Sean C Meldrum

Learn More
The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it(More)
OBJECTIVE To describe the temporal and geographic progression of the Lyme disease epidemic in New York State from 1977 through 1989. DESIGN Communicable disease surveillance system. SETTING Statewide. MAIN OUTCOME MEASURES The progression of the epidemic was examined by analyzing trends in Lyme disease cases reported to the state surveillance system,(More)
BACKGROUND Patients' trust in their health care providers may affect their satisfaction and health outcomes. Despite the potential importance of trust, there are few studies of its correlates using objective measures of physician behavior during encounters with patients. METHODS We assessed physician behavior and length of visit using audio tapes of(More)
OBJECTIVE To assess the effect of low-dose mifepristone on quality of life, pain, bleeding, and uterine size among women with symptomatic leiomyomata. METHODS Forty-two women with symptomatic uterine leiomyomata and uterine volume of 160 mL or more were randomized to mifepristone, 5 mg daily, or placebo for 26 weeks. Quality of life (Uterine Fibroid(More)
BACKGROUND Current assessment formats for medical students reliably test core knowledge and basic skills. Methods for assessing other important domains of competence, such as interpersonal skills, humanism and teamwork skills, are less well developed. This study describes the development, implementation and results of peer assessment as a measure of(More)
OBJECTIVE We examined how navigation, defined as the assessment and alleviation of barriers to adequate health care, influences patients' perspectives on the quality of their cancer care. METHODS We conducted post-study patient interviews from a randomized controlled trial (usual care vs. patient navigation services) from cancer diagnosis through(More)
BACKGROUND Previous work suggests that exploration and validation of patients' concerns is associated with greater patient trust, lower health care costs, improved counseling, and more guideline-concordant care. OBJECTIVE To describe physicians' responses to patients' worries, how their responses varied according to clinical context (straightforward(More)
OBJECTIVE There is considerable interest in the influences on patients' ratings of physicians. METHODS In this cross-sectional study, patients (n = 4616; age range: 18-65 years) rated their level of satisfaction with their primary care physicians (n = 96). Patients and physicians were recruited from primary care practices in the Rochester, NY metropolitan(More)
OBJECTIVE To understand how physicians communicate may contribute to the mistrust and poor clinical outcomes observed in patients who present with medically unexplained symptoms (MUS). METHODS After providing informed consent, 100 primary care physicians in greater Rochester, New York, were visited by two unannounced covert standardized patients (actors,(More)
Information on the association of impulsivity and measures of aggression with suicidal ideation in adolescents and young adults is limited. Data were gathered from a community sample of 625 adolescent and young adult males. Analyses were based on multivariate generalized estimating equations. Impulsivity and irritability were associated strongly with(More)