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https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#1
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28611187/comparing-outcomes-of-coronary-artery-bypass-grafting-among-large-teaching-and-urban-hospitals-in-china-and-the-united-states
#2
Zhe Zheng, Heng Zhang, Xin Yuan, Chenfei Rao, Yan Zhao, Yun Wang, Sharon-Lise Normand, Harlan M Krumholz, Shengshou Hu
BACKGROUND: Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. METHODS AND RESULTS: Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28593267/national-trends-in-use-and-outcomes-of-pulmonary-artery-catheters-among-medicare-beneficiaries-1999-2013
#3
Kevin Ikuta, Yun Wang, Austin Robinson, Tariq Ahmad, Harlan M Krumholz, Nihar R Desai
Importance: Recent studies have observed an increase in the rate of pulmonary artery catheter (PAC) use in heart failure admissions. Little is known about the national trends in other previously common indications for PAC placement, PAC use overall, or outcomes associated with PAC placement. Objective: To determine national trends in PAC use overall as well as across sociodemographic groups and key clinical conditions, including acute myocardial infarction, heart failure, and respiratory failure...
June 7, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28569419/regulating-drivers-with-epilepsy-in-maryland-results-of-the-application-of-a-united-states-consensus-guideline
#4
Brandy B Ma, John Bloch, Allan Krumholz, Jennifer L Hopp, Perry J Foreman, Carl A Soderstrom, Mary A Scottino, Martha Matsumoto, Gregory L Krauss
OBJECTIVE: Driving regulations for people with seizures vary widely throughout the United States and the world. Maryland updated their guidelines in 2003 to reflect those of a U.S. consensus guideline requiring a minimum 3-month seizure-free period as well as an individual risk assessment by a Medical Advisory Board (MAB). This retrospective study provides the first analysis of outcomes after the implementation of the consensus guidelines and an assessment of their predictive validity through longitudinal outcome data...
June 1, 2017: Epilepsia
https://www.readbyqxmd.com/read/28559399/heterogeneity-in-early-responses-in-allhat-antihypertensive-and-lipid-lowering-treatment-to-prevent-heart-attack-trial
#5
Sanket S Dhruva, Chenxi Huang, Erica S Spatz, Andreas C Coppi, Frederick Warner, Shu-Xia Li, Haiqun Lin, Xiao Xu, Curt D Furberg, Barry R Davis, Sara L Pressel, Ronald R Coifman, Harlan M Krumholz
Randomized trials of hypertension have seldom examined heterogeneity in response to treatments over time and the implications for cardiovascular outcomes. Understanding this heterogeneity, however, is a necessary step toward personalizing antihypertensive therapy. We applied trajectory-based modeling to data on 39 763 study participants of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to identify distinct patterns of systolic blood pressure (SBP) response to randomized medications during the first 6 months of the trial...
July 2017: Hypertension
https://www.readbyqxmd.com/read/28548291/practitioner-review-empirical-evolution-of-youth-psychotherapy-toward-transdiagnostic-approaches
#6
REVIEW
Lauren Krumholz Marchette, John R Weisz
BACKGROUND: Psychotherapy for children and adolescents (herein, 'youths') has grown more precise and focused over the decades, shifting toward empirically supported treatments standardized via therapist manuals. The manuals have increasingly emphasized precise targeting of single disorders or problems, or homogenous clusters. These focal treatments represent a valuable advance, with intervention benefit documented in hundreds of studies. However, relatively few of these treatments are widely used in everyday clinical practice, and their level of benefit may not be ideal, particularly in practice contexts and when compared to usual clinical care...
May 26, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28516505/associations-between-nursing-home-performance-and-hospital-30-day-readmissions-for-acute-myocardial-infarction-heart-failure-and-pneumonia-at-the-healthcare-community-level-in-the-united-states
#7
Michelle M Pandolfi, Yun Wang, Ann Spenard, Florence Johnson, Alice Bonner, Shih-Yieh Ho, Timothy Elwell, Anila Bakullari, Deron Galusha, Erica Leifheit-Limson, Judith H Lichtman, Harlan M Krumholz
OBJECTIVES: To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. DESIGN: Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System...
