2024
Validation of an Electronic Health Record–Based Machine Learning Model Compared With Clinical Risk Scores for Gastrointestinal Bleeding
Shung D, Chan C, You K, Nakamura S, Saarinen T, Zheng N, Simonov M, Li D, Tsay C, Kawamura Y, Shen M, Hsiao A, Sekhon J, Laine L. Validation of an Electronic Health Record–Based Machine Learning Model Compared With Clinical Risk Scores for Gastrointestinal Bleeding. Gastroenterology 2024, 167: 1198-1212. PMID: 38971198, PMCID: PMC11493512, DOI: 10.1053/j.gastro.2024.06.030.Peer-Reviewed Original ResearchElectronic health recordsGlasgow-Blatchford scoreEmergency departmentVery-low-risk patientsRisk scoreOakland scoreMachine learning modelsStructured data fieldsClinical risk scoreGastrointestinal bleedingAll-cause mortalityHealth recordsLearning modelsManual data entrySecondary analysisRisk stratification scoresAssess proportionRed blood-cell transfusionPrimary outcomeProportion of patientsData entryOvert gastrointestinal bleedingPrimary analysisReceiver-operating-characteristic curveVery-low-risk
2022
Vonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the United States and Europe: Randomized Clinical Trial
Chey WD, Mégraud F, Laine L, López LJ, Hunt BJ, Howden CW. Vonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the United States and Europe: Randomized Clinical Trial. Gastroenterology 2022, 163: 608-619. PMID: 35679950, DOI: 10.1053/j.gastro.2022.05.055.Peer-Reviewed Original ResearchConceptsEradication rateHelicobacter pylori infectionTriple therapyDual therapyPylori infectionProton pump inhibitor-based triple therapyTreatment-emergent adverse eventsInhibitor-based triple therapyPotassium-competitive acid blockerEfficacy of vonoprazanH pylori eradicationPhase 3 trialOverall study populationAmoxicillin-resistant strainsClarithromycin-resistant strainsH pylori infectionTreatment-naïve adultsPylori eradicationAdverse eventsSecondary outcomesPrimary outcomeStandard treatmentClinical trialsStudy populationAcid blocker
2021
Antiplatelet Monotherapy Is Associated with an Increased Risk of Bleeding After Endoscopic Sphincterotomy
Zakko A, Zakko L, Grimshaw AA, Laine L. Antiplatelet Monotherapy Is Associated with an Increased Risk of Bleeding After Endoscopic Sphincterotomy. Digestive Diseases And Sciences 2021, 67: 4161-4169. PMID: 34796411, DOI: 10.1007/s10620-021-07302-w.Peer-Reviewed Original ResearchConceptsEndoscopic retrograde cholangiopancreatographyPost-sphincterotomy bleedingAntiplatelet monotherapyInclusion criteriaRisk of bleedingROBINS-I toolNewcastle-Ottawa ScaleHigh-quality studiesRandom-effects modelBackgroundClinical guidelinesAntithrombotic therapyAdult patientsCohort studyEndoscopic sphincterotomyPrimary outcomeAntiplatelet agentsOvid EmbaseRetrograde cholangiopancreatographyCochrane LibraryOvid MEDLINEMonotherapyMethodological qualityBleedingUnique citationsPatientsImmune Checkpoint Inhibitor–associated Diarrhea and Colitis: A Systematic Review and Meta-analysis of Observational Studies
Tran AN, Wang M, Hundt M, Chugh R, Ohm J, Grimshaw A, Ciarleglio M, Hung KW, Proctor DD, Price CC, Laine L, Al-Bawardy B. Immune Checkpoint Inhibitor–associated Diarrhea and Colitis: A Systematic Review and Meta-analysis of Observational Studies. Journal Of Immunotherapy 2021, 44: 325-334. PMID: 34380976, DOI: 10.1097/cji.0000000000000383.Peer-Reviewed Original ResearchConceptsImmune checkpoint inhibitorsDiarrhea/colitisICI therapyCheckpoint inhibitorsObservational studyAnti-programmed cell death-1/Outcomes of ICISystematic reviewCell death-1/Permanent ICI discontinuationReal-world incidenceRemission of diarrheaRecurrence of symptomsDeath-1/Treatment of diarrheaRandom-effects modelICI discontinuationAdvanced malignanciesAppropriate patientsPrimary outcomeOverall incidenceAntigen-4Early treatmentColitisHigh riskAcute gastrointestinal bleeding: proposed study outcomes for new randomised controlled trials
