In 2022 …
Kaiser Permanente Washington Health Research Institute (KPWHRI) contributed to these achievements and more in 2022. These highlights provide a snapshot of just a small fraction of the institute’s work to improve health and health care.
We reported on how a KPWHRI study on home screening for colon cancer helped lead to implementation of a new centralized program in all Kaiser Permanente Washington medical centers. The program makes screening easier for patients and increases the likelihood of catching cancer early.
Our researchers working with the Breast Cancer Surveillance Consortium published studies looking at overdiagnosis in breast cancer screening and the benefits and harms of MRI before surgery for breast cancer. They also shared a new method for predicting advanced-stage breast cancer.
Also this year, Aruna Kamineni, PhD, MPH, co-led work finding that possible harms are not reported consistently in cancer screening guidelines. This can make it hard for physicians and patients to weigh the benefits and risks of screening decisions.
Equity in health care and health outcomes remained an important focus for our researchers in 2022. With data from more than 1 million people, Susan Shortreed, PhD, led a study indicating that higher risks of COVID-19 infection drove racial and ethnic disparities in disease outcomes. In the study, the authors emphasized that social factors related to COVID-19 exposure, rather than biological differences, influenced higher rates of severe disease.
KPWHRI researchers and affiliates also contributed to a study finding that delays in breast biopsies after an abnormal mammogram were more likely for Black and Asian women, compared to white women.
The BP-CHECK study led by Beverly Green, MD, MPH, found that blood pressure measurements taken at home were a better option for accurate diagnosis of hypertension than measurements taken in the clinic. The findings are the basis of a new pilot program with Kaiser Permanente Washington to improve diagnosis and treatment for members with hypertension and to empower members to be partners in their own care.
Hypertension is a leading cause of maternal mortality in the United States, and a new study led by Sascha Dublin, MD, PhD, filled an evidence gap by sharing important findings on medications used to treat hypertension in pregnancy. The findings showed that the risks of many maternal and neonatal outcomes were very similar for the 3 most commonly used medications: labetalol, methyldopa, and nifedipine. However, compared to labetalol, methyldopa use was associated with significantly lower risk of an infant being born small for their gestational age.
Two important new studies focused on centering patient voices and experiences in mental health treatment. Julie Richards, PhD, MPH, published new findings that shed light on how to open space for dialogue with patients about access to firearms and opportunities to better identify patients at risk. And researchers with the Center for Accelerating Care Transformation (ACT Center) — who have been partnering with Kaiser Permanente Washington care teams to expand an integrated mental health program to adolescents — talked to teens and their families about what they want and need from health systems and care teams. For teens, communication, privacy, and confidentiality were of central importance. Families expressed a desire for more direct interactions with clinicians and support in talking with their teens about mental health and substance use.
The Center for Community Health and Evaluation (CCHE) reported on the success of the PHASE initiative, which improved care for hundreds of thousands of patients at risk for cardiovascular disease. With CCHE as an evaluation partner, the PHASE sites were able to use ongoing data to drive the evolution of the program. CCHE’s evaluation of the Virtual Care Innovation Network also helped to identify best practices and challenges for delivering virtual care to vulnerable populations and providing equitable access to telehealth.
The advanced analytics team at the ACT Center partnered with Kaiser Permanente Washington to predict and prevent missed clinic visits, developing an intervention that has now been scaled to more than a dozen service lines. A small change — sending 2 reminder text messages instead of 1 — led to a 7% drop in missed primary care visits and an 11% drop in missed mental health visits.
All patients have different needs and deserve the best information to help them make decisions about medical care. This year, the PCORnet Bariatric Study came to a close, providing real-world evidence for informed decision-making about weight-loss surgery. And the Moving to Health project looked at weight gain after residential moves, finding that people who move from neighborhoods with low residential density to high-density areas may gain less weight than those making the opposite transition.
Researchers tested a new tool to help screen for dementia risk, finding that it performed well in different patient populations. Around 50% of people living with dementia are undiagnosed, and the tool could help clinicians decide which patients might benefit from additional screening. And the Seattle Alzheimer’s Disease Brain Cell Atlas Consortium, a partnership between KPWHRI, the Allen Institute, and University of Washington School of Medicine, released new open data showing changes in the brain at the level of individual cells.
KPWHRI researchers contributed to studies looking at efficacy of COVID-19 boosters, confirming the safety of mix-and-match COVID-19 boosters, and providing new data to support the safety of COVID-19 vaccines for people who are pregnant. Former Assistant Investigator Kai Yeung, PharmD, PhD, assessed clinical effectiveness and value of 3 drugs for people at high risk for severe COVID-19. And Jennifer Nelson, PhD, with Lisa Jackson, MD, MPH, led a study confirming the safety of the recombinant zoster vaccine Shingrix, recommended by the CDC (Centers for Disease Control and Prevention) for preventing shingles and related complications.
There’s much more to come in 2023. We look forward to continuing our many collaborations and projects to improve health, well-being, and health equity for all.
By Amelia Apfel
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