Biomedical subjects

Catarina Kiefe

Publications and source records attributed to Catarina Kiefe.

4 recordsLinked to original sources

PubMed2006

History of depression, race, and cardiovascular risk in CARDIA.

Though previous data indicate a positive association between depression and coronary heart disease, the mechanisms mediating these associations remain unclear. These prospective analyses assessed the association between history of Center for Epidemiologic Studies Depression Scale depression and possible mediators of cardiovascular risk at Year 15 of follow-up in African Americans (AA) and Caucasians (C) in the Coronary Artery Risk Development in Young Adults Study. Physiological assessments included plasma levels of low-density-lipoprotein cholestrol (LDL), high-density-lipoprotein cholestrol (HDL), total cholesterol, triglycerides and fasting glucose, diabetes and blood pressure. Behavioral risk factors included alcohol consumption, smoking, physical activity, and body mass index (BMI). AA's showed significant associations between history of depression and diabetes that did not exist in Cs and AA women had significantly more episodes of depression than any other group. However, associations of depression with smoking, BMI, and physical activity were consistent across groups in the expected direction. HDL-cholesterol was positively and LDL-cholesterol inversely associated with depression in Cs, which was unexpected. These data indicate that in this still healthy cohort, there are already associations between depression and factors that predispose to cardiovascular risk.

Adult↗

PubMed2005

Validity of self-reports of reasons for hospitalization by young adults and risk factors for discordance with medical records: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

This research focused on the validity of young adults' (mean age=33 years; standard deviation, 3.9) self-reports of reasons for hospitalization and factors affecting validity in a longitudinal cohort study of over 5,000 young adults in four US cities (1985-1998). Self-reported reasons were considered discordant if they differed from those in medical records. Of the 321 self-reported hospitalizations, overall concordance was 92.5%; concordance ranged from 80% for infections to 100% for injuries/fractures and procedures/surgeries. There were no significant differences among mail, telephone, or face-to-face methods of collecting self-reports. In generalized estimating equations analyses, Black race (odds ratio=4.23, 95% confidence interval: 1.72, 10.40; p=0.002) and intravenous drug use (odds ratio=6.06, 95% confidence interval: 1.17, 31.22; p=0.03) were positively associated with discordance. Nonetheless, self-reports by Blacks were 90.0% concordant. Self-reports by Whites were 95.7% concordant. These results suggest that young adults' self-reported reasons for hospitalization are overwhelmingly concordant with medical records. This has important implications, since obtaining medical records has become more costly and logistically difficult.

Adult↗

PubMed2005

Variation in Institutional Review processes for a multisite observational study.

BACKGROUND: The Veterans Administration is an ideal setting for multisite studies; however, individual VA Institutional Review Board (IRB) approval is necessary. This study examines the burden of multisite IRB approval on a Health Services Research and Development (HSRD) ventral hernia outcomes observational study. METHODS: Data gathered on the IRB process per site included time required for application completion, staff training and compliance, IRB affiliation (VA or university), approval status, and time to IRB approval. Wilcoxon rank sum tests were used to determine differences in median times for application completion and approval. Financial and temporal expenses were calculated. RESULTS: Significant differences were found in median time to complete applications by IRB affiliation (P < .01) and median time to approval by changes required to the consent letter (P < .05). CONCLUSIONS: The IRB process for a multisite observational study is expensive in both time and money. A VA national IRB for multisite studies would significantly decrease the financial and temporal burden for observational studies.

Ethics Committees, Research↗

PubMed2004

Ethnic differences in satisfaction and quality of life in veterans with ischemic heart disease.

OBJECTIVE: To assess differences in self-reported health status and satisfaction between African-American and caucasian veterans with ischemic heart disease (IHD). DATA SOURCES/STUDY SETTING: African-American and caucasian patients enrolled in General Internal Medicine clinics at six Veteran Affairs Medical Centers. STUDY DESIGN: We conducted a cross-sectional analysis of baseline survey data from the Ambulatory Care Quality Improvement Project (ACQUIP). Patients who responded to an initial health-screening questionnaire were sent follow-up surveys, which included the Medical Outcomes Study 36-item Health Survey (SF-36), the Seattle Outpatient Satisfaction Questionnaire (SOSQ), and the Seattle Angina Questionnaire (SAQ). PRINCIPAL FINDINGS: Of the 44,965 patients approached, 27,977 (62%) returned the baseline survey, of which 10,385 patients reported IHD and were sent the SAQ. Of those, 7,985 patients (84% caucasian, 16% African-American) responded. Caucasian respondents tended to be older, married, nonsmokers, with annual incomes over dollar 10,000, and had higher educational attainment than African Americans. African-American patients reported significantly fewer cardiac procedures (33% vs. 52%, p < 0.001) but were more likely to have diabetes (37% vs. 28%, p < 0.001) and hypertension (81% vs. 68%, p < 0.001). After adjustment for demographic characteristics, comorbid conditions, clinic site, and site-ethnicity interactions, SF-36 scores for physical function, role physical, bodily pain, and vitality were greater for African Americans than caucasians, while adjusted scores were significantly lower for role emotional. However, because of the site-ethnicity interaction, scores varied significantly by site. For the SAQ, overall adjusted physical function summary scores and disease stability scores were significantly greater for African Americans than caucasians. Adjusted summary satisfaction scores for provider satisfaction were not significantly lower for African Americans overall but were significant at two of six sites. Similarly, on the SAQ, adjusted treatment satisfaction scores were significantly lower for African Americans at half of the sites and minimally but not clinically significant overall. CONCLUSIONS: Despite a higher prevalence of cardiac risk factors, African-American patients with CAD who were treated in the VA system appeared to have a greater level of physical functioning, vitality, and angina stability. After adjustment for confounding demographic variables, however, these differences were not consistently significant at all geographic locations. This suggests that many other sociodemographic variables, in addition to ethnicity, influence apparent discrepancies in quality of life, satisfaction, and angina.

Black or African American↗