Colleen McCormick

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States

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Publications (7)19.77 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Clinical and healthcare decision makers have repeatedly endorsed patient-centered care as a goal of the health system. However, traditional methods of evaluation reinforce societal views, and research focusing on views of patients is often referred to as 'soft science.' Conjoint analysis presents a scientifically rigorous research tool that can be used to understand patient preferences and inform decision making. This paper documents applications of conjoint analysis in medicine and systematically reviews this literature in order to identify publication trends and the range of topics to which conjoint analysis has been applied. In addition, we document important methodological aspects such as sample size, experimental design, and method of analysis.Publications were identified through a MEDLINE search using multiple search terms for identification. We classified each article into one of three categories: clinical applications (n = 122); methodological contributions (n = 56); and health system applications (n = 47). Articles that did not use or adequately discuss conjoint analysis methods (n = 164) were discarded. We identified a near exponential increase in the application of conjoint analyses over the last 10 years of the study period (1997-2007). Over this period, the proportion of applications on clinical topics increased from 40% of articles published in MEDLINE from 1998 to 2002, to 64% of articles published from 2003 to 2007 (p = 0.002).The average sample size among articles focusing on health system applications (n = 556) was significantly higher than clinical applications (n = 277) [p = 0.001], although this 2-fold difference was primarily due to a number of outliers reporting sample sizes in the thousands. The vast majority of papers claimed to use orthogonal factorial designs, although over a quarter of papers did not report their design properties. In terms of types of analysis, logistic regression was favored among clinical applications (28%), while probit was most commonly used among health systems applications (38%). However, 25% of clinical applications and 33% of health systems articles failed to report what regression methods were used. We used the International Classification of Diseases - version 9 (ICD-9) coding system to categorize clinical applications, with approximately 26% of publications focusing on neoplasm. Program planning and evaluation applications accounted for 22% of the health system articles.While interest in conjoint analysis in health is likely to continue, better guidelines for conducting and reporting conjoint analyses are needed.
    The patient 12/2008; 1(4):273-82. DOI:10.2165/01312067-200801040-00009 · 1.90 Impact Factor

  • The patient 10/2008; 1(4):273-282. DOI:10.2165/1312067-200801040-00009 · 1.90 Impact Factor
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    ABSTRACT: To update the state of evidence on the efficacy of metformin, used either alone or in combination with clomiphene citrate in women with polycystic ovary syndrome, by examining three outcomes: ovulation, pregnancy, and live birth. Sources of heterogeneity among the published randomized controlled trials are systematically assessed. An electronic literature search was performed using MEDLINE, EMBASE, SCOPUS, CENTRAL, Cochrane, and U.S. Food and Drug Administration databases, restricted to studies conducted on humans and published in English. Of the 406 potentially relevant articles identified, 17 met criteria for inclusion in the meta-analysis, rendering a total sample of 1,639 women. Study quality was examined in terms of randomization scheme, masking process, adequacy of allocation concealment, statistical power, and loss to follow-up; publication bias was also assessed. Meta-analytic procedures were used to compare metformin with placebo, and metformin plus clomiphene with clomiphene alone, for all study outcomes. Exploratory analyses were conducted to assess differences in treatment effects between clomiphene-resistant and nonresistant patients, obese and nonobese patients, and trials with long and short durations of follow-up. Metformin improved the odds of ovulation in women with polycystic ovary syndrome when compared with placebo (odds ratio [OR] 2.94; 95% confidence interval [CI] 1.43-6.02; number-needed-to-treat 4.0) and appears more effective for non-clomiphene-resistant women. Metformin and clomiphene increased the likelihood of ovulation (OR 4.39; 95% CI 1.94-9.96; number-needed-to-treat 3.7) and pregnancy (OR 2.67; 95% CI 1.45-4.94; number-needed-to-treat 4.6) when compared with clomiphene alone, especially in clomiphene-resistant and obese women with polycystic ovary syndrome. These treatment effects were greater for trials with shorter follow-up. Using all available evidence, this meta-analysis suggests that metformin increases the likelihood of ovulation and, in combination with clomiphene, increases the odds of both ovulation and pregnancy in women with polycystic ovary syndrome.
    Obstetrics and Gynecology 05/2008; 111(4):959-68. DOI:10.1097/AOG.0b013e31816a4ed4 · 5.18 Impact Factor
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    ET Kinter · JF Bridges · C McCormick · L Kidane ·

