Browsing by Author "Miller, Elise"

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    Differential drug response in pulmonary arterial hypertension: The potential for precision medicine
    (Wiley, 2023-11-02) Miller, Elise; Sampson, Chinwuwanuju Ugo‐Obi; Desai, Ankit A.; Karnes, Jason H.; Medicine, School of Medicine
    Pulmonary arterial hypertension (PAH) is a rare, complex, and deadly cardiopulmonary disease. It is characterized by changes in endothelial cell function and smooth muscle cell proliferation in the pulmonary arteries, causing persistent vasoconstriction, resulting in right heart hypertrophy and failure. There are multiple drug classes specific to PAH treatment, but variation between patients may impact treatment response. A small subset of patients is responsive to pulmonary vasodilators and can be treated with calcium channel blockers, which would be deleterious if prescribed to a typical PAH patient. Little is known about the underlying cause of this important difference in vasoresponsive PAH patients. Sex, race/ethnicity, and pharmacogenomics may also factor into efficacy and safety of PAH-specific drugs. Research has indicated that endothelin receptor antagonists may be more effective in women and there have been some minor differences found in certain races and ethnicities, but these findings are muddled by the impact of socioeconomic factors and a lack of representation of non-White patients in clinical trials. Genetic variants in genes such as CYP3A5, CYP2C9, PTGIS, PTGIR, GNG2, CHST3, and CHST13 may influence the efficacy and safety of certain PAH-specific drugs. PAH research faces many challenges, but there is potential for new methodologies to glean new insights into PAH development and treatment.
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    Evaluating the Effectiveness and Perceived Benefit of a Breast Imaging Website as an Educational Tool for Radiology Residents
    (2023-04-28) Friel, Rylee; Miller, Elise; Niemeyer, Kathryn
    BACKGROUND: The use of social media by medical professionals has grown exponentially over the last decade. Residents are using social media and educational content more frequently as they provide information easily accessible on their personal devices. Reading articles has been shown to help improve residents scores on post-test evaluations. However, how does a resident know which articles are reliable and are appropriate for their level of training? Guided educational materials provided during residency rotations can help lead trainees to the most accurate sources and steer them toward what they need to know. PURPOSE: To evaluate the effectiveness and perceived benefit of an educational website as an adjunctive teaching tool for radiology residents during their breast imaging rotations. METHODS AND MATERIALS: An educational website was created on Wix.com with teaching content organized by appropriateness for level of training. Educational tools included PowerPoint presentations designed for different training levels as well as links to important journal articles and other online resources Links to the department’s YouTube channel, Instagram account, and Twitter account were provided on the website as well. Residents were provided the link to the website at the beginning of their breast imaging rotations. They were given a 20-question multiple self-assessment at the end of their rotation and given an anonymous survey determining level of training and their use of the website over the rotation. Two years later, after the website had been utilized for several years, residents were later sent a survey of 9 questions related to their perceived benefit of the website. RESULTS: There were 21 eligible residents who completed the breast imaging rotation over the 7-months the self-assessment was administered. Of these, 16 residents completed the post-breast imaging rotation quiz for a total participation rate of 76%. 4 of these residents were first years, 7 were second years, and 5 were third years. The average first year score was 52%, average second year score was 64%, and average third year score was 65%. Only 2 residents indicated that they did not use the website. Overall, residents who used the website scored higher on the exam than those who did not (63% vs 52%). On follow-up survey three years later, 19 residents completed the survey. 78.95% stated use of website once per week and 21.05% stated use multiple times per week. Regarding website use outside of breast imaging rotations, 36.84% of residents reported use for board examination and related conferences, while 63.16% reported no use outside of studying for breast imaging rotations. When asked on a scale from 1-10 how useful the curriculum website was, the average was 7.11 with 73.7% recording a 7 or an 8. Overall, 89.47% expressed interest in having similar websites for other rotations. CONCLUSIONS: Online curriculum tools can be used as successful adjunctive teaching tools for radiology residents on their breast imaging rotations. Residents who utilize this tool perform both better on the post-procedure self-assessment had seen a perceived benefit in this educational tool.