Faculty Bibliography

BACKGROUND/UNASSIGNED:Concerns over scientific reproducibility have grown in recent years, leading the National Institutes of Health (NIH) to require researchers to address these issues in research grant applications. Starting in 2020, training grants were required to provide a plan for educating trainees in rigor and reproducibility. Academic medical centers have responded with different solutions to fill this educational need. As experienced instructors with expertise in topics relating to reproducibility, librarians can play a prominent role in providing trainings, classes, and events to educate investigators and trainees, and bolstering reproducibility in their communities. CASE PRESENTATIONS/UNASSIGNED:This special report summarizes efforts at five institutions to provide education in reproducibility to biomedical and life sciences researchers. Our goal is to expand awareness of the range of approaches in providing reproducibility services in libraries. CONCLUSIONS/UNASSIGNED:Reproducibility education by medical librarians can take many forms. These specific programs in reproducibility education build upon libraries' existing collaborations, with funder mandates providing a major impetus. Collaborator needs shaped the exact type of educational or other reproducibility support and combined with each library's strengths to yield a diversity of offerings based on capacity and interest. As demand for and complexity of reproducibility education increases due to new institutional and funder mandates, reproducibility education will merit special attention.

BACKGROUND/UNASSIGNED:Ethical decision-making regarding data collection, visualization and communication is of growing importance to librarians. Data ethics training opportunities for librarians, however, are uncommon. To fill this gap, librarians at an academic medical center developed a pilot data ethics curriculum for librarians across the US and Canada. CASE PRESENTATION/UNASSIGNED:Three data librarians in a health sciences library developed a pilot curriculum to address perceived gaps in librarian training for data ethics. One of the team members had additional academic training in bioethics, which helped to provide an intellectual foundation for this project. The three-module class provided students with an overview of ethical frameworks, skills to apply those frameworks to data issues, and an exploration of data ethics challenges in libraries. Participants from library schools and professional organizations were invited to apply. Twenty-four participants attended the Zoom-based classes and shared feedback through surveys taken after each session and in a focus group after the course's conclusion. DISCUSSION/UNASSIGNED:Responses to the focus group and surveys indicated a high level of student engagement and interest in data ethics. Students also expressed a desire for more time and ways to apply what was learned to their own work. Specifically, participants indicated an interest in dedicating time for networking with other members of their cohort, as well as more extensive discussion of class topics. Several students also suggested creating concrete outputs of their thoughts (e.g., a reflective paper or final project). Finally, student responses expressed a strong interest in mapping ethical frameworks directly to challenges and issues librarians face in the workplace.

Background/UNASSIGNED:Over four years of hosting library data workshops, we conducted post-workshop evaluation of attendees' satisfaction with the workshops but not longer-term follow-up. To best allocate library resources and most effectively serve the needs of our users, we sought to determine whether our data workshops were impactful and useful to our community. This paper describes a pilot project to evaluate the impact of data workshops at our academic health sciences library. Case Presentation/UNASSIGNED:We surveyed individuals who signed up for data workshops between 2016 and 2019. Surveys included open-ended and multiple-choice questions, with the goal of having participants describe their motivations for taking the workshop(s) and how they ultimately used what they learned. An analysis of responses using the Applied Thematic Analysis model indicated that the workshops had an impact on the respondents, although the strength of our conclusions is limited by a relatively low response rate. Conclusions/UNASSIGNED:Survey results indicated that our workshops impacted how researchers at our medical center collect and analyze data, supporting the conclusion that we should concentrate our educational efforts on providing skills-based workshops. The low response rate and time-consuming nature of the analysis point toward several improvements for future evaluation efforts, including better tracking of workshop attendees, a shorter survey with fewer open-ended questions, and survey implementation within one year of the workshop date.

