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Article ; Online: CryoEM structures of adhesion in GPCR CD97: Filling in some of the gaps.

Krumm, Brian E / Roth, Bryan L

Cell chemical biology

2023 Volume 30, Issue 11, Page(s) 1327–1329

Abstract: CD97 (ADGRE5) is an adhesion GPCR (aGPCR) that plays crucial roles in the immune system and cancer. In this issue of Cell Chemical Biology, Wang et al. ...

Abstract	CD97 (ADGRE5) is an adhesion GPCR (aGPCR) that plays crucial roles in the immune system and cancer. In this issue of Cell Chemical Biology, Wang et al.
MeSH term(s)	Receptors, G-Protein-Coupled/metabolism ; GTP-Binding Proteins/metabolism
Chemical Substances	Receptors, G-Protein-Coupled ; GTP-Binding Proteins (EC 3.6.1.-)
Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ISSN	2451-9448
ISSN (online)	2451-9448
DOI	10.1016/j.chembiol.2023.10.014
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Article ; Online: Model-Based Operative Performance Expectations for Quantifying Competency in General Surgery.

Krumm, Andrew E / Marcotte, Kayla / George, Brian C

JAMA surgery

2023 Volume 158, Issue 5, Page(s) 515–521

Abstract: Importance: Understanding how to translate workplace-based assessment (WBA) ratings into metrics that communicate the ability of a surgeon to perform a procedure would represent a critical advancement in graduate medical education.: Objective: To ... ...

Abstract	Importance: Understanding how to translate workplace-based assessment (WBA) ratings into metrics that communicate the ability of a surgeon to perform a procedure would represent a critical advancement in graduate medical education. Objective: To evaluate the association between past and future performance in a comprehensive assessment system for the purpose of assessing point-in-time competence among general surgery trainees. Design, setting, and participants: This case series included WBA ratings from September 2015 to September 2021 from the WBA system of the Society for Improving Medical Professional Learning (SIMPL) for all general surgery residents who were provided a rating following an operative performance across 70 programs in the US. The study included ratings for 2605 trainees from 1884 attending surgeon raters. Analyses were conducted between September 2021 and December 2021 using bayesian generalized linear mixed-effects models and marginal predicted probabilities. Exposures: Longitudinal SIMPL ratings. Main outcomes and measures: Performance expectations for 193 unique general surgery procedures based on an individual trainee's prior successful ratings for a procedure, clinical year of training, and month of the academic year. Results: Using 63 248 SIMPL ratings, the association between prior and future performance was positive (β, 0.13; 95% credible interval [CrI], 0.12-0.15). The largest source of variation was postgraduate year (α, 3.15; 95% CrI, 1.66-6.03), with rater (α, 1.69; 95% CrI, 1.60-1.78), procedure (α, 1.35; 95% CrI, 1.22-1.51), case complexity (α, 1.30; 95% CrI, 0.42-3.66), and trainee (α, 0.99; 95% CrI, 0.94-1.04) accounting for significant variation in practice ready ratings. After marginalizing overcomplexity and trainee and holding rater constant, mean predicted probabilities had strong overall discrimination (area under the receiver operating characteristic curve, 0.81) and were well calibrated. Conclusions and relevance: In this study, prior performance was associated with future performance. This association, combined with an overall modeling strategy that accounted for various facets of an assessment task, may offer a strategy for quantifying competence as performance expectations.
MeSH term(s)	Humans ; Internship and Residency ; Bayes Theorem ; Motivation ; Educational Measurement/methods ; Clinical Competence ; Education, Medical, Graduate
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2023.0014
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Article ; Online: A self-activating orphan receptor.

Krumm, Brian / Roth, Bryan L

Nature

2020 Volume 579, Issue 7797, Page(s) 35–36

MeSH term(s)	Ligands ; Transcription Factors
Chemical Substances	Ligands ; Transcription Factors
Language	English
Publishing date	2020-02-29
Publishing country	England
Document type	News ; Comment
ZDB-ID	120714-3
ISSN	1476-4687 ; 0028-0836
ISSN (online)	1476-4687
ISSN	0028-0836
DOI	10.1038/d41586-020-00411-y
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Article ; Online: Predicting Resident Competence for Otolaryngology Key Indicator Procedures.

