Poster Day 2025: Abstracts: Narrative Review

Catalina Costache OMS-II, Tyler Jahraus OMS-II, David Montoya OMS-II, Steven Pasquali OMS-II, Shaan Reddy OMS-II, Jenna Stremmel OMS-II

Background/
Overview:

Patients with rheumatic diseases often experience limited mobility, which can restrict access to care. To address the challenge, telemedicine has become a critical part of the field of Rheumatology, and its efficacy has been widely studied. The review summarizes and discusses current literature concerning the efficacy and utilization of telemedicine among Rheumatologists and their patients both in the United States and worldwide, as compared to the more traditional face-to-face care format.

The COVID-19 pandemic further highlighted telemedicine’s role in rheumatology as many of these patients were required to isolate to protect their health. The pandemic was a real-world stress test for telemedicine and led to an abundance of data on the subject.

Methods/
Findings:

A scoping review was conducted using the PubMed database to identify research investigating rheumatological patient care, telemedicine-based disease management, and the effects of the COVID 19 pandemic on said patient care and satisfaction. Care models regarding telemedicine-based disease management were directly compared in terms of patient outcomes, adherence to treatment, and disease activity control was prioritized. Filters were also applied to limit results to peer-reviewed journal articles published in English. In addition, evidence was deliberately sought addressing the impact of telerheumatology on patients living in rural or underserved regions to evaluate whether remote care improved access where traditional in-person rheumatology services were limited or unavailable. Articles were also included if they evaluated outcomes relevant to our research question, such as disease activity control, patient satisfaction, provider satisfaction, adherence to treatment, or equity and access to care. Any papers not focusing on the five years before and after the pandemic, specifically between the time of 2013 and 2024 were excluded. Exclusion criteria eliminated studies that focused on other specialties besides rheumatology, and publications that were not primary research or systematic reviews. Age, sex, and race/ethnicity were variables not accounted for in the preliminary research. Of the articles reviewed, ten were selected from the academic journals that fit the inclusion and exclusion criteria.

During the search process, we encountered several challenges. First, despite the use of specific keywords such as “telerheumatology” and “rheumatology,” many search results focused on telemedicine in other specialties, requiring us to screen articles more carefully to identify rheumatology-specific studies. Second, although our time frame covered 2013– 2024, it was difficult to identify pre-pandemic studies because the majority of rheumatology-focused telehealth research was conducted after the onset of COVID-19. To address the gap, we made a deliberate effort to include studies published before 2020 whenever possible, in order to provide a more balanced perspective of telemedicine use across the pre-, during-, and post-pandemic periods.

Telemedicine can become an invaluable supplement to overreliance on physical patient-physical interactions with further integration requiring improving access to the internet, technological training, and incentive programs. The findings of the present review emphasized the ability for telemedicine to improve access to and quality of care. One potential area of focus for future efforts can be to increase the hybrid care model, improving access and equity for patients. Telemedicine has the potential to increase patient satisfaction and provide a better quality of care when properly applied.

Discussion:

Among the ten review articles, outcomes were found to be comparable to in-person visits, with patient satisfaction generally being positive. Patients value telemedicine for its convenience, reduced travel and general cost savings. Providers generally supported the role of telemedicine during care disruptions, allowing for the continuity of care during COVID-19. However, providers noted the limitations in the use of Telehealth delivery, such as difficulty in evaluating complex cases, communication issues and technological barriers. Hybrid care models were particularly effective in improving access, reducing wait times and maintaining the continuity of care.

Telemedicine has proven to be a valuable tool in rheumatology care, especially during the COVID-19 pandemic, with patients reporting high satisfaction due to convenience, reduced travel, and lower costs, and with physicians noting that it offers comparable outcomes to traditional in-person visits for many stable patients. However, limitations remain, particularly regarding the need for physical examinations in more complex cases, as well as issues of digital literacy and equitable access among underserved populations. As a result, hybrid models that combine virtual and in-person visits are increasingly viewed as the most effective and sustainable approach to rheumatology care. Telerheumatology showed outcomes that rivaled in-person clinics, particularly in reducing disease activity and progression in stable patients. Its primary advantage was improved accessibility to healthcare for underserved and rural populations; however, barriers such as technology literacy and the internet continue to threaten its equitable gains.

Potential directions for future research include:

• Evaluating long-term outcomes of telemedicine and hybrid care models on disease activity, adherence, and quality of life, and comparing hybrid versus fully virtual care to determine optimal balance for continuity and quality of care.
• Developing standardized assessment tools to ensure accurate clinical evaluation during virtual visits.
• Exploring equity-focused interventions that address barriers faced by rural, elderly,and low-income patients (for example, improving broadband access, technology training, and device provision).
• Assessing provider perspectives to identify strategies that improve efficiency, reimbursement models, and training for telehealth delivery.

