Larry G Kessler
Dados Biográficos
| ID | 5378279 |
|---|---|
| NOME | Larry G Kessler |
| PRENOMES | Larry G |
| SOBRENOME | Kessler |
| ASSINATURA | KESSLER L G |
| AFILIAÇÕES | National Institutes of Health |
| ORCID | 0000-0002-8024-5424 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAÇÕES | 90 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1980 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2024 |
| ÍNDICE H | 6 |
Critical lessons from a pragmatic randomized trial of home‐based Covid‐19 testing in rural Native American and Latino communities
PURPOSE: Native Americans and Latinos have higher COVID-19 infection and mortality rates and may have limited access to diagnostic testing. Home-based testing may improve access to care in rural and underserved populations. This study tests the effect of community health worker (CHW) support on accessibility, feasibility, and completion of COVID-19 home testing among Native American and Latino adults living on the Flathead Reservation in Montana …
A Call to Improve Usability, Accuracy, and Equity of Self-Testing for Covid-19 and Other Rapid Diagnostic Tests
The increasing availability of rapid diagnostic self-tests (RDSTs) for COVID-19 has played an important and increasing role during the pandemic. However, for many underserved communities, RDSTs potential benefits are offset by problems with usability, accuracy, and equity. Given the increased need for and interest in home testing for acute and chronic diseases, including COVID-19, this piece offers ways that regulatory agencies, federal public he…
Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization
BACKGROUND: Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (ie, colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. OBJECTIVES: To examine whether rates of complete diagnostic evaluation after a positive fecal occult blood test (FOBT) have improved over time after the implementatio…
From Concentration Camp to Campus
The National Japanese American Relocation Council was created in the spring of 1942 at the urging of War Relocation Authority director Milton Eisenhower. This largely Quaker volunteer agency, privately organized and financed, helped more than four thousand Japanese American students incarcerated in internment camps obtain releases to pursue their college education at more than six hundred schools during World War II. Professor Allan W. Austin's w…
The Outcomes of The Cancer Outcomes Research Symposium
This commentary summarizes the important results of the Seattle Symposium on Cancer Outcomes Research. Based on the concepts and ideas raised by the conference speakers, we describe what we see as the “state of the union” of cancer outcomes research. As such, rather than attempting to provide a comprehensive review of the field, we highlight the areas of consensus and controversy that are current in this field. Second, we describe what leaders of…
Medicare Payments from Diagnosis to Death for Elderly Cancer Patients by Stage at Diagnosis
Although extensive resources go to cancer care, national population-based data on the costs of such care at the patient level have been unavailable. Medicare payments subsequent to diagnosis of cancer for elderly enrollees with five common cancers were estimated using tumor registry data from the Surveillance, Epidemiology, and End Results Program linked to Medicare claims from 1984 to 1990. The time between diagnosis and death was divided into f…
Changes in the use of screening mammography
OBJECTIVES: Mammography rates reported by women in the National Health Interview Surveys of 1990 and 1987 are examined. Why this screening modality is not more frequently used is explored. METHODS. Data from the 1987 and 1990 National Health Interview Surveys, conducted by the National Center for Health Statistics, are cross-tabulated and compared. RESULTS. In 1987, approximately 17% of women over 40 years of age reported having had a screening m…
Eat for Health
OBJECTIVES. The results of an evaluation of "Eat for Health," a supermarket nutrition intervention, are presented. The study tested whether such a program could be successfully carried out and whether it could effect changes in knowledge, attitudes, and food purchasing behavior in line with nutrition and cancer risk reduction guidelines. METHODS. The evaluation consisted of an in-store monitoring element, an in-store and telephone consumer survey…
Emotional Support Following Cancer
Reports of changes in emotional support following surgery for breast cancer can be attributed to one of two factors: (1) the stigma associated with cancer, or (2) illness-imposed restrictions in one's activities. These explanations were assessed using data from a longitudinal study of women, following their surgical treatment for early breast cancer (N = 145), gallbladder disease (N = 90), benign breast disease (N = 87), or no surgery (N = 90). M…
Potential for Cancer Related Health Services Research Using a Linked Medicare-Tumor Registry Database
The National Cancer Institute and the Health Care Financing Administration share a strong research interest in cancer costs, access to cancer prevention and treatment services, and cancer patient outcomes. To develop a database for such research, the two agencies have undertaken a collaborative effort to link Medicare Program data with the Surveillance, Epidemiology, and End Results (SEER) Program database. The SEER Program is a system of 9 popul…
Black-white differences in cancer prevention knowledge and behavior
