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Article ; Online: Use of Additional Corticosteroids in Nonresolving COVID-19-Associated Acute Respiratory Distress Syndrome: A Resolved Issue?

Marts, Lucian T / Kang, Mohleen

2023 Volume 51, Issue 10, Page(s) 1434–1436

MeSH term(s)	Humans ; COVID-19/complications ; Adrenal Cortex Hormones/therapeutic use ; Respiratory Distress Syndrome/drug therapy ; Respiratory Distress Syndrome/virology
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000005959
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Article ; Online: Pulmonary symptoms associated with heavy alcohol consumption among people living with HIV: an analysis of the NHANES 1999-2010.

New-Aaron, Moses / Kang, Mohleen / Yeligar, Samantha M

Alcohol and alcoholism (Oxford, Oxfordshire)

2024 Volume 59, Issue 3

Abstract: Aim: This matched case-control study aimed to provide epidemiologic evidence of increased burden of respiratory symptoms and pulmonary function decline among people living with human immunodeficiency virus (HIV) and a history of heavy alcohol ... ...

Abstract	Aim: This matched case-control study aimed to provide epidemiologic evidence of increased burden of respiratory symptoms and pulmonary function decline among people living with human immunodeficiency virus (HIV) and a history of heavy alcohol consumption. Methods: Cases were participants with HIV (PWH; n = 75, 33%), and controls were participants without HIV (PWoH; n = 150, 67%). PWH were matched to PWoH by age and sex in the ratio of 1:2. Eligible participants responded to the respiratory health National Health and Nutrition Examination Survey questionnaire [prolonged coughs (≥3 months), bringing up of phlegm (≥3 months), and a history of wheezing or whistling in the chest (past year)]. The effects of both alcohol and HIV on participants' pulmonary function were determined using linear regression analysis. Results: History of heavy alcohol consumption was more prevalent among PWH (40%) compared to PWoH (27%). PWH who had a history of heavy alcohol consumption had a higher prevalence of coughing most days (45% vs. 4%, P = .0010), bringing up phlegm most days (31% vs. 0%, P = .0012), and wheezing or whistling in the chest (40% vs. 20%, P = .058) compared to participants who did not heavily consume alcohol. Furthermore, a history of heavy alcohol consumption was associated with decreased forced expiratory volume (ml) in 1 s/forced vital capacity among PWH (β = - 0.098 95% C.I. -0.16, -0.04, P = .03) after adjusting for having smoked at least 100 cigarettes in life. Conclusion: A history of heavy alcohol use increased respiratory symptoms and suppressed pulmonary function among people living with HIV. This study provides epidemiological evidence of the respiratory symptom burden of people living with HIV who have a history of heavy alcohol consumption.
MeSH term(s)	Humans ; Nutrition Surveys ; HIV ; HIV Infections/epidemiology ; HIV Infections/complications ; Respiratory Sounds ; Case-Control Studies ; Alcohol Drinking/epidemiology
Language	English
Publishing date	2024-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	604956-4
ISSN	1464-3502 ; 0309-1635 ; 0735-0414
ISSN (online)	1464-3502
ISSN	0309-1635 ; 0735-0414
DOI	10.1093/alcalc/agae021
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Zs.B 798: Show issues

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Article ; Online: The Published Scientific Literature on COVID-19: An Analysis of PubMed Abstracts.

Kang, Mohleen / Gurbani, Saumya S / Kempker, Jordan A

Journal of medical systems

2020 Volume 45, Issue 1, Page(s) 3

MeSH term(s)	Bibliometrics ; COVID-19 ; Humans ; Pandemics ; PubMed ; Publications ; SARS-CoV-2
Language	English
Publishing date	2020-11-25
Publishing country	United States
Document type	Letter
ZDB-ID	423488-1
ISSN	1573-689X ; 0148-5598
ISSN (online)	1573-689X
ISSN	0148-5598
DOI	10.1007/s10916-020-01678-4
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Article ; Online: Definitions, Epidemiology, Clinical Risk Factors, and Health Disparities in Acute Respiratory Distress Syndrome.

Kang, Mohleen / Kempker, Jordan A

Seminars in respiratory and critical care medicine

2019 Volume 40, Issue 1, Page(s) 3–11

Abstract: Acute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the ... ...

