Donna B Jeffe

Barnes Jewish Hospital, San Luis, Missouri, United States

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Publications (163)595.09 Total impact

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    ABSTRACT: To develop evidence-based treatment guidelines for Chiari malformation type 1 (CM-1), preoperative prognostic indices capable of stratifying patients for comparative trials are needed. To develop a preoperative Chiari Severity Index (CSI) integrating the clinical and neuroimaging features most predictive of long-term patient-defined improvement in quality of life (QOL) after CM-1 surgery. We recorded preoperative clinical (eg, headaches, myelopathic symptoms) and neuroimaging (eg, syrinx size, tonsillar descent) characteristics. Brief follow-up surveys were administered to assess overall patient-defined improvement in QOL. We used sequential sequestration to develop clinical and neuroimaging grading systems and conjunctive consolidation to integrate these indices to form the CSI. We evaluated statistical significance using the Cochran-Armitage test and discrimination using the C statistic. Our sample included 158 patients. Sequential sequestration identified headache characteristics and myelopathic symptoms as the most impactful clinical parameters, producing a clinical grading system with improvement rates ranging from 81% (grade 1) to 58% (grade 3) (P = .01). Based on sequential sequestration, the neuroimaging grading system included only the presence (55% improvement) or absence (74% improvement) of a syrinx ≥6 mm (P = .049). Integrating the clinical and neuroimaging indices, improvement rates for the CSI ranged from 83% (grade 1) to 45% (grade 3) (P = .002). The combined CSI had moderately better discrimination (c = 0.66) than the clinical (c = 0.62) or neuroimaging (c = 0.58) systems alone. Integrating clinical and neuroimaging characteristics, the CSI is a novel tool that predicts patient-defined improvement after CM-1 surgery. The CSI may aid preoperative counseling and stratify patients in comparative effectiveness trials. CM-1, Chiari malformation type 1CSI, Chiari Severity IndexQOL, quality of life.
    Neurosurgery 01/2015; DOI:10.1227/NEU.0000000000000608 · 3.03 Impact Factor
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    ABSTRACT: ABSTRACT This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in our Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, we measured grief change from 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD-viewers with DVD-non-viewers and controls. DVD-viewers reported higher grief at 3-month interviews compared with DVD-non-viewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care.
    Death Studies 12/2014; 39(4). DOI:10.1080/07481187.2014.946628 · 0.92 Impact Factor
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    ABSTRACT: The purpose of this study is to examine the associations of neighborhood socioeconomic deprivation and triple-negative breast cancer (TNBC) subtype with causes of death [breast cancer (BC)-specific and non-BC-specific] among non-metastatic invasive BC patients. We identified 3,312 patients younger than 75 years (mean age 53.5 years; 621 [18.8 %] TNBC) with first primary BC treated at an academic medical center from 1999 to 2010. We constructed a census-tract-level socioeconomic deprivation index using the 2000 U.S. Census data and performed a multilevel competing-risk analysis to estimate the hazard ratios (HR) and 95 % confidence intervals (CI) of BC-specific and non-BC-specific mortality associated with neighborhood socioeconomic deprivation and TNBC subtype. The adjusted models controlled for patient sociodemographics, health behaviors, tumor characteristics, comorbidity, and cancer treatment. With a median 62-month follow-up, 349 (10.5 %) patients died; 233 died from BC. In the multivariate models, neighborhood socioeconomic deprivation was independently associated with non-BC-specific mortality (the most- vs. the least-deprived quartile: HR = 2.98, 95 % CI = 1.33-6.66); in contrast, its association with BC-specific mortality was explained by the aforementioned patient-level covariates, particularly sociodemographic factors (HR = 1.15, 95 % CI = 0.71-1.87). TNBC subtype was independently associated with non-BC-specific mortality (HR = 2.15; 95 % CI = 1.20-3.84), while the association between TNBC and BC-specific mortality approached significance (HR = 1.42; 95 % CI = 0.99-2.03, P = 0.057). Non-metastatic invasive BC patients who lived in more socioeconomically deprived neighborhoods were more likely to die as a result of causes other than BC compared with those living in the least socioeconomically deprived neighborhoods. TNBC was associated with non-BC-specific mortality but not BC-specific mortality.
