2024
Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure
Lu Y, Arowojolu O, Qiu X, Liu Y, Curry L, Krumholz H. Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure. JAMA Network Open 2024, 7: e2426135. PMID: 39106065, PMCID: PMC11304113, DOI: 10.1001/jamanetworkopen.2024.26135.Peer-Reviewed Original ResearchConceptsBarriers to guideline adherenceElectronic health recordsGuideline adherenceClinician adherenceEHR dataElevated blood pressureHypertension managementAnalysis of EHR dataYale New Haven Health SystemSevere hypertensionClinical practice guidelinesAdherence scenariosQualitative content analysisPublic health challengeThematic saturationHealth recordsHealth systemBlood pressureThematic analysisTargeted interventionsManagement of severe hypertensionQualitative studyHealth challengesPractice guidelinesPatient outcomesLearning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial
Song J, Wang X, Wang B, Ge Y, Bi L, Jing F, Jin H, Li T, Gu B, Wang L, Hao J, Zhao Y, Liu J, Zhang H, Li X, Li J, Ma W, Wang J, Normand S, Herrin J, Armitage J, Krumholz H, Zheng X. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. The BMJ 2024, 386: e079143. PMID: 39043397, PMCID: PMC11265211, DOI: 10.1136/bmj-2023-079143.Peer-Reviewed Original ResearchConceptsClinical decision support systemsPrimary care practicesElectronic health recordsIntervention groupSystolic blood pressurePrimary careCare practicesBlood pressure <Health recordsPragmatic cluster randomised controlled trialCluster randomised controlled trialImproving hypertension treatmentPrimary care settingBlood pressure control ratesBlood pressureProportion of visitsProportion of participantsRandomised controlled trialsSystolic blood pressure <Control groupInjurious fallsRelated visitsCare settingsDiastolic blood pressure <Follow-up
2021
Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican College
2020
Quality of Care for Patients Hospitalized for Heart Failure in China
Gupta A, Yu Y, Tan Q, Liu S, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J. Quality of Care for Patients Hospitalized for Heart Failure in China. JAMA Network Open 2020, 3: e1918619. PMID: 31913489, PMCID: PMC6991250, DOI: 10.1001/jamanetworkopen.2019.18619.Peer-Reviewed Original ResearchMeSH KeywordsChinaCross-Sectional StudiesGuideline AdherenceHeart FailureHospitalizationHospitalsHumansQuality of Health CareRetrospective StudiesConceptsQuality of careHospital levelHF careEligible patientsComposite performance scoreEvidence-based β-blockersAngiotensin-converting enzyme inhibitorRetrospective cross-sectional studyVentricular ejection fraction assessmentMedian rateAngiotensin receptor blockersMedian patient ageHeart failure epidemicCross-sectional studyEjection fraction assessmentMedian odds ratioPerformance scoresHF hospitalizationReceptor blockersPatient ageHeart failureHospital admissionMedical recordsOdds ratioMAIN OUTCOME
2019
Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular functionAssociation Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak association
2018
Assessment of US Hospital Compliance With Regulations for Patients’ Requests for Medical Records
Lye CT, Forman HP, Gao R, Daniel JG, Hsiao AL, Mann MK, deBronkart D, Campos HO, Krumholz HM. Assessment of US Hospital Compliance With Regulations for Patients’ Requests for Medical Records. JAMA Network Open 2018, 1: e183014. PMID: 30646219, PMCID: PMC6324595, DOI: 10.1001/jamanetworkopen.2018.3014.Peer-Reviewed Original Research
2017
Adherence to Methodological Standards in Research Using the National Inpatient Sample
Khera R, Angraal S, Couch T, Welsh JW, Nallamothu BK, Girotra S, Chan PS, Krumholz HM. Adherence to Methodological Standards in Research Using the National Inpatient Sample. JAMA 2017, 318: 2011-2018. PMID: 29183077, PMCID: PMC5742631, DOI: 10.1001/jama.2017.17653.Peer-Reviewed Original ResearchImplications of Coronary Artery Calcium Testing for Treatment Decisions Among Statin Candidates According to the ACC/AHA Cholesterol Management Guidelines A Cost-Effectiveness Analysis
Hong JC, Blankstein R, Shaw LJ, Padula WV, Arrieta A, Fialkow JA, Blumenthal RS, Blaha MJ, Krumholz HM, Nasir K. Implications of Coronary Artery Calcium Testing for Treatment Decisions Among Statin Candidates According to the ACC/AHA Cholesterol Management Guidelines A Cost-Effectiveness Analysis. JACC Cardiovascular Imaging 2017, 10: 938-952. PMID: 28797417, DOI: 10.1016/j.jcmg.2017.