Papers by Sarah Ratcliffe
American Journal of Obstetrics and Gynecology, Oct 1, 2006
Bookmarks Related papers MentionsView impact
Informa Healthcare eBooks, May 1, 2010
Bookmarks Related papers MentionsView impact
American Journal of Obstetrics and Gynecology, Apr 1, 2005
Bookmarks Related papers MentionsView impact
JAMA Network Open
ImportanceAttrition in cancer clinical trials (CCTs) can lead to systematic bias, underpowered an... more ImportanceAttrition in cancer clinical trials (CCTs) can lead to systematic bias, underpowered analyses, and a loss of scientific knowledge to improve treatments. Little attention has focused on retention, especially the role of perceived benefits and burdens, after participants have experienced the trial.ObjectivesTo examine the association between patients’ perceived benefits and burdens of research participation and CCT retention.Design, Setting, and ParticipantsThis survey study was conducted at a National Cancer Institute–designated comprehensive cancer center in the Northeast region of the US. The sample included adult patients with a cancer diagnosis participating in cancer therapeutic trials. Data were collected from September 2015 to June 2019. Analysis of study data was ongoing since November 2019 through October 2022.ExposuresSelf-reported validated survey instrument with a list of 22 benefits and 23 burdens of research participation that can be rated by patients with a 5...
Bookmarks Related papers MentionsView impact
Objective To define pregnancy episodes and estimate gestational aging within electronic health re... more Objective To define pregnancy episodes and estimate gestational aging within electronic health record (EHR) data from the National COVID Cohort Collaborative (N3C). Materials and Methods We developed a comprehensive approach, named Hierarchy and rule-based pregnancy episode Inference integrated with Pregnancy Progression Signatures (HIPPS) and applied it to EHR data in the N3C from 1 January 2018 to 7 April 2022. HIPPS combines: 1) an extension of a previously published pregnancy episode algorithm, 2) a novel algorithm to detect gestational aging-specific signatures of a progressing pregnancy for further episode support, and 3) pregnancy start date inference. Clinicians performed validation of HIPPS on a subset of episodes. We then generated three types of pregnancy cohorts based on the level of precision for gestational aging and pregnancy outcomes for comparison of COVID-19 and other characteristics. Results We identified 628,165 pregnant persons with 816,471 pregnancy episodes, o...
Bookmarks Related papers MentionsView impact
AMIA ... Annual Symposium proceedings. AMIA Symposium, 2017
Objective: Build and validate a clinical decision support (CDS) algorithm for discharge decisions... more Objective: Build and validate a clinical decision support (CDS) algorithm for discharge decisions regarding referral for post-acute care (PAC) and to what site of care. Materials and Methods: Case studies derived from EHR data were judged by 171 interdisciplinary experts and prediction models were generated. Results: A two-step algorithm emerged with area under the curve (AUC) in validation of 91.5% (yes/no refer) and AUC 89.7% (where to refer). Discussion: CDS for discharge planning (DP) decisions may remove subjectivity, and variation in decision-making. CDS could automate the assessment process and alert clinicians of high need patients earlier in the hospital stay. Conclusion: Our team successfully built and validated a two-step algorithm to support discharge referral decision-making from EHR data. Getting patients the care and support they need may decrease readmissions and other adverse events. Further work is underway to test the effects of the CDS on patient outcomes in two ...
Bookmarks Related papers MentionsView impact
PLOS ONE, 2021
Background Telemedicine has been rapidly adopted in the wake of the COVID-19 pandemic. There is l... more Background Telemedicine has been rapidly adopted in the wake of the COVID-19 pandemic. There is limited work surrounding demographic and socioeconomic disparities that may exist in telemedicine utilization. This study aimed to examine demographic and socioeconomic differences in surgical patient telemedicine usage during the COVID-19 pandemic. Methods Department of Surgery outpatients seen from July 1, 2019 to May 31, 2020 were stratified into three visit groups: pre-COVID-19 in-person, COVID-19 in-person, or COVID-19 telemedicine. Generalized linear models were used to examine associations of sex, race/ethnicity, Distressed Communities Index (DCI) scores, MyChart activation, and insurance status with telemedicine usage during the COVID-19 pandemic. Results 14,792 patients (median age 60, female [57.0%], non-Hispanic White [76.4%]) contributed to 21,980 visits. Compared to visits before the pandemic, telemedicine visits during COVID-19 were more likely to be with patients from the l...
Bookmarks Related papers MentionsView impact
RationaleBreathing motion (respiratory kinematics) can be characterized by the interval and depth... more RationaleBreathing motion (respiratory kinematics) can be characterized by the interval and depth of each breath, and by magnitude-synchrony relationships between locations. Such characteristics and their breath-by-breath variability might be useful indicators of respiratory health.ObjectivesTo enable breath-by-breath characterization of respiratory kinematics, we developed a method to detect breaths using motion sensor signals.MethodsIn 34 volunteers who underwent maximal exercise testing, we used 8 motion sensors to record upper rib, lower rib and abdominal kinematics at 3 exercise stages (rest, lactate threshold and exhaustion). We recorded volumetric air flow signals using clinical exercise laboratory equipment and synchronized them with kinematic signals. Using instantaneous phase landmarks from the analytic representation of kinematic and flow signals, we identified individual breaths and derived respiratory rate signals at 1Hz. To evaluate the fidelity of kinematics-derived r...