    Breast Cancer Research and Treatment 09/2014; 147(3). DOI:10.1007/s10549-014-3135-z · 4.20 Impact Factor
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    ABSTRACT: To develop a prognostic model to predict 30-day mortality following colorectal cancer (CRC) surgery using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data and to assess whether race/ethnicity, neighborhood, and hospital characteristics influence model performance. We included patients aged 66 years and older from the linked 2000-2005 SEER-Medicare database. Outcome included 30-day mortality, both in-hospital and following discharge. Potential prognostic factors included tumor, treatment, sociodemographic, hospital, and neighborhood characteristics (census-tract-poverty rate). We performed a multilevel logistic regression analysis to account for nesting of CRC patients within hospitals. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) for discrimination and the Hosmer-Lemeshow goodness-of-fit test for calibration. In a model that included all prognostic factors, important predictors of 30-day mortality included age at diagnosis, cancer stage, and mode of presentation. Race/ethnicity, census-tract-poverty rate, and hospital characteristics were independently associated with 30-day mortality, but they did not influence model performance. Our SEER-Medicare model achieved moderate discrimination (AUC = 0.76), despite suboptimal calibration. We developed a prognostic model that included tumor, treatment, sociodemographic, hospital, and neighborhood predictors. Race/ethnicity, neighborhood, and hospital characteristics did not improve model performance compared with previously developed models.
    Cancer Causes and Control 08/2014; 25(11). DOI:10.1007/s10552-014-0451-x · 2.96 Impact Factor
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    ABSTRACT: Up to 14% of children with epilepsy continue to experience seizures despite having appropriate medical therapy and develop medically refractory epilepsy (MRE) [8] and [9]. Assessing clinical outcomes and therapeutic efficacy in children with MRE undergoing palliative epilepsy surgery has been challenging because of the lack of a quantitative instrument capable of estimating the clinical status of these patients. The ideal instrument would at once consider seizure control, neurodevelopment, caregiver burden, and quality of life. The purpose of this study was to develop and pilot the Pediatric Refractory Epilepsy Questionnaire (PREQ), a quantitative instrument to assess the severity and individual burden of epilepsy in children with MRE undergoing palliative epilepsy treatments.
    Epilepsy & Behavior 08/2014; 37:26–31. DOI:10.1016/j.yebeh.2014.04.025 · 2.06 Impact Factor
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    ABSTRACT: Purpose MD-PhD scientists are a successful, but small and fairly homogenous group of biomedical researchers. The authors conducted a retrospective cohort study to identify predictors of MD-PhD program enrollment to inform evidence-based strategies to increase the size and diversity of the biomedical research workforce. Method Using deidentified data from all 2001-2006 Pre-Medical College Admission Test Questionnaire (PMQ) respondents, they developed multivariate logistic regression models to identify demographic, experiential, and attitudinal variables associated with MD-PhD program enrollment at matriculation compared with all other MD program enrollment at matriculation and with not enrolling in medical school by August 2012. Results Of 207,436 PMQ respondents with complete data for all variables of interest, 2,575 (1.2%) were MD-PhD program enrollees, 80,856 (39.0%) were other MD program enrollees, and 124,005 (59.8%) were non-medicalschool matriculants. Respondents who were black (versus white), were high school and college laboratory research apprenticeship participants, and highly endorsed the importance of research/finding cures as reasons to study medicine were more likely to be MD-PhD program enrollees, whereas respondents who highly endorsed the status of medicine as a reason to study medicine were less likely to be MD-PhD program enrollees than either other MD program enrollees or non-medical-school matriculants. Conclusions MD-PhD program directors succeed in enrolling students whose attitudes and interests align with MD-PhD program goals. Continued efforts are needed to promote MD-PhD workforce diversity and the value of high school and college research apprenticeships for students considering careers as physician-scientists.
    Academic medicine: journal of the Association of American Medical Colleges 07/2014; 89(10). DOI:10.1097/ACM.0000000000000400 · 3.47 Impact Factor
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    ABSTRACT: Although computerized decision support for imaging is often recommended for optimizing computed tomography (CT) use, no studies have evaluated emergency physicians' (EPs') preferences regarding computerized decision support in the emergency department (ED). In this needs assessment, the authors sought to determine if EPs view overutilization as a problem, if they want decision support, and if so, the kinds of support they prefer.
