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Harlan krumholz

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https://www.readbyqxmd.com/read/29133601/burden-of-catastrophic-health-expenditures-for-acute-myocardial-infarction-and-stroke-among-uninsured-in-the-united-states
#1
Rohan Khera, Jonathan C Hong, Anshul Saxena, Alejandro Arrieta, Salim S Virani, Ron Blankstein, James A de Lemos, Harlan M Krumholz, Khurram Nasir
Acute myocardial infarction (AMI) and stroke are unanticipated major healthcare events that require emergent and expensive care. Given the potential financial implications of AMI and stroke among uninsured patients, we sought to evaluate rates of catastrophic healthcare expenditures (CHEs), defined as expenses beyond financial means, in a period before the implementation of insurance expansion and protections in the Affordable Care Act.(1).
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29133522/systolic-blood-pressure-response-in-sprint-systolic-blood-pressure-intervention-trial-and-accord-action-to-control-cardiovascular-risk-in-diabetes-a-possible-explanation-for-discordant-trial-results
#2
Chenxi Huang, Sanket S Dhruva, Andreas C Coppi, Frederick Warner, Shu-Xia Li, Haiqun Lin, Khurram Nasir, Harlan M Krumholz
BACKGROUND: SPRINT (Systolic Blood Pressure Intervention Trial) and the ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial used similar interventions but produced discordant results. We investigated whether differences in systolic blood pressure (SBP) response contributed to the discordant trial results. METHODS AND RESULTS: We evaluated the distributions of SBP response during the first year for the intensive and standard treatment groups of SPRINT and ACCORD using growth mixture models...
November 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29106473/trends-in-acute-pericarditis-hospitalizations-and-outcomes-among-the-elderly-in-the-united-states-1999-2012
#3
Purav Mody, Behnood Bikdeli, Yun Wang, Massimo Imazio, Harlan M Krumholz
Aim: The elderly are at risk of pericarditis from conditions such as malignancy, renal disease and after cardiac surgery. However, the burden of pericarditis and especially long-term outcomes associated with pericarditis have not been described before among the elderly. Methods and results: We examined hospitalization rates; in-hospital, 30-day, and 1-year all-cause mortality rates; all-cause 30-day readmission rates; length of stay and healthcare expenditure for Medicare beneficiaries aged 65 years or older with a principal discharge diagnosis of pericarditis from 1999 to 2012...
November 2, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29102087/availability-cost-and-prescription-patterns-of-antihypertensive-medications-in-primary-health-care-in-china-a-nationwide-cross-sectional-survey
#4
Meng Su, Qiuli Zhang, Xueke Bai, Chaoqun Wu, Yetong Li, Elias Mossialos, George A Mensah, Frederick A Masoudi, Jiapeng Lu, Xi Li, Sebastian Salas-Vega, Anwen Zhang, Yuan Lu, Khurram Nasir, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Around 200 million adults in China have hypertension, but few are treated or achieve adequate control of their blood pressure. Available and affordable medications are important for successfully controlling hypertension, but little is known about current patterns of access to, and use of, antihypertensive medications in Chinese primary health care. METHODS: We used data from a nationwide cross-sectional survey (the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project primary health care survey), which was undertaken between November, 2016 and May, 2017, to assess the availability, cost, and prescription patterns of 62 antihypertensive medications at primary health-care sites across 31 Chinese provinces...
October 25, 2017: Lancet
https://www.readbyqxmd.com/read/29102084/prevalence-awareness-treatment-and-control-of-hypertension-in-china-data-from-1%C3%A2-7-million-adults-in-a-population-based-screening-study-china-peace-million-persons-project
#5
Jiapeng Lu, Yuan Lu, Xiaochen Wang, Xinyue Li, George C Linderman, Chaoqun Wu, Xiuyuan Cheng, Lin Mu, Haibo Zhang, Jiamin Liu, Meng Su, Hongyu Zhao, Erica S Spatz, John A Spertus, Frederick A Masoudi, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Hypertension is common in China and its prevalence is rising, yet it remains inadequately controlled. Few studies have the capacity to characterise the epidemiology and management of hypertension across many heterogeneous subgroups. We did a study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations. METHODS: We made use of data generated in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project from Sept 15, 2014, to June 20, 2017, a population-based screening project that enrolled around 1·7 million community-dwelling adults aged 35-75 years from all 31 provinces in mainland China...
