2024
Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study
Oikonomou E, Aminorroaya A, Dhingra L, Partridge C, Velazquez E, Desai N, Krumholz H, Miller E, Khera R. Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study. European Heart Journal - Digital Health 2024, 5: 303-313. PMID: 38774380, PMCID: PMC11104476, DOI: 10.1093/ehjdh/ztae023.Peer-Reviewed Original ResearchRisk of acute myocardial infarctionAssociated with lower oddsHospital health systemCoronary artery diseaseCardiac testingRisk of adverse outcomesUK BiobankHealth systemProvider-drivenLower oddsAssociated with better outcomesAcute myocardial infarctionBlack raceStable chest painFemale sexReal world evaluationDiabetes historyMulticohort studyFunction testsSuspected coronary artery diseaseYounger ageRisk profileAdverse outcomesMultinational cohortPost hoc analysis
2018
Emergency Department Volume and Outcomes for Patients After Chest Pain Assessment
Ko DT, Dattani ND, Austin PC, Schull MJ, Ross JS, Wijeysundera HC, Tu JV, Eberg M, Koh M, Krumholz HM. Emergency Department Volume and Outcomes for Patients After Chest Pain Assessment. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004683. PMID: 30354285, DOI: 10.1161/circoutcomes.118.004683.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeChest painHigh-volume EDsCoronary syndromeED volumeVolume thresholdCardiac medication useChest pain assessmentLower adverse outcomesEmergency department visitsAdjusted odds ratioPopulation-based dataProcess of carePotential confounding variablesHigher ED volumesHierarchical logistic regression modelsLogistic regression modelsEmergency department volumeCause deathCardiac testingComposite outcomeDepartment visitsDiabetes mellitusMedication usePrimary outcomeScreening ECGs in low-risk patients are associated with increased risk of downstream cardiac testing
Mahajan S, Krumholz HM. Screening ECGs in low-risk patients are associated with increased risk of downstream cardiac testing. BMJ Evidence-Based Medicine 2018, 23: 150. PMID: 29674521, DOI: 10.1136/bmjebm-2018-110943.Peer-Reviewed Original Research
2011
Do Imaging Studies Performed in Physician Offices Increase Downstream Utilization? An Empiric Analysis of Cardiac Stress Testing With Imaging
Chen J, Fazel R, Ross JS, McNamara RL, Einstein AJ, Al-Mallah M, Krumholz HM, Nallamothu BK. Do Imaging Studies Performed in Physician Offices Increase Downstream Utilization? An Empiric Analysis of Cardiac Stress Testing With Imaging. JACC Cardiovascular Imaging 2011, 4: 630-637. PMID: 21679898, PMCID: PMC3319749, DOI: 10.1016/j.jcmg.2011.04.003.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCardiac CatheterizationChi-Square DistributionEchocardiography, StressEmpirical ResearchFemaleHealthcare DisparitiesHumansInsurance, HealthLogistic ModelsMaleMiddle AgedMyocardial Perfusion ImagingMyocardial RevascularizationOffice VisitsOutpatient Clinics, HospitalPractice Patterns, Physicians'Predictive Value of TestsResidence CharacteristicsTime FactorsUnited StatesYoung AdultConceptsMyocardial perfusion imagingSubsequent myocardial perfusion imagingProportion of patientsStress echocardiographyCardiac catheterizationHospital outpatient settingPhysician's officeOutpatient settingStress testingSubsequent cardiac testingCardiac stress testingDownstream resource utilizationHospital outpatient facilitiesCardiac testingPrivate health insuranceDownstream testingOffice imagingPerfusion imagingCatheterizationImaging studiesOutpatient imagingPatientsHealth insuranceLower ratesHigh rate