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Mona Shah

Publications and source records attributed to Mona Shah.

9 recordsLinked to original sources
PubMed2006

Hispanic acculturation and utilization of colorectal cancer screening in the United States.

BACKGROUND: Despite the evidence on the effectiveness of colorectal cancer (CRC) screening procedures, its use remains low, especially among Hispanics. Social-cultural factors may play a role in the underutilization of cancer screening. This study aimed to examine whether low acculturation was a risk factor for the underutilization of colorectal cancer screening in the Hispanic population. METHODS: The subjects were adults aged 50-80 years who identified themselves as Hispanic and never were diagnosed with colorectal cancer. Colorectal cancer screening utilization was assessed based on the use of at-home Fecal Occult Blood Test (FOBT) and the use of endoscopies (sigmoidoscopy, colonoscopy, or proctoscopy). Respondents who underwent a test for diagnostic purposes were excluded from the study. RESULTS: Our data showed that colorectal screening was underused in Hispanics compared to non-Hispanic Whites. There was a trend that acculturation level was inversely correlated with having an endoscopy in the past 5 years. This trend was also seen with having a FOBT in the past year or an endoscopy in the past 5 years. However, the association disappeared after adjusting for factors pertaining to utilizing other health care services. Additionally, after stratifying by gender, the association between the two variables was diluted. CONCLUSIONS: The findings show that low acculturation was associated with the underutilization of endoscopic colorectal cancer screening. This association may be related to lower utilization of health care services and/or language barriers that may contribute to the lower utilization.

Acculturation↗
PubMed2006

Factors associated with the incompliance with mammogram screening among individuals with a family history of breast cancer or ovarian cancer.

OBJECTIVE: The national guidelines recommend more intensive screening for breast cancer for women with a family history of breast or ovarian cancer. Using the data from the 2000 National Health Interview Survey (NHIS), we examined factors related to the underuse of mammogram in this population. METHOD: The study subjects were 1,215 women aged 30-79 who had a family history of breast or ovarian cancer in their first-degree relatives. According to the American Cancer Society's guidelines for breast cancer screening, having no mammogram in last year was used as an outcome for this study. Socio-demographic characteristics, health-related conditions, lifestyle factors, health behaviors, menstrual/reproductive information and health care access and utilization were analyzed to assess their relations to mammogram underuse using unconditional logistic regression method. RESULTS: The results showed that younger age, having no place to go when sick (OR = 2.2, 95% CI, 1.2-4.0), having no visits to a general doctor (OR = 1.7, 95% CI, 1.2-2.4) or medical specialist (OR = 2.2, 95% CI, 1.6-3.1) and having no influenza shot in last year (OR = 1.7, 95% CI, 1.2-2.3) increased the risk of underusing mammography screening among women who had a family history of breast or ovarian cancer. Women who had no home care from health professionals in the last year were less likely to underuse mammogram with an OR of 0.3 (95% CI, 0.1-0.6), compared with women who had. CONCLUSION: Medical care-related factors may affect the use of mammography screening in women with a family history of breast or ovarian cancer.

Adult↗
PubMed2006

Psychological distress in U.S. women who have experienced false-positive mammograms.

