Monica Katyal - Academia.edu (original) (raw)

Papers by Monica Katyal

Research paper thumbnail of Transitions of care between jail-based medications for opioid use disorder and ongoing treatment in the community: A retrospective cohort study

Background and Aims: Offering medications for opioid use disorder (MOUD) in carceral settings can... more Background and Aims: Offering medications for opioid use disorder (MOUD) in carceral settings can significantly reduce overdose risk. However, it is unknown whether and to what extent individuals in U.S. jail settings continue MOUD once they leave incarceration, and what factors influence treatment continuity. Design: Retrospective cohort study of linked jail-based electronic health records and community OUD treatment claims. Setting: New York City Jail Participants: Incarcerations of individuals with OUD discharged from jail to the community between May 1, 2011 and December 31, 2017 Comparators: Receiving vs. not receiving MOUD (methadone or buprenorphine) at the time of release from jail Measurements: We measured continuity of community-based MOUD treatment within one month of release, among those with and without MOUD during release from jail. We tested for effect modification based on MOUD receipt prior to incarceration and assessed factors associated with treatment discontinuat...

Research paper thumbnail of 1101PHEALTHCARE Resource Utilization (Hcru) in Patients Receiving Ipilimumab for Advanced Melanoma: Impact of Survival and Eastern Cooperative Oncology Group (Ecog) Status

Research paper thumbnail of Methodological and operational considerations in conducting retrospective medical chart review studies in hospitals and medical centers in emerging markets

Value in Health, 2014

develop while clarity on methods to evaluate the cognitive impact of this technology have lagged.... more develop while clarity on methods to evaluate the cognitive impact of this technology have lagged. The steps we present provide a standardized system for ensuring that ePROs measure what is intended and the risk to research data is minimized.

Research paper thumbnail of Assessing the Association of Solitary Confinement Ban With Adolescent Self-Harm in New York City Jails

Journal of Correctional Health Care

Research paper thumbnail of Impact Of Severe And Very Severe Chronic Obstructive Pulmonary Disease (Copd) On Health-Related Quality Of Life (Hrqol) And Work Productivity: Results Of A Nationally Representative Patient Survey And Chart Review Of Recently Exacerbating Patients

Value in Health, 2013

large (13-18) and extremely large effects (19-30). Severity of disease was measured using the Not... more large (13-18) and extremely large effects (19-30). Severity of disease was measured using the Nottingham Eczema Severity scores (NESS). RESULTS: The average QOL scores reported were 15.0±6.69 among infants (IDQOL); 16.4±7.25 among children (CDLQI), and 15.5±7.59 among families (DFI). The mean IDQOL, CDLQI and DFI scores were higher in patients with severe AD (16.7±6.66, 18.4±6.99, and 17.5±7.53, respectively) than among those with moderate AD (13.9±6.49, 15.2±7.14, and 14.2±7.35, respectively). A large proportion of respondents experienced extremely large effect of QOL scores (scoring 19 to 30), including 35.6% of infants, 44.0% of children and 39.1% of families. There were also large differences between the reported QOL from different countries. CONCLUSIONS: The study found that moderate to severe AD affected the QOL of the majority of patients and their families among respondents in the countries surveyed.

Research paper thumbnail of Association between jail‐based methadone or buprenorphine treatment for opioid use disorder and overdose mortality after release from New York City jails 2011–17

Research paper thumbnail of Identifying demographic and health profiles of young adults with frequent jail incarceration in New York City during 2011–2017

Annals of Epidemiology, 2020

PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in... more PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in New York City jails from mid-2011 through 2017, with an aim that identification of frequently incarcerated young "hot spotters" may inform early interventions. METHODS We examined electronic health records for 3114 individuals with no known prior jail admission and admitted within 4.5 years after turning age 18 years. We used group-based trajectory analysis to identify hot spotters and compared their characteristics with those of other trajectory groups. We repeated the analysis for three older adult groups for additional comparison. RESULTS Five percent of the young individuals became hot spotters (mean = 7.7 incarcerations). They were more likely to be homeless (27.1% vs. 7.2%-16.4% in other trajectory groups), have substance use disorders (95.2% vs. 73.2%-89.8%), and mental health needs (65.7% vs. 28.5%-53.3%), and be incarcerated for theft-related charges (52.7% vs. 32.0%-49.6%) and misdemeanors (34.8 vs. 25.5%-29.4%). They differed in charge profile and homelessness compared with older hot spotters. CONCLUSIONS Some young adults are at risk of frequent incarceration. Tailored health- and behavior-related interventions may preclude cyclical incarceration and address barriers to well-being and stability.

