Berks County Medical Society Medical Record Fall 2019 - 32

Reading Hospital/Tower Health

Student Sum mer Research Projects
Serum Estradiol and
Testosterone Levels in
Postmenopausal Women
Treated with Pellet vs. FDA
by Xuezhi Jiang, Sneha Kamarajugadda, Cassandra
Mitchell, Anna Bossert, K. Nathan Parthasarathy,
Rhea Mathew, Shama Khan, Kristine Leaman, Shahab
Minassian, Peter F. Schnatz, Mark B. Woodland
OBJECTIVE: The objective of this study was to assess the serum
estradiol (E2) and total testosterone (T) levels in postmenopausal
women treated with non-FDA approved Pellet Hormonal Therapy
(PHT) and FDA approved Hormonal Therapy (FHT).
METHODS: A retrospective cohort study was designed to compare
two cohorts (PHT vs. FHT). A total of 539 postmenopausal women
with menopausal symptoms were identified from the Reading
Hospital Electronic Medical Record System through pharmacy
coding, including 384 on PHT (estradiol [E2, 6-37.5mg] and/or
testosterone [T,12-137.5 mg] pellets) and 155 on FHT. Data on
patient histories, demographics, side effects (e.g. abnormal uterine
bleeding [AUB], mood swing, anxiety, breast tenderness, change in
hair pattern, acne, weight gain), and endometrial pathology findings
have been previously presented by our group. Serum E2 and T
levels, treatment duration, and the number of lab follow-up were
extracted from medical records.
RESULTS: Women on PHT had significantly longer treatment
duration in years than those on FHT (mean [SD]: 3.92 [2.34] vs.
3.33[4.64], p<0.0001). Of 384 women on PHT, 373 (97.1%) had
serum E2 and T monitored at least once, with mean (SD) total
number of E2 and T follow-up of 6.81 (4.57) and 4.98 (3.52),
respectively. Of 155 women on FHT, 122 (78.8%) never had E2
and T tested during the treatment, with mean (SD) number of
E2 and T follow-up of 0.39 (0.86) and 0.14 (0.49), respectively.
Both mean (SD, Min-Max) highest E2 (pg/mL) and highest T (pg/

mL) are significantly higher in PHT group than those in FHT (E2:
237.70 (168.55, 10-1111) vs. 93.45 (130.77, 5.5-465.8), T: 192.84
(82.31, 4.3-475) vs. 15.59 (19.52, 0.2-70), P<0.00001). Of those
on PHT, 4 women had E2 level > 1000 pg/mL and 9 women with T
level > 400 pg/mL.
CONCLUSION: When compared with women on FDA-HT,
women on PHT had a significantly higher and abnormal level of
peak E2 and T during the treatment. Although most women had E2
and T tested when they were on PHT, the frequency of laboratory
monitoring was still lower than expected.
Sneha Kamarajugadda is a graduate of Drexel University
and is now in the Class of 2022 of the Drexel University
College of Medicine. While at Drexel, she has been a
Research Assistant in a lab focused on understanding the
mechanisms behind development of chronic pain and
discovering drug targets for its treatment. Earlier this year
she was selected to serve as philanthropy chair Drexel
University College of Medicine's chapter of the American
Medical Women's Association.

GERT as an Early Predictor of
Communication Skills in
IM Residents
by Anthony Donato, MD; Sarah Luber, MD;
Thayjas Patil
Department of Medicine, Reading Hospital
Tower Health, Reading, PA
INTRODUCTION: In an effort to assess the validity of the Geneva
Emotion Recognition Test (GERT) as an early predictor of
communication skills, the Reading Hospital is collecting validity
evidence for the GERT in a population of internal medicine
residents. The GERT is a short assessment of skill in recognizing
non-verbal cues in a series of actors performed online, and it will be
compared to both verbal and non-verbal communication skills of the
internal medicine residents.
METHODS: All residents completed the GERT in September
of 2018. Results of the GERT will be compared to residents'
communication skills by performing a qualitative review of existing
feedback tools including rotation evaluations, weekly written
resident performance handoff, CEX (a direct observation tool),
peer evaluations, patient evaluations, and QI evaluations. A total
of 12 months' worth of evaluations, from June 2018 to May 2019,
was included from 42 residents. Each unique comment regarding
communication skills was noted, as well as whether the comment
was positive or negative. Communication was further divided
into both verbal and non-verbal communication. When scoring,

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Berks County Medical Society Medical Record Fall 2019

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