Lauren R Samuels

Vanderbilt University | Vander Bilt · Department of Biostatistics

Introduction: Lung cancer screening with low-dose computed tomography (LDCT) is widely underutilized. Organizational factors, such as readiness for change and belief in the value of change (change valence), may contribute to underutilization. The aim of this study was to evaluate the association between healthcare organizations' preparedness and l...

Objective: To evaluate the association between baseline ultra-processed food consumption in early childhood and child BMI Z-score over 36 months. Methods: We conducted a prospective cohort analysis as a secondary data analysis of the Growing Right Onto Wellness randomised trial. Dietary intake was measured via 24-h diet recalls. The primary outc...

Background: To characterize the association between multiple social determinants of health (SDOH) and overweight and obesity among US children. Methods: We conducted a cross-sectional analysis using the 2016-2020 National Survey of Children's Health. SDOH domains consisted of Economic Stability, Social and Community Context, Neighborhood and Built...

Objective The study purpose was to describe feasibility of implementation of the Reaching Out to Kids with Emotional Trauma (ROcKET) intervention. We hypothesised that the ROcKET Intervention would be feasible in a poor resource school. Design We performed a single-arm, single-centr feasibility study of an intervention pilot, based on the RE-AIM f...

Background: The Nova classification system categorizes foods into 4 processing levels, including ultraprocessed foods (UPFs). Consumption of UPFs is extensive in the United States, and high UPF consumption is associated with chronic disease risk. A reliable and valid method to Nova-categorize foods would advance understanding of UPF consumption an...

Introduction: Sexual assault is an urgent public health concern with both immediate and long-lasting health consequences, affecting 44% of women and 25% of men during their lifetimes. Large studies are needed to understand the unique healthcare needs of this patient population. Methods: We mined clinical notes to identify patients with a history...

Background For patients with high-risk stage II or stage III colorectal cancer (CRC), adjuvant chemotherapy (AC) improves survival, yet use varies substantially across medical oncology settings. Aim Utilization of guideline concordant CRC AC was assessed at a Veterans Health Administration (VHA) facility to determine quality improvement initiative...

Objectives Ultra-processed foods (UPFs) are markers of diet quality and high UPF consumption is associated with chronic disease risk. Methods to accurately categorize the degree of food processing are missing from dietary analysis programs. This study evaluated the reliability and validity of assigning the NOVA classification for UPFs to individual...

Objective To develop a clinical informatics approach to identify patients with a history of sexual assault and to characterize the clinical risk factors and comorbidities of this population in a sex-stratified manner. Methods We developed and applied a keyword-based approach to clinical notes to identify patients with a history of sexual assault i...

Background Veterans Health Administration (VHA) issued policy for lung cancer screening; resources at eight Veterans Affairs medical centers (VAMCs) in a demonstration project (DP) from 2013 to 2015. Research Question Do policies that provide resources increase lung cancer screening rates? Study Design and Methods Data from 8 DP VAMCs (DP group)...

Purpose Lung cancer causes the largest number of cancer-related deaths in the United States. Lung cancer incidence rates, mortality rates, and rates of advanced stage disease are higher among those who live in rural areas. Known disparities in lung cancer outcomes between rural and nonrural populations may be in part because of barriers faced by ru...

The goal of much of medical research is to determine which of 2 or more therapeutic approaches is most effective in a given situation. The power of a study is the probability of detecting a true treatment effect of a given magnitude and is highly dependent on the number of patients studied. When a retrospective observational study design is used, r...

Purpose Postpartum opioid use remains common among women with uncomplicated vaginal delivery and may increase the risk of serious opioid-related events. Therefore, we examined the association between the dose of the first filled opioid prescription after vaginal delivery and the subsequent risk of serious opioid-related events. Methods We conducte...

Objective Adverse childhood experiences (ACEs) contribute to poor overall health among children with obesity. This study evaluated how one potential protective factor—family resilience—affects the association between ACEs and childhood obesity. Methods This analysis was a secondary analysis of the 2016‐2018 National Survey of Children's Health, a...

Background The National Comprehensive Cancer Network has defined metrics for colorectal cancer; however, the association of metric adherence with patient clinical outcomes remains underexplored. The study aim was to evaluate the association of National Comprehensive Cancer Network metric adherence with recurrence and mortality in Veterans with nonm...

ObjectivesA life-course perspective emphasizes healthy behaviors before, during, and after pregnancy to support a multi-generational risk reduction in obesity for mothers and infants. Optimal timing, content, and dose of such interventions is not well defined.Methods We conducted a nested cohort within a randomized trial to evaluate whether a healt...

Background Many Veterans are high risk for lung cancer. Low-dose computed tomography (LDCT) is an effective strategy for lung cancer early detection in a high-risk population. Our objective was to describe and compare annual and geographic utilization trends for LDCT screening in the Veteran’s Health Administration (VHA). Methods A national retros...

Objective: This study aims to characterize the extent of geographic variation in elective sigmoid resection for diverticulitis and to identify factors associated with observed variation. Introduction: National guidelines for treatment of recurrent diverticulitis fail to offer strong recommendations for or against surgical intervention. We hypoth...

Background: Current recommendations for intensive behavioral interventions for childhood obesity treatment do not account for variable participant attendance, optimal duration of the intervention, mode of delivery (phone vs. face-to-face), or address obesity prevention among young children. A secondary analysis of an active one-year behavioral int...

e19159 Background: Rural patients have well described disparities in quality cancer care. The VA Budget and Choice Improvement Act (2015) and VA Mission Act (2018) were passed to increase timely access to cancer care for veterans living at greater distances from VA facilities by paying for community oncology care. We sought to evaluate the baseline...

e19171 Background: For patients with National Comprehensive Cancer Network (NCCN) high risk stage II or stage III colorectal cancer (CRC), adjuvant chemotherapy improves disease free (DFS) and overall survival (OS). Rates of use vary significantly across health care settings. Several demographic and healthcare factors are associated with decreased...

