2024
Artificial intelligence applied to electrocardiographic images for scalable screening of cardiac amyloidosis
Sangha V, Oikonomou E, Krumholz H, Miller E, Khera R. Artificial intelligence applied to electrocardiographic images for scalable screening of cardiac amyloidosis. European Heart Journal 2024, 45: ehae666.3436. DOI: 10.1093/eurheartj/ehae666.3436.Peer-Reviewed Original ResearchATTR-CMBone scintigraphy scansTransthyretin amyloid cardiomyopathyPositive predictive valueAI-ECG algorithmCardiac amyloidosisScintigraphy scanAmyloid cardiomyopathyAI-ECGSex-matchedDevelopment cohortMyocardial remodelingUnder-diagnosedUnder-treatedMatched controlsPredictive valueUnder-recognizedTransthyretin stabilizersConvolutional neural networkPatientsECGArtificial intelligenceHospitalPrevalenceTransthyretinTrends in use of intensive care during hospitalizations at the end‐of‐life among older adults with advanced cancer
Jain S, Long J, Rao V, Law A, Walkey A, Prsic E, Lindenauer P, Krumholz H, Gross C. Trends in use of intensive care during hospitalizations at the end‐of‐life among older adults with advanced cancer. Journal Of The American Geriatrics Society 2024 PMID: 39090970, DOI: 10.1111/jgs.19119.Peer-Reviewed Original ResearchEnd-of-life hospitalizationsLife-sustaining treatmentEnd-of-lifeIntensity of careIn-hospital deathOlder adultsIntensive care unitAdvanced cancerRisk-adjusted hospitalEvaluate trendsIncreased intensity of careIntensive care unit useSEER-Medicare dataIntensive care unit careMultinomial regression modelsYear of diagnosisIntensive careHospital categoryMedicare beneficiariesSEER-MedicareHospitalization ratesCareCancer characteristicsNoninvasive ventilationHospital
2023
Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
Wang Y, Eldridge N, Metersky M, Rodrick D, Eckenrode S, Mathew J, Galusha D, Peterson A, Hunt D, Normand S, Krumholz H. Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009573. PMID: 37463255, PMCID: PMC10351904, DOI: 10.1161/circoutcomes.122.009573.Peer-Reviewed Original ResearchConceptsMore adverse eventsAdverse eventsHeart failureCause mortalityReadmission ratesHigh riskMedicare Patient Safety Monitoring SystemHospital-acquired adverse eventsIn-Hospital Adverse EventsHospital adverse eventsRate of patientsPatient Safety DatabasePerformance categoriesAdverse event dataCross-sectional studyUnited States CentersHospital performanceHospital characteristicsReadmission dataPatient riskMAIN OUTCOMEPatientsWorst hospitalsHospitalHigh mortalityDo PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets?
Shen Y, Krumholz H, Hsia R. Do PCI Facility Openings and Closures Affect AMI Outcomes Differently in High- vs Average-Capacity Markets? JACC Cardiovascular Interventions 2023, 16: 1129-1140. PMID: 37225284, PMCID: PMC10229059, DOI: 10.1016/j.jcin.2023.02.010.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionPCI hospitalsSame-day percutaneous coronary interventionHealth outcomesHigh-volume PCI hospitalsHospital PCI volumeRetrospective cohort studyAcute myocardial infarctionPercentage point decreasePatient health outcomesHospital revascularizationCohort studyCoronary interventionAMI outcomesPCI volumePoint decreasePoor outcomePCI facilitiesMyocardial infarctionRelative increaseHospital openingPatientsHospital availabilityHospitalHospital closures
2022
Hospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study
Yu Y, Guan W, Masoudi FA, Wang B, He G, Spertus JA, Lu Y, Krumholz HM, Li J. Hospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2022, 11: e026300. PMID: 36172964, PMCID: PMC9673705, DOI: 10.1161/jaha.122.026300.Peer-Reviewed Original ResearchConceptsSpironolactone prescriptionSpironolactone useHeart failureMedian odds ratioIdeal patientAldosterone antagonistsHospital variationMedian rateReduced ejection fractionUse of spironolactoneMultivariable linear regression modelsHeart Failure StudyEjection fractionHospital characteristicsOdds ratioRepresentative cohortPatientsHospitalChinese hospitalsInappropriate usePrescriptionSpironolactoneSelect individualsAntagonistHigh rate12th Korea Healthcare Congress 2021; 김치국부터 마시지 말라; The Time for Digital Health is Almost Here
