Nursing at the University of Rhode Island) is hosting a series of webinars on Health Systems Transformation with an emphasis on workforce development issues. The series starts this Tuesday, March 27 at 1 PM with a talk by Ben Littenberg, MD on Integrating Behavioral Health and Primary Care. Registration is free. Learn more at https://web.uri.edu/ahc/hstc/

HSR Seminar

Lucas Higuera from the University of Minnesota, a candidate for a faculty position in the UVM Center for Health Services Research, will be presenting a seminar on Thursday, April 5^th at 12:00 p.m. in HSRF 300.  The title of his talk is, “Narrow Provider Networks and Willingness to Pay for Continuity of Care and Network Breadth”. 

Register for the 2018 BRFSS Training Workshop

The National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Population Health Surveillance Branch (PHSB) is planning for the Behavioral Risk Factor Surveillance System (BRFSS) Training Workshop to be held April 9th to 13th, 2018, in Atlanta, GA. If you are interested in attending, please use this link to register via the BRFSS registration site: http://www.cvent.com/d/xtqy5m Free! - Ben Littenberg