Abstract	Acute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the diagnostic criteria used to define ARDS are helpful in the clinical setting, they are not entirely specific for the characteristic pathophysiology of diffuse alveolar lung damage. This case definition introduces challenges to the reliable and accurate epidemiologic study of the condition. Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
MeSH term(s)	Health Status Disparities ; Humans ; Incidence ; Intensive Care Units ; Respiratory Distress Syndrome, Adult/epidemiology ; Respiratory Distress Syndrome, Adult/etiology ; Respiratory Distress Syndrome, Adult/physiopathology ; Risk Factors
Language	English
Publishing date	2019-05-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Review
ZDB-ID	1183617-9
ISSN	1098-9048 ; 1069-3424
ISSN (online)	1098-9048
ISSN	1069-3424
DOI	10.1055/s-0039-1683884
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Article ; Online: An updated approach to determine minimal clinically important differences in idiopathic pulmonary fibrosis

Mohleen Kang / Srihari Veeraraghavan / Greg S. Martin / Jordan A. Kempker

ERJ Open Research, Vol 7, Iss

2021 Volume 4

Abstract: Introduction Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently published ...

Abstract	Introduction Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently published consensus standards for MCID studies support using anchor-based over distribution-based methods. The aim of this study was to estimate MCID values for worsening in IPF using only an anchor-based approach. Methods We conducted secondary analyses of three randomised controlled trials with different inclusion criteria and follow-up intervals. The health transition question in the 36-Item Short-Form Health Survey (SF-36) questionnaire was used as the anchor. We used receiver operating curves to assess responsiveness between the anchor and 10 variables (four physiological measures and six PROMs). We used an anchor-based method to determine the MCID values of variables that met the responsiveness criteria (area under the curve ≥0.70). Results 6-min walk distance (6MWD), the St George's Respiratory Questionnaire (SGRQ), physical component score (PCS) of SF-36 and University of California, San Diego, Shortness of Breath Questionnaire (UCSD SOBQ) met the responsiveness criteria. The MCID value for 6MWD was −75 m; the MCID value for SF-36 PCS was −7 points; the MCID value for SGRQ was 11 points; and the MCID value for the UCSD SOBQ was 11 points. Conclusions The MCID estimates of 6MWD, SGRQ, SF-36 and UCSD SOBQ using only anchor-based methods were considerably higher compared to previously proposed values. A single MCID value may not be applicable across all classes of disease severity or durations of follow-up time.
Keywords	Medicine ; R
Subject code	310
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	European Respiratory Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pulmonary hypertension mortality trends in United States 1999-2019.

Kang, Mohleen / Hart, Charles Michael / Kempker, Jordan A / Veeraraghavan, Srihari / Trammell, Aaron W

Annals of epidemiology

2022 Volume 75, Page(s) 47–52

Abstract: Purpose: Pulmonary hypertension (PH) is a heterogenous, often progressive disorder leading to right heart failure and death. Previous analyses show stable PH mortality rates from 1980 to 2001 but increasing from 2001 to 2010 especially among women and ... ...

Abstract	Purpose: Pulmonary hypertension (PH) is a heterogenous, often progressive disorder leading to right heart failure and death. Previous analyses show stable PH mortality rates from 1980 to 2001 but increasing from 2001 to 2010 especially among women and non-Hispanic (NH) Black. This study seeks to identify recent trends in PH mortality in the United States from 1999 to 2019. Methods: Mortality rates among individuals more than or equal to 15 years of age were obtained from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiology Research (WONDER) database. ICD-10 codes were used to identify individuals with PH. Results: Between 1999 and 2019, PH was included as a cause on 429,105 recorded deaths. The average age-adjusted PH mortality rate was 7.9 per 100,000 individuals and increased by 1.9% per year. Higher age-adjusted mortality rates were experienced by females and NH Black persons. The crude mortality rate was 105.4 per 100,000 among those decedents 85 or older. From 1999 to 2019, mortality in PH and left heart disease co-occurrence increased at nearly double the annual rate of the overall PH group. Conclusions: Despite therapeutic advances for selected PH subgroups, the overall age-adjusted PH mortality rate increased significantly from 1999 to 2019 and previously reported racial disparities have persisted. These findings emphasize the need for additional study to improve outcomes in PH.
MeSH term(s)	United States/epidemiology ; Humans ; Female ; Cause of Death ; Hypertension, Pulmonary ; Racial Groups ; Ethnicity ; Heart Diseases ; Mortality
Language	English
Publishing date	2022-09-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
ZDB-ID	1074355-8
ISSN	1873-2585 ; 1047-2797
ISSN (online)	1873-2585
ISSN	1047-2797
DOI	10.1016/j.annepidem.2022.09.001
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Article: An updated approach to determine minimal clinically important differences in idiopathic pulmonary fibrosis.

Kang, Mohleen / Veeraraghavan, Srihari / Martin, Greg S / Kempker, Jordan A

ERJ open research

2021 Volume 7, Issue 4

Abstract: Introduction: Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently ... ...

