Michael D Fetters

• MD, MPH, MA
• Professor at University of Michigan

Objectives: Many American police organizations respond to out-of-hospital cardiac arrest (OHCA). This study sought to: 1) explore variation in the role of police in OHCA across emergency medical systems and 2) identify factors influencing this variation. Methods: We conducted a qualitative multisite case study analysis using data collected throu...

Background Preconception care is not widespread in Japan and there is a pressing need to improve the practice. The present study assessed the knowledge and behavior of preconception care among women to seek effective intervention. Our research questions were: 1) How much do women know about preconception care? 2) How much are they practicing precon...

Introduction People with HIV-1 (PWH) have worse health-related quality of life (HRQoL) compared with the general population. Using patient-reported outcomes (PROs) may help reorient the focus of HIV care towards improving HRQoL. This study aims to develop, implement and evaluate the use of PROs in HIV care. Methods and analysis This is a Danish si...

Purpose: Researchers often struggle to integrate quantitative and qualitative data. Joint displays of data collected using mixed methods provide a framework for supporting integration, yet the literature lacks methodologic articles illustrating in detail the iterative nature of constructing such displays. We demonstrate the process for creating a...

Background Multimorbidity management can be extremely challenging in patients with dementia. This study aimed to elucidate the approaches of primary care physicians in Japan and the United States (US) in managing multimorbidity for patients with dementia and discuss the challenges involved. Methods This qualitative study was conducted through one-...

Out-of-hospital cardiac arrest (OHCA) is a common, life-threatening event that is a leading cause of death in the United States. However, it is unclear how to design strategies that can be successfully implemented in emergency medical services (EMS) agencies and broader emergency response systems (such as fire, police, dispatch, and bystanders to O...

The care delivered to patients with cardiovascular disease involves coordination among a multitude of clinical team members spanning diverse inpatient and outpatient settings. The majority of quality improvement interventions in cardiovascular care have been developed based on quantitative evidence, which neither fully accounts for multilevel deter...

Background: Left ventricular assist device (LVAD) implantation leads to substantial and sustained improvement in health-related quality of life (HRQOL) among patients. Infection following device implantation remains an important and frequent complication and adversely affects patient-reported HRQOL. Methods: Patients in The Society of Thoracic S...

Purpose: The purpose of this study series, which involves a questionnaire survey and qualitative interviews, was to (a) evaluate patient-reported usefulness of continuous glucose monitor (CGM) hypoglycemia-informing features and (b) identify challenges in using these features (ie, CGM glucose numbers, trend arrows, trend graphs, and hypoglycemia a...

Background: Communication is a critical component of the patient-provider relationship; however, limited research exists on the role of nonverbal communication. Virtual human training is an informatics-based educational strategy that offers various benefits in communication skill training directed at providers. Recent informatics-based interventio...

BACKGROUND Communication is a critical component of the patient-provider relationship; however, limited research exists on the role of nonverbal communication. Virtual human training is an informatics-based educational strategy that offers various benefits in communication skill training directed at providers. Recent informatics-based interventions...

Large- and small-scale transformation of healthcare delivery toward improved patient experience through promotion of patient-centered and coordinated care continues to be at the forefront of health system efforts in the United States. As part of a Quality Improvement (QI) project at a large, midwestern health system, a case series of high-performin...

Background Guidelines worldwide recommend that physicians should not treat their family members. However, studies in the U.S. have shown that approximately 74–83% of physicians have experience of treating family members. Primary care physicians were more likely to have such experiences than other specialists. In Japan, physicians do not have any gu...

Background Improved health-related quality of life (HRQOL) is an important outcome following durable left ventricular assist device (LVAD) implant. However, half of pre-implant HRQOL data are incomplete in The Society of Thoracic Surgeons’ Intermacs registry. Pre-implant HRQOL incompleteness may reflect patient status or hospital resources to captu...

The purpose of this VSI is to engage in imagining a wealth of design possibilities for mixed methods research by drawing upon a curated collection of 11 empirical and methodological articles as well as two editorials previously published in JMMR. We weave discussions of the collection into our discussions of design advancements and conversations. W...

Mixed methods researchers need tools for planning and demonstrating integration. Mixed methods joint displays have a growing presence in the literature for representing mixed methods findings, and for use as an analytic tool as in the case of joint display analysis. However, the joint display of integrated data collection represents a lesser-known...

BACKGROUND Durable ventricular assist device (VAD) therapy is reserved for patients with advanced heart failure who have a poor estimated 1-year survival. However, despite highly protocolized management processes, patients are at a unique risk for developing a health care-associated infection (HAI). Few studies have examined optimal strategies for...

[This corrects the article DOI: 10.2196/14701.].

