Publications

Take a deeper look into all the publications produced by researchers at The Dartmouth Institute.

Calderwood AH

2024 Jul 31;doi: 10.14309/ajg.0000000000002931

Am J Gastroenterol|2024 Jul 31

Richards DP, Mulhall H, Belton J, de Souza S, Flynn T, Haagaard A, Hunter L, Price A, Riggare S, Tufte J, Twomey R, Khan KM

2024 Jul 29;10(1):77doi: 10.1186/s40900-024-00603-0

Research projects, initiatives and conferences that include patients as partners rather than as participants are becoming more common. Including patients as partners (what we will call 'patient partners') is an approach called patient engagement or involvement in research, and we will call it patient engagement throughout this paper. Patient engagement moves traditional health research conferences and events to include a broader audience for their knowledge exchange and community building efforts, beyond academics and healthcare professionals. However, there are few examples of conferences where patients are given the opportunity to fully lead. Our conference went beyond patient engagement - it was patient-led. Patient partners conceived, planned, and decided on all aspects of a virtual conference.We present the work and processes we undertook throughout 2023 to create and produce a free conference called "PxP: For patients, by patients" or PxP for short, with a tagline of "Partnering to make research stronger." PxP was patient-led and about patient engagement in research rather than a specific disease or condition. PxP was supported by the Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis. The PxP website, known as the PxP Hub, now houses the conference recordings along with resources about patient engagement in research. These resources were recommended by the PxP Steering Committee members, speakers, and others who attended the 2023 conference. Here we lead you through how the idea for PxP was generated; how the international patient partner Steering Committee was convened and supported; how PxP was brought to life over nine months; the PxP 3-day event and feedback collected to improve future efforts; trade-offs, challenges and learnings; and resources required to support this type of event. We close with what the future holds for PxP in 2024 and beyond.It's time to elevate patients into leadership roles for conferences and events, and we encourage you to adopt the PxP ethos by using or adapting our approach and resources to support your opportunity.

Res Involv Engagem|2024 Jul 29

Smith KM, Rogers CR, Akinola OO, Yen RW, Holbert NA, Blunt HB

2024 Jul 29;doi: 10.1111/jep.14112

The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes.

J Eval Clin Pract|2024 Jul 29

Morken V, Perry LM, Coughlin A, O'Connor M, Chmiel R, Xinos S, Peipert JD, Garcia SF, Linder JA, Ackermann RT, Kircher S, Mohindra NA, Aggarwal V, Weitzel M, Nelson EC, Elwyn G, Van Citters AD, Barnard C, Cella D, Hirschhorn LR

2024 Jul 17;13(14)doi: 10.3390/jcm13144178

Shared decision making (SDM) is the process by which patients and clinicians exchange information and preferences to come to joint healthcare decisions. Clinical dashboards can support SDM by collecting, distilling, and presenting critical information, such as patient-reported outcomes (PROs), to be shared at points of care and in between appointments. We describe the implementation strategies and outcomes of a multistakeholder collaborative process known as "co-design" to develop a PRO-informed clinical dashboard to support SDM for patients with advanced cancer or chronic kidney disease (CKD). Across 14 sessions, two multidisciplinary teams comprising patients, care partners, clinicians, and other stakeholders iteratively co-designed an SDM dashboard for either advanced cancer (N = 25) or CKD (N = 24). Eligible patients, care partners, and frontline clinicians were identified by six physician champions. The co-design process included four key steps: (1) define "the problem", (2) establish context of use, (3) build a consensus on design, and (4) define and test specifications. We also evaluated our success in implementing the co-design strategy using measures of fidelity, acceptability, adoption, feasibility, and effectiveness which were collected throughout the process. Mean () scores across implementation measures of the co-design process were high, including observer-rated fidelity and adoption of co-design practices ( = 19.1 on a 7-21 scale, = 36 ratings across 9 sessions), as well as acceptability based on the perceived degree of SDM that occurred during the co-design process ( = 10.4 on a 0 to 12 adapted collaboRATE scale). Capturing the feasibility and adoption of convening multistakeholder co-design teams, min-max normalized scores (ranging from 0 to 1) of stakeholder representation demonstrated that, on average, 95% of stakeholder types were represented for cancer sessions ( = 0.95) and 85% for CKD sessions ( = 0.85). The co-design process was rated as either "fully" or "partially" effective by 100% of respondents, in creating a dashboard that met its intended objective. A co-design process was successfully implemented to develop SDM clinical dashboards for advanced cancer and CKD care. We discuss key strategies and learnings from this process that may aid others in the development and uptake of patient-centered healthcare innovations.

