Wearable motion-based platform for functional spine health assessment
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作者:
Mageswaran, Prasath
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机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USA
Ohio State Univ, Columbus, OH 43210 USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Mageswaran, Prasath
[1
,6
]
Dufour, Jonathan
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Dufour, Jonathan
[1
]
Aurand, Alexander
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Aurand, Alexander
[1
]
Knapik, Gregory
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Knapik, Gregory
[1
]
Hani, Hamed
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Hani, Hamed
[1
]
Blakaj, Dukagjin M.
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USA
Ohio State Univ, Comprehens Canc Ctr, Wexner Med Ctr, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Blakaj, Dukagjin M.
[1
,2
]
Khan, Safdar
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USA
Ohio State Univ, Wexner Med Ctr, Orthoped, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Khan, Safdar
[1
,3
]
Hussain, Nasir
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Hussain, Nasir
[1
]
Tiwari, Maneesh
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Tiwari, Maneesh
[1
]
Vallabh, Jayesh
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USA
Ohio State Univ, Wexner Med Ctr, Phys Med & Rehabil, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Vallabh, Jayesh
[1
,4
]
Weaver, Tristan
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USA
Ohio State Univ, Wexner Med Ctr, Anesthesiol, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Weaver, Tristan
[1
,5
]
Marras, William S.
论文数: 0引用数: 0
h-index: 0
机构:
Ohio State Univ, Spine Res Inst, Columbus, OH USAOhio State Univ, Spine Res Inst, Columbus, OH USA
Marras, William S.
[1
]
机构:
[1] Ohio State Univ, Spine Res Inst, Columbus, OH USA
[2] Ohio State Univ, Comprehens Canc Ctr, Wexner Med Ctr, Columbus, OH USA
[3] Ohio State Univ, Wexner Med Ctr, Orthoped, Columbus, OH USA
[4] Ohio State Univ, Wexner Med Ctr, Phys Med & Rehabil, Columbus, OH USA
[5] Ohio State Univ, Wexner Med Ctr, Anesthesiol, Columbus, OH USA
IntroductionLow back pain is a significant burden to society and the lack of reliable outcome measures, combined with a prevailing inability to quantify the biopsychosocial elements implicated in the disease, impedes clinical decision-making and distorts treatment efficacy. This paper aims to validate the utility of a biopsychosocial spine platform to provide standardized wearable sensor-derived functional motion assessments to assess spine function and differentiate between healthy controls and patients. Secondarily, we explored the correlation between these motion features and subjective biopsychosocial measures.MethodsAn observational study was conducted on healthy controls (n=50) and patients with low back pain (n=50) to validate platform utility. The platform was used to conduct functional assessments along with patient-reported outcome assessments to holistically document cohort differences. Our primary outcomes were motion features; and our secondary outcomes were biopsychosocial measures (pain, function, etc).ResultsOur results demonstrated statistically significant differences in motion features between healthy and patient cohorts across anatomical planes. Importantly, we found velocity and acceleration in the axial plane showed the largest difference, with healthy controls having 49.7% and 55.7% higher values, respectively, than patients. In addition, we found significant correlations between motion features and biopsychosocial measures for pain, physical function and social role only.ConclusionsOur study validated the use of wearable sensor-derived functional motion metrics in differentiating healthy controls and patients. Collectively, this technology has the potential to facilitate holistic biopsychosocial evaluations to enhance spine care and improve patient outcomes.Trial registration numberNCT05776771.
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Amtmann, Dagmar
;
Cook, Karon F.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Cook, Karon F.
;
Jensen, Mark P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Jensen, Mark P.
;
Chen, Wen-Hung
论文数: 0引用数: 0
h-index: 0
机构:
United BioSource Corp, Ctr Hlth Outcomes Res, Bethesda, MD USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Chen, Wen-Hung
;
Choi, Seung
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Choi, Seung
;
Revicki, Dennis
论文数: 0引用数: 0
h-index: 0
机构:
United BioSource Corp, Ctr Hlth Outcomes Res, Bethesda, MD USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Revicki, Dennis
;
Cella, David
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Cella, David
;
Rothrock, Nan
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Rothrock, Nan
;
Keefe, Francis
论文数: 0引用数: 0
h-index: 0
机构:
Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA
Duke Univ, Dept Anesthesiol, Durham, NC USA
Duke Univ, Dept Med, Durham, NC USA
Duke Univ, Dept Psychol & Neurosci, Durham, NC USA
Duke Univ, Med Ctr, Durham, NC USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Keefe, Francis
;
Callahan, Leigh
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Dept Med, Chapel Hill, NC USA
Univ N Carolina, Dept Orthopaed, Chapel Hill, NC USA
Univ N Carolina, Dept Social Med, Chapel Hill, NC USA
Univ N Carolina, Thurston Arthrit Res Ctr, Chapel Hill, NC USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Callahan, Leigh
;
Lai, Jin-Shei
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
机构:
Univ Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
Brodke, Dane Jensen
;
Saltzman, Charles L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
Saltzman, Charles L.
;
Brodke, Darrel Scott
论文数: 0引用数: 0
h-index: 0
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
机构:
Keele Univ, Res Inst Primary Care & Hlth Sci, Arthrit Res UK Primary Care Ctr, Keele, Staffs, EnglandMonash Univ, Cabrini Inst, Monash Cabrini Dept Clin Epidemiol, Malvern, Vic 3144, Australia
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Cook, Karon F.
;
Jensen, Sally E.
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Northwestern Univ, Feinberg Sch Med, Dept Surg, Div Organ Transplant, 251 E Huron,Galter 3-150, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Jensen, Sally E.
;
Schalet, Benjamin D.
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h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Schalet, Benjamin D.
;
Beaumont, Jennifer L.
