2023
National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020
Lu Y, Liu Y, Dhingra L, Caraballo C, Mahajan S, Massey D, Spatz E, Sharma R, Rodriguez F, Watson K, Masoudi F, Krumholz H. National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020. JAMA Network Open 2023, 6: e2345964. PMID: 38039001, PMCID: PMC10692850, DOI: 10.1001/jamanetworkopen.2023.45964.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHistory of ASCVDCross-sectional studyLifestyle modificationPharmacological medicationsOptimal careCurrent careUS adultsEthnic differencesWhite individualsGuideline-recommended therapiesTotal cholesterol controlNon-Hispanic white individualsNutrition Examination SurveyLatino individualsQuality of careSelf-reported raceStatin useRecommended TherapiesSecondary preventionCholesterol controlOptimal regimensSmoking cessationEligible participantsExamination SurveyAssociation of Population Well-Being With Cardiovascular Outcomes
Spatz E, Roy B, Riley C, Witters D, Herrin J. Association of Population Well-Being With Cardiovascular Outcomes. JAMA Network Open 2023, 6: e2321740. PMID: 37405774, PMCID: PMC10323707, DOI: 10.1001/jamanetworkopen.2023.21740.Peer-Reviewed Original ResearchConceptsPopulation health factorsCVD mortalityCoronary heart diseaseCross-sectional studyHeart diseaseCardiovascular diseaseSecondary outcomesHealth factorsCardiovascular outcomesHeart failureCardiovascular healthMortality rateCounty-level ratesLower CVD mortalityTotal CVD mortalityCardiovascular death ratesAcute myocardial infarctionTotal heart diseaseEffect sizePrimary outcomeHighest quintileLowest quintileMyocardial infarctionNational HealthMAIN OUTCOMEVariation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement
Chuzi S, Lindenauer P, Faridi K, Priya A, Pekow P, D'Aunno T, Mazor K, Stefan M, Spatz E, Gilstrap L, Werner R, Lagu T. Variation in Risk‐Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement. Journal Of The American Heart Association 2023, 12: e029758. PMID: 37345796, PMCID: PMC10356066, DOI: 10.1161/jaha.122.029758.Peer-Reviewed Original ResearchConceptsAcute admission ratesHeart failureMedicare Shared Savings Program Accountable Care OrganizationsAccountable care organizationsAdmission ratesMost ACOsPrimary care providersPerformance categoriesCare organizationsACO characteristicsHealth care qualityAdmission riskBlack beneficiariesCare providersMedicare feeService beneficiariesConclusions AdmissionCare qualityPatientsAdmissionHospital affiliationACO structureFuture studiesLower proportionFailureAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOMEDeveloping an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Lu Y, Du C, Khidir H, Caraballo C, Mahajan S, Spatz E, Curry L, Krumholz H. Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009453. PMID: 36727515, DOI: 10.1161/circoutcomes.122.009453.Peer-Reviewed Original ResearchConceptsPersistent hypertensionElectronic health recordsBlood pressureHealth recordsPharmacologic agentsPrescribed treatmentYale New Haven Health SystemTreatment planAdditional pharmacologic agentsAntihypertensive treatment intensificationConsecutive outpatient visitsElevated blood pressurePersistence of hypertensionElectronic health record dataHealth record dataEligible patientsTreatment intensificationChart reviewHispanic patientsOutpatient visitsMean agePharmacological treatmentConventional content analysisHypertensionClinician notes
2019
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states
Roy B, Riley C, Herrin J, Spatz E, Hamar B, Kell KP, Rula EY, Krumholz H. Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states. BMJ Open 2019, 9: e030017. PMID: 31780588, PMCID: PMC6886944, DOI: 10.1136/bmjopen-2019-030017.Peer-Reviewed Original ResearchConceptsHospitalisation ratesZip codesPrimary care physician densityCross-sectional study SETTINGCancer-related admissionsRespiratory-related admissionsCross-sectional studyQuality of lifeRace/ethnicityCause hospitalisationSecondary outcomesPrimary outcomeHighest quintileUnnecessary hospitalisationAdmission ratesSD increaseHospitalisationLife benefitsPhysician densityStudy settingMain independent variableBeing IndexHospital bedsAdmissionGallup-Sharecare WellIdeal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis
Osibogun O, Ogunmoroti O, Spatz ES, Fashanu OE, Michos ED. Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis. Preventive Medicine 2019, 130: 105890. PMID: 31715219, PMCID: PMC6930349, DOI: 10.1016/j.ypmed.2019.105890.Peer-Reviewed Original ResearchConceptsIdeal cardiovascular healthFavorable cardiovascular healthOptimal cardiovascular healthSimple 7 (LS7) metricsCardiovascular healthRace/ethnicityMulti-Ethnic StudyElevated RHRHeart rateLife's Simple 7 (LS7) metricsIncreased cardiovascular disease riskAtrioventricular nodal blockersCardiovascular disease riskCross-sectional analysisClinical CVDLS7 metricsCVH scoreHigher RHRAtherosclerosis participantsMean ageRisk factorsOdds ratioStratified analysisLower oddsMultinomial logistic regressionPhenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study.
Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethnicity & Disease 2019, 29: 535-544. PMID: 31641320, PMCID: PMC6802166, DOI: 10.18865/ed.29.4.535.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure measurementsABPM patternsBP patternAmbulatory blood pressure patternsMore precision-based approachesAmbulatory BP patternsDiagnosis of HTNTreatment of HTNBlood pressure patternWave 2High-risk populationBlood pressure measurementsCommunity-residing adultsPrecision-based approachesAntihypertensive medicationsBlood pressureProspective studyHypertension StudyHypertensive phenotypeCardiovascular diseaseParent studyHTNEcological momentary assessmentSelf-report surveyHigh rateFinancial barriers in accessing medical care for peripheral artery disease are associated with delay of presentation and adverse health status outcomes in the United States
Jelani QU, Jhamnani S, Spatz ES, Spertus J, Smolderen KG, Wang J, Desai NR, Jones P, Gosch K, Shah S, Attaran R, Mena-Hurtado C. Financial barriers in accessing medical care for peripheral artery disease are associated with delay of presentation and adverse health status outcomes in the United States. Vascular Medicine 2019, 25: 13-24. PMID: 31603393, DOI: 10.1177/1358863x19872542.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHealth Care CostsHealth Services AccessibilityHealth Status DisparitiesHealthcare DisparitiesHumansInsurance, HealthMaleMedically UninsuredMiddle AgedPatient Reported Outcome MeasuresPeripheral Arterial DiseaseProspective StudiesQuality of LifeRisk FactorsTime FactorsTime-to-TreatmentUnited StatesConceptsPeripheral artery diseasePeripheral Artery QuestionnaireHealth status outcomesHealth statusArtery diseaseStatus outcomesFinancial barriersGeneral health-related qualityDisease-specific health statusPatient-reported health statusDelay of presentationPatient-reported difficultyVascular specialty clinicsPeripheral arterial diseaseEuroQol-5 DimensionsHealth-related qualityPoor health statusUnited States patientsMulticenter registryMultivariable adjustmentPAD symptomsArterial diseaseTreatment patternsUS patientsLate presentationPrevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project
Mahajan S, Zhang D, He S, Lu Y, Gupta A, Spatz ES, Lu J, Huang C, Herrin J, Liu S, Yang J, Wu C, Cui J, Zhang Q, Li X, Nasir K, Zheng X, Krumholz HM, Li J, Dong Z, Jiang B, Zhang Y, Liu Y, Meng Y, Xi Y, Tian Y, Fu Y, Liu T, Yan S, Jin L, Wang J, Xu X, Xing X, Zhang L, Fang X, Xu Y, Xu C, Fan L, Qi M, Qi J, Li J, Liu Q, Feng Y, Wang J, Wen H, Xu J, He J, Jiang C, Yang C, Yu Y, Tashi Z, Hu Z, Zhang J, Li X, Ma S, Ma Y, Huang Y, Zhang Y, Shen J. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. Journal Of The American Heart Association 2019, 8: e012954. PMID: 31566101, PMCID: PMC6806046, DOI: 10.1161/jaha.119.012954.Peer-Reviewed Original ResearchConceptsMillion Persons ProjectPrior cardiovascular eventsBody mass indexAntihypertensive medicationsDiastolic hypertensionCardiovascular eventsDiabetes mellitusMass indexIsolated diastolic hypertensionDiastolic blood pressureSelf-reported diagnosisTreatment of peoplePersons ProjectBlood pressureTreatment patternsHypertensionLeast collegeHigher likelihoodMellitusMedicationsPrevalenceTreatmentDiagnosisSubstantial numberCurrent useHemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance
