David Paculdo
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View article: Impact of medication nonadherence and drug-drug interaction testing on the management of primary care patients with polypharmacy: a randomized controlled trial
Impact of medication nonadherence and drug-drug interaction testing on the management of primary care patients with polypharmacy: a randomized controlled trial Open
https://clinicaltrials.gov/study/NCT05910684 .
View article: A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB
A Randomized Controlled Study on Clinical Adherence to Evidence-Based Guidelines in the Management of Simulated Patients With Barrett's Esophagus and the Clinical Utility of a Tissue Systems Pathology Test: Results From Q-TAB Open
INTRODUCTION: Barrett's esophagus (BE) is a precursor to esophageal adenocarcinoma. Physicians infrequently adhere to guidelines for managing BE, leading to either reduced detection of dysplasia or inappropriate re-evaluation. METHODS: We …
View article: Clinical utility of a novel test for assessing cardiovascular disease risk in type 2 diabetes: a randomized controlled trial
Clinical utility of a novel test for assessing cardiovascular disease risk in type 2 diabetes: a randomized controlled trial Open
Background The risk for and treatment of cardiovascular disease (CVD) in type 2 diabetes (T2DM) is often incorrect and delayed. We wished to determine if a novel test improved physicians’ ability to risk stratify, diagnose, and treat patie…
View article: Clinical Variation in the Treatment Practices for Patients With Type 2 Diabetes: A Cross‐Sectional Patient Simulation Study Among Primary Care Physicians and Cardiologists
Clinical Variation in the Treatment Practices for Patients With Type 2 Diabetes: A Cross‐Sectional Patient Simulation Study Among Primary Care Physicians and Cardiologists Open
Background Cardiovascular disease risk stratification is necessary and critically important in patients with type 2 diabetes. Despite its known benefits to guide treatment and prevention, we hypothesized that providers do not routinely inc…
View article: Gaps in the Care of Pulmonary Hypertension: A Cross‐Sectional Patient Simulation Study Among Practicing Cardiologists and Pulmonologists
Gaps in the Care of Pulmonary Hypertension: A Cross‐Sectional Patient Simulation Study Among Practicing Cardiologists and Pulmonologists Open
Background Diagnosis of pulmonary hypertension (PH) is often delayed or missed, leading to disease progression and missed treatment opportunities. In this study, we measured variation in care provided by board‐certified cardiologists and p…
View article: Clinical variation in surveillance and management of Barrett’s esophagus: A cross-sectional study of gastroenterologists and gastrointestinal surgeons
Clinical variation in surveillance and management of Barrett’s esophagus: A cross-sectional study of gastroenterologists and gastrointestinal surgeons Open
Appropriate surveillance and treatment of Barrett’s esophagus (BE) is vital to prevent disease progression and decrease esophageal adenocarcinoma (EAC)-related mortality. We sought to determine the variation in BE care and identify improve…
View article: Clinical Variation in the Treatment Practices for Medication Nonadherence, Drug–Drug Interactions, and Recognition of Disease Progression in Patients with Chronic Cardiometabolic Diseases: A Cross‐Sectional Patient Simulation Study among Primary Care Physicians
Clinical Variation in the Treatment Practices for Medication Nonadherence, Drug–Drug Interactions, and Recognition of Disease Progression in Patients with Chronic Cardiometabolic Diseases: A Cross‐Sectional Patient Simulation Study among Primary Care Physicians Open
Background . Medication nonadherence in patients with chronic diseases is common, costly, and often underdiagnosed. In the United States, approximately 40–50% of patients with cardiometabolic conditions are not adherent to long‐term medica…
View article: Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury during Percutaneous Cardiovascular Procedures
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney Injury during Percutaneous Cardiovascular Procedures Open
Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major clinical complication of percutaneous cardiovascular procedures requiring iodinated contrast. Despite its relative frequency, practicing physicians are unlikely to iden…
View article: Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial Open
Background Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients. Objective In this study, we introduced a nove…
View article: Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study
Initiative to Improve Evidence-Based Chronic Obstructive Pulmonary Disease Hospitalist Care Using a Novel On-Line Gamification Patient Simulation Tool: A Prospective Study Open
Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality. Much of the disease burden comes from exacerbations requiring hospitalization. Unwarranted care variation and divergence from evidence-based C…
View article: Randomized Trial to Improve Primary Care Patient Management and Patient Outcomes Using a Drug–Drug Interaction Test: Confirmation of the DECART Simulated Patient Clinical Utility Trial Results
Randomized Trial to Improve Primary Care Patient Management and Patient Outcomes Using a Drug–Drug Interaction Test: Confirmation of the DECART Simulated Patient Clinical Utility Trial Results Open
Drug–drug interactions (DDIs) are a serious problem in the healthcare system, leading to excess healthcare utilization and costs. We conducted a second prospective randomized, controlled trial to further establish the real-world clinical u…
