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 outcomesIllusory generalizability of clinical prediction models
Chekroud A, Hawrilenko M, Loho H, Bondar J, Gueorguieva R, Hasan A, Kambeitz J, Corlett P, Koutsouleris N, Krumholz H, Krystal J, Paulus M. Illusory generalizability of clinical prediction models. Science 2024, 383: 164-167. PMID: 38207039, DOI: 10.1126/science.adg8538.Peer-Reviewed Original Research
2021
Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
Zhou T, Li X, Lu Y, Murugiah K, Bai X, Hu S, Gao Y, Masoudi FA, Krumholz HM, Li J, . Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015. Open Heart 2021, 8: e001666. PMID: 34599073, PMCID: PMC8488733, DOI: 10.1136/openhrt-2021-001666.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionPrehospital delayMyocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionAcute cardiovascular careAcute myocardial infarctionWeighted national estimateHealth service capacityRisk-adjusted ratesAcute reperfusionEligible patientsHospital deathReperfusion therapyMedical chartsPatient characteristicsHospital treatmentPatient outcomesRandom cohortCardiovascular diseaseCardiovascular carePatientsNational estimatesStandardised definitionsAssociation of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes
Khera R, Liu Y, de Lemos JA, Das SR, Pandey A, Omar W, Kumbhani DJ, Girotra S, Yeh RW, Rutan C, Walchok J, Lin Z, Bradley SM, Velazquez EJ, Churchwell KB, Nallamothu BK, Krumholz HM, Curtis JP. Association of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes. The American Journal Of Medicine 2021, 134: 1380-1388.e3. PMID: 34343515, PMCID: PMC8325555, DOI: 10.1016/j.amjmed.2021.06.034.Peer-Reviewed Original ResearchConceptsCOVID-19 hospitalizationHospitalization volumeAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCase volumeUS hospitalsCoronavirus disease 2019 (COVID-19) hospitalizationIntensive care unit therapyHospital case fatality ratePoor COVID-19 outcomesCardiovascular Disease RegistryHospital case volumeCase fatality rateCOVID-19 outcomesHospital bed capacityLowest quartilePatient outcomesHospital careHigher oddsTriage strategiesFuture health challengesDisease RegistryMedical treatmentEarly identificationHospitalSignificant association
2020
Use of intravenous magnesium sulfate among patients with acute myocardial infarction in China from 2001 to 2015: China PEACE—Retrospective AMI Study
Wang X, Du X, Yang H, Bucholz E, Downing N, Spertus JA, Masoudi FA, Li J, Guan W, Gao Y, Hu S, Bai X, Krumholz HM, Li X. Use of intravenous magnesium sulfate among patients with acute myocardial infarction in China from 2001 to 2015: China PEACE—Retrospective AMI Study. BMJ Open 2020, 10: e033269. PMID: 32220910, PMCID: PMC7170603, DOI: 10.1136/bmjopen-2019-033269.Peer-Reviewed Original ResearchConceptsIntravenous magnesium sulfateAcute myocardial infarctionMagnesium sulfate useMyocardial infarctionMagnesium sulfateChina PEACE-Retrospective AMI StudyHospital-level variationProportion of hospitalsHospital-specific characteristicsMedian ORsSignificant initial decreaseReperfusion therapyCardiac arrestAMI careIneffective therapyPatient outcomesRepresentative sampleObservational studyMAIN OUTCOMEChinese guidelinesPatientsChinese hospitalsRoutine useAMI studyInfarction
2018
Prediction of ICU Readmissions Using Data at Patient Discharge
Pakbin A, Rafi P, Hurley N, Schulz W, Krumholz M, Mortazavi J. Prediction of ICU Readmissions Using Data at Patient Discharge. Annual International Conference Of The IEEE Engineering In Medicine And Biology Society (EMBC) 2018, 00: 4932-4935. PMID: 30441449, DOI: 10.1109/embc.2018.8513181.Peer-Reviewed Original ResearchConceptsICU readmissionHigher health care costsSame hospital admissionElectronic health record dataPoor patient outcomesHealth record dataLong-term riskHealth care costsICU dischargeUnplanned readmissionHospital admissionPatient dischargePatient outcomesICU casesClinical careReadmissionCare costsRecord data
2017