Background Mixed methods intervention studies can improve the accuracy of interventional evaluations in the field of emotional and behavioral disorders by helping researchers gain a more nuanced understanding of how a particular intervention works. However, no studies to date have systematically examined the ways in which this type of studies have...

Purpose: Researchers aimed to describe general practitioners' understanding of appropriate ultrasound use, to record actual scanning practices of early adopters in general practice, and to identify differences between attitudes and actual practice via a mixed methods analysis. Methods: This study was part of a larger multistage mixed methods res...

Purpose While improved health-related quality of life (HRQOL) is an important durable left ventricular assist device (LVAD) implant outcome, 50% of HRQOL data are missing in the STS-Intermacs registry. Pre-implant HRQOL missingness may reflect patient and hospital characteristics and thus serve as a novel hospital quality metric. We hypothesized th...

Background Infections are widely prevalent in left ventricular assist device (LVAD) recipients and associated with adverse events including mortality and rehospitalizations. Current evidence examining factors associated with infections in this setting predominantly comprises single-center observational data. We performed a scoping review to systema...

OBJECTIVE This study aimed to 1) identify the frequency of severe and level 2 hypoglycemia presenting in individuals with type 1 diabetes using continuous glucose monitoring systems (CGMs), including those with concomitant closed-loop insulin pumps, in a clinical practice setting, and; 2) evaluate the impact of beliefs around hypoglycemia in the de...

Purpose While infections are common following left ventricular assist device (LVAD) implantation, the relationship between timing and type of first infection with regards to mortality is less well understood. Methods The Society of Thoracic Surgeons Intermacs patients receiving a primary LVAD from 4/2012 to 5/2017 were included. The primary exposu...

Background While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown. Methods Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings a...

Introduction Older adults (age ≥65 years) are pursuing increasingly complex, elective surgeries; and, are at higher risk for intraoperative and postoperative complications. Patients and their caregivers frequently struggle with the postoperative recovery process at home, which may contribute to complications. We aim to identify opportunities to int...

Background Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scopi...

Background Smoking relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates. Objective The purpose of this study was to evaluate the 1-year outcomes of a social media–based and peer and clinician-supported smoking cessation program on Facebook and examine communication patterns that could suppo...

Introduction Diagnostic processes in the emergency department (ED) involve multiple interactions among individuals who interface with information systems to access and record information. A better understanding of diagnostic processes is needed to mitigate errors. This paper describes a study protocol to map diagnostic processes in the ED as a foun...

Objective To investigate variations across hospitals in infection rates and associated costs, the latter reflected in 90-day Medicare payments. Despite high rates and expenditures of healthcare-associated infections associated with durable ventricular assist device implant, few studies have examined inter-hospital variation and associated costs. M...

PURPOSE Racial and ethnic minorities remain underrepresented in research and clinical trials. Better understanding of the components of effective minority recruitment into research studies is critical to understanding and reducing health disparities. Research on recruitment strategies for cancer-specific research—including colorectal cancer (CRC)—a...

Purpose While infections are common following left ventricular assist device (LVAD) implant, the relationship between timing and category of first infection and mortality is less well understood. Methods STS Intermacs patients (>19 yrs) receiving a primary, durable continuous flow LVAD from 4/2012 to 5/2017 were included. The primary exposure was...

Background: To explore the perspectives and approaches of primary care physicians in Japan and the US on diagnosing dementia. Methods: Qualitative comparison conducted in ethnographic tradition using semi-structured interviews and thematic analysis. Primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a tot...

This methodological discussion invites critical reflection about the procedures used to analyze the contribution of qualitative and mixed methods research to nursing trials by mounting an argument that these should rest on multiple publications produced about a project, rather than a single article. We illustrate the value‐added of this approach wi...

BACKGROUND Smoking relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates. OBJECTIVE The purpose of this study was to evaluate the 1-year outcomes of a social media–based and peer and clinician-supported smoking cessation program on Facebook and examine communication patterns that could suppo...

Background Community-engaged research engages the community in a collaborative manner to improve the local setting and has been increasingly applied to health services research. These complex studies require collaboration and team building among clinical experts, methodologists, and community stakeholders, yet few examples of this process have been...

Introduction: Health systems with more robust provider teamwork have lower mortality rates for coronary artery bypass grafting. Patients undergoing durable ventricular assist device (VAD) therapy have complex comorbidities and develop adverse events requiring multidisciplinary provider teamwork. Hypothesis: Provider teamwork is associated with 180-...

Introduction Out-of-hospital cardiac arrest (OHCA) is a common, life-threatening event encountered routinely by first responders, including police, fire and emergency medical services (EMS). Current literature suggests that there is significant regional variation in outcomes, some of which may be related to modifiable factors. Yet, there is a persi...