    Academic Emergency Medicine 07/2014; 21(7):768-777. DOI:10.1111/acem.12410 · 2.20 Impact Factor
  • Donna B Jeffe, Dorothy A Andriole
    Academic medicine: journal of the Association of American Medical Colleges 07/2014; 89(7):959. DOI:10.1097/ACM.0000000000000304 · 3.47 Impact Factor
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    ABSTRACT: The purpose of this study was to describe hospital and geographic variation in 30-day risk of surgical complications and death among colorectal cancer (CRC) patients and the extent to which patient-, hospital-, and census-tract-level characteristics increased risk of these outcomes. We included patients at least 66 years old with first primary stage I-III CRC from the 2000-2005 National Cancer Institute's Surveillance, Epidemiology, and End Results data linked with 1999-2005 Medicare claims. A multilevel, cross-classified logistic model was used to account for nesting of patients within hospitals and within residential census tracts. Outcomes were risk of complications and death after a complication within 30 days of surgery. Data were analyzed for 35,946 patients undergoing surgery at 1,222 hospitals and residing in 12,187 census tracts; 27.2 % of patients developed complications, and of these 13.4 % died. Risk-adjusted variability in complications across hospitals and census tracts was similar. Variability in mortality was larger than variability in complications, across hospitals and across census tracts. Specific characteristics increased risk of complications (e.g., census-tract-poverty rate, emergency surgery, and being African-American). No hospital characteristics increased complication risk. Specific characteristics increased risk of death (e.g. census-tract-poverty rate, being diagnosed with colon (versus rectal) cancer, and emergency surgery), while hospitals with at least 500 beds showed reduced death risk. Large, unexplained variations exist in mortality after surgical complications in CRC across hospitals and geographic areas. The potential exists for quality improvement efforts targeted at the hospital and/or census-tract levels to prevent complications and augment hospitals' ability to reduce mortality risk.
    Annals of Surgical Oncology 04/2014; 21(8). DOI:10.1245/s10434-013-3472-x · 3.94 Impact Factor
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    ABSTRACT: Comanagement of surgical patients has increased, but information regarding detailed characteristics of patients receiving comanagement during hospitalization for colorectal cancer (CRC) surgery is lacking. To examine the use of and characteristics associated with comanagement of patients hospitalized for CRC surgery. This study used a population-based cross-sectional design. We used the linked 2000 to 2005 Surveillance, Epidemiology, and End Results and Medicare claims data. We included 37,065 patients aged 66 years or older, hospitalized for definitive CRC surgery following stage I to III diagnosis. The outcome of interest was comanagement during hospitalization for CRC surgery, and we examined the association between several patient and hospital characteristics. Comanagement was defined as having a relevant physician (ie, internal medicine hospitalist/generalist) submit a claim for evaluation and management services on 70% or more of the days of hospitalization of the patient. During hospitalization for CRC surgery, 27.6% of patients were comanaged, but this percentage varied widely across hospitals (from 1.9% to 83.2%). Several patient and hospital characteristics were associated with the use of comanaged care, of which important characteristics included older age at diagnosis, presence of comorbidity, emergency surgery, and hospital volume. Extensive variability existed in comanagement use across patients and hospitals, likely reflecting the lack of evidence for its clinical effectiveness. Journal of Hospital Medicine 2014. © 2014 Society of Hospital Medicine.
    Journal of Hospital Medicine 04/2014; 9(4). DOI:10.1002/jhm.2161 · 2.08 Impact Factor
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    ABSTRACT: Following reforms to the breast-cancer referral process for our city's health Safety Net (SN), we compared the experiences from first abnormality to definitive diagnosis of breast-cancer patients referred to Siteman Cancer Center from SN and non-SN (NSN) providers. SN-referred patients with any stage (0-IV) and NSN-referred patients with late-stage (IIB-IV) breast cancer were prospectively identified after diagnosis during cancer center consultations conducted between September 2008 and June 2010. Interviews were taped and transcribed verbatim; transcripts were independently coded by two raters using inductive methods to identify themes. Of 82 eligible patients, 57 completed interviews (33/47 SN [70%] and 24/35 NSN [69%]). Eighteen SN-referred patients (52%) had late-stage disease at diagnosis, as did all NSN patients (by design). A higher proportion of late-stage SN patients (67%) than either early-stage SN (47%) or NSN (33%) patients reported feelings of fear and avoidance that deterred them from pursuing care for concerning breast findings. A higher proportion of SN late-stage patients than NSN patient reported behaviors concerning for poor health knowledge or behavior (33% versus 8%), but reported receipt of timely, consistent communication from health care providers once they received care (50% versus 17%). Half of late-stage SN patients reported improper clinical or administrative conduct by health care workers that delayed referral and/or diagnosis. Although SN patients reported receipt of compassionate care once connected with health services, they presented with higher-than-expected rates of late-stage disease. Psychological barriers, life stressors, and provider or clinic delays affected access to and navigation of the health care system and represent opportunities for intervention.
