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Quality improvement of a community-engaged authorship system: lessons learned from the RECOVER initiative

Esquenazi-Karonika, Shari; Mathews, Patenne D; Wood, Marion J; Mudumbi, Praveen M; Linton, Janelle; Briscoe, Jasmine; Seibert, Elle; Coombs, K; Laynor, Gregory; Katz, Stuart D; Chung, Alicia
BACKGROUND:Inclusion of patients, caregivers, and community members in scientific research should be essential for patient-centered care. Patients’ lived experiences can propose new areas of focus that may not have previously been considered, ensure that potentially sensitive topics are addressed thoughtfully, contribute to the interpretation of findings, and identify future directions of research. Further, their inclusion in the drafting of manuscripts can ensure that research findings are translatable to real-world practice. To achieve this goal, the Researching COVID to Enhance Recovery (RECOVER) consortium developed a Representative Authorship system for development of scientific manuscripts that report RECOVER data. This paper describes a Quality Improvement (QI) project that was conducted to identify system strengths and improvement opportunities. METHODS:An online QI survey was distributed to RECOVER’s Representative Authors about a year into the implementation of the Representative Authorship System. The survey focused on several key aspects, including the clarity regarding the authorship process, training opportunities, the matching process, communication within writing groups, and the perceived impact of the representative engagement on the quality and applicability of research. The survey also explored participants’ satisfaction with compensation, support, and involvement in the system, as well as areas for improvement. RESULTS:The survey was sent to 49 representative authors with 17 respondents (35%). Most respondents reported positive experiences, highlighting the effective matching to manuscripts based on their expertise and the perceived positive impact of their involvement on research outcomes. Additionally, participants felt that including diverse voices enhanced the relevance of research for clinical practice. Several areas for improvement were identified, including communication challenges within writing groups, the utility of manuscript orientation calls, and the fairness of compensation. Respondents also indicated a need for more training opportunities and logistical support. CONCLUSIONS:RECOVER’s Representative Authorship system is effective in fostering collaboration and improving the inclusivity of scientific research. The survey findings indicate that there are logistical changes around communication, training, and compensation that could enhance the experience for all collaborators. Based on these findings, we plan to implement changes to improve awareness, understanding, and collaboration. Additional work is needed to solicit feedback from investigators and administrative staff to obtain a more holistic understanding of the system. SUPPLEMENTARY INFORMATION:The online version contains supplementary material available at 10.1186/s12913-025-12914-3.
PMCID:12225380
PMID: 40611083
ISSN: 1472-6963
CID: 5888422

A Scoping Review on the Development, Implementation, and Evaluation of Nurse Well-Being Initiatives in Academic Health Systems

Withall, Jennifer; Laynor, Gregory; Anglin, Carlita; M Millon, Emma; Bass, Benjamin; Alendy, Fariza; DeMarco, Kathleen; Zavotsky, Kathleen Evanovich
BACKGROUND:Nursing well-being is foundational to the specialties workforce and broader healthcare industry worldwide. Despite frequent reports and descriptions of activities that support nurses' well-being, most reports describe singular activities and programs that lack science-based structures contextualized within academic healthcare systems (AHS) with validated impact. AIMS/OBJECTIVE:To evaluate and synthesize the existing national and international literature on nurse well-being initiatives offered in AHS. METHODS:Over 18 months, an 8-member interprofessional team conducted a scoping review adhering to PRISMA-ScR reporting guidelines. Five databases were searched, and results were screened in a multistep process by researcher pairs. Discrepancies were resolved by a third team member's review. Citations were reviewed uniquely three times to ensure methodological rigor. A final set of 54 articles was extracted for key data elements pertinent to the research question describing setting, population, study design, intervention, and other subsidiary fields. Reviewers additionally analyzed publication quality indicators and trends for additional implications for research and practice. RESULTS:Among the 54 eligible articles, 72% were research and 28% were evidence-based practice, quality improvement, or doctoral dissertations. The concepts studied were psychosocial (e.g., resiliency) and physical (e.g., sleep). The number of instruments used per study ranged from 1 to 11. Thirty percent of studies utilized a framework from various disciplines that included nursing, social and behavioral sciences, and safety science principles. Nurses were included as authors 67% of the time, and 35% received funding from either the public or private sector.
PMID: 40572021
ISSN: 1741-6787
CID: 5874842

