Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach.

BACKGROUND: Patient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. OBJECTIVE: This study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM. METHODS: We conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. RESULTS: During co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement. CONCLUSIONS: Although the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care.

Direct Lysis RT-qPCR of SARS-CoV-2 in Cell Culture Supernatant Allows for Fast and Accurate Quantification.

Studying the entire virus replication cycle of SARS-CoV-2 is essential to identify the host factors involved and treatments to combat infection. Quantification of released virions often requires lengthy procedures, whereas quantification of viral RNA in supernatant is faster and applicable to clinical isolates. Viral RNA purification is expensive in terms of time and resources, and is often unsuitable for high-throughput screening. Direct lysis protocols were explored for patient swab samples, but the lack of virus inactivation, cost, sensitivity, and accuracy is hampering their application and usefulness for in vitro studies. Here, we show a highly sensitive, accurate, fast, and cheap direct lysis RT-qPCR method for quantification of SARS-CoV-2 in culture supernatant. This method inactivates the virus and permits detection limits of 0.043 TCID50 virus and <1.89 copy RNA template per reaction. Comparing direct lysis with RNA extraction, a mean difference of +0.69 ± 0.56 cycles was observed. Application of the method to established qPCR methods for RSV (-ve RNA), IAV (segmented -ve RNA), and BHV (dsDNA) showed wider applicability to other enveloped viruses, whereby IAV showed poorer sensitivity. This shows that accurate quantification of SARS-CoV-2 and other enveloped viruses can be achieved using direct lysis protocols, facilitating a wide range of high- and low-throughput applications.

The era of virtual care: Perspectives of youth on virtual appointments in COVID-19 and beyond.

In response to COVID-19, paediatric providers have shifted to providing outpatient health care appointments through telehealth. Youth perspectives on changes to health care access during the pandemic are important to consider when optimizing care for paediatric patients. Youth who contributed to this commentary reported that major benefits of virtual care included time savings, ease of access, continuity of care, and ability to participate in health appointments from the comfort of one's own home without a risk of COVID-19 exposure. These youth also recognized limitations to virtual care, including the inability to complete laboratory or imaging tests, and the lack of physical examination capabilities. Additionally, they stressed the importance of visual components of virtual appointments and health care providers needing to consider privacy restrictions youth may have. Overall, our cohort of youth feel positive about virtual care and hope care providers can work with youth individually to determine the best solution for them.

The Gender of COVID-19 Experts in Newspaper Articles: a Descriptive Cross-Sectional Study.

BACKGROUND: Pre-existing gender-based disparities in academia may have worsened during the COVID-19 pandemic. Being cited as an expert source in newspaper articles about COVID-19 may increase an individual's research or leadership profile. In addition, visibility in a newspaper article is an important component of representation in academia. OBJECTIVE: To determine whether women were underrepresented as COVID-19 expert sources in print newspapers in the USA. DESIGN: We undertook a cross-sectional study of English-language newspaper articles that addressed the COVID-19 pandemic and that were published in the top 10 most widely read newspapers in the USA between April 1 and April 15, 2020. MAIN MEASURES: We extracted the names of all people cited as expert sources and categorized the gender of each expert source based on pronoun usage within the article or on a business, university, or organization website. The professional role of each expert was assigned based on their description in the article. KEY RESULTS: Of 2297 expert sources identified, 35.9% (95% confidence interval [CI] 33.9-37.8%; n = 824) were women and 63.7% were men (95% CI 61.8-65.7%; n = 1464). This result was similar when considering unique experts in each newspaper and for all included newspapers; of the 1738 unique experts per newspaper, 34.6% were women (95% CI 32.3-36.8%; n = 601), and of the 1593 unique experts in all newspapers, 36.5% were women (95% CI 34.1-38.9%; n = 581). Of articles with multiple experts referenced (n = 374), 102 cited only men experts (27.3%) and 44 cited only women experts (11.8%). Women were underrepresented as experts as Healthcare Workers and Professionals, Non-STEM Experts, Public Health Leaders, and STEM Scientists. There were no differences in the proportion of women experts between newspapers or between different regions of the USA. CONCLUSIONS: Altogether, our findings support that men academics outnumber women as COVID-19 experts in newspaper articles.