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https://www.readbyqxmd.com/read/28330750/real-world-data-on-heart-failure-readmission-reduction-real-or-real-uncertain
#1
EDITORIAL
Harlan M Krumholz, Sanket S Dhruva
No abstract text is available yet for this article.
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28325713/two-decades-of-cardiovascular-trials-with-primary-surrogate-endpoints-1990-2011
#2
Behnood Bikdeli, Natdanai Punnanithinont, Yasir Akram, Ike Lee, Nihar R Desai, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Surrogate endpoint trials test strategies more efficiently but are accompanied by uncertainty about the relationship between changes in surrogate markers and clinical outcomes. METHODS AND RESULTS: We identified cardiovascular trials with primary surrogate endpoints published in the New England Journal of Medicine, Lancet, and JAMA: Journal of the American Medical Association from 1990 to 2011 and determined the trends in publication of surrogate endpoint trials and the success of the trials in meeting their primary endpoints...
March 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28319580/hospital-characteristics-associated-with-risk-standardized-readmission-rates
#3
Leora I Horwitz, Susannah M Bernheim, Joseph S Ross, Jeph Herrin, Jacqueline N Grady, Harlan M Krumholz, Elizabeth E Drye, Zhenqiu Lin
BACKGROUND: Safety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions. OBJECTIVE: To examine the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR). DESIGN: This is a retrospective cross-sectional multivariable analysis...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28287993/prediction-of-adverse-events-in-patients-undergoing-major-cardiovascular-procedures
#4
Bobak Mortazavi, Nihar Desai, Jing Zhang, Andreas Coppi, Frederick Warner, Harlan Krumholz, Sahand Negahban
Electronic health records (EHR) provide opportunities to leverage vast arrays of data to help prevent adverse events, improve patient outcomes, and reduce hospital costs. This work develops a postoperative complications prediction system by extracting data from the EHR and creating features. The analytic engine then provides model accuracy, calibration, feature ranking, and personalized feature responses. This allows clinicians to interpret the likelihood of an adverse event occurring, general causes for these events, and the contributing factors for each specific patient...
March 1, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28278602/components-analyses-of-a-school-based-cognitive-behavioral-treatment-for-youth-depression
#5
Prerna G Arora, Courtney N Baker, Lauren Krumholz Marchette, Kevin D Stark
The current study sought to build upon research on cognitive behavioral therapy (CBT) as the first-line treatment for depressed youth by investigating the effects of the various components of a CBT treatment on changes in depressive symptoms in young female participants. Female participants 9-14 years of age (n = 40; M age = 10.58 years) with a diagnosis of a depressive disorder from the CBT-only treatment condition of a larger randomized clinical trial were included in the current study. Participants engaged in a 20-session, 11-week, school-based CBT group intervention (ACTION Treatment; Stark et al...
February 16, 2017: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/28263938/analysis-of-machine-learning-techniques-for-heart-failure-readmissions
#6
Bobak J Mortazavi, Nicholas S Downing, Emily M Bucholz, Kumar Dharmarajan, Ajay Manhapra, Shu-Xia Li, Sahand N Negahban, Harlan M Krumholz
BACKGROUND: The current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. METHODS AND RESULTS: Using data from the Telemonitoring to Improve Heart Failure Outcomes trial, we compared the effectiveness of random forests, boosting, random forests combined hierarchically with support vector machines or logistic regression (LR), and Poisson regression against traditional LR to predict 30- and 180-day all-cause readmissions and readmissions because of heart failure...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28263935/the-promise-of-big-data-opportunities-and-challenges
#7
EDITORIAL
Harlan M Krumholz
No abstract text is available yet for this article.
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28241180/reevaluating-the-efficacy-and-predictability-of-antidepressant-treatments-a-symptom-clustering-approach
#8
Adam M Chekroud, Ralitza Gueorguieva, Harlan M Krumholz, Madhukar H Trivedi, John H Krystal, Gregory McCarthy
Importance: Depressive severity is typically measured according to total scores on questionnaires that include a diverse range of symptoms despite convincing evidence that depression is not a unitary construct. When evaluated according to aggregate measurements, treatment efficacy is generally modest and differences in efficacy between antidepressant therapies are small. Objectives: To determine the efficacy of antidepressant treatments on empirically defined groups of symptoms and examine the replicability of these groups...
