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Article ; Online: Identification of Human Monkeypox Virus Genome Deletions That Impact Diagnostic Assays.

Garrigues, Jacob M / Hemarajata, Peera / Lucero, Briar / Alarcón, Jemma / Ransohoff, Heidi / Marutani, Amy N / Kim, Moon / Marlowe, Elizabeth M / Realegeno, Susan E / Kagan, Ron M / Montero, Clemente I / Chen, Nicholas F G / Grubaugh, Nathan D / Vogels, Chantal B F / Green, Nicole M

Journal of clinical microbiology

2022 Volume 60, Issue 12, Page(s) e0165522

MeSH term(s)	Humans ; Monkeypox virus/genetics ; Biological Assay
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Letter
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/jcm.01655-22
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Article ; Online: Personal genomics: information can be harmful.

Ransohoff, D F / Khoury, M J

European journal of clinical investigation

2010 Volume 40, Issue 1, Page(s) 64–68

MeSH term(s)	Access to Information/ethics ; Consumer Health Information/ethics ; Genetic Predisposition to Disease ; Genetic Testing/ethics ; Genome, Human ; Genomics ; Humans
Language	English
Publishing date	2010-01
Publishing country	England
Document type	Journal Article
ZDB-ID	186196-7
ISSN	1365-2362 ; 0014-2972 ; 0960-135X
ISSN (online)	1365-2362
ISSN	0014-2972 ; 0960-135X
DOI	10.1111/j.1365-2362.2009.02232.x
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Zs.A 677: Show issues

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Article ; Online: Laboratory-Generated Urine Toxicology Interpretations: A Mixed Methods Study.

Chua, Isaac S / Ransohoff, Jaime R / Ehrlich, Olga / Katznelson, Ethan / Virk, Zain M / Demetriou, Christiana A / Petrides, Athena K / Orav, Endel J / Schiff, Gordon D / Melanson, Stacy E F

Pain physician

2021 Volume 24, Issue 2, Page(s) E191–E201

Abstract: Background: Clinicians frequently order urine drug testing (UDT) for patients on chronic opioid therapy (COT), yet often have difficulty interpreting test results accurately.: Objectives: To evaluate the implementation and effectiveness of a ... ...

Abstract	Background: Clinicians frequently order urine drug testing (UDT) for patients on chronic opioid therapy (COT), yet often have difficulty interpreting test results accurately. Objectives: To evaluate the implementation and effectiveness of a laboratory-generated urine toxicology interpretation service for clinicians prescribing COT. Study design: Type II hybrid-convergent mixed methods design (implementation) and pre-post prospective cohort study with matched controls (effectiveness). Setting: Four ambulatory sites (2 primary care, 1 pain management, 1 palliative care) within 2 US academic medical institutions. Methods: Interpretative reports were generated by the clinical chemistry laboratory and were provided to UDT ordering providers via inbox message in the electronic health record (EHR). The Partners Institutional Review Board approved this study.Participants were primary care, pain management, and palliative care clinicians who ordered liquid chromatography-mass spectrometry UDT for COT patients in clinic. Intervention was a laboratory-generated interpretation service that provided an individualized interpretive report of UDT results based on the patient's prescribed medications and toxicology metabolites for clinicians who received the intervention (n = 8) versus matched controls (n = 18).Implementation results included focus group and survey feedback on the interpretation service's usability and its impact on workflow, clinical decision making, clinician-patient relationships, and interdisciplinary teamwork. Effectiveness outcomes included UDT interpretation concordance between the clinician and laboratory, documentation frequency of UDT results interpretation and communication of results to patients, and clinician prescribing behavior at follow-up. Results: Among the 8 intervention clinicians (median age 58 [IQR 16.5] years; 2 women [25%]) on a Likert scale from 1 ("strongly disagree") to 5 ("strongly agree"), 7 clinicians reported at 6 months postintervention that the interpretation service was easy to use (mean 5 [standard deviation {SD}, 0]); improved results comprehension (mean 5 [SD, 0]); and helped them interpret results more accurately (mean 5 [SD, 0]), quickly (mean 4.67 [SD, 0.52]), and confidently (mean 4.83 [SD, 0.41]). Although there were no statistically significant differences in outcomes between cohorts, clinician-laboratory interpretation concordance trended toward improvement (intervention 22/32 [68.8%] to 29/33 [87.9%] vs. control 21/25 [84%] to 23/30 [76.7%], P = 0.07) among cases with documented interpretations. Limitations: This study has a low sample size and was conducted at 2 large academic medical institutions and may not be generalizable to community settings. Conclusions: Interpretations were well received by clinicians but did not significantly improve laboratory-clinician interpretation concordance, interpretation documentation frequency, or opioid-prescribing behavior.
MeSH term(s)	Adult ; Aged ; Analgesics, Opioid/urine ; Chromatography, Liquid ; Female ; Humans ; Laboratories ; Male ; Middle Aged ; Opioid-Related Disorders/diagnosis ; Opioid-Related Disorders/urine ; Pain Management ; Prospective Studies ; Substance Abuse Detection/methods ; Urinalysis/methods
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2146393-1
ISSN	2150-1149 ; 1533-3159
ISSN (online)	2150-1149
ISSN	1533-3159
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Zs.A 5930: Show issues

