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Harlan krumholz

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https://www.readbyqxmd.com/read/29340673/risks-of-statins-for-lower-risk-individuals-reply
#1
LETTER
Harlan M Krumholz
No abstract text is available yet for this article.
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340571/comparison-of-physician-visual-assessment-with-quantitative-coronary-angiography-in-assessment-of-stenosis-severity-in-china
#2
Haibo Zhang, Lin Mu, Shuang Hu, Brahmajee K Nallamothu, Alexandra J Lansky, Bo Xu, Georgios Bouras, David J Cohen, John A Spertus, Frederick A Masoudi, Jeptha P Curtis, Runlin Gao, Junbo Ge, Yuejin Yang, Jing Li, Xi Li, Xin Zheng, Yetong Li, Harlan M Krumholz, Lixin Jiang
Importance: Although physician visual assessment (PVA) of stenosis severity is a standard clinical practice to support decisions for coronary revascularization, there are concerns about its accuracy. Objective: To compare PVA with quantitative coronary angiography (QCA) as a means of assessing stenosis severity among patients undergoing percutaneous coronary intervention (PCI) in China. Design, Setting, and Participants: A cross-sectional study (2012-2013) of a random subset of 1295 patients from the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Prospective PCI Study was carried out...
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29304541/rationale-design-and-methodology-of-the-computerized-registry-of-patients-with-venous-thromboembolism-riete
#3
Behnood Bikdeli, David Jimenez, Mayra Hawkins, Salvador Ortíz, Paolo Prandoni, Benjamin Brenner, Hervé Decousus, Frederick A Masoudi, Javier Trujillo-Santos, Harlan M Krumholz, Manuel Monreal
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding and pregnant patients) have been under-represented in clinical trials. Furthermore, design of clinical trials is challenging in some scenarios, such as in those with hemodynamically unstable PE...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29295826/blood-pressure-guidelines-as-starting-point-in-clinical-decisions
#4
EDITORIAL
Harlan M Krumholz
No abstract text is available yet for this article.
January 2, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29273661/design-and-rationale-of-the-cardiovascular-health-and-text-messaging-chat-study-and-the-chat-diabetes-mellitus-chat-dm-study-two-randomised-controlled-trials-of-text-messaging-to-improve-secondary-prevention-for-coronary-heart-disease-and-diabetes
#5
Xiqian Huo, Erica S Spatz, Qinglan Ding, Paul Horak, Xin Zheng, Claire Masters, Haibo Zhang, Melinda L Irwin, Xiaofang Yan, Wenchi Guan, Jing Li, Xi Li, John A Spertus, Frederick A Masoudi, Harlan M Krumholz, Lixin Jiang
INTRODUCTION: Mobile health interventions have the potential to promote risk factor management and lifestyle modification, and are a particularly attractive approach for scaling across healthcare systems with limited resources. We are conducting two randomised trials to evaluate the efficacy of text message-based health messages in improving secondary coronary heart disease (CHD) prevention among patients with or without diabetes. METHODS AND ANALYSIS: The Cardiovascular Health And Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study are multicentre, single-blind, randomised controlled trials of text messaging versus standard treatment with 6 months of follow-up conducted in 37 hospitals throughout 17 provinces in China...
December 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/29248362/large-scale-epidemiologic-studies-of-cardiovascular-diseases-in-china-need-for-improved-data-collection-methods-transparency-and-documentation
#6
REVIEW
Hui Qu, Yuan Lu, Emily Gudbranson, Emily M Bucholz, Si Xuan, Frederick A Masoudi, John A Spertus, Xin Zheng, Jing Li, Harlan M Krumholz
With the advent of international precision medicine initiatives, it is important to evaluate existing large-scale studies to inform future investigation. This study sought to review, describe, and evaluate all large-scale cardiovascular disease (CVD) studies completed in China. We undertook a review of all large-scale CVD studies completed in China to describe and evaluate their design, implementation, and dissemination in published medical reports. Seventeen studies met the inclusion criteria. There were substantial variations in study design, geographic location, and data collection...
December 13, 2017: Global Heart
https://www.readbyqxmd.com/read/29241491/data-sharing-and-cardiology-platforms-and-possibilities
#7
REVIEW
Pranammya Dey, Joseph S Ross, Jessica D Ritchie, Nihar R Desai, Sanjeev P Bhavnani, Harlan M Krumholz
Sharing deidentified patient-level research data presents immense opportunities to all stakeholders involved in cardiology research and practice. Sharing data encourages the use of existing data for knowledge generation to improve practice, while also allowing for validation of disseminated research. In this review, we discuss key initiatives and platforms that have helped to accelerate progress toward greater sharing of data. These efforts are being prompted by government, universities, philanthropic sponsors of research, major industry players, and collaborations among some of these entities...
