Featured Publications
Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018
Caraballo C, Ndumele CD, Roy B, Lu Y, Riley C, Herrin J, Krumholz HM. Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among Adults in the US, 1999 to 2018. JAMA Health Forum 2022, 3: e223856. PMID: 36306118, PMCID: PMC9617175, DOI: 10.1001/jamahealthforum.2022.3856.Peer-Reviewed Original ResearchConceptsTimely medical careSerial cross-sectional studyNational Health Interview SurveyCross-sectional studyHealth Interview SurveyMedical careLack of transportationEthnic disparitiesHispanics/LatinosWhite individualsEthnicity groupsInterview SurveyCost of careSelf-reported raceStudy cohortClinic hoursMAIN OUTCOMEMedical officesCarePrevalenceLatino individualsBlack individualsSignificant differencesSignificant increasePopulation groupsComparative Effectiveness of Machine Learning Approaches for Predicting Gastrointestinal Bleeds in Patients Receiving Antithrombotic Treatment
Herrin J, Abraham NS, Yao X, Noseworthy PA, Inselman J, Shah ND, Ngufor C. Comparative Effectiveness of Machine Learning Approaches for Predicting Gastrointestinal Bleeds in Patients Receiving Antithrombotic Treatment. JAMA Network Open 2021, 4: e2110703. PMID: 34019087, PMCID: PMC8140376, DOI: 10.1001/jamanetworkopen.2021.10703.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnticoagulantsAntifibrinolytic AgentsAtrial FibrillationClinical Decision-MakingCohort StudiesCross-Sectional StudiesFemaleFibrinolytic AgentsGastrointestinal HemorrhageHumansMachine LearningMaleMiddle AgedMyocardial IschemiaPredictive Value of TestsRetrospective StudiesRisk AssessmentThienopyridinesUnited StatesVenous ThromboembolismYoung AdultConceptsGastrointestinal bleedingIschemic heart diseaseCross-sectional studyThienopyridine antiplatelet agentAntithrombotic treatmentVenous thromboembolismAntiplatelet agentsRandom survival forestStudy cohortAtrial fibrillationValidation cohortHeart diseaseHAS-BLED risk scoreRetrospective cross-sectional studyCox proportional hazards regressionHAS-BLED scorePrior GI bleedPatients 18 yearsCohort of patientsEntire study cohortProportional hazards regressionOptumLabs Data WarehouseMedicare Advantage enrolleesPositive predictive valueRisk prediction model
2024
Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial
Song J, Wang X, Wang B, Ge Y, Bi L, Jing F, Jin H, Li T, Gu B, Wang L, Hao J, Zhao Y, Liu J, Zhang H, Li X, Li J, Ma W, Wang J, Normand S, Herrin J, Armitage J, Krumholz H, Zheng X. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. The BMJ 2024, 386: e079143. PMID: 39043397, PMCID: PMC11265211, DOI: 10.1136/bmj-2023-079143.Peer-Reviewed Original ResearchConceptsClinical decision support systemsPrimary care practicesElectronic health recordsIntervention groupSystolic blood pressurePrimary careCare practicesBlood pressure <Health recordsPragmatic cluster randomised controlled trialCluster randomised controlled trialImproving hypertension treatmentPrimary care settingBlood pressure control ratesBlood pressureProportion of visitsProportion of participantsRandomised controlled trialsSystolic blood pressure <Control groupInjurious fallsRelated visitsCare settingsDiastolic blood pressure <Follow-upEnrollment in High-Deductible Health Plans and Incident Diabetes Complications
McCoy R, Swarna K, Jiang D, Van Houten H, Chen J, Davis E, Herrin J. Enrollment in High-Deductible Health Plans and Incident Diabetes Complications. JAMA Network Open 2024, 7: e243394. PMID: 38517436, PMCID: PMC10960199, DOI: 10.1001/jamanetworkopen.2024.3394.Peer-Reviewed Original ResearchConceptsHigh-deductible health plansHealth plansChronic disease managementOdds of myocardial infarctionLower-extremity complicationsMixed-effects logistic regression modelsOut-of-pocket costsAssociated with increased oddsDiabetic complicationsInverse propensity score weightingLogistic regression modelsCardiovascular risk factorsEmployer-sponsored health plansDiabetes careRetrospective cohort studyUS adultsPropensity score weightingPotential selection biasMain OutcomesCohort studyBaseline yearIncident complicationsDisease managementMixed-effectsPotential harm
2022
Perioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks
Xu X, Soulos PR, Herrin J, Wang SY, Pollack CE, Killelea BK, Forman HP, Gross CP. Perioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks. PLOS ONE 2022, 17: e0265188. PMID: 35290417, PMCID: PMC8923453, DOI: 10.1371/journal.pone.0265188.Peer-Reviewed Original ResearchConceptsPhysician patient-sharing networksPerioperative magnetic resonance imagingClinical risk factorsMagnetic resonance imagingPatient clinical risk factorsPatient-sharing networksBreast cancer careRisk-adjusted ratesMastectomy usePhysician networksCancer careRisk factorsEnd Results-Medicare databaseCharacteristics of patientsProportion of patientsBreast cancer surgeryComposition of patientsMRI adoptionDistinct trajectoriesMore patientsCancer surgeryClinical outcomesCancer specialistsMRI usePatientsTrends and Variation in the Gap Between Current and Anticipated Life Satisfaction in the United States, 2008-2020.