October 25, 2017: Lancet
https://www.readbyqxmd.com/read/29049467/updated-cost-effectiveness-assessments-of-pcsk9-inhibitors-from-the-perspectives-of-the-health-system-and-private-payers-insights-derived-from-the-fourier-trial
#6
Alejandro Arrieta, Jonathan C Hong, Rohan Khera, Salim S Virani, Harlan M Krumholz, Khurram Nasir
Importance: Preliminary cost-effectiveness analyses of proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) were based on benefits estimated from reductions in low-density lipoprotein cholesterol that occurred in PCSK9i trials with variable results. The recent Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial provides better information about the effectiveness of the drug. Objective: To use the trial results to determine the cost-effectiveness of a PCSK9i and statin treatment strategy compared with a statin alone strategy...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29044398/trends-in-mortality-and-major-complications-for-patients-undergoing-coronary-artery-bypass-grafting-among-urban-teaching-hospitals-in-china-2004-to-2013
#7
Xin Yuan, Heng Zhang, Zhe Zheng, Chenfei Rao, Yan Zhao, Yun Wang, Harlan M Krumholz, Shengshou Hu
Aims: Although the number of hospitals performing cardiac surgery has increased rapidly in China, information regarding the trends in coronary artery bypass grafting (CABG) outcomes remains unknown. Methods and results: We used data from the Chinese Cardiac Surgery Registry, the largest registry system that accounts for nearly 50% of total annual CABG volume in China, to assess trends of in-hospital mortality and major complication rates for patients receiving isolated CABG in 102 urban teaching hospitals in China from 25 January 2004 through 31 December 2013 (except 2006 and 2009)...
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28960228/home-health-agency-performance-in-the-united-states-2011-15
#8
Yun Wang, Erica S Spatz, Maliha Tariq, Suveen Angraal, Harlan M Krumholz
OBJECTIVES: To evaluate home health agency quality performance. DESIGN: Observational study. SETTING: Home health agencies. PARTICIPANTS: All Medicare-certified agencies with at least 6 months of data from 2011 to 2015. MEASUREMENTS: Twenty-two quality indicators, five patient survey indicators, and their composite scores. RESULTS: The study included 11,462 Medicare-certified home health agencies that served 92...
September 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28954922/incorporating-stroke-severity-into-hospital-measures-of-30-day-mortality-after-ischemic-stroke-hospitalization
#9
Jennifer Schwartz, Yongfei Wang, Li Qin, Lee H Schwamm, Gregg C Fonarow, Nicole Cormier, Karen Dorsey, Robert L McNamara, Lisa G Suter, Harlan M Krumholz, Susannah M Bernheim
BACKGROUND AND PURPOSE: The Centers for Medicare & Medicaid Services publicly reports a hospital-level stroke mortality measure that lacks stroke severity risk adjustment. Our objective was to describe novel measures of stroke mortality suitable for public reporting that incorporate stroke severity into risk adjustment. METHODS: We linked data from the American Heart Association/American Stroke Association Get With The Guidelines-Stroke registry with Medicare fee-for-service claims data to develop the measures...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28950309/are-non-st-segment-elevation-myocardial-infarctions-nstemi-missing-in-china
#10
Karthik Murugiah, Yongfei Wang, Sudhakar V Nuti, Xi Li, Jing Li, Xin Zheng, Nicholas S Downing, Nihar R Desai, Frederick A Masoudi, John A Spertus, Lixin Jiang, Harlan M Krumholz
Background: HASH(0x31ec138) Methods and results: HASH(0x38c1a60) Conclusions: HASH(0x38be488) Clinical Trial Registration: HASH(0x38da730)
July 27, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28935036/inferior-vena-cava-filters-to-prevent-pulmonary-embolism-systematic-review-and%C3%A2-meta-analysis
#11
REVIEW
Behnood Bikdeli, Saurav Chatterjee, Nihar R Desai, Ajay J Kirtane, Mayur M Desai, Michael B Bracken, Frederick A Spencer, Manuel Monreal, Samuel Z Goldhaber, Harlan M Krumholz
BACKGROUND: Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. OBJECTIVES: The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. METHODS: The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28922297/quality-of-care-in-the-united-states-territories-1999-2012
#12
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28912202/blockchain-technology-applications-in-health-care
#13
Suveen Angraal, Harlan M Krumholz, Wade L Schulz
No abstract text is available yet for this article.
