Barbara Trautner, MD, PhD, FIDSA
Barbara Trautner, MD, PhD, FIDSA, and Steven Zeliadt, PhD, MPH, are both recipients of the HSR&D Best Research Paper of the Year Award, which honors a single article or collection of articles resulting from one or more HSR&D- or QUERI-funded investigations. Research studies also must involve Veterans, with results that are important to Veterans' health and care, and to the VA healthcare system.
Published in JAMA Internal Medicine, Dr. Trautner's article "Effectiveness of an Antimicrobial Stewardship Approach for Urinary Catheter-Associated Asymptomatic Bacteriuria," was chosen for several reasons, including the importance of highlighting theory-driven interventions to improve the quality of healthcare. Dr. Trautner and her co-authors demonstrated that addressing providers' underlying cognitive biases toward unnecessary screening for and over-treatment of asymptomatic bacteriuria - the most common reason for overuse of antibiotics in both acute and long-term care - led to an effective intervention. Described in the article, the intervention became the basis of VA's "Choosing Wisely for UTI" (urinary tract infection) campaign, and has been incorporated into the VA Antimicrobial Stewardship Task Force Medication Use Evaluation for UTI. Dr. Trautner is part of HSR&D's Center for Innovations in Quality, Effectiveness and Safety (IQuESt) and the Michael E. DeBakey VA Medical Center in Houston, TX.
Steven Zeliadt, PhD, MPH
Also chosen, and published in JAMA Internal Medicine, was Dr. Zeliadt's article, Attitudes and Perceptions about Smoking Cessation in the Context of Lung Cancer Screening. Lung cancer is the leading cause of cancer death among Veterans; however, screening must be done in a logical and targeted way. The work done by Dr. Zeliadt and his co-authors suggests that screening must promote smoking cessation and not give patients a false sense of security. For example, interviews conducted by the study team showed that 49% of respondents believed that having a negative scan lessened the need to quit smoking. These findings are of critical importance to Veterans and the VA healthcare system as it begins to offer lung cancer screening. Study results also were widely disseminated in the national media, including The New York Times. This work led to the development of a proactive intervention, which was found during an HSR&D pilot study to improve quit rates among screening participants to 19% compared to 7% in a control group. Dr. Zeliadt is now partnering with the VA Smoking Quitline to test the implementation of the intervention in a large pragmatic trial, recently funded by HSR&D. Dr. Zeliadt is part of HSR&D's Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle, WA.
HSR&D thanks Drs. Trautner and Zeliadt for their outstanding work and contributions to the literature on these vital healthcare issues.