February 22, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28228461/sex-differences-in-inflammatory-markers-and-health-status-among-young-adults-with-acute-myocardial-infarction-results-from-the-virgo-variation-in-recovery-role-of-gender-on-outcomes-of-young-acute-myocardial-infarction-patients-study
#9
Yuan Lu, Shengfan Zhou, Rachel P Dreyer, Erica S Spatz, Mary Geda, Nancy P Lorenze, Gail D'Onofrio, Judith H Lichtman, John A Spertus, Paul M Ridker, Harlan M Krumholz
BACKGROUND: Young women (≤55 years of age) with acute myocardial infarction (AMI) have higher mortality risk than similarly aged men. Elevated inflammatory markers are associated with an increased risk of cardiovascular outcomes after AMI, but little is known about whether young women have higher inflammatory levels after AMI compared with young men. METHODS AND RESULTS: We assessed sex differences in post-AMI inflammatory markers and whether such differences account for sex differences in 12-month health status, using data from 2219 adults with AMI, 18 to 55 years of age, in the United States...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28228455/young-women-with-acute-myocardial-infarction-current-perspectives
#10
Rachel P Dreyer, Christopher Sciria, Erica S Spatz, Basmah Safdar, Gail D'Onofrio, Harlan M Krumholz
In recent years, there has been growing public awareness and increasing attention to young women with acute myocardial infarction (AMI), who represent an extreme phenotype. Young women presenting with AMI may develop coronary disease by different mechanisms and often have worse recoveries, with higher risk for morbidity and mortality compared with similarly aged men. The purpose of this cardiovascular perspective piece is to review recent studies of AMI in young women. More specifically, we emphasize differences in the epidemiology, diagnosis, and management of AMI in young women (when compared with men) across the continuum of care, including their pre-AMI, in-hospital, and post-AMI periods, and highlight gaps in knowledge and outcomes that can inform the next generation of research...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28221063/what-five-decades-of-research-tells-us-about-the-effects-of-youth-psychological-therapy-a-multilevel-meta-analysis-and-implications-for-science-and-practice
#11
John R Weisz, Sofie Kuppens, Mei Yi Ng, Dikla Eckshtain, Ana M Ugueto, Rachel Vaughn-Coaxum, Amanda Jensen-Doss, Kristin M Hawley, Lauren S Krumholz Marchette, Brian C Chu, V Robin Weersing, Samantha R Fordwood
Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth meta-analysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice...
February 2017: American Psychologist
https://www.readbyqxmd.com/read/28196521/comparison-of-two-independent-systematic-reviews-of-trials-of-recombinant-human-bone-morphogenetic-protein-2-rhbmp-2-the-yale-open-data-access-medtronic-project
#12
Jeffrey Low, Joseph S Ross, Jessica D Ritchie, Cary P Gross, Richard Lehman, Haiqun Lin, Rongwei Fu, Lesley A Stewart, Harlan M Krumholz
BACKGROUND: It is uncertain whether the replication of systematic reviews, particularly those with the same objectives and resources, would employ similar methods and/or arrive at identical findings. We compared the results and conclusions of two concurrent systematic reviews undertaken by two independent research teams provided with the same objectives, resources, and individual participant-level data. METHODS: Two centers in the USA and UK were each provided with participant-level data on 17 multi-site clinical trials of recombinant human bone morphogenetic protein-2 (rhBMP-2)...
February 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28153989/sex-differences-in-1-year-all-cause-rehospitalization-in-patients-after-acute-myocardial-infarction-a-prospective-observational-study
#13
Rachel P Dreyer, Kumar Dharmarajan, Kevin F Kennedy, Philip G Jones, Viola Vaccarino, Karthik Murugiah, Sudhakar V Nuti, Kim G Smolderen, Donna M Buchanan, John A Spertus, Harlan M Krumholz
BACKGROUND: Compared with men, women are at higher risk of rehospitalization in the first month after discharge for acute myocardial infarction (AMI). However, it is unknown whether this risk extends to the full year and varies by age. Explanatory factors potentially mediating the relationship between sex and rehospitalization remain unexplored and are needed to reduce readmissions. The aim of this study was to assess sex differences and factors associated with 1-year rehospitalization rates after AMI...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28148599/national-trends-in-atrial-fibrillation-hospitalization-readmission-and-mortality-for-medicare-beneficiaries-1999-2013
#14
James V Freeman, Yun Wang, Joseph G Akar, Nihar Desai, Harlan M Krumholz
BACKGROUND: -Data is lacking on national trends for atrial fibrillation (AF) hospitalization, particularly with regards to long-term outcomes including readmission and mortality. METHODS: -We studied all Medicare fee-for-service beneficiaries between 1999 and 2013, and evaluated rates of hospitalization for AF, in-hospital mortality, length-of-stay, and hospital payments. We then evaluated rates of longer-term outcomes including 30-day readmission, 30-day mortality, and 1-year mortality...
