Use of a commercially available wearable device to assess the relationship between sleep and daily step count on irritable bowel syndrome symptoms
Fellow: Wendi G. Le Brett, MD
Mentor: Lin Chang, MD
Studies have demonstrated the association of sleep disturbances and exercise with gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). This prospective study will evaluate the relationship between sleep and daily step count on IBS symptoms utilizing a commercially available wearable device (Fitbit). One of the primary goals of this project is to assess the feasibility of using commercially available wearable devices to collect health data for patients with IBS and to compare the findings with studies utilizing research grade collection devices. The project will also provide the applicant with experience conducting a prospective study including patient recruitment, study design, data collection and data analysis. Serial measurements of sleep and step count could potentially be used in clinical practice to guide management of IBS symptoms.
Study of iron deficiency anemia after severe GI hemorrhage
Fellow: Elissa Lin, MD
Mentor: Dennis M. Jensen, MD
Iron deficiency anemia (IDA) after a severe GI hemorrhage is a common problem which is often underdiagnosed and undertreated. In patients with major co-morbidities, persistent IDA after a severe GI bleed can result in serious complications such as increased transfusion requirements, hospital readmissions, worsening of co-morbidities, and possible death. Our project is a retrospective analysis of prospectively collected data to assess the prevalence of IDA in patients who have had severe GI hemorrhage and to analyze the outcomes of treated versus undertreated IDA. New data collection and data entry for patient follow-up to 4 months after discharge will also be required to complete this proposal.
Improving rates of pre-procedure diagnostic workup before anti-reflux procedures
Fellow: Anthony Myint, MD
Mentors: Kevin Ghassemi, MD, and Folasade P. May, MD, PhD, MPhil
Anti-reflux procedures provide an important treatment option for patients with medically refractory gastroesophageal reflux disease (GERD) and patients who wish to avoid long term medication use. However, outcomes are heavily dependent on proper patient selection. Per the 2013 Esophageal Diagnostic Advisory Panel consensus statement and the 2019 International Consensus on Selection of Adult Patients for Antireflux Surgery (ICARUS), appropriate workup includes an upper endoscopy, barium esophagram, pH testing, and manometry. Despite these key-opinion recommendations, there is limited data on rates of appropriate workup and the impact of incomplete workup on post-procedural outcomes. In this quality improvement study, we seek to assess the rate of appropriate pre-procedural workup for patients who completed an anti-reflux procedure at our institution, to identify factors contributing to suboptimal rates of appropriate workup, and to implement a targeted intervention to improve rates of appropriate workup.
Effect of mindfulness-based virtual reality intervention on outcomes in hospitalized IBD patients
Fellow: Devin B. Patel, MD
Mentor: Berkeley Limketkai, MD, PhD
This is an exploratory study investigating the use of a mindfulness-based virtual reality (VR) intervention in improving biopsychosocial outcomes in inflammatory bowel disease (IBD) patients. The feasibility of utilizing VR applications within various clinical populations with chronic diseases is a budding area of research. The goal is to characterize the effect of a VR-based mindfulness meditation on pain, mood, and gastrointestinal symptoms as well as quality indicators for hospitalized IBD patients.