2024
Pragmatic Trial of Messaging to Providers About Treatment of Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial
Shah N, Ghazi L, Yamamoto Y, Kumar S, Martin M, Simonov M, Riello Iii R, Faridi K, Ahmad T, Wilson F, Desai N. Pragmatic Trial of Messaging to Providers About Treatment of Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial. Circulation Cardiovascular Quality And Outcomes 2024, 17: e010335. PMID: 38634282, DOI: 10.1161/circoutcomes.123.010335.Peer-Reviewed Original ResearchElectronic health recordsElectronic health record alertsHigh-risk atherosclerotic cardiovascular diseaseLipid lowering therapyAtherosclerotic cardiovascular diseasePragmatic trialCardiovascular diseaseProportion of patientsYale New Haven HealthLDL-CSecondary outcomesPrimary outcomeInternal medicine cliniciansEHR alertUsual careHealth recordsProvider levelCluster-randomizedLDL-C managementLDL-C levelsAdverse cardiovascular eventsRandomized clinical trialsTreatment of hyperlipidemiaCliniciansCardiovascular events
2023
Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageElectronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure
Fuery M, Kadhim B, Samsky M, Freeman J, Clark K, Desai N, Wilson F, Ahmed T, Ahmad T. Electronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure. Current Heart Failure Reports 2023, 20: 280-286. PMID: 37552356, DOI: 10.1007/s11897-023-00614-0.Peer-Reviewed Original ResearchConceptsHeart failure patientsFailure patientsElectronic health recordsEHR alertClinical trialsRandomized clinical trialsCare of patientsQuality of careHeart failureClinician satisfactionRandomized fashionRecent FindingsTherePatientsUnmet needPatient careClinical decisionEvidence-based decisionsFuture interventionsCareHealth recordsTrialsCliniciansInterventionFindingsThere
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalRationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID)
Shah NN, Ghazi L, Yamamoto Y, Martin M, Simonov M, Riello RJ, Faridi KF, Ahmad T, Wilson FP, Desai NR. Rationale and design of a pragmatic trial aimed at improving treatment of hyperlipidemia in outpatients with very high risk atherosclerotic cardiovascular disease: A pragmatic trial of messaging to providers about treatment of hyperlipidemia (PROMPT-LIPID). American Heart Journal 2022, 253: 76-85. PMID: 35841944, PMCID: PMC9936562, DOI: 10.1016/j.ahj.2022.07.002.Peer-Reviewed Original ResearchConceptsLipid-lowering therapyAtherosclerotic cardiovascular diseaseTreatment of hyperlipidemiaProportion of patientsElectronic health recordsPragmatic trialHigh riskCardiovascular diseaseProprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitorsHigh-risk atherosclerotic cardiovascular diseaseSubtilisin/kexin type 9 inhibitorsLow-density lipoprotein cholesterol reductionImportant public health implicationsEnrollment of patientsPublic health implicationsUsual careSecondary outcomesPrimary outcomeGuideline recommendationsCholesterol reductionPatientsLDLHyperlipidemiaScalable interventionsOutpatientsNudging within learning health systems: next generation decision support to improve cardiovascular care
Chen Y, Harris S, Rogers Y, Ahmad T, Asselbergs FW. Nudging within learning health systems: next generation decision support to improve cardiovascular care. European Heart Journal 2022, 43: 1296-1306. PMID: 35139182, PMCID: PMC8971005, DOI: 10.1093/eurheartj/ehac030.Peer-Reviewed Original ResearchConceptsClinical decision support systemElectronic health recordsEvidence-practice gapArtificial intelligence algorithmsDecision support systemPatient outcomesClinical practiceIntelligence algorithmsHealthcare dataHealth systemGuideline-directed therapyActionable insightsDecision supportRoutine clinical practiceSupport systemHealth recordsRobust evidence baseClinical equipoiseCardiovascular careCDSS alertsClinician behaviorEvidence baseAlertsFace of uncertaintyOutcomes
2021
Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)
Ghazi L, Desai NR, Simonov M, Yamamoto Y, O'Connor KD, Riello RJ, Huang J, Olufade T, McDermott J, Inzucchi SE, Velazquez EJ, Wilson FP, Ahmad T. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF). American Heart Journal 2021, 244: 107-115. PMID: 34808104, DOI: 10.1016/j.ahj.2021.11.010.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyBest practice alertLeft ventricular ejection fractionHeart failureUsual careMedical therapyPragmatic trialElectronic health recordsEjection fractionCluster-randomized pragmatic trialLarge integrated healthcare systemDays post randomizationAppropriate medical therapyHeart Failure TrialReduced ejection fractionUsual care groupCommon chronic illnessGlomerular filtration rateVentricular ejection fractionRecent blood pressureIntegrated healthcare systemUse of guidelinesLow-cost interventionCreatinine levelsReal-world practiceREVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice
Ahmad T, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Hsiao A, Kashyap N, Velazquez EJ, Desai NR, Wilson FP. REVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice. JACC Heart Failure 2021, 9: 409-419. PMID: 33992566, DOI: 10.1016/j.jchf.2021.03.006.Peer-Reviewed Original ResearchConceptsHeart failurePatient outcomesClinical decision makingN-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsPragmatic Randomized Controlled TrialIntravenous diuretic agentsNatriuretic peptide levelsRandomized Controlled TrialsRoutine clinical practiceEvidence-based interventionsElectronic health recordsControlled TrialsPatient populationAccurate prognosticationCommon causeDiuretic agentsPeptide levelsClinical practicePg/TrialsHealth recordsSignificant riskMortalityOutcomesElectronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit
Kunitomo Y, Thomas A, Chouairi F, Canavan ME, Kochar A, Khera R, Katz JN, Murphy C, Jentzer J, Ahmad T, Desai NR, Brennan J, Miller PE. Electronic health record risk score provides earlier prognostication of clinical outcomes in patients admitted to the cardiac intensive care unit. American Heart Journal 2021, 238: 85-88. PMID: 33891906, DOI: 10.1016/j.ahj.2021.04.004.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitRothman IndexCare unitRisk scoreModern cardiac intensive care unitSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreElectronic health recordsCICU mortalityCICU patientsSOFA scoreCICU admissionClinical outcomesEarly prognosticationObservational studyPrognostic abilityAssessment scoresOutcome predictionHealth recordsGood calibrationSuperior discriminationPatientsAdmissionScores