Future research could include incorporating larger, diverse, and global samples, include cost-effectiveness analyses, and investigate policy-level impacts of telehealth integration into rheumatology practice. Collaborative research between health systems, policymakers, and technology developers can ensure telemedicine evolves as an equitable and sustainable complement to in-person rheumatologic care.

Hybrid models that employ periodic in-person clinical evaluations while including the convenience and flexibility of telerheumatology sessions have shown promise in finding an optimal healthcare model. Telerheumatology during COVID-19 illustrated the strengths of an online visit format for healthcare providers. Patients still expressed concern over the lack of physical examination, challenges in communication, and inconsistencies in reimbursement.

Telemedicine has the potential to be an invaluable supplement to the preexisting physical infrastructure. Further integration requires improving access to the internet, technological training, and incentive programs. As technology becomes more available both in knowledge and physical access, the benefits of telemedicine will be more evident. When integrated with in-person care, telerheumatology has the capacity to monumentally improve patient outcomes.

Conclusion:

The studies highlighted the effectiveness of telemedicine in the field of rheumatology, especially during the COVID-19 pandemic. Showing the ability to improve access and maintain the continuity of care, while not compromising on quality of the health care delivered to the patient. Future efforts to increase adaptation should focus on increasing the hybrid care model, improving access and equity for patients. Telemedicine has the potential when implemented correctly to be a great modality in the delivery of patient centered care and increase outcomes for patients with rheumatological diseases.

Background/
Overview:

Food deserts, which are low-income areas with limited access to affordable nutritious foods, significantly contribute to shaping dietary behaviors and chronic cardiac disease outcomes such as hypertension in the United States. Additionally, several demographic and socioeconomic factors such as age, race, both household and individual income levels, and educational level have been shown to influence the correlation between food deserts and a higher prevalence of hypertension as low-income and minority communities are disproportionately located in these areas. Findings from research have shown that individuals in food deserts are associated with higher rates of hypertension and that various socioeconomic and demographic factors influence its prevalence.

Methods/
Findings:

Our group examined peer-reviewed studies of U.S. adults aged 18 and older living in food deserts with hypertension conducted from 2015-2025 for our study. These articles were selected through online databases including PubMed, Google Scholar, and Scopus. They were found using keywords such as “food insecurity,” “food deserts,” “food access,” “hypertension,” “blood pressure,” “cardiovascular disease,” and “cardiometabolic health.” The selected articles operationalized the exposure using various methods, including USDA guidelines, GIS mapping, the Area Deprivation Index, and census data as well as national surveys such as NHANES. The studies varied in their research designs. Some of the selected articles focused on groups with hypertension within a particular area or region in the US, while others studied populations that had hypertension across the United States. Selected studies shared several demographic factors. The prevalence of hypertension in food secure versus food deserts was compared and stratified further by age, race/ethnicity, sex, educational level, and income in order to evaluate possible correlations between these factors and hypertension in these areas.

Results/
Discussion:

Research findings revealed a consistent pattern which revealed that individuals residing in food deserts experienced higher rates of hypertension and other related cardiovascular comorbidities compared to those with better food access. The data demonstrated strong correlations between food environment and elevated blood pressure, which supports the relationship between limited access to nutritious food and adverse cardiometabolic outcomes. Furthermore, demographic factors such as race, income, and education level were found to moderate this relationship. The factors that had a larger influence in those exhibiting higher hypertension prevalence rates when compared to other similar demographic factors were black adults, residing in lower-income groups, and a lower education level. Collectively, these findings reinforce that both socioeconomic and environmental determinants play critical roles in hypertension disparities among populations living in food deserts.

Overall, the literature suggests that living in food deserts is a significant risk factor for hypertension, particularly among the socioeconomically disadvantaged and minority populations. However, research limitations such as the predominance of cross-sectional designs, geographically restricted samples, and the varying definitions of food deserts constrain the causal interpretation of the data. Future research should emphasize cohort or longitudinal studies to better assess temporal relationships between factors and determine whether interventions improving food access can directly reduce hypertension prevalence. Additionally, integrating policy-level and community-based interventions may potentially provide deeper insight into addressing the health inequities associated with food insecurity and cardiovascular risk.