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Article ; Online: Provider Misinterpretation, Documentation, and Follow-Up of Definitive Urine Drug Testing Results.

Chua, Isaac / Petrides, Athena K / Schiff, Gordon D / Ransohoff, Jaime R / Kantartjis, Michalis / Streid, Jocelyn / Demetriou, Christiana A / Melanson, Stacy E F

Journal of general internal medicine

2019 Volume 35, Issue 1, Page(s) 283–290

Abstract: Background: Urine drug testing (UDT) is an essential tool to monitor opioid misuse among patients on chronic opioid therapy. Inaccurate interpretation of UDT can have deleterious consequences. Providers' ability to accurately interpret and document UDT, ...

Abstract	Background: Urine drug testing (UDT) is an essential tool to monitor opioid misuse among patients on chronic opioid therapy. Inaccurate interpretation of UDT can have deleterious consequences. Providers' ability to accurately interpret and document UDT, particularly definitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) results, has not been widely studied. Objective: To examine whether providers correctly interpret, document, and communicate LC-MS/MS UDT results. Design: This is a retrospective chart review of 160 UDT results (80 aberrant; 80 non-aberrant) between August 2017 and February 2018 from 5 ambulatory clinics (3 primary care, 1 oncology, 1 pain management). Aberrant results were classified into one or more of the following categories: illicit drug use, simulated compliance, not taking prescribed medication, and taking a medication not prescribed. Accurate result interpretation was defined as concordance between the provider's documented interpretation and an expert laboratory toxicologist's interpretation. Outcome measures were concordance between provider and laboratory interpretation of UDT results, documentation of UDT results, results acknowledgement in the electronic health record, communication of results to the patient, and rate of prescription refills. Key results: Aberrant results were most frequently due to illicit drug use. Overall, only 88 of the 160 (55%) had any documented provider interpretations of which 25/88 (28%) were discordant with the laboratory toxicologist's interpretation. Thirty-six of the 160 (23%) documented communication of the results to the patient. Communicating results was more likely to be documented if the results were aberrant compared with non-aberrant (33/80 [41%] vs. 3/80 [4%], p < 0.001). In all cases where provider interpretations were discordant with the laboratory interpretation, prescriptions were refilled. Conclusions: Erroneous provider interpretation of UDT results, infrequent documentation of interpretation, lack of communication of results to patients, and prescription refills despite inaccurate interpretations are common. Expert assistance with urine toxicology interpretations may be needed to improve provider accuracy when interpreting toxicology results.
MeSH term(s)	Analgesics, Opioid ; Chromatography, Liquid ; Documentation ; Follow-Up Studies ; Humans ; Pharmaceutical Preparations ; Retrospective Studies ; Substance Abuse Detection ; Tandem Mass Spectrometry
Chemical Substances	Analgesics, Opioid ; Pharmaceutical Preparations
Language	English
Publishing date	2019-11-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-019-05514-5
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Zs.A 2205: Show issues

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Article: Sensationalism in the media: when scientists and journalists may be complicit collaborators.

Ransohoff, D F / Ransohoff, R M

Effective clinical practice : ECP

2001 Volume 4, Issue 4, Page(s) 185–188

MeSH term(s)	Communication ; Deception ; Democracy ; Humans ; Journalism, Medical/standards ; Mass Media/standards ; Peer Review, Research ; United States
Language	English
Publishing date	2001-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1479155-9
ISSN	1099-8128
ISSN	1099-8128
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Zs.A 5085: Show issues

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Article: Why Hasn't Genomic Testing Changed the Landscape in Clinical Oncology?

Hayes, Daniel F / Khoury, Muin J / Ransohoff, David

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2014 , Page(s) e52–5

Abstract: The "omics" revolution produced great optimism that tumor biomarker tests based on high-order analysis of multiple (sometimes thousands) of factors would result in truly personalized oncologic care. Unfortunately, 10 years into the revolution, the ... ...