Chen, Jenny X / George, Brian C / Gray, Stacey T / Krumm, Andrew E

The Laryngoscope

2023 Volume 133, Issue 12, Page(s) 3341–3345

Abstract: Objective: Competency-based surgical education requires practical assessments and meaningful benchmarks. In otolaryngology, key indicator procedure (KIP) minima are indicators of surgical exposure during training, yet it remains unknown how many times ... ...

Abstract	Objective: Competency-based surgical education requires practical assessments and meaningful benchmarks. In otolaryngology, key indicator procedure (KIP) minima are indicators of surgical exposure during training, yet it remains unknown how many times trainees must be evaluated on KIPs to ensure operative competence. Herein, we used Bayesian mixed effects models to compute predicted performance expectations for KIPs. Methods: From November 2017 to September 2021, a smartphone application (SIMPL OR) was used by attendings at five otolaryngology training programs to rate resident operative performance after each case on a five-level scale. Bayesian mixed effects models were used to estimate the probability that postgraduate year (PGY) 3, 4, or 5 trainees would earn a "practice-ready" (PR) rating on a subsequent evaluation based on their previously earned PR ratings for each KIP. Probabilities of earning a subsequent PR rating were examined for interpretability, and cross-validation was used to assess predictive validity. Results: A total of 842 assessments of KIPs were submitted by 72 attendings for 92 residents PGY 2-5. The predictive model had an average Area Under the Receiver Operating Curve of 0.77. The number of prior PR ratings that senior residents needed to attain a 95% probability of earning a PR rating on a subsequent evaluation was estimated for each KIP. For example, for mastoidectomies, PGY4 residents needed to earn 10 PR ratings whereas PGY5 residents needed 4 PR ratings on average to have a 95% probability of attaining a PR rating on a subsequent evaluation. Conclusion: Predictive modeling can inform assessment benchmarks for competency-based surgical education. Level of evidence: NA Laryngoscope, 133:3341-3345, 2023.
MeSH term(s)	Humans ; Internship and Residency ; Bayes Theorem ; Clinical Competence ; Education, Medical, Graduate/methods ; Educational Measurement/methods ; Otolaryngology/education ; General Surgery/education
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30680
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Article ; Online: A Structural Understanding of Class B GPCR Selectivity and Activation Revealed.

Krumm, Brian / Roth, Bryan L

Structure (London, England : 1993)

2020 Volume 28, Issue 3, Page(s) 277–279

Abstract: Ma et al. (2020) and Liang et al. (2020) describe the cryo-EM structures of three class B G protein-coupled receptors (GPCRs) in complex with native peptides and Gs. Their work establishes the structural basis of peptide specificity and a conserved ... ...

Abstract	Ma et al. (2020) and Liang et al. (2020) describe the cryo-EM structures of three class B G protein-coupled receptors (GPCRs) in complex with native peptides and Gs. Their work establishes the structural basis of peptide specificity and a conserved mechanism of receptor activation and G protein coupling for class B GPCRs.
MeSH term(s)	Cryoelectron Microscopy ; GTP-Binding Proteins ; Peptides ; Receptors, G-Protein-Coupled
Chemical Substances	Peptides ; Receptors, G-Protein-Coupled ; GTP-Binding Proteins (EC 3.6.1.-)
Language	English
Publishing date	2020-03-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	1213087-4
ISSN	1878-4186 ; 0969-2126
ISSN (online)	1878-4186
ISSN	0969-2126
DOI	10.1016/j.str.2020.02.004
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Article ; Online: Activation mechanisms for a universal signalling protein.

