2023
Developing Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study
Bikdeli B, Lo Y, Khairani C, Bejjani A, Jimenez D, Barco S, Mahajan S, Caraballo C, Secemsky E, Klok F, Hunsaker A, Aghayev A, Muriel A, Wang Y, Hussain M, Appah-Sampong A, Lu Y, Lin Z, Aneja S, Khera R, Goldhaber S, Zhou L, Monreal M, Krumholz H, Piazza G. Developing Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study. Thrombosis And Haemostasis 2023, 123: 649-662. PMID: 36809777, PMCID: PMC11200175, DOI: 10.1055/a-2039-3222.Peer-Reviewed Original ResearchConceptsElectronic health recordsNLP algorithmNatural language processing toolsLanguage processing toolsPrincipal discharge diagnosisICD-10 codesDischarge diagnosisNLP toolsChart reviewHealth systemProcessing toolsYale New Haven Health SystemPatient identificationElectronic databasesHealth recordsData validationHigh-risk PEPulmonary Embolism ResearchSecondary discharge diagnosisIdentification of patientsManual chart reviewNegative predictive valueCodeRadiology reportsAlgorithm
2022
Sex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study
Bikdeli B, Piazza G, Jimenez D, Muriel A, Wang Y, Khairani CD, Rosovsky RP, Mehdipoor G, O'Donoghue ML, Spagnolo P, Dreyer RP, Bertoletti L, López-Jiménez L, Núñez MJ, Blanco-Molina Á, Bates SM, Gerhard-Herman M, Goldhaber SZ, Monreal M, Krumholz HM. Sex Differences in PrEsentation, Risk Factors, Drug and Interventional Therapies, and OUtcomes of Elderly PatientS with Pulmonary Embolism: Rationale and design of the SERIOUS-PE study. Thrombosis Research 2022, 214: 122-131. PMID: 35537232, DOI: 10.1016/j.thromres.2022.04.019.Peer-Reviewed Original ResearchConceptsRisk factorsElderly patientsUS Medicare feeInterventional therapyMedicare feeInternational registryService beneficiariesSex differencesNational US databasePrognostic prediction rulePulmonary embolism studyLarge international registryPrincipal discharge diagnosisSex-based disparitiesAssessment of outcomesPotential sex differencesSex-specific findingsPE presentationPulmonary embolismVenous thromboembolismTreatment patternsDischarge diagnosisAvailable therapiesDisease presentationTreatment-based differences
2021
National Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019)
Lu Y, Wang Y, Spatz ES, Onuma O, Nasir K, Rodriguez F, Watson KE, Krumholz HM. National Trends and Disparities in Hospitalization for Acute Hypertension Among Medicare Beneficiaries (1999–2019). Circulation 2021, 144: 1683-1693. PMID: 34743531, DOI: 10.1161/circulationaha.121.057056.Peer-Reviewed Original ResearchConceptsHigher hospitalization ratesAcute hypertensionHospitalization ratesMedicare feeService beneficiariesBlack adultsSerial cross-sectional analysisCause readmission rateNational hospitalization ratesPrimary discharge diagnosisAnnual hospitalization rateCause mortality ratesPoisson link functionDual-eligible statusMedicare/MedicaidCross-sectional analysisHypertension controlReadmission ratesDischarge diagnosisDiseases codesMedicare denominatorInpatient filesHypertensionInternational ClassificationMedicare beneficiaries
2020
Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults
Ding Q, Spatz ES, Lipska KJ, Lin H, Spertus JA, Dreyer RP, Whittemore R, Funk M, Bueno H, Krumholz HM. Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults. Heart 2020, 107: 657-666. PMID: 33082173, PMCID: PMC8005796, DOI: 10.1136/heartjnl-2020-317101.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth statusDischarge diagnosisPharmacological treatmentMyocardial infarctionShort-term health statusYoung AMI Patients (VIRGO) studyDisease-specific health statusYoung adultsQuality of lifeHospital complicationsHospital mortalityMedication initiationBaseline characteristicsClinical outcomesDiabetesPatientsDiagnosisPatient studiesMonthsComplicationsInfarctionSignificant differencesOutcomesMortalityClinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction
