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Article ; Online: Breast Cancer Screening and Prevention.

Farkas, Amy H / Nattinger, Ann B

2023 Volume 176, Issue 11, Page(s) ITC161–ITC176

Abstract: Breast cancer is the most common cancer among U.S. women and its incidence increases with age. Endogenous estrogen exposure, proliferative benign breast disease, breast density, and family history may also indicate increased risk for breast cancer. Early ...

Abstract	Breast cancer is the most common cancer among U.S. women and its incidence increases with age. Endogenous estrogen exposure, proliferative benign breast disease, breast density, and family history may also indicate increased risk for breast cancer. Early detection with screening mammography reduces breast cancer mortality, but the net benefits vary by age. Assessing a patient's individual breast cancer risk can guide decisions regarding breast cancer screening. All women benefit from healthy behaviors which may reduce breast cancer risk. Some women at increased risk for breast cancer may benefit from risk-reducing medications. Use of screening measures remains suboptimal, especially for uninsured women.
MeSH term(s)	Female ; Humans ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/prevention & control ; Mammography/adverse effects ; Risk Factors ; Early Detection of Cancer/adverse effects ; Breast ; Mass Screening/adverse effects
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/AITC202311210
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Article ; Online: A Proposal by the U.S. Food and Drug Administration for Reliance on Single Institutional Review Boards: Proceed Only With Caution.

Spellecy, Ryan / Thompson, Nathan / Nattinger, Ann B

Annals of internal medicine

2024 Volume 177, Issue 3, Page(s) 383–384

MeSH term(s)	United States ; Humans ; Ethics Committees, Research ; United States Food and Drug Administration
Language	English
Publishing date	2024-02-13
Publishing country	United States
Document type	Editorial
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/M23-2152
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Article ; Online: Efficacy of a Digital Intervention to Increase Annual Wellness Visit Scheduling Amid COVID-19 Backlog.

Penlesky, Annie C / Dunn, Caitlin / Hanson, Ryan / Lodes, Mark / Nattinger, Ann B / Singh, Siddhartha

WMJ : official publication of the State Medical Society of Wisconsin

2024 Volume 122, Issue 5, Page(s) 346–348

Abstract: Background: The Medicare Annual Wellness Visit is a preventive visit that is largely underutilized, a problem further compounded by the COVID-19 pandemic.: Methods: We implemented a digital outreach intervention to improve Annual Wellness Visit ... ...

Abstract	Background: The Medicare Annual Wellness Visit is a preventive visit that is largely underutilized, a problem further compounded by the COVID-19 pandemic. Methods: We implemented a digital outreach intervention to improve Annual Wellness Visit scheduling in our health system. Using a bulk outreach functionality in the electronic medical record, we sent a message to patients due for an Annual Wellness Visit and analyzed the efficacy of this message on scheduling rates while also assessing its impact by race. Results: Patients who read the message were 40% more likely to schedule an Annual Wellness Visit (OR 1.42; 95% CI, 1.34 - 1.50) compared to those who did not read the message. Discussion: After this intervention, Annual Wellness Visit scheduling rates increased by 50% for White patients and 325% for Black patients versus prepandemic rates in 2019.
MeSH term(s)	Aged ; Humans ; COVID-19/epidemiology ; Electronic Health Records ; Medicare ; Pandemics ; United States ; Black or African American ; White ; Health Promotion ; Preventive Medicine ; Digital Health ; Reminder Systems
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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Article ; Online: Association Between COVID-19 and Delirium Development in the General Medical Units at an Academic Medical Center.

Dong, Yilu / Hanson, Ryan / Penlesky, Annie C / Nattinger, Ann B / Heinrich, Thomas W / Pezzin, Liliana E

WMJ : official publication of the State Medical Society of Wisconsin

2024 Volume 122, Issue 5, Page(s) 319–324

Abstract: Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association ... ...

Abstract	Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association between COVID-19 and delirium among hospitalized patients outside the intensive care unit (ICU). This study aimed to examine (1) the independent association between COVID-19 infection and the development of delirium among all non-ICU patients and (2) the risk factors associated with developing delirium among patients admitted with COVID-19, with a special focus on presenting symptoms. Methods: Using electronic health record (EHR) data of adults admitted to any general medical unit at a large academic medical center from July 2020 through February 2021, we used a cross-sectional multivariable logistic regression to estimate the associations, while adjusting for patients' sociodemographic, clinical characteristics, delirium-free length of stay, as well as time fixed effects. Results: Multivariable regression estimates applied to 20 509 patients hospitalized during the study period indicate that COVID-19-positive patients had 72% higher relative risk (odds ratio 1.72; 95% CI, 1.31 - 2.26; Conclusions: COVID-19 positivity was associated with higher odds of developing delirium among patients during their non-ICU hospitalization. These findings may be helpful in targeting the use of delirium prevention strategies among non-ICU patients.
MeSH term(s)	Adult ; Humans ; COVID-19/epidemiology ; Cross-Sectional Studies ; Inpatients ; Academic Medical Centers ; Delirium/epidemiology
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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Article ; Online: Letter to the Editor in Response to: Socioeconomic Status and COVID-19 Outcomes.