J Clin Med|2024 Jul 17

Van Citters AD, Aliaj E, Alvarez JA, Brown CD, Cary J, Cravens R, Frederick CA, Georgiopoulos AM, Goss CH, Kazmerski TM, King JR, Lawrence M, Lovell C, Roman C, Tillman L, Yu E

2024 Jul 25;pii: S1569-1993(24)00779-3. doi: 10.1016/j.jcf.2024.06.010

People with cystic fibrosis (PwCF) have experienced substantial improvements in health following use of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies. However, less is known about how modulator therapies impact well-being.

J Cyst Fibros|2024 Jul 25

Oliver B, Fallon Ingram M, Rudell E

2024 Jul 26;:1-8doi: 10.7812/TPP/23.153

There has been substantial development of shared decision-making (SDM) methods and approaches in the past few decades, but despite this, building capability and scaling application of SDM in clinical practice remains a challenge. Here the authors describe the development and initial experience with a new virtual Practical Approach continuing education program for busy practicing clinicians who care for people with complex, chronic, and costly conditions who are frequently faced with preference-sensitive decisions. This program was designed to provide plain language training in SDM for real-world clinical practice using an easy 4-step approach that does not require prior training or formal education in SDM theory or methods.

Perm J|2024 Jul 26

Johansson M, Albarqouni L, O'Keeffe M, Jørgensen KJ, Woloshin S

2024 Jul 25;doi: 10.1001/jama.2024.12267

JAMA|2024 Jul 25

Zeller TA, Rhoden PA, Pipas CF

2024 Jul-Aug;22(4):352-354doi: 10.1370/afm.3132

Modern measures of physician value are couched in terms of productivity, volume, finance, outcomes, cure rates, and acquisition of an increasingly vast knowledge base. This inherently feeds burnout and imposter syndrome as physicians experience an inability to measure up to unrealistic standards set externally and perceived internally. Ancient and modern wisdom suggests that where populations fail to flourish, at root is a failure to grasp a vision or true purpose. Traditional philosophical conceptions of a physician's purpose center around compassion, empathy, and humanism, which are a key to thwarting burnout and recovering professional satisfaction. New compassion-based metrics are urgently needed and will positively impact physician well-being and improve population health.

Ann Fam Med|2024 Jul-Aug

Marras C, Meyer Z, Liu H, Luo S, Mantri S, Allen A, Baybayan S, Beck JC, Brown AE, Cheung F, Dahodwala N, Davis TL, Engeland M, Fearon C, Jones N, Mills K, Miyasaki JM, Naito A, Neault M, Nelson EC, Onyinanya E, Ropa C, Weintraub D

2024 Jul 19;doi: 10.1002/mdc3.14163

Depression is common in Parkinson's disease (PD) but is underrecognized clinically. Although systematic screening is a recommended strategy to improve depression recognition in primary care practice, it has not been widely used in PD care.

Mov Disord Clin Pract|2024 Jul 19

Sandhu A, Grad R, Bousbiat I, Issa AM, Abbasgolizadeh-Rahimi S, D'Souza V, Elwyn G

2024 Jul 14;128:108373doi: 10.1016/j.pec.2024.108373

To 1) examine the willingness of residents to undertake shared decision-making and 2) explore whether the willingness to engage in shared decision-making is influenced by the perceived stakes of a clinical situation.

Patient Educ Couns|2024 Jul 14

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