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Indexed in MEDLINE, Pubmed, and Pubmed Central National Library of Medicine Indexed in MEDLINE, PubMed, and PubMed Central National Library of Medicine Summer 2020 Volume 24 No. 4 A peer-reviewed journal of medical science, social science in medicine, and medical humanities ORIGINAL RESEARCH & CONTRIBUTIONS 1 A Pharmacist-Led Program to Taper Opioid Use at Kaiser Permanente Northwest: Rationale, Design, and Evaluation 12 An Evaluation of the SCORE Program: A Novel Re- search and Mentoring Program for Medical Students in Obstetrics/Gynecology and Otolaryngology 19 Sequential Changes Advancing from Exercise-In- duced Psychological Improvements to Controlled Eating and Sustained Weight Loss: A Treatment- Focused Causal Chain Model 28 On the Use of Sampling Weights for Retrospective Medical Record Reviews 37 Utilization of Secure Messaging to Primary Care Departments CLINICAL PRACTICE 67 Variation in Colorectal Cancer Stage and Mortality across Large Community-Based Populations: PORTAL Colorectal Cancer Cohort CLINICAL MEDICINE 101 Endocrine Tumor Board: Ten Years’ Experience of a Multidisciplinary Clinical Working Conference CASE REPORTS 110 Pertussis Infection in a Naturopathic Primary Care Setting: Reflection on a Case 114 Hemolytic Anemia in a Glucose-6-Phosphate Dehy- drogenase-Deficient Patient Receiving Hydroxychlo- roquine for COVID-19: A Case Report IMAGE DIAGNOSIS 131 Neodymium Magnetic Bead Ingestion in a Toddler COMMENTARY 133 Addressing Vaccine Hesitancy 135 CARE for COVID-19: A Checklist for Documentation of Coronavirus Disease 2019 Case Reports and Case Series 141 A Day in the Life during COVID-19: Long-term Care Providers in Durham, North Carolina 143 More Than Words: Reflections to Build Resilience during the COVID-19 Pandemic EDITORIAL 150 The South Asian Paradox NURSING 153 Collins Complex Wound Guide Template Find us online at www.thepermanentejournal.org TABLE OF CONTENTS Summer 2020/Volume 24 No. 4 ORIGINAL RESEARCH 28 On the Use of Sampling Weights for Retrospec- & CONTRIBUTIONS tive Medical Record Reviews. Ernest Shen, PhD Sponsored by the 8 Permanente Medical Groups A recent review of articles that used the retro- 1 A Pharmacist-Led Program to Taper Opioid Use spective medical record review method listed 10 at Kaiser Permanente Northwest: Rationale, best practices that ought to be followed. However, Mission: The Permanente Journal advances Design, and Evaluation. Jennifer L Kuntz, PhD; an issue that is not listed is the use of sampling knowledge in scientific research, clinical medicine, Jennifer L Schneider, MPH; Alison J Firemark, MA; weights, which are important when one can only and innovative health care delivery. John F Dickerson, PhD; Dea Papajorgji-Taylor, conduct retrospective medical record review for MPH; Katherine R Reese, PharmD; Traci A Hamer, a sample of the target population. Although that PharmD; Darlene Marsh, PharmD; Lou Ann Circulation: 2 million page views of TPJ articles review acknowledged the importance of carefully Thorsness, RPh; Mark D Sullivan, MD, PhD; Lynn selecting a sampling strategy for such a scenario in PubMed from a broad international readership L Debar, PhD; David H Smith, PhD, RPh and indeed had outlined 3 commonly used sam- Primary care practitioners (PCPs) are concerned pling methods (convenience, simple random, and about adverse effects and poor outcomes of opioid systematic), the authors say nothing of the use of use but may find opioid tapering difficult because sampling information at the data analysis stage. of a lack of pain management training or time This article aims to fill that gap and to demonstrate constraints limiting patient counseling. In 2010, why the use of sample weights ought to be another Kaiser Permanente Northwest implemented a best practice to add to the list by reviewing well- pharmacist-led opioid tapering program—Support known theoretical details and some published data Team Onsite Resource for Management of Pain analysis examples. (STORM)—to address high rates of opioid use, 32 Influence of Psychosocial Factors and alleviate PCPs’ workload demands, and improve Parafunctional Habits in Temporomandibular patient outcomes. Disorders: A Cross-Sectional Study. Utkarsh 12 An Evaluation of the SCORE Program: A Yadav, MDS; Junaid Ahmed, MDS; Ravikiran Novel Research and Mentoring Program for Ongole, MDS; Nandita Shenoy, MDS; Nanditha Medical Students in Obstetrics/Gynecology Sujir, MDS; Srikant Natarajan, MDS and Otolaryngology. Kellie Corcoran, MD, MPH; Temporomandibular disorders (TMDs) are abnor- Miranda Ritterman Weintraub, PhD, MPH; Isabel- malities affecting the temporomandibular joint, jaw la Silvestre; Reshma Varghese; Jonathan Liang, muscles, or both. An intrinsic relationship reportedly MD; Eve Zaritsky, MD exists between TMDs and psychosocial factors, in- There