BACKGROUND: COVID-19 has overwhelmed hospitals at various stages of the pandemic, leading to intense focus on availability of inpatient resources and less attention to primary care contributions. There is clear evidence that medical comorbidities, social determinants of health, and individual behaviors such as mask-wearing affect COVID-19 outcomes. By managing medical comorbidities and modifying social behaviors, it is plausible that primary care physicians (PCPs) improve COVID-19 outcomes. Socioeconomic status (SES) and environment likely affect the number of PCPs and their effectiveness in a community. Notwithstanding these factors, we hypothesize that PCPs contribute to healthier communities and that this will correlate with decreased COVID-19 cases and mortality.
METHOD(S): We used three surrogate measures of PCP effectiveness: PCP rate (#PCPs/population), flu vaccination rate, and number of preventable hospital stays. We merged county-level data from USA Facts, the New York Times masking survey, the Robert Wood Johnson Foundation County Health Data, and the Health Resources & Services Administration. We ran multiple linear regression models to measure the contributed variance in COVID-19 cases or deaths of the measures of PCP effectiveness after adjusting for age, race, economic, and environmental factors. A second model also measured the effect of PCP rates on mask adherence adjusted for the same confounders. Data were merged and analyzed using SPSS v.25.
RESULT(S): Data were available from 2957 of 3143 county equivalents. There were an average of 55 PCPs per 100,000 population. By December 27, 2020 there were 18,750,038 COVID-19 cases and 325,507 deaths nationally. In multiple linear regression models, PCP rate (beta=-0.07), flu vaccination rate (beta=-0.067), and preventable hospital stays (beta=0.136) were all significant (p<=0.001) contributors to the variance seen in COVID-19 cases after adjusting for confounding variables. Similarly, PCP rate (beta=-0.056, p=0.003), flu vaccination rate (beta=-0.006, p=0.001), and preventable hospital stays (beta=0.166, p<0.001) were significant contributors to the variance seen in COVID-19 deaths. PCP rate was also found to be a significant contributor to variance in mask adherence (beta=0.078, p<0.001).
CONCLUSION(S): All measures of PCP effectiveness were significantly correlated with lower COVID-19 cases and deaths and higher self-reported mask adherence even after accounting for SES and environmental factors. The pandemic has exposed an American healthcare system that is detrimentally more reactive than preventative. Our study demonstrates the modest-but significant- success of prevention efforts by PCPs. We hope it will serve to increase resource allocation and attention toward the primary care sector of the healthcare workforce. LEARNING OBJECTIVE #1: Identify how increasing resource allocation to primary care may improve systems-based practice. LEARNING OBJECTIVE #2: Recognize the role that primary care physicians may play in improving COVID-19 outcomes

BACKGROUND: Over 43.5 million American adults identify as informal or unpaid caregivers, and represent an essential part of U.S. healthcare infrastructure for disabled or chronically ill persons. "Caregiver burden" is a well-understood phenomenon, with caregivers at increased risk of social isolation and subsequent mental and physical health consequences. Yet little is known about specific mediators of the burdens of caregiving. This study uses data from the 2018 Health Information National Trends Survey (HINTS) to examine health outcomes of informal caregivers in the US as mediated by intensity of caregiving experiences and level of available social support.
METHOD(S): This cross-sectional study examines the relationships between intensity of caregiving (low versus high) and health outcomes (diagnoses of anxiety, depression, diabetes or hypertension; measures of self-care, health) in a nationally representative sample. Chi square, t-test, linear and logistic regression analyses compared informal caregivers to the general population, and low versus high intensity caregivers. Multivariate modeling among informal caregivers explored effects of social support on these relationships. (SPSS v.25).
RESULT(S): Of 3,504 respondents, 12.3% self-identified as unpaid caregivers. They were more likely to have anxiety/depression diagnoses and poor self-care/health ratings, versus the general population. Among the general population, factors significantly associated with poor self-health rating included being a highintensity caregiver, low education level, and low income. Having emotional/structural support was associated with better self-rated health and self-care, and lower likelihood of an anxiety/depression diagnosis. Among informal caregivers, structural support was associated with better self-care scores and high-intensity caregiving was associated with poorer self-rated health status.
CONCLUSION(S): Our findings demonstrate an overall difference in health outcomes between informal caregivers and the general population, an effect that appears to be modified by intensity of caregiving and presence of social supports. Given our results, we hope physicians will consider screening known caregivers for intensity of caregiving and existing social support systems

