2022
Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding
Li D, Ong S, Hughes M, Hung K, Agarwal R, Alexis J, Damianos J, Sharma S, Pires J, Nanna M, Laine L. Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2022, 57: 94-102. PMID: 36394111, DOI: 10.1111/apt.17278.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsGastrointestinal bleedingPrimary preventionCardiovascular eventsRisk of MACEYale-New Haven HospitalPrimary cardiovascular preventionAdverse cardiovascular eventsKaplan-Meier curvesLong-term outcomesRisk-benefit ratioLog-rank testAspirin 81Hospitalised patientsPrimary endpointSecondary endpointsCardiovascular preventionSubsequent hospitalisationMedian ageDeprescriptionHigh riskAspirinHospitalisationPatientsPrevention
2021
Neural network predicts need for red blood cell transfusion for patients with acute gastrointestinal bleeding admitted to the intensive care unit
Shung D, Huang J, Castro E, Tay JK, Simonov M, Laine L, Batra R, Krishnaswamy S. Neural network predicts need for red blood cell transfusion for patients with acute gastrointestinal bleeding admitted to the intensive care unit. Scientific Reports 2021, 11: 8827. PMID: 33893364, PMCID: PMC8065139, DOI: 10.1038/s41598-021-88226-3.Peer-Reviewed Original ResearchConceptsAcute gastrointestinal bleedingRed blood cell transfusionBlood cell transfusionGastrointestinal bleedingHigh-risk patientsCell transfusionRed blood cellsPatient cohortIntensive Care III (MIMIC-III) critical care databaseIntensive care unit staySevere acute gastrointestinal bleedingPacked red blood cellsBlood cellsCommon gastrointestinal causesLaboratory test featuresTime-updated dataIntensive care unitValidation patient cohortCritical care databaseLarge urban hospitalMedical Information MartInternal validation setGastrointestinal causesUnit stayCare unitEarly identification of patients with acute gastrointestinal bleeding using natural language processing and decision rules
Shung D, Tsay C, Laine L, Chang D, Li F, Thomas P, Partridge C, Simonov M, Hsiao A, Tay JK, Taylor A. Early identification of patients with acute gastrointestinal bleeding using natural language processing and decision rules. Journal Of Gastroenterology And Hepatology 2021, 36: 1590-1597. PMID: 33105045, DOI: 10.1111/jgh.15313.Peer-Reviewed Original ResearchConceptsNatural language processingElectronic health recordsLanguage processingNLP algorithmSystematized NomenclatureReal timeAcute gastrointestinal bleedingBidirectional Encoder RepresentationsDecision rulesEHR-based phenotyping algorithmsGastrointestinal bleedingRisk stratification scoresEncoder RepresentationsData elementsPhenotyping algorithmStratification scoresHealth recordsAlgorithmPhenotyping of patientsEmergency department patientsTime of presentationRisk stratification modelED reviewDeploymentExternal validation
2020
Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry
Kelly CR, Yen EF, Grinspan AM, Kahn SA, Atreja A, Lewis JD, Moore TA, Rubin DT, Kim AM, Serra S, Nersesova Y, Fredell L, Hunsicker D, McDonald D, Knight R, Allegretti JR, Pekow J, Absah I, Hsu R, Vincent J, Khanna S, Tangen L, Crawford CV, Mattar MC, Chen LA, Fischer M, Arsenescu RI, Feuerstadt P, Goldstein J, Kerman D, Ehrlich AC, Wu GD, Laine L. Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry. Gastroenterology 2020, 160: 183-192.e3. PMID: 33011173, PMCID: PMC8034505, DOI: 10.1053/j.gastro.2020.09.038.Peer-Reviewed Original ResearchConceptsClostridioides difficile infectionMicrobiota transplantationSafety profileNational registryProspective real-world studyFull safety profileProspective safety dataBaseline patient characteristicsInflammatory bowel diseaseIrritable bowel syndromeFecal microbiota transplantationLong-term safety outcomesGood safety profileReal-world studyAbdominal painBowel syndromePatient characteristicsReal-world practiceBowel diseaseCDI recurrenceDifficile infectionSafety dataSafety outcomesEffectiveness outcomesSevere symptomsIntestinal metaplasia around the gastroesophageal junction is frequently associated with antral reactive gastropathy: implications for carcinoma at the gastroesophageal junction
