Graphic with headshot of Dr. Julie Bynum from the shoulders up, next to the words "Grand Rounds & Podcast March 2024"

Diagnosed Dementia in Medicare: Benchmarking for Study Planning and Equity

March 2024 – In Grand Rounds 45, Dr. Bynum shares the pros and cons of using healthcare-generated data, such as Medicare Fee-for-Service and Medicare Advantage, to identify people living with Alzheimer's disease and related dementias (ADRD), as well as the use of population benchmarks in study planning and integrating health equity.

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Speaker

Dr. Julie BynumJulie Bynum, MD, MPH

Margaret Terpenning Collegiate Professor of Internal Medicine

Division of Geriatric & Palliative Medicine

University of Michigan

Learning Objectives

  • Identify strengths & challenges when using Medicare data for participant identification
  • Understand characteristics of diagnosed dementia cases across place
  • Consider value of using population benchmarks for planning and equity

 

February 2024 Grand Rounds: Cultural adaptations of ADRD clinical trials for Latino Participants

Cultural adaptation of ADRD clinical trials for Latino participants

February 2024 – In Grand Rounds 44, Drs. Hanson, Lum, Ramirez Gomez, and Fischer discuss barriers to inclusivity in ADRD clinical trials, disparities in caregiving of PLWD, the importance of integrating cultural adaptations and lessons learned from the ADRD-PC trial.

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Stacy Fischer, MD

Stacy Fischer, MD

Professor

University of Colorado Anschutz Medical Campus

 

Hillary Lum, MD, PhD

Hillary Lum, MD, PhD

Associate Professor

University of Colorado Anschutz Medical Campus

 

Laura Hanson, MD, MPHLaura Hanson, MD, MPH

Professor

University of North Carolina School of Medicine

 

Liliana Ramirez Gomez. MDLiliana Ramirez Gomez, MD

Clinical Director

Massachusetts General Hospital

Learning Objectives

  • Review the barriers to ADRD research for diverse populations
  • Learn best practices for engaging Latino ADRD caregiver advisors in research
  • Understand the process of cultural adaptation of ADRD research protocols

 

Graphic with headshots of Drs. McCreedy, Sadarangani, and Zimmerman from the shoulders up, next to the words "Grand Rounds & Podcast. January 2024"

Strategies to Implement ePCTs in Home and Community-Based Settings – Issues and Successes in Assisted Living and Adult Day Centers

January 2024 – In Grand Rounds 43, Drs. McCreedy, Sadarangani, and Zimmerman note common challenges that arise when conducting ePCTs in home and community-based, long-term care settings and suitable solutions to address these challenges.

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Ellen McCreedy, PhD

Assistant Professor

Brown University School of Public Health

 

Tina Sadarangani,
PhD, RN

Associate Professor

NYU Rory Meyers College of Nursing

Sheryl Zimmerman, PhD

University Distinguished Professor

University of North Carolina at Chapel Hill

Learning Objectives

  • Understand the national scope of assisted living and adult day centers (i.e., home and community-based settings)
  • Recognize common challenges conducting ePCTs in home and community-based settings
  • Be familiar with strategies to address challenges conducting ePCTs in home and community-based settings
Graphic with headshots of Drs. O'Brien and Fowler from the shoulders up, next to the words "Grand Rounds & Podcast. December 2023"

The Clinical Implementation of Alzheimer’s Disease Biomarkers

December 2023 – In Grand Rounds 42, Drs. O'Brien and Fowler engage in a discussion regarding the landscape of Alzheimer's disease (AD) biomarker testing, dive into the potential clinical usefulness of plasma AD biomarkers, and identify the obstacles that hinder the implementation of plasma AD biomarkers.

Speakers


Kyra S. O'Brien, MD

Assistant Professor of Neurology

Penn Memory Center, University of Pennsylvania


Nicole Fowler, PhD, MHSA

Associate Professor of Medicine

Indiana University School of Medicine

Learning Objectives

  • Understand the landscape of Alzheimer’s disease (AD) biomarker testing.
  • Describe the potential clinical utility of plasma AD biomarkers.
  • Identify barriers to plasma AD biomarker implementation in specialist and non-specialist settings.

 

Graphic with a headshot of Dr. Michael Harhay from the shoulders up, next to the words "Grand Rounds & Podcast. November 2023"

Outcomes truncated by death in randomized trials

November 2023 - In Grand Rounds 41, Dr. Harhay addresses the impact of intercurrent events, specifically the occurrence of death in patients with critical illness during research studies, which can lead to missing outcome data and potentially biased results. Dr. Harhay discusses various approaches, such as composite outcomes, to navigate complexities of this missing data issue.