May 17, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28506980/sex-differences-in-trajectories-of-risk-after-rehospitalization-for-heart-failure-acute-myocardial-infarction-or-pneumonia
#8
Rachel P Dreyer, Kumar Dharmarajan, Angela F Hsieh, John Welsh, Li Qin, Harlan M Krumholz
BACKGROUND: Women have an increased risk of rehospitalization in the immediate postdischarge period; however, few studies have determined how readmission risk dynamically changes on a day-to-day basis over the full year after hospitalization by sex and how these differences compare with the risk for mortality. METHODS AND RESULTS: We identified >3 000 000 hospitalizations of patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia and estimated sex differences in the daily risk of rehospitalization/death 1 year after discharge from a population of Medicare fee-for-service beneficiaries aged 65 years and older...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28493548/time-for-a-new-approach-to-studying-older-people-with-ischemic-heart-disease
#9
EDITORIAL
John A Dodson, Sarwat I Chaudhry, Harlan M Krumholz
No abstract text is available yet for this article.
May 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28492899/postmarket-safety-events-among-novel-therapeutics-approved-by-the-us-food-and-drug-administration-between-2001-and-2010
#10
Nicholas S Downing, Nilay D Shah, Jenerius A Aminawung, Alison M Pease, Jean-David Zeitoun, Harlan M Krumholz, Joseph S Ross
Importance: Postmarket safety events of novel pharmaceuticals and biologics occur when new safety risks are identified after initial regulatory approval of these therapeutics. These safety events can change how novel therapeutics are used in clinical practice and inform patient and clinician decision making. Objectives: To characterize the frequency of postmarket safety events among novel therapeutics approved by the US Food and Drug Administration (FDA), and to examine whether any novel therapeutic characteristics known at the time of FDA approval were associated with increased risk...
May 9, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28468750/postapproval-studies-of-drugs-initially-approved-by-the-fda-on-the-basis-of-limited-evidence-systematic-review
#11
REVIEW
Alison M Pease, Harlan M Krumholz, Nicholas S Downing, Jenerius A Aminawung, Nilay D Shah, Joseph S Ross
Objective To characterize the prospective controlled clinical studies for all novel drugs that were initially approved by the Food and Drug Administration on the basis of limited evidence.Design Systematic review.Data sources Drugs@FDA database and PubMed.Study inclusion All prospective controlled clinical studies published after approval for all novel drugs initially approved by the FDA between 2005 and 2012 on the basis of a single pivotal trial, pivotal trials that used surrogate markers of disease as primary endpoints, or both...
May 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28461415/living-longer-in-good-cardiovascular-health-prevention-and-wellness-makes-economic-cents
#12
EDITORIAL
Khurram Nasir, Brian Keeley, Harlan M Krumholz
No abstract text is available yet for this article.
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28446493/hospital-performance-on-percutaneous-coronary-intervention-process-and-outcomes-measures
#13
Philip W Chui, Craig S Parzynski, Brahmajee K Nallamothu, Frederick A Masoudi, Harlan M Krumholz, Jeptha P Curtis
BACKGROUND: The Physician Consortium for Performance Improvement recently proposed percutaneous coronary intervention (PCI)-specific process measures. However, information about hospital performance on these measures and the association of PCI process and outcomes measures are not available. METHODS AND RESULTS: We linked the National Cardiovascular Data Registry (NCDR) CathPCI Registry with Medicare claims data to assess hospital performance on established PCI process measures (aspirin, thienopyridines, and statins on discharge; door-to-balloon time; and referral to cardiac rehabilitation), newly proposed PCI process measures (documentation of contrast dose, glomerular filtration rate, and PCI indication; appropriate indication for elective PCI; and use of embolic protection device), and a composite of all process measures...