84 Background: Patients from rural areas have well described disparities in quality cancer care. We hypothesized that longer travel distance is associated with less chemotherapy acceptance and less timely treatment. Methods: We reviewed 705 electronic medical records of patients with colorectal surgeries from January 1, 2000 to December 31, 2015 at...

78 Background: National Comprehensive Cancer Network (NCCN) recommends adjuvant chemotherapy for patients with high risk stage II or stage III colorectal cancer (CRC). Treatment within 8 weeks of surgery improves disease free survival and decreases recurrence. National Veterans Health Administration (VHA) CRC data demonstrated adherence to this sta...

Objective: To evaluate the relationship between utilization of institution-affiliated childcare andemployee stress among parents working at a large, academic medical center. Methods: Cross-sectional analysis of the relationship between institution-affiliated childcare and employee stress. Survey questions asked about personal stress related to j...

Background: Health behavior change interventions that target childhood obesity in minority populations have led to inconsistent and short-lived results. The purpose of this study was to test a novel intervention that was personalized and family-based in a Latino population to reduce childhood obesity. Methods: Competency-Based Approaches to Commun...

Objective: To determine the magnitude of risk of factors that contribute to the emergence of childhood obesity among low-income minority children. Study design: We conducted a prospective cohort analysis of parent-child pairs with children aged 3-5 years who were nonobese (n = 605 pairs) who participated in a 3-year randomized controlled trial o...

Objective Many patients with advanced serious illness or at the end of life experience delirium, a potentially reversible form of acute brain dysfunction, which may impair ability to participate in medical decision-making and to engage with their loved ones. Screening for delirium provides an opportunity to address modifiable causes. Unfortunately,...

Background Many patients use opioids for nonmalignant pain, and opioid use in the general population has been associated with poor long‐term outcomes. The use of high‐risk medications, including opioid analgesics, may increase the risk of unplanned healthcare utilization. Methods and Results We performed a nested evaluation in the VICS (Vanderbilt...

Background: Choosing Wisely® is a national initiative to deimplement or reduce low-value care. However, there is limited evidence on the effectiveness of strategies to influence ordering patterns. Objective: We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and...

Observational studies present challenges due to bias from imbalance in baseline confounders. One‐to‐one matching (OOM), a popular cohort‐construction technique for observational studies, reduces bias and provides a compelling basis for inference but generally leads to at least some loss of efficiency due to the exclusion of potentially informative...

Competency-Based Approaches to Community Health (COACH) is a randomized controlled trial of a family-centered, community-based, and individually-tailored behavioral intervention for childhood obesity among Latino pre-school children. COACH focuses on improving personal agency for health behavior change by tailoring content to overcome contextual ba...

Title Body Mass Index and Health Related Quality of Life Objective There is conflicting data regarding the association between body mass index (BMI) and Health‐Related Quality of Life (HRQoL), especially among certain population sub‐groups and for mental and physical health domains. Methods This study analyzed the relationship between BMI and HRQ...

OBJECTIVES/SPECIFIC AIMS: Opioid prescribing is common and increasing in certain areas of the country with known risk of misuse and dependence. Our study examined the association of opioid prescription at discharge after hospitalization for acute coronary syndrome (ACS) or acute decompensated heart failure (ADHF) with emergency department (ED) care...

White matter hyperintensities (WMHs) are associated with poorer brain health, but their pathophysiological substrates remain elusive. To better understand the mechanistic underpinnings of WMHs among older adults, this study examined in vivo cerebrospinal fluid biomarkers of β-amyloid42 deposition (Aβ42), hyperphosphorylated tau pathology, neurodege...

Observational studies are a widely used and challenging class of studies. A key challenge is selecting a study cohort from the available data, or "pruning" the data, in a way that produces both sufficient balance in pre-treatment covariates and an easily described cohort from which results can be generalized. Visual Pruner is a free, easy-to-use R...

Background A better understanding of the optimal “dose” of behavioral interventions to affect change in weight-related outcomes is a critical topic for childhood obesity intervention research. The objective of this review was to quantify the relationship between dose and outcome in behavioral trials targeting childhood obesity to guide future inter...

Objectives To examine the effect of late-life body mass index (BMI) and rapid weight loss on incident mild cognitive impairment (MCI) and Alzheimer’s disease (AD). DesignProspective longitudinal cohort study. SettingNational Alzheimer’s Coordinating Center (NACC) Uniform Data Set, including 34 past and current National Institute on Aging-funded AD...

A symptom of mild cognitive impairment (MCI) and Alzheimer's disease (AD) is a flat learning profile. Learning slope calculation methods vary, and the optimal method for capturing neuroanatomical changes associated with MCI and early AD pathology is unclear. This study cross-sectionally compared four different learning slope measures from the Rey A...

Alzheimer's disease (AD) biomarkers and stroke risk factors independently predict cognitive impairment, likely through independent disease pathways. However, limited work has sought to describe the dynamic interplay between these important risk factors. This article evaluated the interaction between stroke risk and AD biomarkers on hippocampal volu...

Background: A cognitive concern from the patient, informant, or clinician is required for the diagnosis of mild cognitive impairment (MCI); however, the cognitive and neuroanatomical correlates of complaint are poorly understood. Objective: We assessed how self-complaint relates to cognitive and neuroimaging measures in older adults with MCI. M...