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Steven L. Meyers, M.D.

Steven L. Meyers, M.D.

Steven L. Meyers, M.D.

  • Locations

    NorthShore Medical Group

    9650 Gross Point Rd.
    Suite 3900
    Skokie, IL 60076
    847.570.2570 847.933.3520 fax Get Directions This location is wheelchair accessible.

    NorthShore Medical Group

    920 Milwaukee Ave.
    Suite 2100
    Lincolnshire, IL 60069
    847.570.2570 847.933.3520 fax Get Directions This location is wheelchair accessible.

    NorthShore Medical Group

    757 Park Ave. West
    Suite 2850
    Highland Park, IL 60035
    847.570.2570 847.933.3520 fax Get Directions This location is wheelchair accessible.
  • Publications
    • Design and Implementation of Structured Clinical Documentation Support Tools for Treating Stroke Patients.

      Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2019 Feb 05

      Authors: Simon KC, Munson R, Ong A, Gil FR, Campanella F, Hillman L, Lai R, Chesis R, Tideman S, Vazquez RM, Meyers S, Frigerio R, Maraganore D
      Standardized electronic medical record tools provide an opportunity to efficiently provide care that conforms to Best Practices and supports quality improvement and practice-based research initiatives.
      We describe the development of a customized structured clinical documentation "toolkit" that standardizes patient data collection to conform to Best Practices for treating patients with stroke. The toolkit collects patients' demographic information, relevant score test measures, and captures information on disability, treatment, and outcomes.
      We describe here our creation and implementation of the toolkits and provide example screenshots. As of August 1, 2018, we have evaluated 2332 patients at an initial visit for a possible stroke. We provide basic descriptive data gathered from the use of the toolkits, demonstrating their utility in collecting patient data in a manner that supports both quality clinical care and research initiatives.
      We have developed an EMR toolkit to support Best Practices in the care of patients with stroke. We discuss quality improvement projects and current research initiatives using the toolkit. This toolkit is being shared with other Departments of Neurology as part of the Neurology Practice-Based Research Network.
      PMID: 30737069 [PubMed - as supplied by publisher]
    • Successful utilization of the EMR in a multiple sclerosis clinic to support quality improvement and research initiatives at the point of care.

      Multiple sclerosis journal - experimental, translational and clinical

      Authors: Claire Simon K
      Many physicians enter data into the electronic medical record (EMR) as unstructured free text and not as discrete data, making it challenging to use for quality improvement or research initiatives.
      The objective of this research paper was to develop and implement a structured clinical documentation support (SCDS) toolkit within the EMR to facilitate quality initiatives and practice-based research in a multiple sclerosis (MS) practice.
      We built customized EMR toolkits to capture standardized data at office visits. Content was determined through physician consensus on necessary elements to support best practices in treating patients with demyelinating disorders. We also developed CDS tools and best practice advisories within the toolkits to alert physicians when a quality improvement opportunity exists, including enrollment into our DNA biobanking study at the point of care.
      We have used the toolkit to evaluate 541 MS patients in our clinic and begun collecting longitudinal data on patients who return for annual visits. We provide a description and example screenshots of our toolkits, and a brief description of our cohort to date.
      The EMR can be effectively structured to standardize MS clinic office visits, capture data, and support quality improvement and practice-based research initiatives at the point of care.
      PMID: 30559971 [PubMed - as supplied by publisher]
    • Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.

      JAMIA open 2018 Jul

      Authors: Simon KC, Tideman S, Hillman L, Lai R, Jathar R, Ji Y, Bergman-Bock S, Castle J, Franada T, Freedom T, Marcus R, Mark A, Meyers S, Rubin S, Semenov I, Yucus C, Pham A, Garduno L, Szela M, Frigerio R, Maraganore DM
      To demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design.
      We have designed and are implementing pragmatic trials at the point-of-care using custom-designed structured clinical documentation support and clinical decision support tools within our physician's typical EMR workflow. We are applying a subgroup based adaptive design (SUBA) that enriches treatment assignments based on baseline characteristics and prior outcomes. SUBA uses information from a randomization phase (phase 1, equal randomization, 120 patients), to adaptively assign treatments to the remaining participants (at least 300 additional patients total) based on a Bayesian hierarchical model. Enrollment in phase 1 is underway in our neurology clinical practices for 2 separate trials using this method, for migraine and mild cognitive impairment (MCI).
      We are successfully collecting structured data, in the context of the providers' clinical workflow, necessary to conduct our trials. We are currently enrolling patients in 2 point-of-care trials of non-inferior treatments. As of March 1, 2018, we have enrolled 36% of eligible patients into our migraine study and 63% of eligible patients into our MCI study. Enrollment is ongoing and validation of outcomes has begun.
      This proof of concept article demonstrates the feasibility of conducting pragmatic trials using the EMR and an adaptive design.
      The demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
      PMID: 30386852 [PubMed - as supplied by publisher]
    • Domain-Specific Diaschisis: Lesions to Parietal Action Areas Modulate Neural Responses to Tools in the Ventral Stream.

