Over the past eight years my colleagues and I have been systematically conducting patient-oriented research in the areas of osteoporosis and joint arthroplasty. In the area of osteoporosis, through a series of progressive studies, we have explored how best to communicate dual energy x-ray absoroptiometry (DXA) results to patients and, more broadly, how to communicate tests results, in general, to patients. Specifically, we have examined how DXA testing centers can reduce "missed" DXA results and improve patient satisfaction and treatment of osteoporosis by mailing results directly to patients. In the area of orthopaedics, we have systematically evaluated variations in total hip arthroplasty (THA) and total knee arthroplasty (TKA) outcomes and utilization. The objective of the current K24 Midcareer Investigator Award is to allow me to increase my mentoring of trainees in the areas of osteoporosis and orthopaedics. There is significant need for such mentoring here at the University of Iowa particularly among Internal Medicine subspecialties and Orthopaedic Surgery. We have carefully designed three projects that will advance science in the areas of: A) communication of DXA results to patients;B) evaluation of THA and TKA outcomes. The specific projects are: 1) To investigate optimal textual and graphical methods for conveying DXA results and fracture risk to patients;2) To bring UI joint arthroplasty data into a national joint registry being funded by AHRQ;and 3) To explore variations in joint arthroplasty outcomes and utilization in key patient subgroups including men and women and older and younger adults. Together, these projects will allow mentees to be involved in cutting-edge research while being trained in qualitative and quantitative methods. Likewise these studies will advance knowledge in key areas of musculoskeletal health.

Public Health Relevance

The goal of this proposal is to build a world class program in musculoskeletal patient-oriented research at the University of Iowa. The study Principal Investigator (Dr. Peter Cram) has developed three distinct projects to foster the training and growth of mentees. These projects focus on critically important areas including improving communication of dual energy x-ray absoptiometry (DXA) results to patients and studying variation in joint arthroplasty utilization and outcomes. In total, this study will result in numerus research opportunities for trainees while advancing knowledge in osteoporosis and orthopaedics.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Lester, Gayle E
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University of Iowa
Internal Medicine/Medicine
Schools of Medicine
Iowa City
United States
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Khera, Rohan; Cram, Peter; Vaughan-Sarrazin, Mary et al. (2016) Use of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States. Am J Cardiol 117:10-6
Cram, Peter (2016) CORR Insights(®): Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery. Clin Orthop Relat Res 474:16-8
Edmonds, Stephanie W; Cram, Peter; Lou, Yiyue et al. (2016) Effects of a DXA result letter on satisfaction, quality of life, and osteoporosis knowledge: a randomized controlled trial. BMC Musculoskelet Disord 17:369
Kabra, Rajesh; Cram, Peter; Girotra, Saket et al. (2015) Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation. Am J Cardiol 116:230-5
Vyas, Ankur; Chan, Paul S; Cram, Peter et al. (2015) Early Coronary Angiography and Survival After Out-of-Hospital Cardiac Arrest. Circ Cardiovasc Interv 8:
Khera, Rohan; Cram, Peter; Girotra, Saket (2015) Letter by Khera et al Regarding Article, "Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes: A 5-Year United States Experience (2005-2009)". Circulation 132:e35
Harel, Z; Goldberg, H; Harel, S et al. (2015) The prevalence and characteristics of fast food outlets in Ontario hospitals. Public Health 129:1294-6
Cram, Peter; Ravi, Bheeshma; Vaughan-Sarrazin, Mary S et al. (2015) What Drives Variation in Episode-of-care Payments for Primary TKA? An Analysis of Medicare Administrative Data. Clin Orthop Relat Res 473:3337-47
Shultz, Samuel K; Wu, Robert; Matelski, John J et al. (2015) Patient Preferences for Test Result Notification. J Gen Intern Med 30:1651-6
Fang, Michele; Noiseux, Nicolas; Linson, Eric et al. (2015) The Effect of Advancing Age on Total Joint Replacement Outcomes. Geriatr Orthop Surg Rehabil 6:173-9

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