Advance Articles

Letters to the Editor

The importance of osteopathic physician scientist training programs

Steven J. Doyle, OMS II
Advance Article
Public Health and Primary Care

National disparities in colorectal cancer screening in patients with comorbid conditions: an analysis of the Behavioral Risk Factor Surveillance System

Benjamin Greiner, DO, MPH; Ronak Gandhi, DO; Robinder Abrol, DO; Milee Patel, DO; and Micah Hartwell, PhD
Each year, approximately 53,200 people die in the U.S. from colorectal cancer (CRC), indicating a need to increase screening efforts. To analyze CRC screening rates in patients with comorbidities compared with healthy patients, and to assess whether the number of comorbid diagnoses impacted screening rates, the authors performed cross sectional analysis of 279,784 patients who received CRC screening using the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS).
Advance Article
Clinical Image

Polyarticular, ulcerated tophaceous gout

Cara M. Borelli, DO, and Brendan T. Doherty, MD
Advance Article
Medical Education

The role of extracurricular activities and lectures in mitigating medical student burnout

Jennifer C. Sepede, DO; Joanna Petrides, MBS, PsyD; Philip B. Collins, DO; Meredith C. Jones, PhD; Nicole Cantor, MA; and Linda Boyd, DO
To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students, the authors assessed the anonymous responses of 597 students at Rowan School of Osteopathic Medicine to a survey that included the Maslach Burnout Inventory alongside questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents.
Advance Article
Clinical Image

Orange palpebral spots

Stacey Blannett, MS, OMS III; Shane M. Swink, DO, MS; and Stephen M. Purcell, DO
Advance Article
AOA Communication

Official Call: 2021 Annual Business Meeting of the American Osteopathic Association

Thomas L. Ely, DO; Ray L. Morrison, DO; and David L. Broder, DO
This is the Official Call for the 2021 Annual Business Meeting of the Board of Trustees and Annual House of Delegates (HOD) of the American Osteopathic Association (AOA) to be held July 12–18, 2021.
Advance Article
NMM/OMT

Cost comparison of osteopathic manipulative treatment for patients with chronic low back pain

Danielle Cooley, DO; James Bailey, DO; and Richard Jermyn, DO
Chronic low back pain (cLBP) is the second leading cause of disability in the United States, with significant physical and financial implications. Development of a multifaceted treatment plan that is cost effective and optimizes patients’ ability to function on a daily basis requires data; among the needed data points is a cost comparison of osteopathic manipulative treatment vs standard care for patients with cLBP. To that end, the authors conducted a prospective, observational study of 146 patients over 4 months with either standard care or standard care plus osteopathic manipulative treatment, quantifying patients’ pain scale responses as well as cost data for all associated interventions during the study period.
Advance Article
Obstetrics/Gynecology

United States internet searches for “infertility” following COVID-19 vaccine misinformation

Nicholas B. Sajjadi, BS; William Nowlin, BS; Ross Nowlin, BS; David Wenger, BS; John Martin Beal, DO; Matt Vassar, PhD; and Micah Hartwell, PhD
Following a December 2020 petition to withhold emergency use authorization of the BNT162b2 messenger ribonucleic acid vaccine for coronavirus disease 2019 (COVID-19) manufactured by BioNTech and Pfizer, misinformation claiming that COVID-19 vaccines cause female infertility began circulating on social media. The authors evaluated Google Trends data to quantify the potential influence that misinformation may have had on public perception and medical decision-making among pregnant patients or those seeking to become pregnant.
Advance Article
Medical Education

Meaningful use of COMSAE Phase 1 in preparation for COMLEX-USA Level 1

Xiaolin Wang, PhD; Hotaka Maeda, PhD; Brandon Craig, PhD; Tsung-Hsun Tsai, PhD; Jeanne M. Sandella, DO; and Marie Fleury, DO, MBA
To investigate how the COMSAE Phase 1 examination was used by candidates and how completing Phase 1 impacted their performance on the COMLEX-USA Level 1 examination, the authors assessed Level 1 data from 7,120 first time candidates who took the 2018-2019 COMSAE administration between May 2018 and April 2019, counting the frequency of the unique Phase 1 forms taken by the candidates and calculating the correlations between first attempt Phase 1 scores and the number of Phase 1 forms taken as well as Level 1 scores and Phase 1 scores.
Advance Article
NMM/OMT

Osteopathic manipulative medicine in the management of headaches associated with postconcussion syndrome

Dmitry Esterov, DO; Alphonsa Thomas, DO; and Kyle Weiss, DO
Previous studies have demonstrated the effectiveness of osteopathic manipulative treatment (OMT) for various headache types, with limited evidence of its use for headaches related to mild traumatic brain injury (MTBI). To evaluate the efficacy of OMT for headaches in patients with postconcussion syndrome (PCS) - defined as symptom persistence for longer than 3 months after MTBI – the authors performed a pilot study of 26 patients (13 in an OMT group and 13 in a control group), comparing headache scores on a Visual Analog Scale or Headache Impact Test (HIT-6) at baseline, posttreatment, and 4 to 6 week follow up.
Advance Article
Innovations

