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  1. Article ; Online: Commentary: When suction alone is not enough.

    Bechtel, J F Matthias

    The Journal of thoracic and cardiovascular surgery

    2019  Volume 159, Issue 3, Page(s) 906–907

    MeSH term(s) Heart Failure ; Heart-Assist Devices ; Humans ; Incidence ; Mitral Valve Insufficiency ; Suction ; Ventricular Function, Right
    Language English
    Publishing date 2019-04-30
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2019.04.047
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  2. Article ; Online: REPLY: THROMBOCYTOPENIA AFTER IMPLANTATION OF A PERCEVAL S AORTIC BIOPROSTHESIS SHOULD BE STUDIED MORE VIGOROUSLY, NOT LESS.

    Stegmeier, Philipp / Bechtel, J F Matthias

    The Journal of thoracic and cardiovascular surgery

    2020  

    Language English
    Publishing date 2020-11-07
    Publishing country United States
    Document type Letter
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2020.07.097
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  3. Article ; Online: New, but still the same old story.

    Bechtel, J F Matthias

    The Journal of thoracic and cardiovascular surgery

    2018  Volume 156, Issue 4, Page(s) 1528–1529

    MeSH term(s) Atrial Fibrillation ; Health Resources ; Heart-Assist Devices ; Humans ; Postoperative Period ; Thoracic Surgical Procedures
    Language English
    Publishing date 2018-04-30
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2018.04.089
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  4. Article ; Online: Do we really understand what happens to valve allografts?

    Bechtel, J F Matthias

    The Journal of thoracic and cardiovascular surgery

    2016  Volume 152, Issue 4, Page(s) 1200–1201

    MeSH term(s) Allografts ; Aortic Valve ; Heart Valve Prosthesis
    Language English
    Publishing date 2016-04-28
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2016.04.059
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  5. Article ; Online: Care managers' experiences in a collaborative care program for the treatment of bipolar disorder and PTSD in underserved communities.

    LaRocco-Cockburn, Anna / Jakupcak, Matthew / Bauer, Amy M / Bowen, Deborah J / Bechtel, Jared / Koconis, Natalie / Fortney, John C

    General hospital psychiatry

    2022  Volume 76, Page(s) 16–24

    Abstract: Objectives: To understand care managers' experiences treating primary care patients with bipolar disorder and PTSD in a telepsychiatry collaborative care (TCC) program, as part of a large pragmatic trial.: Methods: We conducted individual qualitative ...

    Abstract Objectives: To understand care managers' experiences treating primary care patients with bipolar disorder and PTSD in a telepsychiatry collaborative care (TCC) program, as part of a large pragmatic trial.
    Methods: We conducted individual qualitative interviews with 12 care managers to evaluate barriers and facilitators to implementation of a previously completed TCC intervention for patients with bipolar disorder and/or PTSD. We used directed and conventional content analysis and Consolidated Framework for Implementation Research (CFIR) constructs to organize care manager experiences.
    Results: Participants described clinical and medication management support from telepsychiatrists and satisfaction with the TCC model as facilitators of success for patients with bipolar disorder and PTSD in underserved communities. Participants also described onboarding of primary care providers and clinic leadership as keys to successful team-care and credited satisfaction with providing Behavioral Activation as essential to sustained delivery of the psychotherapy component of TCC.
    Conclusions: Participants described high satisfaction with TCC for patients with bipolar disorder and PTSD. Challenges included lack of clinic leadership and PCP engagement. Early and ongoing promotion of integrated care and prioritizing telepsychiatry consultation with patients, behavioral health professionals and PCPs, may improve patient care, provide ongoing training and improve workforce satisfaction.
    MeSH term(s) Bipolar Disorder/therapy ; Humans ; Primary Health Care ; Psychiatry ; Qualitative Research ; Stress Disorders, Post-Traumatic/therapy ; Telemedicine
    Language English
    Publishing date 2022-03-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392299-6
    ISSN 1873-7714 ; 0163-8343
    ISSN (online) 1873-7714
    ISSN 0163-8343
    DOI 10.1016/j.genhosppsych.2022.03.004
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  6. Article ; Online: OpenClinical.net: Artificial intelligence and knowledge engineering at the point of care.

    Fox, John / South, Matthew / Khan, Omar / Kennedy, Catriona / Ashby, Peter / Bechtel, John

    BMJ health & care informatics

    2020  Volume 27, Issue 2

    Abstract: Objective: OpenClinical.net is a way of disseminating clinical guidelines to improve quality of care whose distinctive feature is to combine the benefits of clinical guidelines and other human-readable material with the power of artificial intelligence ... ...