Rebecca Best OMS-II, Sagar Desai OMS-II, Carter McEntyre OMS-II, Chris Sancilio OMS-II, Nicole Svirsky OMS-II, Natalie Tam OMS-II

Abstract:

Lower back pain is a commonly seen symptom in the United States, with over 80% of the population experiencing lumbago at least once in their lifetime. While many cases are self-limiting, up to 44% of the affected population will experience chronic symptoms, making the treatment of chronic lower back pain a highly studied topic due to its significant prevalence. Pharmacological management has been a mainstay in the treatment of musculoskeletal pain; however, treatment of the symptoms caused by somatic dysfunction does not fix the underlying problem which is structural and biomechanical in origin. In addition, pain medications also have numerous adverse effects associated with their use, such as tissue injury, organ damage, psychological dependence, physical reliance, etc. Studies have shown a lack of improvement in a patient’s level of disability pre and post-pharmacological treatment, which has opened the door to looking at other, less common treatment options that allows the patient to return to normal function while simultaneously reducing pain symptoms. One of those treatment options is osteopathic manipulative treatment (OMT), which relies on osteopathic physicians making diagnoses based on palpation of underlying structures and then treating the patient using manual manipulative therapy in order to promote self-healing and regulation in the body.

In this literature review, a comprehensive set of articles was compiled related to chronic lower back pain and the various treatments of it, including OMT, to compare how it equates to alternative treatments, such as pharmacological interventions and physical therapy. Using databases like PubMed, Google Scholar, and Policy Map, studies were chosen with populations of patients over the age of 18 with a diagnosis of chronic lower back pain who were treated with either osteopathic manipulation and/or with medication and other non-invasive treatments. Of those studies, research was emphasized on the use of outcome variables such as functional status, which can be measured by various scales including the Oswestry Disability Index, Roland Morris Disability Questionnaire, or Quebec Disability Index, and pain intensity, which can be measured via Visual Analogue Scale, and/or patterns of pain medication used to determine the effects of varying kinds of treatment.

Current research has demonstrated that OMT consistently leads to benefits in pain reduction and decreased reliance on pharmacological therapies, though its effects on functional outcomes were more variable. A portion of the available data supported the hypothesis that patients treated by OMT would have lower disability levels compared to those managed with other therapies; however, there were also studies that reported insignificant differences in functional status between OMT and comparison groups. While functional mobility wasn’t necessarily improved with the use of OMT, there was strong evidence that OMT offers meaningful pain relief while also reducing medication reliance. Findings support OMT as the primary treatment for pain because it produces measurable pain relief compared to patients who used pain medications as their primary treatment while simultaneously reducing the risk of adverse effects associated with pain medications.

Radu Costache OMS II, Kara Daskiewich OMS II, Jeff Lee OMS II, Ariel Kenfack OMS II, Liam Moran OMS II, Erin Ussery OMS II

Abstract:

Accurate clinical documentation in electronic health records (EHRs) remains essential for patient safety, continuity of care, and reducing clinician burnout. Health systems continue to face the challenge of adapting to rapidly advancing technology while maintaining high standards of patient care in demanding times. Artificial intelligence (AI)–assisted note generation, including speech-to-text tools with summarization, has demonstrated potential to improve efficiency, enhance accuracy, and capture patient–provider conversations in real time. Important questions persist regarding whether such gains translate into safer care and improved system performance compared with traditional written or dictated notes. Ongoing concerns include privacy, transparency, cost, and effective implementation. The following scoping review synthesizes available evidence to highlight both the potential and the limitations of AI integration in clinical documentation. Given the rapid pace of technological change, capturing a complete and diverse picture of AI impact across broad patient populations and clinical settings, such as within the United States, remains challenging. The current review explores the state of AI use in clinical documentation in the United States, acknowledging ongoing data gaps and limitations. The goal is to guide future research and inform strategies for safe, responsible integration of AI into modern healthcare systems for provider and patient benefit.

The primary database utilized was the National Center for Biotechnology Information (NCBI) system from the National Institutes of Health (NIH). The PubMed algorithm within the NCBI provided peer-reviewed literature on the use of Artificial Intelligence (AI) in medical practice. Rather than limiting the scope to a specific specialty, the project aimed to display generalized trends, benefits, and error risks associated with AI across the medical field. Additional data were collected on Health Profession Shortage Areas (HPSAs), and the geographical analysis tool PolicyMap was used to identify HPSAs. A literature review was conducted through NCBI PubMed using keywords such as “AI + charting + Ambient AI + charting errors + EHR + Health Care + scribe.” Data were filtered to include research from the past 10 years with a focus on studies performed in the United States. The broad scope of the review enabled coverage of topics ranging from evaluating precision and efficiency of AI to examining the impact of the technology on physician burnout. Twelve studies were identified and utilized, including systematic reviews from other databases such as Ovid, PubMed, Scopus, Web of Science, the Consolidated Framework for Implementation Research (CFIR), MEDLINE, Embase, and the Cochrane Library. Raw data included error rates related to charting, error types, patient satisfaction, and time spent charting.