Abstract	The "omics" revolution produced great optimism that tumor biomarker tests based on high-order analysis of multiple (sometimes thousands) of factors would result in truly personalized oncologic care. Unfortunately, 10 years into the revolution, the promise of omics-based research has not yet been realized. The factors behind the slow progress in omics-based clinical care are many. First, over the last 15 years, there has been a gradual recognition of the importance of conducting tumor biomarker science with the kind of rigor that has traditionally been used for therapeutic research. However, this recognition has only recently been applied widely, and therefore most tumor biomarkers have insufficiently high levels of evidence to determine clinical utility. Second, omics-based research offers its own particular set of concerns, especially in regard to overfitting computational models and false discovery rates. Researchers and clinicians need to understand the importance of analytic validity, and the difference between clinical/biologic validity and clinical utility. The latter is required to introduce a tumor biomarker test of any kind (single analyte or omics-based), and are ideally generated by carefully planned and properly conducted "prospective retrospective" or truly prospective clinical trials. Only carefully planned studies, which take all three of these into account and in which the investigators are aware and recognize the enormous risk of unintended bias and overfitting inherent in omics-based test development, will ultimately result in translation of the exciting new technologies into better care for patients with cancer.
Language	English
Publishing date	2014-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2431126-1
ISSN	1548-8756 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1548-8748
DOI	10.14694/EdBook_AM.2012.32.e52
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Article: Economic impact of surveillance.

Ransohoff, D F

Gastrointestinal endoscopy

1999 Volume 49, Issue 3 Pt 2, Page(s) S67–71

MeSH term(s)	Adenoma/economics ; Colonic Neoplasms/economics ; Colonic Neoplasms/prevention & control ; Colonic Neoplasms/surgery ; Colonic Polyps/economics ; Colonic Polyps/surgery ; Colonoscopy/economics ; Cost Control ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Follow-Up Studies ; Humans ; Mass Screening/economics ; Middle Aged ; Rectal Neoplasms/economics ; Rectal Neoplasms/prevention & control ; Risk Assessment ; Risk Factors ; Survival Rate
Language	English
Publishing date	1999-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/s0016-5107(99)70529-8
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Zs.MO 519: Show issues

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Article ; Online: Traumatic pedestrian and bicyclist injuries associated with intoxication.

Tonellato, D J / Ransohoff, J R / Nash, C / Melanson, S E F / Petrides, A K / Tolan, N V / Goldberg, S A / Boyer, E W / Chai, P R / Erickson, T B

The American journal of emergency medicine

2020 Volume 45, Page(s) 192–195

Abstract: Background: Drug and alcohol use are risk factors for trauma among operators of motor vehicles and contribute to trauma in pedestrians and bicyclists. We describe the prevalence of drug and alcohol use and clinical consequences in a cohort of ... ...

Abstract	Background: Drug and alcohol use are risk factors for trauma among operators of motor vehicles and contribute to trauma in pedestrians and bicyclists. We describe the prevalence of drug and alcohol use and clinical consequences in a cohort of pedestrians and bicyclists with trauma. Methods: We analyzed a 25-month data set of 916 trauma team activations from January 2017-January 2019 at an urban, level I trauma center. Blood ethanol levels and urine toxicology screens were obtained in 94 pedestrian and bicyclist trauma activations. We compared pedestrians or bicyclists with a positive urine or blood screen (n = 69) to those with negative screens (n = 25). We conducted a retrospective chart review to determine mechanism of injury, injury pattern, and disposition from the emergency department (ED). Results: Overall, 38 (55%) of injured patients with positive screen were pedestrians and 31 (45%) were bicyclists. Fentanyl was the most commonly detected drug (n = 38; 40%), followed by opiates (n = 27; 29%), and tetrahydrocannabiol (THC) (n = 23; 25%). Twenty-one patients were positive for ethanol. Pedestrians and bicyclists with positive toxicology screens were significantly more likely to sustain fractures (p < .01), require an operative procedure (p < .05), or intensive care unit admission (p < .05). Conclusion: Our study builds on previous literature which suggests that intoxicated bicyclists and pedestrians suffer frequent and more severe injury than their sober counterparts. Public health campaigns should educate bicyclists and pedestrians about the risks of cycling or walking in areas of road traffic while under the influence of alcohol or illicit drugs.
MeSH term(s)	Accidents, Traffic ; Automobile Driving/statistics & numerical data ; Bicycling/injuries ; Boston/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Substance-Related Disorders/epidemiology ; Trauma Centers ; Walking
Language	English
Publishing date	2020-08-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2020.08.024
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Zs.A 2005: Show issues

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Article: A microglia clonal inflammatory disorder in Alzheimer's Disease.