Abstract	Introduction: Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently published consensus standards for MCID studies support using anchor-based over distribution-based methods. The aim of this study was to estimate MCID values for worsening in IPF using only an anchor-based approach. Methods: We conducted secondary analyses of three randomised controlled trials with different inclusion criteria and follow-up intervals. The health transition question in the 36-Item Short-Form Health Survey (SF-36) questionnaire was used as the anchor. We used receiver operating curves to assess responsiveness between the anchor and 10 variables (four physiological measures and six PROMs). We used an anchor-based method to determine the MCID values of variables that met the responsiveness criteria (area under the curve ≥0.70). Results: 6-min walk distance (6MWD), the St George's Respiratory Questionnaire (SGRQ), physical component score (PCS) of SF-36 and University of California, San Diego, Shortness of Breath Questionnaire (UCSD SOBQ) met the responsiveness criteria. The MCID value for 6MWD was -75 m; the MCID value for SF-36 PCS was -7 points; the MCID value for SGRQ was 11 points; and the MCID value for the UCSD SOBQ was 11 points. Conclusions: The MCID estimates of 6MWD, SGRQ, SF-36 and UCSD SOBQ using only anchor-based methods were considerably higher compared to previously proposed values. A single MCID value may not be applicable across all classes of disease severity or durations of follow-up time.
Language	English
Publishing date	2021-10-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00142-2021
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Article: Minimal clinically important difference in idiopathic pulmonary fibrosis.

Kang, Mohleen / Marts, Lucian / Kempker, Jordan A / Veeraraghavan, Srihari

Breathe (Sheffield, England)

2021 Volume 17, Issue 2, Page(s) 200345

Abstract: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing lung disease with an estimated median survival of 2-5 years and a significant impact on quality of life (QoL). Current approved medications, pirfenidone and nintedanib, have shown a ... ...

Abstract	Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing lung disease with an estimated median survival of 2-5 years and a significant impact on quality of life (QoL). Current approved medications, pirfenidone and nintedanib, have shown a reduction in annual decline of forced vital capacity but no impact on QoL. The minimal clinically important difference (MCID) is a threshold value for a change in a parameter that is considered meaningful by the patient rather than solely relying on statistically significant change in the parameter. This review provides a brief overview of the MCID methodology along with detailed discussion of reported MCID values for commonly used physiological measures and patient-reported outcome measures in IPF. While there is no gold standard methodology for determining MCID, there are certain limitations in the MCID literature in IPF, mainly the choice of death, hospitalisation and pulmonary function tests as sole anchors, and pervasive use of distribution-based methods which do not take into account the patient's input. There is a critical need to identify accurate thresholds of outcome measures that reflect patient's QoL over time in order to more precisely design and evaluate future clinical trials and to develop algorithms for patient-oriented management of IPF in outpatient clinics. Educational aims: To understand the concept of MCID and the methods used to determine these values.To understand the indications and limitations of MCID values in IPF.
Language	English
Publishing date	2021-01-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2562899-9
ISSN	2073-4735 ; 1810-6838
ISSN (online)	2073-4735
ISSN	1810-6838
DOI	10.1183/20734735.0345-2020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Definitions, Epidemiology, Clinical Risk Factors, and Health Disparities in Acute Respiratory Distress Syndrome

Kang, Mohleen / Kempker, Jordan A.

Seminars in Respiratory and Critical Care Medicine

(Acute Respiratory Distress Syndrome: Evolving Concepts)

2019 Volume 40, Issue 01, Page(s) 3–11

Series title	Acute Respiratory Distress Syndrome: Evolving Concepts
Abstract	Acute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the diagnostic criteria used to define ARDS are helpful in the clinical setting, they are not entirely specific for the characteristic pathophysiology of diffuse alveolar lung damage. This case definition introduces challenges to the reliable and accurate epidemiologic study of the condition. Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
Keywords	Acute Respiratory Distress Syndrome ; ARDS ; epidemiology ; health disparities
Language	English
Publishing date	2019-02-01
Publisher	Thieme Medical Publishers
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	1183617-9
ISSN	1098-9048 ; 1069-3424
ISSN (online)	1098-9048
ISSN	1069-3424
DOI	10.1055/s-0039-1683884
Database	Thieme publisher's database

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Article ; Online: Variations in Team-Based Learning Methodology Call for Active Scholarship in Support of a Gold Standard.

Feurdean, Mirela / Matassa, Daniel / Streb, Genevieve / Kang, Mohleen

Journal of graduate medical education

2017 Volume 9, Issue 4, Page(s) 542–543

MeSH term(s)	Education, Medical ; Fellowships and Scholarships ; Internship and Residency ; Learning
Language	English
Publishing date	2017-08-21
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2578612-X
ISSN	1949-8357 ; 1949-8349
ISSN (online)	1949-8357
ISSN	1949-8349
DOI	10.4300/JGME-D-17-00165.1
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