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Your search keyword '"Transcranial Doppler screening"' showing total 4 results
Start Over Descriptor "Transcranial Doppler screening" Topic medicaid
4 results on '"Transcranial Doppler screening"'

1. Missed Opportunities for Transcranial Doppler Screening Among Children With Sickle Cell Disease

Author

Reeves, Sarah L, Fullerton, Heather J, Cohn, Lisa M, Dombkowski, Kevin J, Boulton, Matthew L, Braun, Thomas M, and Lisabeth, Lynda D

Subjects
Paediatrics, Biomedical and Clinical Sciences, Neurosciences, Health Services, Prevention, Rare Diseases, Sickle Cell Disease, Clinical Research, Hematology, Pediatric, Adolescent, Anemia, Sickle Cell, Cerebral Arteries, Cerebral Veins, Cerebrovascular Circulation, Child, Child, Preschool, Female, Humans, Male, Michigan, Predictive Value of Tests, Stroke, Ultrasonography, Doppler, Transcranial, United States, Doppler ultrasound, Children, Epidemiology, Health services research, Medicaid, children, health services research, newborn screening, pediatric stroke, sickle cell disease, stroke prevention, transcranial Doppler screening, Paediatrics and Reproductive Medicine, Pediatrics
Abstract

Transcranial Doppler (TCD) screening rates remain low among children with sickle cell disease (SCD). We assessed TCD screening rates and missed opportunities for TCD screening. Children 2 to 16 years old with SCD enrolled in Michigan Medicaid for ≥1 year (2007-2011) were identified through newborn screening. Receipt of TCD screening and presence of a missed opportunity (≥1 SCD-related outpatient visit, no TCD screening) were identified through administrative claims. Potential correlates of missed opportunities included SCD-related health services, comorbidities, and demographics. Logistic regression with generalized estimating equations modeled associations between a missed opportunity and correlates. Overall, 353 children contributed 1066 person-years. TCD screening was low yearly (10%-32%); missed opportunities occurred in 73% of the person-years. Increasing age (odds ratio [OR] = 1.11; confidence interval CI = 1.07, 1.15), previous TCD screening (OR = 0.26; CI = 0.16, 0.41), and 4 to 5 (OR = 0.48; CI = 0.26, 0.87) or ≥6 outpatient visits (OR = 0.26; CI = 0.14, 0.49) were associated with a missed opportunity. Reduction of missed opportunities is a potential strategy to increase TCD screening rates.

Published
2016

2. The Role of Neighborhoods in the Receipt of Transcranial Doppler Screening Among Children With Sickle Cell Disease

Author

Reeves, Sarah L, Braun, Thomas M, Dombkowski, Kevin J, Fullerton, Heather J, Boulton, Matthew L, and Lisabeth, Lynda D

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Prevention, Sickle Cell Disease, Pediatric, Rare Diseases, Hematology, Clinical Research, Adolescent, Anemia, Sickle Cell, Child, Child, Preschool, Female, Humans, Logistic Models, Male, Ultrasonography, Doppler, Transcranial, sickle cell disease, transcranial Doppler screening, neighborhoods, Medicaid, Cardiorespiratory Medicine and Haematology, Oncology & Carcinogenesis, Cardiovascular medicine and haematology
Abstract

Although transcranial Doppler (TCD) screening assesses the need for stroke prevention efforts among children with sickle cell disease (SCD), screening rates remain low across many parts of the United States. We sought to identify neighborhoods with low TCD screening rates and neighborhood-level factors related to screening to inform the utility of community-level interventions to improve TCD screening. Children ages 2 to 16 years with SCD (HbSS/HbS/β-thalassemia) living in Wayne County, MI, were identified in Michigan Medicaid (2007 to 2011) through newborn screening records. Children were enrolled for ≥ 1 year and could contribute multiple years. We determined receipt of ≥ 1 TCD screening and neighborhood (census tract) each year. The proportion of children receiving TCD in the tract was calculated and investigated for spatial patterns across tracts (Moran's I). Median household income, % unemployment, % black residents, and % less than high school education within each tract were ascertained from the American Community Survey. Logistic regression with generalized estimating equations was used to model associations between TCD screening and neighborhood-level factors. Overall, 329 children contributed 532 person-years and screening rates increased from 7% to 36% from 2007 to 2011. Median screening rate in tracts was 0% (interquartile range = 29%) and there was no spatial pattern of TCD screening across tracts (Moran's I Z-score = -0.94, P-value = 0.35). No associations were found between neighborhood characteristics and receipt of TCD screening in this disadvantaged Michigan county. Additional research is needed to inform interventions to increase TCD screening in this high stroke-risk population.

