2024
Characterizing the progression of subclinical cardiac amyloidosis through artificial intelligence applied to electrocardiographic images and echocardiograms
Oikonomou E, Sangha V, Coppi A, Krumholz H, Miller E, Khera R. Characterizing the progression of subclinical cardiac amyloidosis through artificial intelligence applied to electrocardiographic images and echocardiograms. European Heart Journal 2024, 45: ehae666.2089. DOI: 10.1093/eurheartj/ehae666.2089.Peer-Reviewed Original ResearchDiagnosis of ATTR-CMATTR-CMBone scintigraphy scansClinical diagnosisTransthyretin amyloid cardiomyopathyMonths of diagnosisSex-matched controlsElectrocardiographic (ECGIndolent courseCardiac amyloidosisScintigraphy scanAmyloid cardiomyopathyEchocardiographic studiesAI-ECGEchocardiogramEventual diagnosisDetect longitudinal changesConfirmatory testDiagnosisClinical diseasePercentage of individualsLongitudinal changesECGMedianMonths
2021
Temporal relationship of computed and structured diagnoses in electronic health record data
Schulz WL, Young HP, Coppi A, Mortazavi BJ, Lin Z, Jean RA, Krumholz HM. Temporal relationship of computed and structured diagnoses in electronic health record data. BMC Medical Informatics And Decision Making 2021, 21: 61. PMID: 33596898, PMCID: PMC7890604, DOI: 10.1186/s12911-021-01416-x.Peer-Reviewed Original ResearchConceptsElectronic health recordsStructured diagnosisOutpatient blood pressureElectronic health record dataAcademic health systemLow-density lipoproteinHealth record dataBlood pressureStructured data elementsAdministrative claimsHypertensionClinical informationHyperlipidemiaClinical phenotypeEquivalent diagnosisVital signsHealth systemDiagnosisProblem listAdditional studiesHealth recordsRecord dataTimely accessEHR dataPatients
2020
Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults
Ding Q, Spatz ES, Lipska KJ, Lin H, Spertus JA, Dreyer RP, Whittemore R, Funk M, Bueno H, Krumholz HM. Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults. Heart 2020, 107: 657-666. PMID: 33082173, PMCID: PMC8005796, DOI: 10.1136/heartjnl-2020-317101.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth statusDischarge diagnosisPharmacological treatmentMyocardial infarctionShort-term health statusYoung AMI Patients (VIRGO) studyDisease-specific health statusYoung adultsQuality of lifeHospital complicationsHospital mortalityMedication initiationBaseline characteristicsClinical outcomesDiabetesPatientsDiagnosisPatient studiesMonthsComplicationsInfarctionSignificant differencesOutcomesMortality
2019
Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project
Mahajan S, Zhang D, He S, Lu Y, Gupta A, Spatz ES, Lu J, Huang C, Herrin J, Liu S, Yang J, Wu C, Cui J, Zhang Q, Li X, Nasir K, Zheng X, Krumholz HM, Li J, Dong Z, Jiang B, Zhang Y, Liu Y, Meng Y, Xi Y, Tian Y, Fu Y, Liu T, Yan S, Jin L, Wang J, Xu X, Xing X, Zhang L, Fang X, Xu Y, Xu C, Fan L, Qi M, Qi J, Li J, Liu Q, Feng Y, Wang J, Wen H, Xu J, He J, Jiang C, Yang C, Yu Y, Tashi Z, Hu Z, Zhang J, Li X, Ma S, Ma Y, Huang Y, Zhang Y, Shen J. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. Journal Of The American Heart Association 2019, 8: e012954. PMID: 31566101, PMCID: PMC6806046, DOI: 10.1161/jaha.119.012954.Peer-Reviewed Original ResearchConceptsMillion Persons ProjectPrior cardiovascular eventsBody mass indexAntihypertensive medicationsDiastolic hypertensionCardiovascular eventsDiabetes mellitusMass indexIsolated diastolic hypertensionDiastolic blood pressureSelf-reported diagnosisTreatment of peoplePersons ProjectBlood pressureTreatment patternsHypertensionLeast collegeHigher likelihoodMellitusMedicationsPrevalenceTreatmentDiagnosisSubstantial numberCurrent use
2018
Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Altaf F, Herrin J, Lin Z, Krumholz HM, Drye EE, Lipska KJ, Spatz ES. Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates. American Heart Journal 2018, 207: 19-26. PMID: 30404047, DOI: 10.1016/j.ahj.2018.09.006.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAgedAlgorithmsAnalysis of VarianceCardiovascular DiseasesComorbidityFemaleHeart FailureHospitalizationHumansInternational Classification of DiseasesMaleMedicare Part AMedicare Part BPatient AdmissionPatient DischargePatient-Centered CareSex DistributionTime FactorsUnited StatesConceptsHeart failureAccountable care organizationsMean admission rateAdmission ratesAdmission typeAcute admission ratesNoncardiovascular conditionsAdmission diagnosisCause admission ratesMedicare Shared Savings Program Accountable Care OrganizationsRate of hospitalizationPrincipal discharge diagnosisProportion of admissionsType of admissionNoncardiovascular causesHF admissionsHF patientsPerson yearsDischarge diagnosisPatient populationPatientsAdmissionKey quality metricDiagnosisSubstantial proportion
2017
Young Women With Acute Myocardial Infarction
Dreyer RP, Sciria C, Spatz ES, Safdar B, D'Onofrio G, Krumholz HM. Young Women With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003480. PMID: 28228455, PMCID: PMC5502480, DOI: 10.1161/circoutcomes.116.003480.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionYoung womenMyocardial infarctionManagement of AMIPost-AMI periodContinuum of careCoronary diseaseAged menHigh riskWorse recoveryWomenInfarctionHighlight gapsRecent studiesDifferent mechanismsMorbidityHospitalMortalityEpidemiologyPublic awarenessDiseaseDiagnosisCare
2015
Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012
Murugiah K, Wang Y, Desai NR, Spatz ES, Nuti SV, Dreyer RP, Krumholz HM. Trends in Short- and Long-Term Outcomes for Takotsubo Cardiomyopathy Among Medicare Fee-for-Service Beneficiaries, 2007 to 2012. JACC Heart Failure 2015, 4: 197-205. PMID: 26746377, PMCID: PMC5323042, DOI: 10.1016/j.jchf.2015.09.013.Peer-Reviewed Original ResearchConceptsLong-term outcomesReadmission ratesNonwhite patientsHospitalization ratesSecondary diagnosisMedicare feeYears of ageTakotsubo cardiomyopathyWorse outcomesWhite racePatientsService beneficiariesHospitalMortalityTime pointsOutcomesHospitalizationCohortDiagnosisRepresentative dataTakotsuboTTCReadmissionCardiomyopathyYearsSex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction
Dreyer RP, Ranasinghe I, Wang Y, Dharmarajan K, Murugiah K, Nuti SV, Hsieh AF, Spertus JA, Krumholz HM. Sex Differences in the Rate, Timing, and Principal Diagnoses of 30-Day Readmissions in Younger Patients with Acute Myocardial Infarction. Circulation 2015, 132: 158-166. PMID: 26085455, PMCID: PMC5322973, DOI: 10.1161/circulationaha.114.014776.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionPrincipal diagnosisYounger patientsHigh riskUtilization Project State Inpatient DatabasesYoung womenCause readmission rateGreater mortality riskSex differencesNoncardiac diagnosesReadmission diagnosesReadmission timingReadmission ratesInpatient DatabaseReadmission riskFemale sexCondition categoriesReadmissionMortality riskHealthcare costsDay 2InfarctionPatientsDiagnosis
2012
2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease. Circulation 2012, 126: 3097-3137. PMID: 23166210, DOI: 10.1161/cir.0b013e3182776f83.Peer-Reviewed Original Research2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV, Anderson JL. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease. Circulation 2012, 126: e354-e471. PMID: 23166211, DOI: 10.1161/cir.0b013e318277d6a0.Peer-Reviewed Original Research2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal Of The American College Of Cardiology 2012, 60: e44-e164. PMID: 23182125, DOI: 10.1016/j.jacc.2012.07.013.