Data from the 1987 National Health Interview Survey Cancer Control Supplement were used to estimate multivariate logistic regression models of diet change, mammography utilization, stool blood test utilization, and smoking. Predictor variables included race, sex, age, income, dietary concerns, and four knowledge-related variables: education and three measures of cancer prevention knowledge. When knowledge variables were included in the models, ra…
Cervical cancer screening
BACKGROUND: The decline in death rates from cervical cancer in the United States has been widely attributed to the use of Papanicolaou (Pap) smears for early detection of cervical cancer. METHODS: Pap smear screening rates, beliefs about appropriate screening intervals and factors affecting screening were examined using 1987 National Health Interview Survey data. RESULTS: Results indicate that through age 69, Blacks are screened at similar or hig…
Estimating the Treatment Costs of Breast and Lung Cancer
The Continuous Medicare History Sample File (CMHSF) was used to derive an estimate of the lifetime direct medical expenses attributable to two chronic diseases, lung cancer and female breast cancer. These two cancers are the leading cancer causes of death in men and women in the United States. They inflict large costs on the population, both direct and indirect, but the costs have been difficult to measure. The primary obstacle to quantification …
Breast cancer screening legislation in the United States
We discuss some of the issues emerging from a powerful legislative movement for preventive services over the past three years. During this time an increasing number of states passed, considered, or are currently developing breast cancer screening legislation. Most of these laws require some form of third party payment for mammography or establish breast cancer screening programs. The legislation varies markedly with regard to periodicity of exami…
Psychiatric diagnoses of medical service users
Based on data from the five sites of the National Institute of Mental Health-sponsored Epidemiologic Catchment Area (ECA) Program, this paper examines the prevalence of psychiatric disorder among recent medical service users versus nonusers, with a particular focus on affective disorders, substance abuse/dependence, and phobias. The rate of current Diagnostic Interview Schedule (DIS) disorders among medical users in all five ECA sites is 21.7 per…
Evaluating the Use of Mental Health Screening Scales in Primary Care Settings Using Receiver Operating Characteristic Curves
Factors Influencing the Diagnosis of Mental Disorder Among Primary Care Patients
Understanding the role primary care physicians play in the recognition and management of mental disorder among their patients is a research topic that has assumed considerable importance because of the high prevalence combined with low recognition of mental morbidity in primary care settings. Patient characteristics that influence diagnostic patterns have been one important focus of this research. This paper presents data from a study in two prim…
Patients of psychiatrists and psychologists in office-based practice
Patients of psychiatrists and psychologists in office-based practice
Treated incidence of mental disorders in a prepaid group practice setting
We followed a cohort of 7,666 individuals enrolled continuously for five years in a prepaid group practice in Columbia, Maryland. Incidence rates of all diagnosed mental disorders were estimated at approximately 3.7 per cent, lower for adolescents and children (about 3 per cent), higher for adult males aged 20-49 (4.3 per cent), and highest for adult females (5.8 per cent). Diagnoses are primarily for acute mental disorders and show a tendency to…
A Longitudinal Study of Offset in the Use of Nonpsychiatric Services Following Specialized Mental Health Care
This study examines the use of nonpsychiatric services by mentally ill persons following the receipt of specialized mental health care, frequently referred to as the "offset effect." A total of 9,761 persons enrolled during 1975 in the Columbia Medical Plan, a prepaid group practice in Columbia, Maryland, were studied over a 5-year period. Enrollees were classified into three groups: Treated--mental disorder diagnosis in 1975 and specialized ment…
Episodes of Psychiatric Care and Medical Utilization
This study examines the reduction in medical care utilization after mental health treatment, also known as the offset effect. With data from a computerized ambulatory care information system, an episode-of-care method is used to characterize the mental health care received by patients in a prepaid group practice. The characteristics of the psychiatric episodes, such as duration, type of therapy, and number of visits, are examined in relation to t…
Rates of Symptoms of Depression in a National Sample
This paper is an analysis of data on symptoms of depression in a nationwide sample of adults, collected during the National Center for Health Statistics' first Health and Nutrition Examination Survey. The data are analyzed by a statistical adjustment procedure which assesses the impact of the major sociodemographic variables simultaneously, instead of one by one, which avoids a former major source of confusion. The measure of depression is the Ce…
Utilization of Medical Services After Short-Term Psychiatric Therapy in a Prepaid Health Plan Setting
