National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 112 Research Studies DisplayedStone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Predmore Z, Nie X, Main R
Anesthesia service use during outpatient gastroenterology procedures continued to increase from 2010 to 2013 and potentially discretionary spending remained high.
Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. The aim of this study was to update these trends with the most recent years of data. It found that during 2010 to 2013, anesthesia service use in GI procedures continued to increase and the proportion of these services rendered for low-risk patients remained high.
AHRQ-funded; HS000029.
Citation: Predmore Z, Nie X, Main R .
Anesthesia service use during outpatient gastroenterology procedures continued to increase from 2010 to 2013 and potentially discretionary spending remained high.
Am J Gastroenterol 2017 Feb;112(2):297-302. doi: 10.1038/ajg.2016.266.
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Keywords: Digestive Disease and Health, Ambulatory Care and Surgery, Healthcare Costs
Banerjee T, Meyer TW, Shafi T
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
P-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. The researchers explored the relationship between free and total PCS and indoxyl sulfate (IS) with infection-related hospitalizations (IH) and septicemia in 2 cohorts. Their results suggest an association between higher concentrations of free PCS and infection-related and sepsis-related hospitalizations in hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Banerjee T, Meyer TW, Shafi T .
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
Medicine 2017 Feb;96(6):e5799. doi: 10.1097/md.0000000000005799.
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Keywords: Hospitalization, Kidney Disease and Health, Kidney Disease and Health, Digestive Disease and Health, Sepsis
Schroeder J, Hoffswell J, Chung CF
Supporting patient-provider collaboration to identify individual triggers using food and symptom journals.
The researchers examined patient-provider collaboration to interpret patient-generated data. Irritable bowel syndrome (IBS) management often requires patient-provider collaboration using a patient's food and symptom journal to identify the patient's triggers. Drawing upon individual and collaborative interviews with patients and providers, the researchers found that collaborative review helps improve data comprehension and build mutual trust.
AHRQ-funded; HS023654.
Citation: Schroeder J, Hoffswell J, Chung CF .
Supporting patient-provider collaboration to identify individual triggers using food and symptom journals.
CSCW 2017 Feb 25;2017:1726-39. doi: 10.1145/2998181.2998276.
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Keywords: Digestive Disease and Health, Health Information Technology (HIT), Nutrition, Clinician-Patient Communication, Patient Self-Management
Zia JK, Chung CF, Schroeder J
The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome.
The primary aim of this study was to evaluate the feasibility, usability, and clinical utility of paper food and gastrointestinal symptom journals as a data collection tool. Over half of the 17 participants perceived paper journaling of food and symptoms as feasible, usable, and clinically useful. Thirteen participants demonstrated a strong association with at least one symptom and meal nutrient.
AHRQ-funded; HS023654.
Citation: Zia JK, Chung CF, Schroeder J .
The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome.
Neurogastroenterol Motil 2017 Feb;29(2). doi: 10.1111/nmo.12935.
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Keywords: Digestive Disease and Health, Nutrition, Patient Experience, Patient Self-Management
Chuang LS, Villaverde N, Hui KY
A frameshift in CSF2RB predominant among Ashkenazi Jews increases risk for Crohn's disease and reduces monocyte signaling via GM-CSF.
The authors sought to identify rare, Crohn's disease-associated frameshift variants of high functional and statistical effects. They associated Crohn's disease with a frameshift mutation in CSF2RB. Intestinal monocytes from carriers of this mutation had reduced responses to granulocyte-macrophage colony-stimulating factor.
AHRQ-funded; HS021747.
Citation: Chuang LS, Villaverde N, Hui KY .
A frameshift in CSF2RB predominant among Ashkenazi Jews increases risk for Crohn's disease and reduces monocyte signaling via GM-CSF.
Gastroenterology 2016 Oct;151(4):710-23.e2. doi: 10.1053/j.gastro.2016.06.045.
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Keywords: Digestive Disease and Health, Genetics, Risk, Racial and Ethnic Minorities
Li D, Achkar JP, Haritunians T
A pleiotropic missense variant in SLC39A8 is associated with crohn's disease and human gut microbiome composition.
This study aimed to identify novel associations between inflammatory bowel disease (IBD) and functional genetic variants. The results suggest that an SLC39A8-dependent shift in the gut microbiome could explain its pleiotropic effects on multiple complex diseases including Crohn's disease.
AHRQ-funded; HS021747.
Citation: Li D, Achkar JP, Haritunians T .
