Joel Adu-Brimpong

All Publications

• Single-Lesion Skin Cancer Risk Stratification Triage Pathway. JAMA dermatology Chen, Y., Gui, H., Yao, H., Adu-Brimpong, J., Javitz, S., Golovko, V., Ko, J., Daneshjou, R., Chiou, A. S. 2024

  Abstract

  Importance: Access to timely dermatologic care remains a challenge, especially for patients with new skin lesions. Assessing the efficiency of new triage pathways may assist in better resource allocation and shorter time to care.Objective: To evaluate whether a rule-based triage system was associated with better skin cancer risk stratification of patients and reduced wait times.Design, Setting, and Participants: This retrospective quality improvement cohort study of patients referred to Stanford University dermatology clinics was conducted between November 2017 and January 2023. A rules-based triage system based on a priori-determined high-risk lesion characteristics was implemented.Exposures: Referral reasons and risk factors of patients provided by their primary care physicians.Main Outcomes and Measures: Biopsy results of patients (diagnosis of any skin cancer and melanoma) at their visit or within 6 months after the visit. Regression models were used to assess the association between risk factors at referral and (1) biopsy outcomes and (2) time to first visit, adjusting for sociodemographic factors.Results: Among 37 478 patients (mean [SD] age, 54 (18) years; 21 292 women [57%]), the rates of aggregate biopsy, malignant biopsy specimens, and melanoma were comparable across patients seen after (n=12 302) and before (n=25 176) the implementation of the new triage pathway. Patients seen through the lesion pathway had a higher risk of having malignant biopsy results (adjusted risk ratio [aRR], 1.6; 95% CI, 1.4-1.9) and melanoma (aRR, 2.0; 95% CI, 1.2-3.2) than those not seen through the pathway. Lesions that were concerning to referring clinicians for skin cancer were associated with an increased risk of skin cancer (all skin cancer: aRR, 2.8; 95% CI, 2.2-3.5; melanoma: aRR, 2.02; 95% CI, 1.1-3.7). Patients in the 3 high-risk lesion groups were seen faster in the new triage pathway (mean reduction, 26 days; 95% CI, 18-34 days).Conclusions and Relevance: In this study, a new automated, rules-based referral pathway was implemented that expedited care for patients with high-risk skin cancer. This reform may have contributed to improving patient stratification, reducing the time from referral to first encounter, and maintaining accuracy in identifying malignant lesions. The findings highlight the potential to optimize clinical resource allocation by better risk stratification of referred patients.

  View details for DOI 10.1001/jamadermatol.2024.1832

  View details for PubMedID 38922597

• Telemedicine retinopathy of prematurity severity score (TeleROP-SS) versus modified activity score (mROP-ActS) retrospective comparison in SUNDROP cohort. Scientific reports Xu, C. L., Adu-Brimpong, J., Moshfeghi, H. P., Rosenblatt, T. R., Yu, M. D., Ji, M. H., Wang, S. K., Zaidi, M., Ghoraba, H., Michalak, S., Callaway, N. F., Kumm, J., Nudleman, E., Wood, E. H., Patel, N. A., Stahl, A., Lepore, D., Moshfeghi, D. M. 2023; 13 (1): 15219

  Abstract

  Identifying and planning treatment for retinopathy of prematurity (ROP) using telemedicine is becoming increasingly ubiquitous, necessitating a grading system to help caretakers of at-risk infants gauge disease severity. The modified ROP Activity Scale (mROP-ActS) factors zone, stage, and plus disease into its scoring system, addressing the need for assessing ROP's totality of binocular burden via indirect ophthalmoscopy. However, there is an unmet need for an alternative score which could facilitate ROP identification and gauge disease improvement or deterioration specifically on photographic telemedicine exams. Here, we propose such a system (Telemedicine ROP Severity Score [TeleROP-SS]), which we have compared against the mROP-ActS. In our statistical analysis of 1568 exams, we saw that TeleROP-SS was able to return a score in all instances based on the gradings available from the retrospective SUNDROP cohort, while mROP-ActS obtained a score of 80.8% in right eyes and 81.1% in left eyes. For treatment-warranted ROP (TW-ROP), TeleROP-SS obtained a score of 100% and 95% in the right and left eyes respectively, while mROP-ActS obtained a score of 70% and 63% respectively. The TeleROP-SS score can identify disease improvement or deterioration on telemedicine exams, distinguish timepoints at which treatments can be given, and it has the adaptability to be modified as needed.

  View details for DOI 10.1038/s41598-023-42150-w

  View details for PubMedID 37709791

• Examining Diversity in Digital Therapeutics Clinical Trials: Descriptive Analysis. Journal of medical Internet research Adu-Brimpong, J., Pugh, J., Darko, D. A., Shieh, L. 2023; 25: e37447

  Abstract

  BACKGROUND: Digital therapeutics (DTx) are an emerging class of software-based medical therapies helping to improve care access and delivery. As we leverage these digital health therapies broadly in clinical care, it is important to consider sociodemographic representation underlying clinical trials data to ensure broad application to all groups.OBJECTIVE: We review current sociodemographic representation in DTx clinical trials using data from the Digital Therapeutics Alliance Product Library database.METHODS: We conducted a descriptive analysis of DTx products. We analyzed 15 manuscripts associated with 13 DTx products. Sociodemographic information was retrieved and compared with the US population's demographic distribution.RESULTS: The median study size and age of participants were 252 and 43.3 years, respectively. Of the 15 studies applicable to this study, 10 (67%) reported that females made up 65% or greater of the study cohort. A total of 14 studies reported race data with Black or African American and Asian American individuals underrepresented in 9 and 11 studies, respectively. In 7 studies that reported ethnicity, Hispanics were underrepresented in all 7 studies. Furthermore, 8 studies reported education levels, with 5 studies reporting populations in which 70% or greater had at least some college education. Only 3 studies reported health insurance information, each reporting a study cohort in which 100% of members were privately insured.CONCLUSIONS: Our findings indicate opportunities for improved sociodemographic representation in DTx clinical trials, especially for underserved populations typically underrepresented in clinical trials. This review is a step in examining sociodemographic representation in DTx clinical trials to help inform the path forward for DTx development and testing.

  View details for DOI 10.2196/37447

  View details for PubMedID 37531157

• Validation of a Photographic Retinopathy of Prematurity Severity Score (ROP-SS) and Comparison to the Modified Activity Score (mROP-ActS) in a Retrospective SUNDROP Cohort Xu, C., Adu-Brimpong, J., Moshfeghi, H., Rosenblatt, T., Yu, M., Wang, S., Zaidi, M., Ghoraba, H., Michalak, S., Callaway, N., Wood, E., Stahl, A., Lepore, D., Moshfeghi, D. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2023

  View details for Web of Science ID 001053795601300