Mahajan S, Gu J, Lu Y, Khera R, Spatz ES, Zhang M, Sun N, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance. The American Journal Of Medicine 2019, 133: e127-e139. PMID: 31525336, DOI: 10.1016/j.amjmed.2019.08.042.Peer-Reviewed Original ResearchConceptsSystemic vascular resistance indexVascular resistance indexSystemic vascular resistanceCardiac indexBlood pressure categoriesResistance index ratioResistance indexVascular resistanceCardiac outputBlood pressureHemodynamic phenotypesPressure categoriesHigh systemic vascular resistance indexNormal systemic vascular resistance indexSystolic blood pressure 140Systolic blood pressure categoriesBlood pressure 140Health checkup centerNormal cardiac indexLow cardiac indexStroke volume indexHigher cardiac indexSystolic blood pressureBody mass indexSubtypes of hypertensionEffects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus
Huo X, Krumholz HM, Bai X, Spatz ES, Ding Q, Horak P, Zhao W, Gong Q, Zhang H, Yan X, Sun Y, Liu J, Wu X, Guan W, Wang X, Li J, Li X, Spertus JA, Masoudi FA, Zheng X. Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005805. PMID: 31474119, DOI: 10.1161/circoutcomes.119.005805.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBiomarkersBlood GlucoseChinaCoronary DiseaseCulturally Competent CareDiabetes MellitusExerciseFemaleGlycated HemoglobinHealth CommunicationHealthy LifestyleHumansHypoglycemic AgentsMaleMedication AdherenceMiddle AgedMotivationPatient Education as TopicRisk Reduction BehaviorSelf CareSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseHeart diseaseGlycemic controlIntervention groupUsual careDiabetes mellitusBlood glucosePhysical activityControl groupText message-based interventionBlood pressure controlProportion of patientsRisk factor managementGood glycemic controlSystolic blood pressureBody mass indexText messaging programsText message interventionMobile health interventionsSecondary outcomesBlood pressurePrimary outcomeLDL cholesterolMass indexMedication adherenceTraditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study
Yu Y, Spatz ES, Tan Q, Liu S, Lu Y, Masoudi FA, Schulz WL, Krumholz HM, Li J, Group T. Traditional Chinese Medicine Use in the Treatment of Acute Heart Failure in Western Medicine Hospitals in China: Analysis From the China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2019, 8: e012776. PMID: 31364457, PMCID: PMC6761625, DOI: 10.1161/jaha.119.012776.Peer-Reviewed Original ResearchConceptsTraditional Chinese medicineAcute heart failureHeart failureEvidence-based therapiesWestern Medicine HospitalTCM useMedicine HospitalEvidence-based therapy useTraditional Chinese medicine useChinese medicine useCoronary artery diseaseHeart Failure StudyHierarchical logistic regression modelsLogistic regression modelsSalvia miltiorrhizaRandom sampleHospital bleedingPatient's bleedingPatient characteristicsArtery diseaseTherapy useMedicine useHospital characteristicsRetrospective analysisHospital useDisparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT
Shahu A, Herrin J, Dhruva SS, Desai NR, Davis BR, Krumholz HM, Spatz ES. Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT. Journal Of The American Heart Association 2019, 8: e012277. PMID: 31362591, PMCID: PMC6761647, DOI: 10.1161/jaha.119.012277.Peer-Reviewed Original ResearchConceptsBlood pressure controlLow-income sitesCardiovascular outcomesPressure controlALLHAT participantsPoor blood pressure controlEnd-stage renal diseaseHospitalization/mortalityAdverse cardiovascular eventsCardiovascular risk factorsWorse cardiovascular outcomesHigh blood pressureStandardized treatment protocolRandomized clinical trialsBackground Observational studiesLow socioeconomic statusHighest income quintileAngina hospitalizationCardiovascular eventsCause mortalityCoronary revascularizationClinical characteristicsBlood pressureRenal diseaseClinical outcomesPersistent geographic variations in availability and quality of nursing home care in the United States: 1996 to 2016