Research paper thumbnail of Abstract 126, 15th Conference on Retroviruses and Opportunistic Infections, Boston, USA

Research paper thumbnail of Agreement between patient-reported and chart documented outcomes: Case study in COPD

European Respiratory Journal, 2013

Objective To describe agreement between patient (PT) report and medical chart (CH) documentation ... more Objective To describe agreement between patient (PT) report and medical chart (CH) documentation of smoking status and exacerbation frequency/severity in severe (SEV) and very SEV COPD. Methods Within this 2011-12 CH review/PT survey, 99 US-based pulmonologists and primary care physicians recruited physician-reported SEV or very SEV COPD PTs who had experienced a moderate (MOD) or SEV exacerbation in the last 3 months. Smoking status, 12-month exacerbation frequency, and exacerbation severity were compared between CH vs PT self-report using concordance, weighted kappa (κ) statistics, and intraclass correlation coefficients (ICC). Results Of 314 PTs, 25.5%/68.8% reported current/former smoking, with high PT vs CH agreement (κ=0.878). Severities of most recent PT- and CH-reported exacerbations were concordant in 79.2% (54.4% agree MOD; 24.8% agree SEV; 20.7% not concordant; κ=0.540). PTs reported a mean±SD of 2.5±2.7/1.0±1.3 MOD/SEV exacerbations vs CH-reported, 1.8±1.3/0.9±1.0, with ...

Research paper thumbnail of Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

International Journal of Chronic Obstructive Pulmonary Disease, 2014

This study aimed to compare spirometry-and risk + symptom-based classification systems to physici... more This study aimed to compare spirometry-and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C). Materials and methods: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV 1 ] 50%; severe, 30%  FEV 1 50%; very severe, FEV 1 30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/ more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems. Results: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV 1 50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not. Conclusion: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry.

Research paper thumbnail of Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease

International Journal of Chronic Obstructive Pulmonary Disease, 2013

Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very s... more Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very severe chronic obstructive pulmonary disease (COPD) is ill-defined. This study describes patterns, HRQoL, and the work productivity impact of COPD-related moderate and SEV exacerbations in patients with SEV/VSEV COPD, focusing on the chronic bronchitis subtype. Patients and methods: A US sample of SEV and VSEV COPD patients with recent moderate or SEV exacerbation was recruited. Along with the demographic and clinical data collected from medical records, patients reported on exacerbation frequency, health-related quality of life (HRQoL) (using the St George's Respiratory Questionnaire for COPD [SGRQ-C] and the European Quality of Life-5 Dimensions [EQ-5D]™ index), and work productivity and activity impairment (using the Work Productivity and Activity Impairment Questionnaire − Specific Health Problem [WPAI-SHP]). The HRQoL-related impacts of exacerbation frequency, time since exacerbation, and last exacerbation severity were evaluated via linear regressions. Results: A total of 314 patients (190 SEV/124 VSEV, mean age =68.0 years, 51% male, 28% current smokers) were included. In the previous 12 months, patients reported an average of 1.8 moderate exacerbations and 0.9 SEV exacerbations. Overall, 16% of patients were employed and reported a high percentage of overall work impairment (42.4% ± 31.1%). Activity impairment was positively associated with recent exacerbation severity (SEV 64.6% ± 26.8% versus moderate 55.6% ± 28.2%) (P=0.006). The HRQoL was significantly worse for SEV versus VSEV COPD (EQ-5D: 0.62 ± 0.23 versus 0.70 ± 0.17, respectively, and SGRQ-C: 70.1 ± 21.3 versus 61.1 ± 19.0, respectively) (P,0.001). Worse current HRQoL was reported by patients with a SEV versus moderate recent exacerbation (EQ-5D: 0.63 ± 0.21 versus 0.70 ± 0.20, respectively) (P=0.003); SGRQ-C: 70.3 ± 19.9 versus 61.7 ± 20.1, respectively (P,0.001). One additional exacerbation in the previous 12 months was associated with a 2.4-point SGRQ-C increase and a 0.02-point EQ-5D index decrease. Conclusion: The severity and frequency of COPD-related moderate/SEV exacerbations in SEV and VSEV COPD patients were positively associated with poor HRQoL and work productivity and activity impairment.

Research paper thumbnail of COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March–April 2020

Public Health Reports, 2021

Objectives People detained in correctional facilities are at high risk for infection with severe ... more Objectives People detained in correctional facilities are at high risk for infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). We described the epidemiology of the COVID-19 outbreak in a large urban jail system, including signs and symptoms at time of testing and risk factors for hospitalization. Methods This retrospective observational cohort study included all patients aged ≥18 years who were tested for COVID-19 during March 11–April 28, 2020, while in custody in the New York City jail system (N = 978). We described demographic characteristics and signs and symptoms at the time of testing and performed Cox regression analysis to identify factors associated with hospitalization among those with a positive test result. Results Of 978 people tested for COVID-19, 568 received a positive test result. Among symptomatic patients, the most common symptoms among those who received a positive test result were cough (n = ...

