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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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; Hawker, Gillian; Matelski, John et al. (2018) Disparities in Knee and Hip Arthroplasty Outcomes: an Observational Analysis of the ACS-NSQIP Clinical Registry. J Racial Ethn Health Disparities 5:151-161
Cram, Peter; Landon, Bruce E; Matelski, John et al. (2018) Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data. Arthritis Rheumatol 70:547-554
Zhang, Joyce C; Matelski, John; Gandhi, Rajiv et al. (2018) Can Patient Selection Explain the Obesity Paradox in Orthopaedic Hip Surgery? An Analysis of the ACS-NSQIP Registry. Clin Orthop Relat Res 476:964-973
Darragh, Patrick J; Bodley, T; Orchanian-Cheff, A et al. (2018) A Systematic Review of Interventions to Follow-Up Test Results Pending at Discharge. J Gen Intern Med 33:750-758
Nguyen, V T; Edmonds, S W; Lou, Y et al. (2017) Validity, reliability, and responsiveness to change of the ""Osteoporosis and You"" knowledge scale. Osteoporos Int 28:3379-3388
Roblin, Douglas W; Zelman, David; Plummer, Sally et al. (2017) Evaluation of a ""Just-in-Time"" Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial. Perm J 21:
Vaisman, Alon; Cram, Peter (2017) Procedural Competence Among Faculty in Academic Health Centers: Challenges and Future Directions. Acad Med 92:31-34
Hall, Sylvie F; Edmonds, Stephanie W; Lou, Yiyue et al. (2017) Patient-reported reasons for nonadherence to recommended osteoporosis pharmacotherapy. J Am Pharm Assoc (2003) 57:503-509
Yermak, Darya; Cram, Peter; Kwan, Janice L (2017) Five things to know about diagnostic error. Diagnosis (Berl) 4:13-15
Cram, Peter; Dhalla, Irfan; Kwan, Janice L (2017) Trade-Offs: Pros and Cons of Being a Doctor and Patient in Canada. J Gen Intern Med 32:563-565

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