      Cerebral cortex (New York, N.Y. : 1991) 2018 Aug 28

      Authors: Garcea FE
      Neural responses to small manipulable objects ("tools") in high-level visual areas in ventral temporal cortex (VTC) provide an opportunity to test how anatomically remote regions modulate ventral stream processing in a domain-specific manner. Prior patient studies indicate that grasp-relevant information can be computed about objects by dorsal stream structures independently of processing in VTC. Prior functional neuroimaging studies indicate privileged functional connectivity between regions of VTC exhibiting tool preferences and regions of parietal cortex supporting object-directed action. Here we test whether lesions to parietal cortex modulate tool preferences within ventral and lateral temporal cortex. We found that lesions to the left anterior intraparietal sulcus, a region that supports hand-shaping during object grasping and manipulation, modulate tool preferences in left VTC and in the left posterior middle temporal gyrus. Control analyses demonstrated that neural responses to "place" stimuli in left VTC were unaffected by lesions to parietal cortex, indicating domain-specific consequences for ventral stream neural responses in the setting of parietal lesions. These findings provide causal evidence that neural specificity for "tools" in ventral and lateral temporal lobe areas may arise, in part, from online inputs to VTC from parietal areas that receive inputs via the dorsal visual pathway.
      PMID: 30169596 [PubMed - as supplied by publisher]
    • Structured Clinical Documentation to Improve Quality and Support Practice-Based Research in Headache.

      Headache 2018 Sep

      Authors: Meyers S, Claire Simon K, Bergman-Bock S, Campanella F, Marcus R, Mark A, Freedom T, Rubin S, Semenov I, Lai R, Hillman L, Tideman S, Pham A, Frigerio R, Maraganore DM
      To use the electronic medical record (EMR) to optimize patient care, facilitate documentation, and support quality improvement and practice-based research, in a headache specialty clinic.
      Many physicians enter data into the EMR as unstructured free text and not as discrete data. This makes it challenging to use data for quality improvement or research initiatives.
      We describe the process of building a customized structured clinical documentation support toolkit, specific for patients seen in a headache specialty clinic. The content was developed through frequent physician meetings to reach consensus on elements that define clinical Best Practices. Tasks were assigned to the care team and data mapped to the progress note.
      The toolkit collects hundreds of fields of discrete, standardized data. Auto scored and interpreted score tests include the Generalized Anxiety Disorder 7-item, Center for Epidemiology Studies Depression Scale, Migraine Disability Assessment questionnaire, Insomnia Sleep Index, and Migraine-Specific Quality of Life. We have developed Best Practice Advisories (BPA) and other clinical documentation support tools that alert physicians, when appropriate. As of April 1, 2018, we have used the toolkits at 4346 initial patient visits. We provide screenshots of our toolkits, details of data fields collected, and diagnoses of patients at the initial visit.
      The EMR can be used to effectively structure and standardize headache clinic visits for quality improvement and practice-based research. We are sharing our proprietary toolkit with other clinics as part of the Neurology Practice-Based Research Network. These tools are also facilitating clinical research enrollment and a pragmatic trial of comparative effectiveness at the point-of-care among migraine patients.
      PMID: 30066412 [PubMed - as supplied by publisher]
    • The cingulate cortex of older adults with excellent memory capacity.

      Cortex; a journal devoted to the study of the nervous system and behavior 2017 01

      Authors: Lin F, Ren P, Mapstone M, Meyers SP, Porsteinsson A, Baran TM, Alzheimer's Disease Neuroimaging Initiative
      Memory deterioration is the earliest and most devastating cognitive deficit in normal aging and Alzheimer's disease (AD). Some older adults, known as "Supernormals", maintain excellent memory. This study examined relationships between cerebral amyloid deposition and functional connectivity (FC) within the cingulate cortex (CC) and between CC and other regions involved in memory maintenance between Supernormals, healthy controls (HC), and those at risk for AD (amnestic mild cognitive impairment [MCI]). Supernormals had significantly stronger FC between anterior CC and R-hippocampus, middle CC (MCC) and L-superior temporal gyrus, and posterior CC (PCC) and R-precuneus, while weaker FC between MCC and R-middle frontal gyrus and MCC and R-thalamus than other groups. All of these FC were significantly related to memory and global cognition in all participants. Supernormals had less amyloid deposition than other groups. Relationships between global cognition and FC were stronger among amyloid positive participants. Relationships between memory and FC remained regardless of amyloid level. This revealed how CC-related neural function participates in cognitive maintenance in the presence of amyloid deposition, potentially explaining excellent cognitive function among Supernormals.
      PMID: 27930899 [PubMed - as supplied by publisher]
    • Quality improvement and practice-based research in neurology using the electronic medical record.