Jackevicius CA, Krumholz HM, Ross JS, Koh M, Chong A, Austin PC, Stukel TA, Azizi P, Ko DT. Clinical Outcomes With Beta-Blocker Use in Patients With Recent History of Myocardial Infarction. Canadian Journal Of Cardiology 2020, 36: 1633-1640. PMID: 32416066, DOI: 10.1016/j.cjca.2020.01.024.Peer-Reviewed Original ResearchConceptsPrior myocardial infarctionMyocardial infarctionStable patientsPopulation-based observational studyAngina 1 yearDeath/hospitalizationHistory of revascularisationBeta-blocker useMajor cardiovascular eventsHospital discharge diagnosisUse of BBsIndividual end pointsContemporary clinical trialsYears of ageCardiovascular eventsIndex dateCohort studyComposite outcomeBB useHeart failureMedian agePrimary outcomeClinical outcomesAtrial fibrillationDischarge diagnosis
2019
Population Impact of Generic Valsartan Recall
Jackevicius CA, Krumholz HM, Chong A, Koh M, Ozaki AF, Austin PC, Udell JA, Ko DT. Population Impact of Generic Valsartan Recall. Circulation 2019, 141: 411-413. PMID: 31707798, DOI: 10.1161/circulationaha.119.044494.Peer-Reviewed Original ResearchConceptsNational Ambulatory Care Reporting System databaseEmergency department visitsRegistered Persons DatabaseOntario Registered Persons DatabaseReporting System databaseHealth care systemDrug recallsSegmented regression analysisBaseline comorbiditiesOral medicationsDepartment visitsHospital admissionMedication useClinical outcomesDischarge diagnosisVital statusChronic conditionsHealthcare databasesHealth CanadaCare systemCanadian InstituteHealth informationPopulation impactPatientsRegression analysis
2018
Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Altaf F, Herrin J, Lin Z, Krumholz HM, Drye EE, Lipska KJ, Spatz ES. Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates. American Heart Journal 2018, 207: 19-26. PMID: 30404047, DOI: 10.1016/j.ahj.2018.09.006.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAgedAlgorithmsAnalysis of VarianceCardiovascular DiseasesComorbidityFemaleHeart FailureHospitalizationHumansInternational Classification of DiseasesMaleMedicare Part AMedicare Part BPatient AdmissionPatient DischargePatient-Centered CareSex DistributionTime FactorsUnited StatesConceptsHeart failureAccountable care organizationsMean admission rateAdmission ratesAdmission typeAcute admission ratesNoncardiovascular conditionsAdmission diagnosisCause admission ratesMedicare Shared Savings Program Accountable Care OrganizationsRate of hospitalizationPrincipal discharge diagnosisProportion of admissionsType of admissionNoncardiovascular causesHF admissionsHF patientsPerson yearsDischarge diagnosisPatient populationPatientsAdmissionKey quality metricDiagnosisSubstantial proportionNational and Regional Trends in Deep Vein Thrombosis Hospitalization Rates, Discharge Disposition, and Outcomes for Medicare Beneficiaries
Minges KE, Bikdeli B, Wang Y, Attaran RR, Krumholz HM. National and Regional Trends in Deep Vein Thrombosis Hospitalization Rates, Discharge Disposition, and Outcomes for Medicare Beneficiaries. The American Journal Of Medicine 2018, 131: 1200-1208. PMID: 29753792, PMCID: PMC7040884, DOI: 10.1016/j.amjmed.2018.04.033.Peer-Reviewed Original ResearchConceptsDeep vein thrombosisHospitalization ratesVein thrombosisBlack patientsMedicare Standard Analytic FilesProportion of patientsPrincipal discharge diagnosisStandard Analytic FilesSecondary prevention effortsDischarge dispositionHospital lengthInpatient managementReadmission ratesDischarge diagnosisService patientsAdjusted outcomesOutpatient careAnalytic FilesMedicare feeMedicare beneficiariesMortality rateClinical practiceHospitalizationPatientsThrombosis
2017
Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999–2012
Mody P, Bikdeli B, Wang Y, Imazio M, Krumholz HM. Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999–2012. European Heart Journal - Quality Of Care And Clinical Outcomes 2017, 4: 98-105. PMID: 29106473, PMCID: PMC6279101, DOI: 10.1093/ehjqcco/qcx040.Peer-Reviewed Original ResearchConceptsLength of stayHospitalization ratesMortality rateReadmission ratesStudy periodCause readmission rateCause mortality ratesLong-term outcomesPrincipal discharge diagnosisRisk of pericarditisHealth care expendituresAcute pericarditisCardiac surgeryRenal diseaseDischarge diagnosisPericarditisHigh riskMedicare beneficiariesHospitalizationOlder adultsCare expendituresStayOutcomesRiskCauseSex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dreyer RP, Dharmarajan K, Hsieh AF, Welsh J, Qin L, Krumholz HM. Sex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003271. PMID: 28506980, PMCID: PMC5650228, DOI: 10.1161/circoutcomes.116.003271.