Krumholz HM. 12th Korea Healthcare Congress 2021; 김치국부터 마시지 말라; The Time for Digital Health is Almost Here. Yonsei Medical Journal 2022, 63: 493-498. PMID: 35512753, PMCID: PMC9086693, DOI: 10.3349/ymj.2022.63.5.493.Peer-Reviewed Original ResearchInstitutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Ngo L, Ali A, Ganesan A, Woodman R, Krumholz HM, Adams R, Ranasinghe I. Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e022009. PMID: 35156395, PMCID: PMC9245833, DOI: 10.1161/jaha.121.022009.Peer-Reviewed Original ResearchConceptsProcedure-related complicationsComplication rateAF ablationAtrial fibrillationCatheter ablationStroke/transient ischemic attackCare qualityTransient ischemic attackRisk of complicationsIschemic attackHospital stayCohort studyCommon complicationHospital dischargePericardial effusionCardiorespiratory failurePrimary outcomeProcedural characteristicsComplicationsPatientsHospitalStudy periodBackground ComplicationsPotential disparitiesFibrillation
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospitalAssociation 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 associationAssociation of STEMI regionalization of care with de facto NSTEMI regionalization
Montoy JCC, Shen YC, Krumholz HM, Hsia RY. Association of STEMI regionalization of care with de facto NSTEMI regionalization. American Heart Journal 2021, 242: 1-5. PMID: 34274313, PMCID: PMC8568654, DOI: 10.1016/j.ahj.2021.07.002.Peer-Reviewed Original ResearchConceptsNon-ST elevation myocardial infarctionST-elevation myocardial infarctionElevation myocardial infarctionMyocardial infarctionPercutaneous coronary intervention-capable hospitalsPCI-capable hospitalsRegionalization of careCapable hospitalsSTEMI regionalizationPatient volumeHospitalInfarctionPatientsCareRegionalization program
2020
Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand
Labrosciano C, Horton D, Air T, Tavella R, Beltrame JF, Zeitz CJ, Krumholz HM, Adams R, Scott IA, Gallagher M, Hossain S, Hariharaputhiran S, Ranasinghe I. Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand. European Journal Of Heart Failure 2020, 23: 31-40. PMID: 33094886, DOI: 10.1002/ejhf.2030.Peer-Reviewed Original ResearchConceptsHF hospitalisationUnplanned readmissionReadmission ratesHeart failure hospitalisationUnplanned readmission rateMortality cohortReadmission cohortCause mortalityHeart failurePrimary outcomeHospitalisationReadmissionSeparate cohortMortality rateHospitalPatientsMortalityCare qualityPrivate hospitalsStudy periodCohortModest declineNational averageOutcomesDaysEvaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities
Hsia RY, Krumholz H, Shen YC. Evaluation of STEMI Regionalization on Access, Treatment, and Outcomes Among Adults Living in Nonminority and Minority Communities. JAMA Network Open 2020, 3: e2025874. PMID: 33196809, PMCID: PMC7670311, DOI: 10.1001/jamanetworkopen.2020.25874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBlack or African AmericanCaliforniaCause of DeathCohort StudiesFemaleHealth Services AccessibilityHealthcare DisparitiesHispanic or LatinoHospitalizationHumansMaleMiddle AgedMinority GroupsMortalityNon-Randomized Controlled Trials as TopicPercutaneous Coronary InterventionRegional Medical ProgramsResidence CharacteristicsST Elevation Myocardial InfarctionTime-to-TreatmentWhite PeopleConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionPercutaneous coronary interventionPCI-capable hospitalsZip codesNon-Hispanic whitesPatient's countyCause mortalityCohort studyCoronary interventionPCI hospitalsPCI treatmentWhite patientsCapable hospitalsMyocardial infarctionTop tertileInpatient dataMAIN OUTCOMEPatientsSTEMI regionalizationSmall improvementHospitalPotential mechanismsSame dayHispanic populationThe impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction
Raparelli V, Pilote L, Behlouli H, Dziura J, Bueno H, D'Onofrio G, Krumholz H, Dreyer R. The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction. European Heart Journal 2020, 41: ehaa946.3175. DOI: 10.1093/ehjci/ehaa946.3175.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careYoung adultsMyocardial infarctionHealthcare systemHigher risk factor burdenRisk factor burdenPost-discharge carePhases of careMultipayer systemImpact of sexSystem-level factorsHospital phaseAMI careCare scoresSingle-payer systemCareWomenCanadian InstituteSexAdultsMenInfarctionHospitalLinear regression modelsAn instrument for assessing the quality of informed consent documents for elective procedures: development and testing
