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Harlan krumholz

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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/28355219/discovery-of-temporal-and-disease-association-patterns-in-condition-specific-hospital-utilization-rates
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/28263938/analysis-of-machine-learning-techniques-for-heart-failure-readmissions
#18
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
#19
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
#20
COMPARATIVE STUDY
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
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