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CDA 09-213 – HSR&D Study

 
CDA 09-213
Medical Decision-Making Screening and Surveillance Colonoscopy
Sameer D. Saini MD MS
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, MI
Funding Period: October 2010 - September 2015

BACKGROUND/RATIONALE:
: Current colorectal cancer (CRC) screening recommendations call for routine screening of average-risk patients ("standardized screening"). These recommendations do not incorporate patient factors that determine the health benefits of screening (risk of CRC and life expectancy). As predictive models for CRC risk and life expectancy improve, we will be poised to provide screening to our patients in a more individualized fashion. However, individualized screening will lead to recommendations to de-intensify screening in low-risk patients. Such recommendations are likely to be met with resistance by some patients and providers and are not supported by existing VHA performance management systems. If we are to successfully implement an individualized, Veteran-centered approach to screening, we must understand how it will be received (or rejected) by patients, providers, and health systems.



OBJECTIVE(S):
(1) to develop a benefit-based individualized approach to CRC screening (Aim 1); (2) to examine patient, provider, and organizational factors that will impact implementation of targeted screening (Aim 2); (3) to develop an intervention to promote a more individualized and Veteran-centered approach to CRC screening (Aim 3).



METHODS:
In Aim 1, I will develop a simulation model that utilizes estimated CRC risk and life expectancy to compute clinical and economic outcomes for individualized versus standardized screening. In Aim 2, I will undertake a mixed-methods study that will identify patient, provider, and system level factors that may impact the successful implementation of individualized CRC screening. This work will inform the development and an individualized CRC screening intervention (Aim 3), ultimately leading to submission for an IIR that will assess the effectiveness of this intervention.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
This work has the potential to improve the efficiency of CRC screening by targeting screening to the patients who are most likely to benefit while minimizing harms in low-risk patients. Though the proposed work is focused on CRC screening, the approach is applicable to cancer screening and preventive care in general and therefore has the potential to broadly impact Veterans' health.


External Links for this Project

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PUBLICATIONS:

Journal Articles

  1. Read AJ, Rice MD, Conjeevaram HS, Saini SD. A Deeper Look at the Small Bowel: Training Pathways in Video Capsule Endoscopy and Device-Assisted Enteroscopy. Digestive diseases and sciences. 2018 Sep 1; 63(9):2210-2219. [view]
  2. Read AJ, Waljee AK, Saini SD. A National Survey of Adoption of the 2018 American Cancer Society Colorectal Cancer Screening Guideline in Primary Care. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2021 Sep 1; 19(9):1973-1975.e1. [view]
  3. Govani SM, Lipson R, Noureldin M, Wiitala W, Higgins PDR, Saini SD, Pugh JA, Velligan DI, Stidham RW, Waljee AK. Adalimumab persistence for inflammatory bowel disease in veteran and insured cohorts. The American journal of managed care. 2018 Dec 1; 24(12):e374-e379. [view]
  4. Maratt JK, Naylor K, Saini SD. Adding Value to the Conversation About Colorectal Cancer Screening: Practical Pearls For Gastroenterologists. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2018 Oct 1; 16(10):1545-1548. [view]
  5. Kerdsirichairat T, Saini SD, Chamberlain PR, Prabhu A. Autoimmune Pancreatitis Diagnosed with Core Biopsy Obtained from a Novel Fork-Tip EUS Needle. ACG case reports journal. 2017 Jan 18; 4:e7. [view]
  6. Saini SD, Schoenfeld P, Vijan S. Can the adenoma detection rate reliably identify low-performing endoscopists? Results of a modeling study. Digestive diseases and sciences. 2013 Jul 1; 58(7):1856-62. [view]
  7. Kerr EA, Kullgren JT, Saini SD. Choosing Wisely: How To Fulfill The Promise In The Next 5 Years. Health affairs (Project Hope). 2017 Nov 1; 36(11):2012-2018. [view]
  8. Maratt JK, Saini SD. Colorectal cancer screening in the 21st century: where do we go from here? The American journal of managed care. 2015 Jul 1; 21(7):e447-9. [view]
  9. Elmunzer BJ, Singal AG, Sussman JB, Deshpande AR, Sussman DA, Conte ML, Dwamena BA, Rogers MA, Schoenfeld PS, Inadomi JM, Saini SD, Waljee AK. Comparing the effectiveness of competing tests for reducing colorectal cancer mortality: a network meta-analysis. Gastrointestinal endoscopy. 2015 Mar 1; 81(3):700-709.e3. [view]
  10. Saini SD, Waljee AK, Higgins PD. Cost utility of inflammation-targeted therapy for patients with ulcerative colitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2012 Oct 1; 10(10):1143-51. [view]
  11. Saini SD, Fendrick AM, Scheiman JM. Cost-effectiveness analysis: cardiovascular benefits of proton pump inhibitor co-therapy in patients using aspirin for secondary prevention. Alimentary pharmacology & therapeutics. 2011 Jul 1; 34(2):243-51. [view]
  12. Govani SM, Noureldin M, Higgins PDR, Heisler M, Saini SD, Stidham RW, Waljee JF, Waljee AK. Defining an Optimal Adherence Threshold for Patients Taking Subcutaneous Anti-TNFs for Inflammatory Bowel Diseases. The American journal of gastroenterology. 2018 Feb 1; 113(2):276-282. [view]
  13. Caverly TJ, Kerr EA, Saini SD. Delivering Patient-Centered Cancer Screening: Easier Said Than Done. American journal of preventive medicine. 2016 Jan 1; 50(1):118-21. [view]
  14. Saini SD, Powell AA, Dominitz JA, Fisher DA, Francis J, Kinsinger L, Pittman KS, Schoenfeld P, Moser SE, Vijan S, Kerr EA. Developing and Testing an Electronic Measure of Screening Colonoscopy Overuse in a Large Integrated Healthcare System. Journal of general internal medicine. 2016 Apr 1; 31 Suppl 1:53-60. [view]
  15. Piper MS, Saini SD. Diverticular Diseases: A Modern Renaissance? Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2016 Jan 1; 14(1):104-6. [view]
  16. DeBenedet AT, Saini SD, Takami M, Fisher LR. Do clinical characteristics predict the presence of small bowel angioectasias on capsule endoscopy? Digestive diseases and sciences. 2011 Jun 1; 56(6):1776-81. [view]
  17. DiMagno MJ, Wamsteker EJ, Maratt J, Rivera MA, Spaete JP, Ballard DD, Elmunzer J, Saini SD. Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis? Pancreas. 2014 May 1; 43(4):642-7. [view]
  18. Elmunzer BJ, Higgins PD, Saini SD, Scheiman JM, Parker RA, Chak A, Romagnuolo J, Mosler P, Hayward RA, Elta GH, Korsnes SJ, Schmidt SE, Sherman S, Lehman GA, Fogel EL, United States Cooperative for Outcomes Research in Endoscopy. Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients undergoing high-risk ERCP? Post hoc efficacy and cost-benefit analyses using prospective clinical trial data. The American journal of gastroenterology. 2013 Mar 1; 108(3):410-5. [view]