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHeart failureReadmission riskDaily riskImmediate postdischarge periodRisk of rehospitalizationSex differencesDeath 1 yearPrincipal discharge diagnosisHospitalization of patientsAssociation of sexRehospitalization riskPostdischarge periodDischarge diagnosisMedicare patientsHigh riskMortality riskMedicare feeTrajectories of riskRehospitalizationInfarctionService beneficiariesHospitalizationPneumonia
2015
Medication 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 diagnosisAn Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction
Kim N, Bernheim SM, Ott LS, Han L, Spivack SB, Xu X, Volpe M, Liu A, Krumholz HM. An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction. Medical Care 2015, 53: 542-549. PMID: 25970575, DOI: 10.1097/mlr.0000000000000361.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionICD-9 codes 410Administrative Claims MeasurePatients 65 yearsDate of admissionClaims-based measuresIntraclass correlation coefficient scoreIntraclass correlation coefficientValue of careHigh-value careClinical variablesDischarge diagnosisMedicare patientsMedicare claimsClinical careAMI episodeAMI hospitalizationCare costsCode 410HospitalizationMedicaid ServicesHospitalClaims measuresCareTrajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study
Dharmarajan K, Hsieh AF, Kulkarni VT, Lin Z, Ross JS, Horwitz LI, Kim N, Suter LG, Lin H, Normand SL, Krumholz HM. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. The BMJ 2015, 350: h411. PMID: 25656852, PMCID: PMC4353309, DOI: 10.1136/bmj.h411.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyHeart failureRisk of deathMyocardial infarctionFirst readmissionAbsolute riskOlder patientsCohort studyRelative riskMedicare feeService beneficiariesRisk of readmissionGeneral elderly populationGeneral older populationRisk trajectoriesHigh-risk periodHospital dischargeHospital admissionDischarge diagnosisAdverse outcomesReadmissionHospitalizationTrajectories of riskElderly population
2014
Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities
Ben-Josef G, Ott LS, Spivack SB, Wang C, Ross JS, Shah SJ, Curtis JP, Kim N, Krumholz HM, Bernheim SM. Payments for Acute Myocardial Infarction Episodes-of-Care Initiated at Hospitals With and Without Interventional Capabilities. Circulation Cardiovascular Quality And Outcomes 2014, 7: 882-888. PMID: 25387777, DOI: 10.1161/circoutcomes.114.000927.Peer-Reviewed Original ResearchConceptsNon-PCI hospitalsCoronary artery bypass graft ratesPCI hospitalsAcute myocardial infarctionMyocardial infarctionPercutaneous coronary intervention capabilityAcute myocardial infarction admissionsLower revascularization ratesPrincipal discharge diagnosisTreatment of patientsMyocardial infarction admissionsHigh rateMyocardial infarction episodeGraft ratePCI capabilityPCI useIndex admissionRevascularization ratesClinical characteristicsPatient demographicsDays postadmissionDischarge diagnosisMedicare patientsCare proceduresMedicare feeDesign and Rationale of Gulf locals with Acute Coronary Syndrome Events (Gulf Coast) Registry
Zubaid M, Thani KB, Rashed W, Alsheikh-Ali A, Alrawahi N, Ridha M, Akbar M, Alenezi F, Alhamdan R, Almahmeed W, Ouda H, Al-Mulla A, Baslaib F, Shehab A, Alnuaimi A, Amin H, Krumholz HM, . Design and Rationale of Gulf locals with Acute Coronary Syndrome Events (Gulf Coast) Registry. The Open Cardiovascular Medicine Journal 2014, 8: 88-93. PMID: 25328551, PMCID: PMC4197526, DOI: 10.2174/1874192401408010088.Peer-Reviewed Original ResearchAcute coronary syndromeST-segment elevation myocardial infarctionElevation myocardial infarctionMyocardial infarctionRisk profileBundle branch block myocardial infarctionDiagnosis of ACSSegment elevation myocardial infarctionCardiovascular risk profileGulf COAST registryHistory of hypertensionOne-year outcomesPast medical historyEvent registryHigh-risk profileActive smokingHospital presentationCoronary syndromePatient demographicsUnstable anginaDischarge diagnosisMean ageTherapeutic managementPhysical findingsMedical historyTrends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, D'Onofrio G, Lichtman JH, Krumholz HM. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. Journal Of The American College Of Cardiology 2014, 64: 337-345. PMID: 25060366, PMCID: PMC4415523, DOI: 10.1016/j.jacc.2014.04.054.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLength of stayHospital mortalityHospitalization ratesClinical characteristicsAge groupsAMI hospitalization ratesYounger patientsMyocardial infarctionLonger LOSNationwide Inpatient Sample dataYoung womenU.S. hospital dischargesPrevalence of comorbiditiesPrincipal discharge diagnosisNational Inpatient SampleSex differencesContemporary longitudinal dataLarge national datasetMore comorbiditiesHospital dischargeDischarge diagnosisInpatient SampleMortality rateAge 30National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release
Suter LG, Li SX, Grady JN, Lin Z, Wang Y, Bhat KR, Turkmani D, Spivack SB, Lindenauer PK, Merrill AR, Drye EE, Krumholz HM, Bernheim SM. National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release. Journal Of General Internal Medicine 2014, 29: 1333-1340. PMID: 24825244, PMCID: PMC4175654, DOI: 10.1007/s11606-014-2862-5.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failurePneumonia mortalityMyocardial infarctionMedian risk-standardized mortality rateHospital-level mortalityUnplanned readmission ratePrincipal discharge diagnosisHospital performanceRisk-Standardized MortalityHF mortalityReadmission resultsReadmission ratesDischarge diagnosisOutcome measuresAMI mortalityReadmission measuresPneumoniaMortality rateService MedicareHierarchical logistic modelsMortalityMedicaid ServicesReadmissionHospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes
Safavi KC, Li SX, Dharmarajan K, Venkatesh AK, Strait KM, Lin H, Lowe TJ, Fazel R, Nallamothu BK, Krumholz HM. Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes. JAMA Internal Medicine 2014, 174: 546-553. PMID: 24515551, PMCID: PMC5459406, DOI: 10.1001/jamainternmed.2013.14407.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoninvasive cardiac imagingDownstream testingReadmission ratesRevascularization proceduresCardiac imagingHospital variationCardiac ischemiaProportion of patientsNoninvasive imagingLower readmission ratesPrincipal discharge diagnosisCross-sectional studyCardiac biomarker testsQ4 hospitalsChest discomfortCoronary angiographyCoronary diseaseDischarge diagnosisCoronary angiogramEmergency departmentMyocardial infarctionSame hospitalCurrent guidelinesInpatient wards
2013
National Trends in Heart Failure Hospital Stay Rates, 2001 to 2009
Chen J, Dharmarajan K, Wang Y, Krumholz HM. National Trends in Heart Failure Hospital Stay Rates, 2001 to 2009. Journal Of The American College Of Cardiology 2013, 61: 1078-1088. PMID: 23473413, PMCID: PMC3939721, DOI: 10.1016/j.jacc.2012.11.057.Peer-Reviewed Original ResearchConceptsHospital stay ratesLength of stayHF hospital stayHospital mortalityYears of ageHospital stayPatients 18Stay ratesNational Inpatient Sample dataU.S. hospital dischargesPatients 65 yearsPrimary discharge diagnosisSignificant declineOlder Medicare beneficiariesNational Inpatient SampleBlack menLarge national datasetHospital dischargeOlder patientsPatients 55Younger patientsDischarge diagnosisInpatient SampleMedicare beneficiariesAge 65
2011
Quality of Care in the US Territories
Nunez-Smith M, Bradley EH, Herrin J, Santana C, Curry LA, Normand SL, Krumholz HM. Quality of Care in the US Territories. JAMA Internal Medicine 2011, 171: 1528-1540. PMID: 21709184, PMCID: PMC3251926, DOI: 10.1001/archinternmed.2011.284.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk-standardized readmission ratesRisk-standardized mortality ratesHeart failureMortality rateReadmission ratesProcess measuresHospital characteristicsHighest risk-standardized mortality ratesPrincipal discharge diagnosisQuality of careHealth care qualityDischarge diagnosisService patientsMyocardial infarctionTerritorial HospitalNonfederal hospitalsUS territoriesMedicare feePneumoniaHospitalCare qualityPatientsPerformance of hospitalsUS states