Kenneth Adam Taylor

Calculates mean cumulative count (MCC) to estimate the expected cumulative number of recurrent events per person over time in the presence of competing risks and censoring. Implements both the Dong-Yasui equation method and sum of cumulative incidence method described in Dong, et al. (2015) . Supports inverse probability weighting for causal inference as outlined in Gaber, et al. (2023) . Provides S3 methods for printing, summarizing, plotting, and extracting results. Handles grouped analyses and integrates with 'ggplot2' for visualization.

Purpose: To examine five-year trends in 30-day readmission and length of stay (LOS) among the geriatric population after surgical fixation for hip fracture in a large database model. Methods: Patients ≥ 65 years of age in the American College of Surgeons National Surgical Quality Improvement Program Targeted Hip Fracture (ACS-NSQIP THF) were identified using Current Procedural Terminology (CPT®) codes 27 236, 27 244, 27 245 for intramedullary nailing or Open Reduction and Internal Fixation (ORIF) of fractures involving the femoral head, neck, peritrochanteric, intertrochanteric, and subtrochanteric regions. The primary outcome was incidence of ≥1 30-day hospital readmission and secondary outcome was total hospital length of stay in trend analysis. Results: Overall, there were 64 794 patients who met inclusion criteria, of which 7.85% (95% CI: 7.64% to 8.05%) were readmitted within 30 days of hip fracture surgical fixation. The proportion of patients with ≥1 30-day readmission were presented over time and Cochran-Armitage Trend Testing indicated a statistically significant decreasing trend in the 30-day readmission incidence from 2016-2021 ( P < 0.0001). The mean absolute change in incidence from year-to-year was −0.24% (mean relative change, 0.97) and the total absolute difference in incidence from 2016 to 2021 was −1.20% (relative difference, 0.85). LOS data were missing for 1048 cases (1.62%). Mean and median length of stay data was similar across all years. Conclusion: The probability of having ≥1 30-day readmission decreased 0.85-times from 2016 to 2021, with a statistically significant downward trend over time. There were no meaningful changes in length of stay. Healthcare providers, policymakers, and stakeholders can utilize these findings to implement initiatives that enhance value-based care in hip fracture management and benchmark institutional metrics, ultimately improving patient outcomes and optimizing healthcare resources.

Importance: Retained surgical items (RSI) are serious, preventable medical errors that continue to occur despite widespread implementation of safety protocols and technological interventions. Understanding RSI incidence can inform quality improvement aimed at prevention and patient safety. Objective: To estimate the incidence of retained surgical items in the United States from 2016 to 2023 overall, annually, and stratified by state and surgery category. Design: This was a longitudinal retrospective cohort study utilizing de-identified healthcare claims data from 2016 to 2023. Setting: Data were from the Komodo Research Dataset, which aggregates medical and pharmacy claims from US commercial and government insurance sources. Participants: 198,619,904 surgeries between January 1, 2016, and December 31, 2023 where the patient had at least six months of prior continuous medical and pharmacy insurance enrollment. Surgeries were excluded if there was evidence of RSI before surgery or present on admission, surgery was performed in a US territory, or the patient was aged < 2 on the surgery date. Exposure: Surgical procedures identified by administrative codes categorized as broad or narrow by the Agency for Healthcare Research and Quality. Main Outcome(s) and Measure(s): The primary outcome was the incidence proportion of RSIs, identified using International Classification of Diseases, Tenth Revision, Clinical Modification codes up to 365 days after surgery. Incidence was estimated overall, annually, and stratified by state and surgical category. Data were analyzed from March 2025 to May 2025. Results: The overall RSI incidence was 1.34 (95% CI: 1.32 to 1.36) per 10,000 surgeries, decreasing from 1.63 (95% CI: 1.58 to 1.70) in 2016 to 1.08 (95% CI: 1.04 to 1.12) in 2023. The 5 highest state-stratified RSI incidences were in the District of Columbia, Maine, Nebraska, Ohio, and West Virginia. Exploratory laparotomies and transplant surgeries had the highest surgery category-stratified RSI incidence. Conclusion and Relevance: This large national claims-based study estimated RSI incidence and describes associated patterns in the US, confirming a persistent but declining annual incidence across the 8-year period. These findings highlight the ongoing need for targeted prevention strategies and system-wide efforts to reduce RSIs and improve surgical care. Key Points: Question: What is the incidence of retained surgical items from 2016 to 2023 in the United States overall, annually, and stratified by surgery type and geographic region? Findings: In this descriptive study of over 198 million surgical procedures from 2016 to 2023, retained surgical item incidence was 1.34 per 10,000 surgeries, declining from 1.63 in 2016 to 1.08 per 10,000 surgeries in 2023. The highest surgery category-stratified incidence was exploratory laparotomy; geographically-stratified incidence was highest in the District of Columbia. Meaning: Retained surgical items remain a national issue, though declining, highlighting the need for targeted clinical and hospital prevention.