    Value in Health 05/2008; 11(3). DOI:10.1016/S1098-3015(10)70569-6 · 3.28 Impact Factor
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    ABSTRACT: Recognition of an ovarian tumor as a metastasis from an undiagnosed primary gastrointestinal tract carcinoma can be difficult when specific symptoms referable to the primary tumor are lacking and the tumor simulates a primary ovarian neoplasm grossly and microscopically. Ovarian metastases of colorectal adenocarcinomas, in particular, continue to pose diagnostic challenges both clinically and pathologically. Clinicopathologic features of 20 cases of ovarian metastases from undiagnosed colorectal adenocarcinomas (U-CRAs) were compared with those of 22 cases having metastases from known colorectal adenocarcinomas (K-CRAs). Women with ovarian metastases from U-CRAs were significantly younger (mean age, 48 years; median, 47 years) than those with ovarian metastases from K-CRAs (mean, 61 years; median, 63 years) (P = 0.002), presented with clinical findings related to the ovarian metastases, often had elevated CA-125 levels, and lacked specific symptoms due to the colorectal carcinomas, which were diagnosed only at the time of intraoperative evaluation of the ovarian tumors. Mean/median ovarian tumor sizes (12.8/13.0 cm for U-CRAs; 14.1/15.8 cm for K-CRAs) and frequencies of bilaterality (45% for U-CRAs and 36% for K-CRAs) were not significantly different for the 2 groups; frequencies of clinically unilateral tumors of more than 10 cm were similar in both groups (30% for U-CRAs and 45% for KCRAs). Other features more commonly observed in ovarian metastases from U-CRAs included mucinous differentiation, extracellular mucin production, and some degree of cytokeratin 7 expression; endometrioid-like differentiation was more common in metastases from K-CRA, but a garland pattern of necrosis and the presence of a confluent glandular, rather than infiltrative, pattern of invasion were similarly common in both groups. In cases having ovarian metastases from U-CRA, the younger age of the women, uniform presentation as pelvic masses without symptoms referable to the bowel, elevated CA-125 levels, occasional presentation as a large clinically unilateral tumor, frequent mucinous differentiation, and frequent coexpression of cytokeratin 7 are features that can contribute to misclassification of these metastases as primary ovarian neoplasms.
    International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists 05/2008; 27(2):182-90. DOI:10.1097/PGP.0b013e31815b9752 · 1.67 Impact Factor
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    ABSTRACT: We sought to further elucidate the survival impact of cytoreductive surgery among patients with colon cancer metastatic to the ovary. All women diagnosed with primary colon cancer metastatic to the ovary at a single institution from 1980 to 2005 were retrospectively identified. Survival analyses and comparisons were performed using Kaplan-Meier plots and the log rank test. A total of 39 patients with 40 cases of colon cancer metastatic to the ovary were identified. Patients with metastatic disease confined to the ovaries (n=11) had a median overall survival (OS) time of 61 months (range 15-120) compared to 17 months (range 0.5-73) for those with more extensive metastases (n=24) (p=0.0428). Patients undergoing optimal cytoreduction (residual < or =1 cm) had a median progression-free survival (PFS) of 11 months (range 0.5-120, n=26) compared to 2.5 months (range 0.5-12, n=9) for those receiving suboptimal cytoreduction (p=0.0001). Optimal cytoreduction was also associated with a significantly longer median OS (35 months, range 0.5-120) compared to suboptimal cytoreduction (median OS=7 months, range=0.5-17) (p<0.0001). The peri-operative mortality rate was 5%. Significant morbidity occurred in 10% of the cases. All major complications occurred in women with diffuse disease who underwent extensive cytoreductive surgery. The observation that optimal cytoreduction was associated with prolonged PFS and OS in both patients with localized ovarian and widespread metastases of colon cancer suggests a role for surgical management of metastatic colon cancer in women.
    Gynecologic Oncology 06/2007; 105(3):791-5. DOI:10.1016/j.ygyno.2007.02.025 · 3.77 Impact Factor
  • Colleen C McCormick · Hyun S Kim ·
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    ABSTRACT: Uterine arteriovenous malformation (AVM) causes significant morbidity with vaginal bleeding. Traditional therapy is a hysterectomy with no potential for future pregnancy. We present a case of successful superselective embolization of uterine AVM using n-butyl cyanoacrylate with subsequent normal term pregnancy and uncomplicated vaginal delivery in 1 year.
    CardioVascular and Interventional Radiology 08/2006; 29(4):699-701. DOI:10.1007/s00270-005-0202-1 · 2.07 Impact Factor

Publication Stats

196 Citations
19.77 Total Impact Points


  • 2008
    • Johns Hopkins Bloomberg School of Public Health
      Baltimore, Maryland, United States
  • 2007-2008
    • Johns Hopkins Medicine
      • Department of Gynecology & Obstetrics
      Baltimore, Maryland, United States
  • 2006-2008
    • Johns Hopkins University
      • Department of Gynecology & Obstetrics
      Baltimore, Maryland, United States