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAdrenergic beta-AntagonistsAlcohol DrinkingAngina PectorisBody WeightCholesterol, LDLClopidogrelComorbidityCost of IllnessDepressionDiabetes ComplicationsDisease ManagementElectrocardiographyExerciseExercise TestGlycated HemoglobinHealth BehaviorHumansHypertensionLife StyleMyocardial InfarctionMyocardial IschemiaMyocardial RevascularizationPhysical ExaminationPlatelet Aggregation InhibitorsPractice Guidelines as TopicQuality of LifeRisk AssessmentRisk FactorsRisk Reduction BehaviorSmoking CessationTiclopidineConceptsAmerican CollegeAmerican Heart Association Task ForcePreventive Cardiovascular Nurses AssociationCardiology Foundation/American Heart Association Task ForceManagement of patientsThoracic surgeryPractice guidelinesCardiovascular AngiographyThoracic surgeonsSTS guidelinesA ReportNurses AssociationAmerican AssociationTask ForceAssociationGuidelinesPatientsSurgeryAngiographyPhysiciansDiagnosisSurgeons2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal Of The American College Of Cardiology 2012, 60: 2564-2603. PMID: 23182124, DOI: 10.1016/j.jacc.2012.07.012.Peer-Reviewed Original ResearchAmerican CollegeAmerican Heart Association Task ForcePreventive Cardiovascular Nurses AssociationStable ischemic heart diseaseCardiology Foundation/American Heart Association Task ForceIschemic heart diseaseManagement of patientsThoracic surgeryHeart diseasePractice guidelinesCardiovascular AngiographyThoracic surgeonsSTS guidelinesA ReportNurses AssociationAmerican AssociationTask ForceAssociationGuidelinesPatientsSurgeryAngiographyDiseaseDiagnosisPhysicians
2011
2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Gersh B, Maron B, Bonow R, Dearani J, Fifer M, Link M, Naidu S, Nishimura R, Ommen S, Rakowski H, Seidman C, Towbin J, Udelson J, Yancy C, Jacobs A, Smith S, Anderson J, Albert N, Buller C, Creager M, Ettinger S, Guyton R, Halperin J, Hochman J, Krumholz H, Kushner F, Nishimura R, Ohman E, Page R, Stevenson W, Tarkington L, Yancy C. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal Of Thoracic And Cardiovascular Surgery 2011, 142: e153-e203. PMID: 22093723, DOI: 10.1016/j.jtcvs.2011.10.020.Peer-Reviewed Original Research2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: Executive summary A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Gersh B, Maron B, Bonow R, Dearani J, Fifer M, Link M, Naidu S, Nishimura R, Ommen S, Rakowski H, Seidman C, Towbin J, Udelson J, Yancy C, Jacobs A, Smith S, Anderson J, Albert N, Buller C, Creager M, Ettinger S, Guyton R, Halperin J, Hochman J, Krumholz H, Kushner F, Nishimura R, Ohman E, Page R, Stevenson W, Tarkington L, Yancy C. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: Executive summary A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal Of Thoracic And Cardiovascular Surgery 2011, 142: 1303-1338. PMID: 22093712, DOI: 10.1016/j.jtcvs.2011.10.019.Peer-Reviewed Original Research
2010
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary
Hiratzka L, Bakris G, Beckman J, Bersin R, Carr V, Casey D, Eagle K, Hermann L, Isselbacher E, Kazerooni E, Kouchoukos N, Lytle B, Milewicz D, Reich D, Sen S, Shinn J, Svensson L, Williams D, Jacobs A, Smith S, Anderson J, Adams C, Buller C, Creager M, Ettinger S, Guyton R, Halperin J, Hunt S, Krumholz H, Kushner F, Lytle B, Nishimura R, Page R, Riegel B, Stevenson W, Tarkington L, Yancy C. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary. Catheterization And Cardiovascular Interventions 2010, 76: e43-e86. PMID: 20687249, DOI: 10.1002/ccd.22537.Peer-Reviewed Original Research
2009
Patterns of Hospital Performance in Acute Myocardial Infarction and Heart Failure 30-Day Mortality and Readmission