April 26, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28420352/assessing-the-reliability-of-self-reported-weight-for-the-management-of-heart-failure-application-of-fraud-detection-methods-to-a-randomised-trial-of-telemonitoring
#14
Adam Steventon, Sarwat I Chaudhry, Zhenqiu Lin, Jennifer A Mattera, Harlan M Krumholz
BACKGROUND: Since clinical management of heart failure relies on weights that are self-reported by the patient, errors in reporting will negatively impact the ability of health care professionals to offer timely and effective preventive care. Errors might often result from rounding, or more generally from individual preferences for numbers ending in certain digits, such as 0 or 5. We apply fraud detection methods to assess preferences for numbers ending in these digits in order to inform medical decision making...
April 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28384834/prime-time-for-shared-decision-making
#15
Erica S Spatz, Harlan M Krumholz, Benjamin W Moulton
No abstract text is available yet for this article.
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28384786/data-escrow-and-clinical-trial-transparency
#16
Harlan M Krumholz, Jeanie Kim
No abstract text is available yet for this article.
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28373270/patient-provider-communication-and-health-outcomes-among-individuals-with-atherosclerotic-cardiovascular-disease-in-the-united-states-medical-expenditure-panel-survey-2010-to-2013
#17
Victor Okunrintemi, Erica S Spatz, Paul Di Capua, Joseph A Salami, Javier Valero-Elizondo, Haider Warraich, Salim S Virani, Michael J Blaha, Ron Blankstein, Adeel A Butt, William B Borden, Kumar Dharmarajan, Henry Ting, Harlan M Krumholz, Khurram Nasir
BACKGROUND: Consumer-reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative US adult population with established atherosclerotic cardiovascular disease. METHODS AND RESULTS: The study population consisted of a nationally representative sample of 6810 individuals (aged ≥18 years), representing 18...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28359737/a-flow-cytometric-method-to-evaluate-eosinophil-mediated-uptake-of-probiotic-lactobacillus-reuteri
#18
Laura S Kraemer, Todd A Brenner, Julia O Krumholz, Helene F Rosenberg
Eosinophils are resident leukocytes of gut mucosa. Here we present a combined flow cytometric-antibiotic protection assay to identify mouse eosinophils capable of bacterial uptake, specifically, Gram-positive Lactobacillus reuteri, in studies performed ex vivo. The assay may be adapted for use in vivo.
June 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28355219/discovery-of-temporal-and-disease-association-patterns-in-condition-specific-hospital-utilization-rates
#19
Julian S Haimovich, Arjun K Venkatesh, Abbas Shojaee, Andreas Coppi, Frederick Warner, Shu-Xia Li, Harlan M Krumholz
Identifying temporal variation in hospitalization rates may provide insights about disease patterns and thereby inform research, policy, and clinical care. However, the majority of medical conditions have not been studied for their potential seasonal variation. The objective of this study was to apply a data-driven approach to characterize temporal variation in condition-specific hospitalizations. Using a dataset of 34 million inpatient discharges gathered from hospitals in New York State from 2008-2011, we grouped all discharges into 263 clinical conditions based on the principal discharge diagnosis using Clinical Classification Software in order to mitigate the limitation that administrative claims data reflect clinical conditions to varying specificity...
2017: PloS One
https://www.readbyqxmd.com/read/28345539/admission-glucose-and-in-hospital-mortality-after-acute-myocardial-infarction-in-patients-with-or-without-diabetes-a-cross-sectional-study
#20
Shi Zhao, Karthik Murugiah, Na Li, Xi Li, Zi-Hui Xu, Jing Li, Chen Cheng, Hong Mao, Nicholas S Downing, Harlan M Krumholz, Li-Xin Jiang
BACKGROUND: Hyperglycemia on admission has been found to elevate risk for mortality and adverse clinical events after acute myocardial infarction (AMI), but there are evidences that the relationship of blood glucose and mortality may differ between diabetic and nondiabetic patients. Prior studies in China have provided mixed results and are limited by statistical power. Here, we used data from a large, nationally representative sample of patients hospitalized with AMI in China in 2001, 2006, and 2011 to assess if admission glucose is of prognostic value in China and if this relationship differs depending on the presence or absence of diabetes...
April 5, 2017: Chinese Medical Journal
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