Springfield

Researchers are evaluating the effectiveness of the iCHART integrated Care to Help At-Risk Teens intervention for adolescents aged 12 to 18 who are experiencing depression or suicidal behavior. This study aims to reduce suicide-related events by comparing iCHART to usual treatment in a randomized controlled trial including 900 participants. The study also examines factors that affect treatment response and uses implementation science to assess barriers, facilitators, and outcomes like acceptability and feasibility to support health equity. iCHART combines three main parts a Safety Planning App that helps providers deliver care through an app instead of paper, a Mental Health Screener questionnaire to personalize treatment plans, and a series of text messages over 2 to 3 weeks to encourage engagement with safety plans and treatment. Participants are randomly assigned to either receive iCHART or treatment as usual, which may include a paper safety plan and standard care from their providers. Participants will be actively involved through mental health assessments at baseline and follow-up points up to 12 months, including evaluations of depression severity and suicidal thoughts and behaviors. The study also tracks service use, app usage, and participants views on the interventions acceptability, usability, feasibility, and appropriateness. This comprehensive monitoring helps understand how well iCHART works and informs future use in pediatric care settings.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.