    Abstract Objective: OpenClinical.net is a way of disseminating clinical guidelines to improve quality of care whose distinctive feature is to combine the benefits of clinical guidelines and other human-readable material with the power of artificial intelligence to give patient-specific recommendations. A key objective is to empower healthcare professionals to author, share, critique, trial and revise these 'executable' models of best practice.
    Design: OpenClinical.net
    Results: PRO
    Conclusion: OpenClinical.net is a showcase for a PRO
    MeSH term(s) Artificial Intelligence ; Decision Support Systems, Clinical ; Humans ; Knowledge Bases ; Point-of-Care Systems ; Practice Guidelines as Topic
    Language English
    Publishing date 2020-07-29
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2632-1009
    ISSN (online) 2632-1009
    DOI 10.1136/bmjhci-2020-100141
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  7. Article ; Online: Outcomes of a health informatics technology-supported behavioral activation training for care managers in a collaborative care program.

    Bauer, Amy M / Jakupcak, Matthew / Hawrilenko, Matt / Bechtel, Jared / Arao, Rob / Fortney, John C

    Families, systems & health : the journal of collaborative family healthcare

    2020  Volume 39, Issue 1, Page(s) 89–100

    Abstract: Introduction: Health informatics-supported strategies for training and ongoing support may aid the delivery of evidence-based psychotherapies. The objective of this study was to describe the development, implementation, and practice outcomes of a ... ...

    Abstract Introduction: Health informatics-supported strategies for training and ongoing support may aid the delivery of evidence-based psychotherapies. The objective of this study was to describe the development, implementation, and practice outcomes of a scalable health informatics-supported training program for behavioral activation for patients who screened positive for posttraumatic stress disorder and/or bipolar disorder.
    Method: We trained 34 care managers in 12 rural health centers. They used a registry checklist to document the delivery of 10 behavioral activation skills for 4,632 sessions with 455 patients. Care managers received performance feedback based on registry data. Using encounter-level data reported by care managers, we described the implementation outcomes of patient reach and care manager skill adoption. We used cross-classified multilevel modeling to explore variation in skill delivery accounting for patient characteristics, provider characteristics, and change over time.
    Results: Care managers engaged 88% of patients in behavioral activation and completed a minimum course for 57%. The average patient received 5.9 skills during treatment, with substantial variation driven more by providers (63%) than patients (29%). Care managers significantly increased the range of skills offered to patients over time.
    Discussion: The registry-based checklist was a feasible training and support tool for community-based providers to deliver behavioral activation. Providers received data-driven performance feedback and demonstrated skill improvement over time, promoting sustainment. Future research will examine patient-level outcomes. Results underscore the potential public health impact of a simple registry-based skills checklist coupled with a scalable remote training program for evidence-based psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
    MeSH term(s) Humans ; Medical Informatics/methods ; Medical Informatics/standards ; Medical Informatics/statistics & numerical data ; Psychotherapy/instrumentation ; Psychotherapy/methods ; Psychotherapy/statistics & numerical data ; Registries/statistics & numerical data ; Rural Population/statistics & numerical data ; Teaching/statistics & numerical data ; Telemedicine/methods ; Telemedicine/standards ; Telemedicine/statistics & numerical data
    Language English
    Publishing date 2020-08-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1326859-4
    ISSN 1939-0602 ; 1091-7527 ; 0736-1718
    ISSN (online) 1939-0602
    ISSN 1091-7527 ; 0736-1718
    DOI 10.1037/fsh0000523
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  8. Article ; Online: Examining the future in retrospect.

    Bechtel, J F Matthias / Strauch, Justus T

    The Journal of thoracic and cardiovascular surgery

    2017  Volume 154, Issue 5, Page(s) 1554–1555

    MeSH term(s) Aortic Valve ; Forecasting ; Heart Valve Prosthesis ; Humans ; Patient Readmission
    Language English
    Publishing date 2017-07-19
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2017.06.058
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  9. Article ; Online: Thrombocytopenia after implantation of the Perceval S aortic bioprosthesis.

    Stegmeier, Philipp / Schlömicher, Markus / Stiegler, Hugo / Strauch, Justus T / Bechtel, J F Matthias

    The Journal of thoracic and cardiovascular surgery

    2019  Volume 160, Issue 1, Page(s) 61–68.e8

    Abstract: Objective: The Perceval S bioprosthesis (LivaNova PLC, London, United Kingdom) is based on the Freedom Solo aortic bioprosthesis (LivaNova PLC), which has been reported to be associated with perioperative thrombocytopenia. We compared platelet counts ... ...