Krumm, Brian / Roth, Bryan L

Nature

2018 Volume 557, Issue 7705, Page(s) 318–319

MeSH term(s)	Signal Transduction
Language	English
Publishing date	2018-05-11
Publishing country	England
Document type	News ; Comment
ZDB-ID	120714-3
ISSN	1476-4687 ; 0028-0836
ISSN (online)	1476-4687
ISSN	0028-0836
DOI	10.1038/d41586-018-04977-6
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Article ; Online: Simplified cardiovascular index may be the best comorbidity index for clinical use in prediction of mortality for renal cancer patients.

Boynton, Dennis / Noyes, Sabrina L / Murali, Adharsh / Peabody, Henry / Krumm, Andrew / Singh, Karandeep / Lane, Brian R

Urologic oncology

2024 Volume 42, Issue 3, Page(s) 72.e1–72.e8

Abstract: Objective: Understanding the relationship between comorbidities and life expectancy is important in cancer patients who carry risks of cancer and noncancer-related mortality. Comorbidity indices (CI) are tools to provide an objective measure of ... ...

Abstract	Objective: Understanding the relationship between comorbidities and life expectancy is important in cancer patients who carry risks of cancer and noncancer-related mortality. Comorbidity indices (CI) are tools to provide an objective measure of competing risks of death. We sought to determine which CI might be best incorporated into clinical practice for patients with suspected renal cancer. Materials and methods: 1572 patients diagnosed with renal masses (stage I-IV) between 1998 and 2016 were analyzed for this study. Patient data were gathered from a community-based health center. Comorbidities were evaluated individually, and with 1 of 4 CI: Charlson (CCI), updated CCI (uCCI), age-adjusted CCI (aCCI), and simplified cardiovascular index (CVI). Cox-proportional hazard analysis of all-cause mortality was performed using the four CI, adjusting for the 4 CI, adjusting for age, gender, race, tumor size, and tumor stage. Results: Univariable analyses revealed the four CI were significant predictors of mortality (P < 0.05), as were age, gender, tumor size, and stage. Comorbid conditions at diagnosis included hypertension (47.8%), diabetes mellitus (47.2%), coronary artery disease (41.1%), chronic kidney disease (31.8%), peripheral vascular disease (8.0%), congestive heart failure (5.7%), chronic obstructive pulmonary disease (5.7%), and cerebrovascular disease (2.0%). When analyzing the 4 CI in multivariable survival analyses accounting for factors available at diagnosis, and analyses incorporating pathologic and recurrence data, only CVI score and uCCI remained statistically significant (P < 0.05). Limitations of this work are the retrospective nature of data collection and data from a single institution, limiting the generalizability. Conclusion: Increasing comorbidity, age, tumor size, and cM stage are predictors of ACM for suspected renal cancer patients. CVI appears to provide comparable information to various iterations of CCI (uCCI, aCCI) while being the simplest to use. Utilization of CVI may assist clinicians and patients when considering between interventional and noninterventional approaches for suspected renal cancer.
MeSH term(s)	Humans ; Retrospective Studies ; Comorbidity ; Diabetes Mellitus ; Kidney Neoplasms ; Carcinoma, Renal Cell
Language	English
Publishing date	2024-01-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2024.01.004
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Article ; Online: Technical, Biological, and Systems Barriers for Molecular Clinical Decision Support.

Krumm, Niklas / Shirts, Brian H

Clinics in laboratory medicine

2019 Volume 39, Issue 2, Page(s) 281–294

Abstract: Genome-enabled or molecular clinical decision support (CDS) systems provide unique advantages for the clinical use of genomic data; however, their implementation is complicated by technical, biological, and systemic barriers. This article reviews the ... ...

Abstract	Genome-enabled or molecular clinical decision support (CDS) systems provide unique advantages for the clinical use of genomic data; however, their implementation is complicated by technical, biological, and systemic barriers. This article reviews the substantial technical progress that has been made in the past decade and finds that the underlying biological limitations of genomics as well as systemic barriers to adoption of molecular CDS have been comparatively underestimated. A hybrid consultative CDS system, which integrates a genomics consultant into an active CDS system, may provide an interim path forward.
MeSH term(s)	Decision Support Systems, Clinical ; Electronic Health Records ; Genomics ; Humans
Language	English
Publishing date	2019-03-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	604580-7
ISSN	1557-9832 ; 0272-2712
ISSN (online)	1557-9832
ISSN	0272-2712
DOI	10.1016/j.cll.2019.01.007
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Article ; Online: Right Case, Right Time: Which Procedures Best Differentiate General Surgery Trainees' Operative Performance?