Bookmarks Related papers MentionsView impact
JAMA Network Open, 2021
Bookmarks Related papers MentionsView impact
Frontiers in Pediatrics, 2019
Bookmarks Related papers MentionsView impact
Immune dysregulation is characteristic of the more severe stages of SARS-CoV-2 infection. Underst... more Immune dysregulation is characteristic of the more severe stages of SARS-CoV-2 infection. Understanding the mechanisms by which the immune system contributes to COVID-19 severity may open new avenues to treatment. Here we report that elevated interleukin-13 (IL-13) was associated with the need for mechanical ventilation in two independent patient cohorts. In addition, patients who acquired COVID-19 while prescribed Dupilumab had less severe disease. In SARS-CoV-2 infected mice, IL-13 neutralization reduced death and disease severity without affecting viral load, demonstrating an immunopathogenic role for this cytokine. Following anti-IL-13 treatment in infected mice, in the lung, hyaluronan synthase 1 (Has1) was the most downregulated gene and hyaluronan accumulation was decreased. Blockade of the hyaluronan receptor, CD44, reduced mortality in infected mice, supporting the importance of hyaluronan as a pathogenic mediator, and indicating a new role for IL-13 in lung disease. Unders...
Bookmarks Related papers MentionsView impact
Medical Decision Making, 2020
Background. Patients may find clinical prediction models more useful if those models accounted fo... more Background. Patients may find clinical prediction models more useful if those models accounted for preferences for false-positive and false-negative predictive errors and for other model characteristics. Methods. We conducted a discrete choice experiment to compare preferences for characteristics of a hypothetical mortality prediction model among community-dwelling patients with chronic lung disease recruited from 3 clinics in Philadelphia. This design was chosen to allow us to quantify “exchange rates” between different characteristics of a prediction model. We provided previously validated educational modules to explain model attributes of sensitivity, specificity, confidence intervals (CI), and time horizons. Patients reported their interest in using prediction models themselves or having their physicians use them. Patients then chose between 2 hypothetical prediction models each containing varying levels of the 4 attributes across 12 tasks. Results. We completed interviews with ...
Bookmarks Related papers MentionsView impact
JAMA Pediatrics, 2020
Bookmarks Related papers MentionsView impact
Innovation in Aging, 2019
Falls disproportionately burden frail older adults in long-term care, which is evidenced by the 6... more Falls disproportionately burden frail older adults in long-term care, which is evidenced by the 60% fall rate annually in this setting. Our health systems improvement model, framed by the Health Outcomes Model for falls prevention, is targeted to achieve the triple aim of better health, better care, and better value. Highlighting evidence from three inter-related studies, this presentation describes the impact of a practice change model and its impact on patient, unit/staff, and organizational level factors as related to facility-wide falls prevention. In study one, we used an evidenced-based practice approach and assessment tool to achieve total and recurrent falls reduction over one year by 32% and 25%, respectively (p<0.001). In study two, the annual savings of using this approach was assessed and showed a total savings of $53,531.00, which equates to $700.00 per falling person. In pilot study three, a convenience sample of 15 older adults who were interviewed about their fall...
Bookmarks Related papers MentionsView impact
Pacing and Clinical Electrophysiology, 2018
Bookmarks Related papers MentionsView impact
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2019
BackgroundInfants with congenital diaphragmatic hernia (CDH) often experience hypoxaemia with aci... more BackgroundInfants with congenital diaphragmatic hernia (CDH) often experience hypoxaemia with acidosis immediately after birth. The traditional approach in the delivery room is immediate cord clamping followed by intubation. Initiating resuscitation prior to umbilical cord clamping (UCC) may support this transition.ObjectivesTo establish the safety and feasibility of intubation and ventilation prior to UCC for infants with CDH. To compare short-term outcomes between trial participants and matched controls treated with immediate cord clamping before intubation and ventilation.DesignSingle-arm, single-site trial of infants with CDH and gestational age ≥36 weeks. Infants were placed on a trolley immediately after birth and underwent intubation and ventilation, with UCC performed after qualitative CO2 detection. The primary feasibility endpoint was successful intubation prior to UCC. Prespecified safety and physiological outcomes were compared with historical controls matched for progno...
Bookmarks Related papers MentionsView impact
Journal of Empirical Research on Human Research Ethics, 2018
We developed measures of benefits and burdens of research participation in cancer clinical trials... more We developed measures of benefits and burdens of research participation in cancer clinical trials using a sequential mixed methods design with a qualitative ( n = 32) and quantitative sample ( n = 110) of cancer clinical trial participants. Benefit–burden items (22 for benefits, 23 for burdens) were subsequently developed and assessed through cognitive interviewing for content, clarity, and meaning. Preliminary psychometric analyses support the internal consistency reliability and construct validity of Benefit (α = .90) and Burden (α = .87) research participation scales. Item response theory models supported the discrimination ability of the items on the scales. Participants who had thoughts of dropping out had lower Benefit scale scores ( p < .001) and higher Burden scores ( p < .001) than those who had no thoughts of dropping out, supporting construct validity. With further psychometric testing, the scale can be used to develop appropriate interventions to address recruitmen...
Bookmarks Related papers MentionsView impact
Innovation in Aging, 2018
Bookmarks Related papers MentionsView impact
Journal of the American Medical Directors Association, 2018
Bookmarks Related papers MentionsView impact
Innovation in Aging, 2017
Bookmarks Related papers MentionsView impact
Uploads
Papers by Sarah Ratcliffe