Barriers to telehealth uptake and use: a scoping review

Kemp, Mackenzie; Rising, Kristin L; Laynor, Gregory; Miao, Jessica; Worster, Brooke; Chang, Anna Marie; Monick, Andrew J; Guth, Amanda; Esteves Camacho, Tracy; McIntosh, Kiana; Amadio, Grace; Shughart, Lindsey; Hsiao, TingAnn; Leader, Amy E
OBJECTIVES/UNASSIGNED:We conducted a scoping review to identify barriers to telehealth use and uptake from the perspective of patient, provider, and system that were documented in the literature. In addition to identifying and categorizing the barriers, we aimed to assess how barriers differed for studies conducted during the COVID-19 pandemic, as well as how barriers differed between the United States vs internationally based studies. MATERIALS AND METHODS/UNASSIGNED:Comprehensive searches of the PubMed/MEDLINE, CINAHL, and Scopus databases conducted on December 29, 2021 yielded 17 887 results, with 11 221 potentially eligible documents after duplicates were removed. The team conducted an initial title and abstract review, followed by full text review. Data from the included sources were extracted and summarized into primary themes. RESULTS/UNASSIGNED:We identified 395 articles specifically related to barriers of telehealth use. The top 5 barriers, in order of frequency, were: lack of skills or ability (55%), lack of interest (49%), lack of access to technology (45%), limitations of technology infrastructure (45%), and lack of quality of care (42%). Roughly one-third (39%) of studies were related to the COVID-19 pandemic and 54% were US-based studies. The rank order of barriers between COVID-19 vs non-COVID-19 studies and US vs non-US studies was the same; however, patients in the United States and those using telehealth during COVID-19 were more likely to cite barriers related to the lack of access to technology (COVID = 56% vs 38%; United States = 51% vs 38%). DISCUSSION/UNASSIGNED:Interventions to address barriers need to consider the unique needs of specific populations and the ways in which different barriers may intersect. CONCLUSION/UNASSIGNED:This review found that barriers to telehealth uptake and use are multilayered and occur at several levels (individual, structural, technological).
PMCID:11921419
PMID: 40109500
ISSN: 2574-2531
CID: 5813512

Suicide and Self-Harm Events With GLP-1 Receptor Agonists in Adults With Diabetes or Obesity: A Systematic Review and Meta-Analysis

Ebrahimi, Pouya; Batlle, Juan Carlos; Ayati, Aryan; Maqsood, M Haisum; Long, Clarine; Tarabanis, Constantine; McGowan, Natalie; Liebers, David T; Laynor, Gregory; Hosseini, Kaveh; Heffron, Sean P
IMPORTANCE/UNASSIGNED:Bariatric surgery, once the criterion standard in obesity treatment, has a small but concerning association with increased suicidality. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), originally developed to treat diabetes, now provide substantial efficacy in the treatment of obesity. However, concerns of risk of suicidality with these medicines have been raised. OBJECTIVE/UNASSIGNED:To evaluate the risk of suicidality and self-harm in randomized, placebo-controlled trials of GLP-1 RAs in adults with diabetes or obesity. DATA SOURCES/UNASSIGNED:MEDLINE, Embase, ClinicalTrials.gov, and Cochrane databases were systematically searched from inception to August 29, 2023. STUDY SELECTION/UNASSIGNED:Reports of randomized clinical trials (RCTs) lasting 6 or more months comparing GLP-1 RAs with placebo for the treatment of diabetes or obesity published in peer-reviewed journals were identified. Two independent reviewers screened all search-identified studies for inclusion. Records of outcomes were queried from primary papers, ClinicalTrials.gov entries, and corresponding authors. DATA EXTRACTION AND SYNTHESIS/UNASSIGNED:Two independent researchers abstracted data and assessed data quality and validity using PRISMA guidelines. Data were pooled using random-effects models. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Pooled incidence of completed or attempted suicide, occurrences of suicidal ideation, or self-harm. RESULTS/UNASSIGNED:A total of 27 of 144 RCTs meeting inclusion criteria systematically recorded suicide and/or self-harm-related events and included 32 357 individuals receiving GLP-1 RAs and 27 046 treated with placebo, over 74 740 and 68 095 person-years of follow-up, respectively. Event incidence was very low in the GLP-1 RA (0.044 per 100 person-years) and placebo (0.040 per 100 person-years) groups, with no statistically significant difference (rate ratio [RR], 0.76; 95% CI, 0.48-1.21; P = .24). Subgroup analyses did not suggest differences in outcomes based on diabetes status or GLP-1 RA used. Five studies were considered at risk of bias due to the loss of more than 5% of participants to follow-up. Otherwise, studies were not found to be heterogeneous nor at high risk of bias. CONCLUSIONS AND RELEVANCE/UNASSIGNED:There is unlikely to be an increase in the very low incidence of suicide-related adverse events among individuals receiving GLP-1 RAs within the context of RCTs. While these findings may further ease concerns about these adverse effects, continued monitoring is warranted to identify particular patients who may be at risk as extended use of GLP-1 RAs expands.
PMCID:11923776
PMID: 40105856
ISSN: 2168-6238
CID: 5813382