A pleiotropic missense variant in SLC39A8 is associated with crohn's disease and human gut microbiome composition.
Gastroenterology 2016 Oct;151(4):724-32. doi: 10.1053/j.gastro.2016.06.051.
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Keywords: Digestive Disease and Health, Genetics, Risk
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Dimou FM, Adhikari D, Mehta HB
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
The authors aimed to determine the timing, incidence, and management of stricture after biliary-enteric anastomosis. They found that younger age was associated with a decreased likelihood of stricture formation and that the presence of an endostent predicted stricture formation. They concluded that biliary-enteric anastomotic strictures occur with significant frequency after a biliary-enteric anastomosis, and that while many patients are managed nonoperatively, stricture diagnosis remains burdensome.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
Surgery 2016 Sep;160(3):691-8. doi: 10.1016/j.surg.2016.05.021.
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Keywords: Surgery, Adverse Events, Digestive Disease and Health, Elderly, Patient-Centered Outcomes Research
Guerrerio AL, Frischmeyer-Guerrerio PA, Huang C
Increased prevalence of inflammatory bowel disease in patients with mutations in genes encoding the receptor subunits for TGFbeta.
The researchers evaluated the potential genetic risk factors that could predict which patients with Loeys-Dietz syndrome (LDS) would develop inflammatory bowel disease (IBD). They reported a 10-fold increase in the prevalence of IBD in patients with LDS compared with the general population.
AHRQ-funded; HS021747.
Citation: Guerrerio AL, Frischmeyer-Guerrerio PA, Huang C .
Increased prevalence of inflammatory bowel disease in patients with mutations in genes encoding the receptor subunits for TGFbeta.
Inflamm Bowel Dis 2016 Sep;22(9):2058-62. doi: 10.1097/mib.0000000000000872.
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Keywords: Digestive Disease and Health, Genetics, Risk
Govani SM, Wiitala WL, Stidham RW
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
The investigators compared the use of steroids and steroid-sparing therapies and rates of complications among elderly and younger patients in a national cohort of veterans with inflammatory bowel disease (IBD). They found that, after starting steroids, fracture rates increased in the elderly patients with IBD, whereas increases in venous thromboembolism and infections after starting steroids affected both age groups. Additonally, elderly veterans were less likely to receive steroids and steroid-sparing medications than younger veterans.
AHRQ-funded; HS024122.
Citation: Govani SM, Wiitala WL, Stidham RW .
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
Inflamm Bowel Dis 2016 Aug;22(8):1923-8. doi: 10.1097/mib.0000000000000817.
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Keywords: Digestive Disease and Health, Disparities, Elderly, Medication, Practice Patterns
Shah MP, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
The researchers compared the rates of gastroenteritis- and rotavirus-coded ED visits among children <5 years of age in pre-rotavirus vaccine (2003 to 2006) with those in postvaccine (2008-2013) years; 2007 was excluded as a transition year They concluded that. ED visits for gastroenteritis in US children have declined since the introduction of rotavirus vaccine.
AHRQ-authored.
Citation: Shah MP, Tate JE, Steiner CA .
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
Pediatr Infect Dis J 2016 Jul;35(7):782-6. doi: 10.1097/inf.0000000000001175.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Vaccination, Emergency Medical Services (EMS), Digestive Disease and Health
Simianu VV, Fichera A, Bastawrous AL
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
The authors described patterns of episodes of diverticulitis before surgery and factors associated with earlier interventions using inpatient, outpatient, and antibiotic prescription claims. They found that 56.3% of elective resections for uncomplicated diverticulitis occurred after fewer than 3 episodes. Further, they determined that earlier surgery was not explained by younger age, laparoscopy, time between the last 2 episodes preceding surgery, or financial risk-bearing for patients.
AHRQ-funded; HS020025.
Citation: Simianu VV, Fichera A, Bastawrous AL .
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
JAMA Surg 2016 Jul;151(7):604-10. doi: 10.1001/jamasurg.2015.5478.
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Keywords: Shared Decision Making, Digestive Disease and Health, Health Systems, Healthcare Utilization, Surgery
McLean LP, Cross RK
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. It concluded that vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from tumor necrosis factor (TNF)-alpha inhibitors and immune suppressants, allowing it to be used in cases of TNF-alpha inhibitor failure or non-response, or as a first-line biologic drug.
AHRQ-funded; HS018975.
Citation: McLean LP, Cross RK .
