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55. Structural and Social Determinants of Health Factors Associated with County-Level Variation in Non-Adherence to Antihypertensive Medication Treatment

Author

Donneyong, Macarius M., primary, Chang, Teng-Jen, additional, Jackson, John W., additional, Langston, Michael A., additional, Juarez, Paul D., additional, Sealy-Jefferson, Shawnita, additional, Lu, Bo, additional, Im, Wansoo, additional, Valdez, R. Burciaga, additional, Way, Baldwin M., additional, Colen, Cynthia, additional, Fischer, Michael A., additional, Salsberry, Pamela, additional, Bridges, John F.P., additional, and Hood, Darryl B., additional

Published
2020
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63. Overcoming bias in estimating the volume-outcome relationship

Author

Tsai, Alexander C., Votruba, Mark, Bridges, John F.P., and Cebul, Randall D.

Subjects
Congestive heart failure -- Case studies, Congestive heart failure -- Care and treatment, Health risk assessment -- Research
Abstract

Objective. To examine the effect of hospital volume on 30-day mortality for patients with congestive heart failure (CHF) using administrative and clinical data in conventional regression and instrumental variables (IV) estimation models. Data Sources. The primary data consisted of longitudinal information on comorbid conditions, vital signs, clinical status, and laboratory test results for 21,555 Medicare-insured patients aged 65 years and older hospitalized for CHF in northeast Ohio in 1991-1997. Study Design. The patient was the primary unit of analysis. We fit a linear probability model to the data to assess the effects of hospital volume on patient mortality within 30 days of admission. Both administrative and clinical data elements were included for risk adjustment. Linear distances between patients and hospitals were used to construct the instrument, which was then used to assess the endogeneity of hospital volume. Principal Findings. When only administrative data elements were included in the risk adjustment model, the estimated volume-outcome effect was statistically significant (p = .029) but small in magnitude. The estimate was markedly attenuated in magnitude and statistical significance when clinical data were added to the model as risk adjusters (p = .39). IV estimation shifted the estimate in a direction consistent with selective referral, but we were unable to reject the consistency of the linear probability estimates. Conclusions. Use of only administrative data for volume-outcomes research may generate spurious findings. The IV analysis further suggests that conventional estimates of the volume-outcome relationship may be contaminated by selective referral effects. Taken together, our results suggest that efforts to concentrate hospital-based CHF care in high-volume hospitals may not reduce mortality among elderly patients. Key Words. Volume-outcome effect, selective referral, instrumental variables, congestive heart failure, outcomes research, Twenty-five years ago (Luft, Bunker, and Enthoven 1979), documented an inverse volume-outcome relationship for surgical care. Subsequent studies in this literature (Halm, Lee, and Chassin 2000) have generated similar results. [...]

Published
2006

65. Loss of Community‐Dwelling Status Among Survivors of High‐Acuity Emergency General Surgery Disease

Author

Smith, Jason W., primary, Knight Davis, Jennifer, additional, Quatman‐Yates, Catherine C., additional, Waterman, Brittany L., additional, Strassels, Scott A., additional, Wong, Jen D., additional, Heh, Victor K., additional, Baselice, Holly E., additional, Brock, Guy N., additional, Clark, Brian C., additional, Bridges, John F.P., additional, and Santry, Heena P., additional

Published
2019
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66. Integrating Advance Care Planning Videos into Surgical Oncologic Care: A Randomized Clinical Trial

Author

Aslakson, Rebecca A., primary, Isenberg, Sarina R., additional, Crossnohere, Norah L., additional, Conca-Cheng, Alison M., additional, Moore, Madeleine, additional, Bhamidipati, Akshay, additional, Mora, Silvia, additional, Miller, Judith, additional, Singh, Sarabdeep, additional, Swoboda, Sandra M., additional, Pawlik, Timothy M., additional, Weiss, Matthew, additional, Volandes, Angelo, additional, Smith, Thomas J., additional, Bridges, John F.P., additional, and Roter, Debra L., additional

Published
2019
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69. Is immunotherapy toxicity associated with improved overall survival among older adults with advanced cancer?