Research paper thumbnail of Comparison of Treatment Retention of Adults With Opioid Addiction Managed With Extended-Release Buprenorphine vs Daily Sublingual Buprenorphine-Naloxone at Time of Release From Jail

JAMA Network Open

IMPORTANCE Extended-release buprenorphine (XRB), a monthly injectable long-acting opioid use diso... more IMPORTANCE Extended-release buprenorphine (XRB), a monthly injectable long-acting opioid use disorder (OUD) treatment, has not been studied for use in corrections facilities. OBJECTIVE To compare treatment retention following release from jail among adults receiving daily sublingual buprenorphine-naloxone (SLB) vs those receiving XRB. DESIGN, SETTING, AND PARTICIPANTS This open-label, randomized comparative effectiveness study included 52 incarcerated adults in New York City observed for 8 weeks postrelease between June 2019 and May 2020. Participants were soon-to-be-released volunteers from 1 men's and 1 women's jail facility who had OUDs already treated with SLB. Follow-up treatment was received at a primary care clinic in Manhattan. Data were analyzed between June 2020 and December 2020. INTERVENTIONS XRB treatment was offered prior to release and continued monthly through 8 weeks after release. SLB participants continued to receive daily directly observed in-jail SLB administration, were provided a 7-day SLB supply at jail release, and followed up at a designated clinic (or other preferred clinics). MAIN OUTCOMES AND MEASURES Buprenorphine treatment retention at 8 weeks postrelease. RESULTS A total of 52 participants were randomized 1:1 to XRB (26 participants) and SLB (26 participants). Participants had a mean (SD) age of 42.6 (10.0) years; 45 participants (87%) were men; and 40 (77%) primarily used heroin prior to incarceration. Most participants (30 [58%]) reported prior buprenorphine use; 18 (35%) reported active community buprenorphine treatment prior to jail admission. Twenty-one of 26 assigned to XRB received 1 or more XRB injection prior to release; 3 initiated XRB postrelease; and 2 did not receive XRB. Patients in the XRB arm had fewer jail medical visits compared with daily SLB medication administration (mean [SD] visits per day: XRB, 0.11 [0.03] vs SLB, 1.06 [0.08]). Community buprenorphine treatment retention at week 8 postrelease was 18 participants in the XRB group (69.2%) vs 9 in the SLB group (34.6%), and rates of opioid-negative urine tests were 72 of 130 tests in the XRB group (55.3%) and 50 of 130 tests in the SLB group (38.4%). There were no differences in rates of serious adverse events, no overdoses, and no deaths. CONCLUSIONS AND RELEVANCE XRB was acceptable among patients currently receiving SLB, and patients had fewer in-jail clinic visits and increased community buprenorphine treatment retention when compared with standard daily SLB treatment. These results support wider use and further study of XRB as correctional and reentry OUD treatment.

Research paper thumbnail of Clinical Outcomes of Specialized Treatment Units for Patients With Serious Mental Illness in the New York City Jail System

Research paper thumbnail of IGRA-Based Screening for Latent Tuberculosis Infection in Persons Newly Incarcerated in New York City Jails

Journal of Correctional Health Care

In the United States, latent tuberculosis infection (LTBI) detection in correctional settings is ... more In the United States, latent tuberculosis infection (LTBI) detection in correctional settings is a public health priority. Interferon gamma release assay (IGRA)-based LTBI screening was introduced in New York City jails in 2011 to 2012, replacing historically used tuberculin skin testing (TST), which was associated with substantial incomplete screening rates. This retrospective, cross-sectional study evaluated LTBI screening outcomes and correlates of positivity in 40,986 persons newly incarcerated in 2011 to 2013. Of 35,090 eligible patients tested (96.4%), final results were 6.3% positive, 93.4% negative, and 0.2% indeterminate. In multivariable regression modeling, sex, age, race/ethnicity, nativity, marital status, prior jail incarceration, and HIV status were correlated with positivity. IGRA-based screening yielded high screening and low indeterminate test rates and may be recommended in correctional and other settings where TST is currently used.

Research paper thumbnail of Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

International Journal of Chronic Obstructive Pulmonary Disease, 2014

This study aimed to compare spirometry-and risk + symptom-based classification systems to physici... more This study aimed to compare spirometry-and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C). Materials and methods: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV 1 ] 50%; severe, 30%  FEV 1 50%; very severe, FEV 1 30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/ more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems. Results: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV 1 50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not. Conclusion: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry.

Research paper thumbnail of Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease

International Journal of Chronic Obstructive Pulmonary Disease, 2013

Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very s... more Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very severe chronic obstructive pulmonary disease (COPD) is ill-defined. This study describes patterns, HRQoL, and the work productivity impact of COPD-related moderate and SEV exacerbations in patients with SEV/VSEV COPD, focusing on the chronic bronchitis subtype. Patients and methods: A US sample of SEV and VSEV COPD patients with recent moderate or SEV exacerbation was recruited. Along with the demographic and clinical data collected from medical records, patients reported on exacerbation frequency, health-related quality of life (HRQoL) (using the St George's Respiratory Questionnaire for COPD [SGRQ-C] and the European Quality of Life-5 Dimensions [EQ-5D]™ index), and work productivity and activity impairment (using the Work Productivity and Activity Impairment Questionnaire − Specific Health Problem [WPAI-SHP]). The HRQoL-related impacts of exacerbation frequency, time since exacerbation, and last exacerbation severity were evaluated via linear regressions. Results: A total of 314 patients (190 SEV/124 VSEV, mean age =68.0 years, 51% male, 28% current smokers) were included. In the previous 12 months, patients reported an average of 1.8 moderate exacerbations and 0.9 SEV exacerbations. Overall, 16% of patients were employed and reported a high percentage of overall work impairment (42.4% ± 31.1%). Activity impairment was positively associated with recent exacerbation severity (SEV 64.6% ± 26.8% versus moderate 55.6% ± 28.2%) (P=0.006). The HRQoL was significantly worse for SEV versus VSEV COPD (EQ-5D: 0.62 ± 0.23 versus 0.70 ± 0.17, respectively, and SGRQ-C: 70.1 ± 21.3 versus 61.1 ± 19.0, respectively) (P,0.001). Worse current HRQoL was reported by patients with a SEV versus moderate recent exacerbation (EQ-5D: 0.63 ± 0.21 versus 0.70 ± 0.20, respectively) (P=0.003); SGRQ-C: 70.3 ± 19.9 versus 61.7 ± 20.1, respectively (P,0.001). One additional exacerbation in the previous 12 months was associated with a 2.4-point SGRQ-C increase and a 0.02-point EQ-5D index decrease. Conclusion: The severity and frequency of COPD-related moderate/SEV exacerbations in SEV and VSEV COPD patients were positively associated with poor HRQoL and work productivity and activity impairment.

Research paper thumbnail of Sa1072 Symptom Control, Quality of Life, and Treatment Satisfaction in Patients Treated With Lubiprostone vs. Other Treatments for Irritable Bowel Syndrome-Constipation (IBS-C)

Research paper thumbnail of Effectiveness and safety of ipilimumab therapy in advanced melanoma: evidence from clinical practice sites in the US

The Journal of Community and Supportive Oncology, 2015

he incidence of melanoma, the most serious form of skin cancer, is rising globally. 1,2 Although ... more he incidence of melanoma, the most serious form of skin cancer, is rising globally. 1,2 Although most patients are diagnosed and treated at an early stage of the disease and have a good prognosis, survival among patients with unresectable or metastatic (advanced) melanoma remains poor. In the United States, an estimated 9,940 deaths from melanoma will occur in 2015; 1 in Europe, melanoma accounts for an estimated 20,000 deaths annually. 2 Patients with advanced melanoma historically had a dismal prognosis, with median survival of less than a year. 3,4 In a meta-analysis of 2,100 patients with advanced melanoma from 42 phase 2 cooperative group clinical trials with accrual closing between 1975 and 2005, the median overall survival (OS) was 6.2 months (95% confdence interval [CI], 5.9-6.5), with 25.5% (95% CI, 23.6-27.4) alive at 1 year. 3 Another recent systematic review estimated median OS for stage IV melanoma of about 8 months,

Research paper thumbnail of Female sex workers incarcerated in New York City jails: prevalence of sexually transmitted infections and associated risk behaviors

Sexually Transmitted Infections, 2013

Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incar... more Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incarcerated women and female sex workers (FSW). Little is known about FSW incarcerated in New York City (NYC) jails. We reviewed jail health records to identify the STI and HIV prevalence among newly incarcerated FSW in NYC jails. We also examined the relationship of demographics and self-reported clinical and risk behaviour history with FSW status and compared FSW with non-FSW incarcerated women to identify FSW predictors and, guide NYC jail programme planning and policy. Methods We retrospectively reviewed routinely collected jail health record data to identify the prevalence of chlamydia (Ct), gonorrhoea (Ng) and HIV infection among women newly incarcerated in NYC jails in 2009-2010 (study period) and studied the relationship of STIs, demographics and self-reported clinical and risk behaviour history with FSW status. Results During the study period, 10 828 women were newly incarcerated in NYC jails. Of these, 10 115 (93%) women were tested for Ct and Ng; positivity was 6.2% (95% CI 5.7% to 6.7%) and 1.7% (95% CI 1.4% to 1.9%), respectively. Nine percent had HIV infection. Seven hundred (6.5%) were defined as FSW. FSW were more likely to have Ct (adjusted OR (AOR): 1.55; 95% CI 1.17 to 2.05; p<0.0001) but not Ng or HIV. FSW were more likely to report age 20-24 years, reside in boroughs other than Manhattan, ≥6 prior incarcerations, ≥2 incarcerations during the study period, condom use with current sex partners, multiple sex partners and current drug use. Conclusions Women incarcerated in NYC jails had high rates of Ct, Ng, and HIV infection. FSW were at higher risk for Ct than non-FSW incarcerated women. These findings are being used to design targeted interventions to identify FSW, provide clinical and preventive services in jail and coordinate care with community partners.