    Journal of Surgical Research 03/2014; 190(1). DOI:10.1016/j.jss.2014.03.030 · 2.12 Impact Factor
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    ABSTRACT: National guidelines recommend annual Chlamydia trachomatis and Neisseria gonorrhoeae screening for sexually active youth at risk for infection. These infections have serious sequelae in women if untreated, and methods to improve testing are needed. We hypothesize that an electronic method of identifying at-risk youth will significantly increase testing for these sexually transmitted infections during emergency department (ED) visits. We developed an audio-enhanced computer-assisted self-interview (ACASI) to obtain sexual histories from ED patients and an embedded decision tree to create a sexually transmitted infection testing recommendation. ED health care providers were prompted by the electronic medical record to review the participant answers and testing recommendations, and to offer testing to at-risk youth. Patients aged 15 to 21 years and visiting the St. Louis Children's Hospital ED, regardless of complaint, were eligible for participation. Sexually transmitted infection testing among all 15- to 21-year-old ED patients increased from 9.3% in the 3 months before the ACASI to 17.8% during the 8-month period the ACASI was available and diminished to 12.4% in the 3 months after ACASI withdrawal (P<.001). During the ACASI period, we approached 51.4% of eligible patients and enrolled 59.8% (800/1,337) of those approached. Among ACASI participants, 52.4% (419/800) received a recommendation to receive sexually transmitted infection testing. Of these patients, 52.7% (221/419) received testing in the ED and 18.1% (40/221) of those tested had positive results for chlamydia or gonorrhea, 55% of whom (22/40) had chief complaints unrelated to sexually transmitted infections. Most participants (89%) rated the ACASI easy to use. Sexually transmitted infection testing in the ED significantly increased during ACASI use and diminished after withdrawal. The ACASI was well accepted by youth and holds promise for enhancing sexually transmitted infection testing in the ED.
    Annals of emergency medicine 03/2014; 64(4). DOI:10.1016/j.annemergmed.2014.01.031 · 4.33 Impact Factor
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    ABSTRACT: Objective To assess hospital and geographic variability in 30-day mortality after surgery for CRC and examine the extent to which sociodemographic, area-level, clinical, tumor, treatment, and hospital characteristics were associated with increased likelihood of 30-day mortality in a population-based sample of older CRC patients.Data Sources/Study SettingLinked Surveillance Epidemiology End Results (SEER) and Medicare data from 47,459 CRC patients aged 66 years or older who underwent surgical resection between 2000 and 2005, resided in 13,182 census tracts, and were treated in 1,447 hospitals.Study DesignAn observational study using multilevel logistic regression to identify hospital- and patient-level predictors of and variability in 30-day mortality.Data Collection/Extraction Methods We extracted sociodemographic, clinical, tumor, treatment, hospital, and geographic characteristics from Medicare claims, SEER, and census data.Principal FindingsOf 47,459 CRC patients, 6.6 percent died within 30 days following surgery. Adjusted variability in 30-day mortality existed across residential census tracts (predicted mortality range: 2.7–12.3 percent) and hospitals (predicted mortality range: 2.5–10.5 percent). Higher risk of death within 30 days was observed for CRC patients age 85+ (12.7 percent), census-tract poverty rate >20 percent (8.0 percent), two or more comorbid conditions (8.8 percent), stage IV at diagnosis (15.1 percent), undifferentiated tumors (11.6 percent), and emergency surgery (12.8 percent).Conclusions Substantial, but similar variability was observed across census tracts and hospitals in 30-day mortality following surgery for CRC in patients 66 years and older. Risk of 30-day mortality is driven not only by patient and hospital characteristics but also by larger social and economic factors that characterize geographic areas.