    Abstract Objective: The Perceval S bioprosthesis (LivaNova PLC, London, United Kingdom) is based on the Freedom Solo aortic bioprosthesis (LivaNova PLC), which has been reported to be associated with perioperative thrombocytopenia. We compared platelet counts after aortic valve replacement with the Perceval S with those with other aortic valve bioprostheses.
    Methods: A total of 87 patients receiving aortic valve replacement were included in this retrospective study; 25 patients received the Perceval S, 23 patients received the Labcor TLPB-A (Labcor, Belo Horizonte, Brazil), and 39 patients received the Hancock II bioprosthesis (Medtronic, Minneapolis, Minn). Thrombocyte count was corrected for hematocrit. Multivariable analyses were performed to assess the potential effect of other variables.
    Results: Preoperatively, there were no differences in platelet counts comparing the Perceval S group (median 200/nl, interquartile range, 157-252) and the control group (Labcor: median 213/nl, interquartile range, 160-246, Hancock: median 227/nl, interquartile range, 183-280, P = .23). Postoperatively, there was significant evidence that the minimum platelet count (median, Perceval: 47, interquartile range, 38-66; Labcor: 76, interquartile range, 61-110; Hancock: 78, interquartile range, 61-111/nl; P = .001), both absolute and corrected, was lower for the Perceval S, even after allowing for other variables. The significant difference in absolute platelet counts persisted until discharge or death. However, there were no significant differences regarding blood loss, transfusion requirements, or rates of reoperation for bleeding.
    Conclusions: After aortic valve replacement, platelet counts in patients with the Perceval S decrease more severely compared with other bioprostheses, but in our small study we found no evidence of a detrimental clinical effect of this phenomenon. Future studies have to confirm our findings and investigate a cause for this phenomenon.
    MeSH term(s) Aged ; Aged, 80 and over ; Aortic Valve/surgery ; Female ; Heart Valve Prosthesis/adverse effects ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/instrumentation ; Humans ; Male ; Platelet Count ; Postoperative Complications/epidemiology ; Retrospective Studies ; Thrombocytopenia/epidemiology ; Thrombocytopenia/etiology
    Language English
    Publishing date 2019-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2019.07.046
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  10. Article ; Online: Improving the quality conduct and efficiency of clinical trials with training: Recommendations for preparedness and qualification of investigators and delegates.

    Bechtel, Jimmy / Chuck, Tina / Forrest, Annemarie / Hildebrand, Christine / Panhuis, Janette / Pattee, Suzanne R / Comic-Savic, Sabrina / Swezey, Teresa

    Contemporary clinical trials

    2019  Volume 89, Page(s) 105918

    Abstract: The Clinical Trials Transformation Initiative (CTTI) Investigator Qualification Project addresses the need for a more efficient and effective means of identifying qualified clinical investigators and delegates. Selection of investigators and delegates ... ...

    Abstract The Clinical Trials Transformation Initiative (CTTI) Investigator Qualification Project addresses the need for a more efficient and effective means of identifying qualified clinical investigators and delegates. Selection of investigators and delegates who are qualified by training and experience to conduct clinical trials is essential to safeguarding protections for study participants and ensuring data quality and integrity. Sponsors generally document investigator qualification through training on the principles of good clinical practice (GCP), as defined by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), adopted by regulatory authorities in the United States, Japan and the European Union. Although these GCP principles provide an important foundation for promoting the conduct of quality clinical trials, the industry standard "one-size-fits-all" GCP training may not fully prepare investigators and delegates for conducting quality clinical trials. Routine GCP training alone may not be sufficient to prepare an inexperienced member of a site team, while repeating such training is unlikely to enhance the qualifications of an experienced researcher. The CTTI project team used findings from qualitative research activities, as well as input from an expert meeting with multiple stakeholders, to identify gaps and redundancies in the current training of investigators and their delegates and recommend practical, action-based solutions. CTTI provides recommendations on how to implement a more efficient and effective means of preparedness and qualification of investigators and delegates, determining whether a site team is a good fit for a particular protocol, and improving the quality of clinical trial conduct.
    MeSH term(s) Biomedical Research/organization & administration ; Biomedical Research/standards ; Efficiency, Organizational ; Humans ; Qualitative Research ; Quality Improvement ; Research Design ; Research Personnel/education ; Research Personnel/organization & administration ; Research Personnel/standards
    Language English
    Publishing date 2019-12-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2182176-8
    ISSN 1559-2030 ; 1551-7144
    ISSN (online) 1559-2030
    ISSN 1551-7144
    DOI 10.1016/j.cct.2019.105918
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