Robert Lawrence McNamara, MD, MHS
Associate Professor of Medicine (Cardiology)
Research Interests
Atrial Fibrillation; Cardiology; Cardiovascular Diseases; Echocardiography; International Cooperation; Myocardial Infarction; Global Health; Electronic Health Records
Research Organizations
Research Summary
My research has centered on evaluating the use of evidence-based medicine on the diagnosis and management of patients with cardiovascular disease. I have sought to identify areas in clinical medicine with significant variation in care, use various methodologies to obtain and analyze the different strategies and outcomes, and provide a sound base of evidence on which to recommend clinical decisions. The methodologies include primary data collection, secondary data analysis, synthesis of results of various studies into clinically useful forms such as meta-analyses and cost-effectiveness analysis, qualitative studies, establishing clinical practice guidelines and data standards, and promoting quality assurance and improvement.
Specialized Terms: Cardiovascular outcomes; International comparisons; Large registries; Global health;
Extensive Research Description
Current projects include evaluating differences in the treatment and outcome of patients with myocardial infarction among different countries, designing ways to evaluate hospital performance in treating patients with acute myocardial infarction through use of the electronic health record, and establishing quality performance standards for noninvasive cardiac imaging.
Selected Publications
- Contemporary Risk Model for In-hospital Mortality for Patients with Acute Myocardial Infarction: The Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry® -Get With the Guidelines (GWTG)™ McNamara RL, Kennedy K, Cohen DJ, Diercks D, Moscucci M, Ramee S, Wang TY, Connolly T, Spertus J. J Am Coll Cardiol. 2016:68(6):626-635.
- ACC/AHA Clinical Performance and Quality Measures for Adults with Atrial Fibrillation or Atrial Flutter: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Heidenreich PA, Solis P, Estes M, Fonorow G, Jurgens CY, Marine JE, McManus DD, McNamara RL. 2016:68(5):525-568.
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Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records: 30-Day Risk-standardized Mortality After Acute Myocardial Infarction.
McNamara RL, Wang Y, Partovian C, Montague J, Mody P, Eddy E, Krumholz HK, Bernheim SM. Medical Care 2015; 53(9):818-826
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Standardized Outcome Measurement for Patients with Coronary Artery Disease: Consensus from the International Consortium for Health Outcomes Measurement (ICHOM).
McNamara RL, Spatz ES , Kelley TA, Stowell C, Beltrame J, Heidenreich P, Gaju RT, Jernberg T, Jin TCS, Morgan L, Panigrahi B, Ruiz AR, Rumsfeld J, Sadwin L, Schoeberl M, Shahian D, Weston C, Yeh R, Lewin J. J Am Heart Assoc. 2015 May 19;4(5) DOI 10.1161/JAHA.115.001767
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International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries.
McNamara RL, Chung S, Jernberg T, Holmes D, Roe M, Timmis A, James S, Deanfield J, Fonorow G, Peterson E, Jeppsson A, Hemmingway H. Int J Cardiology. 2014; 175 (2):240-247
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Cardiovascular registry research comes of age.
Heart 2010:96:908-910
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ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society.
Estes NA 3rd, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS, McNamara RL, Messer JV, Ritchie JL, Romeo SJ, Waldo AL, Wyse DG.Circulation 2008 117(8):1101-20. J Am Coll of Cardiol 2008 51(8):865-84.
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Impact of Delay in Door-to-Needle Time on Mortality in Patients with ST-Segment Myocardial Infarction.
McNamara RL, Herrin J, Wang Y, Curtis J, Bradley EH, Magid DJ, Rathore S, Nallamothu BK, Peterson E, Blaney M, Frederick P, Krumholz HM. Am J of Cardiol 2007 Oct 15100(8):1227-32.
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Hospital Improvement in Time to Reperfusion in Patients with Acute Myocardial Infarction, 1999-2002. J
McNamara RL, Herrin J, Bradley EH, Portnay EL, Curtis J, Wang Y, Magid D, Blaney M, Krumholz HM. Am Coll Cardiol. 2006;47:45-47.
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Achieving Quality in Cardiovascular Imaging: Proceedings From the American College of Cardiology–Duke University Medical Center Think Tank on Quality in Cardiovascular Imaging.