Urban–Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment–Elevation Myocardial Infarction in China From 2001 to 2011
Li X, Murugiah K, Li J, Masoudi FA, Chan PS, Hu S, Spertus JA, Wang Y, Downing NS, Krumholz HM, Jiang L. Urban–Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment–Elevation Myocardial Infarction in China From 2001 to 2011. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003905. PMID: 29158421, PMCID: PMC6312853, DOI: 10.1161/circoutcomes.117.003905.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChinaDisease ManagementFemaleHealthcare DisparitiesHospital MortalityHospitalizationHospitals, RuralHospitals, UrbanHumansMaleMiddle AgedOdds RatioQuality ImprovementRetrospective StudiesRural PopulationST Elevation Myocardial InfarctionSurvival RateTime FactorsUrban PopulationConceptsEvidence-based treatmentsMyocardial infarctionEnzyme inhibitors/angiotensin receptor blockersRural hospitalsST-segment elevation myocardial infarctionUrban-rural disparitiesAngiotensin receptor blockersElevation myocardial infarctionAdjusted odds ratioResource-intensive careRisk-adjusted ratesHospital deathReperfusion therapyReceptor blockersHospital admissionCardiac facilitiesPatient outcomesOdds ratioCare persistUrban hospitalΒ-blockersBetter outcomesRural careHealthcare resourcesST segmentQuality of Care in the United States Territories, 1999–2012
Nuti SV, Wang Y, Masoudi FA, Nunez-Smith M, Normand ST, Murugiah K, Rodríguez-Vilá O, Ross JS, Krumholz HM. Quality of Care in the United States Territories, 1999–2012. Medical Care 2017, 55: 886-892. PMID: 28906314, PMCID: PMC6482857, DOI: 10.1097/mlr.0000000000000797.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospitalization ratesMedicare beneficiariesMortality rateService Medicare beneficiariesQuality of careRecent study periodPneumonia hospitalizationsMyocardial infarctionPatient outcomesMillions of AmericansMedicare feeHealth outcomesPneumoniaService beneficiariesHospital reimbursementUnique beneficiariesHealth equityStudy periodPatient paymentsInpatient paymentsHealth careMortalityCarePrediction of Adverse Events in Patients Undergoing Major Cardiovascular Procedures
Mortazavi B, Desai N, Zhang J, Coppi A, Warner F, Krumholz H, Negahban S. Prediction of Adverse Events in Patients Undergoing Major Cardiovascular Procedures. IEEE Journal Of Biomedical And Health Informatics 2017, 21: 1719-1729. PMID: 28287993, DOI: 10.1109/jbhi.2017.2675340.Peer-Reviewed Original ResearchConceptsMajor cardiovascular proceduresElectronic health recordsRespiratory failureAdverse eventsCardiovascular proceduresYale-New Haven HospitalPostoperative respiratory failurePatient cohortHospital costsPatient outcomesSpecific patientPatientsHealth recordsCohort-specific modelsCharacteristic curveInfectionFailureHospitalCohortClinicians
2013
Comprehensive quality of discharge summaries at an academic medical center
Horwitz LI, Jenq GY, Brewster UC, Chen C, Kanade S, Van Ness P, Araujo KL, Ziaeian B, Moriarty JP, Fogerty RL, Krumholz HM. Comprehensive quality of discharge summaries at an academic medical center. Journal Of Hospital Medicine 2013, 8: 436-443. PMID: 23526813, PMCID: PMC3695055, DOI: 10.1002/jhm.2021.Peer-Reviewed Original ResearchConceptsDays of dischargeDischarge summariesAcute coronary syndromeProspective cohort studyAdvanced practice nursesImproved patient outcomesAcademic medical centerDischarge summary qualityCoronary syndromeCohort studyOutpatient cliniciansHeart failureOutside physiciansPractice nursesOutpatient physiciansPatient outcomesMedical CenterConsensus conferenceJoint CommissionMedical societiesPatientsSafe transitionTotalPhysiciansDaysCenters for Cardiovascular Outcomes Research
