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
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
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 feeTrends 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
Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome
Dharmarajan K, Strait KM, Lagu T, Lindenauer PK, Tinetti ME, Lynn J, Li SX, Krumholz HM. Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome. PLOS ONE 2013, 8: e78222. PMID: 24250751, PMCID: PMC3824040, DOI: 10.1371/journal.pone.0078222.Peer-Reviewed Original ResearchConceptsDecompensated heart failureHeart failureRespiratory therapyHospital daysCardiopulmonary syndromeAcute decompensated heart failureAcute heart failure treatmentChronic obstructive pulmonary diseaseReceipt of medicationHeart failure hospitalizationHigh-dose corticosteroidsHospital day 2Hospital day 3Half of patientsChronic lung diseaseDays of hospitalizationHeart failure treatmentObstructive pulmonary diseaseShortness of breathIntensive care unitPrincipal discharge diagnosisLate intubationAcute asthmaFailure hospitalizationHospital death
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 statesAn Administrative Claims Model for Profiling Hospital 30-Day Mortality Rates for Pneumonia Patients
Bratzler DW, Normand SL, Wang Y, O'Donnell WJ, Metersky M, Han LF, Rapp MT, Krumholz HM. An Administrative Claims Model for Profiling Hospital 30-Day Mortality Rates for Pneumonia Patients. PLOS ONE 2011, 6: e17401. PMID: 21532758, PMCID: PMC3075250, DOI: 10.1371/journal.pone.0017401.Peer-Reviewed Original ResearchConceptsMortality rateDerivation cohortValidation cohortModel derivation cohortAge 66 yearsPrincipal discharge diagnosisAdministrative diagnosis codesStandardized mortality rateRisk-adjustment variablesQuality of careState mortality ratesAdministrative Claims ModelClaims-based modelsIndex hospitalizationPatient demographicsDischarge diagnosisOutpatient encountersPneumonia mortalityPneumonia patientsRetrospective studyDiagnosis codesPneumonia casesMortality estimatesOutcome measuresProfiling HospitalsDevelopment, validation, and results of a measure of 30‐day readmission following hospitalization for pneumonia
Lindenauer PK, Normand S, Drye EE, Lin Z, Goodrich K, Desai MM, Bratzler DW, O'Donnell WJ, Metersky ML, Krumholz HM. Development, validation, and results of a measure of 30‐day readmission following hospitalization for pneumonia. Journal Of Hospital Medicine 2011, 6: 142-150. PMID: 21387551, DOI: 10.1002/jhm.890.Peer-Reviewed Original ResearchConceptsHospital readmission ratesReadmission ratesOdds of readmissionRetrospective cohort studyMedical record reviewPrincipal discharge diagnosisDays of treatmentElderly patientsHospital dischargeCohort studyRecord reviewDischarge diagnosisUnadjusted ratesOutpatient MedicareMedical recordsAdministrative claimsMedicare beneficiariesReadmissionPneumoniaRisk-standardized hospital readmission ratesHospital
2006
Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment
Graff LG, Wang Y, Borkowski B, Tuozzo K, Foody JM, Krumholz HM, Radford MJ. Delay in the Diagnosis of Acute Myocardial Infarction: Effect on Quality of Care and Its Assessment. Academic Emergency Medicine 2006, 13: 931-938. PMID: 16894002, DOI: 10.1197/j.aem.2006.04.016.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge DistributionAgedAged, 80 and overAngina, UnstableAspirinCohort StudiesConnecticutEvidence-Based MedicineFemaleFibrinolytic AgentsHumansMaleMyocardial InfarctionPatient AdmissionQuality Assurance, Health CareQuality of Health CareRetrospective StudiesTime FactorsConceptsAcute myocardial infarctionAdmission diagnosisBeta blockersQuality of careMyocardial infarctionDiagnosis of AMICharacteristics of patientsPercutaneous coronary interventionPrincipal discharge diagnosisEvidence-based therapiesRate of administrationCoronary interventionCardiac catheterizationDischarge diagnosisPrincipal diagnosisFrequency of delaysDischarge statusPatient careAdmissionAMI diagnosisPatientsDiagnosisMedicare casesCareInfarctionHydroxymethylglutaryl‐CoA Reductase Inhibitors in Older Persons with Acute Myocardial Infarction: Evidence for an Age–Statin Interaction