has been a steady decrease in the number cluding stress. Parafunctional habits such as brux- Chrysler Trylons of physician-scientists and a lack of diversity and ism and clenching are also known to be responsible photograph inclusion of underrepresented minorities (URMs) for TMDs. Patients included in the study reported, Manfred Hauben, MD, MPH in medicine. To assess the research productivity, as their chief concern, pain lasting for more than a interest, and experience of medical students, week in the temporomandibular joint area and/or In the heart of New York City, adjacent to the Chrysler Building including URMs, and resident and faculty masticatory muscles. The patients were divided into (left), the famed architect Philip Johnson designed the Trylons mentors of the Kaiser Permanente Oakland age groups as follows: Younger than 20 years, 21 “as a monument for 42nd Street… to give you the top of the Medical Center’s 8-week, intensive, mentored to 30 years, 31 to 40 years, 41 to 50 years, 51 to Chrysler building at street level” via visual analogy with the Summer Clinical Otolaryngology and Obstetrics/ 60 years, and above 60 years. Patients were ex- chevron-ornamented spire of its namesake. It’s one of many Gynecology Research (SCORE) Program for amined clinically and were asked to complete an visual reminders that the epicenter of the COVID-19 pandemic in second-year medical students. A database of anamnestic questionnaire (modified version of Hel- the US is still a bejeweled city. SCORE Program research projects was generat- kimo Anamnestic Index) and the Hospital Anxiety ed from 2016, when the program was launched, and Depression Scale (HADS). Dr Hauben is a Senior Director at Worldwide Medical & Safety, through 2018. SCORE Program students and 37 Utilization of Secure Messaging to Primary Pfizer, Inc and a Clinical Assistant Professor in the Department of faculty completed a brief, mixed-methods, anon- Care Departments. Jose Yakushi, MD; Mose Medicine at NYU Langone Health. ymous exit survey that captured respondents’ Wintner, PhD; Naomi Yau; Lina Borgo, MPH; experiences, perceived program strengths, and Edwin Solorzano, MD opportunities for improvement. Photograph and caption by Manfred Hauben, MD, MPH Secure messaging is a platform for email commu- 19 Sequential Changes Advancing from Exer- nication between patients and their physicians. cise-Induced Psychological Improvements to Although patient-generated emails are associated Controlled Eating and Sustained Weight Loss: with increased use of clinical services, greater A Treatment-Focused Causal Chain Model. member retention, and improved quality of care, EDITORIAL & PUBLISHING OFFICE James J Annesi, PhD, FAAHB, FTOS, FAPA secure messaging has a marked impact on prima- The Permanente Journal Behavioral (nonsurgical/nonpharmacologic) weight ry care physicians’ workload. To understand how c/o Laura Fegraus 1 Kaiser Plaza, 27th Floor loss treatments have been overwhelmingly unsuc- the email topic and volume vary by demographics Oakland, CA 94612 cessful beyond the short term. Rather than incor- and clinical factors among members of a managed Email: [email protected] porating accepted behavioral change theory, most care organization, we analyzed all secure mes- INSTRUCTIONS FOR SUBMISSION have inadequately relied on providing exercise and sages sent to primary care departments by adult Instructions for Authors are available along with a link to our manuscript nutrition information. Although adherence is a chal- members of Kaiser Permanente Southern Califor- submission center at www.thepermanentejournal.org/authors.html lenge, exercise has emerged as the most robust nia (KPSC) in 2017. PERMISSIONS AND REPRINTS predictor of sustained weight reduction. However, Reprint Permission Form available at: exercise might be more associated with long-term www.thepermanentejournal.org/about-us/5818-reprint-permissions.html weight loss through the relationship of its associated The Editorial Staff have disclosed that they have no personal, professional, psychological changes with improved nutrition than or financial involvement in any of the manuscripts they might judge. Should a through direct effects of energy expenditures, which conflict arise in the future, the Editorial Staff have agreed to recuse themselves are typically minimal in deconditioned individuals. regarding any specific manuscripts. The Editorial Staff also will not use the information attained through working with manuscripts for private gain. The Permanente Journal (ISSN 1552-5775) is a quarterly publication of articles from the online journal of record, which is available at: Contents continued on next page www.thepermanentejournal.org. Copyright © 2020 The Permanente Journal The Permanente Journal • Summer 2020 46 Psychometric
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