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)
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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Cram, Peter (2014) CORR Insights®: the National Hospital Discharge Survey and the Nationwide Inpatient Sample: the databases used affect results in THA research. Clin Orthop Relat Res 472:3450-1
Pugely, Andrew J; Lu, Xin; Amendola, Annunziato et al. (2014) Trends in the use of total ankle replacement and ankle arthrodesis in the United States Medicare population. Foot Ankle Int 35:207-15
Erickson, Bradley A; Lu, Xin; Vaughan-Sarrazin, Mary et al. (2014) Initial treatment of men with newly diagnosed lower urinary tract dysfunction in the Veterans Health Administration. Urology 83:304-9
Singh, Jasvinder A; Lu, Xin; Rosenthal, Gary E et al. (2014) Racial disparities in knee and hip total joint arthroplasty: an 18-year analysis of national Medicare data. Ann Rheum Dis 73:2107-15
Pate, Scott C; Uhlman, Matthew A; Rosenthal, Jaime A et al. (2014) Variations in the open market costs for prostate cancer surgery: a survey of US hospitals. Urology 83:626-30
Cram, Peter; Bozic, Kevin J; Callaghan, John J et al. (2014) Use of present-on-admission indicators for complications after total knee arthroplasty: an analysis of Medicare administrative data. J Arthroplasty 29:923-928.e2
Vaughan Sarrazin, Mary S; Cram, Peter; Mazur, Alexandur et al. (2014) Patient perspectives of dabigatran: analysis of online discussion forums. Patient 7:47-54
Singh, Jasvinder A; Lewallen, David G (2014) Time trends in the characteristics of patients undergoing primary total knee arthroplasty. Arthritis Care Res (Hoboken) 66:897-906
Nassar, Boulos S; Vaughan-Sarrazin, Mary S; Jiang, Lan et al. (2014) Impact of an intensive care unit telemedicine program on patient outcomes in an integrated health care system. JAMA Intern Med 174:1160-7
Sattui, Sebastian E; Singh, Jasvinder A; Gaffo, Angelo L (2014) Comorbidities in patients with crystal diseases and hyperuricemia. Rheum Dis Clin North Am 40:251-78

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