Riley C, Herrin J, Lam V, Parsons AA, Kaplan GA, Liu D, Witters D, Krumholz HM, Roy B. Trends and Variation in the Gap Between Current and Anticipated Life Satisfaction in the United States, 2008-2020. American Journal Of Public Health 2022, 112: 509-517. PMID: 35196041, PMCID: PMC8887183, DOI: 10.2105/ajph.2021.306589.Peer-Reviewed Original Research
2021
National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlTrends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdultsA Longitudinal Study Exploring Learning Environment Culture and Subsequent Risk of Burnout Among Resident Physicians Overall and by Gender
Dyrbye LN, West CP, Herrin J, Dovidio J, Cunningham B, Yeazel M, Lam V, Onyeador IN, Wittlin NM, Burke SE, Hayes SN, Phelan SM, van Ryn M. A Longitudinal Study Exploring Learning Environment Culture and Subsequent Risk of Burnout Among Resident Physicians Overall and by Gender. Mayo Clinic Proceedings 2021, 96: 2168-2183. PMID: 34218879, DOI: 10.1016/j.mayocp.2020.12.036.Peer-Reviewed Original ResearchPhysician variation in the de‐adoption of ineffective statin and fibrate therapy
Everhart A, Desai NR, Dowd B, Herrin J, Higuera L, Jeffery MM, Jena AB, Ross JS, Shah ND, Smith LB, Karaca‐Mandic P. Physician variation in the de‐adoption of ineffective statin and fibrate therapy. Health Services Research 2021, 56: 919-931. PMID: 33569804, PMCID: PMC8522575, DOI: 10.1111/1475-6773.13630.Peer-Reviewed Original ResearchMeSH KeywordsAgedDiabetes Mellitus, Type 2Drug Therapy, CombinationDrug UtilizationFemaleFibric AcidsGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypoglycemic AgentsHypolipidemic AgentsLongitudinal StudiesMaleMedicare Part CMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'Risk FactorsUnited StatesConceptsMedicare Advantage patientsType 2 diabetic patientsACCORD lipid trialFibrate useAdvantage patientsCommercial patientsPhysician characteristicsLIPID trialFibrate therapyDiabetic patientsPhysician variationDiabetes careType 2 diabetes diagnosisContinuous insurance enrollmentPatient diabetes carePhysician random effectsGlucose-lowering drugsElectronic health record dataHealth record dataReal-world data assetConcurrent statinCardiovascular eventsStatin usersClinical evidenceManagement visits
2020
Association of Survival With Adjuvant Chemotherapy Among Patients With Early-Stage Non–Small Cell Lung Cancer With vs Without High-Risk Clinicopathologic Features
Pathak R, Goldberg SB, Canavan M, Herrin J, Hoag JR, Salazar MC, Papageorge M, Ermer T, Boffa DJ. Association of Survival With Adjuvant Chemotherapy Among Patients With Early-Stage Non–Small Cell Lung Cancer With vs Without High-Risk Clinicopathologic Features. JAMA Oncology 2020, 6: 1741-1750. PMID: 32940636, PMCID: PMC7499246, DOI: 10.1001/jamaoncol.2020.4232.Peer-Reviewed Original ResearchConceptsNode-negative non-small cell lung cancerHigh-risk pathologic featuresNon-small cell lung cancerAdjuvant chemotherapyCell lung cancerPathologic featuresTumor sizeSurvival benefitCohort studyLung cancerNode-negative NSCLCEarly-stage non-small cell lung cancerCox proportional hazards regression modelHigh-risk clinicopathologic featuresProportional hazards regression modelsNational Cancer DatabaseRetrospective cohort studyTreatment-naive patientsAdjuvant chemotherapy useHigh-risk featuresAssociation of survivalHazards regression modelsImmortal time biasChemotherapy useEligible patientsPhysician trajectories of abandoning long‐course breast radiotherapy and their cost impact