Addressing the immigrant screening gap: A protocol for a systematic review on interventions to enhance colorectal cancer screening among immigrants in the United States

McCready, Taylor M; Cohen, Ethan M; Laynor, Gregory; Chebli, Perla; Liang, Peter S; Renson, Audrey
INTRODUCTION/BACKGROUND:Colorectal cancer (CRC) screening rates are lower among immigrant populations in the United States (US) than the general population. Immigrant communities face structural barriers that disincentivize their engagement from CRC screening. A growing body of literature has evaluated the effects of interventions aimed at increasing CRC screening engagement among various immigrant groups, but there has not yet been a systematic synthesis of this literature. OBJECTIVE:This review will systematically evaluate quantitative studies assessing the effects of interventions designed to increase CRC screening rates among immigrant populations residing in the US. METHODS:We will conduct a comprehensive search of English language peer-reviewed and grey literature using specific keywords and database-specific structured vocabulary on interventions to improve CRC screening rates among immigrants published in 7 databases (PubMed, Cochrane Library (Wiley), CINAHL (EBSCO), ClinicalTrials.gov, Embase (Ovid), Scopus (Elsevier), and Web of Science) from January 1, 2000 to December 31, 2024. All studies will be imported into Covidence. Two reviewers will independently screen titles, abstracts, and full-texts for inclusion and exclusion criteria. Pilot screenings and consensus discussions will ensure accuracy and agreement in study selection and data extraction. Iterative data extraction of eligible studies will include critical appraisal using the Risk of Bias 2 (ROB2) for randomized controlled trials, while other study designs will be appraised with the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool. Data synthesis will disaggregate pooled effect estimates by ethnicity, to the extent possible. The study protocol was pre-registered in International Prospective Register of Systematic reviews (PROSPERO): CRD42023488183. EXPECTED OUTPUTS/UNASSIGNED:This systematic review aims to generate an exhaustive summary of the evidence base, including a description of the intervention methods and settings, target populations, recruitment and retention strategies, partnerships and collaborations, and reported outcomes. The results will provide actionable recommendations for public health practitioners, healthcare providers, and policymakers developing tailored interventions and policies aimed at improving CRC screening uptake among diverse immigrant populations in the US.
PMCID:12040244
PMID: 40299980
ISSN: 1932-6203
CID: 5833582

From Questions to Answers: Teaching Evidence-Based Medicine Question Formulation and Literature Searching Skills to First-Year Medical Students

Magro, Juliana; Plovnick, Caitlin; Laynor, Gregory; Nicholson, Joey
INTRODUCTION/UNASSIGNED:Medical students may arrive at medical school with some research background but not necessarily evidence-based medicine (EBM) skills. First-year preclinical medical students require foundational skills for EBM (formulating background and foreground questions, navigating information sources, and conducting database searches) before critically appraising evidence and applying it to clinical scenarios. METHODS/UNASSIGNED:We developed a flipped classroom EBM workshop for preclinical students combining prework modules and a 60-minute in-person session. After completing the online modules on foundational EBM skills, students participated in an in-person activity based on patient cases. In small groups, students formulated background and foreground questions based on a case and looked for evidence in resources assigned to each group. Small groups reported back to the whole group how they searched for information for their patient cases. A total of 105 first-year medical students were required to complete this workshop after concluding their basic sciences courses. RESULTS/UNASSIGNED:= .002). DISCUSSION/UNASSIGNED:This flipped classroom approach to teaching foundational EBM skills may be adapted for different contexts, but educators should consider time limitations, group size, and tools for interactivity.
PMCID:11832641
PMID: 39968292
ISSN: 2374-8265
CID: 5841032