Background/UNASSIGNED:Data visualization is a growing topic of discussion and area of educational programming in health sciences libraries. This paper synthesizes information on eight institutions' experiences in offering Excel-focused data visualization workshops with the goal of providing an overview of the current state of educational offerings in this area. Methods/UNASSIGNED:Semi-structured interviews were conducted by phone and email with librarians at institutions that offer Excel-focused workshops, which were identified by reviewing the websites of Association of Academic Health Sciences Libraries members and the 2019 Medical Library Association annual meeting program. Results/UNASSIGNED:Librarians from six institutions were interviewed, online class materials from one institution were reviewed, and information from the author's institution was included, resulting in a total of eight institutions. Educational offerings in Excel-focused data visualization ranged from one workshop to five workshops in a series, which typically first presented information for beginners and then progressed to more advanced data visualization skills. Regarding motivations for offering these workshops, librarians stated that they were committed to providing instruction in software programs that were already familiar to users. Workshop evaluations, when available, were generally positive. Discussion/UNASSIGNED:Because of its widespread availability and usage, Excel offers a compelling opportunity for providing hands-on data visualization instruction in health sciences libraries.

OBJECTIVE:To systematically review the literature on genomic tests for prostate cancer (PCa) and evaluate the current state of the evidence on their use in patients with newly diagnosed PCa. METHODS:We conducted a systematic review by searching PubMed, Embase, Cochrane Central, and conference abstracts from the American Urological Association published between 2010 and 2018. Studies evaluating Prolaris, Oncotype Dx, and Decipher assays were assessed for inclusion by two authors. Studies were excluded if the results were derived from surgical specimens rather than biopsy specimens. Meta-analysis was not performed owing to significant variations in methodologies, definitions and outcome measures. RESULTS:A total of 729 articles were retrieved in our initial search. After removing duplicates (270) and excluding articles deemed not relevant (432), 21 full-text articles were deemed suitable for inclusion in our analysis. The full-text articles comprised 8 studies on Prolaris, 8 studies on Oncotype Dx, and 5 studies on Decipher. For each genomic test we extracted data regarding the risk of adverse pathology, biochemical recurrence, metastasis, and prostate cancer mortality. CONCLUSION/CONCLUSIONS:The results of genomic tests that use biomarkers derived from prostate biopsy can be used in conjunction with clinicopathologic variables to improve our ability to risk stratify patients with newly diagnosed prostate cancer. Additional data are needed on the impact of using these tests on long-term patient outcomes and their cost-effectiveness. This article is protected by copyright. All rights reserved.

