15 research outputs found
Large expert-curated database for benchmarking document similarity detection in biomedical literature search
Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe
Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis
The objective was to examine insomnia and insomnia-related care within a regional network of Department of Veterans Affairs (VA) facilities since the VA roll-out of cognitive behavioral therapy for insomnia (CBT-I) in 2011. A retrospective analysis of VA electronic health records (EHR) data from 2011 to 2019 was conducted. The annual and overall prevalence of four insomnia indicators was measured: diagnoses, medications, consultations for assessment/treatment, and participation in CBT-I. Also examined were sociodemographic and clinical differences among veterans with and without an insomnia indicator, as well as differences among the four individual insomnia indicators. The sample included 439,887 veterans, with 17% identified by one of the four indicators; medications was most common (15%), followed by diagnoses (6%), consults (1.5%), and CBT-I (0.6%). Trends over time included increasing yearly rates for diagnoses, consults, and CBT-I, and decreasing rates for medications. Significant differences were identified between the sociodemographic and clinical variables across indicators. An evaluation of a large sample of veterans identified that prescription sleep medications remain the best way to identify veterans with insomnia. Furthermore, insomnia continues to be under-diagnosed, per VA EHR data, which may have implications for treatment consistent with clinical practice guidelines and may negatively impact veteran health
A hybrid type I trial to increase Veterans’ access to insomnia care: study protocol for a randomized controlled trial
Abstract Background Chronic insomnia is among the most reported complaints of Veterans and military personnel referred for mental health services. It is highly comorbid with medical and psychiatric disorders, and is associated with significantly increased healthcare utilization and costs. Evidence-based psychotherapy, namely Cognitive Behavioral Therapy for Insomnia (CBTI), is an effective treatment and recommended over prescription sleep medications. While CBTI is part of a nationwide rollout in the Veterans Health Administration to train hundreds of providers, access to treatment is still limited for many Veterans due to limited treatment availability, low patient and provider knowledge about treatment options, and Veteran barriers such as distance and travel, work schedules, and childcare. Uptake of a briefer, more primary-care-friendly treatment into routine clinical care in Veterans Affairs (VA) primary care settings, where insomnia is typically first recognized and diagnosed, may effectively and efficiently increase access to effective insomnia interventions and help decrease the risks and burdens related to chronic insomnia. Methods This hybrid type I trial is composed of two aims. The first preliminarily tests the clinical non-inferiority of Brief Behavioral Treatment for Insomnia (BBTI) versus the current “gold standard” treatment, CBTI. The second is a qualitative needs assessment, guided by the Consolidated Framework for Implementation Research (CFIR), to identify potential factors that may affect successful implementation and integration of behavioral treatments for insomnia in the primary care setting. To identify potential implementation factors, individual interviews are conducted with the Veterans who participate in the clinical trial, as well as VA primary care providers and nursing staff. Discussion It is increasingly important to better understand barriers to, and facilitators of, implementing insomnia interventions in order to ensure that Veterans have the best access to care. Furthermore, it is important to evaluate the potential for new avenues of treatment delivery, like BBTI in the primary care setting, which can benefit Veterans who may not have adequate access to specialty mental health providers trained in CBTI. Trial registration ClinicalTrials.gov, ID: NCT02724800. Registered on 31 March 2016
Veterans\u27 experiences with and perspectives on insomnia treatment: A qualitative study
Qualitative interviews were conducted with veterans to understand their experiences and perceptions about insomnia and its treatment, with a focus on cognitive-behavioral therapy for insomnia (CBT-I) and brief behavioral treatment for insomnia (BBTI). There is a lack of knowledge about veterans\u27 understanding of this prevalent disorder, yet their experiences and perceptions can influence treatment delivery and treatment outcomes. The Department of Veterans Affairs (VA) can improve insomnia care by considering and responding to this valuable information from veteran stakeholders. Twenty veterans with an insomnia diagnosis or complaint were interviewed about their experiences with insomnia, its treatment, and their preferences for care. Transcripts from the audio-recorded interviews were independently analyzed by 2 coders using content analysis, and discrepancies were resolved through negotiated consensus. The 20 veterans were mostly male (85%), older (60.4 years ± 9.0), and white (60%). Experiences with insomnia and perspectives regarding treatment focused on (a) insomnia symptoms, (b) comorbid symptoms, (c) seeking treatment, (d) intervention experiences, (e) intervention preferences and expectations, and (f) patient attributes. Barriers to care included a lack of knowledge about treatment and a lack of options that fit veterans\u27 preference for delivery. These results provide insight into veterans\u27 experiences with and perspectives on insomnia treatment that is crucial to the support, development, and implementation of interventions. A focus on increasing knowledge of, and expectations for, insomnia treatments as well as offering multiple delivery options has the potential to improve utilization and access to quality insomnia care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Pain Catastrophizing and Arthritis Self-Efficacy as Mediators of Sleep Disturbance and Osteoarthritis Symptom Severity
Objective. Sleep and pain-related experiences are consistently associated, but the pathways linking these experiences are not well understood. We evaluated whether pain catastrophizing and arthritis self-efficacy mediate the association between sleep disturbance and osteoarthritis (OA) symptom severity in patients with knee OA. Methods. We analyzed cross-sectional baseline data collected from Veterans Affairs (VA) patients enrolled in a clinical trial examining the effectiveness of a positive psychology intervention in managing pain from knee OA. Participants indicated how often in the past two weeks they were bothered by trouble falling asleep, staying asleep, or sleeping too much. We used validated scales to assess the primary outcome (OA symptom severity) and potential mediators (arthritis self-efficacy and pain catastrophizing). To test the proposed mediation model, we used parallel multiple mediation analyses with bootstrapping, controlling for sociodemographic and clinical characteristics with bivariate associations with OA symptom severity. Results. The sample included 517 patients (M-age = 64 years, 72.9% male, 52.2% African American). On average, participants reported experiencing sleep disturbance at least several days in the past two weeks (M = 1.41, SD = 1.18) and reported moderate OA symptom severity (M = 48.22, SD = 16.36). More frequent sleep disturbance was associated with higher OA symptom severity directly (b= 3.08, P <0.001) and indirectly, through higher pain catastrophizing (b = 0.60, 95% confidence interval [CI] = 0.20 to 1.11) and lower arthritis self-efficacy (b = 0.84, 95% CI = 0.42 to 1.42). Conclusions. Pain catastrophizing and arthritis self-efficacy partially mediated the association between sleep disturbance and OA symptom severity. Behavioral interventions that address pain catastrophizing and/or self-efficacy may buffer the association between sleep disturbance and OA symptom severity.Public domain articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]