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Beaumont, Jennifer L.
;
Arntmand, Dagmar
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Sch Med, Dept Rehabil Med, 4907 25th Ave NE, Seattle, WA 98105 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Arntmand, Dagmar
;
Czajkowski, Susan
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h-index: 0
机构:
NHLBI, Bldg 31,Room 5A52,31 Ctr Dr MSC 2486, Bethesda, MD 20892 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Czajkowski, Susan
;
Dewalt, Darren A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Sch Med, Div Gen Internal Med, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USA
Univ N Carolina, Sch Med, Cecil G Sheps Ctr Hlth Serv Res, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Dewalt, Darren A.
;
Fries, James F.
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h-index: 0
机构:
Stanford Univ, Sch Med, Dept Med, 300 Pasteur Dr H3580, Stanford, CA 94305 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Fries, James F.
;
Pilkonis, Paul A.
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h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Psychiat, 3811 OHara St, Pittsburgh, PA 15213 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Pilkonis, Paul A.
;
Reeve, Bryce B.
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h-index: 0
机构:
Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Policy & Management, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Reeve, Bryce B.
;
Stone, Arthur A.
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h-index: 0
机构:
Univ So Calif, 635 Downey Way, Los Angeles, CA USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Stone, Arthur A.
;
Weinfurt, Kevin P.
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h-index: 0
机构:
Duke Univ, Sch Med, Dept Psychiat, 2400 Pratt St, Durham, NC 27705 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Weinfurt, Kevin P.
;
Cella, David
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h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Amtmann, Dagmar
;
Cook, Karon F.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Cook, Karon F.
;
Jensen, Mark P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Jensen, Mark P.
;
Chen, Wen-Hung
论文数: 0引用数: 0
h-index: 0
机构:
United BioSource Corp, Ctr Hlth Outcomes Res, Bethesda, MD USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Chen, Wen-Hung
;
Choi, Seung
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Choi, Seung
;
Revicki, Dennis
论文数: 0引用数: 0
h-index: 0
机构:
United BioSource Corp, Ctr Hlth Outcomes Res, Bethesda, MD USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Revicki, Dennis
;
Cella, David
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Cella, David
;
Rothrock, Nan
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Rothrock, Nan
;
Keefe, Francis
论文数: 0引用数: 0
h-index: 0
机构:
Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA
Duke Univ, Dept Anesthesiol, Durham, NC USA
Duke Univ, Dept Med, Durham, NC USA
Duke Univ, Dept Psychol & Neurosci, Durham, NC USA
Duke Univ, Med Ctr, Durham, NC USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Keefe, Francis
;
Callahan, Leigh
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Dept Med, Chapel Hill, NC USA
Univ N Carolina, Dept Orthopaed, Chapel Hill, NC USA
Univ N Carolina, Dept Social Med, Chapel Hill, NC USA
Univ N Carolina, Thurston Arthrit Res Ctr, Chapel Hill, NC USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
Callahan, Leigh
;
Lai, Jin-Shei
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USAUniv Washington, Dept Rehabil Med, Seattle, WA 98195 USA
机构:
Univ Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
Brodke, Dane Jensen
;
Saltzman, Charles L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
Saltzman, Charles L.
;
Brodke, Darrel Scott
论文数: 0引用数: 0
h-index: 0
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Calif San Francisco, Sch Med, Dept Orthopaed Surg, San Francisco, CA 94143 USA
机构:
Keele Univ, Res Inst Primary Care & Hlth Sci, Arthrit Res UK Primary Care Ctr, Keele, Staffs, EnglandMonash Univ, Cabrini Inst, Monash Cabrini Dept Clin Epidemiol, Malvern, Vic 3144, Australia
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Cook, Karon F.
;
Jensen, Sally E.
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Northwestern Univ, Feinberg Sch Med, Dept Surg, Div Organ Transplant, 251 E Huron,Galter 3-150, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Jensen, Sally E.
;
Schalet, Benjamin D.
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Schalet, Benjamin D.
;
Beaumont, Jennifer L.
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Beaumont, Jennifer L.
;
Arntmand, Dagmar
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Sch Med, Dept Rehabil Med, 4907 25th Ave NE, Seattle, WA 98105 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Arntmand, Dagmar
;
Czajkowski, Susan
论文数: 0引用数: 0
h-index: 0
机构:
NHLBI, Bldg 31,Room 5A52,31 Ctr Dr MSC 2486, Bethesda, MD 20892 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Czajkowski, Susan
;
Dewalt, Darren A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Sch Med, Div Gen Internal Med, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USA
Univ N Carolina, Sch Med, Cecil G Sheps Ctr Hlth Serv Res, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Dewalt, Darren A.
;
Fries, James F.
论文数: 0引用数: 0
h-index: 0
机构:
Stanford Univ, Sch Med, Dept Med, 300 Pasteur Dr H3580, Stanford, CA 94305 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Fries, James F.
;
Pilkonis, Paul A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Psychiat, 3811 OHara St, Pittsburgh, PA 15213 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Pilkonis, Paul A.
;
Reeve, Bryce B.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Policy & Management, CB 7590,725 Martin Luther King Jr Blvd, Chapel Hill, NC 27599 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Reeve, Bryce B.
;
Stone, Arthur A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ So Calif, 635 Downey Way, Los Angeles, CA USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Stone, Arthur A.
;
Weinfurt, Kevin P.
论文数: 0引用数: 0
h-index: 0
机构:
Duke Univ, Sch Med, Dept Psychiat, 2400 Pratt St, Durham, NC 27705 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA
Weinfurt, Kevin P.
;
Cella, David
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USANorthwestern Univ, Feinberg Sch Med, Dept Med Social Sci, 633 N St Clair,19th Floor, Chicago, IL 60611 USA