Xu X, Soulos PR, Herrin J, Wang S, Pollack CE, Evans SB, Yu JB, Gross CP. Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact. Health Services Research 2020, 56: 497-506. PMID: 33070305, PMCID: PMC8143683, DOI: 10.1111/1475-6773.13572.Peer-Reviewed Original ResearchConceptsPhysician peer groupsWhole breast irradiationCF-WBIRisk-adjusted ratesBreast radiotherapyPractice patternsLow useChronic Conditions Data WarehouseDistinct practice patternsPatients' clinical characteristicsSetting of radiotherapyAdjuvant breast radiotherapyYears of ageDistinct trajectoriesImportant cost implicationsHigher useAdjuvant radiotherapyClinical characteristicsEligible womenBreast cancerCost implicationsLatent class growth analysisService beneficiariesMedicare programRadiotherapyEvaluation of Cancer Care After Medicaid Expansion Under the Affordable Care Act
Salazar MC, Canavan ME, Walters SL, Herrin J, Schwartz JL, Leapman M, Boffa DJ. Evaluation of Cancer Care After Medicaid Expansion Under the Affordable Care Act. JAMA Network Open 2020, 3: e2017544. PMID: 32990734, PMCID: PMC7525361, DOI: 10.1001/jamanetworkopen.2020.17544.Peer-Reviewed Original ResearchRisk of Systemic Adverse Events after Intravitreal Bevacizumab, Ranibizumab, and Aflibercept in Routine Clinical Practice
Maloney MH, Payne SR, Herrin J, Sangaralingham LR, Shah ND, Barkmeier AJ. Risk of Systemic Adverse Events after Intravitreal Bevacizumab, Ranibizumab, and Aflibercept in Routine Clinical Practice. Ophthalmology 2020, 128: 417-424. PMID: 32781110, DOI: 10.1016/j.ophtha.2020.07.062.Peer-Reviewed Original ResearchMeSH KeywordsAngiogenesis InhibitorsBevacizumabCerebrovascular DisordersDrug-Related Side Effects and Adverse ReactionsFemaleHemorrhageHospitalizationHumansIntravitreal InjectionsMaleMyocardial InfarctionRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsRetinal DiseasesRetrospective StudiesRisk AssessmentVascular Endothelial Growth Factor AConceptsNeovascular age-related macular degenerationRetinal venous occlusive diseaseDiabetic retinal diseaseSystemic serious adverse eventsAnti-VEGF injectionsAnti-VEGF agentsMajor bleedingAcute myocardial infarctionCause hospitalizationCerebrovascular diseaseRoutine clinical practiceMyocardial infarctionIntravitreal bevacizumabTreatment initiationAdverse eventsPropensity score-weighted Cox proportional hazards modelClinical practiceLarge U.S. administrative claims databaseRisk of MICox proportional hazards modelU.S. administrative claims databaseAge-related macular degenerationRisk-adjusted effectSystemic safety profileRetrospective cohort studyFewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention
Abraham NS, Yang EH, Noseworthy PA, Inselman J, Yao X, Herrin J, Sangaralingham LR, Ngufor C, Shah ND. Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention. Alimentary Pharmacology & Therapeutics 2020, 52: 646-654. PMID: 32657466, PMCID: PMC8183594, DOI: 10.1111/apt.15790.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedClopidogrelCohort StudiesFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPostoperative ComplicationsPrasugrel HydrochlorideRetrospective StudiesThromboembolismTicagrelorTreatment OutcomeUnited StatesConceptsPercutaneous coronary interventionAcute coronary syndromeGIB ratesGIB riskCoronary syndromeGastrointestinal bleedingSTEMI patientsCoronary interventionHazard ratioMajor adverse cardiac eventsRisk reductionCox proportional hazards modelNSTE-ACS patientsAdverse cardiac eventsMajor bleeding eventsConfidence intervalsInverse probability treatmentProportional hazards modelMedicare Advantage enrolleesBleeding eventsClopidogrel prescriptionGIB eventsNSTE-ACSGastrointestinal bleedBaseline characteristicsAssociation of Do-Not-Resuscitate Patient Case Mix With Publicly Reported Risk-Standardized Hospital Mortality and Readmission Rates