Vyas M, Celli R, Singh M, Patel N, Aslanian HR, Boffa D, Deng Y, Ciarleglio MM, Laine L, Jain D. Intestinal metaplasia around the gastroesophageal junction is frequently associated with antral reactive gastropathy: implications for carcinoma at the gastroesophageal junction. Human Pathology 2020, 105: 67-73. PMID: 32941964, PMCID: PMC11152084, DOI: 10.1016/j.humpath.2020.08.007.Peer-Reviewed Original ResearchConceptsNonsteroidal anti-inflammatory drugsBile refluxIntestinal metaplasiaReactive gastropathyGEJ regionMucosal injuryMucosal changesGastroesophageal junctionAntral intestinal metaplasiaDistal esophageal adenocarcinomaDetailed clinical historySex-matched patientsGastric antral biopsiesAnti-inflammatory drugsGastric bile refluxMucosal inflammationProximal stomachDistal esophagusMedication usePancreatic metaplasiaPathology databaseProximal gastricAntral biopsiesClinical historyGastric biopsiesPhysicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey.
Kurlander JE, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Zikmund-Fisher BJ, Yang YX, Laine L, Weissman A, Saini SD. Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey. The American Journal Of Gastroenterology 2020, 115: 689-696. PMID: 32091419, PMCID: PMC7196016, DOI: 10.14309/ajg.0000000000000558.Peer-Reviewed Original ResearchConceptsProton pump inhibitorsPPI adverse effectsAdverse effectsHigh riskLong-term PPI useGastroesophageal reflux diseaseMultiple adverse effectsPPI useReflux diseasePPI discontinuationInhibitor riskMost internistsPump inhibitorsPhysicians' perceptionsInternists' perceptionsSignificant associationGeneral medicineDiscontinuationLogistic regressionClinical usePatientsFuture interventionsIndividual riskPreventionUGIB
2019
The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding
Saffouri E, Blackwell C, Laursen SB, Laine L, Dalton HR, Ngu J, Shultz M, Norton R, Stanley AJ. The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2019, 51: 253-260. PMID: 31642558, DOI: 10.1111/apt.15541.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArea Under CurveBlood TransfusionCohort StudiesEndoscopy, GastrointestinalFemaleGastrointestinal HemorrhageHospitalizationHumansMaleMiddle AgedMortalityPredictive Value of TestsPrognosisProspective StudiesReproducibility of ResultsRisk AssessmentSeverity of Illness IndexShockSurvival AnalysisUpper Gastrointestinal TractYoung AdultConceptsUpper gastrointestinal bleedingGlasgow-Blatchford scoreShock indexGastrointestinal bleedingABC scoreMajor transfusionAcute upper gastrointestinal bleedingUK National Confidential EnquiryAdmission Rockall scoreSevere gastrointestinal bleedingMajor clinical endpointsPredictors of outcomeNational Confidential EnquiryRockall scoreBlatchford scoreEndoscopic therapyConsecutive patientsHospital admissionConfidential EnquiryProspective studyClinical endpointsPatient outcomesRisk scoreDeath reportsBleedingRandomized Trial of Medical versus Surgical Treatment for Refractory Heartburn
Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, Sanchez VM, Dunbar KB, Pham TH, Murthy UK, Kim T, Jackson CS, Wallen JM, von Rosenvinge EC, Pearl JP, Laine L, Kim AW, Kaz AM, Tatum RP, Gellad ZF, Lagoo-Deenadayalan S, Rubenstein JH, Ghaferi AA, Lo WK, Fernando RS, Chan BS, Paski SC, Provenzale D, Castell DO, Lieberman D, Souza RF, Chey WD, Warren SR, Davis-Karim A, Melton SD, Genta RM, Serpi T, Biswas K, Huang GD. Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn. New England Journal Of Medicine 2019, 381: 1513-1523. PMID: 31618539, DOI: 10.1056/nejmoa1811424.Peer-Reviewed Original ResearchConceptsPPI-refractory heartburnActive medical treatmentMedical treatmentTreatment successGastroenterology clinicSurgical treatmentProton pump inhibitor treatmentMultichannel intraluminal impedance-pH monitoringMedical groupGastroesophageal reflux diseaseFrequent clinical problemMinority of patientsHealth Related QualityImpedance-pH monitoringMultiple potential causesFunctional heartburnRefractory heartburnVisceral hypersensitivityAntireflux surgeryGastroesophageal refluxReflux diseaseUnderwent endoscopyEsophageal manometryPrimary outcomeEsophageal biopsiesValidation of a Machine Learning Model That Outperforms Clinical Risk Scoring Systems for Upper Gastrointestinal Bleeding
Shung DL, Au B, Taylor RA, Tay JK, Laursen SB, Stanley AJ, Dalton HR, Ngu J, Schultz M, Laine L. Validation of a Machine Learning Model That Outperforms Clinical Risk Scoring Systems for Upper Gastrointestinal Bleeding. Gastroenterology 2019, 158: 160-167. PMID: 31562847, PMCID: PMC7004228, DOI: 10.1053/j.gastro.2019.09.009.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingHospital-based interventionsComposite endpointScoring systemRockall scoreGastrointestinal bleedingClinical riskConsecutive unselected patientsLow-risk patientsClinical scoring systemRisk-scoring systemExternal validation cohortCharacteristic curve analysisInternal validation setOutpatient managementUnselected patientsValidation cohortEmergency departmentMedical CenterGreater AUCPatientsAbstractTextCurve analysisEndpointAUCMAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding
Redondo‐Cerezo E, Vadillo‐Calles F, Stanley AJ, Laursen S, Laine L, Dalton HR, Ngu JH, Schultz M, Jiménez‐Rosales R. MAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding. Journal Of Gastroenterology And Hepatology 2019, 35: 82-89. PMID: 31359521, DOI: 10.1111/jgh.14811.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingGastrointestinal bleedingEndoscopic interventionGlasgow-Blatchford scoreSystolic blood pressureNew scoring systemBlatchford scoreProspective databaseBlood pressureRisk stratificationValidation cohortDevelopment cohortOriginal cohortEmergency roomMental statusRisk scoreClinical practiceFair discriminationScoring systemPatientsMortalityCohortNew scoreInterventionBleedingMachine Learning to Predict Outcomes in Patients with Acute Gastrointestinal Bleeding: A Systematic Review
Shung D, Simonov M, Gentry M, Au B, Laine L. Machine Learning to Predict Outcomes in Patients with Acute Gastrointestinal Bleeding: A Systematic Review. Digestive Diseases And Sciences 2019, 64: 2078-2087. PMID: 31055722, DOI: 10.1007/s10620-019-05645-z.Peer-Reviewed Original ResearchConceptsClinical risk scoreUpper gastrointestinal bleedingGastrointestinal bleedingOutcomes of mortalityRisk scoreSystematic reviewOvert gastrointestinal bleedingAcute gastrointestinal bleedingPrognosis Studies toolRisk of biasFull-text studiesCurrent risk assessment toolsRisk assessment toolHospital stayHemostatic interventionRisk stratificationInclusion criteriaPrognostic performanceHigh riskIndependent reviewersConference abstractsLower riskMedian AUCPatientsMortality
2018
Impact of Changeover to Newer Endoscopic Systems on Quality and Efficiency of Screening and Surveillance Colonoscopy
Singh M, Sacatos M, Laine L. Impact of Changeover to Newer Endoscopic Systems on Quality and Efficiency of Screening and Surveillance Colonoscopy. Journal Of Clinical Gastroenterology 2018, 52: 891-895. PMID: 28906425, DOI: 10.1097/mcg.0000000000000931.Peer-Reviewed Original ResearchPrevious Use of Antithrombotic Agents Reduces Mortality and Length of Hospital Stay in Patients With High-risk Upper Gastrointestinal Bleeding