Calculate morphine milligram equivalents (MME) for opioid dose comparison using standardized methods. Includes API wrapper functions to call 'NIH HEAL MME Online Calculator' and functions that replicate API calculations on the user's local machine from the comfort of 'R'. Creation of the 'NIH HEAL MME Online Calculator' and the MME calculations implemented in this package are described in Adams MCB, Sward KA, Perkins ML, Hurley RW (2025) .

Low hand grip strength (HGS) is associated with several conditions, but its value outside of the older adult population is unclear. We sought to identify the most salient factors associated with HGS from an extensive list of candidate variables while stratifying by age and sex. We used data from the initial visit from the Project Baseline Health Study (N = 2502) which captured detailed demographic, occupational, social, lifestyle, and clinical data. We applied MI-LASSO using group methods to determine variables most associated with HGS out of 175 candidate variables. We performed analyses separately for sex and age (< 65 vs. ≥ 65 years). Race was associated with HGS to varying degrees across groups. Osteoporosis and osteopenia were negatively associated with HGS in female study participants. Immune cell counts were negatively associated with HGS for male participants ≥ 65 (neutrophils) and female participants (≥ 65, monocytes; < 65, lymphocytes). Most findings were age and/or sex group-specific; few were common across all groups. Several of the variables associated with HGS in each group were novel, while others corroborate previous research. Our results support HGS as a useful indicator of a variety of clinical characteristics; however, its utility varies by age and sex.

Acute low back pain (LBP) is a common experience, however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, three acute LBP severity categorization definitions were used based on LBP frequency combined with either 1) pain impact frequency (impact-based) or 2) pain intensity (intensity-based), as well as LBP pain interference frequency (interference only-based) severity categories. The purpose of this manuscript is to describe and then compare these acute LBP severity groups in the following characteristics: 1) sociodemographic, 2) general and physical health, and 3) psychological. This cross-sectional study used baseline data from 131 community-based participants with acute LBP (g for continuous variables. Our analyses identified several large associations for impact-based and intensity-based categories with global mental health, global physical health, STarT Back Screening Tool risk category, and general health. Larger associations were found with social constructs (racially and ethnically minoritized, performance of social roles, and isolation) when using the intensity-based versus impact-based categorization. The interference-based category did not capture as much variability between acute LBP severity categories. This study adds to the literature by providing standard ways to characterize community-based individuals experiencing acute LBP. The robust differences observed between these categorization approaches suggest that how we define acute LBP severity is consequential; these different approaches may be used to improve the early identification of factors potentially contributing to the development of chronic LBP.

We appreciate Krakow’s interest in our recent paper investigating nightmares as a possible risk factor for cardiovascular disease (CVD) [ 1] and the opportunity to respond to his letter to the editor [ 2]. We agree with Krakow’s position that Cartesian dualism remains a prevalent lens through which practitioners across many healthcare specialties view the patients for whom they provide care. We further agree that dualism in clinical practice and research may also negatively impact the patients whose lives practitioners and researchers aim to improve through their work.