Research paper thumbnail of Transitions of care between jail-based medications for opioid use disorder and ongoing treatment in the community: A retrospective cohort study

Background and Aims: Offering medications for opioid use disorder (MOUD) in carceral settings can... more Background and Aims: Offering medications for opioid use disorder (MOUD) in carceral settings can significantly reduce overdose risk. However, it is unknown whether and to what extent individuals in U.S. jail settings continue MOUD once they leave incarceration, and what factors influence treatment continuity. Design: Retrospective cohort study of linked jail-based electronic health records and community OUD treatment claims. Setting: New York City Jail Participants: Incarcerations of individuals with OUD discharged from jail to the community between May 1, 2011 and December 31, 2017 Comparators: Receiving vs. not receiving MOUD (methadone or buprenorphine) at the time of release from jail Measurements: We measured continuity of community-based MOUD treatment within one month of release, among those with and without MOUD during release from jail. We tested for effect modification based on MOUD receipt prior to incarceration and assessed factors associated with treatment discontinuat...

Research paper thumbnail of 1101PHEALTHCARE Resource Utilization (Hcru) in Patients Receiving Ipilimumab for Advanced Melanoma: Impact of Survival and Eastern Cooperative Oncology Group (Ecog) Status

Research paper thumbnail of Methodological and operational considerations in conducting retrospective medical chart review studies in hospitals and medical centers in emerging markets

Value in Health, 2014

develop while clarity on methods to evaluate the cognitive impact of this technology have lagged.... more develop while clarity on methods to evaluate the cognitive impact of this technology have lagged. The steps we present provide a standardized system for ensuring that ePROs measure what is intended and the risk to research data is minimized.

Research paper thumbnail of Assessing the Association of Solitary Confinement Ban With Adolescent Self-Harm in New York City Jails

Journal of Correctional Health Care

Research paper thumbnail of Impact Of Severe And Very Severe Chronic Obstructive Pulmonary Disease (Copd) On Health-Related Quality Of Life (Hrqol) And Work Productivity: Results Of A Nationally Representative Patient Survey And Chart Review Of Recently Exacerbating Patients

Value in Health, 2013

large (13-18) and extremely large effects (19-30). Severity of disease was measured using the Not... more large (13-18) and extremely large effects (19-30). Severity of disease was measured using the Nottingham Eczema Severity scores (NESS). RESULTS: The average QOL scores reported were 15.0±6.69 among infants (IDQOL); 16.4±7.25 among children (CDLQI), and 15.5±7.59 among families (DFI). The mean IDQOL, CDLQI and DFI scores were higher in patients with severe AD (16.7±6.66, 18.4±6.99, and 17.5±7.53, respectively) than among those with moderate AD (13.9±6.49, 15.2±7.14, and 14.2±7.35, respectively). A large proportion of respondents experienced extremely large effect of QOL scores (scoring 19 to 30), including 35.6% of infants, 44.0% of children and 39.1% of families. There were also large differences between the reported QOL from different countries. CONCLUSIONS: The study found that moderate to severe AD affected the QOL of the majority of patients and their families among respondents in the countries surveyed.

Research paper thumbnail of Association between jail‐based methadone or buprenorphine treatment for opioid use disorder and overdose mortality after release from New York City jails 2011–17

Research paper thumbnail of Identifying demographic and health profiles of young adults with frequent jail incarceration in New York City during 2011–2017

Annals of Epidemiology, 2020

PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in... more PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in New York City jails from mid-2011 through 2017, with an aim that identification of frequently incarcerated young "hot spotters" may inform early interventions. METHODS We examined electronic health records for 3114 individuals with no known prior jail admission and admitted within 4.5 years after turning age 18 years. We used group-based trajectory analysis to identify hot spotters and compared their characteristics with those of other trajectory groups. We repeated the analysis for three older adult groups for additional comparison. RESULTS Five percent of the young individuals became hot spotters (mean = 7.7 incarcerations). They were more likely to be homeless (27.1% vs. 7.2%-16.4% in other trajectory groups), have substance use disorders (95.2% vs. 73.2%-89.8%), and mental health needs (65.7% vs. 28.5%-53.3%), and be incarcerated for theft-related charges (52.7% vs. 32.0%-49.6%) and misdemeanors (34.8 vs. 25.5%-29.4%). They differed in charge profile and homelessness compared with older hot spotters. CONCLUSIONS Some young adults are at risk of frequent incarceration. Tailored health- and behavior-related interventions may preclude cyclical incarceration and address barriers to well-being and stability.