  19. Elmunzer BJ, Hayward RA, Schoenfeld PS, Saini SD, Deshpande A, Waljee AK. Effect of flexible sigmoidoscopy-based screening on incidence and mortality of colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. PLoS Medicine. 2013 Jun 4; 9(12):e1001352. [view]
  20. Sampath K, Saini SD, Calderwood AH. Elective Colonoscopy in Older Adults-Minimizing Risks: A Teachable Moment. JAMA internal medicine. 2019 Mar 1; 179(3):425-426. [view]
  21. Waljee AK, Ryan KA, Krenz CD, Ioannou GN, Beste LA, Tincopa MA, Saini SD, Su GL, Arasim ME, Roman PT, Nallamothu BK, De Vries R. Eliciting patient views on the allocation of limited healthcare resources: a deliberation on hepatitis C treatment in the Veterans Health Administration. BMC health services research. 2020 May 1; 20(1):369. [view]
  22. Elmunzer BJ, Padhya KT, Lewis JJ, Rangnekar AS, Saini SD, Eswaran SL, Scheiman JM, Pagani FD, Haft JW, Waljee AK. Endoscopic findings and clinical outcomes in ventricular assist device recipients with gastrointestinal bleeding. Digestive diseases and sciences. 2011 Nov 1; 56(11):3241-6. [view]
  23. Tapper EB, Saini SD, Sengupta N. Extensive testing or focused testing of patients with elevated liver enzymes. Journal of Hepatology. 2017 Feb 1; 66(2):313-319. [view]
  24. Saini SD, Waljee AK. Fool Me Thrice: The Evolving Story of Multiply Recurrent Clostridium difficile Infection. Annals of internal medicine. 2017 Aug 1; 167(3):202-203. [view]
  25. Tapper EB, Ezaz G, Patwardhan V, Mellinger J, Bonder A, Curry M, Saini SD. Hospital-level balloon tamponade use is associated with increased mortality for all patients presenting with acute variceal haemorrhage. Liver International : Official Journal of The International Association For The Study of The Liver. 2018 Mar 1; 38(3):477-483. [view]
  26. Kurlander JE, Sondhi AR, Waljee AK, Menees SB, Connell CM, Schoenfeld PS, Saini SD. How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review. PLoS ONE. 2016 Oct 14; 11(10):e0164442. [view]
  27. Sondhi AR, Kurlander JE, Menees SB, Saini SD. Hydrogen Breath Testing Predicts Bowel Preparation Quality Prior to Colonoscopy: A Systematic Review. Gastroenterology research. 2018 Oct 1; 11(5):361-368. [view]
  28. Elmunzer BJ, O'Connell MT, Prendes S, Saini SD, Sussman DA, Volk ML, Deshpande A. Improving access to colorectal cancer screening through medical philanthropy: feasibility of a flexible sigmoidoscopy health fair for uninsured patients. The American journal of gastroenterology. 2011 Oct 1; 106(10):1741-6. [view]
  29. Read AJ, Vijan S, Waljee AK, Saini SD. Increased Cost With Use of Brand-Name Bowel Preparation by Patients With Medicare Part D From 2013 to 2015. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2019 Dec 1; 17(13):2806-2807. [view]
  30. Gupta A, Saini SD, Naylor KB. Increased Driving Distance to Screening Colonoscopy Negatively Affects Bowel Preparation Quality: an Observational Study. Journal of general internal medicine. 2021 Jun 1; 36(6):1666-1672. [view]
  31. Saini SD. Individualized screening for colorectal cancer: one size does not fit all. Gastroenterology. 2012 Mar 1; 142(3):672-3. [view]
  32. Kurlander JE, Kolbe M, Rubenstein JH, Richardson CR, Heisler M, Weissman A, De Vries R, Saini SD. Internists' Perceptions of Proton Pump Inhibitor Adverse Effects and Impact on Prescribing Practices: Results of a Nationwide Survey. Gastroenterology research. 2018 Feb 23; 11(1):11-17. [view]
  33. Sharma P, Saini SD, Kuhn LB, Rubenstein JH, Pardi DS, Marrero JA, Schoenfeld PS. Knowledge of hepatocellular carcinoma screening guidelines and clinical practices among gastroenterologists. Digestive diseases and sciences. 2011 Feb 1; 56(2):569-77. [view]
  34. Konerman MA, Beste LA, Van T, Liu B, Zhang X, Zhu J, Saini SD, Su GL, Nallamothu BK, Ioannou GN, Waljee AK. Machine learning models to predict disease progression among veterans with hepatitis C virus. PLoS ONE. 2019 Jan 4; 14(1):e0208141. [view]