Cook NL, Bonds DE, Kiefe CI, Curtis JP, Krumholz HM, Kressin NR, Peterson ED. Centers for Cardiovascular Outcomes Research. Circulation Cardiovascular Quality And Outcomes 2013, 6: 223-228. PMID: 23481526, PMCID: PMC3684990, DOI: 10.1161/circoutcomes.0b013e31828e8d5c.Peer-Reviewed Original ResearchMeSH KeywordsCardiovascular DiseasesContinuity of Patient CareCooperative BehaviorHealth Care ReformHealth Services ResearchHealthcare DisparitiesHumansInterdisciplinary CommunicationInterinstitutional RelationsMulticenter Studies as TopicNational Heart, Lung, and Blood Institute (U.S.)Organizational ObjectivesOutcome Assessment, Health CareProgram DevelopmentProgram EvaluationQuality Indicators, Health CareQuality of LifeTreatment OutcomeUnited StatesConceptsCardiovascular Outcomes ResearchOutcomes research programsBlood InstituteNational HeartCardiovascular conditionsCross-program collaborationOutcomes researchAcute coronary syndromeBetter patient outcomesQuality of lifeCoronary syndromeVenous thromboembolismClinical eventsCare transitionsPatient outcomesDisparate careEarly-stage investigatorsClinical practiceTranslational gapLungNational InstituteHealthcare deliveryOutcomesHeartCareVariation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States
Safavi KC, Dharmarajan K, Kim N, Strait KM, Li SX, Chen SI, Lagu T, Krumholz HM. Variation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States. Circulation 2013, 127: 923-929. PMID: 23355624, PMCID: PMC3688061, DOI: 10.1161/circulationaha.112.001088.Peer-Reviewed Original ResearchConceptsIntensive care unitHeart failureRisk-standardized mortalityICU admissionICU useCare unitPatient outcomesCoronary intensive care unitMedical intensive care unitNoninvasive positive pressure ventilationSurgical intensive care unitTop quartileGreater ICU useOverall heart failureTop quartile hospitalsICU admission ratePercent of patientsPremier Perspective databaseHeart failure patientsPositive pressure ventilationRate of admissionHigh-cost settingsQuality of careHF admissionsICU days
2012
Hospitalist utilization and hospital performance on 6 publicly reported patient outcomes
Goodrich K, Krumholz HM, Conway PH, Lindenauer P, Auerbach AD. Hospitalist utilization and hospital performance on 6 publicly reported patient outcomes. Journal Of Hospital Medicine 2012, 7: 482-488. PMID: 22689448, PMCID: PMC3531241, DOI: 10.1002/jhm.1943.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPercentage of patientsHeart failurePatient outcomesOutcome measuresPresence of hospitalistsReadmission measuresCongestive heart failureCross-sectional studyMultivariable regression modelsComparison of hospitalQuality outcome measuresReadmission ratesIndependent predictorsMyocardial infarctionInpatient careHospitalist serviceHospitalist useMedical conditionsHospital personnelHospitalist programHospitalistsHospitalExpectation of improvementOutcomes
2011
Effect of Living Alone on Patient Outcomes After Hospitalization for Acute Myocardial Infarction
Bucholz EM, Rathore SS, Gosch K, Schoenfeld A, Jones PG, Buchanan DM, Spertus JA, Krumholz HM. Effect of Living Alone on Patient Outcomes After Hospitalization for Acute Myocardial Infarction. The American Journal Of Cardiology 2011, 108: 943-948. PMID: 21798499, PMCID: PMC3670597, DOI: 10.1016/j.amjcard.2011.05.023.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionSeattle Angina QuestionnaireMyocardial infarctionPatient outcomesLife 1 yearRegistry of patientsHealth status measurementPhysical health componentAngina QuestionnaireMultivariable adjustmentLife scoresTreatment characteristicsComparable riskOutcome measurementsPatientsReadmissionHealth componentHealth statusMean qualityMortalityStatus measurementsComponent scaleOutcomesInfarctionSocial supportAssociation of Door-In to Door-Out Time With Reperfusion Delays and Outcomes Among Patients Transferred for Primary Percutaneous Coronary Intervention
