Papers by Katrina Romagnoli
Journal of Personalized Medicine, 2021
Ovarian cancer (OVCA) patients may carry genes conferring cancer risk to biological family; howev... more Ovarian cancer (OVCA) patients may carry genes conferring cancer risk to biological family; however, fewer than one-quarter of patients receive genetic testing. “Traceback” cascade testing —outreach to potential probands and relatives—is a possible solution. This paper outlines a funded study (U01 CA240747-01A1) seeking to determine a Traceback program’s feasibility, acceptability, effectiveness, and costs. This is a multisite prospective observational feasibility study across three integrated health systems. Informed by the Conceptual Model for Implementation Research, we will outline, implement, and evaluate the outcomes of an OVCA Traceback program. We will use standard legal research methodology to review genetic privacy statutes; engage key stakeholders in qualitative interviews to design communication strategies; employ descriptive statistics and regression analyses to evaluate the site differences in genetic testing and the OVCA Traceback testing; and assess program outcomes ...
AMIA Joint Summits on Translational Science proceedings AMIA Summit on Translational Science, 2013
The purpose of this paper is to describe pilot work on a semantic model of the pharmacogenomics i... more The purpose of this paper is to describe pilot work on a semantic model of the pharmacogenomics information found in drug product labels. The model's development is driven by a series of use cases that we have developed to demonstrate how structured pharmacogenomics information could be more effectively used to support clinical and translational efforts. Using an iterative process, the semantic model was field-tested by five pharmacists, who used it to manually annotate a subset of the sections that the Food and Drug Administration's Table of Pharmacogenomic Biomarkers in Drug Labels cites as containing pharmacogenomics information. The five pharmacists identified a total of 213 pharmacogenomics statements in 29 sections. The model showed the potential to make the unstructured pharmacogenomic information currently written in product labeling more accessible and actionable through structured annotations of pharmacogenomics effects and clinical recommendations.
BMJ quality & safety, 2013
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2011
Polypharmacy and medication non-adherence are common in older adults, potentially leading to medi... more Polypharmacy and medication non-adherence are common in older adults, potentially leading to medication-related problems and increased healthcare expenditures. Medication Delivery Units (MDUs) may improve adherence, but their interfaces may present usability challenges for older adults with age-related impairments. We used a combination of three inspection methods - heuristic evaluation, cognitive walkthrough, and simulated elderly interaction, to identify potential concerns with the usability of a commercially available telemedicine MDU. Each method revealed different problems, with repeated discoveries via different methods providing triangulated evidence. Despite the MDU's general usability, issues of varying severity were discovered. Significant usability issues associated with physical interactions with the MDU included loading and unloading the medication blister packs, and opening the delivered medication prior to administration. Less severe issues centered on small text ...
Assessing the impact of cognitive impairment on the usability of an electronic medication delivery unit in an assisted living population
International Journal of Medical Informatics, 2014
To examine the relationship between cognitive status and the usability of an integrated medicatio... more To examine the relationship between cognitive status and the usability of an integrated medication delivery unit (MDU) in older adults who reside in an Assisted Living Facility (ALF). Subjects were recruited from a single ALF in Pittsburgh, PA. Usability testing sessions required subjects to execute tasks essential to using EMMA(®) (Electronic Medication Management Assistant), a Class II Federal Drug Administration (FDA) approved integrated MDU. Video coding allowed for quantification of usability errors observed during the testing sessions. Each subject's cognitive status was assessed using the Mini Mental State Exam (MMSE(®)) with scores <24 indicating cognitive impairment. Functional status was assessed using the Lawton Instrumental Activities of Daily Living (IADL) questionnaire, and a global assessment of subjective usability was assessed by completing the System Usability Scale (SUS). Non-parametric statistics and correlation analysis were used to determine whether significant differences existed between cognitively impaired and non-impaired subjects. Nineteen subjects were recruited and completed the protocol. The subject pool was primarily white, female, 80+ and in possession of above average education. There was a significant relationship between MMSE(®) scores and the percentage of task success (z=-2.03, p=0.04). Subjects with MMSE(®) scores of 24+ (no cognitive impairment) successfully completed an average of 69.0% of tasks vs. the 34.7% performance for those in the cognitively impaired group (<24). Six of the unimpaired group also succeeded at meeting the 85% (6 out of 7 correct) threshold. No subject with cognitive impairments (<24 MMSE(®)) completed more than 5/7 (71.4%) of their tasks. Two of the impaired subjects failed all of the tasks. Three of the MMSE(®)'s subsections (Date, Location and Spell 'world' backwards) were found to be significantly related (p<0.05) to the percentage of task success. Tasks success rates were related with IADL scores (z=-3.826, p<0.0001), and SUS scores (r=0.467, p=0.0429). Medication delivery units like EMMA(®) have the potential to improve medication management by combining reminder systems with telemedical monitoring and control capabilities. However, subjects judged to be "cognitively impaired" (<24 MMSE(®)) scored a significantly smaller percentage of task success than the "unimpaired" (>=24), suggesting that cognitive screening…
Objective To understand home-care nurses' perceptions of the post-hospitalisation information nee... more Objective To understand home-care nurses' perceptions of the post-hospitalisation information needs and communication problems of older patients, and how these factors might contribute to undesirable outcomes including poor patient reintegration into prior living environments and unplanned hospital readmissions.
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Papers by Katrina Romagnoli