  35. Bajaj JS, Brenner DM, Cai Q, Cash BD, Crowell M, DiBaise J, Gallegos-Orozco JF, Gardner TB, Gyawali CP, Ha C, Holtmann G, Jamil LH, Kaplan GG, Karsan HA, Kinoshita Y, Lebwohl B, Leontiadis GI, Lichtenstein GR, Longstreth GF, Muthusamy VR, Oxentenko AS, Pimentel M, Pisegna JR, Rubenstein JH, Russo MW, Saini SD, Samadder NJ, Shaukat A, Simren M, Stevens T, Valdovinos M, Vargas H, Spiegel B, Lacy BE. Major Trends in Gastroenterology and Hepatology Between 2010 and 2019: An Overview of Advances From the Past Decade Selected by the Editorial Board of The American Journal of Gastroenterology. The American journal of gastroenterology. 2020 Jul 1; 115(7):1007-1018. [view]
  36. Chang JW, Saini SD, Mellinger JL, Chen JW, Zikmund-Fisher BJ, Rubenstein JH. Management of eosinophilic esophagitis is often discordant with guidelines and not patient-centered: results of a survey of gastroenterologists. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 2019 Jun 1; 32(6). [view]
  37. Maratt JK, Kerr EA, Klamerus ML, Lohman SE, Froehlich W, Bhatia RS, Saini SD. Measures Used to Assess the Impact of Interventions to Reduce Low-Value Care: a Systematic Review. Journal of general internal medicine. 2019 Sep 1; 34(9):1857-1864. [view]
  38. Kurlander JE, Gu X, Scheiman JM, Haymart B, Kline-Rogers E, Saini SD, Kaatz S, Froehlich JB, Richardson CR, Barnes GD. Missed opportunities to prevent upper GI hemorrhage: The experience of the Michigan Anticoagulation Quality Improvement Initiative. Vascular medicine (London, England). 2019 Apr 1; 24(2):153-155. [view]
  39. Imler TD, Morea J, Kahi C, Cardwell J, Johnson CS, Xu H, Ahnen D, Antaki F, Ashley C, Baffy G, Cho I, Dominitz J, Hou J, Korsten M, Nagar A, Promrat K, Robertson D, Saini S, Shergill A, Smalley W, Imperiale TF. Multi-center colonoscopy quality measurement utilizing natural language processing. The American journal of gastroenterology. 2015 Apr 1; 110(4):543-52. [view]
  40. Adams MA, Prenovost KM, Dominitz JA, Kerr EA, Krein SL, Saini SD, Rubenstein JH. National Trends in Use of Monitored Anesthesia Care for Outpatient Gastrointestinal Endoscopy in the Veterans Health Administration. JAMA internal medicine. 2017 Mar 1; 177(3):436-438. [view]
  41. Saini SD. Optimizing risk stratification in individuals with a personal history of colorectal adenomas. Gastroenterology. 2013 Sep 1; 145(3):682-4. [view]
  42. Wallace BI, Waljee AK, Weissman A, Caverly TJ, Saini SD. Overuse of glucocorticoids in rheumatoid arthritis: a national survey of primary care physicians. Rheumatology advances in practice. 2018 Nov 23; 3(1):rky049. [view]
  43. Piper MS, Maratt JK, Zikmund-Fisher BJ, Lewis C, Forman J, Vijan S, Metko V, Saini SD. Patient Attitudes Toward Individualized Recommendations to Stop Low-Value Colorectal Cancer Screening. JAMA Network Open. 2018 Dec 7; 1(8):e185461. [view]
  44. Kurlander JE, Kennedy JK, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Saini SD. Patients' Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation: A National Survey. The American journal of gastroenterology. 2019 Feb 1; 114(2):244-249. [view]
  45. van Hees F, Saini SD, Lansdorp-Vogelaar I, Vijan S, Meester RG, de Koning HJ, Zauber AG, van Ballegooijen M. Personalizing colonoscopy screening for elderly individuals based on screening history, cancer risk, and comorbidity status could increase cost effectiveness. Gastroenterology. 2015 Nov 1; 149(6):1425-37. [view]
  46. Kurlander JE, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Zikmund-Fisher BJ, Yang YX, Laine L, Weissman A, Saini SD. Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey. The American journal of gastroenterology. 2020 May 1; 115(5):689-696. [view]
  47. Waljee AK, Stidham RW, Higgins PD, Vijan S, Saini SD. Point-counterpoint: Are we overtreating patients with mild ulcerative colitis? Journal of Crohn's & colitis. 2014 Jan 1; 8(1):80-4. [view]
  48. Govani SM, Elliott EE, Menees SB, Judd SL, Saini SD, Anastassiades CP, Urganus AL, Boyce SJ, Schoenfeld PS. Predictors of suboptimal bowel preparation in asymptomatic patients undergoing average-risk screening colonoscopy. World journal of gastrointestinal endoscopy. 2016 Sep 16; 8(17):616-22. [view]
  49. Adams MA, Prenovost KM, Dominitz JA, Holleman RG, Kerr EA, Krein SL, Saini SD, Rubenstein JH. Predictors of Use of Monitored Anesthesia Care for Outpatient Gastrointestinal Endoscopy in a Capitated Payment System. Gastroenterology. 2017 Dec 1; 153(6):1496-1503.e1. [view]