Jensen DM, Barkun A, Cave D, Gralnek IM, Jutabha R, Laine L, Lau JYW, Saltzman JR, Soetikno R, Sung JJY. Acute gastrointestinal bleeding: proposed study outcomes for new randomised controlled trials. Alimentary Pharmacology & Therapeutics 2021, 54: 616-626. PMID: 34288017, PMCID: PMC9385213, DOI: 10.1111/apt.16483.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAcute gastrointestinal bleedingGastrointestinal bleedingPrimary endpointRed blood cell transfusionRelevant outcomesHealth care resource utilisationLength of hospitalisationSerious adverse eventsTrial of patientsBlood cell transfusionPeer-reviewed fundingMeaningful primary endpointCell transfusionAcute bleedingAdverse eventsComposite outcomeSecondary outcomesFuture RCTsNew RCTsPrimary outcomeHemostatic outcomesClinical trialsCommon causeOutcome measuresGI sourceResection of pancreatic cystic neoplasms in recurrent acute pancreatitis prevents recurrent pancreatitis but does not identify more malignancies
Muniraj T, Aslanian HR, Laine L, Jamidar PA, Farrell JF, Mitchell KA, Salem RR. Resection of pancreatic cystic neoplasms in recurrent acute pancreatitis prevents recurrent pancreatitis but does not identify more malignancies. World Journal Of Gastroenterology 2021, 27: 1630-1642. PMID: 33958848, PMCID: PMC8058652, DOI: 10.3748/wjg.v27.i15.1630.Peer-Reviewed Original ResearchConceptsIntra-ductal papillary mucinous neoplasmRecurrent acute pancreatitisPancreatic cystic neoplasmsCystic neoplasmsBD-IPMNAcute pancreatitisCause of pancreatitisRole of resectionMucinous cystic neoplasmPrevalence of malignancyPapillary mucinous neoplasmSerous cystic neoplasmsCross-sectional imagingMean episodesRAP patientsSurgical resectionCyst resectionMD-IPMNPrimary outcomeIPMN patientsRecurrent pancreatitisRetrospective studyCyst featuresGallstone aetiologyMucinous neoplasms
2019
Early Colonoscopy Does Not Improve Outcomes of Patients With Lower Gastrointestinal Bleeding: Systematic Review of Randomized Trials
Tsay C, Shung D, Stemmer Frumento K, Laine L. Early Colonoscopy Does Not Improve Outcomes of Patients With Lower Gastrointestinal Bleeding: Systematic Review of Randomized Trials. Clinical Gastroenterology And Hepatology 2019, 18: 1696-1703.e2. PMID: 31843595, PMCID: PMC7292779, DOI: 10.1016/j.cgh.2019.11.061.Peer-Reviewed Original ResearchConceptsAcute lower gastrointestinal bleedingLower gastrointestinal bleedingRandomized trialsEarly colonoscopyElective colonoscopyGastrointestinal bleedingSecondary outcomesHemostatic interventionEndoscopic interventionDiagnostic yieldSevere acute lower gastrointestinal bleedingSystematic reviewDual independent reviewTiming of colonoscopyOutcomes of patientsHours of presentationRandom-effects modelRecurrent bleedingPrimary outcomeIndex examinationColonoscopy evaluationBias assessmentObservational studyBleedingColonoscopyRandomized Trial of Medical versus Surgical Treatment for Refractory Heartburn
Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, Sanchez VM, Dunbar KB, Pham TH, Murthy UK, Kim T, Jackson CS, Wallen JM, von Rosenvinge EC, Pearl JP, Laine L, Kim AW, Kaz AM, Tatum RP, Gellad ZF, Lagoo-Deenadayalan S, Rubenstein JH, Ghaferi AA, Lo WK, Fernando RS, Chan BS, Paski SC, Provenzale D, Castell DO, Lieberman D, Souza RF, Chey WD, Warren SR, Davis-Karim A, Melton SD, Genta RM, Serpi T, Biswas K, Huang GD. Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn. New England Journal Of Medicine 2019, 381: 1513-1523. PMID: 31618539, DOI: 10.1056/nejmoa1811424.Peer-Reviewed Original ResearchConceptsPPI-refractory heartburnActive medical treatmentMedical treatmentTreatment successGastroenterology clinicSurgical treatmentProton pump inhibitor treatmentMultichannel intraluminal impedance-pH monitoringMedical groupGastroesophageal reflux diseaseFrequent clinical problemMinority of patientsHealth Related QualityImpedance-pH monitoringMultiple potential causesFunctional heartburnRefractory heartburnVisceral hypersensitivityAntireflux surgeryGastroesophageal refluxReflux diseaseUnderwent endoscopyEsophageal manometryPrimary outcomeEsophageal biopsies
2018
Severity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis
Laine L, Laursen SB, Zakko L, Dalton HR, Ngu JH, Schultz M, Stanley AJ. Severity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis. The American Journal Of Gastroenterology 2018, 113: 358. PMID: 29380820, DOI: 10.1038/ajg.2018.5.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood PreservationBlood TransfusionEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHeart RateHematemesisHemoglobinsHemostasis, EndoscopicHumansMaleMelenaMiddle AgedMortalityProspective StudiesRecurrenceRisk AssessmentSeverity of Illness IndexUpper Gastrointestinal TractConceptsCoffee ground emesisBloody emesisHemostatic interventionUpper gastrointestinal bleedingComposite end pointRisk stratification scoresSystolic blood pressureTiming of endoscopyPredictors of outcomeBeats/minGastrointestinal bleedingConsecutive patientsPrimary outcomeSevere bleedingStratification scoresBlood pressureProspective studyHematemesisMelenaEmesisHigh mortalityEnd pointMortalityOutcomesSeverity
2017
Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis
Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J. Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis. Journal Of Clinical Gastroenterology 2017, 51: 534-538. PMID: 27875357, DOI: 10.1097/mcg.0000000000000763.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdolescentAdultAgedAged, 80 and overCholangiopancreatography, Endoscopic RetrogradeCholangitisFemaleHospitalizationHumansIntensive Care UnitsIntubation, IntratrachealLength of StayMaleMiddle AgedMultivariate AnalysisProspective StudiesTime FactorsTreatment OutcomeYoung AdultConceptsEndoscopic retrograde cholangiopancreatographyIntensive care unit admissionCare unit admissionLength of hospitalizationAcute cholangitisUnit admissionRetrograde cholangiopancreatographyFrequent intensive care unit admissionOptimal timingAdditional adverse outcomesCases of cholangitisProcedural adverse eventsDays of presentationVasopressor requirementVasopressor supportBiliary decompressionHospital stayVasopressor useSecondary outcomesAdverse eventsAntibiotic therapyPrimary outcomeEndotracheal intubationAdverse outcomesEmergency departmentNarrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial
Buxbaum JL, Hormozdi D, Dinis-Ribeiro M, Lane C, Dias-Silva D, Sahakian A, Jayaram P, Pimentel-Nunes P, Shue D, Pepper M, Cho D, Laine L. Narrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial. Gastrointestinal Endoscopy 2017, 86: 857-865. PMID: 28366441, DOI: 10.1016/j.gie.2017.03.1528.Peer-Reviewed Original ResearchConceptsGastric intestinal metaplasiaDetection of GIMNarrow-band imagingHD-WLMapping biopsyIntestinal metaplasiaHigh-definition white light endoscopyProportion of patientsProspective blinded trialGastric cancer precursorsGastric cancer riskWhite light endoscopyNBI examinationPrimary outcomeUpper endoscopyHigher proportionBlinded trialCancer precursorsBiopsy specimensMedian numberSecond endoscopistGastric cancerCancer riskBiopsyPatients
2016
No Benefit From Platelet Transfusion for Gastrointestinal Bleeding in Patients Taking Antiplatelet Agents
Zakko L, Rustagi T, Douglas M, Laine L. No Benefit From Platelet Transfusion for Gastrointestinal Bleeding in Patients Taking Antiplatelet Agents. Clinical Gastroenterology And Hepatology 2016, 15: 46-52. PMID: 27464591, DOI: 10.1016/j.cgh.2016.07.017.Peer-Reviewed Original ResearchConceptsGastrointestinal bleedingAntiplatelet agentsPlatelet transfusionsCardiovascular eventsNon-variceal upper gastrointestinal bleedingYale-New Haven HospitalRecurrent gastrointestinal bleedingSerious gastrointestinal bleedingMajor cardiovascular eventsRetrospective cohort studySevere gastrointestinal bleedingUpper gastrointestinal bleedingLower blood pressureMultivariable regression analysisHigher heart rateLack of benefitRecurrent bleedingBaseline characteristicsCohort studyBlood pressurePrimary outcomeSuch patientsHemoglobin levelsMultivariable analysisIntensive careDiagnosis of sessile serrated adenomas/polyps with image-enhanced endoscopy: a systematic review and meta-analysis
Parikh ND, Chaptini L, Njei B, Laine L. Diagnosis of sessile serrated adenomas/polyps with image-enhanced endoscopy: a systematic review and meta-analysis. Endoscopy 2016, 48: 731-739. PMID: 27223636, DOI: 10.1055/s-0042-107592.Peer-Reviewed Original ResearchConceptsImage-enhanced endoscopyWhite light endoscopyNarrow-band imagingNon-neoplastic lesionsSSA/PsAdenomas/polypsFlexible spectral imaging color enhancementSystematic reviewCorresponding histologic diagnosesSSA/P detection rateSessile serrated adenomas/polypsSerrated adenomas/polypsNon-neoplastic tissuesAppearance of polypsSSA/PNBI studiesPrimary outcomeHistologic diagnosisInclusion criteriaEndoscopic diagnosisHyperplastic polypsSSA/P.Autofluorescence imagingHead comparisonBand imagingYield of repeat forward-view examination of the right side of the colon in screening and surveillance colonoscopy
Clark BT, Parikh ND, Laine L. Yield of repeat forward-view examination of the right side of the colon in screening and surveillance colonoscopy. Gastrointestinal Endoscopy 2016, 84: 126-132. PMID: 26769408, PMCID: PMC4912931, DOI: 10.1016/j.gie.2015.12.030.Peer-Reviewed Original ResearchConceptsAdenoma detection rateForward-view examinationOverall adenoma detection rateSecond examinationRight sideSurveillance colonoscopyAdditional adenomasWest Haven Veterans Affairs Medical CenterVeterans Affairs Medical CenterBoston Bowel Preparation Scale scoreDistal colon cancerNumber of patientsYears of ageDevelopment of cancerSecondary outcomesPrimary outcomeMen 50Prospective studySurveillance intervalsAdenoma detectionDetection rateMedical CenterInitial examinationPatientsColon cancer
2015
Can a Computerized Simulator Assess Skill Level and Improvement in Performance of ERCP?
