Steven Lin

Journal Articles

• Renewing US medical students' interest in primary care: bridging the role model gap POSTGRADUATE MEDICAL JOURNAL Teng, V. C., Lin, S. Y. 2014; 90 (1059): 1-2

  View details for DOI 10.1136/postgradmedj-2013-131802

• The Symptom Cluster-Based Approach to Individualize Patient-Centered Treatment for Major Depression JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE Lin, S. Y., Stevens, M. B. 2014; 27 (1): 151-159

  Abstract

  Unipolar major depressive disorder is a common, disabling, and costly disease that is the leading cause of ill health, early death, and suicide in the United States. Primary care doctors, in particular family physicians, are the first responders in this silent epidemic. Although more than a dozen different antidepressants in 7 distinct classes are widely used to treat depression in primary care, there is no evidence that one drug is superior to another. Comparative effectiveness studies have produced mixed results, and no specialty organization has published recommendations on how to choose antidepressants in a rational, evidence-based manner. In this article we present the theory and evidence for an individualized, patient-centered treatment model for major depression designed around a targeted symptom cluster-based approach to antidepressant selection. When using this model for healthy adults with major depressive disorder, the choice of antidepressants should be guided by the presence of 1 of 4 common symptom clusters: anxiety, fatigue, insomnia, and pain. This model was built to foster future research, provide a logical framework for teaching residents how to select antidepressants, and equip primary care doctors with a structured treatment strategy to deliver optimal patient-centered care in the management of a debilitating disease: major depressive disorder.

  View details for DOI 10.3122/jabfm.2014.01.130145

  View details for Web of Science ID 000329292000021

  View details for PubMedID 24390897

• Stopping a Silent Killer in the Underserved Asian and Pacific Islander Community: A Chronic Hepatitis B and Liver Cancer Prevention Clinic by Medical Students ASIAN PACIFIC JOURNAL OF CANCER PREVENTION Lin, S. Y., Chang, E. T., So, S. K. 2009; 10 (3): 383-386

  Abstract

  To assess and alleviate the burden of chronic hepatitis B virus (HBV) infection among low-income, uninsured Asian and Pacific Islanders (APIs) in San Jose, California.From 2007 to 2008, we provided free HBV testing and follow-up to 510 patients, 74% of whom were foreign-born Vietnamese. Patients were tested for hepatitis B surface antigen and surface antibody. Chronically infected patients who elected to undergo follow-up monitoring were evaluated for liver damage (ALT), liver cancer (AFP), and HBV replication (HBV DNA).Overall, 17% were chronically infected; 33% of these were unaware that they were infected. Of those who underwent follow-up monitoring, 100% had elevated ALT, 9% had elevated AFP, and 24% had HBV DNA levels that exceeded the threshold for treatment. Patients who were candidates for antiviral therapy were enrolled in drug assistance programs, and those with elevated AFP levels were referred for CT scans. Uninfected patients lacking protective antibodies were provided free HBV vaccinations.More liver cancer prevention in the medically underserved API community is needed, including universal screening for HBV and follow-up for those chronically infected.

  View details for Web of Science ID 000270750100011

  View details for PubMedID 19640178

• Building partnerships with Traditional Chinese Medicine Practitioners to increase hepatitis B awareness and prevention JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Chang, E. T., Lin, S. Y., Sue, E., Bergin, M., Su, J., So, S. K. 2007; 13 (10): 1125-1127

  Abstract

  The annual Hepatitis B Prevention and Education Symposium aims to develop partnerships between non-Western and Western health care providers to prevent chronic hepatitis B virus (HBV) infection and death from liver cancer among Asians and Pacific Islanders (APIs).Each year from 2004 through 2007, we partnered with professional, academic, and community-based organizations to organize an educational symposium for Traditional Chinese Medicine practitioners and acupuncturists in California. Participants completed pre- and postsymposium surveys assessing knowledge about HBV and liver cancer.The symposia were held in San Francisco, Los Angeles, and Stanford, California.Over 1000 participants attended the four symposia combined; most were born in Asia.Symposium activities included educational lectures and games, presentation of a physician's guide to HBV management, and case studies.Chi-square tests were used to compare the proportion of correct responses to each knowledge-based question, as well as the total number of correct responses, before and after the symposium.Knowledge about HBV and liver cancer was low prior to the symposium. The proportion of correct responses to the most commonly mistaken questions increased significantly at the conclusion of each symposium. The total number of correct responses rose from below 60% to above 75% each year.Similar educational symposia targeting health care providers who serve API patients can improve HBV and liver cancer awareness and prevention throughout the API community.

