2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2019
Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak associationTrends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular function
2015
Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes
Desai NR, Parzynski CS, Krumholz HM, Minges KE, Messenger JC, Nallamothu BK, Curtis JP. Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes. JAMA Internal Medicine 2015, 175: 1988. PMID: 26551259, PMCID: PMC5584388, DOI: 10.1001/jamainternmed.2015.6217.Peer-Reviewed Original ResearchMeSH KeywordsCoronary Artery DiseaseFollow-Up StudiesGuideline AdherenceHospital MortalityHumansOutcome and Process Assessment, Health CarePercutaneous Coronary InterventionPractice Guidelines as TopicRegistriesRetrospective StudiesUnited StatesUnnecessary ProceduresHospital variation in admission to intensive care units for patients with acute myocardial infarction
Chen R, Strait KM, Dharmarajan K, Li SX, Ranasinghe I, Martin J, Fazel R, Masoudi FA, Cooke CR, Nallamothu BK, Krumholz HM. Hospital variation in admission to intensive care units for patients with acute myocardial infarction. American Heart Journal 2015, 170: 1161-1169. PMID: 26678638, PMCID: PMC5459386, DOI: 10.1016/j.ahj.2015.09.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnterior Wall Myocardial InfarctionCoronary Care UnitsHealth Care RationingHospital MortalityHumansLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionQuality ImprovementRetrospective StudiesRisk AssessmentTriageUnited StatesConceptsAcute myocardial infarctionIntensive care unitCritical care therapiesRisk-standardized mortality ratesHospital risk-standardized mortality ratesICU admissionResource-intensive settingsCare therapyAMI patientsCare unitMyocardial infarctionMortality rateAdult hospitalizationsHospital variationNinth RevisionClinical ModificationICU triageInternational ClassificationBetter outcomesPatientsHospitalAdmissionPremier databaseTherapyAppropriate useImprovements in the Distribution of Hospital Performance for the Care of Patients With Acute Myocardial Infarction, Heart Failure, and Pneumonia, 2006–2011
Nuti SV, Wang Y, Masoudi FA, Bratzler DW, Bernheim SM, Murugiah K, Krumholz HM. Improvements in the Distribution of Hospital Performance for the Care of Patients With Acute Myocardial Infarction, Heart Failure, and Pneumonia, 2006–2011. Medical Care 2015, 53: 485-491. PMID: 25906012, PMCID: PMC8635168, DOI: 10.1097/mlr.0000000000000358.Peer-Reviewed Original Research
2014
Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes
Safavi KC, Li SX, Dharmarajan K, Venkatesh AK, Strait KM, Lin H, Lowe TJ, Fazel R, Nallamothu BK, Krumholz HM. Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes. JAMA Internal Medicine 2014, 174: 546-553. PMID: 24515551, PMCID: PMC5459406, DOI: 10.1001/jamainternmed.2013.14407.Peer-Reviewed Original ResearchMeSH KeywordsBiomarkersCardiovascular DiseasesCross-Sectional StudiesDiagnostic ImagingFemaleHospitalizationHumansMaleOutcome and Process Assessment, Health CarePractice Patterns, Physicians'United StatesConceptsAcute myocardial infarctionNoninvasive cardiac imagingDownstream testingReadmission ratesRevascularization proceduresCardiac imagingHospital variationCardiac ischemiaProportion of patientsNoninvasive imagingLower readmission ratesPrincipal discharge diagnosisCross-sectional studyCardiac biomarker testsQ4 hospitalsChest discomfortCoronary angiographyCoronary diseaseDischarge diagnosisCoronary angiogramEmergency departmentMyocardial infarctionSame hospitalCurrent guidelinesInpatient wards
2013
Goodbye, Thank You, and Welcome
Krumholz HM. Goodbye, Thank You, and Welcome. Circulation Cardiovascular Quality And Outcomes 2013, 6: 249. PMID: 23674309, DOI: 10.1161/circoutcomes.113.000307.Peer-Reviewed Original ResearchCardiovascular DiseasesEditorial PoliciesHumansOutcome and Process Assessment, Health CarePeriodicals as TopicQuality of Health CareTreatment OutcomePromoting Publication of Rigorous Qualitative Research
Krumholz HM, Bradley EH, Curry LA. Promoting Publication of Rigorous Qualitative Research. Circulation Cardiovascular Quality And Outcomes 2013, 6: 133-134. PMID: 23481529, DOI: 10.1161/circoutcomes.113.000186.Peer-Reviewed Original ResearchBiomedical ResearchCardiovascular DiseasesEvidence-Based MedicineHealth Services ResearchHumansOutcome and Process Assessment, Health CarePeriodicals as TopicResearch DesignTreatment Outcome
2012
Development of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention
Curtis JP, Geary LL, Wang Y, Chen J, Drye EE, Grosso LM, Spertus JA, Rumsfeld JS, Weintraub WS, Masoudi FA, Brindis RG, Krumholz HM. Development of 2 Registry-Based Risk Models Suitable for Characterizing Hospital Performance on 30-Day All-Cause Mortality Rates Among Patients Undergoing Percutaneous Coronary Intervention. Circulation Cardiovascular Quality And Outcomes 2012, 5: 628-637. PMID: 22949491, DOI: 10.1161/circoutcomes.111.964569.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAged, 80 and overAngina PectorisChi-Square DistributionComorbidityFemaleHeart DiseasesHospital MortalityHospitalsHumansLogistic ModelsMaleMyocardial InfarctionOdds RatioOutcome and Process Assessment, Health CarePercutaneous Coronary InterventionQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsShock, CardiogenicTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionPercutaneous coronary interventionRisk-standardized mortality ratesElevation myocardial infarctionPatient mortality ratesMyocardial infarctionMortality rateCardiogenic shockCoronary interventionDerivation cohortHospital risk-standardized mortality ratesCause mortality ratesAdministrative claims dataQuality of careHierarchical logistic regression modelsNational Quality ForumLogistic regression modelsObserved mortality rateCathPCI RegistryNational HospitalClaims dataInfarctionPatientsQuality ForumFinal modelProcedure Intensity and the Cost of Care
Chen SI, Dharmarajan K, Kim N, Strait KM, Li SX, Safavi KC, Lindenauer PK, Krumholz HM, Lagu T. Procedure Intensity and the Cost of Care. Circulation Cardiovascular Quality And Outcomes 2012, 5: 308-313. PMID: 22576844, PMCID: PMC3415230, DOI: 10.1161/circoutcomes.112.966069.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCosts and Cost AnalysisCross-Sectional StudiesFemaleHeart FailureHospital Bed CapacityHospital CostsHospital MortalityHospitalizationHospitals, RuralHospitals, TeachingHospitals, UrbanHumansLength of StayLinear ModelsMaleMiddle AgedModels, EconomicOutcome and Process Assessment, Health CareResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsHF hospitalizationHeart failureInvasive proceduresHospital groupRisk-standardized mortality ratesProportion of patientsLength of stayCost of careWilcoxon rank sum testHigher procedure ratesRank sum testPatient demographicsPerspective databaseMedian lengthSurgical proceduresProcedure ratesHospitalizationOutcome differencesMortality rateHospitalPatientsPractice styleProcedure useSum testOverall use
2011
Real-world Imperative of Outcomes Research
Krumholz HM. Real-world Imperative of Outcomes Research. JAMA 2011, 306: 754-755. PMID: 21846857, DOI: 10.1001/jama.2011.1170.Peer-Reviewed Original ResearchComparative Effectiveness ResearchDecision MakingDelivery of Health CareEvidence-Based MedicineForecastingHumansOutcome and Process Assessment, Health CarePopulation SurveillanceAn Administrative Claims Measure Suitable for Profiling Hospital Performance Based on 30-Day All-Cause Readmission Rates Among Patients With Acute Myocardial Infarction
Krumholz HM, Lin Z, Drye EE, Desai MM, Han LF, Rapp MT, Mattera JA, Normand SL. An Administrative Claims Measure Suitable for Profiling Hospital Performance Based on 30-Day All-Cause Readmission Rates Among Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2011, 4: 243-252. PMID: 21406673, PMCID: PMC3350811, DOI: 10.1161/circoutcomes.110.957498.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesFemaleHumansInsurance Claim ReviewLogistic ModelsMaleMedicareModels, StatisticalMyocardial InfarctionOutcome and Process Assessment, Health CareOutcome Assessment, Health CarePatient ReadmissionQuality of Health CareReproducibility of ResultsRisk FactorsTime FactorsUnited States
2010
Who is missing from the measures? Trends in the proportion and treatment of patients potentially excluded from publicly reported quality measures
Bernheim SM, Wang Y, Bradley EH, Masoudi FA, Rathore SS, Ross JS, Drye E, Krumholz HM. Who is missing from the measures? Trends in the proportion and treatment of patients potentially excluded from publicly reported quality measures. American Heart Journal 2010, 160: 943-950.e5. PMID: 21095284, PMCID: PMC3319386, DOI: 10.1016/j.ahj.2010.06.046.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAngiotensin-Converting Enzyme InhibitorsCross-Sectional StudiesFemaleHospitalizationHumansMaleMedicaidMedicareMyocardial InfarctionOutcome and Process Assessment, Health CarePlatelet Aggregation InhibitorsPrognosisQuality ImprovementQuality Indicators, Health CareRetrospective StudiesUnited StatesConceptsAcute myocardial infarctionProportion of patientsRelative contraindicationAngiotensin-converting enzyme inhibitorTreatment of patientsMedicaid Services core measuresQuality improvement projectPublic reportingCross-sectional analysisMyocardial infarctionMedicare patientsHospital careΒ-blockersAMI admissionsPatientsInsufficient evidenceEnzyme inhibitorsTreatment ratesBetter careContraindicationsMedicaid ServicesData cohortCore measuresTreatmentImprovement projectNational Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure
Bernheim SM, Grady JN, Lin Z, Wang Y, Wang Y, Savage SV, Bhat KR, Ross JS, Desai MM, Merrill AR, Han LF, Rapp MT, Drye EE, Normand SL, Krumholz HM. National Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure. Circulation Cardiovascular Quality And Outcomes 2010, 3: 459-467. PMID: 20736442, PMCID: PMC3027304, DOI: 10.1161/circoutcomes.110.957613.Peer-Reviewed Original Research
2009
Hospital Variation in Time to Defibrillation After In-Hospital Cardiac Arrest
Chan PS, Nichol G, Krumholz HM, Spertus JA, Nallamothu BK. Hospital Variation in Time to Defibrillation After In-Hospital Cardiac Arrest. JAMA Internal Medicine 2009, 169: 1265-1273. PMID: 19636027, DOI: 10.1001/archinternmed.2009.196.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overElectric CountershockFemaleHeart ArrestHospitalsHumansMaleMiddle AgedOutcome and Process Assessment, Health CareProspective StudiesRegistriesTime FactorsUnited StatesConceptsCardiac arrestHospital factorsHospital variationIn-Hospital Cardiac ArrestHospital-level effectsHospital cardiac arrestWorse survivalImproved survivalPatient factorsAdult inpatientsHospital predictorsNational registryHospital ratesCardiopulmonary resuscitationGreater oddsIdentical covariatesDefibrillation delaysHospitalDefibrillationDefibrillation timeSurvivalArrestWide variationPatientsInpatientsAssociation of Physician Certification and Outcomes Among Patients Receiving an Implantable Cardioverter-Defibrillator
Curtis JP, Luebbert JJ, Wang Y, Rathore SS, Chen J, Heidenreich PA, Hammill SC, Lampert RI, Krumholz HM. Association of Physician Certification and Outcomes Among Patients Receiving an Implantable Cardioverter-Defibrillator. JAMA 2009, 301: 1661-1670. PMID: 19383957, PMCID: PMC2805129, DOI: 10.1001/jama.2009.547.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac ElectrophysiologyCertificationClinical CompetenceDefibrillators, ImplantableFemaleHumansIntraoperative ComplicationsLogistic ModelsMaleMedicineMiddle AgedOutcome and Process Assessment, Health CarePhysiciansPostoperative ComplicationsProsthesis ImplantationRegistriesRetrospective StudiesSpecializationTreatment OutcomeUnited StatesConceptsCRT-D devicesThoracic surgeonsICD implantationPhysician certificationImplantable cardioverter-defibrillator (ICD) proceduresRetrospective cohort studyCardiac resynchronization therapyPatients meeting criteriaRisk of complicationsProcedural complication rateImplantable cardioverter defibrillatorHierarchical logistic regression modelsLogistic regression modelsCohort studyComplication rateICD RegistryResynchronization therapyProcedural complicationsIndependent associationPhysician specialtyCardioverter defibrillatorHigh riskPatientsMeeting criteriaNonelectrophysiologistsOutcomes Research
Krumholz HM. Outcomes Research. Circulation Cardiovascular Quality And Outcomes 2009, 2: 1-3. PMID: 20031804, DOI: 10.1161/circoutcomes.108.844035.Peer-Reviewed Original ResearchEvidence-Based MedicineHealth Care ReformHealth Services ResearchHumansOutcome and Process Assessment, Health CareQuality of LifeTerminology as TopicTreatment Outcome
2007
Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement
Krumholz HM, Normand SL, Spertus JA, Shahian DM, Bradley EH. Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement. Health Affairs 2007, 26: 75-85. PMID: 17211016, DOI: 10.1377/hlthaff.26.1.75.Peer-Reviewed Original Research
2006
A Taxonomy for Disease Management
Krumholz HM, Currie PM, Riegel B, Phillips CO, Peterson ED, Smith R, Yancy CW, Faxon DP. A Taxonomy for Disease Management. Circulation 2006, 114: 1432-1445. PMID: 16952985, DOI: 10.1161/circulationaha.106.177322.Peer-Reviewed Original ResearchMeSH KeywordsCardiologyCase ManagementClinical ProtocolsComorbidityDelivery of Health CareDepressionDiabetes MellitusDisease ManagementHeart FailureInterdisciplinary CommunicationMedicareModels, TheoreticalOutcome and Process Assessment, Health CarePatient Care ManagementPatient Care TeamPatient Education as TopicPatient SelectionRisk FactorsSocieties, MedicalTerminology as TopicConceptsDisease management programsDisease management interventionsHeart failureDisease managementHealthcare providersTerms heart failureLevel of comorbidityMedical resource utilizationHome-based programPatient-centered measuresSystematic MEDLINE searchDuration of exposureHealthcare delivery systemSecondary outcomesClinical outcomesPatient populationPostacute careCaregiver burdenMedication managementStudy protocolChronic carePatient outcomesPatient educationWriting groupManagement interventions