Foody JM, Rathore SS, Galusha D, Masoudi FA, Havranek EP, Radford MJ, Krumholz HM. Hydroxymethylglutaryl‐CoA Reductase Inhibitors in Older Persons with Acute Myocardial Infarction: Evidence for an Age–Statin Interaction. Journal Of The American Geriatrics Society 2006, 54: 421-430. PMID: 16551308, PMCID: PMC2797316, DOI: 10.1111/j.1532-5415.2005.00635.x.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAged, 80 and overAtorvastatinCholesterol, LDLDrug PrescriptionsFatty Acids, MonounsaturatedFemaleFluvastatinFollow-Up StudiesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIndolesLovastatinMaleMyocardial InfarctionOdds RatioPravastatinPyridinesPyrrolesRetrospective StudiesSurvival RateTreatment OutcomeConceptsAcute myocardial infarctionHydroxymethylglutaryl-CoA reductase inhibitorsStatin therapyMyocardial infarctionLower mortalityOlder personsReductase inhibitorsPrincipal discharge diagnosisAcute care hospitalsCause mortalityEligible patientsOlder patientsYounger patientsCare hospitalDischarge prescriptionsPrimary outcomeDischarge diagnosisHospital characteristicsEfficacy dataMedicare patientsMultivariable modelObservational studyPatientsStatinsDischarge statinsQuality of Care for Acute Myocardial Infarction in Elderly Patients with Alcohol‐Related Diagnoses
Fiellin DA, O'Connor PG, Wang Y, Radford MJ, Krumholz HM. Quality of Care for Acute Myocardial Infarction in Elderly Patients with Alcohol‐Related Diagnoses. Alcohol Clinical And Experimental Research 2006, 30: 70-75. PMID: 16433733, DOI: 10.1111/j.1530-0277.2006.00001.x.Peer-Reviewed Original ResearchConceptsAlcohol-related diagnosesAcute myocardial infarctionMyocardial infarctionElderly patientsEligible patientsCare measuresRetrospective cohort analysisPrincipal discharge diagnosisTime of dischargeCooperative Cardiovascular ProjectAcute care hospitalsMedical record dataQuality of careBaseline characteristicsCare hospitalPrimary outcomeDischarge diagnosisCohort analysisAlcohol abuseMedicare beneficiariesInfarctionPatientsElderly adultsAlcohol dependenceQuality care
2005
Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project
Kosiborod M, Curtis JP, Wang Y, Smith GL, Masoudi FA, Foody JM, Havranek EP, Krumholz HM. Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project. JAMA Internal Medicine 2005, 165: 2237-2244. PMID: 16246989, DOI: 10.1001/archinte.165.19.2237.Peer-Reviewed Original ResearchConceptsHeart failureLower hematocrit levelsIndependent predictorsHematocrit levelsComorbid illnessesHigh riskCare ProjectMultivariable logistic regression analysisPatients 65 yearsPrincipal discharge diagnosisAcute care hospitalsLogistic regression analysisLow hematocrit valuesCause mortalityHF patientsMultiple comorbiditiesMultivariable adjustmentOlder patientsCare hospitalClinical factorsHospital readmissionComorbid conditionsDischarge diagnosisSevere anemiaAdverse outcomesThiazolidinediones, Metformin, and Outcomes in Older Patients With Diabetes and Heart Failure
Masoudi FA, Inzucchi SE, Wang Y, Havranek EP, Foody JM, Krumholz HM. Thiazolidinediones, Metformin, and Outcomes in Older Patients With Diabetes and Heart Failure. Circulation 2005, 111: 583-590. PMID: 15699279, DOI: 10.1161/01.cir.0000154542.13412.b1.Peer-Reviewed Original ResearchConceptsHeart failureInsulin-sensitizing drugsOlder patientsLower riskCox proportional hazards modelAntidiabetic drug prescriptionRetrospective cohort studyPrincipal discharge diagnosisClustering of patientsProportional hazards modelCohort studySecondary outcomesPrimary outcomeMetformin treatmentRandomized trialsThiazolidinedione treatmentDischarge diagnosisInsulin sensitizersAdverse outcomesDrug prescriptionsMultivariable modelObservational studyHospital variablesThiazolidinedione classHigh risk
2004
Delay in diagnosis of acute myocardial infarction: Increasingly common, lower quality of care
Graff L, Wang Y, Foody J, Meehan T, Tuozzo K, Krumholz H, Radford M. Delay in diagnosis of acute myocardial infarction: Increasingly common, lower quality of care. Annals Of Emergency Medicine 2004, 44: s46. DOI: 10.1016/j.annemergmed.2004.07.151.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careDiagnosis of AMIUnstable anginaMyocardial infarctionAMI casesPossible acute myocardial infarctionCoronary artery diseaseMedical record abstractionPrincipal discharge diagnosisSecondary diagnosis codesAMI dischargeDischarge therapyAdmission diagnosisComorbidity scoreArtery diseasePatient characteristicsComorbid conditionsRecord abstractionAcute careDischarge diagnosisDiagnosis codesAnginaAMI diagnosisCare measurement