Privacy Concerns Among Older Adults Using Voice Assistant Systems

Voice Assistant Systems (VAS) are software platforms that complete various tasks using voice commands (e.g., Amazon Alexa), with increasing usage by older adults. It is unknown whether older adults have significant privacy concerns with VAS. 55 participants were evaluated from ambulatory practice sites for a study on VAS detection of early cognitive decline. The mean age was 73.3±5.6 years, 58% female, 93% white, and 53% had mild cognitive impairment. Privacy concerns were assessed via Likert-based surveys. Participants believed data was used with consent (71%) and stored properly (67%); however, 71% wanted new privacy regulations, 43% were comfortable with daily activity monitoring, and 85% thought the data needs to be highly protected. Qualitative themes included “listening-in”, “tracking”, and unwanted sharing of information. Findings suggest that older adults do not have significant privacy concerns for VAS use, but requested additional regulations. Future research can compare VAS privacy concerns between age groups.

Discriminatory ability of milestones: An analysis of milestone variability by obstetrics and gynecology subspecialty

Background: Little evidence exists regarding Accreditation Council for Graduate Medical Education (ACGME) milestone discriminatory ability. This short report describes variability in milestone scores by category to determine their utility in discerning high and low performers in a single Obstetrics and Gynecology residency. Methods: A Clinical Competency Committee (CCC) design was implemented with four subcommittees, each responsible for a predetermined milestones subset: Obstetrics, Gynecology, Ambulatory Practice, and Professional Activities. Milestone scores for 44 residents per year over four biannual evaluation cycles (2014-2016) were evaluated, for a total of 176 independent evaluations. Results: Findings indicate that discriminatory ability, assessed by variability between resident scores, differed by subcommittee. Subcommittees that were primarily tasked with evaluating clinical- and procedural-based milestones demonstrated lower discriminatory ability among trainees. Conclusion: Greater Professional Activity milestone variability indicates better differentiation; future research should determine correlation of these findings with other professionalism performance metrics and novel intervention strategies.

Coronavirus Related Mortality in the Geriatrics Ambulatory Practice

Background Older adults often have atypical presentations of common diseases and COVID-19 is no exception. Presentations range from asymptomatic to overwhelming symptoms that result in hospitalization, intubation, or death. The number of COVID-19 related deaths among older adults in the outpatient practice during the peak of the pandemic is unclear. Methods The objective is to describe the COVID-19 status and clinical characteristics of patients in a Geriatrics Ambulatory Practice who died during the peak of the COVID-19 pandemic. Design: Retrospective chart review Participants: 54 adults age 65 years and older. Methods: COVID-19 status defined by positive test result and presumed COVID-19 status based upon clinical presentation. Results Out of 1200 active patients in the Geriatrics Ambulatory Practice, 54 (4.5%) died between January 1st, 2020 and June 30th, 2020. The study sample was 63% female, 33% Hispanic/Latino, 27% Black/African American, and 22% white. The mean (SD) age was 86(8.6) years, range (72-107 years). The most prevalent medical comorbidities in decreasing order of frequency were hypertension (88.9%), diabetes (51.9%), and cognitive impairment (51.9%). Nineteen (35%) were COVID-19 positive and 8 had presumed COVID-19. There were no statistically significant differences in age, gender, race/ethnicity, and medical comorbidities between the COVID-19 or presumed COVID-19 group compared to those with No COVID-19. Conclusion Approximately 35% of Geriatric patients who died during the first 6 months of 2020 had confirmed COVID-19 and an additional 15% had presumed COVID-19. The actual number of COVID-19 related deaths among older adults in the ambulatory practice during the peak of the pandemic is difficult to estimate and likely underestimated.