Regenstrief Institute

About: Regenstrief Institute is a nonprofit organization based out in Indianapolis, Indiana, United States. It is known for research contribution in the topics: Health care & Population. The organization has 742 authors who have published 2042 publications receiving 96966 citations.

Hypertension and cognitive decline in rural elderly Chinese.

Abstract: Hypertension is a leading cause of cardiovascular disease, but results from longitudinal studies on hypertension and cognitive decline have been inconsistent. There is a consensus that midlife high blood pressure (BP) is associated with late-life low cognitive function.1,2 A comprehensive review of the relationship between BP, hypertension, and cognitive decline indicates that many large cohort studies report no association between late-life BP and cognitive decline or dementia.2 Among plausible explanations for this null effect is the possibly protective effects of antihypertensive medications taken by substantial number of individuals in the study samples. The relationship between late-life BP and cognitive decline deserves further examination because of the sharp increase of hypertension prevalence with increase in age. It has been reported that there is a 90% lifetime risk of developing hypertension for people who are not hypertensive at age 55.3 Because hypertension is a chronic disease that can be managed using medications, controlling hypertension may lead to potential prevention strategies for dementia and cognitive decline if the relationship between late-life BP and cognitive decline exists. Few of the published studies on hypertension and cognitive decline have included populations from developing countries, with the exception of one newly published clinical trial that included patients from China, Eastern Europe, and North Africa.4 The tripling of older persons living in developing countries from 249 million in 2000 to an estimated 690 million in 20305 and that many of these elderly persons do not have adequate access to medical diagnosis or treatment of chronic diseases underscores the projected significance of the relationship between late-life BP and cognitive decline. Given the increasing prevalence of hypertension with age and the paucity of research conducted in developing countries, it is of great public health interest to examine the relationship between hypertension and cognitive decline in these developing countries. This article reports findings from a prospective study in a rural elderly Chinese cohort.

Comparative Responsiveness and Minimally Important Difference of Common Anxiety Measures.

Abstract: Background:Anxiety is one of the most prevalent mental disorders and accounts for substantial disability as well as increased health care costs. This study examines the minimally important difference (MID) and responsiveness of 6 commonly used anxiety scales.Methods:The sample comprised 294 patients

Meta-analysis: Randomized Controlled Trials of 4-L Polyethylene Glycol and Sodium Phosphate Solution as Bowel Preparation for Colonoscopy

Abstract: Aliment Pharmacol Ther 2010; 32: 171–181 Summary Background Randomized controlled trials (RCTs) comparing polyethylene glycol (PEG) with sodium phosphate (NaP) are inconsistent. Aim To compare the efficacy of and tolerance to PEG vs. NaP for bowel preparation. Methods We used MEDLINE and EMBASE to identify English-language RCTs published between 1990 and 2008 comparing 4-L PEG with two 45 mL doses of NaP in adults undergoing elective colonoscopy. We calculated the pooled odds ratios (ORs) for preparation quality and proportion of subjects completing the preparation. Results From 18 trials (n = 2792), subjects receiving NaP were more likely to have an excellent or good quality preparation than those receiving PEG (82% vs. 77%; OR = 1.43; 95% CI, 1.01–2.00). Among a subgroup of 10 trials in which prep quality was reported in greater detail, there were no differences in the proportions of excellent, good, fair or poor preparation quality. Among nine trials that assessed preparation completion rates, patients receiving NaP were more likely to complete the preparation than patients receiving 4-L PEG (3.9% vs. 9.8% respectively did not complete the preparation; OR = 0.40; CI, 0.17–0.88). Conclusion Among 18 head-to-head RCTs of NaP vs. 4-L PEG, NaP was more likely to be completed and to result in an excellent or good quality preparation.

A successful model and visual design for creating context-aware drug-drug interaction alerts.

Abstract: Evaluating the potential harm of a drug-drug interaction (DDI) requires knowledge of a patient’s relevant co-morbidities and risk factors Current DDI alerts lack such patient-specific contextual data In this paper, we present an efficient model for integrating pertinent patient data into DDI alerts This framework is designed to be interoperable across multiple drug knowledge bases and clinical information systems To evaluate the model, we generated a set of contextual DDI data using our local drug knowledge base then conducted an evaluation study of a prototype contextual alert design The alert received favorable ratings from study subjects, who agreed it was an improvement over traditional alerts and was likely to support clinical management and save physician time This framework may ultimately help reduce alert fatigue through the dynamic display of DDI alerts based on patient risk

The SPADE Symptom Cluster in Primary Care Patients With Chronic Pain.

Abstract: Objectives Sleep disturbance, pain, anxiety, depression, and low energy/fatigue, the SPADE pentad, are the most prevalent and co-occurring symptoms in the general population and clinical practice. Co-occurrence of SPADE symptoms may produce additive impairment and negatively affect treatment response, potentially undermining patients' health and functioning. The purpose of this paper is to determine: (1) prevalence and comorbidity (ie, clustering) of SPADE symptoms; (2) internal reliability and construct validity of a composite SPADE symptom score derived from the Patient-Reported Outcomes Measurement Information System (PROMIS) measures; and (3) whether improvement in somatic symptom burden represented by a composite score predicted subsequent measures of functional status at 3 and 12 months follow-up. Methods Secondary analysis of data from the Stepped Care to Optimize Pain care Effectiveness study, a randomized trial of a collaborative care intervention for Veterans with chronic pain. Results Most patients had multiple SPADE symptoms; only 9.6% of patients were monosymptomatic. The composite PROMIS symptom score had good internal reliability (Cronbach's alpha=0.86) and construct validity and strongly correlated with multiple measures of functional status; improvement in the composite score significantly correlated with higher scores for 5 of 6 functional status outcomes. The standardized error of measurement (SEM) for the composite T-score was 2.84, suggesting a 3-point difference in an individual's composite score may be clinically meaningful. Discussion Brief PROMIS measures may be useful in evaluating SPADE symptoms and overall symptom burden. Because symptom burden may predict functional status outcomes, better identification and management of comorbid symptoms may be warranted.