Rivera, Frida / Munoz-Price, L Silvia / Nattinger, Ann B

Journal of general internal medicine

2021 Volume 36, Issue 10, Page(s) 3238

MeSH term(s)	COVID-19 ; Humans ; SARS-CoV-2 ; Social Class ; Socioeconomic Factors
Language	English
Publishing date	2021-08-10
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-021-07058-z
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Article ; Online: Centralization of Initial Care and Improved Survival of Poor Patients With Breast Cancer.

Nattinger, Ann B / Bickell, Nina A / Schymura, Maria J / Laud, Purushottam / McGinley, Emily L / Fergestrom, Nicole / Pezzin, Liliana E

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2023 Volume 41, Issue 11, Page(s) 2067–2075

Abstract: Purpose: Poor women with breast cancer have worse survival than others, and are more likely to undergo surgery in low-volume facilities. We leveraged a natural experiment to study the effectiveness of a policy intervention undertaken by New York (NY) ... ...

Abstract	Purpose: Poor women with breast cancer have worse survival than others, and are more likely to undergo surgery in low-volume facilities. We leveraged a natural experiment to study the effectiveness of a policy intervention undertaken by New York (NY) state in 2009 that precluded payment for breast cancer surgery for NY Medicaid beneficiaries treated in facilities performing fewer than 30 breast cancer surgeries annually. Methods: We identified 37,822 women with stage I-III breast cancer during 2004-2008 or 2010-2013 and linked them to NY hospital discharge data. A multivariable difference-in-differences approach compared mortality of Medicaid insured patients with that of commercially or otherwise insured patients unaffected by the policy. Results: Women treated during the postpolicy years had slightly lower 5-year overall mortality than those treated prepolicy; the survival gain was significantly larger for Medicaid patients ( Conclusion: A statewide centralization policy discouraging initial care for breast cancer in low-volume facilities was associated with better survival for the Medicaid population targeted. Given these impressive results and those from prior research, other policymakers should consider adopting comparable policies to improve breast cancer outcomes.[Media: see text].
MeSH term(s)	United States ; Humans ; Female ; Breast Neoplasms ; Medicaid ; New York
Language	English
Publishing date	2023-01-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.22.02012
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Article ; Online: Breast Cancer Screening and Prevention.

Nattinger, Ann B / Mitchell, Julie L

Annals of internal medicine

2016 Volume 164, Issue 11, Page(s) ITC81–ITC96

Abstract: This issue provides a clinical overview of breast cancer screening and prevention, focusing on risk assessment, screening, prevention, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources ... ...

Abstract	This issue provides a clinical overview of breast cancer screening and prevention, focusing on risk assessment, screening, prevention, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.
MeSH term(s)	Age Factors ; Breast Neoplasms/diagnosis ; Breast Neoplasms/prevention & control ; Early Detection of Cancer/adverse effects ; False Positive Reactions ; Female ; Humans ; Mammography/adverse effects ; Mass Screening/adverse effects ; Medical Overuse ; Patient Education as Topic ; Risk Assessment ; Risk Factors ; United States
Language	English
Publishing date	2016-06-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/AITC201606070
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Article ; Online: Association of Inpatient Continuity of Care With Complications and Length of Stay Among Hospitalized Medicare Enrollees.

Goodwin, James S / Li, Shuang / Hommel, Erin / Nattinger, Ann B / Kuo, Yong-Fang / Raji, Mukaila

JAMA network open

2021 Volume 4, Issue 8, Page(s) e2120622

Abstract: Importance: Continuity in primary care is associated with improved outcomes, but less information is available on the association of continuity of care in the hospital with hospital complications.: Objective: To assess whether the number of ... ...

