Disparities in Mobile Phone Use Among Adults With Type 2 Diabetes Participating in Clinical Trials 2017-2021

Despite smartphone ownership becoming ubiquitous, it is unclear whether and where disparities persist in experience using health apps. In 2 diverse samples of adults with type 2 diabetes collected 2017-2018 and 2020-2021, we examined adjusted disparities in smartphone ownership and health app use by age, gender, race, education, annual household income, health insurance status, health literacy, and hemoglobin A1c. In the earlier sample (N = 422), 87% owned a smartphone and 49% of those had ever used a health app. Participants with lower income or limited health literacy had ≥50% lower odds of owning a smartphone. Comparatively, in the later sample (N = 330), almost all participants (98%) owned a smartphone and 70% of those had ever used a health app; however, disparities in health app use closely mirrored disparities in smartphone ownership from 2017 to 2018. Our findings suggest device ownership is necessary but insufficient for assuming people will use apps to support their health

The effect of CPAP treatment on T2DM in moderate to severe OSA subjects

Introduction: Obstructive sleep apnea (OSA) is a significant risk factor for type 2 diabetes mellitus (T2DM). CPAP treatment can potentially improve glycemic control in such subjects. However, the exact effects of CPAP treatment on diabetes are uncertain. The objective of this study is to examine the effect of CPAP treatment on HbA1c levels in subjects with moderate to severe OSA and T2DM. Methods: This is a combined retrospective and prospective study collecting data through EPIC medical record reviews. We are collecting HbA1c levels (primary outcome variable) before and after CPAP treatment in subjects with moderate to severe OSA and T2DM. The analysis will be controlled for via CPAP compliance, which will be assessed as both a categorical (adherent/non-adherent) and continuous predictor variable (number of hours of nightly usage). Results: Reproducibility of collected data has been verified as \u3e95% between chart reviewers on this project. We have collected data on 10 subjects so far and analysis results are pending. We hypothesize that higher levels of CPAP compliance will correlate with significant reductions in HbA1c levels in patients with both moderate to severe OSA and T2DM. Discussion: Some studies report a decrease in HbA1c levels after CPAP treatment, while others report no significant change. All studies report that their limiting factor was variable CPAP adherence rates and small sample size. This project will add to the existing literature with a goal sample size of n=5000 and CPAP adherence rates above 70%, much higher than the national average (30%)

Effect of Drain Duration and Output on Perioperative Outcomes and Readmissions after Lumbar Spine Surgery

Study design: Single-center retrospective cohort. Purpose: To compare surgical outcomes of patients based on lumbar drain variables relating to output and duration. Overview of literature: The use of drains following lumbar spine surgery, specifically with respect to hospital readmission, postoperative hematoma, postoperative anemia, and surgical site infections, has been controversial. Methods: Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (\u3c40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05. Results: Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify any of the drain variables as independent predictors of hospital readmission, postoperative blood transfusion, or postoperative anemia. ROC analysis demonstrated the drain variables to be poor predictors of hospital readmission, with the highest area under curve of 0.524 (drain duration), corresponding to a sensitivity of 61.3% and specificity of 49.9%. Conclusions: Drain output or duration did not affect readmission rates following lumbar spine surgery