Scrambler therapy for incident pain in bone metastases

Lauren E. Berninger, DO, and Thomas J. Smith, MD
The authors present the case of a 69 year old man with shoulder destruction due to bone metastases who was able to use his arm for normal activities without pain after three sessions of scrambler therapy, a noninvasive form of electrical neuromodulation that requires further study.
Advance Article
NMM/OMT

Perceptions of nonopioid treatment for pain in a homeless population

Kristina A. Fraser, OMS IV; Harvard Nguyen, OMS IV; Suhhyun Kim, OMS III; Flora Park, OMS III; Joshua Bernal, OMS IV; Alexa D. Westberg, OMS IV; and Alan Podawiltz, DO
The authors collected voluntary responses from 200 residents at the True Worth Place Homeless Shelter in Fort Worth, Texas – where the University of North Texas Health Science Center (UNTHSC) offers a Homeless Outreach through Medical Education (HOME) Clinic – to assess the past and current use of complementary and alternative treatments for chronic pain among people experiencing homelessness, as well as their awareness and perception of osteopathic manipulative treatment (OMT) as a complementary treatment.
Advance Article
Musculoskeletal Medicine and Pain

The enigmatic fascia: eosinophilic fasciitis

Jonathan A. Aun, DO; Rachel S. Knox, DO; and Jared E. Roberts, MD
This case report highlights the potentially underrecognized subtype of unilateral eosinophilic fasciitis (EF) in a 28 year old man. With fewer than 300 reported encounters to date, EF is a rare disease that eludes clinicians by presenting as a scleroderma like syndrome. As EF remains a clinical diagnosis, biopsy results may be nonspecific, and the disease can easily be misdiagnosed (or missed entirely) if a full thickness biopsy is not reviewed by a dermatopathologist. The authors also emphasize the importance of internationally accepted diagnostic criteria, of which at least two different sets exist.
Advance Article
Cardiopulmonary Medicine

Development of atrial fibrillation following trauma increases short term risk of cardiovascular events

Sean P. Nassoiy, DO; Robert H. Blackwell, MD; McKenzie Brown, MD; Anai N. Kothari, MD; Timothy P. Plackett, DO, MPH; Paul C. Kuo, MD, MBA; and Joseph A. Posluszny, MD
In this study of 15,424 trauma patients identified through the Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida, the authors assessed the effect of newly developed atrial fibrillation on cardiovascular events such as myocardial infarction and cerebrovascular accident during the patients’ acute index hospitalization period.
Advance Article
Medical Education

Efficacy of implementing intermittent STOP THE BLEED reviews on long term retention of hemorrhage control skills of first year medical students

Enkhtsogt Sainbayar, OMS II; Nathan Holt, III, OMS II; Amber Jacobson, OMS II; Shalini Bhatia, MS; and Christina Weaver, DO
Using pretraining and posttraining surveys, the authors investigated whether intermittent reviews after initial STOP THE BLEED® training – a single day didactive course used by some medical schools to teach students how to identify and stop life threatening bleeds – improved students’ retention and confidence in hemorrhage control.
Advance Article
Musculoskeletal Medicine and Pain

Impact of COVID-19 on utilization of nonpharmacological and pharmacological treatments for chronic low back pain and clinical outcomes

John C. Licciardone, DO, MS, MBA
In this pre-post study of 476 participants enrolled in a pain registry, the author measured changes in utilization of nonpharmacological and pharmacological treatments for chronic low back pain and related outcomes during the COVID-19 pandemic to help quantify how the pandemic has impacted the delivery of health care services throughout the United States.
Advance Article
Musculoskeletal Medicine and Pain

An analysis of Google Trends following athletic injuries by high profile NBA players during the 2019 NBA finals

Jay C. Thompson, DO; Christopher M. Price, DO; Jake X. Checketts, DO; Chad Hanson, DO; Trevor Torgerson, BS; Micah Hartwell, PhD; and Matt B. Vassar, PhD
In this article, the authors evaluate search traffic information to assess public interest following athletic injuries in high profile National Basketball Association players, with an eye toward identifying an ideal time period after prominent injury during which sports medicine providers could offer patient education to increase awareness.
Advance Article
NMM/OMT

A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research

James W. Price, DO, MPH
The author used a systematic review and Bayesian network metaanalysis to perform a mixed treatment comparison to assess the results of 5 previous randomized controlled trials documenting the outcomes of osteopathic manipulative treatment techniques used to treat acute, nonspecific low back pain in 430 total patients.
Advance Article
NMM/OMT

Effects of osteopathic manipulative treatment and bioelectromagnetic energy regulation therapy on lower back pain

Kyle Auger, OMS IV; Gregory Shedlock, OMS IV; Kasey Coutinho, OMS IV; Nicole E. Myers, DO, MS; and Santiago Lorenzo, PhD, MS, MS
In this study of 40 patients, the authors compared the individual and combined effects of osteopathic manipulative treatment and Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy - which has also been shown to relieve musculoskeletal pain by deploying biorhythmically defined stimulus through a pulsed electromagnetic field – for managing low back pain in adults.
Advance Article