2021
Integration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database
Yan Z, Nielsen V, Song G, Christie A, Schwamm L, Zachrison K. Integration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database. Journal Of Stroke And Cerebrovascular Diseases 2021, 31: 106236. PMID: 34954597, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106236.Peer-Reviewed Original ResearchMeSH KeywordsDatabases, FactualHospitalizationHumansIschemic StrokeMassachusettsRegistriesVital StatisticsConceptsStroke databaseDetailed clinical variablesPopulation-based studyLong-term outcomesIndirect identifiersVital statistics databaseHospitalization registryStroke admissionsHospitalization databaseVital statistics dataTerm outcomesVital statusClinical variablesLarge-scale outcome researchClinical registryHospitalization recordsPatient variablesAdministrative databasesClinical dataRich clinical dataRegistryHospitalizationDeterministic linkageCumulative mortalityVital records
2020
Digital triage: Novel strategies for population health management in response to the COVID-19 pandemic
Lai L, Wittbold K, Dadabhoy F, Sato R, Landman A, Schwamm L, He S, Patel R, Wei N, Zuccotti G, Lennes I, Medina D, Sequist T, Bomba G, Keschner Y, Zhang H. Digital triage: Novel strategies for population health management in response to the COVID-19 pandemic. Healthcare 2020, 8: 100493. PMID: 33129176, PMCID: PMC7586929, DOI: 10.1016/j.hjdsi.2020.100493.Peer-Reviewed Original ResearchConceptsPre-hospital triagePotential viral transmissionHealthcare system capacityPopulation health managementCOVID-19 pandemicEmergency departmentCOVID-19 casesAppropriate careU.S. healthcare systemClinical staffViral transmissionPatient demandPartners HealthCareHealthcare systemCOVID-19PatientsCareNovel strategyHealth managementArtificial intelligenceHospitalizationPandemicUnique challengesClinicCliniciansImpact of Emergency Department Crowding on Delays in Acute Stroke Care
Jaffe T, Goldstein J, Yun B, Etherton M, Leslie-Mazwi T, Schwamm L, Zachrison K. Impact of Emergency Department Crowding on Delays in Acute Stroke Care. Western Journal Of Emergency Medicine 2020, 21: 892-899. PMID: 32726261, PMCID: PMC7390586, DOI: 10.5811/westjem.2020.5.45873.Peer-Reviewed Original ResearchConceptsAcute stroke careStroke careED crowdingEndovascular therapyConsecutive acute ischemic stroke patientsCare deliveryAcute ischemic stroke patientsGroin puncture timeGuidelines-Stroke registryStroke care deliveryHealth Stroke ScaleIschemic stroke patientsMultiple clinical factorsUrban academic EDInitial stroke severityHigh ED utilizationSingle-institution analysisAcute care deliveryEmergency stroke careOutcomes of interestWilcoxon rank sum testEmergency department (ED) crowdingRank sum testAlteplase deliveryDTN time
2018
Virtual Visits Partially Replaced In-Person Visits In An ACO-Based Medical Specialty Practice
Shah S, Schwamm L, Cohen A, Simoni M, Estrada J, Matiello M, Venkataramani A, Rao S. Virtual Visits Partially Replaced In-Person Visits In An ACO-Based Medical Specialty Practice. Health Affairs 2018, 37: 2045-2051. PMID: 30633681, DOI: 10.1377/hlthaff.2018.05105.Peer-Reviewed Original Research
2017
Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network
Moreno A, Schwamm L, Siddiqui K, Viswanathan A, Whitney C, Rost N, Zachrison K. Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network. Telemedicine Journal And E-Health 2017, 24: 678-683. PMID: 29271703, PMCID: PMC6014912, DOI: 10.1089/tmj.2017.0252.Peer-Reviewed Original ResearchConceptsDTN timePatient presentationTelestroke consultsTelestroke networkPatient-level regression analysesAcute ischemic stroke patientsShorter DTN timesIschemic stroke patientsFrequent contactPrimary predictor variableMedian DTNTPA administrationNeedle timeTPA useSpoke hospitalsStroke patientsMore frequent contactsHub hospitalImproved outcomesMedian numberTPA deliveryPatientsHospitalRegression analysisTelestroke
2012
Implementing a State-based Stroke Quality Improvement Collaborative
O’Neill H, Coe L, Magdon-Ismail Z, Schwamm L. Implementing a State-based Stroke Quality Improvement Collaborative. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2012, 11: 114-122. PMID: 22825531, DOI: 10.1097/hpc.0b013e31825e12a6.Peer-Reviewed Original ResearchConceptsStroke quality improvementService hospitalsAmerican Heart Association/American Stroke AssociationHealthcare Improvement collaborative modelAcute stroke careAmerican Stroke AssociationNational clinical guidelinesQuality Improvement CollaborativeClinical quality improvementCase entryHospital quality improvementStroke careStroke AssociationClinical guidelinesHospital representativesPatient careStroke dischargesHospitalMassachusetts DepartmentQuality improvementHospital fundingPublic healthConsistent participationDescriptive statisticsCollaborative modelPredictors of Increased Intravenous Tissue Plasminogen Activator Use Among Hospitals Participating in the Massachusetts Primary Stroke Service Program