Moreci, Rebecca / Gates, Rebecca S / Marcotte, Kayla M / George, Brian C / Krumm, Andrew E

Journal of surgical education

2023 Volume 80, Issue 11, Page(s) 1493–1502

Abstract: Objective: Assessing surgical trainee operative performance is time- and resource-intensive. To maximize the utility of each assessment, it is important to understand which assessment activities provide the most information about a trainee's performance. ...

Abstract	Objective: Assessing surgical trainee operative performance is time- and resource-intensive. To maximize the utility of each assessment, it is important to understand which assessment activities provide the most information about a trainee's performance. The objective of this study is to identify the procedures that best differentiate performance for each general surgery postgraduate year (PGY)-level, leading to recommendations for targeted assessment. Design: The Society for Improving Medical Professional Learning (SIMPL) operative performance ratings were modeled using a multilevel Rasch model which identified the highest and lowest performing trainees for each PGY-level. For each procedure within each PGY-level, a procedural performance discrimination index was calculated by subtracting the proportion of "practice-ready" ratings of the lowest performing trainees from the proportion of "practice-ready" ratings of the highest performing trainees. Four-quadrant plots were created using the median procedure volume and median discrimination index for each PGY-level. All procedures within the upper right quadrant were considered "highly differentiating, high volume" procedures. Setting: This study was conducted across 70 general surgical residency programs who are members of the SIMPL collaborative. Participants: A total of 54,790 operative performance evaluations of categorical general surgery trainees were collected between 2015 and 2021. Trainees who had at least 1 procedure in common were included. Procedures with less than 25 evaluations per training year were excluded. Results: The total number of evaluations per procedure ranged from 25 to 2,131. Discrimination values were generated for 51 (PGY1), 54 (PGY2), 92 (PGY3), 105 (PGY4), and 103 (PGY5) procedures. Using the above criteria, a total of 12 (PGY1), 15 (PGY2), 22 (PGY3), 21 (PGY4), and 28 (PGY5) procedures were identified as highly differentiating, high volume procedures. Conclusions: Our study draws on national data to identify procedures which are most useful in differentiating trainee operative performance at each PGY-level. This list of procedures can be used to guide targeted assessment and improve assessment efficiency.
MeSH term(s)	Humans ; Internship and Residency ; Education, Medical, Graduate/methods ; Clinical Competence ; Educational Measurement/methods ; General Surgery/education
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.05.009
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Article ; Online: An Ideal System of Assessment to Support Competency-Based Graduate Medical Education: Key Attributes and Proposed Next Steps.

Gates, Rebecca S / Marcotte, Kayla / Moreci, Rebecca / Krumm, Andrew E / Lynch, Kenneth A / Bailey, Christina / George, Brian C

Journal of surgical education

2023 Volume 81, Issue 2, Page(s) 172–177

Abstract: Competency-based medical education (CBME) is the future of medical education and relies heavily on high quality assessment. However, the current assessment practices employed by many general surgery graduate medical education training programs are subpar. ...

Abstract	Competency-based medical education (CBME) is the future of medical education and relies heavily on high quality assessment. However, the current assessment practices employed by many general surgery graduate medical education training programs are subpar. Assessments often lack reliability and validity evidence, have low faculty engagement, and differ from program to program. Given the importance of assessment in CBME, it is critical that we build a better assessment system for measuring trainee competency. We propose that an ideal system of assessment is standardized, evidence-based, comprehensive, integrated, and continuously improving. In this article, we explore these characteristics and propose next steps to achieve such a system of assessment in general surgery.
MeSH term(s)	Humans ; Reproducibility of Results ; Education, Medical, Graduate ; Competency-Based Education ; Education, Medical ; Faculty, Medical ; Clinical Competence
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.10.006
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