2023
Physician responses to apple watch-detected irregular rhythm alerts
Demkowicz P, Dhruva S, Spatz E, Beatty A, Ross J, Khera R. Physician responses to apple watch-detected irregular rhythm alerts. American Heart Journal 2023, 262: 29-37. PMID: 37084933, PMCID: PMC10988207, DOI: 10.1016/j.ahj.2023.04.008.Peer-Reviewed Original ResearchConceptsAtrial fibrillationPrimary careEmergency medicinePhysician responsesDiagnostic testingUse of antiarrhythmicsClinical practice guidelinesMeasurement of BNPFurther diagnostic testingCase-based surveyLarge academic centerAF alertsAsymptomatic patientsPatient demographicsClinical symptomsTreatment optionsMedical historyPatient referralPhysician specialtyPractice guidelinesPhysician differencesRhythm monitoringAcademic centersUS FoodClinical complexityIdentifying treatment heterogeneity in atrial fibrillation using a novel causal machine learning method
Ngufor C, Yao X, Inselman J, Ross J, Dhruva S, Graham D, Lee J, Siontis K, Desai N, Polley E, Shah N, Noseworthy P, MN; New Haven C. Identifying treatment heterogeneity in atrial fibrillation using a novel causal machine learning method. American Heart Journal 2023, 260: 124-140. PMID: 36893934, PMCID: PMC10615250, DOI: 10.1016/j.ahj.2023.02.015.Peer-Reviewed Original ResearchConceptsOral anticoagulantsAtrial fibrillationPatient subgroupsComposite outcomeIschemic strokeEffect of OACsLifelong oral anticoagulationNonvitamin K antagonistNew oral anticoagulantsNonvalvular atrial fibrillationPrimary composite outcomeGlomerular filtration rateFuture prospective studiesOptumLabs Data WarehousePopulation-level effectivenessOAC useOral anticoagulationVASc scoreCause mortalityK antagonistsPrimary endpointWarfarin usersRenal functionAF patientsEntire cohort
2022
SAFETY AND EFFECTIVENESS OF THERMOCOOL ST CATHETER FOR ABLATION OF PERSISTENT ATRIAL FIBRILLATION USING REAL-WORLD DATA
Dhruva S, Zhang S, Chen J, Noseworthy P, Doshi A, Agboola K, Herrin J, Jiang G, Yu Y, Cafri G, Farr K, Ervin K, Ross J, Coplan P, Drozda J. SAFETY AND EFFECTIVENESS OF THERMOCOOL ST CATHETER FOR ABLATION OF PERSISTENT ATRIAL FIBRILLATION USING REAL-WORLD DATA. Journal Of The American College Of Cardiology 2022, 79: 73. DOI: 10.1016/s0735-1097(22)01064-6.Peer-Reviewed Original ResearchAssessment of Hypothetical Out-of-Pocket Costs of Guideline-Recommended Medications for the Treatment of Older Adults With Multiple Chronic Conditions, 2009 and 2019
Zhou T, Liu P, Dhruva SS, Shah ND, Ramachandran R, Berg KM, Ross JS. Assessment of Hypothetical Out-of-Pocket Costs of Guideline-Recommended Medications for the Treatment of Older Adults With Multiple Chronic Conditions, 2009 and 2019. JAMA Internal Medicine 2022, 182: 185-195. PMID: 34982097, PMCID: PMC8728660, DOI: 10.1001/jamainternmed.2021.7457.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtrial FibrillationChronic DiseaseCross-Sectional StudiesDiabetes Mellitus, Type 2Drug CostsHealth ExpendituresHeart FailureHumansHypercholesterolemiaHypertensionMedicare Part CMedicare Part DMultiple Chronic ConditionsOsteoarthritisOsteoporosisPrescription DrugsPulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited StatesConceptsCommon chronic diseasesGuideline-recommended medicationsGuideline-recommended managementPrescription drug plansCross-sectional studyChronic conditionsChronic diseasesPocket costsOlder adultsOutpatient medicationsMedicare prescription drug plansInitial treatmentMedicare Advantage plansRetrospective cross-sectional studyMultiple chronic conditionsMedicare Part D plansPart D plansSubstantial financial burdenAtrial fibrillationMAIN OUTCOMEExclusion criteriaMedicare beneficiariesAnnual outHypothetical patientsMedications
