Featured Publications
Comparative Effectiveness of Machine Learning Approaches for Predicting Gastrointestinal Bleeds in Patients Receiving Antithrombotic Treatment
Herrin J, Abraham NS, Yao X, Noseworthy PA, Inselman J, Shah ND, Ngufor C. Comparative Effectiveness of Machine Learning Approaches for Predicting Gastrointestinal Bleeds in Patients Receiving Antithrombotic Treatment. JAMA Network Open 2021, 4: e2110703. PMID: 34019087, PMCID: PMC8140376, DOI: 10.1001/jamanetworkopen.2021.10703.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnticoagulantsAntifibrinolytic AgentsAtrial FibrillationClinical Decision-MakingCohort StudiesCross-Sectional StudiesFemaleFibrinolytic AgentsGastrointestinal HemorrhageHumansMachine LearningMaleMiddle AgedMyocardial IschemiaPredictive Value of TestsRetrospective StudiesRisk AssessmentThienopyridinesUnited StatesVenous ThromboembolismYoung AdultConceptsGastrointestinal bleedingIschemic heart diseaseCross-sectional studyThienopyridine antiplatelet agentAntithrombotic treatmentVenous thromboembolismAntiplatelet agentsRandom survival forestStudy cohortAtrial fibrillationValidation cohortHeart diseaseHAS-BLED risk scoreRetrospective cross-sectional studyCox proportional hazards regressionHAS-BLED scorePrior GI bleedPatients 18 yearsCohort of patientsEntire study cohortProportional hazards regressionOptumLabs Data WarehouseMedicare Advantage enrolleesPositive predictive valueRisk prediction model
2021
National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlReal-world Cardiovascular Outcomes Associated With Degarelix vs Leuprolide for Prostate Cancer Treatment
Wallach JD, Deng Y, McCoy RG, Dhruva SS, Herrin J, Berkowitz A, Polley EC, Quinto K, Gandotra C, Crown W, Noseworthy P, Yao X, Shah ND, Ross JS, Lyon TD. Real-world Cardiovascular Outcomes Associated With Degarelix vs Leuprolide for Prostate Cancer Treatment. JAMA Network Open 2021, 4: e2130587. PMID: 34677594, PMCID: PMC8536955, DOI: 10.1001/jamanetworkopen.2021.30587.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsSecondary end pointsMyocardial infarctionClinical trialsCardiovascular diseaseProstate cancerCardiovascular eventsEnd pointRisk of MACELarge US administrative claims databasePropensity-matched cohort studyUS administrative claims databasePropensity score-matched patientsAdverse cardiovascular eventsPrimary end pointAdministrative claims databaseProportional hazards regressionRandomized clinical trialsAdministrative claims dataTrial eligibility criteriaMedicare Advantage beneficiariesProstate cancer treatmentReal-world evidenceElectronic health recordsCardiovascular outcomes
2020
Association of Do-Not-Resuscitate Patient Case Mix With Publicly Reported Risk-Standardized Hospital Mortality and Readmission Rates
Pollock BD, Herrin J, Neville MR, Dowdy SC, Franco P, Shah ND, Ting HH. Association of Do-Not-Resuscitate Patient Case Mix With Publicly Reported Risk-Standardized Hospital Mortality and Readmission Rates. JAMA Network Open 2020, 3: e2010383. PMID: 32662845, PMCID: PMC7361656, DOI: 10.1001/jamanetworkopen.2020.10383.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesChronic obstructive pulmonary diseaseAcute myocardial infarctionRevision diagnosis codesHeart failureCross-sectional studyDNR statusReadmission cohortInpatient encountersMortality cohortHighest quintileDiagnosis codesTenth Revision diagnosis codesNinth Revision diagnosis codesAcute care transfersStandard Analytical FilesObstructive pulmonary diseaseCMS Hospital Compare websitePatient-level dataHospital-level performanceHospital-level dataInternational Statistical ClassificationRelated Health ProblemsHospital Compare websiteHospital mortalityPatient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm
Smith LB, Desai NR, Dowd B, Everhart A, Herrin J, Higuera L, Jeffery MM, Jena AB, Ross JS, Shah ND, Karaca-Mandic P. Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm. International Journal Of Health Economics And Management 2020, 20: 299-317. PMID: 32350680, PMCID: PMC7725279, DOI: 10.1007/s10754-020-09282-2.Peer-Reviewed Original ResearchConceptsPermanent atrial fibrillationType 2 diabetesAtrial fibrillationPermanent atrial fibrillation patientsProvider-level factorsAtrial fibrillation patientsEffective new therapiesPrimary care providersUse of medicationsProvider-level characteristicsUtilization of treatmentHigh-quality health careDronedarone useInterrupted time-series regression modelsFibrillation patientsMedication useDiabetes patientsProvider characteristicsCare providersMedicare feeNew therapiesService claimsFemale providersPatientsMedications
2019
Income disparities in needle biopsy patients prior to breast cancer surgery across physician peer groups
Killelea BK, Herrin J, Soulos PR, Pollack CE, Forman HP, Yu J, Xu X, Tannenbaum S, Wang SY, Gross CP. Income disparities in needle biopsy patients prior to breast cancer surgery across physician peer groups. Breast Cancer 2019, 27: 381-388. PMID: 31792804, PMCID: PMC7512133, DOI: 10.1007/s12282-019-01028-4.Peer-Reviewed Original ResearchConceptsPhysician peer groupsLow-income patientsNeedle biopsyOdds ratioHigh-income patientsBreast cancer surgeryMethodsThe SurveillanceCancer surgeryIncome patientsMedicare databaseBiopsy patientsMedicare beneficiariesPatientsBiopsyLow incomeGroupDisparitiesReceiptEnd resultHigher incomeSurgeryPeer groupEpidemiologyFurther workGroup-level effectsPeer Influence on Physician Use of Shorter Course External Beam Radiation Therapy for Patients with Breast Cancer
Yu JB, Pollack CE, Herrin J, Soulos PR, Zhu W, Xu X, Gross CP. Peer Influence on Physician Use of Shorter Course External Beam Radiation Therapy for Patients with Breast Cancer. Practical Radiation Oncology 2019, 10: 75-83. PMID: 31785370, PMCID: PMC7061062, DOI: 10.1016/j.prro.2019.11.001.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrachytherapyBreast NeoplasmsCohort StudiesFemaleHumansPeer InfluencePhysiciansConceptsAdjuvant external beam radiation therapyExternal beam radiation therapyPhysician peer groupsPalliative external beam radiation therapyBeam radiation therapyBreast cancerAdjuvant therapyBone metastasesPatient receiptRadiation therapyBreast-conserving surgeryMixed-effects logistic regressionPatient-sharing relationshipsPalliative therapyCancer careMedicare beneficiariesPatientsPhysician useTherapyLogistic regressionShort courseCancerPhysiciansGroup rateMetastasisHome Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization
Weerahandi H, Bao H, Herrin J, Dharmarajan K, Ross JS, Jones S, Horwitz LI. Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization. Journal Of The American Geriatrics Society 2019, 68: 96-102. PMID: 31603248, PMCID: PMC6964248, DOI: 10.1111/jgs.16179.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesHF hospitalizationReadmission ratesReadmission riskHeart failure readmission ratesDays of dischargeHeart failure hospitalizationRetrospective cohort studyHospital discharge practicesMore functional impairmentHome health careFailure hospitalizationHF patientsUnplanned readmissionCohort studyHospital dischargePrimary outcomeRestorative therapySNF stayFunctional impairmentHome healthcare servicesService Medicare dataAdjusted modelCox modelNursing facilitiesRacial and Ethnic Differences in 30-Day Hospital Readmissions Among US Adults With Diabetes
Rodriguez-Gutierrez R, Herrin J, Lipska KJ, Montori VM, Shah ND, McCoy RG. Racial and Ethnic Differences in 30-Day Hospital Readmissions Among US Adults With Diabetes. JAMA Network Open 2019, 2: e1913249. PMID: 31603490, PMCID: PMC6804020, DOI: 10.1001/jamanetworkopen.2019.13249.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overAsianBlack or African AmericanComorbidityDiabetes ComplicationsEthnicityFemaleHispanic or LatinoHospital Bed Capacity, 300 to 499Hospital Bed Capacity, 500 and overHospitals, UniversityHospitals, VoluntaryHumansIncomeMaleMiddle AgedMinority GroupsPatient ReadmissionRacial GroupsRetrospective StudiesUnited StatesWhite PeopleConceptsCause readmissionIndex hospitalizationBlack patientsWhite patientsUS adultsHigh riskAdministrative claims data setsHospital-level risk factorsEthnic differencesLarge hospitalsPlace of hospitalizationDays of dischargeRetrospective cohort studyLow-income patientsMedicare Advantage beneficiariesSystem-level factorsClaims data setsHealth care qualityRace/ethnicityCohort studyReadmission ratesAdult patientsHospital readmissionHispanic patientsReadmission riskHospital Variation in Spending for Lung Cancer Resection in Medicare Beneficiaries