Abstract	Importance: Continuity in primary care is associated with improved outcomes, but less information is available on the association of continuity of care in the hospital with hospital complications. Objective: To assess whether the number of hospitalists providing care is associated with subsequent hospital complications and length of stay. Design, setting, and participants: This retrospective cohort study used multilevel logistic regression models to analyze Medicare claims for medical admissions from 2016 to 2018 with a length of stay longer than 4 days. Admissions with multiple charges on the same day from a hospitalist or an intensive care unit (ICU) stay during hospital days 1 to 3 were excluded. The data were accessed and analyzed from November 1, 2020, to April 30, 2021. Exposures: The number of different hospitalists who submitted charges during hospital days 1 to 3. Main outcomes and measures: Overall length of stay and transfer to ICU or a new diagnosis of drug toxic effects on hospital day 4 or later. Results: Among the 617 680 admissions, 362 376 (58.7%) were women, with a mean (SD) age of 80.2 (8.4) years. In 306 037 admissions (49.6%), the same hospitalist provided care on days 1 to 3, while 2 hospitalists provided care in 274 658 admissions (44.5%), and 3 hospitalists provided care in 36 985 admissions (6.0%). There was no significant association between the number of different hospitalists on days 1 to 3 and either length of stay or subsequent ICU transfers. Admissions seeing 2 or 3 hospitalists had a slightly greater adjusted odds of subsequent new diagnoses of drug toxic effects (2 hospitalists: odds ratio [OR], 1.04; 95% CI, 1.02-1.07; 3 hospitalists: OR, 1.07; 95% CI, 1.03-1.12). Conclusions and relevance: There was little evidence that receiving care from multiple hospitalists was associated with worse outcomes for patients receiving all their general medical care from hospitalists.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Continuity of Patient Care/economics ; Continuity of Patient Care/statistics & numerical data ; Female ; Humans ; Inpatients/statistics & numerical data ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Male ; Medicare/economics ; Medicare/statistics & numerical data ; Middle Aged ; Practice Patterns, Physicians'/economics ; Practice Patterns, Physicians'/statistics & numerical data ; Primary Health Care/economics ; Primary Health Care/statistics & numerical data ; Retrospective Studies ; Texas ; United States
Language	English
Publishing date	2021-08-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.20622
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Article ; Online: Guideline-concordant treatment predicts survival: a National Cancer Database validation study of novel composite locoregional and systemic treatment scores among women with early stage breast cancer.

Yen, Tina W F / Garacci, Zhuping / Laud, Purushottam W / Pezzin, Liliana E / Nattinger, Ann B

Breast cancer (Tokyo, Japan)

2021 Volume 28, Issue 3, Page(s) 698–709

Abstract: Background: The aim of this large nationwide study was to validate two novel composite treatment scores that address guideline-concordant locoregional and systemic breast cancer care. We examined the relationship between these two scores and their ... ...

Abstract	Background: The aim of this large nationwide study was to validate two novel composite treatment scores that address guideline-concordant locoregional and systemic breast cancer care. We examined the relationship between these two scores and their association with survival. Methods: Women with Stage I-III unilateral breast cancer were identified within the National Cancer Database. For each woman, a locoregional and a systemic treatment score (0, 1, 2) was assigned based on receipt of guideline-concordant care. Multivariable Cox regression models evaluated the association between the scores and survival. Results: 623,756 women were treated at 1,221 different American College of Surgeons Commission on Cancer (CoC) facilities. Overall, 86% had a locoregional treatment score of 2 (most guideline-concordant), 75% had a systemic treatment score of 2, and 72% had both scores of 2. Median follow-up was 4.5 years. Compared to women with a locoregional treatment score of 2, those with a score of 1 or 0 had a 1.7-fold and 2.0-fold adjusted greater risk of death. Compared to women with a systemic treatment score of 2, those with a score of 1 or 0 had a 1.5-fold and 2.1-fold adjusted greater risk of death. Risk-adjusted 5-year overall survival was 91.6% when both scores were 2 compared to 73.4% when both scores were 0. Conclusions: In this large national study of CoC facilities, two composite scores capturing guideline-concordant breast cancer care had independent and combined robust effects on survival. These clinically constructed novel scores are promising tools for health services research and quality-of-care studies.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Disease-Free Survival ; Female ; Guideline Adherence/standards ; Humans ; Middle Aged ; Outcome Assessment, Health Care/statistics & numerical data ; Proportional Hazards Models ; Registries ; Retrospective Studies
Language	English
Publishing date	2021-01-04
Publishing country	Japan
Document type	Journal Article ; Multicenter Study ; Validation Study
ZDB-ID	2052429-8
ISSN	1880-4233 ; 1340-6868
ISSN (online)	1880-4233
ISSN	1340-6868
DOI	10.1007/s12282-020-01206-9
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Zs.A 5536: Show issues

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Article ; Online: In the clinic. Breast cancer screening and prevention.

Nattinger, Ann B

Annals of internal medicine

2010 Volume 152, Issue 7, Page(s) ITC41

MeSH term(s)	Age Factors ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/prevention & control ; Cost-Benefit Analysis ; Estrogen Antagonists/therapeutic use ; Female ; Humans ; Mammography/economics ; Mass Screening/economics ; Mass Screening/methods ; Raloxifene Hydrochloride/therapeutic use ; Risk Factors ; Tamoxifen/therapeutic use ; Time Factors
Chemical Substances	Estrogen Antagonists ; Tamoxifen (094ZI81Y45) ; Raloxifene Hydrochloride (4F86W47BR6)
Language	English
Publishing date	2010-04-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-152-7-201004060-01004
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