      Neurology. Clinical practice 2015 Oct

      Authors: Maraganore DM, Frigerio R, Kazmi N, Meyers SL, Sefa M, Walters SA, Silverstein JC
      We describe quality improvement and practice-based research using the electronic medical record (EMR) in a community health system-based department of neurology. Our care transformation initiative targets 10 neurologic disorders (brain tumors, epilepsy, migraine, memory disorders, mild traumatic brain injury, multiple sclerosis, neuropathy, Parkinson disease, restless legs syndrome, and stroke) and brain health (risk assessments and interventions to prevent Alzheimer disease and related disorders in targeted populations). Our informatics methods include building and implementing structured clinical documentation support tools in the EMR; electronic data capture; enrollment, data quality, and descriptive reports; quality improvement projects; clinical decision support tools; subgroup-based adaptive assignments and pragmatic trials; and DNA biobanking. We are sharing EMR tools and deidentified data with other departments toward the creation of a Neurology Practice-Based Research Network. We discuss practical points to assist other clinical practices to make quality improvements and practice-based research in neurology using the EMR a reality.
      PMID: 26576324 [PubMed - as supplied by publisher]
    • Urinary bladder function and somatic sensitivity in vasoactive intestinal polypeptide (VIP)-/- mice.

      Journal of molecular neuroscience : MN 2008 Nov

      Authors: Studeny S, Cheppudira BP, Meyers S, Balestreire EM, Apodaca G, Birder LA, Braas KM, Waschek JA, May V, Vizzard MA
      Vasoactive intestinal polypeptide (VIP) is an immunomodulatory neuropeptide widely distributed in neural pathways that regulate micturition. VIP is also an endogenous anti-inflammatory agent that has been suggested for the development of therapies for inflammatory disorders. In the present study, we examined urinary bladder function and hindpaw and pelvic sensitivity in VIP(-/-) and littermate wildtype (WT) controls. We demonstrated increased bladder mass and fewer but larger urine spots on filter paper in VIP(-/-) mice. Using cystometry in conscious, unrestrained mice, VIP(-/-) mice exhibited increased void volumes and shorter intercontraction intervals with continuous intravesical infusion of saline. No differences in transepithelial resistance or water permeability were demonstrated between VIP(-/-) and WT mice; however, an increase in urea permeability was demonstrated in VIP(-/-) mice. With the induction of bladder inflammation by acute administration of cyclophosphamide, an exaggerated or prolonged bladder hyperreflexia and hindpaw and pelvic sensitivity were demonstrated in VIP(-/-) mice. The changes in bladder hyperreflexia and somatic sensitivity in VIP(-/-) mice may reflect increased expression of neurotrophins and/or proinflammatory cytokines in the urinary bladder. Thus, these changes may further regulate the neural control of micturition.
      PMID: 18561033 [PubMed - as supplied by publisher]
    • Liquid crystal thermography: quantitative studies of abnormalities in carpal tunnel syndrome.

      Neurology 1989 Nov

      Authors: Meyers S, Cros D, Sherry B, Vermeire P
      We performed liquid crystal thermography (LCT) in 38 normal hands and in 23 hands with carpal tunnel syndrome (CTS) documented by nerve conduction studies (NCS). Two of the authors unaware of the clinical situation read the 2 palmar thermograms taken at a 5-minute interval. They determined the absolute temperatures of the tip of digit 1 (D1), D2, D3, D4, D5, and of the thenar and hypothenar eminences. We calculated the temperature differences (absolute values throughout) between any 2 of these 7 sites, and computed the median index (MI = [D1 - D2] + [D1 - D3] + [D2 - D3]). Comparison of the control and CTS groups revealed greater temperature differences in CTS between D1 - D3, D1 - D4, D3 - D5, D4 - D5, and MI. There was a marked overlap between the 2 groups. Comparison of individual CTS hands with controls revealed definite thermographic abnormalities in 0 of 9 hands with mild NCS abnormalities, and in 7 of 14 hands with marked NCS abnormalities. These findings indicate that the sensitivity of LCT in CTS is low compared with NCS, and previous favorable reports concerning thermography in CTS may have been due to lack of control series or absence of quantitation.
      PMID: 2812323 [PubMed - as supplied by publisher]
    • Chemical changes in the cerebrospinal fluid and brain in magnesium deficiency.

      Neurology 1968 Oct

      PMID: 5748753 [PubMed - as supplied by publisher]
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