Douglas P, Iskandrian AE, Krumholz HM, Gillam L, Hendel R Jollis J, Peterson E, Chen J, Masoudi F, Mohler E, McNamara RL, Patel M, Spertus J. J Am Coll Cardiol 2006; 48 2141-2151
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Strategies for reducing the door-to-balloon time in acute myocardial infarction.
Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, Roumanis SA, Curtis JP, Nallamathou BK, Magid DJ, McNamara RL, Parkosewich J, Loeb JM, Krumholz HM. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med. 2006 Nov 30;355(22):2308-20.
Full List of PubMed Publications
- Castro-Dominguez Y, Dharmarajan K, McNamara RL: Predicting death after acute myocardial infarction. Trends Cardiovasc Med. 2018 Feb; 2017 Aug 2. PMID: 28826668
- Desai NR, Kennedy KF, Cohen DJ, Connolly T, Diercks DB, Moscucci M, Ramee S, Spertus J, Wang TY, McNamara RL: Contemporary risk model for inhospital major bleeding for patients with acute myocardial infarction: The acute coronary treatment and intervention outcomes network (ACTION) registry®-Get With The Guidelines (GWTG)®. Am Heart J. 2017 Dec; 2017 Aug 12. PMID: 29223432
- Liu RB, Donroe JH, McNamara RL, Forman HP, Moore CL: The Practice and Implications of Finding Fluid During Point-of-Care Ultrasonography: A Review. JAMA Intern Med. 2017 Dec 1. PMID: 29059269
- Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM: Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke. 2017 Nov; 2017 Sep 27. PMID: 28954922
- Dharmarajan K, McNamara RL, Wang Y, Masoudi FA, Ross JS, Spatz EE, Desai NR, de Lemos JA, Fonarow GC, Heidenreich PA, Bhatt DL, Bernheim SM, Slattery LE, Khan YM, Curtis JP: Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling. Ann Intern Med. 2017 Oct 17; 2017 Sep 26. PMID: 28973634
- Chokshi M, McNamara RL, Rajeswaran Y, Lampert R: Effect of a Reminder Statement on Echocardiography Reports on Referrals for Implantable Cardioverter-Defibrillators for Primary Prevention. Am J Cardiol. 2017 Feb 1; 2016 Nov 1. PMID: 27939224
- Robinson AA, Jain A, Gentry M, McNamara RL: Left ventricular thrombi after STEMI in the primary PCI era: A systematic review and meta-analysis. Int J Cardiol. 2016 Oct 15; 2016 Jul 6. PMID: 27424314
- McNamara RL, Kennedy KF, Cohen DJ, Diercks DB, Moscucci M, Ramee S, Wang TY, Connolly T, Spertus JA: Predicting In-Hospital Mortality in Patients With Acute Myocardial Infarction. J Am Coll Cardiol. 2016 Aug 9. PMID: 27491907
- McNamara RL, Wang Y, Partovian C, Montague J, Mody P, Eddy E, Krumholz HM, Bernheim SM: Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records: 30-Day Risk-standardized Mortality After Acute Myocardial Infarction. Med Care. 2015 Sep. PMID: 26225445
- McNamara RL, Spatz ES, Kelley TA, Stowell CJ, Beltrame J, Heidenreich P, Tresserras R, Jernberg T, Chua T, Morgan L, Panigrahi B, Rosas Ruiz A, Rumsfeld JS, Sadwin L, Schoeberl M, Shahian D, Weston C, Yeh R, Lewin J: Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM). J Am Heart Assoc. 2015 May 19; 2015 May 19. PMID: 25991011
- Bagai A, Wang Y, Wang TY, Curtis JP, Gurm HS, Shah B, Cheema AN, Peterson ED, Saucedo JF, Granger CB, Roe MT, Bhatt DL, McNamara RL, Alexander KP: In-hospital switching between clopidogrel and prasugrel among patients with acute myocardial infarction treated with percutaneous coronary intervention: insights into contemporary practice from the national cardiovascular data registry. Circ Cardiovasc Interv. 2014 Aug; 2014 Aug 5. PMID: 25097196
- Lombardi KC, Northrup V, McNamara RL, Sugeng L, Weismann CG: Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation. Am J Cardiol. 2013 Dec 1; 2013 Sep 13. PMID: 24035164