Krumholz HM, Merrill AR, Schone EM, Schreiner GC, Chen J, Bradley EH, Wang Y, Wang Y, Lin Z, Straube BM, Rapp MT, Normand SL, Drye EE. Patterns of Hospital Performance in Acute Myocardial Infarction and Heart Failure 30-Day Mortality and Readmission. Circulation Cardiovascular Quality And Outcomes 2009, 2: 407-413. PMID: 20031870, DOI: 10.1161/circoutcomes.109.883256.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureReadmission ratesMyocardial infarctionMortality rateRisk-standardized mortality ratesAge 65 yearsRisk-standardized mortalityHospital referral regionsHospital structural characteristicsType of hospitalHospital performancePrimary diagnosisHospital characteristicsReferral regionsMedicare feeMortalityMedicaid ServicesInfarctionHospitalGeographic differencesReadmissionFailureDiagnosis
2008
Consequences of Inadequate Sign-out for Patient Care
Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. Consequences of Inadequate Sign-out for Patient Care. JAMA Internal Medicine 2008, 168: 1755-1760. PMID: 18779462, DOI: 10.1001/archinte.168.16.1755.Peer-Reviewed Original ResearchConceptsHealth care providersClinical conditionsCare providersIntensive care unit transferPatient's clinical conditionCare of patientsHouse staff teamsAdverse eventsImportant adverse consequencesCase reportClinical informationAnticipatory guidancePatientsPatient careUnit transferIterative coding processHouse staffAdverse consequencesSignsCareDaysSessionsProvidersDiagnosisRecipients
2006
Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment
Graff LG, Wang Y, Borkowski B, Tuozzo K, Foody JM, Krumholz HM, Radford MJ. Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment. Academic Emergency Medicine 2006, 13: 931-938. PMID: 16894002, DOI: 10.1197/j.aem.2006.04.016.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge DistributionAgedAged, 80 and overAngina, UnstableAspirinCohort StudiesConnecticutEvidence-Based MedicineFemaleFibrinolytic AgentsHumansMaleMyocardial InfarctionPatient AdmissionQuality Assurance, Health CareQuality of Health CareRetrospective StudiesTime FactorsConceptsAcute myocardial infarctionAdmission diagnosisBeta blockersQuality of careMyocardial infarctionDiagnosis of AMICharacteristics of patientsPercutaneous coronary interventionPrincipal discharge diagnosisEvidence-based therapiesRate of administrationCoronary interventionCardiac catheterizationDischarge diagnosisPrincipal diagnosisFrequency of delaysDischarge statusPatient careAdmissionAMI diagnosisPatientsDiagnosisMedicare casesCareInfarction
2005
Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice
Dorsey KB, Wells C, Krumholz HM, Concato J. Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice. JAMA Pediatrics 2005, 159: 632-638. PMID: 15996996, DOI: 10.1001/archpedi.159.7.632.Peer-Reviewed Original ResearchConceptsBody mass indexRisk of overweightHospital-based clinicsHealth maintenance visitsRate of diagnosisType of treatmentComorbid diseasesMass indexOverweight childrenChildhood obesityMedical recordsTreatment recommendationsHigh burdenPediatric practiceRoutine screeningOverweightClinical practiceMaintenance visitsDiagnosisEncounter notesFormal diagnosisTreatmentChildrenSingle-parent householdsRiskValidity of Using an Electronic Medical Record for Assessing Quality of Care in an Outpatient Setting
Benin AL, Vitkauskas G, Thornquist E, Shapiro ED, Concato J, Aslan M, Krumholz HM. Validity of Using an Electronic Medical Record for Assessing Quality of Care in an Outpatient Setting. Medical Care 2005, 43: 691-698. PMID: 15970784, DOI: 10.1097/01.mlr.0000167185.26058.8e.Peer-Reviewed Original ResearchConceptsElectronic medical recordsManagement of pharyngitisMedical recordsHealth Plan Employer DataDiagnostic testsEpisode of pharyngitisOutpatient electronic medical recordsProportion of episodesDiagnosis of pharyngitisOutpatient settingTotal episodesPharyngitisEmployer DataElectronic databasesDiagnostic testingClinical encountersMeasures of qualityEpisodesComplete evaluationCareAssessing QualityPediatricsYearsProportionDiagnosis