Research paper thumbnail of Abstract 126, 15th Conference on Retroviruses and Opportunistic Infections, Boston, USA

Research paper thumbnail of Agreement between patient-reported and chart documented outcomes: Case study in COPD

European Respiratory Journal, 2013

Objective To describe agreement between patient (PT) report and medical chart (CH) documentation ... more Objective To describe agreement between patient (PT) report and medical chart (CH) documentation of smoking status and exacerbation frequency/severity in severe (SEV) and very SEV COPD. Methods Within this 2011-12 CH review/PT survey, 99 US-based pulmonologists and primary care physicians recruited physician-reported SEV or very SEV COPD PTs who had experienced a moderate (MOD) or SEV exacerbation in the last 3 months. Smoking status, 12-month exacerbation frequency, and exacerbation severity were compared between CH vs PT self-report using concordance, weighted kappa (κ) statistics, and intraclass correlation coefficients (ICC). Results Of 314 PTs, 25.5%/68.8% reported current/former smoking, with high PT vs CH agreement (κ=0.878). Severities of most recent PT- and CH-reported exacerbations were concordant in 79.2% (54.4% agree MOD; 24.8% agree SEV; 20.7% not concordant; κ=0.540). PTs reported a mean±SD of 2.5±2.7/1.0±1.3 MOD/SEV exacerbations vs CH-reported, 1.8±1.3/0.9±1.0, with ...

Research paper thumbnail of Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

International Journal of Chronic Obstructive Pulmonary Disease, 2014

This study aimed to compare spirometry-and risk + symptom-based classification systems to physici... more This study aimed to compare spirometry-and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C). Materials and methods: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV 1 ] 50%; severe, 30%  FEV 1 50%; very severe, FEV 1 30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/ more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems. Results: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV 1 50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not. Conclusion: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry.

Research paper thumbnail of Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease

International Journal of Chronic Obstructive Pulmonary Disease, 2013

Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very s... more Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very severe chronic obstructive pulmonary disease (COPD) is ill-defined. This study describes patterns, HRQoL, and the work productivity impact of COPD-related moderate and SEV exacerbations in patients with SEV/VSEV COPD, focusing on the chronic bronchitis subtype. Patients and methods: A US sample of SEV and VSEV COPD patients with recent moderate or SEV exacerbation was recruited. Along with the demographic and clinical data collected from medical records, patients reported on exacerbation frequency, health-related quality of life (HRQoL) (using the St George's Respiratory Questionnaire for COPD [SGRQ-C] and the European Quality of Life-5 Dimensions [EQ-5D]™ index), and work productivity and activity impairment (using the Work Productivity and Activity Impairment Questionnaire − Specific Health Problem [WPAI-SHP]). The HRQoL-related impacts of exacerbation frequency, time since exacerbation, and last exacerbation severity were evaluated via linear regressions. Results: A total of 314 patients (190 SEV/124 VSEV, mean age =68.0 years, 51% male, 28% current smokers) were included. In the previous 12 months, patients reported an average of 1.8 moderate exacerbations and 0.9 SEV exacerbations. Overall, 16% of patients were employed and reported a high percentage of overall work impairment (42.4% ± 31.1%). Activity impairment was positively associated with recent exacerbation severity (SEV 64.6% ± 26.8% versus moderate 55.6% ± 28.2%) (P=0.006). The HRQoL was significantly worse for SEV versus VSEV COPD (EQ-5D: 0.62 ± 0.23 versus 0.70 ± 0.17, respectively, and SGRQ-C: 70.1 ± 21.3 versus 61.1 ± 19.0, respectively) (P,0.001). Worse current HRQoL was reported by patients with a SEV versus moderate recent exacerbation (EQ-5D: 0.63 ± 0.21 versus 0.70 ± 0.20, respectively) (P=0.003); SGRQ-C: 70.3 ± 19.9 versus 61.7 ± 20.1, respectively (P,0.001). One additional exacerbation in the previous 12 months was associated with a 2.4-point SGRQ-C increase and a 0.02-point EQ-5D index decrease. Conclusion: The severity and frequency of COPD-related moderate/SEV exacerbations in SEV and VSEV COPD patients were positively associated with poor HRQoL and work productivity and activity impairment.

Research paper thumbnail of COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March–April 2020

Public Health Reports, 2021

Objectives People detained in correctional facilities are at high risk for infection with severe ... more Objectives People detained in correctional facilities are at high risk for infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). We described the epidemiology of the COVID-19 outbreak in a large urban jail system, including signs and symptoms at time of testing and risk factors for hospitalization. Methods This retrospective observational cohort study included all patients aged ≥18 years who were tested for COVID-19 during March 11–April 28, 2020, while in custody in the New York City jail system (N = 978). We described demographic characteristics and signs and symptoms at the time of testing and performed Cox regression analysis to identify factors associated with hospitalization among those with a positive test result. Results Of 978 people tested for COVID-19, 568 received a positive test result. Among symptomatic patients, the most common symptoms among those who received a positive test result were cough (n = ...

