Explanipedia

Qualitative Analysis of Patient-Physician Discussions About the Benefits and Tradeoffs of Heart Failure Medications Open

Henry D. Biermann, Candace D. Speight, Sarah C. Montembeau, Andrea R. Mitchell, Emily Fryman Lowe , et al. · 2025

Rare inclusion of medication benefit magnitude, variability in the presentation of benefits, and use of persuasive and emotive communication all challenge traditional notions of shared decision-making but are commonly encountered in clinic…

Transforming research recruitment: Leveraging EHR systems and patient portals Open

Megan Schwinne, Edward Woods, Becky Chan, Candace D. Speight, Vivian Corry , et al. · 2024

Electronic health records and patient portals are increasingly utilized to enhance research recruitment efficiency, yet response patterns across patient groups remain unclear. We examined 10 studies at Emory Healthcare that used these tool…

Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF) Open

Neal W. Dickert, Candace D. Speight, Madeline Balser, Henry Biermann, J. Kelly Davis , et al. · 2024

BACKGROUND: Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable dur…

Integrating Cost into Shared Decision-Making for Heart Failure with Reduced Ejection Fraction (POCKET-COST-HF): A Trial Providing Out-of-Pocket Costs for Heart Failure Medications during Clinical Encounters Open

Sarah C. Montembeau, Birju Rao, Andrea R. Mitchell, Candace D. Speight, Larry A. Allen , et al. · 2023

Highlights From the <i>Circulation</i> Family of Journals Open

Martin Burke, Reinoud E. Knops, Vivek Y. Reddy, Johan D. Aasbo, Michael Husby , et al. · 2023

The August highlights from the Circulation family of journals cover a variety of interesting topics.The experience with a novel extravascular ICD lead is reported in Circulation: Arrhythmia and Electrophysiology.The incidence of cardiogeni…

Patients’ Perspectives Regarding Generator Exchanges of Implantable Cardioverter Defibrillators Open

Sarah C. Montembeau, Faisal M. Merchant, Candace D. Speight, Daniel B. Kramer, Daniel D. Matlock , et al. · 2023

BACKGROUND: Shared decision-making is mandated for patients receiving primary prevention implantable cardioverter defibrillators (ICDs). Less attention has been paid to generator exchange decisions, although at the time of generator exchan…

Deciding Whether to Take Sacubitril/Valsartan: How Cardiologists and Patients Discuss Out‐of‐Pocket Costs Open

Birju Rao, Dennis Akrobetu, Neal W. Dickert, Thuy‐Vi V. Nguyen, J. Kelly Davis , et al. · 2023

Background Out‐of‐pocket costs have significant implications for patients with heart failure and should ideally be incorporated into shared decision‐making for clinical care. High out‐of‐pocket cost is one potential reason for the slow upt…

Research recruitment through the patient portal: perspectives of community focus groups in Seattle and Atlanta Open

Kathryn M. Porter, Stephanie A. Kraft, Candace D. Speight, Devan M. Duenas, Nyiramugisha Niyibizi , et al. · 2023

Objective Research recruitment through patient portals (ie, patient-facing, web-based clinical interfaces) has the potential to be effective, efficient, and inclusive, but best practices remain undefined. We sought to better understand how…

Impact of Financial Considerations on Willingness to Take Sacubitril/Valsartan for Heart Failure Open

Birju Rao, Candace D. Speight, Larry A. Allen, Scott D. Halpern, Yi‐An Ko , et al. · 2022

Background Sacubitril/valsartan improves health outcomes for heart failure with reduced ejection fraction relative to angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers, but it carries higher out‐of‐pocket costs. Nei…

Experimenting with modifications to consent forms in comparative effectiveness research: understanding the impact of language about financial implications and key information Open

Nyiramugisha Niyibizi, Candace D. Speight, Gabriel Najarro, Andrea R. Mitchell, Ofer Sadan , et al. · 2022

Framing Benefits in Decision Aids: Effects of Varying Contextualizing Statements on Decisions About Sacubitril-Valsartan for Heart Failure Open

Mary Catherine Thomson, Larry A. Allen, Scott D. Halpern, Yi‐An Ko, Daniel D. Matlock , et al. · 2021

Background. Presenting numeric data alone may result in patients underappreciating clinically significant benefits. Contextualizing statements to counter this may raise concern about absence of neutrality. These issues arose during constru…

PREDICTORS OF LIKELIHOOD OF TAKING SACUBITRIL-VALSARTAN AND A HYPOTHETICAL MEDICATION FOR COVID-19 Open

Mary Catherine Thomson, Larry A. Allen, Scott D. Halpern, Yi-An Ko, Daniel D. Matlock , et al. · 2021