BACKGROUND: In the United States, approximately 10.7% of all screening mammograms lead to a false-positive result, but the overall impact of false-positives on psychological well-being is poorly understood. MATERIALS AND METHODS: Data were analyzed from the 2000 U.S. National Health Interview Survey (NHIS), the most recent national survey that included a cancer control module. Study subjects were 9,755 women who ever had a mammogram, of which 1,450 had experienced a false-positive result. Psychological distress was assessed using the validated K6 questionnaire and logistic regression was used to discern any association with previous false-positive mammograms. RESULTS: In a multivariate analysis, women who had indicated a previous false-positive mammogram were more likely to report feeling sad (OR = 1.18, 95% CI, 1.03-1.35), restless (OR = 1.23, 95% CI, 1.08-1.40), worthless (OR = 1.27, 95% CI, 1.04-1.54), and finding that everything was an effort (OR = 1.27, 95% CI, 1.10-1.47). These women were also more likely to have seen a mental health professional in the 12 months preceding the survey (OR = 1.28, 95% CI, 1.03-1.58) and had a higher composite score on all items of the K6 scale (P < 0.0001), a reflection of increased psychological distress. Analyses by age and race revealed that, among women who had experienced false-positives, younger women were more likely to feel that everything was an effort, and blacks were more likely to feel restless. CONCLUSION: In a random sampling of the U.S. population, women who had previously experienced false-positive mammograms were more likely to report symptoms of anxiety and depression.

Adult↗
PubMed2006

Multi-detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance.

BACKGROUND: Cardiac magnetic resonance (CMR) accurately quantifies right ventricular (RV) and left ventricular (LV) volumes and function. Limited availability of CMR and increasing use of MR-incompatible cardiovascular devices underscore the potential utility of cardiac computed tomography (CT) for ventricular quantification. This study quantified biventricular size and systolic function with multi-detector row CT compared with CMR imaging. METHODS: Twenty-six subjects prospectively underwent CT and CMR examinations on a 16-detector CT and 1.5 T MR scanner, respectively; claustrophobia in one and nongated CT imaging in another precluded complete imaging in 2 subjects. Contiguous multiphase short-axis images were generated from axial CT data, and steady-state free precession cine MR produced contiguous short-axis cines. Semiautomated software generated ventricular borders to calculate volume, mass, and ejection fraction (EF) from both sets of images. Blinded observers completed quantification and wall motion analyses of 23 CMR and CT data sets independently. RESULTS: All measures of LV size and function by cardiac CT correlated well with CMR over a wide range of LV function (LVEF 30%-72% by CMR), including end-diastolic volume (r = 0.97), end-systolic volume (r = 0.97), EF (r = 0.97), and mass (r = 0.95). Of 24 cases, 6 had inadequate contrast opacification of the RV precluding RV segmentation. In the remaining 18 CMR-CT data pairs, RVEF showed moderate agreement (r = 0.86), and RV volumes correlated well (r = 0.97 and 0.94 for RV end-diastolic volume and RV end-systolic volume, respectively). Ten percent of LV segments visualized by CT were inadequate for wall motion assessment due to motion artifact or inadequate contrast between myocardium and endocardium. For segments adequately visualized by both techniques, the mean kappa statistic was 0.88 (range 0.78-1.0), consistent with good agreement. CONCLUSION: Cardiac CT accurately quantifies LV size and function; RV quantification with cardiac CT requires optimized contrast opacification of the RV.

Aged↗
PubMed2005

Hispanic acculturation and utilization of cervical cancer screening in the US.

BACKGROUND: Hispanic women have an incidence rate of invasive cervical cancer that is twice as high as that of non-Hispanic White women. Previous investigations have reported that Hispanics are less likely to utilize cancer screening services. Using data from the 2000 National Health Interview Survey, this study examined whether acculturation of Hispanic women was associated with cervical cancer screening. METHODS: The subjects included 2307 Hispanic women aged 21-70 who did not have a history of cervical cancer or a hysterectomy. Women were analyzed by acculturation level according to whether or not they ever had a Pap smear and had one in the previous year and previous 3 years. RESULTS: Acculturation levels tended to be inversely correlated with no Pap smear. Compared to lower acculturated women, women who were more acculturated were less likely to never had a Pap smear (OR = 0.86; 95% CI = 0.58-1.27 for moderate acculturated women and OR = 0.51; 95% CI = 0.29-0.89 for higher acculturated women). Similar results were found for having no Pap smear within the past 3 years (OR = 0.83; 95% CI = 0.61-1.13 for moderate acculturated women and OR = 0.73; 95% CI = 0.49-1.08 for higher acculturated women). CONCLUSION: The findings show that lower acculturation was associated with the under use of cervical cancer screening and suggest that these women might have barriers in accessing and utilizing Pap smears.