  View details for DOI 10.1089/acm.2007.0655

  View details for Web of Science ID 000252247200014

  View details for PubMedID 18166125

• Why we should routinely screen Asian American adults for hepatitis B: A cross-sectional study of Asians in California HEPATOLOGY Lin, S. Y., Chang, E. T., So, S. K. 2007; 46 (4): 1034-1040

  Abstract

  Chronic hepatitis B virus (HBV) infection is a serious liver disease that, if left undiagnosed or without appropriate medical management, is associated with a 25% chance of death from cirrhosis or liver cancer. To study the demographics and prevalence of chronic HBV infection and HBV vaccination in the Asian American population, we provided free HBV serological screening and administered a survey to 3163 Asian American adult volunteers in the San Francisco Bay Area between 2001 and 2006. Of those screened, 8.9% were chronically infected with HBV. Notably, one-half to two-thirds (65.4%) of the chronically infected adults were unaware that they were infected. Of those who were not chronically infected, 44.8% lacked protective antibodies against HBV and were likely susceptible to future infection. Men were twice as likely as women to be chronically infected (12.1% versus 6.4%). Asian Americans born in East Asia, Southeast Asia, or the Pacific Islands were 19.4 times more likely to be chronically infected than those born in the United States. Self-reporting of prior vaccination was unreliable to assess protection against HBV. Among the 12% who reported having been vaccinated, 5.2% were chronically infected, and 20.3% lacked protective antibodies.Given the high prevalence of unrecognized chronic HBV infection in the Asian American population, we call for healthcare providers to routinely screen Asian adults for HBV, regardless of their vaccination status. Those who test positive should be provided with culturally appropriate information to prevent disease transmission and proper medical management to reduce their risk of liver disease.

  View details for DOI 10.1002/hep.21784

  View details for Web of Science ID 000249910500013

  View details for PubMedID 17654490

• Hepatitis B and liver cancer knowledge and preventive practices among Asian Americans in the San Francisco Bay Area, California ASIAN PACIFIC JOURNAL OF CANCER PREVENTION Wu, C. A., Lin, S. Y., So, S. K., Chang, E. T. 2007; 8 (1): 127-134

  Abstract

  Chronic hepatitis B virus (HBV) infection causes liver cancer and disproportionately affects the Asian community in the U.S. In order to advance HBV and liver cancer awareness and prevention, it is important to identify existing gaps in knowledge and preventive practices among Asian Americans. Therefore, the authors administered a written questionnaire to 199 adults in the Asian-American community of the San Francisco Bay Area, California. Although the majority of adults had at least a college education, knowledge regarding HBV transmission, prevention, symptoms, risks, and occurrence was low. Fewer than 60% reported having been tested for HBV, only 31% reported having been vaccinated against HBV, and only 44% reported having had their children vaccinated. Asians, especially those born in China or Southeast Asia, had significantly poorer knowledge regarding HBV and liver cancer than non-Asians. Those with higher knowledge levels were significantly more likely to have been tested for HBV and to have had their children vaccinated. Younger adults, women, Caucasians, more highly educated individuals, those not born in China or Hong Kong, and those with a personal or family history of liver disease were more likely to have taken preventive action against HBV. Our results suggest that HBV and liver cancer knowledge among Asian Americans, especially Chinese Americans, is poor, and that better knowledge is associated with increased preventive practices. Thus, there is a need for increased HBV education and improved community-based interventions to prevent HBV-related liver disease in the high-risk Asian-American community.

  View details for Web of Science ID 000253887000026

  View details for PubMedID 17477787