Author

Johns, Andrew, primary, Grogan, Madison, additional, Hoyd, Rebecca, additional, Bridges, John F.P, additional, Wei, Lai, additional, Patel, Sandipkumar, additional, Li, Mingjia, additional, Husain, Marium, additional, Kendra, Kari Lynn, additional, Otterson, Gregory Alan, additional, Burkart, Jarred Thomas, additional, Rosko, Ashley Elizabeth, additional, Andersen, Barbara L., additional, Carbone, David Paul, additional, Owen, Dwight Hall, additional, Spakowicz, Daniel, additional, and Presley, Carolyn J, additional

Published
2019
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75. Portfolio evaluation of health programs: a reply to Sendi et al

Author

Bridges, John F.P. and Terris, Darcey D.

Subjects
Medical care -- Research, Uncertainty, Health, Social sciences
Abstract

Sendi et al. (Soc. Sci. Med. 57 (2003) 2207) extend previous research on cost-effectiveness analysis to the evaluation of a portfolio of interventions with risky outcomes using a 'second best' approach that can identify improvements in efficiency in the allocation of resources. This method, however, cannot be used to directly identify the optimal solution to the resource allocation problem. Theoretically, a stricter adherence to the foundations of portfolio theory would permit direct optimization in portfolio selection, however, when we include uncertainty in our analysis in addition to the traditional concept of risk (which is often mislabelled uncertainty) complexities are introduced that create significant hurdles in the development of practical applications of portfolio theory for health care policy decision making. Keywords: Portfolio; Uncertainty; Cost-effectiveness analysis

Published
2004

78. Developing the Storyline for an Advance Care Planning Video for Surgery Patients: Patient-Centered Outcomes Research Engagement from Stakeholder Summit to State Fair

Author

Aslakson, Rebecca A., primary, Schuster, Anne L.R., additional, Lynch, Thomas J., additional, Weiss, Matthew J., additional, Gregg, Lydia, additional, Miller, Judith, additional, Isenberg, Sarina R., additional, Crossnohere, Norah L., additional, Conca-Cheng, Alison M., additional, Volandes, Angelo E., additional, Smith, Thomas J., additional, and Bridges, John F.P., additional

Published
2018
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79. Utilizing advance care planning videos to empower perioperative cancer patients and families: Results from a randomized controlled trial.

Author

Aslakson, Rebecca, primary, Isenberg, Sarina, additional, Crossnohere, Norah L., additional, Conca-Cheng, Alison M., additional, Moore, Madeleine, additional, Bhamidipati, Akshay, additional, Mora, Silvia, additional, Miller, Judith, additional, Singh, Sarabdeep, additional, Larson, Susan, additional, Swoboda, Sandy, additional, Pawlik, Timothy M., additional, Weiss, Matthew J., additional, Volandes, Angelo E., additional, Smith, Thomas J., additional, Bridges, John F.P., additional, and Roter, Debra, additional

Published
2017
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84. Randomized trial of paired and triplet profile choice tasks in the elicitation of patient preferences for hearing aids with conjoint analysis

Author

Bridges, John F.P., Oudshoorn, Karin G.M., and Buttorff, Christine

Abstract

Purpose: Most applications of conjoint analysis in health use choice tasks with 2 profiles, while marketing studies routinely use 3 or more. This study reports a randomized trial of paired and triplet profile choice formats experiments focused on hearing aids. Method: Respondents with hearing loss were drawn from a nationally representative cohort complete identical surveys were randomized between choice tasks with 2 or 3 profiles. When they were offered, respondents also provided a full ranking of the 3 profiles cases. Baseline differences between the 2 groups were explored using ANOVA and C2 tests. The primary outcomes (i.e., the differences in estimated preference models) were explored using Wald and t tests and analysis of individual level models estimated by ordinary least squares. Result: 500 respondents participated in the study, but 127 had no hearing loss, 28 had profound and 22 declined to participate and were excluded from analysis. of the remaining 323 participants, 146 individuals were randomized to the pairs and 177 to triplets, but the only significant difference between the groups was time to complete the survey (11.5 and 21 minutes, respectively). Pairs and triplets produced identical rankings of attribute importance but homogeneity was rejected (P = 0.0001). Pairs led to more variation, and were systematically biased toward the null, given a high proportion (32.2%) lexicographic respondents (i.e., respondents who did not trade across attributes), while all respondents in the triplet traded across attributes. The relative benefits of a full ranking also dominated pairs, but were not conceptually different form a single choice triplet. Conclusion: The number of profiles in choice tasks affects the results of conjoint analysis studies. Here triplets are preferred to pairs as they avoid nontrading and allow for more accurate estimation of preferences models, but the benefits of requiring a full ranking of the 3 profiles are less clear.