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationBayes TheoremClinical Decision-MakingComputer SimulationCoronary AngiographyCoronary Artery DiseaseCoronary VesselsCost-Benefit AnalysisDecision Support TechniquesDrug CostsFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedModels, EconomicMonte Carlo MethodMultivariate AnalysisPractice Guidelines as TopicPredictive Value of TestsQuality of LifeQuality-Adjusted Life YearsTime FactorsTreatment OutcomeUnited StatesVascular CalcificationConceptsCoronary artery calciumQuality-adjusted life yearsStatin therapyArtery calciumLong-term statin therapyAtherosclerotic cardiovascular disease eventsCholesterol management guidelinesIncremental cost-effectiveness ratioCardiovascular disease eventsAtherosclerotic cardiovascular diseaseCost-effectiveness ratioCost-effectiveness analysisStatin candidatesCholesterol managementCardiovascular diseaseTreatment decisionsAmerican CollegeDisease eventsLifetime horizonLife yearsAmerican HeartSocietal perspectiveManagement guidelinesStatinsPatientsQuality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction
Downing NS, Wang Y, Dharmarajan K, Nuti SV, Murugiah K, Du X, Zheng X, Li X, Li J, Masoudi FA, Spertus JA, Jiang L, Krumholz HM. Quality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction. Journal Of The American Heart Association 2017, 6: e005040. PMID: 28645937, PMCID: PMC5669155, DOI: 10.1161/jaha.116.005040.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionRisk-standardized mortality ratesQuality of careGuideline-recommended careGuideline-recommended treatmentMyocardial infarctionMortality rateST-segment elevation myocardial infarctionChina PEACE-Retrospective AMI StudyComposite rateMedian risk-standardized mortality rateProportion of patientsElevation myocardial infarctionQuality improvement initiativesProportion of opportunitiesDefect-free rateHospital levelInfarctionHospitalChinese hospitalsPatientsCareAMI studyImprovement initiativesHigh rate
2016
Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries
Bucholz EM, Butala NM, Normand SL, Wang Y, Krumholz HM. Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries. Journal Of The American College Of Cardiology 2016, 67: 2378-2391. PMID: 27199062, PMCID: PMC5097252, DOI: 10.1016/j.jacc.2016.03.507.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAspirinFemaleFollow-Up StudiesGuideline AdherenceHospitalizationHumansLife ExpectancyMaleMedicareMyocardial InfarctionPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPractice Guidelines as TopicThrombolytic TherapyTime-to-TreatmentUnited StatesConceptsAcute myocardial infarctionPrimary percutaneous coronary interventionGuideline-based therapyYears of lifeAdmission therapyLife expectancyMyocardial infarctionMedicare beneficiariesCox proportional hazards regressionAcute reperfusion therapyLate survival benefitReceipt of aspirinPercutaneous coronary interventionLong-term outcomesProportional hazards regressionCooperative Cardiovascular ProjectElderly Medicare beneficiariesDose-response relationshipAssociation of GuidelineShort life expectancyLonger life expectancyReperfusion therapyCoronary interventionD2B timeElderly patientsReply Coronary Artery Calcification Testing: A Platonic Certainty
Nasir K, Krumholz HM. Reply Coronary Artery Calcification Testing: A Platonic Certainty. Journal Of The American College Of Cardiology 2016, 67: 1126-1127. PMID: 26940937, DOI: 10.1016/j.jacc.2015.12.027.Peer-Reviewed Original ResearchThe China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design
Rao C, Bongiovanni T, Li X, Gao H, Zhang H, Li J, Zhao Y, Yuan X, Hua K, Hu S, Krumholz HM, Jiang L, Zheng Z. The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design. BMJ Open 2016, 6: e009743. PMID: 26880670, PMCID: PMC4762131, DOI: 10.1136/bmjopen-2015-009743.Peer-Reviewed Original ResearchConceptsComplex coronary artery diseaseCoronary artery diseaseArtery diseaseLarge cardiovascular centresCardiac eventsProspective studyCardiovascular CenterTreatment strategiesCoronary revascularisation proceduresSYNTAX score calculationThree-vessel diseaseElective coronary angiographyMedical record abstractionPatient-reported outcomesAppropriateness of treatmentQuality improvement initiativesQuality of lifeEligible patientsRevascularisation proceduresAdverse eventsGuideline adherenceHospital factorsProspective cohortSecondary preventionCoronary angiography
2015
Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes
Desai NR, Parzynski CS, Krumholz HM, Minges KE, Messenger JC, Nallamothu BK, Curtis JP. Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes. JAMA Internal Medicine 2015, 175: 1988. PMID: 26551259, PMCID: PMC5584388, DOI: 10.1001/jamainternmed.2015.6217.Peer-Reviewed Original ResearchImplications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis)