Research paper thumbnail of Comparison of Treatment Retention of Adults With Opioid Addiction Managed With Extended-Release Buprenorphine vs Daily Sublingual Buprenorphine-Naloxone at Time of Release From Jail

JAMA Network Open

IMPORTANCE Extended-release buprenorphine (XRB), a monthly injectable long-acting opioid use diso... more IMPORTANCE Extended-release buprenorphine (XRB), a monthly injectable long-acting opioid use disorder (OUD) treatment, has not been studied for use in corrections facilities. OBJECTIVE To compare treatment retention following release from jail among adults receiving daily sublingual buprenorphine-naloxone (SLB) vs those receiving XRB. DESIGN, SETTING, AND PARTICIPANTS This open-label, randomized comparative effectiveness study included 52 incarcerated adults in New York City observed for 8 weeks postrelease between June 2019 and May 2020. Participants were soon-to-be-released volunteers from 1 men's and 1 women's jail facility who had OUDs already treated with SLB. Follow-up treatment was received at a primary care clinic in Manhattan. Data were analyzed between June 2020 and December 2020. INTERVENTIONS XRB treatment was offered prior to release and continued monthly through 8 weeks after release. SLB participants continued to receive daily directly observed in-jail SLB administration, were provided a 7-day SLB supply at jail release, and followed up at a designated clinic (or other preferred clinics). MAIN OUTCOMES AND MEASURES Buprenorphine treatment retention at 8 weeks postrelease. RESULTS A total of 52 participants were randomized 1:1 to XRB (26 participants) and SLB (26 participants). Participants had a mean (SD) age of 42.6 (10.0) years; 45 participants (87%) were men; and 40 (77%) primarily used heroin prior to incarceration. Most participants (30 [58%]) reported prior buprenorphine use; 18 (35%) reported active community buprenorphine treatment prior to jail admission. Twenty-one of 26 assigned to XRB received 1 or more XRB injection prior to release; 3 initiated XRB postrelease; and 2 did not receive XRB. Patients in the XRB arm had fewer jail medical visits compared with daily SLB medication administration (mean [SD] visits per day: XRB, 0.11 [0.03] vs SLB, 1.06 [0.08]). Community buprenorphine treatment retention at week 8 postrelease was 18 participants in the XRB group (69.2%) vs 9 in the SLB group (34.6%), and rates of opioid-negative urine tests were 72 of 130 tests in the XRB group (55.3%) and 50 of 130 tests in the SLB group (38.4%). There were no differences in rates of serious adverse events, no overdoses, and no deaths. CONCLUSIONS AND RELEVANCE XRB was acceptable among patients currently receiving SLB, and patients had fewer in-jail clinic visits and increased community buprenorphine treatment retention when compared with standard daily SLB treatment. These results support wider use and further study of XRB as correctional and reentry OUD treatment.

Research paper thumbnail of Clinical Outcomes of Specialized Treatment Units for Patients With Serious Mental Illness in the New York City Jail System

Research paper thumbnail of IGRA-Based Screening for Latent Tuberculosis Infection in Persons Newly Incarcerated in New York City Jails

Journal of Correctional Health Care

In the United States, latent tuberculosis infection (LTBI) detection in correctional settings is ... more In the United States, latent tuberculosis infection (LTBI) detection in correctional settings is a public health priority. Interferon gamma release assay (IGRA)-based LTBI screening was introduced in New York City jails in 2011 to 2012, replacing historically used tuberculin skin testing (TST), which was associated with substantial incomplete screening rates. This retrospective, cross-sectional study evaluated LTBI screening outcomes and correlates of positivity in 40,986 persons newly incarcerated in 2011 to 2013. Of 35,090 eligible patients tested (96.4%), final results were 6.3% positive, 93.4% negative, and 0.2% indeterminate. In multivariable regression modeling, sex, age, race/ethnicity, nativity, marital status, prior jail incarceration, and HIV status were correlated with positivity. IGRA-based screening yielded high screening and low indeterminate test rates and may be recommended in correctional and other settings where TST is currently used.

Research paper thumbnail of Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

International Journal of Chronic Obstructive Pulmonary Disease, 2014

This study aimed to compare spirometry-and risk + symptom-based classification systems to physici... more This study aimed to compare spirometry-and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C). Materials and methods: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV 1 ] 50%; severe, 30%  FEV 1 50%; very severe, FEV 1 30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/ more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems. Results: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV 1 50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not. Conclusion: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry.

Research paper thumbnail of Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease

International Journal of Chronic Obstructive Pulmonary Disease, 2013

Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very s... more Exacerbation-associated health-related quality of life (HRQoL) in patients with severe and very severe chronic obstructive pulmonary disease (COPD) is ill-defined. This study describes patterns, HRQoL, and the work productivity impact of COPD-related moderate and SEV exacerbations in patients with SEV/VSEV COPD, focusing on the chronic bronchitis subtype. Patients and methods: A US sample of SEV and VSEV COPD patients with recent moderate or SEV exacerbation was recruited. Along with the demographic and clinical data collected from medical records, patients reported on exacerbation frequency, health-related quality of life (HRQoL) (using the St George's Respiratory Questionnaire for COPD [SGRQ-C] and the European Quality of Life-5 Dimensions [EQ-5D]™ index), and work productivity and activity impairment (using the Work Productivity and Activity Impairment Questionnaire − Specific Health Problem [WPAI-SHP]). The HRQoL-related impacts of exacerbation frequency, time since exacerbation, and last exacerbation severity were evaluated via linear regressions. Results: A total of 314 patients (190 SEV/124 VSEV, mean age =68.0 years, 51% male, 28% current smokers) were included. In the previous 12 months, patients reported an average of 1.8 moderate exacerbations and 0.9 SEV exacerbations. Overall, 16% of patients were employed and reported a high percentage of overall work impairment (42.4% ± 31.1%). Activity impairment was positively associated with recent exacerbation severity (SEV 64.6% ± 26.8% versus moderate 55.6% ± 28.2%) (P=0.006). The HRQoL was significantly worse for SEV versus VSEV COPD (EQ-5D: 0.62 ± 0.23 versus 0.70 ± 0.17, respectively, and SGRQ-C: 70.1 ± 21.3 versus 61.1 ± 19.0, respectively) (P,0.001). Worse current HRQoL was reported by patients with a SEV versus moderate recent exacerbation (EQ-5D: 0.63 ± 0.21 versus 0.70 ± 0.20, respectively) (P=0.003); SGRQ-C: 70.3 ± 19.9 versus 61.7 ± 20.1, respectively (P,0.001). One additional exacerbation in the previous 12 months was associated with a 2.4-point SGRQ-C increase and a 0.02-point EQ-5D index decrease. Conclusion: The severity and frequency of COPD-related moderate/SEV exacerbations in SEV and VSEV COPD patients were positively associated with poor HRQoL and work productivity and activity impairment.

Research paper thumbnail of Sa1072 Symptom Control, Quality of Life, and Treatment Satisfaction in Patients Treated With Lubiprostone vs. Other Treatments for Irritable Bowel Syndrome-Constipation (IBS-C)

Research paper thumbnail of Effectiveness and safety of ipilimumab therapy in advanced melanoma: evidence from clinical practice sites in the US

The Journal of Community and Supportive Oncology, 2015

he incidence of melanoma, the most serious form of skin cancer, is rising globally. 1,2 Although ... more he incidence of melanoma, the most serious form of skin cancer, is rising globally. 1,2 Although most patients are diagnosed and treated at an early stage of the disease and have a good prognosis, survival among patients with unresectable or metastatic (advanced) melanoma remains poor. In the United States, an estimated 9,940 deaths from melanoma will occur in 2015; 1 in Europe, melanoma accounts for an estimated 20,000 deaths annually. 2 Patients with advanced melanoma historically had a dismal prognosis, with median survival of less than a year. 3,4 In a meta-analysis of 2,100 patients with advanced melanoma from 42 phase 2 cooperative group clinical trials with accrual closing between 1975 and 2005, the median overall survival (OS) was 6.2 months (95% confdence interval [CI], 5.9-6.5), with 25.5% (95% CI, 23.6-27.4) alive at 1 year. 3 Another recent systematic review estimated median OS for stage IV melanoma of about 8 months,

Research paper thumbnail of Female sex workers incarcerated in New York City jails: prevalence of sexually transmitted infections and associated risk behaviors

Sexually Transmitted Infections, 2013

Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incar... more Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incarcerated women and female sex workers (FSW). Little is known about FSW incarcerated in New York City (NYC) jails. We reviewed jail health records to identify the STI and HIV prevalence among newly incarcerated FSW in NYC jails. We also examined the relationship of demographics and self-reported clinical and risk behaviour history with FSW status and compared FSW with non-FSW incarcerated women to identify FSW predictors and, guide NYC jail programme planning and policy. Methods We retrospectively reviewed routinely collected jail health record data to identify the prevalence of chlamydia (Ct), gonorrhoea (Ng) and HIV infection among women newly incarcerated in NYC jails in 2009-2010 (study period) and studied the relationship of STIs, demographics and self-reported clinical and risk behaviour history with FSW status. Results During the study period, 10 828 women were newly incarcerated in NYC jails. Of these, 10 115 (93%) women were tested for Ct and Ng; positivity was 6.2% (95% CI 5.7% to 6.7%) and 1.7% (95% CI 1.4% to 1.9%), respectively. Nine percent had HIV infection. Seven hundred (6.5%) were defined as FSW. FSW were more likely to have Ct (adjusted OR (AOR): 1.55; 95% CI 1.17 to 2.05; p<0.0001) but not Ng or HIV. FSW were more likely to report age 20-24 years, reside in boroughs other than Manhattan, ≥6 prior incarcerations, ≥2 incarcerations during the study period, condom use with current sex partners, multiple sex partners and current drug use. Conclusions Women incarcerated in NYC jails had high rates of Ct, Ng, and HIV infection. FSW were at higher risk for Ct than non-FSW incarcerated women. These findings are being used to design targeted interventions to identify FSW, provide clinical and preventive services in jail and coordinate care with community partners.