Sahakian AB, Laine L, Jamidar PA, Siddiqui UD, Duffy A, Ciarleglio MM, Deng Y, Nagar A, Aslanian HR. Can a Computerized Simulator Assess Skill Level and Improvement in Performance of ERCP? Digestive Diseases And Sciences 2015, 61: 722-730. PMID: 26572779, DOI: 10.1007/s10620-015-3939-7.Peer-Reviewed Original ResearchConceptsTotal procedure timeProcedure timePrimary outcomeAcademic tertiary referral centerShorter total procedure timeTertiary referral centerPerformance of ERCPReferral centerCohort studyRetrograde cholangiographyERCP proceduresTrainee experienceGastroenterology fellowsSurgical skills centerFlexible endoscopyERCP trainingLittle dataGastroenterology facultyERCPSignificant differencesConsiderable riskSession 2Session 1Baseline sessionsOutcomesQuantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men
Clark BT, Protiva P, Nagar A, Imaeda A, Ciarleglio MM, Deng Y, Laine L. Quantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men. Gastroenterology 2015, 150: 396-405. PMID: 26439436, PMCID: PMC4728019, DOI: 10.1053/j.gastro.2015.09.041.Peer-Reviewed Original ResearchConceptsAdequate bowel preparationBBPS scoreSurveillance colonoscopyBowel preparationColon segmentsBBPS scoresSecond examinationWest Haven Veterans Affairs Medical CenterVeterans Affairs Medical CenterFirst examinationGuideline-recommended intervalsProspective observational studyDetection of adenomasIdentification of polypsColonoscopic evaluationPrimary outcomeSurveillance intervalsBlinded endoscopistsColonoscopy examinationObservational studyPrEP scaleMedical CenterInitial examinationStudy subjectsAdequate preparationDelayed endoscopic retrograde cholangiopancreatography is associated with persistent organ failure in hospitalised patients with acute cholangitis
Lee F, Ohanian E, Rheem J, Laine L, Che K, Kim JJ. Delayed endoscopic retrograde cholangiopancreatography is associated with persistent organ failure in hospitalised patients with acute cholangitis. Alimentary Pharmacology & Therapeutics 2015, 42: 212-220. PMID: 25997554, DOI: 10.1111/apt.13253.Peer-Reviewed Original ResearchConceptsEarly endoscopic retrograde cholangiopancreatographyPersistent organ failureEarly ERCPOrgan failureEndoscopic retrograde cholangiopancreatographyAcute cholangitisRetrograde cholangiopancreatographySystemic inflammatory response syndromeConsecutive hospitalised patientsCharlson Comorbidity IndexInflammatory response syndromeRelative risk increaseComorbidity indexHospitalised patientsPrimary outcomeResponse syndromeBenign obstructionMalignant stricturesCholangitisPatientsMultivariate analysisRisk increaseHospitalisationHypoalbuminemiaBacteremia
2013
The Utility of Esophagogastroduodenoscopy Before Endoscopic Ultrasonography in Patients Undergoing Endoscopic Ultrasonography for Pancreatico-biliary and Mediastinal Indications
Sahakian AB, Aslanian HR, Mehra M, Rossi F, Laine L, Sanchez M, Ciarleglio MM, Adimoolam V, Siddiqui UD. The Utility of Esophagogastroduodenoscopy Before Endoscopic Ultrasonography in Patients Undergoing Endoscopic Ultrasonography for Pancreatico-biliary and Mediastinal Indications. Journal Of Clinical Gastroenterology 2013, 47: 857-860. PMID: 23632349, DOI: 10.1097/mcg.0b013e31828ba28c.Peer-Reviewed Original ResearchConceptsEndoscopic ultrasonographyMeaningful lesionsMedical managementEUS examinationMulticenter prospective cohort studyLarge community practiceUtility of esophagogastroduodenoscopyProportion of patientsProspective cohort studyTertiary referral centerLarge hiatal herniaCohort studyReferral centerHiatal herniaPrimary outcomeBarrett's esophagusProspective dataLuminal lesionsPractice patternsEsophagogastroduodenoscopyNeoplastic lesionsOblique-viewing echoendoscopesHyperplastic gastricPatientsCombined outcome
2008
Systematic Review of the Predictors of Recurrent Hemorrhage After Endoscopic Hemostatic Therapy for Bleeding Peptic Ulcers
Elmunzer BJ, Young SD, Inadomi JM, Schoenfeld P, Laine L. Systematic Review of the Predictors of Recurrent Hemorrhage After Endoscopic Hemostatic Therapy for Bleeding Peptic Ulcers. The American Journal Of Gastroenterology 2008, 103: ajg2008521. PMID: 18684171, DOI: 10.1111/j.1572-0241.2008.02070.x.Peer-Reviewed Original ResearchConceptsEndoscopic therapyIndependent predictorsRecurrent hemorrhageProspective studySystematic reviewIntensive care unit observationLarge ulcer sizePosterior duodenal ulcerSecond-look endoscopyEndoscopic hemostatic therapySignificant independent predictorsPrespecified inclusion criteriaComorbid illnessesHemodynamic instabilityHemostatic therapyDuodenal ulcerEndoscopic predictorsPrimary outcomeUlcer sizeMultivariable analysisPooled ratePeptic ulcerClinical managementBibliographic database searchInclusion criteria