2024
Diagnostic experiences of Black and White patients with uterine cancer: A qualitative study
Britton M, Izampuye E, Clark M, Ornstein R, Nunez-Smith M, Wright J, Xu X. Diagnostic experiences of Black and White patients with uterine cancer: A qualitative study. Gynecologic Oncology 2024, 191: 67-73. PMID: 39362045, DOI: 10.1016/j.ygyno.2024.09.010.Peer-Reviewed Original ResearchDiagnosis of uterine cancerUterine cancerRacial disparitiesHealthcare systemSocial determinants of healthNon-Hispanic White (WhiteGynecologic careDeterminants of healthDiscriminatory experiencesSemi-structured interviewsPatient engagementSocial determinantsAcceptance of discomfortHealthcare accessPerceived barriersPatient experienceThematic analysisDiagnostic journeyQualitative studyAudio-recordedBlack respondentsWhite patientsNegative experiencesHealthcareStage II-IV diseaseTubal Sterilization Rates by State Abortion Laws After the Dobbs Decision
Xu X, Chen L, Desai V, Gross C, Pollack C, Schwartz P, Wright J. Tubal Sterilization Rates by State Abortion Laws After the Dobbs Decision. JAMA 2024, 332: 1204-1206. PMID: 39259564, PMCID: PMC11391354, DOI: 10.1001/jama.2024.16862.Peer-Reviewed Original ResearchImpact of medicaid expansion on cervical cancer screening: A state-specific difference in difference analysis
Bergstein A, Huang Y, Hershman D, Xu X, Wright J. Impact of medicaid expansion on cervical cancer screening: A state-specific difference in difference analysis. Gynecologic Oncology 2024, 189: 49-55. PMID: 39013240, DOI: 10.1016/j.ygyno.2024.06.028.Peer-Reviewed Original ResearchConceptsCervical cancer screeningBaseline screening ratesNon-expansion statesCancer screeningMedicaid expansion statesScreening ratesExpansion statesMedicaid expansionBehavioral Risk Factor Surveillance SystemRisk Factor Surveillance SystemImpact of Medicaid expansionPre-expansion periodPost-expansion periodAffordable Care ActEffect of Medicaid expansionOutcome measuresCare ActMedicaid coverageHousehold incomeEvaluate trendsSurveillance systemMedicaidDiD analysisState-specific differencesFemale respondentsImplementation of a multi-site neonatal simulation improvement program: a cost analysis
Xu X, Yao J, Bohnert J, Yamada N, Lee H. Implementation of a multi-site neonatal simulation improvement program: a cost analysis. BMC Health Services Research 2024, 24: 623. PMID: 38741098, PMCID: PMC11090826, DOI: 10.1186/s12913-024-11075-z.Peer-Reviewed Original ResearchConceptsNeonatal resuscitation trainingCalifornia Perinatal Quality Care CollaborativePre-implementation periodResuscitation trainingParticipating sitesPre-implementationNon-financial benefitsSuccessful programsConfidence intervalsMonthly costProgram implementation periodImprovement programsData collection formQuality Improvement ProgramMicro-costing approachCost accountingCare CollaborativeHealthcare sector perspectiveAssist hospitalsU.S. dollarsImplementation periodTeam practiceCollection formMean costTraining curriculumBundled Payments for Care Improvement and Quality of Care and Outcomes in Heart Failure
Oddleifson D, Holmes D, Alhanti B, Xu X, Heidenreich P, Wadhera R, Allen L, Greene S, Fonarow G, Spatz E, Desai N. Bundled Payments for Care Improvement and Quality of Care and Outcomes in Heart Failure. JAMA Cardiology 2024, 9: 222-232. PMID: 38170516, PMCID: PMC10765313, DOI: 10.1001/jamacardio.2023.5009.Peer-Reviewed Original ResearchNon-BPCI hospitalsCause readmission rateReadmission ratesHeart failureSignificant differential changesCare measuresHospital participationBPCI hospitalsHospital mortalityEnzyme inhibitors/angiotensin receptor blockersMortality rateBPCI programAngiotensin receptor neprilysin inhibitorEvidence-based β-blockersGuidelines-Heart Failure registryEnd pointBPCI Model 2Heart failure educationAngiotensin receptor blockersPrimary end pointSecondary end pointsThird of patientsCardiac resynchronization therapyCause mortality ratesHeart failure programPostpartum readmission risk: a comparison between stillbirths and live births