  50. Hosmer AE, Saini SD, Menees SB. Prevalence and Severity of Fecal Incontinence in Veterans. Journal of neurogastroenterology and motility. 2019 Oct 30; 25(4):576-588. [view]
  51. Spencer M, Lenhart A, Baker J, Dickens J, Weissman A, Read AJ, Saini S, Saini SD. Primary care physicians are under-testing for celiac disease in patients with iron deficiency anemia: Results of a national survey. PLoS ONE. 2017 Sep 20; 12(9):e0184754. [view]
  52. Adams MA, Saini SD, Allen JI. Quality measures in gastrointestinal endoscopy: the current state. Current Opinion in Gastroenterology. 2017 Sep 1; 33(5):352-357. [view]
  53. Powell AA, Saini SD, Breitenstein MK, Noorbaloochi S, Cutting A, Fisher DA, Bloomfield HE, Halek K, Partin MR. Rates and correlates of potentially inappropriate colorectal cancer screening in the Veterans Health Administration. Journal of general internal medicine. 2015 Jun 1; 30(6):732-41. [view]
  54. Platt KD, Kurlander JE, Zikmund-Fisher BJ, Lipson R, Knaus M, Waljee AK, Saini SD. Rethinking the Re-Prep: Attitudes Toward Noninvasive Colorectal Cancer Screening Tests After Inadequate Bowel Preparation. The American journal of gastroenterology. 2019 Oct 1; 114(10):1685-1687. [view]
  55. DiMagno MJ, Spaete JP, Ballard DD, Wamsteker EJ, Saini SD. Risk models for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP): smoking and chronic liver disease are predictors of protection against PEP. Pancreas. 2013 Aug 1; 42(6):996-1003. [view]
  56. Saini SD, van Hees F, Vijan S. Smarter screening for cancer: possibilities and challenges of personalization. JAMA. 2014 Dec 3; 312(21):2211-2. [view]
  57. Patel SG, Keswani R, Elta G, Saini S, Menard-Katcher P, Del Valle J, Hosford L, Myers A, Ahnen D, Schoenfeld P, Wani S. Status of Competency-Based Medical Education in Endoscopy Training: A Nationwide Survey of US ACGME-Accredited Gastroenterology Training Programs. The American journal of gastroenterology. 2015 Jul 1; 110(7):956-62. [view]
  58. Tapper EB, Beste L, Curry M, Bonder A, Waljee A, Saini S. Suboptimal Implementation of Evidence-based Therapy for Acute Variceal Hemorrhage: A Systematic Review of Observational Studies. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2017 Sep 1; 15(9):1373-1381.e7. [view]
  59. Stidham RW, Lee TC, Higgins PD, Deshpande AR, Sussman DA, Singal AG, Elmunzer BJ, Saini SD, Vijan S, Waljee AK. Systematic review with network meta-analysis: the efficacy of anti-tumour necrosis factor-alpha agents for the treatment of ulcerative colitis. Alimentary pharmacology & therapeutics. 2014 Apr 1; 39(7):660-71. [view]
  60. Kurlander JE, Sultan S, Saini SD. The Clinical and Economic Effects of Targeted Bowel Preparation: Results of a Decision Analysis. Journal of clinical gastroenterology. 2018 Nov 1; 52(10):853-858. [view]
  61. Cohen-Mekelburg S, Rosenblatt R, Gold S, Burakoff R, Waljee AK, Saini S, Schackman BR, Scherl E, Crawford C. The Impact of Opioid Epidemic Trends on Hospitalised Inflammatory Bowel Disease Patients. Journal of Crohn's & colitis. 2018 Aug 29; 12(9):1030-1035. [view]
  62. Saini SD, Waljee AK, Schoenfeld P, Kerr EA, Vijan S. The increasing importance of quality measures for trainees. Gastroenterology. 2014 Oct 1; 147(4):725-9. [view]
  63. Kurlander JE, Kolbe M, Scheiman JM, Weissman A, Piette JD, Rubenstein JH, Waljee AK, Saini SD. The Right Idea for the Wrong Patient: Results of a National Survey on Stopping PPIs. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2017 Sep 1; 15(9):1475-1476. [view]
  64. Shah ED, Saini SD, Chey WD. Value-based Pricing for Rifaximin Increases Access of Patients With Irritable Bowel Syndrome With Diarrhea to Therapy. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2019 Dec 1; 17(13):2687-2695.e11. [view]
  65. Maratt JK, Calderwood AH, Saini SD. When and How to Stop Surveillance Colonoscopy in Older Adults: Five Rules of Thumb for Practitioners. The American journal of gastroenterology. 2018 Jan 1; 113(1):5-7. [view]
  66. Read AJ, Weissman A, Schoenfeld PS, Saini S, Menees SB, Saini SD. Who is Responsible for What Happens Before, During, and After Colonoscopy? Results of a National Survey of Primary Care Physicians. Journal of clinical gastroenterology. 2018 Jul 1; 52(6):e44-e47. [view]
Journal Other