2021
Heart Watch Study: protocol for a pragmatic randomised controlled trial
Dhruva SS, Shah ND, Vemulapalli S, Deshmukh A, Beatty AL, Gamble GM, Freeman JV, Hummel JP, Piccini JP, Akar JG, Ervin K, Arges KL, Emanuel L, Noseworthy PA, Hu T, Bartlett V, Ross JS. Heart Watch Study: protocol for a pragmatic randomised controlled trial. BMJ Open 2021, 11: e054550. PMID: 35234659, PMCID: PMC8719216, DOI: 10.1136/bmjopen-2021-054550.Peer-Reviewed Original ResearchConceptsHealthcare utilisationSecondary outcomesAtrial fibrillationAtrial flutterDuke University Health SystemRoutine clinical care settingsAtrial Fibrillation EffectLife global scoresTime of cardioversionAdditional secondary outcomesPopulation of patientsPatient-reported outcomesClinical care settingsUniversity Health SystemQuality of lifeInstitutional review boardMulticentre pragmaticPeer-reviewed journalsPrimary outcomePatients' qualityTrial protocolClinical trialsMayo ClinicECG featuresCare settingsFeasibility of using real-world data in the evaluation of cardiac ablation catheters: a test-case of the National Evaluation System for Health Technology Coordinating Center
Dhruva SS, Jiang G, Doshi AA, Friedman DJ, Brandt E, Chen J, Akar JG, Ross JS, Ervin KR, Farr K, Shah ND, Coplan P, Noseworthy PA, Zhang S, Forsyth T, Schulz WL, Yu Y, Drozda JP. Feasibility of using real-world data in the evaluation of cardiac ablation catheters: a test-case of the National Evaluation System for Health Technology Coordinating Center. BMJ Surgery Interventions & Health Technologies 2021, 3: e000089. PMID: 35047806, PMCID: PMC8749235, DOI: 10.1136/bmjsit-2021-000089.Peer-Reviewed Original ResearchPositive predictive valuePersistent atrial fibrillationIschemic ventricular tachycardiaAblation catheterHealth systemAtrial fibrillationVentricular tachycardiaCardiac ablation catheterAcute heart failureDuration of patientsHealth system dataCardiac tamponadeIschemic strokeRetrospective cohortHeart failureClinical outcomesEndpoint ascertainmentPredictive valueCatheterChart validationCoordinating CenterTachycardiaPatientsFibrillationParticipant populationPhysical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices
Bartlett VL, Ross JS, Shah ND, Ciaccio L, Akar JG, Noseworthy PA, Dhruva SS. Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices. Cardiovascular Digital Health Journal 2021, 2: 212-221. PMID: 35265911, PMCID: PMC8890038, DOI: 10.1016/j.cvdhj.2021.06.002.Peer-Reviewed Original ResearchPatient-reported outcome measuresMedian daily stepsAtrial fibrillationDaily stepsPostprocedural recoveryBariatric surgeryClinical eventsAF ablation patientsPatient-reported symptomsElectronic health record dataUsual clinical settingSignificant mean decreaseHealth record dataAntiarrhythmic drug prescriptionAblation patientsAF ablationCatheter ablationDrug prescriptionsPatient recoveryOutcome measuresPROM dataPhysical activityMean decreasePatientsRhythm assessmentCardiovascular outcomes and rates of fractures and falls among patients with brand-name versus generic L-thyroxine use
Brito JP, Ross JS, Deng Y, Sangaralingham L, Graham DJ, Qiang Y, Wang Z, Yao X, Zhao L, Smallridge RC, Bernet V, Shah ND, Lipska KJ. Cardiovascular outcomes and rates of fractures and falls among patients with brand-name versus generic L-thyroxine use. Endocrine 2021, 74: 592-602. PMID: 34089480, PMCID: PMC9210353, DOI: 10.1007/s12020-021-02779-x.Peer-Reviewed Original ResearchConceptsCongestive heart failureRate of fracturesCardiovascular outcomesL-thyroxineRate of fallHeart failureHip fractureAtrial fibrillationMyocardial infarctionNational administrative claims databasePropensity-matched patientsAdministrative claims databaseRate of hospitalizationMIU/L.Main outcome measuresSignificant differencesDose subgroupsHospitalization ratesClaims databaseThyroid cancerInpatient settingBaseline thyroidHormone levelsOutcome measuresPatients