Across the twelve studies reviewed, strong evidence supported improvements in accuracy, efficiency, and overall clinician satisfaction, along with reductions in EHR-related burnout. Findings varied by specialty, with notable benefits observed in hospitalized adults and primary care. For example, trials integrating AI ambient scribe tools within major EHR systems such as Epic demonstrated a 20–30% reduction in after-hours charting and improved work–life balance. AI-generated notes continue to contribute to error rates that, although reduced compared with traditional dictation or written documentation, remain clinically significant. Reported errors involved incorrect application of medical terminology, generation of nonfactual or hallucinated data, and documentation inaccuracies. AI-generated clinical documentation frequently contained omission, addition, or misattribution errors, even when overall accuracy metrics appeared acceptable. For instance, omission of a key medication from a history by an AI scribe has led to inappropriate diagnostic testing and distorted care, endangering patients. Additional challenges involve corporate management of data servers, patient confidentiality, and compliance with HIPAA regulations.

Catherine Rothman OMS II, Mary Howard Singleton OMS II, Arshia Goyal OMS II, Jacob Hudson OMS II, Robert Castle OMS II, Robert Willis OMS II

Background:

Gestational diabetes is a known and common complication in pregnancy. Despite its relatively high prevalence, it is not without risk to both mother and the infant. The mother has a higher risk of heart disease, type 2 diabetes, and preterm birth, while the infant has a higher risk of obesity, diabetes, and the complications associated with preterm birth. Identifying risk factors associated with gestational diabetes is critical for timely diagnosis and effective management. Patients living in areas of lower socioeconomic status are known to be at a higher risk of developing a wide range of both acute and chronic diseases, especially type 2 diabetes and obesity, which are known to be related to gestational diabetes.

Methods:

A literature-based project was conducted using peer-reviewed articles identified and summarized within a structured PICO framework. Literature searches were conducted in PubMed, using keywords such as “gestational diabetes”, “socioeconomic status”, “pregnancy”, “HbA1c”, “HbA1c level”, and “demographic factors” to find studies on gestational diabetes specifically related to patients in areas of lower socioeconomic status. Selection criteria included journal reputability, studies’ direct links to socioeconomic status, and studies’ direct links to HbA1c, glycemic index, or gestational diabetes rates and outcomes. Studies that met these criteria were reviewed for completeness, relevance, and reliability of conclusions; those meeting these criteria were then included in the literature review. PolicyMap was utilized as a supplementary resource to generate visual comparisons between areas of low socioeconomic status and regions with high gestational diabetes rates based on data from the Centers for Disease Control and the University of Wisconsin, respectively.

Results:

Across the United States, lower socioeconomic status was almost uniformly associated with increased rates of gestational diabetes. The association was found to be due to the confluence of several factors, such as difficulty accessing prenatal care, food insecurity, low health literacy, and psychological stressors. However, the finding was not universal across the globe. International studies found varying rates of gestational diabetes in low socioeconomic classes; a Finnish study was consistent with American findings, while one from India found higher rates of gestational diabetes among pregnant women with higher socioeconomic status. However, confounding factors such as a lack of access to health screenings among lower socioeconomic statuses may have falsely decreased their reported rates in some of these studies, while richer individuals were more likely to see a physician and be diagnosed. Additionally, neighborhood-level SES scores were noted to correlate with an increase in gestational diabetes, regardless of an individual’s status.

Conclusion:

Overall, lower socioeconomic status correlated with increased rates of gestational diabetes internationally. Pregnant women from lower socioeconomic classes consistently had higher HbA1c scores and had difficulty maintaining a lower blood glucose level than medically similar women from more affluent areas. Discrepancies in international findings are primarily related to variations in healthcare access and screening availability, causing falsely low rates due to a lack of reporting. Therefore, a multifactorial approach is needed and that patients from lower socioeconomic classes may benefit from lower barriers to screenings and treatment, easier access to nutritious food, and improvements on their social and psychological support systems.

PDL remains a challenge in LAAO device implantation. Many factors, including anatomical, device-related, procedural variable, and implanter experience, play a role. PDL more than 5 mm is considered severe and should be under regular monitoring and oral anticoagulation. Rigorous studies should be done, and standardized guidelines should be made for further management of PDLs.

Keywords: left atrial appendage closure; peridevice leaks; stroke; atrial fibrillation

HFmethRF is a growing but under-recognized public health crisis. Early identification, harm reduction strategies, and the integration of addiction treatment into heart failure care are essential for improving outcomes. Further research is needed to establish risk stratification models, standardized treatment pathways, and long-term prognostic data.

Keywords: Methamphetamine, Cardiomyopathy, Heart failure