Rost N, Smith E, Pervez M, Mello P, Dreyer P, Schwamm L. Predictors of Increased Intravenous Tissue Plasminogen Activator Use Among Hospitals Participating in the Massachusetts Primary Stroke Service Program. Circulation Cardiovascular Quality And Outcomes 2012, 5: 314-320. PMID: 22534407, PMCID: PMC3361890, DOI: 10.1161/circoutcomes.111.962829.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overEmergency Service, HospitalFemaleFibrinolytic AgentsHealthcare DisparitiesHumansInfusions, IntravenousLinear ModelsLogistic ModelsMaleMassachusettsMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionPractice Guidelines as TopicQuality ImprovementRegional Medical ProgramsRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntravenous tissue plasminogen activator useTissue plasminogen activator useAcute ischemic strokeTPA useIschemic strokeOlder acute ischemic stroke patientsAcute ischemic stroke patientsGuidelines-Stroke programStroke center designationIschemic stroke patientsRate of thrombolysisQuality improvement initiativesEmergency medical servicesStroke onsetSymptom onsetStroke patientsTreatment disparitiesCenter designationPatientsHospitalMassachusetts DepartmentImprovement initiativesMedical servicesOverall rateFurther studies
2008
Stroke Center Designation Can be Achieved by Small Hospitals
Smith E, Dreyer P, Prvu-Bettger J, Abdullah A, Palmeri G, Goyette L, McElligott C, Schwamm L. Stroke Center Designation Can be Achieved by Small Hospitals. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2008, 7: 173-177. PMID: 18791405, DOI: 10.1097/hpc.0b013e318184e2bc.Peer-Reviewed Original ResearchConceptsAcute stroke teamSmall hospitalsStroke teamMassachusetts hospitalsStroke center designationTeaching hospital statusAcute ischemic strokeAcute stroke carePrimary stroke centerMassachusetts DepartmentPublic healthStroke RegistryIschemic strokeStroke centersStroke careStroke servicesCenter designationCare pathwayHospital characteristicsHospital statusTelemedicine consultationsHospitalTomography scanningLarge hospitalsBed size
2007
Serum lipid profile on admission for ischemic stroke
Smith E, Abdullah A, Amirfarzan H, Schwamm L. Serum lipid profile on admission for ischemic stroke. Neurology 2007, 68: 660-665. PMID: 17325272, DOI: 10.1212/01.wnl.0000255941.03761.dc.Peer-Reviewed Original ResearchConceptsLipid-lowering agentsLow-density lipoproteinStroke/TIALDL goalLDL targetsNational Cholesterol Education Program Adult Treatment Panel guidelinesAdult Treatment Panel guidelinesLow-density lipoprotein levelsIschemic stroke/TIACharacteristics of patientsSerum lipid profileATPIII guidelinesCardiovascular eventsIschemic strokeLipoprotein levelsLDL levelsLipid profileMultivariable modelPanel guidelinesLipid measurementsNational guidelinesTherapeutic targetGreater riskPatientsCalendar time
2006
The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes
Reeves M, Broderick J, Frankel M, LaBresh K, Schwamm L, Moomaw C, Weiss P, Katzan I, Arora S, Heinrich J, Hickenbottom S, Karp H, Malarcher A, Mensah G, Reeves M. The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes. American Journal Of Preventive Medicine 2006, 31: s202-s209. PMID: 17178304, DOI: 10.1016/j.amepre.2006.08.007.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorStroke admissionsPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryPlasminogen activatorAcute stroke admissionsAcute Stroke RegistrySmoking cessation counselingPercent of patientsTransient ischemic attackAcute stroke careAcute stroke patientsPercent of admissionsHours of onsetIschemic stroke admissionsHealthcare system levelQuality improvement interventionsYears of ageAntithrombotic treatmentIschemic attackLipid testingStroke RegistryEligible subjectsIschemic stroke
2005
Acute Stroke Care in the US
Reeves M, Arora S, Broderick J, Frankel M, Heinrich J, Hickenbottom S, Karp H, LaBresh K, Malarcher A, Mensah G, Moomaw C, Schwamm L, Weiss P. Acute Stroke Care in the US. Stroke 2005, 36: 1232-1240. PMID: 15890989, DOI: 10.1161/01.str.0000165902.18021.5b.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageFemaleFibrinolytic AgentsGeorgiaHospital RecordsHumansInfusions, IntravenousIschemic Attack, TransientMaleMassachusettsMichiganMiddle AgedOhioPilot ProjectsProspective StudiesQuality ControlRecombinant ProteinsRegistriesRetrospective StudiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsRecombinant tissue plasminogen activatorAcute stroke careStroke careStroke admissionsPaul Coverdell National Acute Stroke RegistryIntravenous recombinant tissue plasminogen activatorNational Acute Stroke RegistryHealth care system levelsAcute stroke admissionsAcute Stroke RegistryTransient ischemic attackAcute stroke patientsHours of onsetIschemic stroke admissionsMinutes of arrivalSecondary prevention practicesAge 60 yearsQuality improvement interventionsTissue plasminogen activatorIschemic attackCessation counselingStroke RegistryIschemic strokeIntracerebral hemorrhageStroke patients