2020
Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology
Akar JG, Hummel JP, Yao X, Sangaralingham L, Dhruva S, Dong J, Ward R, Shah ND, Ross J, Noseworthy PA. Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology. BMJ Surgery Interventions & Health Technologies 2020, 2: e000058. PMID: 35047796, PMCID: PMC8647613, DOI: 10.1136/bmjsit-2020-000058.Peer-Reviewed Original ResearchContact force-sensing catheterForce-sensing catheterAcute care useAtrial fibrillation ablationCatheter-related complicationsFibrillation ablationCare useAtrial fibrillationStroke/transient ischemic attackTransient ischemic attackRetrospective cohort analysisEmergency department visitsInverse probability treatment weightsOptumLabs Data WarehouseCatheter complicationsIschemic attackBaseline characteristicsComplication rateDepartment visitsAtrioesophageal fistulaEsophageal injuryCohort analysisContact force monitoringClinical practiceCatheterComparative Effectiveness and Safety of Oral Anticoagulants Across Kidney Function in Patients With Atrial Fibrillation
Yao X, Inselman JW, Ross JS, Izem R, Graham DJ, Martin DB, Thompson AM, Ross Southworth M, Siontis KC, Ngufor CG, Nath KA, Desai NR, Nallamothu BK, Saran R, Shah ND, Noseworthy PA. Comparative Effectiveness and Safety of Oral Anticoagulants Across Kidney Function in Patients With Atrial Fibrillation. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006515. PMID: 33012172, PMCID: PMC7580213, DOI: 10.1161/circoutcomes.120.006515.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAged, 80 and overAnticoagulantsAntithrombinsAtrial FibrillationComparative Effectiveness ResearchDabigatranDatabases, FactualFactor Xa InhibitorsFemaleGlomerular Filtration RateHemorrhageHumansKidneyMaleMiddle AgedPyrazolesPyridonesRenal Insufficiency, ChronicRetrospective StudiesRisk AssessmentRisk FactorsRivaroxabanTime FactorsTreatment OutcomeUnited StatesWarfarinConceptsGlomerular filtration rateKidney functionMajor bleedingAtrial fibrillationOral anticoagulantsLower riskFiltration rateComparative effectivenessGlomerular filtration rate categoriesUS administrative claims databaseFalsification end pointsKidney function declineReduced kidney functionProportion of patientsAdministrative claims databaseSubstantial residual confoundingBaseline characteristicsFunction declineClaims databaseComparative safetyResidual confoundingTreatment weightingSimilar riskTreatment groupsPatientsPatient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm
Smith LB, Desai NR, Dowd B, Everhart A, Herrin J, Higuera L, Jeffery MM, Jena AB, Ross JS, Shah ND, Karaca-Mandic P. Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm. International Journal Of Health Economics And Management 2020, 20: 299-317. PMID: 32350680, PMCID: PMC7725279, DOI: 10.1007/s10754-020-09282-2.Peer-Reviewed Original ResearchConceptsPermanent atrial fibrillationType 2 diabetesAtrial fibrillationPermanent atrial fibrillation patientsProvider-level factorsAtrial fibrillation patientsEffective new therapiesPrimary care providersUse of medicationsProvider-level characteristicsUtilization of treatmentHigh-quality health careDronedarone useInterrupted time-series regression modelsFibrillation patientsMedication useDiabetes patientsProvider characteristicsCare providersMedicare feeNew therapiesService claimsFemale providersPatientsMedicationsClinical 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