Published
2015

3. Missed Opportunities for Transcranial Doppler Screening Among Children With Sickle Cell Disease

Author

Lisa M. Cohn, Thomas Braun, Matthew L. Boulton, Heather J. Fullerton, Kevin J. Dombkowski, Lynda D. Lisabeth, and Sarah L. Reeves

Subjects
Male, Michigan, Pediatrics, pediatric stroke, Ultrasonography, Doppler, Transcranial, Epidemiology, Logistic regression, Doppler ultrasound, 0302 clinical medicine, Medicine, Pediatric stroke, Child, Stroke, Ultrasonography, Pediatric, Doppler, Anemia, Hematology, Health Services, health services research, Sickle Cell, Child, Preschool, Cerebrovascular Circulation, 030220 oncology & carcinogenesis, Predictive value of tests, cardiovascular system, Female, stroke prevention, transcranial Doppler screening, medicine.medical_specialty, Adolescent, Anemia, Sickle Cell, Transcranial, Paediatrics and Reproductive Medicine, 03 medical and health sciences, Rare Diseases, children, Clinical Research, Predictive Value of Tests, 030225 pediatrics, Humans, Preschool, Newborn screening, business.industry, Medicaid, newborn screening, Prevention, Neurosciences, Odds ratio, Cerebral Arteries, medicine.disease, Cerebral Veins, United States, Confidence interval, Transcranial Doppler, Pediatrics, Perinatology and Child Health, sickle cell disease, business
Abstract

Transcranial Doppler (TCD) screening rates remain low among children with sickle cell disease (SCD). We assessed TCD screening rates and missed opportunities for TCD screening. Children 2 to 16 years old with SCD enrolled in Michigan Medicaid for ≥1 year (2007-2011) were identified through newborn screening. Receipt of TCD screening and presence of a missed opportunity (≥1 SCD-related outpatient visit, no TCD screening) were identified through administrative claims. Potential correlates of missed opportunities included SCD-related health services, comorbidities, and demographics. Logistic regression with generalized estimating equations modeled associations between a missed opportunity and correlates. Overall, 353 children contributed 1066 person-years. TCD screening was low yearly (10%-32%); missed opportunities occurred in 73% of the person-years. Increasing age (odds ratio [OR] = 1.11; confidence interval CI = 1.07, 1.15), previous TCD screening (OR = 0.26; CI = 0.16, 0.41), and 4 to 5 (OR = 0.48; CI = 0.26, 0.87) or ≥6 outpatient visits (OR = 0.26; CI = 0.14, 0.49) were associated with a missed opportunity. Reduction of missed opportunities is a potential strategy to increase TCD screening rates.

Published
2016

4. The role of neighborhoods in the receipt of transcranial Doppler screening among children with sickle cell disease

Author

Heather J. Fullerton, Thomas Braun, Matthew L. Boulton, Kevin J. Dombkowski, Lynda D. Lisabeth, and Sarah L. Reeves

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, Ultrasonography, Doppler, Transcranial, Population, Psychological intervention, Anemia, Sickle Cell, Transcranial, Cardiorespiratory Medicine and Haematology, Logistic regression, American Community Survey, Rare Diseases, Interquartile range, Clinical Research, Medicine, Humans, Oncology & Carcinogenesis, education, Preschool, Child, Generalized estimating equation, Ultrasonography, Pediatric, Newborn screening, education.field_of_study, business.industry, Medicaid, Prevention, Doppler, Anemia, Hematology, Sickle Cell, Logistic Models, Oncology, Child, Preschool, Pediatrics, Perinatology and Child Health, cardiovascular system, sickle cell disease, neighborhoods, Female, transcranial Doppler screening, business
Abstract

Summary: Although transcranial Doppler (TCD) screening assesses the need for stroke prevention efforts among children with sickle cell disease (SCD), screening rates remain low across many parts of the United States. We sought to identify neighborhoods with low TCD screening rates and neighborhood-level factors related to screening to inform the utility of community-level interventions to improve TCD screening. Children ages 2 to 16 years with SCD (HbSS/HbS/b-thalassemia) living in Wayne County, MI, were identified in Michigan Medicaid (2007 to 2011) through newborn screening records. Children were enrolled for Z1 year and could contribute multiple years. We determined receipt of Z1 TCD screening and neighborhood (census tract) each year. The proportion of children receiving TCD in the tract was calculated and investigated for spatial patterns across tracts (Moran's I). Median household income, % unemployment, % black residents, and % less than high school education within each tract were ascertained from the American Community Survey. Logistic regression with generalized estimating equations was used to model associations between TCD screening and neighborhood-level factors. Overall, 329 children contributed 532 person-years and screening rates increased from 7% to 36% from 2007 to 2011. Median screening rate in tracts was 0% (interquartile range=29%) and there was no spatial pattern of TCD screening across tracts (Moran's I Z-score= 0.94, P-value=0.35). No associations were found between neighborhood characteristics and receipt of TCD screening in this disadvantaged Michigan county. Additional research is needed to inform interventions to increase TCD screening in this high stroke-risk population.

Published
2014

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