    Health Services Research 03/2014; 49(4). DOI:10.1111/1475-6773.12171a · 2.49 Impact Factor
  • Journal of Surgical Research 02/2014; 186(2):672. DOI:10.1016/j.jss.2013.11.753 · 2.12 Impact Factor
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    ABSTRACT: The prevalence of hearing loss (HL) in adolescents has grown over the past decade, but hearing-related quality of life (QOL) has not been well-measured. We sought to develop a reliable, valid measure of hearing-related QOL for adolescents, the Hearing Environments And Reflection on Quality of Life (HEAR-QL). Multi-site observational study. Adolescents with HL and siblings without HL were recruited from five centers. Participants completed the HEAR-QL and validated questionnaires measuring generic pediatric QOL (PedsQL), depression and anxiety (RCADS-25), and hearing-related QOL for adults (HHIA) to determine construct and discriminant validity. Participants completed the HEAR-QL two weeks later for test-retest reliability. We used exploratory principal components analysis to determine the HEAR-QL factor structure and measured reliability. Sensitivity and specificity of the HEAR-QL, PedsQL, HHIA and RCADS-25 were assessed. We compared scores on all surveys between those with normal hearing, unilateral and bilateral HL. 233 adolescents (13-18 years old) participated-179 with HL, 54 without HL. The original 45-item HEAR-QL was shortened to 28 items after determining factor structure. The resulting HEAR-QL-28 demonstrated excellent reliability (Cronbach's alpha= 0.95) and construct validity (HHIA: r =.845, PedsQL: r =.587; RCADS-25: r =.433). The HEAR-QL-28 displayed excellent discriminant validity, with higher area under the curve (0.932) than the PedsQL (0.597) or RCADS-25 (0.529). Teens with bilateral HL using hearing devices reported worse QOL on the HEAR-QL and HHIA than peers with HL not using devices. The HEAR-QL is a sensitive, reliable and valid measure of hearing-related QOL for adolescents. 2b (Diagnostic validation study, see Laryngoscope, 2013.
    The Laryngoscope 02/2014; 124(2). DOI:10.1002/lary.24336 · 2.03 Impact Factor
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    ABSTRACT: The Summer Institute Program to Increase Diversity (SIPID) in Health-Related Research is a career advancement opportunity sponsored by the National Heart, Lung, and Blood Institute. Three mentored programs address difficulties experienced by junior investigators in establishing independent research careers and academic advancement. Aims are to increase the number of faculty from under-represented minority groups who successfully compete for external research funding. Data were collected using a centralized data-entry system from three Summer Institutes. Outcomes include mentees' satisfaction rating about the program, grant and publications productivity and specific comments. Fifty-eight junior faculty mentees (38% male) noticeably improved their rates of preparing/submitting grant applications and publications, with a 18-23% increase in confidence levels in planning and conducting research. According to survey comments, the training received in grantsmanship skills and one-on-one mentoring were the most valuable program components. The SIPID mentoring program was highly valued by the junior faculty mentees. The program will continue in 2011-2014 as PRIDE (PRogram to Increase Diversity among individuals Engaged in health-related research). Long-term follow-up of current mentees will be indexed at five years post training (2013). In summary, these mentoring programs hope to continue increasing the diversity of the next generation of scientists in biomedical research.
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    ABSTRACT: To describe educational outcomes for a national cohort of students who enrolled in MD-PhD programs at medical school matriculation (MD-PhD matriculants). The authors used multivariate logistic regression to identify factors independently associated with overall MD-PhD program attrition (MD-only graduation or medical school withdrawal/dismissal) compared with MD-PhD program graduation among the 1995-2000 national cohort of MD-PhD matriculants at medical schools with and without Medical Scientist Training Program (MSTP) support. Of 2,582 MD-PhD matriculants, 1,885 (73.0%) were MD-PhD graduates, 597 (23.1%) were MD-only graduates, and 100 (3.9%) withdrew/were dismissed from medical school by July 2011. MD-PhD matriculants at non-MSTP-funded schools (adjusted odds ratio [AOR], 1.96; 95% confidence interval [CI], 1.60-2.41) and who had lower Medical College Admission Test scores (< 31 versus ≥ 36: AOR, 1.60; 95% CI, 1.20-2.14; 31-33 versus ≥ 36: AOR, 1.31; 95% CI, 1.01-1.70) were more likely to leave the MD-PhD program; matriculants who reported greater planned career involvement in research (AOR, 0.65; 95% CI, 0.51-0.84) and matriculated more recently (AOR, 0.90; 95% CI, 0.85-0.96) were less likely to leave the MD-PhD program. Gender, race/ethnicity, and premedical debt were not independently associated with overall MD-PhD program attrition. Most MD-PhD matriculants completed the MD-PhD program; most of those who left were MD-only graduates. Findings regarding variables associated with attrition can inform efforts to recruit and support students through successful completion of MD-PhD program requirements.