Wang Y, Zhang Q, Spatz ES, Gao Y, Eckenrode S, Johnson F, Ho SY, Hu S, Xing C, Krumholz HM. Persistent geographic variations in availability and quality of nursing home care in the United States: 1996 to 2016. BMC Geriatrics 2019, 19: 103. PMID: 30975076, PMCID: PMC6460800, DOI: 10.1186/s12877-019-1117-z.Peer-Reviewed Original ResearchEffect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease
Zheng X, Spatz ES, Bai X, Huo X, Ding Q, Horak P, Wu X, Guan W, Chow CK, Yan X, Sun Y, Wang X, Zhang H, Liu J, Li J, Li X, Spertus JA, Masoudi FA, Krumholz HM. Effect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005616. PMID: 30998400, DOI: 10.1161/circoutcomes.119.005616.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBlood PressureChinaCoronary DiseaseCulturally Competent CareFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPatient Education as TopicRisk AssessmentRisk FactorsSecondary PreventionSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseSystolic blood pressureBody mass indexBlood pressureHeart diseaseSecondary preventionIntervention groupPhysical activityEnd pointSmoking statusMass indexControl groupPrimary end pointRisk factor controlSecondary end pointsRisk factor managementLDL-C levelsDisease-specific knowledgeMobile phone textMobile health technologyUsual careDiabetes mellitusMedication adherenceRisk factorsFactor managementTrends 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 of Income Disparities with Patient-Reported Healthcare Experience
Okunrintemi V, Khera R, Spatz ES, Salami JA, Valero-Elizondo J, Warraich HJ, Virani SS, Blankstein R, Blaha MJ, Pawlik TM, Dharmarajan K, Krumholz HM, Nasir K. Association of Income Disparities with Patient-Reported Healthcare Experience. Journal Of General Internal Medicine 2019, 34: 884-892. PMID: 30783877, PMCID: PMC6544715, DOI: 10.1007/s11606-019-04848-4.Peer-Reviewed Original ResearchConceptsPatient healthcare experienceHealthcare experiencesHigher oddsMedical Expenditure Panel Survey cohortHealthcare providersRepresentative US adult populationUS adult populationTimes higher oddsQuality of careTimes greater oddsLow incomePoor healthcare experiencesRetrospective studyPatient incomePatient levelPatient reportsUS adultsProvider satisfactionGreater oddsPatientsHealth outcomesSurvey cohortAdult populationStudy participantsAspects of access
2018
Association Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States
Annapureddy A, Valero-Elizondo J, Khera R, Grandhi GR, Spatz ES, Dreyer RP, Desai NR, Krumholz HM, Nasir K. Association Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e005180. PMID: 30571331, DOI: 10.1161/circoutcomes.118.005180.Peer-Reviewed Original ResearchVariation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications
Rodwin BA, Salami JA, Spatz ES, Valero-Elizondo J, Virani SS, Blankstein R, Blaha MJ, Nasir K, Desai NR. Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications. The American Journal Of Medicine 2018, 132: 61-70.e1. PMID: 30290193, DOI: 10.1016/j.amjmed.2018.09.026.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsUse of DOACsAtrial fibrillationOral anticoagulantsDiseases Ninth Edition (ICD-9) codesPocket costsProportion of patientsUse of warfarinNinth Edition codesMedical Expenditure Panel SurveyPrescription drug useTotal drug expendituresPrescription drug spendingWarfarin useAnticoagulant useNationwide cohortClinical factorsMedication useEdition codesStudy populationInternational ClassificationDrug useFibrillationClinical groupsAnticoagulants