Utilization of medical services in Group Health Association of Washington, D.C., was analyzed for patients referred in 1970 for short-term psychiatric therapy under benefits but who had no therapy or referral for at least the 12 preceding months. A matched comparison group and family members were also studied. Medical visits were analyzed in three time periods: the 12 months preceding referral, the next 4 months when therapy was likely to be rece…
Episodes of Psychiatric Utilization
The continued growth of outpatient psychiatric care has been accompanied by a large number of research studies concerning the determinants of psychiatric utilization. One of the major limitations of these efforts has been the inability to go beyond distributional data on the use of services. This article describes a methodology for generating episodes of psychiatric care given a data set with a small amount of routinely collected data present in …
Cervical cancer screening
BACKGROUND: The decline in death rates from cervical cancer in the United States has been widely attributed to the use of Papanicolaou (Pap) smears for early detection of cervical cancer. METHODS: Pap smear screening rates, beliefs about appropriate screening intervals and factors affecting screening were examined using 1987 National Health Interview Survey data. RESULTS: Results indicate that through age 69, Blacks are screened at similar or hig…
Changes in the use of screening mammography
OBJECTIVES: Mammography rates reported by women in the National Health Interview Surveys of 1990 and 1987 are examined. Why this screening modality is not more frequently used is explored. METHODS. Data from the 1987 and 1990 National Health Interview Surveys, conducted by the National Center for Health Statistics, are cross-tabulated and compared. RESULTS. In 1987, approximately 17% of women over 40 years of age reported having had a screening m…
Black-white differences in cancer prevention knowledge and behavior
Data from the 1987 National Health Interview Survey Cancer Control Supplement were used to estimate multivariate logistic regression models of diet change, mammography utilization, stool blood test utilization, and smoking. Predictor variables included race, sex, age, income, dietary concerns, and four knowledge-related variables: education and three measures of cancer prevention knowledge. When knowledge variables were included in the models, ra…
Emotional Support Following Cancer
Reports of changes in emotional support following surgery for breast cancer can be attributed to one of two factors: (1) the stigma associated with cancer, or (2) illness-imposed restrictions in one's activities. These explanations were assessed using data from a longitudinal study of women, following their surgical treatment for early breast cancer (N = 145), gallbladder disease (N = 90), benign breast disease (N = 87), or no surgery (N = 90). M…
Psychiatric diagnoses of medical service users
Based on data from the five sites of the National Institute of Mental Health-sponsored Epidemiologic Catchment Area (ECA) Program, this paper examines the prevalence of psychiatric disorder among recent medical service users versus nonusers, with a particular focus on affective disorders, substance abuse/dependence, and phobias. The rate of current Diagnostic Interview Schedule (DIS) disorders among medical users in all five ECA sites is 21.7 per…
Eat for Health
OBJECTIVES. The results of an evaluation of "Eat for Health," a supermarket nutrition intervention, are presented. The study tested whether such a program could be successfully carried out and whether it could effect changes in knowledge, attitudes, and food purchasing behavior in line with nutrition and cancer risk reduction guidelines. METHODS. The evaluation consisted of an in-store monitoring element, an in-store and telephone consumer survey…
Breast cancer screening legislation in the United States
We discuss some of the issues emerging from a powerful legislative movement for preventive services over the past three years. During this time an increasing number of states passed, considered, or are currently developing breast cancer screening legislation. Most of these laws require some form of third party payment for mammography or establish breast cancer screening programs. The legislation varies markedly with regard to periodicity of exami…
Treated incidence of mental disorders in a prepaid group practice setting
We followed a cohort of 7,666 individuals enrolled continuously for five years in a prepaid group practice in Columbia, Maryland. Incidence rates of all diagnosed mental disorders were estimated at approximately 3.7 per cent, lower for adolescents and children (about 3 per cent), higher for adult males aged 20-49 (4.3 per cent), and highest for adult females (5.8 per cent). Diagnoses are primarily for acute mental disorders and show a tendency to…
Episodes of Psychiatric Utilization
The continued growth of outpatient psychiatric care has been accompanied by a large number of research studies concerning the determinants of psychiatric utilization. One of the major limitations of these efforts has been the inability to go beyond distributional data on the use of services. This article describes a methodology for generating episodes of psychiatric care given a data set with a small amount of routinely collected data present in …
Rates of Symptoms of Depression in a National Sample
