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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
4K24AR062133-05
Application #
9086249
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Lester, Gayle E
Project Start
2012-07-01
Project End
2017-06-30
Budget Start
2016-07-01
Budget End
2017-06-30
Support Year
5
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of Iowa
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52246
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
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
Wolinsky, F D; Lou, Y; Edmonds, S W et al. (2017) The effects of a patient activation intervention on smoking and excessive drinking cessations: results from the PAADRN randomized controlled trial. Osteoporos Int 28:3055-3060
Wolinsky, F D; Hall, S F; Lou, Y et al. (2017) The cost of a patient activation intervention for achieving successful outcomes: results from the PAADRN randomized controlled trial. Osteoporos Int 28:3061-3066
Wolinsky, Fredric D; Lou, Yiyue; Edmonds, Stephanie W et al. (2017) Activating Patients With a Tailored Bone Density Test Results Letter and Educational Brochure: the PAADRN Randomized Controlled Trial. J Clin Densitom 20:464-471
Cram, Peter; Yan, Lin; Bohm, Eric et al. (2017) Trends in Operative and Nonoperative Hip Fracture Management 1990-2014: A Longitudinal Analysis of Manitoba Administrative Data. J Am Geriatr Soc 65:27-34

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