Background: Self-efficacy to manage chronic conditions affects patients' health-related behaviors and interactions with the healthcare system and therefore influences health outcomes. Few studies have explored the complex relationships between mental health, self-efficacy, and management of chronic disease. A greater understanding of these interactions could inform successful community programming for marginalized populations such as public housing residents. Harlem Health Advocacy Partners is a community health worker (CHW) program designed to close health and social outcomes gaps in residents living in New York City Housing Authority (NYCHA). This study uses survey data collected for this initiative to explore the relationship between mental health and self-efficacy to manage chronic conditions among NYCHA residents with asthma, diabetes, and/or hypertension, and assess whether key variables such as connectedness to health care, social isolation and general health influence this relationship.
Method(s): Five NYCHA housing developments were selected for the CHW intervention with five matched developments for comparison. Four-hundred adult residents with a chronic disease were recruited. Baseline intake interviews were conducted in person. Self-efficacy for managing chronic disease was measured with a 6-question scale. Depression was assessed using PHQ9 scores, a screen for the presence and severity of depression. Difficulty with mental health was assessed with questions on how difficult mental health problems made it to do work, take care of things at home, or get along with others. Bivariate analyses were conducted to assess the relationship between mental health and self-efficacy. A hierarchical linear regression model was run with mental health and other relevant variables (selected based on availability in the dataset and theoretical significance) as independent variables and self-efficacy as the outcome variable.
Result(s): Self-rated general health predicted the greatest amount of variance in self-efficacy (15.7%, p < 0.001). Mental health also contributed significantly; difficulty with mental health contributed 4.0% (p< 0.001) and depressive symptoms contributed 1.1% (p=0.03) to the variance in self-efficacy. Other variables, including demographics, type of insurance, connectedness to a primary care provider, and social isolation, were not associated with self-efficacy. Overall, the full model explained 22.5% of the variance in self-efficacy to manage chronic conditions.
Conclusion(s): NYCHA residents with mental health difficulty or depression represent a uniquely marginalized subpopulation of public housing residents, and were found to have lower self-efficacy than other residents, which may mean decreased ability to self-manage chronic medical conditions. Future research should explore relationships among mental health, self-management, and health care outcomes with the goal of augmenting targeted CHW interventions

OBJECTIVE:The purpose of this study is to determine the most accurate imaging techniques to measure glenoid bone loss in anterior glenohumeral instability through a systematic review of existing literature. MATERIALS AND METHODS/METHODS:We performed a comprehensive literature search of five databases for original research measuring glenoid bone loss at radiography, CT, or MRI, using prospective or retrospective cohort, case-control, or cadaveric study designs up to January 2018. The Quality Assessment of Diagnostic Accuracy Studies-2 tool aided qualitative assessment of the methods. Data extraction included results, index test interobserver agreement, and accuracy analysis. RESULTS:Twenty-seven studies (evaluating 1425 shoulders) met inclusion criteria after full-text review by two independent readers. Glenoid bone loss was assessed, comparing several index tests to nonimaging (n = 18 studies) and imaging (n = 11) reference standards. Compared with arthroscopic or cadaveric measurements, 2D CT was accurate in six of seven studies (86%), 3D CT was accurate in eight of 10 studies (80%), 2D MRI was accurate in five of seven studies (71%), 3D MRI was accurate in four of four studies (100%), and radiographs were accurate in zero of four studies (0%). Best-fit circle methods (glenoid width or Pico surface area) were the most common and both were accurate (86-90% and 75-100%, respectively) using CT and MRI. Studies had good external validity (78%). Most risk for bias arose from patient selection and reference standards. Only two studies reported sensitivity and specificity, both comparing CT to arthroscopy using different bone loss thresholds (20% and 25%). CONCLUSION/CONCLUSIONS:CT and MRI (2D or 3D) accurately measure glenoid bone loss in anterior shoulder instability, but radiographs do not. Best-fit circle measurement techniques are reliable and accurate. Current literature about glenoid bone loss is heterogeneous, and future studies should focus on diagnosis of clinically relevant glenoid bone loss.

Background/UNASSIGNED:The authors' main university library and affiliated academic medical center library sought to increase library programming around data visualization, a new service area for both libraries. Additionally, our institution is home to many researchers with a strong interest in data visualization but who are generally working in isolation of one another. Case Presentation/UNASSIGNED:This case study describes an innovative workshop, the "Data Visualization Clinic," where members of our library's community bring in data visualization projects such as figures in papers, projects hosted online, and handouts and receive constructive feedback from a group of peers. The authors detail the process of hosting a clinic and the feedback that we received from participants. Conclusions/UNASSIGNED:The "Data Visualization Clinic" offers a viable workshop to leverage expertise of library users and build the library's reputation as a hub of data visualization services without heavy investment in infrastructure like special monitors or coding skills. That said, it faces the challenge of relying on the participation of the broader community, which is often pressed for time. The event can also serve as an opportunity for researchers who have an interest in data visualization to meet and network.