    Academic medicine: journal of the Association of American Medical Colleges 11/2013; DOI:10.1097/ACM.0000000000000071 · 3.47 Impact Factor
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    ABSTRACT: To characterize gynecologic oncology patients' perceptions of the process of disclosure of a cancer diagnosis. We surveyed 100 gynecologic oncology patients between December 2011 and September 2012. An 83-item tool based on three validated assessment tools evaluated patient-centered factors, physician behavior and communication skills, and environmental factors. Associations between patients' satisfaction and these variables were analyzed using Wilcoxon rank-sum, Kruskal-Wallis, and Spearman's rho tests. Poisson regression was used to assess factors associated with patient's satisfaction. Twenty-four percent of patients were notified of their diagnosis by phone, 60% in the physician's office, and 16% in the hospital. Disclosure was performed by an obstetrician-gynecologist (58%), gynecologic oncologist (26%), primary care physician (8%), or other (8%). Fifty-two percent of all patients were accompanied by a support person. Higher patient satisfaction scores were associated with face-to-face disclosure (mean score 91% compared with over the phone 72%, P=.02), a private setting (mean score 92% compared with impersonal setting 72%, P=.004), and duration of the encounter of greater than 10 minutes (mean score 94% compared with less than 10 minutes 79%, P<.001). Multivariate analysis confirmed that both physician communication skills (P<.001) and patient-centered factors (eg, perception of physician sensitivity and empathy, opportunities to ask questions and express emotion, and set the pace of conversation; P=.013) were associated with higher patient satisfaction. Effective physician communication skills and patient-centered factors resulted in higher patient satisfaction with the gynecologic cancer diagnosis disclosure experience. LEVEL OF EVIDENCE:: II.
    Obstetrics and Gynecology 10/2013; DOI:10.1097/AOG.0b013e3182a9bf42 · 4.37 Impact Factor
  • R.T. Griffey, D. Jeffe, T. Bailey
    Annals of Emergency Medicine 10/2013; 62(4):S50-S51. DOI:10.1016/j.annemergmed.2013.07.421 · 4.33 Impact Factor
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    ABSTRACT: There has been a paucity of interventions developed for African American women to address persistent health disparities between African American and Caucasian breast cancer patients. We developed and piloted a technologically innovative, culturally targeted, cancer-communication intervention for African American breast cancer patients using African American breast cancer survivor stories. We rated 917 clips from a video library of survivors' stories for likability, clarity and length, and emotional impact (scaled responses) and categorized each clip by theme (Coping, Support and Relationships, Healthcare Experiences, Follow-up Care, Quality of Life, and Treatment Side Effects). We selected 207 clips told by 35 survivors (32-68 years old; 4-30 years after diagnosis), fitting one of 12 story topics, for inclusion in the interactive video program loaded onto a touch-screen computer. Videos can be searched by storyteller or story topics; stories with the strongest emotional impact were displayed first in the video program. We pilot tested the video program with ten African American breast cancer survivors (mean age, 54; range 39-68 years), who, after training, watched videos and then evaluated the stories and video-program usability. Survivor stories were found to be "interesting and informative," and usability was rated highly. Participants identified with storytellers (e.g., they "think a lot like me," "have values like mine") and agreed that the stories convinced them to receive recommended surveillance mammograms. This novel, cancer-communication technology using survivor stories was very favorably evaluated by breast cancer survivors and is now being tested in a randomized controlled clinical trial. Breast cancer survivors can draw support and information from a variety of sources, including from other breast cancer survivors. We developed the survivor stories video program specifically for African American survivors to help improve their quality of life and adherence to follow-up care. Breast cancer survivors' experiences with treatment and living with cancer make them especially credible messengers of cancer information. Our novel, interactive technology is being tested in a randomized controlled trial and will be more broadly disseminated to reach a wider audience.
    Journal of Cancer Survivorship 09/2013; 8(1). DOI:10.1007/s11764-013-0308-4 · 3.29 Impact Factor

Publication Stats

2k Citations
595.09 Total Impact Points


  • 2003–2014
    • Barnes Jewish Hospital
      • Alvin J. Siteman Cancer Center
      San Luis, Missouri, United States
  • 1996–2014
    • Washington University in St. Louis
      • • Division of Health Behavior
      • • Department of Medicine
      • • Department of Obstetrics and Gynecology
      San Luis, Missouri, United States
  • 2011
    • Aurora University
      Aurora, Illinois, United States