Acculturation↗
PubMed2005

Self-reported hepatitis and non-Hodgkin lymphoma: an analysis according to the time since hepatitis diagnosis.

PURPOSE: Using data from the Selected Cancers Study, the authors tested whether the association between hepatitis infection and non-Hodgkin lymphoma (NHL) varied according to the time since the diagnosis of hepatitis. METHODS: Cases were 1177 men ages 32-60 diagnosed with NHL between 1984 and 1988. Controls were men with no history of NHL who were frequency-matched to lymphoma cases by age and cancer registry (n = 1852). Interviews were conducted to collect data on risk factors including history of hepatitis. No information on types of hepatitis was obtained. RESULTS: Logistic regression analyses indicated that history of hepatitis diagnosed 3 or more years prior to the reference date was not a significant risk factor for NHL (OR [odds ratio] = 0.92, 95% CI: 0.63-1.35). In contrast, men with a history of hepatitis diagnosed within 3 years prior to the diagnosis date had more than a five-fold increased risk of NHL (OR = 5.77, 95% CI: 1.99-16.74). CONCLUSIONS: Although the study was limited by lack of information on different types of hepatitis, the increased OR for hepatitis diagnosed more closely to the NHL diagnosis suggests that the reported association between hepatitis and NHL might partly result from increased detection of NHL in patients with recently reported hepatitis virus infection.

Adult↗
PubMed2004

Specificity and sensitivity of claims-based algorithms for identifying members of Medicare+Choice health plans that have chronic medical conditions.

OBJECTIVE: To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. STUDY SETTING: Secondary 1999-2000 data from two Medicare+Choice health plans. STUDY DESIGN: Retrospective analysis of algorithm specificity and sensitivity. DATA COLLECTION: Physician, facility, and pharmacy claims data were extracted from electronic records for a sample of 3,633 continuously enrolled beneficiaries who responded to an independent survey that included questions about chronic diseases. PRINCIPAL FINDINGS: Compared to an algorithm that required a single medical claim in a one-year period that listed the diagnosis, either requiring that the diagnosis be listed on two separate claims or that the diagnosis to be listed on one claim for a face-to-face encounter with a health care provider significantly increased specificity for the conditions studied by 0.03 to 0.11. Specificity of algorithms was significantly improved by 0.03 to 0.17 when both a medical claim with a diagnosis and a pharmacy claim for a medication commonly used to treat the condition were required. Sensitivity improved significantly by 0.01 to 0.20 when the algorithm relied on a medical claim with a diagnosis or a pharmacy claim, and by 0.05 to 0.17 when two years rather than one year of claims data were analyzed. Algorithms that had specificity more than 0.95 were found for all six conditions. Sensitivity above 0.90 was not achieved all conditions. CONCLUSIONS: Varying claims criteria improved the performance of case-finding algorithms for six chronic conditions. Highly specific, and sometimes sensitive, algorithms for identifying members of health plans with several chronic conditions can be developed using claims data.

Algorithms↗
PubMedDate not supplied

Use of geocoding in managed care settings to identify quality disparities.

Tracking quality-of-care measures is essential for improving care, particularly for vulnerable populations. Although managed care plans routinely track quality measures, few examine whether their performance differs by enrollee race/ethnicity or socioeconomic status (SES), in part because plans do not collect that information. We show that plans can begin examining and targeting potential disparities using indirect measures of enrollee race/ethnicity and SES based on geocoding. Using such measures, we demonstrate disparities within both Medicare+Choice and commercial plans on Health Plan Employer Data and Information Set (HEDIS) measures of diabetes and cardiovascular care, including instances in which race/ethnicity and SES have distinct effects.

Ethnicity↗