Spatz ES, Suter LG, George E, Perez M, Curry L, Desai V, Bao H, Geary LL, Herrin J, Lin Z, Bernheim SM, Krumholz HM. An instrument for assessing the quality of informed consent documents for elective procedures: development and testing. BMJ Open 2020, 10: e033297. PMID: 32434933, PMCID: PMC7247404, DOI: 10.1136/bmjopen-2019-033297.Peer-Reviewed Original ResearchQuality of informed consent documents among US. hospitals: a cross-sectional study
Spatz ES, Bao H, Herrin J, Desai V, Ramanan S, Lines L, Dendy R, Bernheim SM, Krumholz HM, Lin Z, Suter LG. Quality of informed consent documents among US. hospitals: a cross-sectional study. BMJ Open 2020, 10: e033299. PMID: 32434934, PMCID: PMC7247389, DOI: 10.1136/bmjopen-2019-033299.Peer-Reviewed Original ResearchConceptsInformed consent documentsHOSPITAL scoreUS hospitalsMean hospital scoresRetrospective observational studyConsent documentsCross-sectional studyEight-item instrumentService patientsElective proceduresProcedure typeObservational studySurgical proceduresMedicare feeHospitalHospital qualityMeasure scoresInformed consentMost hospitalsSpearman correlationScoresFace validityIndependent ratersOutcomesStakeholder feedbackAvailability of Telemedicine Services Across Hospitals in the United States in 2018: A Cross-sectional Study
Jain S, Khera R, Lin Z, Ross JS, Krumholz HM. Availability of Telemedicine Services Across Hospitals in the United States in 2018: A Cross-sectional Study. Annals Of Internal Medicine 2020, 173: m20-1201. PMID: 32353106, PMCID: PMC7212823, DOI: 10.7326/m20-1201.Peer-Reviewed Original Research
2019
Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation: A Cohort Study.
Ranasinghe I, Labrosciano C, Horton D, Ganesan A, Curtis JP, Krumholz HM, McGavigan A, Hossain S, Air T, Hariharaputhiran S. Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation: A Cohort Study. Annals Of Internal Medicine 2019, 171: 309-317. PMID: 31357210, DOI: 10.7326/m18-2810.Peer-Reviewed Original ResearchConceptsCardiovascular implantable electronic devicesComplication rateCohort studyCIED complicationsCardiovascular implantable electronic device (CIED) implantationMajor device-related complicationsDays of dischargeDevice-related complicationsProcedure-related complicationsImplantable electronic devicesPPM implantationMajor complicationsICD placementDevice implantationElective proceduresComplicationsHospitalCare qualityStudy periodPatientsAdministrative dataInstitutional variationNational averageImplantationEvaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework
Khera R, Wang Y, Nasir K, Lin Z, Krumholz HM. Evaluation of 30-Day Hospital Readmission and Mortality Rates Using Regression-Discontinuity Framework. Journal Of The American College Of Cardiology 2019, 74: 219-234. PMID: 31296295, PMCID: PMC8669780, DOI: 10.1016/j.jacc.2019.04.060.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHospital Readmissions Reduction ProgramHeart failureReadmission ratesElderly Medicare feeMedian readmission rateReadmissions Reduction ProgramPost-discharge daysInstitution of strategiesHospital readmissionReadmission riskMyocardial infarctionReadmission reductionCardiovascular conditionsEligible hospitalsMedicare feeReadmission penaltiesMortality rateDay 1Day 30ReadmissionDay 60HospitalU.S. hospitalsHospitalizationEvaluation of the Patient Request Process for Radiology Imaging in U.S. Hospitals.
Lye CT, Krumholz HM, Eckroate JE, Daniel JG, deBronkart D, Mann MK, Hsiao AL, Forman HP. Evaluation of the Patient Request Process for Radiology Imaging in U.S. Hospitals. Radiology 2019, 292: 409-413. PMID: 31184560, DOI: 10.1148/radiol.2019190473.Peer-Reviewed Original ResearchTRADITIONAL CHINESE MEDICINE FOR HEART FAILURE ADMISSIONS IN WESTERN MEDICINE HOSPITALS IN CHINA: ANALYSIS FROM THE CHINA PEACE RETROSPECTIVE HEART FAILURE STUDY
Yu Y, Spatz E, Krumholz H, Li J. TRADITIONAL CHINESE MEDICINE FOR HEART FAILURE ADMISSIONS IN WESTERN MEDICINE HOSPITALS IN CHINA: ANALYSIS FROM THE CHINA PEACE RETROSPECTIVE HEART FAILURE STUDY. Journal Of The American College Of Cardiology 2019, 73: 796. DOI: 10.1016/s0735-1097(19)31403-2.Peer-Reviewed Original Research