2024
StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifier
2022
No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias
Moura L, Yan Z, Donahue M, Smith L, Schwamm L, Hsu J, Newhouse J, Haneuse S, Blacker D, Hernandez-Diaz S. No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias. Journal Of Clinical Epidemiology 2022, 154: 136-145. PMID: 36572369, PMCID: PMC10033385, DOI: 10.1016/j.jclinepi.2022.12.013.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeRisk differenceIschemic strokeBenzodiazepine useShort-term mortalityImmortal time biasElectronic health recordsAIS admissionsBenzodiazepine initiationStroke RegistryPoststroke mortalityTreatment initiationMortality riskPatientsFurther adjustmentMortalityBenzodiazepinesOlder adultsTime biasHealth recordsImmortal timeStrokeRiskDaysContraindicationsComparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke
Moura L, Donahue M, Yan Z, Smith L, Hsu J, Newhouse J, Schwamm L, Haneuse S, Hernandez-Diaz S, Blacker D. Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke. Stroke 2022, 54: 527-536. PMID: 36544249, PMCID: PMC9870933, DOI: 10.1161/strokeaha.122.039946.Peer-Reviewed Original ResearchConceptsSeizure prophylaxisRisk differenceAntiseizure drugsEarly seizure prophylaxisSevere AIS patientsAcute ischemic strokePrespecified subgroup analysisHealth care factorsInverse probability weightsElectronic health recordsAIS admissionsPoststroke mortalityStroke RegistryIschemic strokeAIS patientsStroke settingsCare factorsSubgroup analysisProphylaxisMortality riskHigh riskPatientsComparative effectivenessExcess deathsTrial data
2020
Patterns of anticonvulsant use and adverse drug events in older adults
Moura L, Smith J, Yan Z, Blacker D, Schwamm L, Newhouse J, Hernandez‐Diaz S, Hsu J. Patterns of anticonvulsant use and adverse drug events in older adults. Pharmacoepidemiology And Drug Safety 2020, 30: 28-36. PMID: 33009718, PMCID: PMC7849867, DOI: 10.1002/pds.5139.Peer-Reviewed Original ResearchConceptsAdverse drug eventsElectronic health recordsIncident usersAnticonvulsant useDrug eventsMedicare beneficiariesRate of ADEsSeverity of ADEsSignificant adverse drug eventsEligible beneficiariesOlder adultsCohort of communityDuration of useRange of indicationsTraditional Medicare beneficiariesInverse probability weightsADE ratesMonotherapy usersSingle anticonvulsantAnticonvulsant therapyPain reliefCommon indicationOriginal cohortNervous systemOlder adult community
2019
Epilepsy Among Elderly Medicare Beneficiaries
Moura L, Smith J, Blacker D, Vogeli C, Schwamm L, Cole A, Hernandez-Diaz S, Hsu J. Epilepsy Among Elderly Medicare Beneficiaries. Medical Care 2019, 57: 318-324. PMID: 30762723, PMCID: PMC6417929, DOI: 10.1097/mlr.0000000000001072.Peer-Reviewed Original ResearchConceptsMedicare administrative dataEpilepsy statusMedicare beneficiariesMedicare dataEpilepsy diagnosisElectronic health record dataElderly Medicare beneficiariesHealth record dataHealth insurance claimsAdministrative dataElectronic health recordsIncident epilepsyPrevalent epilepsyDrug claimsEpilepsyDiagnostic thresholdStratified random sampleInverse probabilityHealth recordsMedicare claims can identify post-stroke epilepsy
Moura L, Smith J, Blacker D, Vogeli C, Schwamm L, Hsu J. Medicare claims can identify post-stroke epilepsy. Epilepsy Research 2019, 151: 40-47. PMID: 30780120, PMCID: PMC6640134, DOI: 10.1016/j.eplepsyres.2019.02.002.Peer-Reviewed Original ResearchConceptsElectronic health recordsAccountable care organizationsMedicare claimsCommunity-dwelling elderly individualsPost-stroke epilepsyElderly Medicare beneficiariesClaims-based algorithmPositive predictive valuePioneer Accountable Care OrganizationsDiscrete etiologyNeurologist visitOverall prevalenceMedicare patientsClaims diagnosesPSE diagnosisElderly individualsMedicare beneficiariesPatientsPredictive valueEpilepsyFuture epidemiological surveillanceEpidemiological surveillanceInverse probabilityHealth recordsDiagnosis
2015
Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke
Joynt K, Bhatt D, Schwamm L, Xian Y, Heidenreich P, Fonarow G, Smith E, Neely M, Grau-Sepulveda M, Hernandez A. Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke. Journal Of The American College Of Cardiology 2015, 65: 1964-1972. PMID: 25953748, DOI: 10.1016/j.jacc.2015.02.059.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overElectronic Health RecordsFemaleHospital Bed CapacityHospital MortalityHospitals, TeachingHumansLength of StayMaleMiddle AgedOutcome Assessment, Health CarePatient DischargePractice Guidelines as TopicQuality of Health CareStrokeTime-to-TreatmentTissue Plasminogen ActivatorUnited StatesConceptsElectronic health recordsIschemic strokeGWTG-Stroke hospitalsHealth recordsBetter clinical outcomesLogistic regression analysisAmerican Hospital Association Annual SurveyQuality of careOutcomes of interestHigh-quality careGuidelines-StrokeHospital mortalityStroke centersClinical outcomesStroke careSimilar oddsHospital characteristicsOutcome measuresTimely careHospitalPatientsStudy periodCareU.S. hospitalsStroke