Published
2011

87. Use of best-worst scaling to assess patient perceptions of treatments for refractory overactive bladder.

Author

BeusteriEN, KathleEN, KENnelly, Michael J., Bridges, John F.P., Amos, Kaitlan, Williams, Mary Jo, and Vasavada, Sandip

Abstract

Aims Refractory overactive bladder (OAB) treatments, including sacral neuromodulation (SNM), onabotulinumtoxin A (OnabotA), and percutaneous tibial nerve stimulation (PTNS), differ considerably. Best-Worst Scaling (BWS) was used to assess patient preferences for these treatments. Methods A cross-sectional Web survey, based on findings from qualitative interviews with 23 OAB patients and 7 clinical experts, was conducted with idiopathic OAB patients in the US and UK. The BWS exercise involved prioritizing subsets of 13 attributes across 13 choice tasks, where patients identified the attribute they considered as best and as worst in each task. Attribute BWS scores, ranging from −1.0 (worst) to 1.0 (best) were calculated based on the rates that each attribute was chosen. Attitudes toward the attributes also were assessed via like/dislike Likert scales, and questions regarding the percentage likelihood (0-100%) of trying each treatment, based on standardized treatment descriptions. Results The sample included 245 patients (118 US, 127 UK); 79% female, mean age 50 ± 7.8 years. All 13 attribute BWS scores were significantly positive or negative. 'Lasting improvement' (0.82), 'minimal side effects' (0.67), and 'sends signals between bladder and brain' (0.35)' were rated most favorably, and 'complications with implant' (−0.65), and 'be willing to self-catheterize' (−0.53) were rated worst. All but one of the attribute BWS scores were significantly correlated with the respective like/dislike scores and the percentage likelihood estimates for trying one of the three treatments. Conclusion BWS was successful in assessing the magnitude of patient preferences for key attributes associated with substantially different refractory OAB therapies. Neurourol. Urodynam. 35:1028-1033, 2016. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Published
2016
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95. Decision Making about Cancer Screening: An Assessment of the State of the Science and a Suggested Research Agenda from the ASPO Behavioral Oncology and Cancer Communication Special Interest Group

Author

Kiviniemi, Marc T., primary, Hay, Jennifer L., additional, James, Aimee S., additional, Lipkus, Isaac M., additional, Meissner, Helen I., additional, Stefanek, Michael, additional, Studts, Jamie L., additional, Bridges, John F.P., additional, Close, David R., additional, Erwin, Deborah O., additional, Jones, Resa M., additional, Kaiser, Karen, additional, Kash, Kathryn M., additional, Kelly, Kimberly M., additional, Craddock Lee, Simon J., additional, Purnell, Jason Q., additional, Siminoff, Laura A., additional, Vadaparampil, Susan T., additional, and Wang, Catharine, additional

Published
2009
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96. Future challenges for the economic evaluation of healthcare: patient preferences, risk attitudes and beyond.

Author

Bridges, John F.P.

Subjects
*MEDICAL economics, *MEDICAL care costs, *MEDICAL care, *PATIENTS, *PUBLIC health, *ATTITUDE (Psychology), *COMPARATIVE studies, *RESEARCH methodology, *MEDICAL cooperation, *PATIENT satisfaction, *RESEARCH, *RESEARCH funding, *RISK assessment, *EVALUATION research, *RELATIVE medical risk
Abstract