Meeting unique requirements: Community consultation and public disclosure for research in emergency setting using exception from informed consent Open

Neal W. Dickert, Kathleen E. Metz, Michael D. Fetters, Adrianne Haggins, Deneil K. Harney , et al. · 2021

Background Exception from informed consent (EFIC) regulations for research in emergency settings contain unique requirements for community consultation and public disclosure. These requirements address ethical challenges intrinsic to this …

Reframing Recruitment: Evaluating Framing in Authorization for Research Contact Programs Open

Candace D. Speight, Charlie Gregor, Yi-An Ko, Stephanie A. Kraft, Andrea R. Mitchell , et al. · 2021

This study demonstrated that employing behavioral science-driven communication strategies for authorization for research contact had an effect on likelihood of hypothetical enrollment but did not significantly affect comprehension. Strateg…

Show Me the Money Open

Neal W. Dickert, Andrea R. Mitchell, Grace Venechuk, Daniel D. Matlock, Miranda A. Moore , et al. · 2020

Background: Out-of-pocket medication costs for patients who have heart failure with reduced ejection fraction may be an important part of shared decision-making, but cost has generally been excluded from clinical discussions. This study re…

Heart Failure and Shared Decision-Making: Patients Open to Medication-Related Cost Discussions Open

Birju Rao, Neal W. Dickert, Alanna A. Morris, Candace D. Speight, Graham Smith , et al. · 2020

Background: Discussions of medication costs between patients and clinicians are infrequent and often suboptimal. In the context of recently introduced drugs that are effective but expensive, patients with heart failure with reduced ejectio…

Understanding and Improving Informed Consent for Clinical Trials during Health Emergencies Open

Neal W. Dickert, Andrea R. Mitchell, Candace D. Speight, Michael Frankel, Sara F. Goldkind , et al. · 2020

Public attitudes toward an authorization for contact program for clinical research Open

Nyiramugisha Niyibizi, Candace D. Speight, Charlie Gregor, Yi-An Ko, Stephanie A. Kraft , et al. · 2020

We conducted an online experimental survey to evaluate attitudes toward an authorization for contact (AFC) program allowing researchers to contact patients about studies based on electronic record review. A total of 1070 participants were …

Determinants of Patient and Surrogate Experiences With Acute Care Research Consent: A Key Informant Interview Study Open

Victoria M. Scicluna, Sara F. Goldkind, Andrea R. Mitchell, Rebecca D. Pentz, Candace D. Speight , et al. · 2019

Background Informed consent for acute myocardial infarction and stroke research is challenging. Time for enrollment decisions is limited, patients and family are usually stressed, and being asked to participate in research is often unexpec…

Why Do Patients Decline Heart Failure Trials, and What Should We Do About It? Open

Supriya Shore, Candace D. Speight, Anita A. Kelkar, Divya Kishore, Neal W. Dickert · 2019

Background: Low patient enrollment in randomized clinical trials (RCTs) escalates costs, leads to under-representation of real-world patient populations, and delays generation of knowledge. Limited data exists on why patients decline parti…

Emergency Consent: Patients’ and Surrogates’ Perspectives on Consent for Clinical Trials in Acute Stroke and Myocardial Infarction Open

Neal W. Dickert, Victoria M. Scicluna, Opeolu Adeoye, Dominick J. Angiolillo, James C. Blankenship , et al. · 2019

Background Emergent informed consent for clinical trials in acute myocardial infarction (AMI) and stroke is challenging. The role and value of consent are controversial, and insufficient data exist regarding patients’ and surrogates’ exper…

Discussing Out‐of‐Pocket Costs With Patients: Shared Decision Making for Sacubitril‐Valsartan in Heart Failure Open

Graham Smith, Supriya Shore, Larry A. Allen, David W. Markham, Andrea R. Mitchell , et al. · 2018

Background “Financial toxicity” is a concern for patients, but little is known about how patients consider out‐of‐pocket cost in decisions. Sacubitril‐valsartan provides a contemporary scenario to understand financial toxicity. It is guide…

Consent for Pragmatic Trials in Acute Myocardial Infarction Open

Neal W. Dickert, David Wendler, Chandan Devireddy, Sara F. Goldkind, Yi‐An Ko , et al. · 2018

Trends in Consent for Clinical Trials in Cardiovascular Disease Open

Louis A. Kerkhoff, Javed Butler, Anita A. Kelkar, Supriya Shore, Candace D. Speight , et al. · 2016

Background Cardiovascular clinical trials depend on patient enrollment. Enrollment rates appear inadequate, but little is known about how frequently patients accept or decline offers of enrollment. The objective of this study was to assess…

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