Speaker

Michael Harhay, PhD, MPH

Assistant Professor of Epidemiology and Medicine (Pulmonary and Critical Care)

University of Pennsylvania

Learning Objectives

  • Articulate the risks of bias associated with having outcomes truncated by death in randomized trials.
  • Assess options to address outcomes truncated by death using the estimand framework.
  • Understand tradeoffs between approaches such as statistical models and composite outcome to address outcomes truncated by death.

 

Graphic with a headshot of Dr. Katherine (Katie) Courtright from the shoulders up, next to the words "Grand Rounds & Podcast. October 2023"

Electronic Nudges and Pragmatic Trials to Improve Hospital Palliative Care Delivery

October 2023 - In Grand Rounds 40, Dr. Courtright shares the integration of systematic referral criteria ("triggers") with behavioral insights to nudge clinicians, offering a low-cost, scalable, and powerful approach to promote palliative care delivery.

Speaker

Katherine Courtright, MD, MSHP

Assistant Professor of Medicine
Palliative and Advanced Illness Research (PAIR)

Perelman School of Medicine, University of Pennsylvania

Learning Objectives

  • Consider ways to leverage technology within a learning health system to improve palliative care delivery.
  • Describe choice architecture and tradeoffs with different types of behavioral nudges.
  • Anticipate implementation challenges and opportunities for nudges to improve inpatient palliative care delivery.

 

Graphic with a headshot of Dr. James Flory from the shoulders up, next to the words "Grand Rounds & Podcast. September 2023"

Decision Architecture Randomization Trials: Extremely Low-Cost Trials with Preservation of Clinician and Patient Choice

September 2023 – In Grand Rounds 39, Dr. Flory introduces an innovative trial design known as Decision Architecture Randomization Trials (DART), which aims to utilize the 'decision architecture' of electronic health records to incorporate randomized nudges into various prescribing decisions.

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Speaker

 

James Flory, MD, MSCE

Assistant Attending Physician

Endocrinology Service

Memorial Sloan Kettering Cancer Center

Learning Objectives

  • Define ‘nudges’, ‘decision architecture’, and ‘A/B testing’.
  • Describe a decision architecture randomization trial (DART).
  • Understand how DART relates to other pragmatic clinical trial designs.

 

Results and Lessons Learned from the HAS-QOL ePCT

June 2023 – In Grand Rounds 38, Dr. Ab Brody dives into the results and lessons learned from the Hospice Advanced Dementia Symptom Management and Quality of Life (HAS-QOL) ePCT, a 25-site trial exploring a quality improvement program tailored to improve care for PLWD and their care partners receiving hospice across care settings.

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Speaker

 

Ab Brody, PhD, RN, FAAN

Founder, Aliviado Health

Pilot Studies Core Leader, NIA IMPACT Collaboratory

Mathy Mezey Professor, NYU Rory Meyers College of Nursing
Associate Director, Hartford Institute for Geriatric Nursing

Learning Objectives

  • Understand the current gaps and challenges in providing effective care to people living with dementia and their care partners in hospice.
  • Describe the process of preparing a full-scale ePCT.
  • Summarize challenges and effective solutions, including human support and technology-based strategies, to sustain interdisciplinary dementia care workforce training in hospice settings amid COVID-19 in a 25-site ePCT.

 

eRADAR: An embedded, pragmatic trial using electronic health record data for targeted dementia screening

May 2023 – In Grand Rounds 37, Drs. Barnes and Dublin discuss the use of eRADAR - electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule - for targeted dementia screening in higher-risk older adults.

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Speakers

 

Deborah Barnes, PhD 

Professor
Psychiatry and Behavioral Sciences
Epidemiology & Biostatistics

University of California, San Francisco

 


Sascha Dublin, MD, PhD

Senior Investigator

Kaiser Permanente Washington Health
Research Institute

Learning Objectives

  • Describe eRADAR's accuracy for identifying older patients at risk of undiagnosed dementia.
  • Describe patient acceptance of targeted screening for dementia using eRADAR.
  • Describe preliminary outcomes of brain health assessment visits.

More than a Meal: Results from a Pilot Pragmatic Clinical Trial Evaluating Two Models of Home-Delivered Meals for Older Adults Living with Dementia

April 2023 – In Grand Rounds 36, Dr. Kali S. Thomas shares findings from a pilot pragmatic clinical trial that evaluated the impact of two models of home-delivered meals for older adults living with dementia.

Speaker

Kali S. Thomas, PhD

Associate Professor
Health Services, Policy & Practice

Brown University

Learning Objectives

  • Understand the steps taken to design a pilot pragmatic randomized control trial comparing two types of home-delivered meals among older adults living with dementia.
  • Describe the feasibility of conducting this study, including recruitment, retention, and assessment procedures.
  • Summarize the process for linking data to examine trends in treatment effects.