- Chen J, Fazel R, Ross JS, McNamara RL, Einstein AJ, Al-Mallah M, Krumholz HM, Nallamothu BK: Do imaging studies performed in physician offices increase downstream utilization?: an empiric analysis of cardiac stress testing with imaging. JACC Cardiovasc Imaging. 2011 Jun. PMID: 21679898
- Moore CL, Tham ET, Samuels KJ, McNamara RL, Galante NJ, Stachenfeld N, Shelley K, Dziura J, Silverman DG: Tissue Doppler of early mitral filling correlates with simulated volume loss in healthy subjects. Acad Emerg Med. 2010 Nov. PMID: 21175513
- Sosa JA, Mehta P, Thomas DC, Berland G, Gross C, McNamara RL, Rosenthal R, Udelsman R, Bravata DM, Roman SA: Evaluating the surgery literature: can standardizing peer-review today predict manuscript impact tomorrow? Ann Surg. 2009 Jul. PMID: 19561471
- Austin BA, Wang Y, Smith GL, Vaccarine V, Krumholz HM, McNamara RL: Systolic function as a predictor of mortality and quality of life in long-term survivors with heart failure. Clin Cardiol. 2008 Mar. PMID: 18383045
- McNamara RL, Herrin J, Wang Y, Curtis JP, Bradley EH, Magid DJ, Rathore SS, Nallamothu BK, Peterson ED, Blaney ME, Frederick P, Krumholz HM: Impact of delay in door-to-needle time on mortality in patients with ST-segment elevation myocardial infarction. Am J Cardiol. 2007 Oct 15; 2007 Aug 1. PMID: 17920362
- Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, Roumanis SA, Curtis JP, Nallamothu BK, Magid DJ, McNamara RL, Parkosewich J, Loeb JM, Krumholz HM: Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med. 2006 Nov 30; 2006 Nov 13. PMID: 17101617
- Mena C, Wencker D, Krumholz HM, McNamara RL: Detection of heart transplant rejection in adults by echocardiographic diastolic indices: a systematic review of the literature. J Am Soc Echocardiogr. 2006 Oct. PMID: 17000376
- Bradley EH, Herrin J, Elbel B, McNamara RL, Magid DJ, Nallamothu BK, Wang Y, Normand SL, Spertus JA, Krumholz HM: Hospital quality for acute myocardial infarction: correlation among process measures and relationship with short-term mortality. JAMA. 2006 Jul 5. PMID: 16820549
- Bradley EH, Herrin J, Wang Y, McNamara RL, Radford MJ, Magid DJ, Canto JG, Blaney M, Krumholz HM: Door-to-drug and door-to-balloon times: where can we improve? Time to reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI). Am Heart J. 2006 Jun. PMID: 16781237
- Curtis JP, Portnay EL, Wang Y, McNamara RL, Herrin J, Bradley EH, Magid DJ, Blaney ME, Canto JG, Krumholz HM, National Registry of Myocardial Infarction-4.: The pre-hospital electrocardiogram and time to reperfusion in patients with acute myocardial infarction, 2000-2002: findings from the National Registry of Myocardial Infarction-4. J Am Coll Cardiol. 2006 Apr 18; 2006 Mar 29. PMID: 16630989
- Bradley EH, Curry LA, Webster TR, Mattera JA, Roumanis SA, Radford MJ, McNamara RL, Barton BA, Berg DN, Krumholz HM: Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. Circulation. 2006 Feb 28; 2006 Feb 20. PMID: 16490818
- McNamara RL, Herrin J, Bradley EH, Portnay EL, Curtis JP, Wang Y, Magid DJ, Blaney M, Krumholz HM, NRMI Investigators.: Hospital improvement in time to reperfusion in patients with acute myocardial infarction, 1999 to 2002. J Am Coll Cardiol. 2006 Jan 3; 2005 Dec 13. PMID: 16386663
- Bradley EH, Roumanis SA, Radford MJ, Webster TR, McNamara RL, Mattera JA, Barton BA, Berg DN, Portnay EL, Moscovitz H, Parkosewich J, Holmboe ES, Blaney M, Krumholz HM: Achieving door-to-balloon times that meet quality guidelines: how do successful hospitals do it? J Am Coll Cardiol. 2005 Oct 4. PMID: 16198837
- Bradley EH, Herrin J, Wang Y, McNamara RL, Webster TR, Magid DJ, Blaney M, Peterson ED, Canto JG, Pollack CV Jr, Krumholz HM: Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA. 2004 Oct 6. PMID: 15467058
- McNamara RL, Tamariz LJ, Segal JB, Bass EB: Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Ann Intern Med. 2003 Dec 16. PMID: 14678922