This paper is an analysis of data on symptoms of depression in a nationwide sample of adults, collected during the National Center for Health Statistics' first Health and Nutrition Examination Survey. The data are analyzed by a statistical adjustment procedure which assesses the impact of the major sociodemographic variables simultaneously, instead of one by one, which avoids a former major source of confusion. The measure of depression is the Ce…
Utilization of Medical Services After Short-Term Psychiatric Therapy in a Prepaid Health Plan Setting
Utilization of medical services in Group Health Association of Washington, D.C., was analyzed for patients referred in 1970 for short-term psychiatric therapy under benefits but who had no therapy or referral for at least the 12 preceding months. A matched comparison group and family members were also studied. Medical visits were analyzed in three time periods: the 12 months preceding referral, the next 4 months when therapy was likely to be rece…
Episodes of Psychiatric Care and Medical Utilization
This study examines the reduction in medical care utilization after mental health treatment, also known as the offset effect. With data from a computerized ambulatory care information system, an episode-of-care method is used to characterize the mental health care received by patients in a prepaid group practice. The characteristics of the psychiatric episodes, such as duration, type of therapy, and number of visits, are examined in relation to t…
A Longitudinal Study of Offset in the Use of Nonpsychiatric Services Following Specialized Mental Health Care
This study examines the use of nonpsychiatric services by mentally ill persons following the receipt of specialized mental health care, frequently referred to as the "offset effect." A total of 9,761 persons enrolled during 1975 in the Columbia Medical Plan, a prepaid group practice in Columbia, Maryland, were studied over a 5-year period. Enrollees were classified into three groups: Treated--mental disorder diagnosis in 1975 and specialized ment…
Patients of psychiatrists and psychologists in office-based practice
Patients of psychiatrists and psychologists in office-based practice
Treated incidence of mental disorders in a prepaid group practice setting
We followed a cohort of 7,666 individuals enrolled continuously for five years in a prepaid group practice in Columbia, Maryland. Incidence rates of all diagnosed mental disorders were estimated at approximately 3.7 per cent, lower for adolescents and children (about 3 per cent), higher for adult males aged 20-49 (4.3 per cent), and highest for adult females (5.8 per cent). Diagnoses are primarily for acute mental disorders and show a tendency to…
Factors Influencing the Diagnosis of Mental Disorder Among Primary Care Patients
Understanding the role primary care physicians play in the recognition and management of mental disorder among their patients is a research topic that has assumed considerable importance because of the high prevalence combined with low recognition of mental morbidity in primary care settings. Patient characteristics that influence diagnostic patterns have been one important focus of this research. This paper presents data from a study in two prim…
Psychiatric diagnoses of medical service users
Based on data from the five sites of the National Institute of Mental Health-sponsored Epidemiologic Catchment Area (ECA) Program, this paper examines the prevalence of psychiatric disorder among recent medical service users versus nonusers, with a particular focus on affective disorders, substance abuse/dependence, and phobias. The rate of current Diagnostic Interview Schedule (DIS) disorders among medical users in all five ECA sites is 21.7 per…
Evaluating the Use of Mental Health Screening Scales in Primary Care Settings Using Receiver Operating Characteristic Curves
Breast cancer screening legislation in the United States
We discuss some of the issues emerging from a powerful legislative movement for preventive services over the past three years. During this time an increasing number of states passed, considered, or are currently developing breast cancer screening legislation. Most of these laws require some form of third party payment for mammography or establish breast cancer screening programs. The legislation varies markedly with regard to periodicity of exami…
Black-white differences in cancer prevention knowledge and behavior
Data from the 1987 National Health Interview Survey Cancer Control Supplement were used to estimate multivariate logistic regression models of diet change, mammography utilization, stool blood test utilization, and smoking. Predictor variables included race, sex, age, income, dietary concerns, and four knowledge-related variables: education and three measures of cancer prevention knowledge. When knowledge variables were included in the models, ra…
Cervical cancer screening
BACKGROUND: The decline in death rates from cervical cancer in the United States has been widely attributed to the use of Papanicolaou (Pap) smears for early detection of cervical cancer. METHODS: Pap smear screening rates, beliefs about appropriate screening intervals and factors affecting screening were examined using 1987 National Health Interview Survey data. RESULTS: Results indicate that through age 69, Blacks are screened at similar or hig…
Estimating the Treatment Costs of Breast and Lung Cancer
The Continuous Medicare History Sample File (CMHSF) was used to derive an estimate of the lifetime direct medical expenses attributable to two chronic diseases, lung cancer and female breast cancer. These two cancers are the leading cancer causes of death in men and women in the United States. They inflict large costs on the population, both direct and indirect, but the costs have been difficult to measure. The primary obstacle to quantification …
