OBJECTIVE To determine whether clinician prompting regarding a child's symptom severity and guideline recommendations at the time of an office visit improves the delivery of preventive asthma care. DESIGN Randomized controlled trial. SETTING Two inner-city pediatric practices in Rochester, NY. PARTICIPANTS Two hundred twenty-six children with persistent asthma (aged 2-12 years) presenting...

Medication in for ma lion is one of [he most important clinical data types in electronic medical records (EMR) This study developed an NLP application (PredMED) to extract full prescriptions and their relevant components from a large corpus of unstructured ambulatory office visit clinical notes and the corresponding structured medication reconciliation (MED REC) data in the EMR. PredMED achieve...

Blood pressure (BP) is known to vary over time within individuals. Although variability between office visits has traditionally been regarded as a barrier to the accurate measurement of BP, several recent studies have reported strong associations between visit-to-visit variability (VVV) of BP and increased risk for cardiovascular outcomes. In this article, we review data on VVV of BP and outcom...

BACKGROUND Patients and physicians value effective communication and consider it an essential part of the medical encounter. This study examined physician-patient communication patterns, and interruptions in communication, during patient visits with family practice and internal medicine residents. METHODS Observational data obtained from 60 routine primary care office visits included the time...

Objective: To assess the effect of differing health insurance coverage of physician office visits on the use of colorectal cancer (CRC) tests among an employed and insured population. Method: Cohort study of persons ages 50 to 64 years enrolled in fee-for-service (FFS) or preferred provider organization (PPO) health plans, where FFS plan enrollees bear disproportionate share of office visit cov...

Pediatric practice guidelines call for repeating an elevated office blood pressure (BP) at the same visit, but there are few data available to support this recommendation. We compared the visit results in children aged 3 to 17 years with a BP reading ≥95th percentile (n = 186 732) based on the initial BP and the mean of two BP readings, using electronic medical records from 2012-2015. Failure t...

BACKGROUND Oral rehydration solutions (ORS) for the treatment of acute diarrhea remain an underutilized therapy in the United States, despite multiple clinical trials confirming their efficacy and safety. Economic barriers to their use have been identified. OBJECTIVE To determine whether providing ORS to patients at the time of their office visit for acute diarrhea can increase ORS utilizatio...

Delaying treatment for benign musculoskeletal conditions may allow patients to learn self-efficacy and develop coping strategies, leading to less medical intervention and reduced cost. We tested the hypothesis that time from booking until appointment is not associated with healthcare costs. We further tested the secondary hypothesis that time from booking to appointment is not associated with s...

Introduction. We evaluated the effectiveness of office-based accommodative/vergence therapy (OBAVT) with home reinforcement to improve accommodative function in myopic children with poor accommodative response. Methods. This was a prospective unmasked pilot study. 14 Chinese myopic children aged 8 to 12 years with at least 1 D of lag of accommodation were enrolled. All subjects received 12 week...