Sweeney L, Reddy U, Campbell K, Xu X. Postpartum readmission risk: a comparison between stillbirths and live births. American Journal Of Obstetrics And Gynecology 2024, 231: 463.e1-463.e14. PMID: 38367754, DOI: 10.1016/j.ajog.2024.02.017.Peer-Reviewed Original ResearchRisk of readmissionMental health/substance use disordersPostpartum readmissionHigher risk of readmissionLive birthsRisk of postpartum readmissionSecondary outcomesDelivery characteristicsNationally representative estimatesComplex sampling designRisk factorsIncreased maternal morbidityHigher household incomeTime of readmissionWeeks of dischargeHypertensive disorders of pregnancyUse disorderHigh riskVenous thromboembolismChildbirth hospitalizationPrimary cesareanSingleton stillbirthsDisorders of pregnancyMultivariate regression modelMaternal morbidity
2023
Black-White differences in uterine cancer symptomatology and stage at diagnosis
Xu X, Chen L, Nunez-Smith M, Clark M, Ferris J, Hershman D, Wright J. Black-White differences in uterine cancer symptomatology and stage at diagnosis. Gynecologic Oncology 2023, 180: 118-125. PMID: 38091770, PMCID: PMC10922746, DOI: 10.1016/j.ygyno.2023.11.029.Peer-Reviewed Original ResearchAdvanced stage diagnosisWhite patientsPostmenopausal bleedingPatient characteristicsEnd Results-Medicare databaseBlack-white differencesBlack-White disparitiesBlack patientsUterine cancerCancer symptomsHigh riskPatientsAdvanced stageSymptomsDiagnosisCancer symptomatologyRegression modelsRiskLarge proportionBleedingHistologyCancerEpidemiologySymptomatologyMonthsQuality, outcome, and cost of care provided to very low birth weight infants in California
Lapcharoensap W, Bennett M, Xu X, Lee H, Profit J, Dukhovny D. Quality, outcome, and cost of care provided to very low birth weight infants in California. Journal Of Perinatology 2023, 44: 224-230. PMID: 37805592, DOI: 10.1038/s41372-023-01792-4.Peer-Reviewed Original ResearchConceptsVery low birth weightCare of VLBW infantsLow birth weightRisk-adjusted costVLBW infantsQuality of careMethodsRetrospective studyBirth weightClinical outcomesHospital discharge recordsClinical factorsCost of careClinical dataHierarchical generalized linear modelsResultsIn totalBirth certificatesPatient outcomesInfantsPearson correlation coefficientAssociation of costDischarge recordsHospitalMeasures of costOutcomesCareTimeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data
Xu X, Chen L, Nunez-Smith M, Clark M, Wright J. Timeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data. PLOS ONE 2023, 18: e0289692. PMID: 37682914, PMCID: PMC10490884, DOI: 10.1371/journal.pone.0289692.Peer-Reviewed Original ResearchConceptsPostmenopausal bleedingFirst diagnostic procedureDiagnostic evaluationDiagnostic proceduresGynecologic conditionsMedicaid patientsCox proportional hazards modelPrompt diagnostic evaluationRetrospective cohort studyMarketScan Research DatabasesAdditional risk factorsNon-clinical factorsCommon gynecologic conditionProportional hazards modelLower ratesCohort studyMost patientsPatient characteristicsBenign etiologyGynecologic cancerCancer patientsPreventive careUterine cancerInsurance typeRisk factorsIn Situ Simulation and Clinical Outcomes in Infants Born Preterm