Jean RA, Bongiovanni T, Soulos PR, Chiu AS, Herrin J, Kim N, Xu X, Kim AW, Gross CP. Hospital Variation in Spending for Lung Cancer Resection in Medicare Beneficiaries. The Annals Of Thoracic Surgery 2019, 108: 1710-1716. PMID: 31400321, DOI: 10.1016/j.athoracsur.2019.06.048.Peer-Reviewed Original ResearchConceptsStage I non-small cell lung carcinomaNon-small cell lung carcinomaCell lung carcinomaHospital volumeLung carcinomaComplication rateMedicare beneficiariesExcess costsEnd Results-MedicareIndex hospital costsLung cancer careMean excess costLung cancer resectionHospital-level variationNumber of complicationsLung cancer treatmentEpisode of careCost of careLowest cost quintileIndex hospitalizationCancer resectionHospital factorsPerioperative careHospital variationSurgical hospitalizationAssociation Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging
Shi Y, Pollack CE, Soulos PR, Herrin J, Christakis NA, Xu X, Gross CP. Association Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging. Medical Care 2019, 57: 460-467. PMID: 31008899, PMCID: PMC6522278, DOI: 10.1097/mlr.0000000000001123.Peer-Reviewed Original ResearchConceptsBreast magnetic resonance imagingMagnetic resonance imagingPerioperative magnetic resonance imagingMRI useResonance imagingSurgeons' useBreast cancer carePatient-sharing networksPractice of surgeonsPairs of surgeonsUnproven benefitRetrospective studyPhysician pairsCancer carePractice patternsBreast cancerMRI utilizationMedicare dataSurgical colleaguesPatientsSurgeonsStudy periodPhysician networksCareAssociationPersistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014
Yu JB, Pollack CE, Herrin J, Zhu W, Soulos PR, Xu X, Gross CP. Persistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014. American Journal Of Clinical Oncology 2019, 42: 493-499. PMID: 31033511, PMCID: PMC6538429, DOI: 10.1097/coc.0000000000000548.Peer-Reviewed Original ResearchConceptsPalliative radiotherapyBone metastasesMedicare beneficiariesBreast cancerAssociation of clinicalProportion of patientsChoice of treatmentHospital-based practiceService Medicare beneficiariesSingle-fraction treatmentProvider financial incentivesLogistic regression modelsDifferent fractionation schemesProlonged courseRadiation courseRadiotherapy usePayer perspectiveProvider characteristicsMean costMultiple guidelinesPatientsRadiotherapyMetastasisCancerNumber of daysDifferential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery
Hoag JR, Resio BJ, Monsalve AF, Chiu AS, Brown LB, Herrin J, Blasberg JD, Kim AW, Boffa DJ. Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery. JAMA Network Open 2019, 2: e191912. PMID: 30977848, PMCID: PMC6481444, DOI: 10.1001/jamanetworkopen.2019.1912.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer surgeryCancer HospitalMedicare beneficiariesCancer NetworkRelative safetyStandardized mortality ratioComplex cancer careCross-sectional studyTop-ranked hospitalsMedicaid Services 100Hierarchical logistic regressionPerioperative mortalityAffiliated HospitalCancer careMortality ratioOdds ratioMAIN OUTCOMESurgeryHospitalReview filesDifferential safetyLogistic regressionMortalityMedicare providersRisk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. Journal Of The American Medical Directors Association 2019, 20: 432-437. PMID: 30954133, PMCID: PMC6486375, DOI: 10.1016/j.jamda.2019.01.135.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesSNF dischargeRetrospective cohort studySNF lengthHeart failureHF hospitalizationComposite outcomeCohort studyNursing facilitiesService beneficiaries 65Heart failure hospitalizationRisk of readmissionHazard rate ratiosFailure hospitalizationUnplanned readmissionHF diagnosisHospital dischargePostdischarge outcomesSNF stayMedicare patientsMedicare feeHome transitionPatientsReadmissionDay 3Trends in Hospital Readmission of Medicare-Covered Patients With Heart Failure