Vicario, Rocio / Fragkogianni, Stamatina / Weber, Leslie / Lazarov, Tomi / Hu, Yang / Hayashi, Samantha Y / Craddock, Barbara P / Socci, Nicholas D / Alberdi, Araitz / Baako, Ann / Ay, Oyku / Ogishi, Masato / Lopez-Rodrigo, Estibaliz / Kappagantula, Rajya / Viale, Agnes / Iacobuzio-Donahue, Christine A / Zhou, Ting / Ransohoff, Richard M / Chesworth, Richard /

Bank, Netherlands Brain / Abdel-Wahab, Omar / Boisson, Bertrand / Elemento, Olivier / Casanova, Jean-Laurent / Miller, W Todd / Geissmann, Frederic

bioRxiv : the preprint server for biology

2024

Abstract: Somatic genetic heterogeneity resulting from post-zygotic DNA mutations is widespread in human tissues and can cause diseases, however few studies have investigated its role in neurodegenerative processes such as Alzheimer's Disease (AD). Here we report ... ...

Abstract	Somatic genetic heterogeneity resulting from post-zygotic DNA mutations is widespread in human tissues and can cause diseases, however few studies have investigated its role in neurodegenerative processes such as Alzheimer's Disease (AD). Here we report the selective enrichment of microglia clones carrying pathogenic variants, that are not present in neuronal, glia/stromal cells, or blood, from patients with AD in comparison to age-matched controls. Notably, microglia-specific AD-associated variants preferentially target the MAPK pathway, including recurrent CBL ring-domain mutations. These variants activate ERK and drive a microglia transcriptional program characterized by a strong neuro-inflammatory response, both
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.25.577216
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Article: Early Detection of Adverse Drug Reactions in Social Health Networks: A Natural Language Processing Pipeline for Signal Detection.

Nikfarjam, Azadeh / Ransohoff, Julia D / Callahan, Alison / Jones, Erik / Loew, Brian / Kwong, Bernice Y / Sarin, Kavita Y / Shah, Nigam H

JMIR public health and surveillance

2019 Volume 5, Issue 2, Page(s) e11264

Abstract: ... Our named entity recognition system achieved a 0.738 microaveraged F-measure in detecting ADR entities, not ...

Abstract	Background: Adverse drug reactions (ADRs) occur in nearly all patients on chemotherapy, causing morbidity and therapy disruptions. Detection of such ADRs is limited in clinical trials, which are underpowered to detect rare events. Early recognition of ADRs in the postmarketing phase could substantially reduce morbidity and decrease societal costs. Internet community health forums provide a mechanism for individuals to discuss real-time health concerns and can enable computational detection of ADRs. Objective: The goal of this study is to identify cutaneous ADR signals in social health networks and compare the frequency and timing of these ADRs to clinical reports in the literature. Methods: We present a natural language processing-based, ADR signal-generation pipeline based on patient posts on Internet social health networks. We identified user posts from the Inspire health forums related to two chemotherapy classes: erlotinib, an epidermal growth factor receptor inhibitor, and nivolumab and pembrolizumab, immune checkpoint inhibitors. We extracted mentions of ADRs from unstructured content of patient posts. We then performed population-level association analyses and time-to-detection analyses. Results: Our system detected cutaneous ADRs from patient reports with high precision (0.90) and at frequencies comparable to those documented in the literature but an average of 7 months ahead of their literature reporting. Known ADRs were associated with higher proportional reporting ratios compared to negative controls, demonstrating the robustness of our analyses. Our named entity recognition system achieved a 0.738 microaveraged F-measure in detecting ADR entities, not limited to cutaneous ADRs, in health forum posts. Additionally, we discovered the novel ADR of hypohidrosis reported by 23 patients in erlotinib-related posts; this ADR was absent from 15 years of literature on this medication and we recently reported the finding in a clinical oncology journal. Conclusions: Several hundred million patients report health concerns in social health networks, yet this information is markedly underutilized for pharmacosurveillance. We demonstrated the ability of a natural language processing-based signal-generation pipeline to accurately detect patient reports of ADRs months in advance of literature reporting and the robustness of statistical analyses to validate system detections. Our findings suggest the important contributions that social health network data can play in contributing to more comprehensive and timely pharmacovigilance.
Language	English
Publishing date	2019-06-03
Publishing country	Canada
Document type	Journal Article
ISSN	2369-2960
ISSN	2369-2960
DOI	10.2196/11264
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