View article: List of Substances Detected by DDI Testing
List of Substances Detected by DDI Testing Open
List of Substances Detected by DDI Testing
View article: Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial (Preprint)
Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial (Preprint) Open
BACKGROUND Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients. OBJECTIVE In this study, we introduced a n…
View article: A nationwide program to improve clinical care quality in the Kyrgyz Republic
A nationwide program to improve clinical care quality in the Kyrgyz Republic Open
This study demonstrates serial measurement of care provided by over 2000 physicians in the Kyrgyz Republic can be improved as measured by CPVs. This project may be a useful template to improve health care quality at a national level in oth…
View article: Randomized Trial on the Clinical Utility of a Novel Biomarker Panel to Identify Treatable Determinants of Chronic Pain
Randomized Trial on the Clinical Utility of a Novel Biomarker Panel to Identify Treatable Determinants of Chronic Pain Open
Millions suffer daily from chronic pain diagnosed anatomically and treated with opioids. Research shows that underlying nutritional, metabolic and oxidative stressors, which drive the development or worsening of chronic pain, are not diagn…
View article: Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer
Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer Open
The alarming situation of the 2019 novel coronavirus disease (COVID‐19) is contrasted by the limited efforts to curb the spread and impact of the disease among patients with cancer. This commentary proposes a simple 5‐part strategy plus ra…
View article: The Diagnostic Error in Medicine 12th Annual International Conference
The Diagnostic Error in Medicine 12th Annual International Conference Open
Background:The prevailing theory regarding disparities in diagnostic errors in primary care suggests implicit bias, and clinical reasoning as the major causal factors.This view is limited to physician-related factors, and excludes patient,…
View article: Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy
Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy Open
PURPOSE: Addressing unwarranted clinical variation in oncology is a high priority for health systems that aspire to ensure consistent levels of high-quality and cost-effective care. Efforts to improve clinical practice and standardize care…
View article: Quality of Health Care in the Lao People's Democratic Republic
Quality of Health Care in the Lao People's Democratic Republic Open
The Lao People's Democratic Republic (Lao PDR) has ambitious and laudable goals for universal health coverage, with a view to increasing health outcomes especially for the most vulnerable in society. It has set up the National Health Insur…
View article: Variation in Diabetes Management: A National Assessment of Primary Care Providers
Variation in Diabetes Management: A National Assessment of Primary Care Providers Open
Background: Glucose control is monitored primarily through ordering HbA1c levels, which is problematic in patients with glycemic variability. Herein, we report on the management of these patients by board-certified primary care providers (…
View article: Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design
Establishing Clinical Utility for Diagnostic Tests Using a Randomized Controlled, Virtual Patient Trial Design Open
Demonstrating clinical utility for diagnostic tests and securing coverage and reimbursement requires high quality and, ideally, randomized controlled trial (RCT) data. Traditional RCTs are often too costly, slow, and cumbersome for diagnos…
View article: Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System Open
OBJECTIVE To (1) measure hospitalist care for sepsis and heart failure patients using online simulated patients, (2) improve quality and reduce cost through customized feedback, and (3) compare patient‐level outcomes between project partic…
View article: Variation in Assessing Renal Allograft Rejection: A National Assessment of Nephrology Practice
Variation in Assessing Renal Allograft Rejection: A National Assessment of Nephrology Practice Open
Background . The clinical utility of early detection and treatment of allograft rejection is well-established. Despite frequent testing called for by standard of care protocols, the five-year kidney allograft survival rate is estimated to …
View article: Standardising practice in cardiology: reducing clinical variation and cost at Ochsner Health System
Standardising practice in cardiology: reducing clinical variation and cost at Ochsner Health System Open
Objective Low quality and unwarranted clinical variation harm patients and increase unnecessary costs. Effective approaches to improve clinical and economic value have been difficult. The Ochsner Health System looked to improve clinical ca…
View article: Clinical Utility of Definitive Drug–Drug Interaction Testing in Primary Care
Clinical Utility of Definitive Drug–Drug Interaction Testing in Primary Care Open
Drug–drug interactions (DDIs) are a leading cause of morbidity and mortality. New tools are needed to improve identification and treatment of DDIs. We conducted a randomized controlled trial to assess the clinical utility of a new test to …
View article: Drug-Drug Interaction Assessment and Identification in the Primary Care Setting
Drug-Drug Interaction Assessment and Identification in the Primary Care Setting Open
PCPs in this study did not recognize or adequately treat DDIs. Better methods are needed to screen for DDIs in the primary care setting.