  1. Sondhi AR, Kurlander JE, Waljee AK, Saini SD. A telephone-based education program improves bowel preparation quality in patients undergoing outpatient colonoscopy. Gastroenterology. 2015 Mar 1; 148(3):657-8. [view]
  2. Saini SD. Dedicated outreach is effective in increasing uptake of colorectal cancer screening in an underserved population. Gastroenterology. 2014 Feb 1; 146(2):577-9. [view]
  3. Saini SD. Gender-specific differences in colorectal neoplasia and potential implications for screening policy: is it time to discriminate based on gender? Gastroenterology. 2012 Jun 1; 142(7):1616-7. [view]
  4. Saini SD, Platt KD. Risk Factors and Patient Care in Post-Polypectomy Surveillance Colonoscopy. [Editorial]. The American journal of gastroenterology. 2018 Jun 1; 113(6):803-804. [view]
  5. Ayers K, Waljee AK, Saini SD. Short-term use of selective serotonin reuptake inhibitors increases risk of gastrointestinal bleeding in men with psychiatric diagnoses. Gastroenterology. 2014 Nov 1; 147(5):1173-4. [view]
  6. Read AJ, Weissman A, Schoenfeld PS, Saini S, Menees SB, Saini SD. The Effect of Endoscopist Recommendations on PCPs Choosing Wisely about Colonoscopy. [Letter to the Editor]. The American journal of gastroenterology. 2016 May 1; 111(5):749-51. [view]
  7. Karsan HA, Saini SD. Welcome to the New Red Section. [Editorial]. The American journal of gastroenterology. 2016 Jan 1; 111(1):4-5. [view]
Center Products