Wang TY, Nallamothu BK, Krumholz HM, Li S, Roe MT, Jollis JG, Jacobs AK, Holmes DR, Peterson ED, Ting HH. Association of Door-In to Door-Out Time With Reperfusion Delays and Outcomes Among Patients Transferred for Primary Percutaneous Coronary Intervention. JAMA 2011, 305: 2540-2547. PMID: 21693742, DOI: 10.1001/jama.2011.862.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngioplasty, Balloon, CoronaryCohort StudiesFemaleHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionOdds RatioPatient AdmissionPatient DischargePatient TransferQuality Indicators, Health CareReferral and ConsultationRetrospective StudiesTime FactorsTreatment OutcomeUnited StatesConceptsPrimary percutaneous coronary interventionST-elevation myocardial infarctionPrimary PCIPercutaneous coronary interventionDIDO timeHospital mortalityDTB timeCoronary interventionReperfusion delayFirst hospital presentationMedian DIDO timeOff-hour presentationSTEMI referral hospitalsClinical performance measuresHospital presentationAbsolute contraindicationBalloon timeRetrospective cohortReferral hospitalInterhospital transferACTION RegistryFemale sexMyocardial infarctionFirst HospitalPatient outcomes
2010
Shifting views on lipid lowering therapy
Krumholz HM, Hayward RA. Shifting views on lipid lowering therapy. The BMJ 2010, 341: c3531. PMID: 20667950, DOI: 10.1136/bmj.c3531.Peer-Reviewed Original Research
2009
What Works In Chronic Care Management: The Case Of Heart Failure
Sochalski J, Jaarsma T, Krumholz HM, Laramee A, McMurray JJ, Naylor MD, Rich MW, Riegel B, Stewart S. What Works In Chronic Care Management: The Case Of Heart Failure. Health Affairs 2009, 28: 179-189. PMID: 19124869, DOI: 10.1377/hlthaff.28.1.179.Peer-Reviewed Original ResearchConceptsCare management programChronic care managementCare managementChronic care management programEvidence baseRoutine care patientsRandomized clinical trialsReadmission daysCare patientsHeart failureHospital readmissionClinical trialsPatient outcomesMulti-disciplinary teamHealth plansProgram delivery methodsPatientsImportant guidepostsManagement programDelivery methodsReadmissionTrials
2008
Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study
Bernheim SM, Ross JS, Krumholz HM, Bradley EH. Influence of Patients’ Socioeconomic Status on Clinical Management Decisions: A Qualitative Study. The Annals Of Family Medicine 2008, 6: 53-59. PMID: 18195315, PMCID: PMC2203396, DOI: 10.1370/afm.749.Peer-Reviewed Original ResearchConceptsClinical management decisionsPatients' socioeconomic statusClinical managementSocioeconomic statusPatient sPatient outcomesPrimary care physiciansStandard of careInfluence of patientLow socioeconomic statusVaried practice settingsHealth care qualitySES influencesCare physiciansHispanic ethnicityPhysician perspectivesPractice settingsCare qualityPatientsPhysiciansPatient interestMinority racial backgroundsInterview guideFinancial strainOutcomes
2007
Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement
Krumholz HM, Normand SL, Spertus JA, Shahian DM, Bradley EH. Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement. Health Affairs 2007, 26: 75-85. PMID: 17211016, DOI: 10.1377/hlthaff.26.1.75.Peer-Reviewed Original Research
2006
A Taxonomy for Disease Management
Krumholz HM, Currie PM, Riegel B, Phillips CO, Peterson ED, Smith R, Yancy CW, Faxon DP. A Taxonomy for Disease Management. Circulation 2006, 114: 1432-1445. PMID: 16952985, DOI: 10.1161/circulationaha.106.177322.Peer-Reviewed Original ResearchMeSH KeywordsCardiologyCase ManagementClinical ProtocolsComorbidityDelivery of Health CareDepressionDiabetes MellitusDisease ManagementHeart FailureInterdisciplinary CommunicationMedicareModels, TheoreticalOutcome and Process Assessment, Health CarePatient Care ManagementPatient Care TeamPatient Education as TopicPatient SelectionRisk FactorsSocieties, MedicalTerminology as TopicConceptsDisease management programsDisease management interventionsHeart failureDisease managementHealthcare providersTerms heart failureLevel of comorbidityMedical resource utilizationHome-based programPatient-centered measuresSystematic MEDLINE searchDuration of exposureHealthcare delivery systemSecondary outcomesClinical outcomesPatient populationPostacute careCaregiver burdenMedication managementStudy protocolChronic carePatient outcomesPatient educationWriting groupManagement interventions