February 1, 2017: Circulation
https://www.readbyqxmd.com/read/28135350/copy-fees-and-limitation-of-patients-access-to-their-own-medical-records
#15
Austin W Jaspers, Jennifer L Cox, Harlan M Krumholz
No abstract text is available yet for this article.
January 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28132746/acc-aha-special-report-clinical%C3%A2-practice-guideline-implementation-strategies-a%C3%A2-summary-of-systematic-reviews-by-the-nhlbi-implementation-science-work-group-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#16
Wiley V Chan, Thomas A Pearson, Glen C Bennett, William C Cushman, Thomas A Gaziano, Paul N Gorman, Joel Handler, Harlan M Krumholz, Robert F Kushner, Thomas D MacKenzie, Ralph L Sacco, Sidney C Smith, Victor J Stevens, Barbara L Wells
BACKGROUND: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. OBJECTIVES: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines...
February 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28126839/acc-aha-special-report-clinical-practice-guideline-implementation-strategies-a-summary-of-systematic-reviews-by-the-nhlbi-implementation-science-work-group-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#17
Wiley V Chan, Thomas A Pearson, Glen C Bennett, William C Cushman, Thomas A Gaziano, Paul N Gorman, Joel Handler, Harlan M Krumholz, Robert F Kushner, Thomas D MacKenzie, Ralph L Sacco, Sidney C Smith, Victor J Stevens, Barbara L Wells, Graciela Castillo, Susan K R Heil, Jennifer Stephens, Julie C Jacobson Vann
BACKGROUND: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. OBJECTIVES: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines...
January 26, 2017: Circulation
https://www.readbyqxmd.com/read/28125758/is-hemoglobin-a1c-the-right-outcome-for-studies-of-diabetes
#18
Kasia J Lipska, Harlan M Krumholz
No abstract text is available yet for this article.
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28027367/association-between-hospital-penalty-status-under-the-hospital-readmission-reduction-program-and-readmission-rates-for-target-and-nontarget-conditions
#19
COMPARATIVE STUDY
Nihar R Desai, Joseph S Ross, Ji Young Kwon, Jeph Herrin, Kumar Dharmarajan, Susannah M Bernheim, Harlan M Krumholz, Leora I Horwitz
Importance: Readmission rates declined after announcement of the Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for excess readmissions for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Objective: To compare trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status. Design, Setting, and Participants: Retrospective cohort study of Medicare fee-for-service beneficiaries older than 64 years discharged between January 1, 2008, and June 30, 2015, from 2214 penalty hospitals and 1283 nonpenalty hospitals...
December 27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27984507/perceived-stress-after-acute-myocardial-infarction-a-comparison-between-young-and-middle-aged-women-versus-men
#20
Xiao Xu, Haikun Bao, Kelly M Strait, Donald E Edmondson, Karina W Davidson, John F Beltrame, Héctor Bueno, Haiqun Lin, Rachel P Dreyer, John E Brush, John A Spertus, Judith H Lichtman, Gail DʼOnofrio, Harlan M Krumholz
OBJECTIVE: The aim of the study was to examine how psychological stress changes over time in young and middle-aged patients after experiencing an acute myocardial infarction (AMI) and whether these changes differ between men and women. METHODS: We analyzed data obtained from 2358 women and 1151 men aged 18 to 55 years hospitalized for AMI. Psychological stress was measured using the 14-item Perceived Stress Scale (PSS-14) at initial hospitalization and at 1 month and 12 months after AMI...
January 2017: Psychosomatic Medicine
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