Potential for Cancer Related Health Services Research Using a Linked Medicare-Tumor Registry Database
The National Cancer Institute and the Health Care Financing Administration share a strong research interest in cancer costs, access to cancer prevention and treatment services, and cancer patient outcomes. To develop a database for such research, the two agencies have undertaken a collaborative effort to link Medicare Program data with the Surveillance, Epidemiology, and End Results (SEER) Program database. The SEER Program is a system of 9 popul…
Changes in the use of screening mammography
OBJECTIVES: Mammography rates reported by women in the National Health Interview Surveys of 1990 and 1987 are examined. Why this screening modality is not more frequently used is explored. METHODS. Data from the 1987 and 1990 National Health Interview Surveys, conducted by the National Center for Health Statistics, are cross-tabulated and compared. RESULTS. In 1987, approximately 17% of women over 40 years of age reported having had a screening m…
Eat for Health
OBJECTIVES. The results of an evaluation of "Eat for Health," a supermarket nutrition intervention, are presented. The study tested whether such a program could be successfully carried out and whether it could effect changes in knowledge, attitudes, and food purchasing behavior in line with nutrition and cancer risk reduction guidelines. METHODS. The evaluation consisted of an in-store monitoring element, an in-store and telephone consumer survey…
Emotional Support Following Cancer
Reports of changes in emotional support following surgery for breast cancer can be attributed to one of two factors: (1) the stigma associated with cancer, or (2) illness-imposed restrictions in one's activities. These explanations were assessed using data from a longitudinal study of women, following their surgical treatment for early breast cancer (N = 145), gallbladder disease (N = 90), benign breast disease (N = 87), or no surgery (N = 90). M…
Medicare Payments from Diagnosis to Death for Elderly Cancer Patients by Stage at Diagnosis
Although extensive resources go to cancer care, national population-based data on the costs of such care at the patient level have been unavailable. Medicare payments subsequent to diagnosis of cancer for elderly enrollees with five common cancers were estimated using tumor registry data from the Surveillance, Epidemiology, and End Results Program linked to Medicare claims from 1984 to 1990. The time between diagnosis and death was divided into f…
The Outcomes of The Cancer Outcomes Research Symposium
This commentary summarizes the important results of the Seattle Symposium on Cancer Outcomes Research. Based on the concepts and ideas raised by the conference speakers, we describe what we see as the “state of the union” of cancer outcomes research. As such, rather than attempting to provide a comprehensive review of the field, we highlight the areas of consensus and controversy that are current in this field. Second, we describe what leaders of…
From Concentration Camp to Campus
The National Japanese American Relocation Council was created in the spring of 1942 at the urging of War Relocation Authority director Milton Eisenhower. This largely Quaker volunteer agency, privately organized and financed, helped more than four thousand Japanese American students incarcerated in internment camps obtain releases to pursue their college education at more than six hundred schools during World War II. Professor Allan W. Austin's w…
Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization
BACKGROUND: Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (ie, colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. OBJECTIVES: To examine whether rates of complete diagnostic evaluation after a positive fecal occult blood test (FOBT) have improved over time after the implementatio…
A Call to Improve Usability, Accuracy, and Equity of Self-Testing for Covid-19 and Other Rapid Diagnostic Tests
The increasing availability of rapid diagnostic self-tests (RDSTs) for COVID-19 has played an important and increasing role during the pandemic. However, for many underserved communities, RDSTs potential benefits are offset by problems with usability, accuracy, and equity. Given the increased need for and interest in home testing for acute and chronic diseases, including COVID-19, this piece offers ways that regulatory agencies, federal public he…
Critical lessons from a pragmatic randomized trial of home‐based Covid‐19 testing in rural Native American and Latino communities
PURPOSE: Native Americans and Latinos have higher COVID-19 infection and mortality rates and may have limited access to diagnostic testing. Home-based testing may improve access to care in rural and underserved populations. This study tests the effect of community health worker (CHW) support on accessibility, feasibility, and completion of COVID-19 home testing among Native American and Latino adults living on the Flathead Reservation in Montana …
Medicine (21 obras) · Psychiatry (11 obras) · Health care (10 obras) · Cancer (9 obras) · Environmental health (8 obras) · Family medicine (8 obras) · Internal Medicine (8 obras) · Internal Medicine (7 obras) · Political science (6 obras) · Computer Science (5 obras)