Dunne P, Laursen SB, Laine L, Dalton HR, Ngu JH, Schultz M, Rahman A, Anderloni A, Murray IA, Stanley AJ. Previous Use of Antithrombotic Agents Reduces Mortality and Length of Hospital Stay in Patients With High-risk Upper Gastrointestinal Bleeding. Clinical Gastroenterology And Hepatology 2018, 17: 440-447.e2. PMID: 29705263, DOI: 10.1016/j.cgh.2018.04.046.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingAnti-thrombotic agentsAnti-thrombotic drugsGlasgow-Blatchford scoreRockall scoreHospital stayGastrointestinal bleedingEndoscopic therapyAcute upper gastrointestinal bleedingAnesthesiologists classification scoreBleeding-related mortalityFull Rockall scoreMean hospital stayOutcomes of patientsHigher American SocietyLength of hospitalShorter hospital staySystolic blood pressureMean American SocietyFrequency of malignancyLevels of hemoglobinHigher mean American SocietyAmerican SocietyAIMS65 scoreAnesthesiologists classificationSeverity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis
Laine L, Laursen SB, Zakko L, Dalton HR, Ngu JH, Schultz M, Stanley AJ. Severity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis. The American Journal Of Gastroenterology 2018, 113: 358. PMID: 29380820, DOI: 10.1038/ajg.2018.5.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood PreservationBlood TransfusionEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHeart RateHematemesisHemoglobinsHemostasis, EndoscopicHumansMaleMelenaMiddle AgedMortalityProspective StudiesRecurrenceRisk AssessmentSeverity of Illness IndexUpper Gastrointestinal TractConceptsCoffee ground emesisBloody emesisHemostatic interventionUpper gastrointestinal bleedingComposite end pointRisk stratification scoresSystolic blood pressureTiming of endoscopyPredictors of outcomeBeats/minGastrointestinal bleedingConsecutive patientsPrimary outcomeSevere bleedingStratification scoresBlood pressureProspective studyHematemesisMelenaEmesisHigh mortalityEnd pointMortalityOutcomesSeverityImage-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease
Parikh ND, Viana AV, Shah S, Laine L. Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease. Scandinavian Journal Of Gastroenterology 2018, 53: 260-264. PMID: 29368532, PMCID: PMC6080852, DOI: 10.1080/00365521.2018.1430847.Peer-Reviewed Original ResearchConceptsNon-erosive gastroesophageal reflux diseaseGastroesophageal reflux diseaseImage-enhanced endoscopyNarrow-band imagingReflux diseaseEndoscopic findingsSquamocolumnar junctionUpper endoscopyPatient acceptanceEndoscopyBand imagingI-scanVascularityAdditional studiesPit patternHeartburnPatientsDiseaseDiagnosisImpedance monitoringRRSpecificityFindingsControlCases
2017
Randomized trial of cholangioscopy-guided laser lithotripsy versus conventional therapy for large bile duct stones (with videos)
Buxbaum J, Sahakian A, Ko C, Jayaram P, Lane C, Yu CY, Kankotia R, Laine L. Randomized trial of cholangioscopy-guided laser lithotripsy versus conventional therapy for large bile duct stones (with videos). Gastrointestinal Endoscopy 2017, 87: 1050-1060. PMID: 28866457, DOI: 10.1016/j.gie.2017.08.021.Peer-Reviewed Original ResearchConceptsCholangioscopy-guided laser lithotripsyBile duct stonesDuct stonesConventional therapyLaser lithotripsy groupEndoscopic clearanceMechanical lithotripsyBalloon dilationLaser lithotripsyLithotripsy groupProcedure timeLarge common bile duct stonesCommon bile duct stonesLarge bile duct stonesConventional therapy groupHistory of ERCPCommon duct explorationPost-ERCP pancreatitisLarge bile ductsCholangioscopy-guided lithotripsyLonger procedure timeSuccessful endoscopic extractionNumber of proceduresAdverse eventsDuct explorationOptimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis
Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J. Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis. Journal Of Clinical Gastroenterology 2017, 51: 534-538. PMID: 27875357, DOI: 10.1097/mcg.0000000000000763.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdolescentAdultAgedAged, 80 and overCholangiopancreatography, Endoscopic RetrogradeCholangitisFemaleHospitalizationHumansIntensive Care UnitsIntubation, IntratrachealLength of StayMaleMiddle AgedMultivariate AnalysisProspective StudiesTime FactorsTreatment OutcomeYoung AdultConceptsEndoscopic retrograde cholangiopancreatographyIntensive care unit admissionCare unit admissionLength of hospitalizationAcute cholangitisUnit admissionRetrograde cholangiopancreatographyFrequent intensive care unit admissionOptimal timingAdditional adverse outcomesCases of cholangitisProcedural adverse eventsDays of presentationVasopressor requirementVasopressor supportBiliary decompressionHospital stayVasopressor useSecondary outcomesAdverse eventsAntibiotic therapyPrimary outcomeEndotracheal intubationAdverse outcomesEmergency departmentPredictors and outcomes of delayed plastic biliary stent removal following endoscopic retrograde cholangiopancreatography
Kim SJ, Ohanian E, Lee F, Nam B, Che K, Laine L, Kim SE, Kim JJ. Predictors and outcomes of delayed plastic biliary stent removal following endoscopic retrograde cholangiopancreatography. Scandinavian Journal Of Gastroenterology 2017, 52: 1128-1132. PMID: 28657377, DOI: 10.1080/00365521.2017.1342138.Peer-Reviewed Original ResearchConceptsEndoscopic retrograde cholangiopancreatographyBiliary stent removalBiliary stent placementStent removalStent obstructionRetrograde cholangiopancreatographyStent placementIndex endoscopic retrograde cholangiopancreatographyNon-English primary languageOutcomes of patientsOutpatient endoscopic retrograde cholangiopancreatographyPreventable adverse eventsMultivariable regression analysisUniversity Medical CenterPlastic biliary stentsAnesthesia assistanceBaseline characteristicsAdverse eventsConsecutive patientsClinical outcomesLoma Linda University Medical CenterOne-fifthMedical CenterBiliary stentsLower oddsRelationship of time to presentation after onset of upper GI bleeding with patient characteristics and outcomes: a prospective study
Laine L, Laursen SB, Dalton HR, Ngu JH, Schultz M, Stanley AJ. Relationship of time to presentation after onset of upper GI bleeding with patient characteristics and outcomes: a prospective study. Gastrointestinal Endoscopy 2017, 86: 1028-1037. PMID: 28396275, DOI: 10.1016/j.gie.2017.03.1549.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood TransfusionConfusionDuodenal DiseasesEsophageal DiseasesFemaleGlasgow Coma ScaleHematemesisHemoglobinsHemostasis, EndoscopicHumansLength of StayLethargyMaleMelenaMiddle AgedPatient Acceptance of Health CarePrognosisProspective StudiesSerum AlbuminStomach DiseasesStuporTime-to-TreatmentConceptsUpper GI bleedingPatient characteristicsHemoglobin levelsDecreased hemoglobin levelLikelihood of transfusionLower hemoglobin levelsSignificant independent factorsGI bleedingHospital daysConsecutive patientsUpper GIHemostatic interventionPoor outcomeProspective studyEmergency departmentRelationship of timeMental statusIndependent factorsPatientsMulti-national studyLogistic regressionMelenaOutcomesTransfusionHospitalNarrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial
Buxbaum JL, Hormozdi D, Dinis-Ribeiro M, Lane C, Dias-Silva D, Sahakian A, Jayaram P, Pimentel-Nunes P, Shue D, Pepper M, Cho D, Laine L. Narrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial. Gastrointestinal Endoscopy 2017, 86: 857-865. PMID: 28366441, DOI: 10.1016/j.gie.2017.03.1528.Peer-Reviewed Original ResearchConceptsGastric intestinal metaplasiaDetection of GIMNarrow-band imagingHD-WLMapping biopsyIntestinal metaplasiaHigh-definition white light endoscopyProportion of patientsProspective blinded trialGastric cancer precursorsGastric cancer riskWhite light endoscopyNBI examinationPrimary outcomeUpper endoscopyHigher proportionBlinded trialCancer precursorsBiopsy specimensMedian numberSecond endoscopistGastric cancerCancer riskBiopsyPatients