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
Expert Opin Drug Metab Toxicol 2016 Jul;12(7):833-42. doi: 10.1080/17425255.2016.1181171.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Treatments
Volkmann ER, Chang YL, Barroso N
Association of systemic sclerosis with a unique colonic microbial consortium.
The authors compared colonic microbial composition in systemic sclerosis (SSc) patients and healthy controls and determined whether certain microbial genera are associated with gastrointestinal (GI) tract symptoms in patients with SSc. They found that SSc patients had decreased levels of commensal bacteria and increased levels of pathobiont bacteria compared with healthy controls. They concluded that this unique ecologic change may perpetuate immunologic aberrations and contribute to clinical manifestations of SSc.
AHRQ-funded; HS021747.
Citation: Volkmann ER, Chang YL, Barroso N .
Association of systemic sclerosis with a unique colonic microbial consortium.
Arthritis Rheumatol 2016 Jun;68(6):1483-92. doi: 10.1002/art.39572.
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Keywords: Adverse Events, Digestive Disease and Health, Skin Conditions
Karkar R, Zia J, Vilardaga R
A framework for self-experimentation in personalized health.
The authors examined an interdisciplinary and methodological framework's applicability to various health conditions and presented an initial case study with irritable bowel syndrome (IBS). They concluded that using mobile technology to guide people through self-experimentation to investigate health questions is a feasible and promising approach to advancing personalized health.
AHRQ-funded; HS023654.
Citation: Karkar R, Zia J, Vilardaga R .
A framework for self-experimentation in personalized health.
J Am Med Inform Assoc 2016 May;23(3):440-8. doi: 10.1093/jamia/ocv150.
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Keywords: Education: Patient and Caregiver, Digestive Disease and Health, Health Information Technology (HIT)
Ehlers AP, Simianu VV, Bastawrous AL
Alvimopan use, outcomes, and costs: a report from the Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research Translation Network Collaborative.
The researchers investigated the effectiveness of alvimopan in routine clinical practice and its impact on hospital costs. They found that when used in routine clinical practice, alvimopan was associated with a shorter length of stay and limited but significant hospital cost savings. They concluded that both efficacy and effectiveness data support the use of alvimopan in routine clinical practice, and its use could be measured as a marker of higher quality care.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Simianu VV, Bastawrous AL .
Alvimopan use, outcomes, and costs: a report from the Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research Translation Network Collaborative.
J Am Coll Surg 2016 May;222(5):870-7. doi: 10.1016/j.jamcollsurg.2016.01.051.
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Keywords: Comparative Effectiveness, Surgery, Digestive Disease and Health, Healthcare Costs
Yadlapati R, Adkins C, Jaiyeola DM
Abilities of oropharyngeal pH tests and salivary pepsin analysis to discriminate between asymptomatic volunteers and subjects with symptoms of laryngeal irritation.
The researchers examined the ability of oropharyngeal pH tests and salivary pepsin tests to discriminate between asymptomatic volunteers and subjects with a combination of laryngeal and reflux symptoms. They found that oropharyngeal pH testing and salivary pepsin analysis are not able to distinguish between healthy volunteers and subjects with a combination of laryngeal and reflux symptoms.
AHRQ-funded; HS023011.
Citation: Yadlapati R, Adkins C, Jaiyeola DM .
Abilities of oropharyngeal pH tests and salivary pepsin analysis to discriminate between asymptomatic volunteers and subjects with symptoms of laryngeal irritation.
Clin Gastroenterol Hepatol 2016 Apr;14(4):535-42.e2. doi: 10.1016/j.cgh.2015.11.017.
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Keywords: Diagnostic Safety and Quality, Digestive Disease and Health, Patient-Centered Outcomes Research
Siegel CA, Lofland JH, Naim A
Novel statistical approach to determine inflammatory bowel disease: patients' perspectives on shared decision making.
The aim of this study was to examine patient insights regarding shared decision making among patients with inflammatory bowel disease (IBD) using novel statistical technology to analyze qualitative data. From the 355 patients surveyed, the researchers identified three unique patient clusters: satisfied, content, and dissatisfied. They concluded that patient perspectives in this study indicate an increased desire for shared decision making in determining an optimal IBD treatment plan.
AHRQ-funded; HS021747.
Citation: Siegel CA, Lofland JH, Naim A .
Novel statistical approach to determine inflammatory bowel disease: patients' perspectives on shared decision making.
Patient 2016 Feb;9(1):79-89. doi: 10.1007/s40271-015-0126-z.