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28906314/quality-of-care-in-the-united-states-territories-1999-2012
#14
Sudhakar V Nuti, Yun Wang, Frederick A Masoudi, Marcella Nunez-Smith, Sharon-Lise T Normand, Karthik Murugiah, Orlando Rodríguez-Vilá, Joseph S Ross, Harlan M Krumholz
BACKGROUND: Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS: Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28902587/hospital-readmission-risk-isolating-hospital-effects-from-patient-effects
#15
Harlan M Krumholz, Kun Wang, Zhenqiu Lin, Kumar Dharmarajan, Leora I Horwitz, Joseph S Ross, Elizabeth E Drye, Susannah M Bernheim, Sharon-Lise T Normand
BACKGROUND: To isolate hospital effects on risk-standardized hospital-readmission rates, we examined readmission outcomes among patients who had multiple admissions for a similar diagnosis at more than one hospital within a given year. METHODS: We divided the Centers for Medicare and Medicaid Services hospital-wide readmission measure cohort from July 2014 through June 2015 into two random samples. All the patients in the cohort were Medicare recipients who were at least 65 years of age...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28865896/comparison-of-electrocardiographic-characteristics-in-men-versus-women%C3%A2-%C3%A2-%C3%A2-55-years-with-acute-myocardial-infarction-a-variation-in-recovery-role-of-gender-on-outcomes-of-young-acute-myocardial-infarction-patients-substudy
#16
MULTICENTER STUDY
José A Barrabés, Aakriti Gupta, Andreu Porta-Sánchez, Kelly M Strait, J Gabriel Acosta-Vélez, Gail D'Onofrio, Rosa-Maria Lidón, Mary Geda, Rachel P Dreyer, Nancy P Lorenze, Judith H Lichtman, John A Spertus, Héctor Bueno, Harlan M Krumholz
Young women with acute myocardial infarction (AMI) have a worse prognosis than their male counterparts. We searched for differences in the electrocardiographic presentation of men and women in a large, contemporary registry of young adults with AMI that could help explain gender differences in outcomes. The qualifying electrocardiogram was blindly assessed by a central core lab in 3,354 patients (67% women) aged 18 to 55 years included in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28860874/can-machine-learning-complement-traditional-medical-device-surveillance-a-case-study-of-dual-chamber-implantable-cardioverter-defibrillators
#17
Joseph S Ross, Jonathan Bates, Craig S Parzynski, Joseph G Akar, Jeptha P Curtis, Nihar R Desai, James V Freeman, Ginger M Gamble, Richard Kuntz, Shu-Xia Li, Danica Marinac-Dabic, Frederick A Masoudi, Sharon-Lise T Normand, Isuru Ranasinghe, Richard E Shaw, Harlan M Krumholz
BACKGROUND: Machine learning methods may complement traditional analytic methods for medical device surveillance. METHODS AND RESULTS: Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, we applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models: one specified by subject-matter experts (PS-SME), and the other one by machine learning-based selection (PS-ML)...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28851781/protocol-for-a-nationwide-survey-of-primary-health-care-in-china-the-china-peace-patient-centered-evaluative-assessment-of-cardiac-events-mpp-million-persons-project-primary-health-care-survey
#18
Meng Su, Qiuli Zhang, Jiapeng Lu, Xi Li, Na Tian, Yun Wang, Winnie Yip, Kar Keung Cheng, George A Mensah, Ralph I Horwitz, Elias Mossialos, Harlan M Krumholz, Lixin Jiang
INTRODUCTION: China has pioneered advances in primary health care (PHC) and public health for a large and diverse population. To date, the current state of PHC in China has not been subjected to systematic assessments. Understanding variations in primary care services could generate opportunities for improving the structure and function of PHC. METHODS AND ANALYSIS: This paper describes a nationwide PHC study (PEACE MPP Primary Health Care Survey) conducted across 31 provinces in China...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#19
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28742902/nonclinical-factors-affecting-shared-decision-making-reply
#20
LETTER
Erica S Spatz, Benjamin W Moulton, Harlan M Krumholz
No abstract text is available yet for this article.
July 25, 2017: JAMA: the Journal of the American Medical Association
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