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https://www.readbyqxmd.com/read/28446493/hospital-performance-on-percutaneous-coronary-intervention-process-and-outcomes-measures
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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.
March 27, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28355219/discovery-of-temporal-and-disease-association-patterns-in-condition-specific-hospital-utilization-rates
#7
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
#8
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
https://www.readbyqxmd.com/read/28330750/real-world-data-on-heart-failure-readmission-reduction-real-or-real-uncertain
#9
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
#10
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
#11
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...
May 2017: Medical Care
https://www.readbyqxmd.com/read/28287993/prediction-of-adverse-events-in-patients-undergoing-major-cardiovascular-procedures
#12
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
#13
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
#14
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
#15
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
#16
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...
April 1, 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
#17
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
#18
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
#19
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
#20
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
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