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Keywords: Shared Decision Making, Digestive Disease and Health, Patient and Family Engagement, Patient Experience, Clinician-Patient Communication
Cleynen I, Boucher G, Jostins L
Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study.
The researchers undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between between Crohn's disease and ulcerative colitis. Their data support a continuum of disorders within inflammatory bowel disease, much better explained by three groups (ileal Crohn's disease, colonic Crohn's disease, and ulcerative colitis) than by Crohn's disease and ulcerative colitis as currently defined.
AHRQ-funded; HS021747.
Citation: Cleynen I, Boucher G, Jostins L .
Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study.
Lancet 2016 Jan 9;387(10014):156-67. doi: 10.1016/s0140-6736(15)00465-1.
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Keywords: Genetics, Digestive Disease and Health, Chronic Conditions
Stein BN, Pellish RS, Thompson KD
Using therapeutic drug monitoring to identify variable infliximab metabolism in an individual patient with ulcerative colitis.
In this case report, the authors demonstrate how therapeutic drug monitoring can be used to personalize a dosing regimen to ensure appropriate induction, and to safely deescalate therapy after remission is achieved. By identifying a change in drug clearance in an individual patient over time, they were able to attain significant cost savings despite the high price of serially measured drug and antibody concentrations.
AHRQ-funded; HS021747.
Citation: Stein BN, Pellish RS, Thompson KD .
Using therapeutic drug monitoring to identify variable infliximab metabolism in an individual patient with ulcerative colitis.
J Clin Gastroenterol 2016 Jan;50(1):66-8. doi: 10.1097/mcg.0000000000000370.
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Keywords: Care Management, Digestive Disease and Health, Quality of Care, Medication
Almario CV, Chey WD, Iriana S
Computer versus physician identification of gastrointestinal alarm features.
This study's objective was to compare the number of alarms documented by physicians during usual care vs. that collected by a computer algorithm called Automated Evaluation of Gastrointestinal Symptoms (AEGIS). AEGIS identified more patients with positive alarm features compared to physicians and also documented more positive alarms. Moreover, clinicians documented only 30% of the positive alarms self-reported by patients through AEGIS.
AHRQ-funded; HS000046.
Citation: Almario CV, Chey WD, Iriana S .
Computer versus physician identification of gastrointestinal alarm features.
Int J Med Inform 2015 Dec;84(12):1111-7. doi: 10.1016/j.ijmedinf.2015.07.006.
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Keywords: Clinical Decision Support (CDS), Diagnostic Safety and Quality, Digestive Disease and Health, Electronic Health Records (EHRs), Patient Safety
Krouse RS, You YN
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
This paper is an update on the status of the Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction trial (S1316), the aim of which is to assess the quality of life outcome of “good days” for patients with malignant bowel obstruction (MBO) who receive surgical intervention in comparison with patients who undergo nonsurgical intervention.
AHRQ-funded; HS021491.
Citation: Krouse RS, You YN .
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
Bull Am Coll Surg 2015 Dec;100(12):49-50.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Patient-Centered Outcomes Research, Quality of Life
Johnson SL, Bartels CM, Palta M
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
The researchers examined the frequency and predictors of antitumour necrosis factor (TNF) use, among US patients with inflammatory bowel disease (IBD) aged 65 years and older prior to the publication of a new Medicare quality measure calling for the use of anti-TNFs and other steroid-sparing agents. They found that anti-TNF use was very low in this population of older patients with IBD.
AHRQ-funded; HS022786.
Citation: Johnson SL, Bartels CM, Palta M .
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
BMJ Open 2015 Sep 07;5(9):e008597. doi: 10.1136/bmjopen-2015-008597.
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Keywords: Elderly, Digestive Disease and Health, Medication, Quality Measures
Siegel CA, Lofland JH, Naim A
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
The researchers examined gastroenterologists' perspectives about shared decision making (SDM) with patients with inflammatory bowel disease (IBD). They found three key barriers to practicing SDM were lack of time, reimbursement, and tools. They concluded that gastroenterologists lack the systematic approaches and tools for implementing SDM within their IBD practices.
AHRQ-funded; HS021747.
Citation: Siegel CA, Lofland JH, Naim A .
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
Dig Dis Sci 2015 Sep;60(9):2636-45. doi: 10.1007/s10620-015-3675-z.
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Keywords: Shared Decision Making, Digestive Disease and Health, Patient and Family Engagement, Practice Patterns