ABSTRACT
Background: Several studies reported sharp decreases in screening mammography for breast cancer and low-dose computerized tomographic screening for lung cancer in the early months of the COVID-19 pandemic, followed by a return to normal or near-normal levels in the summer of 2020. Objective(s): To determine the observed vs. expected mammography and low dose computed tomography rates from the beginning of the pandemic through April 2022. Method(s): Retrospective cohort study assessing mammography and low dose computed tomography rates from January 2017 through April 2022. Data for January 2016 to February 2020 were used to generate expected rates for the period March 2020 to April 2022. Setting(s): United States Medicare population. Participant(s): A 20% national sample of Medicare fee-for-service enrollees among women aged 50-74 for mammography, and men and women aged 55-79 for low dose computerized tomography. Main outcome: Receipt of screening mammography or low dose computed tomography. Result(s): From January 2017 through February 2020, monthly mammography rates were flat, while there was a monotonic increase in low dose computed tomography rates, from approximately 500 per million per month in early 2017 to 1100 per million per month by January 2020. Over the period from March 2020 to April 2022, there were episodic drops in both mammography and low dose computed tomography rates, coincident with increases in national COVID-19 infection rates. For the periods from March 2020 to February 2020 and March 2021 to February 2022, the observed low dose computed tomography rates were 24% (95% Confidence Interval: 23%, 24%) and 14% (95% Confidence Interval: 13%, 15%) below expected rates, while mammography rates were 17% (95% Confidence Interval: 17%, 18%) and 4% (95% Confidence Interval: 4%, 3%) below expected. Conclusions and Relevance: The negative impact of the COVID-19 pandemic on lung cancer screening and breast cancer screening did not resolve after the initial pandemic surges. Successful interventions to improve screening rates should address pandemic-specific reasons for low screening participation.
ABSTRACT
Background: The Vietnam's Methadone program initiated in 2008 has been a success in treating and helping more than 52 thousand individuals who used heroin recover and be productive members of family and community. The COVID-19 pandemic caused significant disruptions in accessing all services due to strict lockdowns and interventions to improve treatment outcomes are needed. Method(s): We teamed up with the clinic counselor to do clinical counseling and supervision using a Zoom application. Our work was among the six months that social distancing was intensified in Vietnam due to the 4th wave of the COVID-19 pandemic, restricting all in person activities. Result(s): Dai Dong methadone clinic is dispensing methadone for 267 patients daily, contributing to 14% of all methadone patients (n=1,945) of the Nam Dinh Province. We observed counseling sessions by the counselor for a total of 30 patients, scheduling three days per week in June of the year 2021. Each session lasted for at least two hours, from 8.30-10.30AM, on Monday, Wednesday or Friday. Preparation with clinic leader, staff and patients were crucial in the success of our work. Conclusion(s): Our summer experience confirms the benefits of and how to use Zoom technology effectively for supporting the work counselor to improve treatment and recovery for patients. Given the busy schedule and challenges often occur when using technology, careful preparation would be critical. Copyright © 2022, Anka Publishers. All rights reserved.
ABSTRACT
In this article, we propose a novel approach to address the major ethical and societal problem of misinformation on social media. Specifically, how can we identify misinformation, understand how it spreads, and produce effective interventions? Our envisioned solution is sociotechnical in that it relies upon people (specifically community leaders) to push back against the ravages of misinformation but incorporates novel computational support for doing so. Specifically, we envision a digital communication twin platform for misinformation flow in social networks. We present the motivation, components, challenges, and opportunities in the development of this platform. We illustrate the potential for this approach via misinformation about healthcare, which has flourished during the COVID-19 pandemic.
ABSTRACT
Successful management of sociotechnical issues like those raised by the COVID-19 pandemic requires members of the public to use scientific research in their reasoning. In this study, we explore the nature and extent of the public’s abilities to assess research publications through analyzing a corpus of close to 5 K tweets from the early months of the pandemic which mentioned one of six key studies on the then-uncertain topic of the efficacy of face masks. We find that arguers relied on a variety of critical questions to test the adequacy of the research publications to serve as premises in reasoning, their relevance to the issues at hand, and their sufficiency in justifying conclusions. In particular, arguers showed more skill in assessing the authoritativeness of the sources of the publications than in assessing the epistemic qualities of the studies being reported. These results indicate specific areas for interventions to improve reasoning about research publications. Moreover, this study suggests the potential of studying argumentation at the system level in order to document collective preparedness to address sociotechnical issues, i.e., community science literacy. © 2022, The Author(s).
ABSTRACT
Background: Providing monoclonal antibody therapy infusions requires challenging logistics, resources, and technology, hindering availability across the United States. Early identification and treatment of COVID-positive patients can reduce hospitalizations. Objective: This study aimed to describe the referral, selection process, and deployment of outpatient monoclonal infusion clinics, as well as the impact of monoclonal antibody therapy in COVID-positive patients on the rate of emergency department (ED) visits and hospitalization. Methods: This is a retrospective cohort study that used screening of all COVID-positive ambulatory patients using a unique scoring rubric embedded in the emergency medical response for appropriateness for therapy between November 2020 and January 2021. Participants included all outpatients testing positive for COVID-19 were screened, and those eligible were referred for treatment with bamlanivimab. Of the 443 patients referred for treatment, 252 patients were treated with bamlanivimab compared with 191 patients who declined treatment. Patients were treated either in 1 of the 2 outpatient infusion centers (74%) or the ED (26%.) Results: Of 443 patients with positive COVID-19 diagnoses who were eligible for treatment based on a risk assessment rubric, 252 received bamlanivimab. There was a significant reduction in hospitalization of the treatment versus control group (6.7% vs 13.6%, P < 0.05). No significant differences were noted in risk score at screening, ED visits after infusion, days of symptom onset at screening or infusion, or death. Conclusions and Relevance: The efficacy of monoclonal antibody therapy on reducing hospitalization was demonstrated. Rapid development of screening technology, scheduling and operational logistics, and physical space can overcome the challenges in the current environment.