The continued growth in the economic evaluation of healthcare over the past 25 years has led to a shortage of trained health economists globally, leading to a number of universities and/or national governments developing specialised health economics programmes to train more health economists. One of the common problems with many of these training programmes is that they only educate new health economists to the Masters level, and as such they are unable to cover the many skills needed by a successful health economist. Furthermore, government and industry interests have ensured that economic evaluation is a heavily regulated environment that gives little incentive to seek further education. These two related factors (under-education and over-regulation) have lead to a situation where economic evaluation methods may adversely limit innovation of therapeutics and devices in clinical areas that perform badly when evaluated on the cost per QALY scale. The good news, however, is that the tide is turning and theoretically sound adjustments (such as risk adjustments and stated preferences) to the current paradigm are now being considered. This, of cause, is just the tip of the iceberg with other important issues such as time preference and the endogeneity of preference remaining very much under-researched areas in health. This paper concludes that many of these real-world issues, such as patient preferences, can be avoided by using artificial objective functions such as cost per QALY, but this comes at the cost of irrelevance and the misallocation of resources. If we are to meet all of the future challenges in economic evaluation in healthcare then we must focus more on advanced education and far less on the regulation of health economists. [ABSTRACT FROM AUTHOR]

Published
2005
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97. User experience with HIV molecular epidemiology in research, surveillance, and cluster detection and response: a needs assessment.

Author

Schuster, Anne L.R., Folta, Ashley, Bollinger, Juli, Geller, Gail, Mehta, Sanjay R., Little, Susan J., Sanchez, Travis, Sugarman, Jeremy, and Bridges, John F.P.

Subjects
*MEDICAL personnel, *MOLECULAR epidemiology, *THEMATIC analysis, *USER experience, *RESEARCH personnel
Abstract

AbstractObjectiveMethodsResultsConclusionHIV molecular epidemiology (HIV ME) is a tool that aims to improve HIV research, surveillance, and cluster detection and response. HIV ME is a core pillar of the U.S. initiative to End the HIV Epidemic but faces some challenges and criticisms from stakeholders. We sought to assess user experience to identify the current needs for HIV ME.Users of HIV ME, including researchers and public health practitioners, were engaged via a structured survey. Needs were assessed via open-ended questions about HIV ME. Data were analyzed using reflexive thematic analysis; the concordance of results was assessed semi-quantitatively.Of 90 possible HIV-ME end-users, 57 completed the survey (response rate = 63%), which included users engaged in research (n = 29) and public health (n = 28). Respondents identified current imperatives, challenges, and strategies to improve HIV ME. Imperatives included characterization of the virus, identification of HIV hotspots, and tailoring of HIV interventions. Challenges encompassed technological issues, ethical concerns, and implementation difficulties. Strategies to improve HIV ME involved improving data access and analysis, enhancing implementation guidance and resources, and fostering community engagement and support. Researchers and public health practitioners prioritized different imperatives, but similarly emphasized the ethical concerns with HIV ME.The imperatives identified by users underscore the necessity of HIV ME, while the challenges highlight the hurdles to be overcome, including ethical concerns which emerged as a shared emphasis across user groups. The strategies outlined offer a roadmap for overcoming these challenges. These insights, drawn from user experience, present a valuable opportunity to inform the development of guidelines for the ethical application of HIV ME in research, surveillance, and cluster detection and response. [ABSTRACT FROM AUTHOR]

Published
2024
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99. Hospitalized Women's Willingness to Pay for an Inpatient Screening Mammogram

Author

Khaliq, Waseem, Harris, Ché Matthew, Landis, Regina, Bridges, John F.P., and Wright, Scott M.

Abstract

Lower rates for breast cancer screening persist among low income and uninsured women. Although Medicare and many other insurance plans would pay for screening mammograms done during hospital stays, breast cancer screening has not been part of usual hospital care. This study explores the mean amount of money that hospitalized women were willing to contribute towards the cost of a screening mammogram. Of the 193 enrolled patients, 72% were willing to pay a mean of $83.41 (95% CI, $71.51–$95.31) in advance towards inpatient screening mammogram costs. The study's findings suggest that hospitalized women value the prospect of screening mammography during the hospitalization. It may be wise policy to offer mammograms to nonadherent hospitalized women, especially those who are at high risk for developing breast cancer.

Published
2014
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100. Can economics add to the illicit drug debate?

Author

Bridges, John F.P.

Subjects
*SOCIOECONOMICS, *DRUG abuse, *ECONOMICS
Abstract

Editorial. Comments on the influence of economics in policy development for illicit drug abuse; Application of economics on drug research; Development of effective response of the economics of illicit drugs.

Published
1999
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