The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review

O'Mara, Matthew A; Emanuel, Peter G; Tabibzadeh, Aaron; Duve, Robert J; Galati, Jonathan S; Laynor, Gregory; Gross, Samantha; Gross, Seth A
GOALS/OBJECTIVE:The goal of this clinical review is to provide an overview of the current literature regarding the utility of prophylactic clips in reducing postpolypectomy bleeding and to provide an expert statement regarding their appropriateness in clinical practice. BACKGROUND:Colonoscopy enables the identification and removal of premalignant and malignant lesions through polypectomy, yet complications including postpolypectomy bleeding (PPB) can arise. While various studies have explored applying clips prophylactically to prevent PPB, their effectiveness remains uncertain. STUDY/METHODS:A literature search conducted in PubMed and Embase identified 671 publications discussing clip use postpolypectomy; 67 were found to be relevant after screening, reporting outcomes related to PPB. Data related to clip utilization, polyp characteristics, and adverse events were extracted and discussed. RESULTS:The current literature suggests that prophylactic clipping is most beneficial for nonpedunculated polyps ≥20 mm, especially those in the proximal colon. The utility of clipping smaller polyps and those in the distal colon remains less clear. Antithrombotic medication usage, particularly anticoagulants, has been linked to an increased risk of bleeding, prompting consideration for clip placement in this patient subgroup. While cost-effectiveness analyses may indicate potential savings, the decision to clip should be tailored to individual patient factors and polyp characteristics. CONCLUSIONS:Current research suggests that the application of prophylactic clips can be particularly beneficial in preventing delayed bleeding after removal of large nonpedunculated polyps, especially for those in the proximal colon and in patients on antithrombotic medications. In addition, for large pedunculated polyps prophylactic clipping is most effective at controlling immediate bleeding.
PMID: 39008609
ISSN: 1539-2031
CID: 5699282

What Comes Next for Large Language Models in Medicine?

Laynor, Gregory
There has been a surge of interest in large language models (LLMs) since ChatGPT"™s public debut in 2022. The implementation of LLMs in medicine raises questions about the reliability of LLM-generated content. Next steps for LLMs in medicine include more research to establish validity, regulation to ensure safety, and integration of information retrieval techniques to improve accuracy.
SCOPUS:85187135244
ISSN: 1542-4065
CID: 5693752

Nutrition and diet in the general U.S. Asian American population: A scoping review protocol

Chan, Sze Wan; Laynor, Gregory; Ali, Shahmir H; Yi, Stella S
INTRODUCTION/BACKGROUND:Asian American populations face unique structural/social inequities contributing to poor diet quality and health disparities. The current body of literature on diet and food consumption of Asian Americans mainly focuses on the health of Filipino and East Asian Americans, or those with pre-existing non-communicable diseases. OBJECTIVE:The aim of this review is to comprehensively compile all available literature on nutrition and dietary consumption among the general population in Asian American ethnic subgroups, highlight any disparities and research gaps, and suggest further research action. METHODS:With guidance from a research librarian, we enumerated and searched key terms related to diet, food, nutrition, and Asian Americans in PubMed/MEDLINE, Food Science Collection (CABI Digital Library), CINAHL (EBSCO), Scopus, Food Science and Technology Abstracts (Web of Science), and Biological & Agricultural Index Plus (EBSCO) in accordance with PRISMA-S guidelines. An article will be included if it was published in the English language; is a peer-reviewed research manuscript or published in grey literature from 2000 to present; and describes what food groups and macronutrients healthy non-institutionalized Asian Americans in the U.S. are eating. An article will be excluded if it contains only research conducted outside of the U.S.; combines Asian Americans with Native Hawaiian and Pacific Islanders; and had no explicit focus on Asian American nutrition and dietary consumption. Two or more reviewers will participate in the study screening and selection process. We will record article characteristics, diet outcomes, and recommendations from final included articles using a data extraction table and prepare a summary narrative with key findings. EXPECTED OUTPUTS/UNASSIGNED:Results will be disseminated through a peer-reviewed manuscript. The findings from this review can have broad implications for designing and implementing nutrition-focused initiatives that will appropriately reflect and address the needs as well as norms and values of each distinct Asian American ethnic subgroup.
PMCID:11343400
PMID: 39178198
ISSN: 1932-6203
CID: 5681172

Enhancing the quality and efficiency of regulatory science literature reviews through innovation and collaboration with library and information science experts

Stevens, Elizabeth R; Laynor, Gregory
PMCID:11251899
PMID: 39021816
ISSN: 2296-858x
CID: 5731942