  1. Saini SD. Colon Cancer Prevention 2015 and Beyond. University of Michigan Cancer Center Men's Fellowship Breakfast. Ypsilanti, MI. 2015 Mar 21. [view]
Conference Presentations

  1. Kurlander JE, Sondhi AR, Waljee AK, Mennes SB, Schoenfeld P, Saini SD. A Systematic Review of Patient Education Interventions To Improve Colonoscopy Bowel Preparation. Poster session presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 9; Philadelphia, PA. [view]
  2. Sondhi AR, Kurlander JE, Waljee AK, Menees SB, Schoenfeld PS, Saini SD. A Systematic Review of Patient-Oriented Educational Interventions To Improve Quality of Pre-Colonoscopy Bowel Preparation. Poster session presented at: Digestive Disease Week Annual Conference; 2015 May 17; Washington, DC. [view]
  3. Saini SD, Vijan S, Metko V, Zikmund-Fisher BJ. Attitudes towards stopping colorectal cancer screening: Does individualized risk information make a difference? Poster session presented at: Digestive Disease Week Annual Meeting; 2013 May 20; Orlando, FL. [view]
  4. Saini SD. Colon Cancer Screening and Surveillance. Paper presented at: Digestive Disease Week Annual Meeting; 2013 May 18; Orlando, FL. [view]
  5. Schoen RE, Saini SD. Colorectal cancer screening and surveillance. Paper presented at: Digestive Disease Week Annual Meeting; 2013 May 19; Orlando, FL. [view]
  6. Saini SD. Colorectal Cancer Screening Quality Measures. Paper presented at: Digestive Disease Week Annual Conference; 2015 May 18; Washington, DC. [view]
  7. Saini SD, Dominitz JA, Fisher DA, Vijan S, Pittmann KS, Powell AA, Schoenfeld P, Francis J, Kinsinger L, Kerr EA. Developing and Testing an Electronic Measure of Screening Colonoscopy Overuse in a Large Integrated Healthcare System. Paper presented at: VA HSR&D / QUERI National Meeting; 2015 Jul 9; Philadelphia, PA. [view]
  8. Saini SD. Ethical Considerations in Screening in the Elderly. Paper presented at: Digestive Disease Week Annual Meeting; 2013 May 18; Orlando, FL. [view]
  9. Govani SM, Wiitala WL, Stidham RW, Saini SD, Hou JK, Feagins LA, Higgins P, Waljee AK. Factors Associated with the Use of Corticosteroid-Sparing Medications among Elderly Veterans with Inflammatory Bowel Disease. Poster session presented at: Digestive Disease Week Annual Conference; 2015 May 19; Washington, DC. [view]
  10. Kerr EA, Holleman R, Klamerus ML, Saini SD, Min L, Vijan S, Sussman JB, Hofer TP. Failing to Choose Wisely: Lack of Treatment De-intensification in Older Patients with Diabetes. Paper presented at: Society of General Internal Medicine Annual Meeting; 2014 Apr 24; San Diego, CA. [view]
  11. Kerr EA, Sussman JB, Klamerus ML, Min L, Holleman R, Saini SD, Vijan S, Hofer TP. Failing to Choose Wisely: Lack of Treatment De-intensification in Older Patients with Diabetes. Paper presented at: AcademyHealth Annual Research Meeting; 2014 Jun 9; San Diego, CA. [view]
  12. Saini SD. Getting Medicine Back to Chicken Value: Getting More Bang for the Medical Buck. Paper presented at: American Society for Gastrointestinal Endoscopy Annual Meeting; 2012 Aug 19; Chicago, IL. [view]
  13. Saini SD. Impact of Performance Measurement on Utilization of Screening among Veterans. Paper presented at: Preventing Overdiagnosis Annual Conference; 2013 Sep 11; Hanover, NH. [view]
  14. Ubel PA, Zahuranec D, Burke J, Saini SD, Fagerlin A. On strategies to control healthcare cost: influence patients to "self-ration" by communicating the social implications of overuse. Poster session presented at: Society for Medical Decision Making Annual Meeting; 2012 Oct 17; Phoenix, AZ. [view]
  15. Piper MS, Kurlander J, Zikmund-Fisher BJ, Maratt JK, Waljee AK, Saini SD. Patients' Willingness To Share Limited Endoscopic Resources: Results Of A Large Regional Survey. Poster session presented at: Digestive Disease Week Annual Conference; 2016 May 22; San Diego, CA. [view]
  16. Saini SD, Schoenfeld P, McMahon L, Vijan S. Technical Factors Cannot Explain The Limited Effectiveness of Colonoscopy In Reducing Mortality From Right-sided Colorectal Cancer. Paper presented at: Digestive Disease Week Annual Meeting; 2011 May 7; Chicago, IL. [view]
  17. Saini SD. Technology and Innovation Dialogue for Action. Paper presented at: Prevent Cancer Foundation Spring Gala Meeting; 2015 Apr 23; Washington, DC. [view]
  18. Kolbe MS, Waljee AK, Weissman A, Saini SD. The Impact of Potential PPI Harms on Self-Reported PPI Prescribing: A National Survey of Physicians. Poster session presented at: Digestive Disease Week Annual Meeting; 2014 May 5; Chicago, IL. [view]
  19. Saini SD, Schoenfeld P, Vijan S. The Unintended Consequences of Efforts to Improve Colonoscopy Sensitivity. Poster session presented at: Digestive Disease Week Annual Meeting; 2011 May 7; Chicago, IL. [view]
  20. Saini SD, Schoenfeld P, Vijan S. Using Adenoma Detection Rates to Profile Endoscopists: Results of a Modeling Study. Poster session presented at: Digestive Disease Week Annual Meeting; 2011 May 7; Chicago, IL. [view]
  21. Saini SD. What are the ethical considerations in the performance of colonoscopy in the elderly? Paper presented at: Digestive Disease Week Annual Meeting; 2013 May 18; Orlando, FL. [view]
  22. Saini SD. Will the time come when we Risk Models to Individualize Screening. Paper presented at: Digestive Disease Week Annual Meeting; 2012 May 19; San Diego, CA. [view]


DRA: Health Systems, Cancer, Aging, Older Veterans' Health and Care
DRE: Technology Development and Assessment
Keywords: none
MeSH Terms: none

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