Patient-Reported Outcomes studies
A Registry to Improve Care and Research in Lung Cancer Screening
This is an award to demonstrate the feasibility of developing a registry of individuals who undergo lung cancer screening with low-dose CT.
Comparing Strategies for Implementing Primary HPV Testing for Routine Cervical Cancer Screening
The major goal of this project is to compare two implementation strategies to facilitate adoption of primary HPV testing for routine cervical cancer screening measured by patient-, provider- and system-centered outcomes. A sub-analysis and survey data collection will evaluate the impact of the COVID pandemic on this practice change and cervical cancer screening.
Developing a Risk Prediction Model and Evaluating the Economic Burden of Ankylosing Spondylitis in an Integrated Healthcare System
The primary aim is to develop an ankylosing spondylitis risk prediction model using data from Kaiser’s electronic medical records (EMR). We will also evaluate medical expenditure, health related quality of life and work productivity losses associated with ankylosing spondylitis.
Mental Health Research Network II
We have established a Mental Health Research Network including 13 established public-domain research centers based in integrated not-for-profit health systems. These systems provide care to a diverse population of 10 million people in 11 states, and they share rich and compatible data resources to support a range of effectiveness research. Diversity of member demographics, insurance coverage, and organization of health services make this network an ideal environment for studying variation in care, comparing effectiveness and cost of treatments across practice environments, and studying dissemination and health policies. Participating research centers are experienced in a wide range of clinical areas and research methods. The long-term objectives are to expand the Mental Health Research Network to include additional health systems and external investigators, to conduct multi-site observational and experimental studies of comparative effectiveness, to develop and evaluate methods for dissemination and implementation, and to become a national resource of research methods and effectiveness evidence for researchers, patients, providers and healthcare leaders.
Mental Health Research Network: Embedded Research in Learning Health Systems (MHRN III)
The overall goal of MHRN is to support population-based research to evaluate and improve delivery of mental health care. The network includes 13 health systems currently part of the Health Care Systems Research Network as well as 8 health systems currently part of the INSIGHT Network (formerly the NYC CDRN of PCORnet). The Administrative Core and Methods Core support a series of research projects (approximately 20 as of this application) using a variety of methods to address a variety of questions. Each of those projects is a distinct activity subject to review and approval by one or more responsible IRBs. The Administrative Core and Methods Core will also conduct routine descriptive analyses of existing electronic records data across all participating health systems – both to monitor quality of research data warehouse tables and to identify trends in diagnosis and treatment of mental health conditions. These descriptive analyses have been performed annually for the last eight years under the previous MHRN cooperative agreements. This new cooperative agreement calls for performing these analyses each quarter.
Real World Effectiveness and Economic Impact of Subcutaneous Methotrexate compared to Oral Methotrexate Treatment for Rheumatoid Arthritis
This prospective study will evaluate the real-world effectiveness of subcutaneous vs. oral methotrexate treatment on disease activity and functional status of rheumatoid arthritis patients. We will also evaluate effectiveness on patient centered outcomes, treatment adherence, cost, and work productivity. Lastly, using a discrete choice experiment, we will estimate patient’s valuation of these outcomes and their willingness to pay.
Sleep Disturbance, Inflammation & Cellular Aging in Breast Cancer Survivors (STRIVE 2)
The goal of this prospective recruitment study is to evaluate longitudinal differences in the rates of change in inflammation and telomere erosion in breast cancer survivors vs. non-cancer comparison women to determine if such molecular changes are due to cancer biology, or its treatment, or consequences of aging.
Sleep Inflammation and Depression Occurrence in Breast Cancer Survivors (STRIVE1)
The aim of this prospective study is to examine the association between sleep disturbance, cellular and genomic markers of inflammation, and depression occurrence in breast cancer survivors.
The Bariatric Experience Long Term (BELONG) II for Racial and Ethnic Minority Patients
Effective treatments for severe obesity are particularly needed in racial/ethnic minority populations. Rates of severe obesity are as high as 36% for middle-aged non-Hispanic black women compared to 16% for their white counterparts in the U.S. Research on bariatric weight loss outcomes among racial/ethnic minorities is limited. What evidence does exist suggests that black patients consistently lose less weight than whites over 2–3 years of follow-up. The evidence for differences between Hispanic and white or black bariatric patients is equivocal. Hispanic patients have been shown to lose more, less, or the same amount of weight as non-Hispanic black and white patients. Across studies, the disparities in % total weight loss vary from less than 2% to 10%. This variability is twice as much as the amount of weight loss considered clinically meaningful. This study will extend the work done by our team during the Bariatric Experience Long-Term (BELONG) study which addressed how self-reported behavioral, psychosocial, and perceived environmental factors predicted weight loss over 3 years following gastric bypass and sleeve. Patients (n = 1,975) were 41% Hispanic, 17% non-Hispanic black, and 37% non-Hispanic white. The proposed study will expand the work of BELONG by incorporating: 1) A focus on weight regain during 3-5 years after surgery; 2) measures shown to contribute to health disparities in severe obesity (vigilant coping style and internalized racism); and 3) innovative qualitative methods (photo-elicitation and ethnography) to understand the patient experience.
Understanding the Impact of Increasing Use of Telehealth on Screening for Depression Across Racial and Ethnic Groups
This observational, data-only study will use diagnostic and treatment data from the electronic medical records (EMR) and administrative systems from three Kaiser regions (Northwest, Southern California, and Georgia) including depression screening rates, rates of depression treatment initiation and receipt of different depression treatment services. The overall goal is to examine how race/ethnicity impacts these services. The study aims are: Aim 1: Examine how race/ethnicity impacts receipt of screening for depression in all settings or service types for adults at 3 sites, including examining unadjusted differences, and differences controlling for other patient-level factors (age, socioeconomic status, insurance coverage, other social determinants of health). Aim 2: Controlling for severity of depression symptoms (PHQ-9 category) and other sociodemographic characteristics, do racial and ethnic groups of patients have different patterns of depression diagnosis and treatment initiation compared to White patients? Aim 3: Do racial and ethnic groups of patients who screen positive for depression (PHQ-9 score above 9) have different longer-term outcomes compared to White patients? Aim 4: Explore whether response to depression treatment is associated with treatment outcomes, and whether these outcomes are different for racial and ethnic groups of patients compared to White patients.