December 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29237746/impact-of-telemonitoring-on-health-status
#8
Natalie M Jayaram, Yevgeniy Khariton, Harlan M Krumholz, Sarwat I Chaudhry, Jennifer Mattera, Fengming Tang, Jeph Herrin, Beth Hodshon, John A Spertus
BACKGROUND: Although noninvasive telemonitoring in patients with heart failure does not reduce mortality or hospitalizations, less is known about its effect on health status. This study reports the results of a randomized clinical trial of telemonitoring on health status in patients with heart failure. METHODS AND RESULTS: Among 1521 patients with recent heart failure hospitalization randomized in the Tele-HF trial (Telemonitoring to Improve Heart Failure Outcomes), 756 received telephonic monitoring and 765 usual care...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29231837/the-primary-health-care-system-in-china
#9
REVIEW
Xi Li, Jiapeng Lu, Shuang Hu, K K Cheng, Jan De Maeseneer, Qingyue Meng, Elias Mossialos, Dong Roman Xu, Winnie Yip, Hongzhao Zhang, Harlan M Krumholz, Lixin Jiang, Shengshou Hu
China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes)...
December 9, 2017: Lancet
https://www.readbyqxmd.com/read/29206052/risk-trajectories-of-readmission-and-death-in-the-first-year-following-hospitalization-for-copd
#10
Peter K Lindenauer, Kumar Dharmarajan, Li Qin, Zhenqui Lin, Andrea S Gershon, Harlan M Krumholz
Rationale Characterizing the dynamic nature of post-hospital risk in COPD is needed to provide counseling and plan clinical services. Objectives To analyze risk of readmission and death among Medicare beneficiaries >=65 years following discharge for COPD, and to determine the association between ventilator support and risk trajectory. Methods We computed daily absolute risks of hospital readmission and death for one year after discharge for COPD, stratified by ventilator support. We determined the time required for risks to decline 50% from maximum daily values after discharge; and for daily risks to plateau...
December 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29183077/adherence-to-methodological-standards-in-research-using-the-national-inpatient-sample
#11
Rohan Khera, Suveen Angraal, Tyler Couch, John W Welsh, Brahmajee K Nallamothu, Saket Girotra, Paul S Chan, Harlan M Krumholz
Importance: Publicly available data sets hold much potential, but their unique design may require specific analytic approaches. Objective: To determine adherence to appropriate research practices for a frequently used large public database, the National Inpatient Sample (NIS) of the Agency for Healthcare Research and Quality (AHRQ). Design, Setting, and Participants: In this observational study of the 1082 studies published using the NIS from January 2015 through December 2016, a representative sample of 120 studies was systematically evaluated for adherence to practices required by AHRQ for the design and conduct of research using the NIS...
November 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29169478/2017-roadmap-for-innovation-acc%C3%A2-health-policy-statement-on-healthcare-transformation-in-the-era%C3%A2-of-digital-health-big-data-and%C3%A2-precision-health-a-report-of-the-american-college-of-cardiology-task-force-on-health-policy-statements-and-systems-of-care
#12
Sanjeev P Bhavnani, Kapil Parakh, Ashish Atreja, Regina Druz, Garth N Graham, Salim S Hayek, Harlan M Krumholz, Thomas M Maddox, Maulik D Majmudar, John S Rumsfeld, Bimal R Shah
No abstract text is available yet for this article.
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29164250/consequences-of-reductions-in-hospital-readmissions-reply
#13
LETTER
Kumar Dharmarajan, Harlan M Krumholz
No abstract text is available yet for this article.
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29158421/urban-rural-comparisons-in-hospital-admission-treatments-and-outcomes-for-st-segment-elevation-myocardial-infarction-in-china-from-2001-to-2011-a-retrospective-analysis-from-the-china-peace-study-patient-centered-evaluative-assessment-of-cardiac-events
#14
Xi Li, Karthik Murugiah, Jing Li, Frederick A Masoudi, Paul S Chan, Shuang Hu, John A Spertus, Yongfei Wang, Nicholas S Downing, Harlan M Krumholz, Lixin Jiang
BACKGROUND: In response to urban-rural disparities in healthcare resources, China recently launched a healthcare reform with a focus on improving rural care during the past decade. However, nationally representative studies comparing medical care and patient outcomes between urban and rural areas in China during this period are not available. METHODS AND RESULTS: We created a nationally representative sample of patients in China admitted for ST-segment-elevation myocardial infarction in 2001, 2006, and 2011, using a 2-stage random sampling design in 2 urban and 3 rural strata...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29133601/burden-of-catastrophic-health-expenditures-for-acute-myocardial-infarction-and-stroke-among-uninsured-in-the-united-states
#15
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
#16
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
#17
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
#18
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
#19
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...
December 9, 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
#20
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
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