Blecker S, Herrin J, Li L, Yu H, Grady JN, Horwitz LI. Trends in Hospital Readmission of Medicare-Covered Patients With Heart Failure. Journal Of The American College Of Cardiology 2019, 73: 1004-1012. PMID: 30846093, PMCID: PMC7011858, DOI: 10.1016/j.jacc.2018.12.040.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramSecondary heart failureReadmission ratesHeart failureReadmissions Reduction ProgramHF hospitalizationAffordable Care ActMedicare's Hospital Readmissions Reduction ProgramRisk-adjusted readmission ratesCause readmission rateHigher readmission ratesAcute myocardial infarctionCare ActReduction programsLinear spline regression modelsPneumonia hospitalizationsHospital readmissionMedicare hospitalizationsRetrospective studySecondary diagnosisMyocardial infarctionPrincipal diagnosisHospitalizationSpline regression modelsPatients
2018
Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI
Tannenbaum SS, Soulos PR, Herrin J, Pollack CE, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang S, Gross CP. Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI. Cancer Medicine 2018, 7: 5901-5909. PMID: 30444005, PMCID: PMC6308117, DOI: 10.1002/cam4.1821.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPatient-sharing networksBreast cancerPerioperative MRISubsequent receiptNon-cancer patientsBreast cancer practiceMultivariable hierarchical modelsUse of MRIClinical characteristicsCare physiciansFemale patientsCancer practiceMedicare databaseNew imaging techniquesMedicare sampleStage 0Claims dataPatientsPhysician groupsMRISurgeonsCancerEquivocal evidencePhysiciansAssociation of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristicsPhysician peer group characteristics and timeliness of breast cancer surgery
Bachand J, Soulos PR, Herrin J, Pollack CE, Xu X, Ma X, Gross CP. Physician peer group characteristics and timeliness of breast cancer surgery. Breast Cancer Research And Treatment 2018, 170: 657-665. PMID: 29693229, PMCID: PMC6048589, DOI: 10.1007/s10549-018-4789-8.Peer-Reviewed Original ResearchConceptsPhysician peer groupsSurgical delayProvider densityPatient racial compositionBreast cancerEnd Results-Medicare dataBreast cancer patientsBreast cancer surgeryResultsThe study sampleConclusionsThe likelihoodBlack patientsCancer surgeryCancer patientsSurgeryPatientsStudy sampleWomenCancerAssociationGroupGroup characteristicsPurposeLittleInterdisciplinary groupPeer groupEpidemiologyRecurrent hospitalizations for severe hypoglycemia and hyperglycemia among U.S. adults with diabetes
McCoy RG, Herrin J, Lipska KJ, Shah ND. Recurrent hospitalizations for severe hypoglycemia and hyperglycemia among U.S. adults with diabetes. Journal Of Diabetes And Its Complications 2018, 32: 693-701. PMID: 29751961, PMCID: PMC6015781, DOI: 10.1016/j.jdiacomp.2018.04.007.Peer-Reviewed Original ResearchConceptsRecurrent hyperglycemiaRecurrent hypoglycemiaNew glucose-lowering medicationsPost-discharge managementGlucose-lowering medicationsHigh-risk patientsOptumLabs Data WarehouseHypoglycemia hospitalizationIndex dischargeOlder patientsRisk patientsUnrelated causesSevere hypoglycemiaRecurrent hospitalizationsNational cohortEarly recognitionPrincipal diagnosisRisk factorsRetrospective analysisHyperglycemiaHypoglycemiaPatientsReadmissionU.S. adultsHospitalization
2017
Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer
Tannenbaum S, Soulos PR, Herrin J, Mougalian S, Long JB, Wang R, Ma X, Gross CP, Xu X. Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer. Medical Care 2017, 55: 1030-1038. PMID: 29068906, PMCID: PMC5863278, DOI: 10.1097/mlr.0000000000000822.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsNonmetastatic breast cancerBreast cancerCancer careMedicare beneficiariesMedicare expendituresCancer expendituresBetter survivalEnd Results-MedicareRetrospective cohort studyPatients 3 yearsClinical characteristicsCohort studyOverall survivalCancer stagePatient outcomesOutcome measuresReferral regionsOlder womenSignificant associationStage IIBivariate analysisCancerQuintile