Pallabi Sanyal

Bio: Pallabi Sanyal is an academic researcher. The author has contributed to research in topics: Cancer screening & Depression (differential diagnoses). The author has an hindex of 1, co-authored 1 publications receiving 87 citations.

Depressive symptom burden as a barrier to screening for breast and cervical cancers.

Abstract: Background: Depression has been associated with lower cancer screening rates in some studies. We examined whether a higher depressive symptom burden presented a barrier to subsequent mammography an...

Patient–Physician Connectedness and Quality of Primary Care

Abstract: Persistent deficiencies exist in the quality of health care in the United States (1– 4). Because primary care physicians are the first source of health care for most patients to receive preventive and chronic illness care, efforts to measure and improve quality of care have often focused on these physicians (5–7). In practice, however, many patients receive episodic care from different physicians (8 –12). Patients without a regular source of care are less likely to receive care consistent with guidelines (13–20). Continuity of care is a shared responsibility between physicians and patients. Even if physicians or practices treated all patients similarly, patients vary in their ability and willingness to adhere to recommendations. Performance measures originally designed for use in large populations are increasingly used to assess the quality of practices and individual physicians. One concern with this approach is that physicians who care for patients who are less willing or able to adhere to recommendations will seem to perform less well. To investigate this possibility, we developed the concept of physician–patient connectedness. We use the term connectedness to describe the closeness of the relationship between a patient and an individual physician on the basis of a model predicting how likely a physician is to identify a patient as “my patient.” We hypothesized that patients highly connected to a specific physician would be more likely to receive care consistent with guidelines, according to common performance measures. We further hypothesized that differences in connectedness may contribute to health care disparities to the extent that connectedness is correlated with race or ethnicity and insurance status. We investigated these hypotheses in a network of primary care physicians affiliated with a large teaching hospital. We used a previously developed and validated algorithm (21, 22) to determine the connectedness of more than 150 000 patients with a specific physician. The algorithm used the designated primary care physician field from the practice registration system along with patient age, time since most recent visit, and in-state residence. We then examined variation in the proportion of connected patients among practices and the association of connectedness with the performance of commonly used measures of health care quality.

Adherence to cervical cancer screening guidelines for U.S. women aged 25-64: data from the 2005 Health Information National Trends Survey (HINTS).

Abstract: Background: Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical cancer mortality, many women still do not maintain regular cervical cancer screenings. Objective: To describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force (USPSTF) cervical cancer screening guidelines among women in the United States. Methods: Data for women aged 25–64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample comprised 2070 women. Results: Ninety-eight percent of women reported ever having a Pap smear, 90% reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening guidelines. M...

The association between depression and anxiety and use of oral health services and tooth loss.

Abstract: Okoro CA, Strine TW, Eke PI, Dhingra SS, Balluz LS. The association between depression and anxiety and use of oral health services and tooth loss. Community Dent Oral Epidemiol 2012; 40: 134–144. © 2011 John Wiley & Sons A/S Abstract – Objective: The purpose of this study is to examine the associations among depression, anxiety, use of oral health services, and tooth loss. Methods: Data were analysed for 80 486 noninstitutionalized adults in 16 states who participated in the 2008 Behavioral Risk Factor Surveillance System. Binomial and multinomial logistic regression analyses were used to estimate predicted marginals, adjusted prevalence ratios, adjusted odds ratios (AOR) and their 95% confidence intervals (CI). Results: The unadjusted prevalence for use of oral health services in the past year was 73.1% [standard error (SE), 0.3%]. The unadjusted prevalence by level of tooth loss was 56.1% (SE, 0.4%) for no tooth loss, 29.6% (SE, 0.3%) for 1–5 missing teeth, 9.7% (SE, 0.2%) for 6–31 missing teeth and 4.6% (SE, 0.1%) for total tooth loss. Adults with current depression had a significantly higher prevalence of nonuse of oral health services in the past year than those without this disorder (P < 0.001), after adjustment for age, sex, race/ethnicity, education, marital status, employment status, adverse health behaviours, chronic conditions, body mass index, assistive technology use and perceived social support. In logistic regression analyses employing tooth loss as a dichotomous outcome (0 versus ≥1) and as a nominal outcome (0 versus 1–5, 6–31, or all), adults with depression and anxiety were more likely to have tooth loss. Adults with current depression, lifetime diagnosed depression and lifetime diagnosed anxiety were significantly more likely to have had at least one tooth removed than those without each of these disorders (P < 0.001 for all), after fully adjusting for evaluated confounders (including use of oral health services). The adjusted odds of being in the 1–5 teeth removed, 6–31 teeth removed, or all teeth removed categories versus 0 teeth removed category were increased for adults with current depression versus those without (AOR = 1.35; 95% CI = 1.14–1.59; AOR = 1.83; 95% CI = 1.51–2.22; and AOR = 1.44; 95% CI = 1.11–1.86, respectively). The adjusted odds of being in the 1–5 teeth removed and 6–31 teeth removed categories versus 0 teeth removed category were also increased for adults with lifetime diagnosed depression or anxiety versus those without each of these disorders. Conclusions: Use of oral health services and tooth loss was associated with depression and anxiety after controlling for multiple confounders.

Symptom burden: a concept analysis and implications for oncology nurses.

Abstract: Purpose/objectives To analyze the concept of symptom burden and discuss implications for symptom research and symptom management. Data sources MEDLINE, CINAHL, PsycINFO, Cochrane Reviews, and published literature. Data synthesis Through Rodgers's evolutionary method of concept analysis, attributes of symptom burden were identified as dynamic, multidimensional, quantifiable, subjective, and physiologic. The major antecedent was multiple symptoms related to worsening disease status. Consequences of symptom burden included decreased survival, poor prognosis, delay or termination of treatment, increased hospitalizations and medical costs, decreased functional status, and lowered self-reported quality of life. Symptom burden is defined as the subjective, quantifiable prevalence, frequency, and severity of symptoms placing a physiologic burden on patients and producing multiple negative, physical, and emotional patient responses. Conclusions Symptom burden is an important concept in the symptoms experience, separate from symptom distress and other related terms. The continued differentiation of symptom concepts is important for sound methodologic research and meaningful interventions that affect and improve patient experiences. Implications for nursing Clarifying multiple symptom concepts in the symptoms experience, determining appropriate measurement methodologies for the concepts, and identifying appropriate strategies will lessen the burden of symptoms and contribute to improved quality of life and better patient outcomes.