Nasir K, Bittencourt MS, Blaha MJ, Blankstein R, Agatson AS, Rivera JJ, Miedema MD, Sibley CT, Shaw LJ, Blumenthal RS, Budoff MJ, Krumholz HM. Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis). Journal Of The American College Of Cardiology 2015, 66: 1657-1668. PMID: 26449135, DOI: 10.1016/j.jacc.2015.07.066.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationAtherosclerosisCalciumCoronary AngiographyCoronary Artery DiseaseCoronary VesselsEthnicityFemaleFollow-Up StudiesGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProspective StudiesRisk AssessmentRisk FactorsUnited StatesConceptsCoronary artery calciumASCVD event ratesYears of ageStatin therapyAmerican CollegeAbsence of CACHard coronary heart disease eventsNew ACC/AHA guidelinesCoronary Artery Calcium TestingACC/AHA guidelinesAtherosclerotic cardiovascular disease riskCoronary heart disease eventsLow-density lipoprotein levelsEvent ratesCholesterol management guidelinesHigh-intensity statinsHeart disease eventsLipid-lowering medicationsModerate-intensity statinsCardiovascular disease riskLow-density lipoproteinStatin candidatesASCVD riskAHA guidelinesArtery calciumMedication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures
Allen LA, Fonarow GC, Liang L, Schulte PJ, Masoudi FA, Rumsfeld JS, Ho PM, Eapen ZJ, Hernandez AF, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures. Circulation 2015, 132: 1347-1353. PMID: 26316616, PMCID: PMC4941099, DOI: 10.1161/circulationaha.115.014281.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBody Mass IndexCardiovascular AgentsComorbidityContraindicationsCross-Sectional StudiesDrug HypersensitivityDrug PrescriptionsDrug SubstitutionDrug Therapy, CombinationDrug UtilizationEvidence-Based MedicineFemaleGuideline AdherenceHeart FailureHospitalsHumansMaleMedication AdherenceMiddle AgedPatient AdmissionPatient DischargePolypharmacyPractice Guidelines as TopicQuality Assurance, Health CareConceptsHF quality measuresHydralazine/isosorbide dinitrateAngiotensin receptor blockersMedication groupHeart failureAldosterone antagonistsReceptor blockersMedication regimenIsosorbide dinitrateNew medicationsΒ-blockersEnzyme inhibitorsGuideline-directed medical therapyInitiation of angiotensinPrimary discharge diagnosisQuarter of patientsPatient's medication regimenHospital quality measuresAdequate prescribingMedication initiationHospital dischargeHospital admissionMedical therapyGuideline recommendationsDischarge diagnosisTrends in Cardiac Biomarker Testing in China for Patients with Acute Myocardial Infarction, 2001 to 2011: China PEACE-Retrospective AMI Study
Zhan L, Masoudi FA, Li X, Hu S, Venkatesh AK, Spertus JA, Lin Z, Desai NR, Li J, Krumholz HM, Jiang L, . Trends in Cardiac Biomarker Testing in China for Patients with Acute Myocardial Infarction, 2001 to 2011: China PEACE-Retrospective AMI Study. PLOS ONE 2015, 10: e0122237. PMID: 25893247, PMCID: PMC4404305, DOI: 10.1371/journal.pone.0122237.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac biomarker testingProportion of hospitalsBiomarker testingChinese hospitalsDiagnosis of AMIChina PEACE-Retrospective AMI StudyRate of useMiddle-income countriesMyocardial infarctionPractice compliesHigh-income countriesAMI admissionsBiomarker testsUrban hospitalBiomarker use
2014
Hospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure
Allen LA, Fonarow GC, Grau-Sepulveda MV, Hernandez AF, Peterson PN, Partovian C, Li SX, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Hospital Variation in Intravenous Inotrope Use for Patients Hospitalized With Heart Failure. Circulation Heart Failure 2014, 7: 251-260. PMID: 24488983, PMCID: PMC5459367, DOI: 10.1161/circheartfailure.113.000761.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiotonic AgentsCross-Sectional StudiesDose-Response Relationship, DrugFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHospital MortalityHospitalsHumansInfusions, IntravenousInpatientsLength of StayMaleOutcome Assessment, Health CarePractice Patterns, Physicians'RegistriesRetrospective StudiesSurvival RateUnited StatesConceptsInotrope useHeart failureInotropic therapyInotropic agentsGuidelines-Heart Failure registryIntravenous inotropic agentsIntravenous inotropic therapyRisk-standardized ratesUse of inotropesHeart failure hospitalizationHospital-level ratesRandom hospital effectsFailure hospitalizationClinical characteristicsHospital factorsInpatient mortalityClinical factorsClinical outcomesHospital variationHospital characteristicsHospital effectsPatientsUS hospitalsHospitalStudy period
2012
A Note to My Younger Colleagues. . .Be Brave
Krumholz HM. A Note to My Younger Colleagues. . .Be Brave. Circulation Cardiovascular Quality And Outcomes 2012, 5: 245-246. PMID: 22592750, DOI: 10.1161/circoutcomes.112.966473.Peer-Reviewed Original Research
2010
Blueprint for the dissemination of evidence-based practices in health care.
Yuan CT, Nembhard IM, Stern AF, Brush JE, Krumholz HM, Bradley EH. Blueprint for the dissemination of evidence-based practices in health care. Commonwealth Fund Issue Briefs 2010, 86: 1-16. PMID: 20469542.Peer-Reviewed Original Research