Chitkara R, Bennett M, Bohnert J, Yamada N, Fuerch J, Halamek L, Quinn J, Padua K, Gould J, Profit J, Xu X, Lee H. In Situ Simulation and Clinical Outcomes in Infants Born Preterm. The Journal Of Pediatrics 2023, 263: 113715. PMID: 37659586, PMCID: PMC10841094, DOI: 10.1016/j.jpeds.2023.113715.Peer-Reviewed Original ResearchConceptsChronic lung diseaseClinical outcomesNeonatal resuscitationDelivery room continuous positive airway pressureVery low birth weight birthsNeonatal intensive care unit admissionCalifornia Perinatal Quality Care CollaborativeContinuous positive airway pressureVery low birth weightSecondary outcomesNeonatal intensive care unitInfants born pretermLow birth weight birthsSevere intraventricular hemorrhageIntensive care unit admissionPositive airway pressureLow birth weightInfant born pretermEvaluate clinical outcomesIntensive care unitParticipating sitesIntraventricular hemorrhageWeeks gestationBorn pretermCollaborative quality improvement projectRacial disparities in diagnostic evaluation of uterine cancer among Medicaid beneficiaries
Xu X, Chen L, Nunez-Smith M, Clark M, Wright J. Racial disparities in diagnostic evaluation of uterine cancer among Medicaid beneficiaries. Journal Of The National Cancer Institute 2023, 115: 636-643. PMID: 36788453, PMCID: PMC10248843, DOI: 10.1093/jnci/djad027.Peer-Reviewed Original ResearchConceptsAbnormal uterine bleedingWhite patientsUterine cancerFirst diagnostic procedureDiagnostic evaluationBlack patientsDiagnostic proceduresBlack-White disparitiesManagement visitsMarketScan Multi-State Medicaid DatabaseMulti-State Medicaid DatabaseUterine bleedingPatient characteristicsMedicaid databaseEarly diagnosisMedicaid beneficiariesMultivariable regressionPatientsCancerRacial disparitiesDiagnosisVisitsMore evaluationDisparitiesBleedingRisk of postpartum readmission: a comparison between stillbirths and live births
Sweeney L, Reddy U, Campbell K, Xu X. Risk of postpartum readmission: a comparison between stillbirths and live births. American Journal Of Obstetrics And Gynecology 2023, 228: s522. DOI: 10.1016/j.ajog.2022.11.893.Peer-Reviewed Original Research
2022
Containment Bag Use Among Women Who Undergo Hysterectomy With Laparoscopic Power Morcellation.
Wright JD, Chen L, Melamed A, Clair CMS, Hou JY, Khoury-Collado F, Gockley A, Accordino M, Hershman DL, Xu X. Containment Bag Use Among Women Who Undergo Hysterectomy With Laparoscopic Power Morcellation. Obstetrics And Gynecology 2022 PMID: 35926199, DOI: 10.1097/AOG.0000000000004886.Peer-Reviewed Original ResearchMode of Delivery in Antepartum Singleton Stillbirths and Associated Risk Factors
Underwood K, Reddy UM, Hosier H, Sweeney L, Campbell KH, Xu X. Mode of Delivery in Antepartum Singleton Stillbirths and Associated Risk Factors. American Journal Of Perinatology 2022, 41: e193-e203. PMID: 35850142, DOI: 10.1055/s-0042-1750795.Peer-Reviewed Original ResearchMode of deliveryAntepartum stillbirthCesarean deliveryPrior cesareanVaginal deliveryMaternal hospital discharge recordsLower likelihoodAssociated risk factorsWeeks of gestationHospital discharge recordsNon-clinical factorsUrban teaching hospitalMultivariable regression analysisPopulation-based sampleFetal death certificatesSingleton stillbirthsPrimary outcomeHospital characteristicsRisk factorsTeaching hospitalDeath certificatesMultivariable regressionCesareanPatientsStillbirthMaternal Outcomes in Subsequent Pregnancies After Classical Cesarean Delivery
Thompson BB, Reddy UM, Burn M, Abdel-Razeq S, Xu X. Maternal Outcomes in Subsequent Pregnancies After Classical Cesarean Delivery. Obstetrics And Gynecology 2022, 140: 212-219. PMID: 35852271, DOI: 10.1097/aog.0000000000004869.Peer-Reviewed Original ResearchConceptsPrior classical cesarean deliveryLow transverse cesarean deliveryPrior low transverse cesarean deliveryClassical cesarean deliverySevere maternal morbidityClinical risk factorsCesarean deliveryUterine ruptureMaternal outcomesSubsequent pregnancyHospital characteristicsRate of SMMPatient clinical risk factorsNational Inpatient Sample databaseLive singleton birthsWeeks of gestationMode of deliveryCross-sectional analysisMaternal morbiditySingleton birthsRisk factorsOutcome measuresMultivariable regressionHigh riskPropensity score methodsPerioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks
Xu X, Soulos PR, Herrin J, Wang SY, Pollack CE, Killelea BK, Forman HP, Gross CP. Perioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks. PLOS ONE 2022, 17: e0265188. PMID: 35290417, PMCID: PMC8923453, DOI: 10.1371/journal.pone.0265188.Peer-Reviewed Original ResearchConceptsPhysician patient-sharing networksPerioperative magnetic resonance imagingClinical risk factorsMagnetic resonance imagingPatient clinical risk factorsPatient-sharing networksBreast cancer careRisk-adjusted ratesMastectomy usePhysician networksCancer careRisk factorsEnd Results-Medicare databaseCharacteristics of patientsProportion of patientsBreast cancer surgeryComposition of patientsMRI adoptionDistinct trajectoriesMore patientsCancer surgeryClinical outcomesCancer specialistsMRI usePatientsSafety Warning about Laparoscopic Power Morcellation in Hysterectomy: A Cost-Effectiveness Analysis of National Impact
Xu X, Desai VB, Schwartz PE, Gross CP, Lin H, Schymura MJ, Wright JD. Safety Warning about Laparoscopic Power Morcellation in Hysterectomy: A Cost-Effectiveness Analysis of National Impact. Women's Health Reports 2022, 3: 369-384. PMID: 35415718, PMCID: PMC8994439, DOI: 10.1089/whr.2021.0101.Peer-Reviewed Original ResearchSurgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database
Andiman SE, Bui A, Ascher-Walsh C, Wright J, Xu X. Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database. Urogynecology 2022, 28: e142-e148. PMID: 35113048, DOI: 10.1097/spv.0000000000001133.Peer-Reviewed Original ResearchConceptsConventional laparoscopic procedureConventional laparoscopic hysterectomyNationwide Readmissions DatabasePerioperative complicationsLaparoscopic hysterectomyLaparoscopic proceduresHospital costsMajor perioperative complicationsConventional laparoscopic approachMultivariable regression analysisRobot-assisted approachLarge national databaseProcedure codesSurgical complicationsInvasive hysterectomyLaparoscopic approachHysterectomyLower riskComplicationsReadmissionSacrocolpopexyPatient linkageNational databaseWeighted samplePatients
2021
Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma
Kho RM, Desai VB, Schwartz PE, Wright JD, Gross CP, Hutchison LM, Boscoe FP, Lin H, Xu X. Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma. Journal Of Minimally Invasive Gynecology 2021, 29: 119-127. PMID: 34265441, PMCID: PMC8752465, DOI: 10.1016/j.jmig.2021.07.004.Peer-Reviewed Original ResearchConceptsEndometrial samplingUterine leiomyosarcomaPreoperative diagnosisPreoperative detectionNew York State Cancer RegistryNew York Statewide PlanningPreoperative endometrial samplingSuboptimal surgical managementUse of hysteroscopyOutcomes of patientsRetrospective cohort studyState Cancer RegistryMultivariable regression analysisResearch Cooperative SystemAmbulatory surgery centersSample eligibility criteriaRace/ethnicityIndex surgeryCohort studyLocalized stageSupracervical hysterectomyCancer RegistryOutpatient encountersSurgical managementTumor size743 Mode of delivery in singleton stillbirths and associated risk factors
Underwood K, Reddy U, Hosier H, Sweeney L, Campbell K, Xu X. 743 Mode of delivery in singleton stillbirths and associated risk factors. American Journal Of Obstetrics And Gynecology 2021, 224: s465. DOI: 10.1016/j.ajog.2020.12.766.Peer-Reviewed Original Research