Objective In addition to assessing educational needs of family medicine trainees in Ghana, we sought to assess whether those entering the training programme aimed to pursue an academic career. Design A case study using an anonymous cross-sectional survey through collaboration between faculty members from the family medicine departments of Ghana an...

Objectives Although frequent emergency department (ED) use is a global issue, little research has been conducted in a country like Japan where universal health insurance is available. The study aims to (1) document the proportion of ED visits that are by frequent users and (2) describe the differences in characteristics of frequent ED users and oth...

Background: Smoking-relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates. The purpose of this study was to 1) evaluate the one-year outcomes of a social media-based and peer-supported smoking cessation program on Facebook and 2) examine communication patterns that could support smoking cessa...

The Role of Champions for Out-of-Hospital Cardiac Arrest Survival

Adolescents with ADHD are at increased risk of having a co-existing medical disorder. Research shows that having co-existing ADHD and a medical disorder interferes with the adolescents’ daily life, creating a dual task that cannot be managed as two independent disorders. Interventions to support adolescents in managing the dual task of living with...

[This corrects the article DOI: 10.2196/14701.].

Mixed methods research has been increasingly recognized as a useful approach for describing and explaining complex issues in palliative care and end-of-life research. However, little is known about the use of this methodology in the field and the ways in which mixed methods studies have been reported. The purpose of this methodological review was t...

Cervical cancer has become rare in high-income countries but is a leading cause of mortality among women in low- and middle-income countries (LMICs). This inequity is due to economic, social, and cultural factors and should be seen as an epidemiological tragedy. This article examines ethical considerations that should compel policymakers and intern...

In Press

In Press

Introduction: EMS system factors key to improved survival for out-of-hospital cardiac arrest (OHCA) have not been well elucidated. This study explores factors associated with sustained return of spontaneous circulation (ROSC) in the field with pulse upon arrival to the ED-a measure of high quality of prehospital care-across the chain of survival. M...

Mixed methods has the potential to add values to simulation research by informing healthcare simulations, developing assessments and measures, and evaluating the effectiveness of simulations. However, it seems under-utilized relative to other single methodology designs. This chapter provides an introduction to mixed methods in simulation research a...

Most primary care researchers lack a practical approach for including field observations in their studies, even though observations can offer important qualitative insights and provide a mechanism for documenting behaviors, events, and unexpected occurrences. We present an overview of unstructured field observations as a qualitative research method...

Objective To understand general practice (GP) residents’ attitudes about their residency training in China. Design Mixed methods survey administered cross-sectionally. Setting Two GP training programmes similar in most regards according to current GP training policy of 5 years’ undergraduate degree in medicine and 3 years of postgraduate GP resid...

Applied therapy is a commonly utilized method of treatment for preventive and therapeutic measures. Avicenna, a significant physician of the Islamic golden age, described 36 methods to restore balance of patients’ elements, humors and faculties. We propose a categorization of these methods within a single theory and framework, as this has previousl...

Introduction Chinese policy increasingly emphasizes growth of general practice (GP). The purpose of this research was to understand attitudes toward GP among first-year Chinese and international medical students studying in China. Methods Based on a cross-sectional survey using a 5-point Likert scale of medical students at Peking University Health...

Background: Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)-based simulation, MPathic-VR, was developed to train health care providers in empathic communicati...

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication...

Introduction Colorectal cancer (CRC) is preventable, as screening leads to the identification and removal of precancerous polyps. African-American men consistently have the highest CRC mortality rates, and their CRC-screening uptake remains low for complex reasons. Culture-specific masculinity barriers to care may contribute to the low uptake among...

Research Objective: Despite improvements in patient- and systems-level processes to treat prehospital cardiac arrests, survival continues to be low with significant variation for the 356,000 annual prehospital cardiac arrests in communities in the United States. Although police are often arrive first to cardiac arrest incidents, the impact of polic...

BACKGROUND Deaf American Sign Language (ASL) users often struggle with limited health literacy compared to their hearing peers. Yet, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing ind...

Background: Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hea...

Background: The number of dementia patients in Japan is projected to reach seven million by 2025. While modern ethicists have largely reached the conclusion that full disclosure of dementia serves the best interest of patient, the implications of disclosure of a dementia diagnosis remains an underexplored area of research in Japan. The purpose of...

BACKGROUND Background: Durable Ventricular Assist Device (VAD) therapy is reserved for patients with advanced heart failure that have a poor estimated one-year survival. However, despite highly protocolized management processes, patients are at a unique risk for healthcare-associated infection (HAI). Few studies have examined optimal strategies for...