Pollock BD, Herrin J, Neville MR, Dowdy SC, Franco P, Shah ND, Ting HH. Association of Do-Not-Resuscitate Patient Case Mix With Publicly Reported Risk-Standardized Hospital Mortality and Readmission Rates. JAMA Network Open 2020, 3: e2010383. PMID: 32662845, PMCID: PMC7361656, DOI: 10.1001/jamanetworkopen.2020.10383.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesChronic obstructive pulmonary diseaseAcute myocardial infarctionRevision diagnosis codesHeart failureCross-sectional studyDNR statusReadmission cohortInpatient encountersMortality cohortHighest quintileDiagnosis codesTenth Revision diagnosis codesNinth Revision diagnosis codesAcute care transfersStandard Analytical FilesObstructive pulmonary diseaseCMS Hospital Compare websitePatient-level dataHospital-level performanceHospital-level dataInternational Statistical ClassificationRelated Health ProblemsHospital Compare websiteHospital mortalityA Comparison of Depression and Anxiety Symptoms Between Sexual Minority and Heterosexual Medical Residents: A Report from the Medical Trainee CHANGE Study
Wang K, Burke SE, Przedworski JM, Wittlin NM, Onyeador IN, Dovidio JF, Dyrbye LN, Herrin J, van Ryn M. A Comparison of Depression and Anxiety Symptoms Between Sexual Minority and Heterosexual Medical Residents: A Report from the Medical Trainee CHANGE Study. LGBT Health 2020, 7: 332-339. PMID: 32598215, PMCID: PMC7475081, DOI: 10.1089/lgbt.2020.0027.Peer-Reviewed Original ResearchConceptsAnxiety symptomsSexual minority mental healthSexual minority stressorsMinority mental healthSexual minoritiesSexual minority individualsSexual identityGrowth Evaluation StudyIdentity-based differencesMental health disparitiesCognitive habitsMental health impactMinority stressorsLow senseMedical residentsAnxietySuch stressorsMental healthTraining environmentMinority individualsHigh levelsHeterosexual residentsHeterosexual peersDepressionStressorsSurvival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals
Boffa DJ, Mallin K, Herrin J, Resio B, Salazar MC, Palis B, Facktor M, McCabe R, Nelson H, Shulman LN. Survival After Cancer Treatment at Top-Ranked US Cancer Hospitals vs Affiliates of Top-Ranked Cancer Hospitals. JAMA Network Open 2020, 3: e203942. PMID: 32453382, PMCID: PMC7251445, DOI: 10.1001/jamanetworkopen.2020.3942.Peer-Reviewed Original ResearchConceptsLong-term survivalCancer HospitalSurgical treatmentShort-term survivalComplex cancer treatmentAffiliate hospitalsCancer treatmentCancer careAdjusted long-term survivalNational Cancer DatabaseAnnual surgical volumeComplex cancer careIndividuals 18 yearsComplex surgical proceduresPerioperative mortalityCohort studyAffiliated HospitalPooled analysisBladder cancerCancer DatabasePatient outcomesSurgical volumeSurgical proceduresMAIN OUTCOMESurvival advantagePatient 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 providersPatientsMedications
2019
Income disparities in needle biopsy patients prior to breast cancer surgery across physician peer groups
Killelea BK, Herrin J, Soulos PR, Pollack CE, Forman HP, Yu J, Xu X, Tannenbaum S, Wang SY, Gross CP. Income disparities in needle biopsy patients prior to breast cancer surgery across physician peer groups. Breast Cancer 2019, 27: 381-388. PMID: 31792804, PMCID: PMC7512133, DOI: 10.1007/s12282-019-01028-4.Peer-Reviewed Original ResearchConceptsPhysician peer groupsLow-income patientsNeedle biopsyOdds ratioHigh-income patientsBreast cancer surgeryMethodsThe SurveillanceCancer surgeryIncome patientsMedicare databaseBiopsy patientsMedicare beneficiariesPatientsBiopsyLow incomeGroupDisparitiesReceiptEnd resultHigher incomeSurgeryPeer groupEpidemiologyFurther workGroup-level effects