2020
Fewer 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 characteristics338 FEWER GASTROINTESTINAL BLEEDS WITH TICAGRELOR WHEN COMPARED TO CLOPIDOGREL OR PRASUGREL IN PATIENTS WITH ACUTE CORONARY SYNDROME FOLLOWING PERCUTANEOUS CORONARY INTERVENTION
Abraham N, Yang E, Noseworthy P, Inselman J, Yao X, Herrin J, Sangaralingham L, Ngufor C, Shah N. 338 FEWER GASTROINTESTINAL BLEEDS WITH TICAGRELOR WHEN COMPARED TO CLOPIDOGREL OR PRASUGREL IN PATIENTS WITH ACUTE CORONARY SYNDROME FOLLOWING PERCUTANEOUS CORONARY INTERVENTION. Gastroenterology 2020, 158: s-58. DOI: 10.1016/s0016-5085(20)30827-1.Peer-Reviewed Original Research
2017
Impact of a Shared Decision Making Intervention on Health Care Utilization: A Secondary Analysis of the Chest Pain Choice Multicenter Randomized Trial
Schaffer JT, Hess EP, Hollander JE, Kline JA, Torres CA, Diercks DB, Jones R, Owen KP, Meisel ZF, Demers M, Leblanc A, Inselman J, Herrin J, Montori VM, Shah ND. Impact of a Shared Decision Making Intervention on Health Care Utilization: A Secondary Analysis of the Chest Pain Choice Multicenter Randomized Trial. Academic Emergency Medicine 2017, 25: 293-300. PMID: 29218817, DOI: 10.1111/acem.13355.Peer-Reviewed Original ResearchConceptsHealth care utilizationLength of stayCare utilizationObservation unit admissionUnit admissionChest painED visitsIntervention armStudy armsIndex emergency department visitLow-risk chest painOverall health care utilizationSecondary analysisBilling dataIndex ED visitAcute coronary syndromeEmergency department visitsCardiac imaging testsCardiac stress testingPlanned secondary analysisHealth care systemInitial EDPragmatic multicenterCardiac testingCoronary syndromeEffectiveness of a Decision Aid in Potentially Vulnerable Patients: A Secondary Analysis of the Chest Pain Choice Multicenter Randomized Trial
Rising K, Hollander J, Schaffer J, Kline J, Torres C, Diercks D, Jones R, Owen K, Meisel Z, Demers M, Leblanc A, Shah N, Inselman J, Herrin J, Montori V, Hess E. Effectiveness of a Decision Aid in Potentially Vulnerable Patients: A Secondary Analysis of the Chest Pain Choice Multicenter Randomized Trial. Medical Decision Making 2017, 38: 69-78. PMID: 28525723, DOI: 10.1177/0272989x17706363.Peer-Reviewed Original ResearchConceptsUsual careHealth literacySecondary analysisAcute coronary syndromeDecision aidOne-thirdChest painCoronary syndromePatient characteristicsSDM interventionsIntervention groupVulnerable patientsHigh school educationPatientsControl groupPhysician trustPatient trustSubgroup effectsArm assignmentVulnerable subgroupsSociodemographic groupsMulticenterTrialsSimilar extentPhysicians
2016
Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial
Hess EP, Hollander JE, Schaffer JT, Kline JA, Torres CA, Diercks DB, Jones R, Owen KP, Meisel ZF, Demers M, Leblanc A, Shah ND, Inselman J, Herrin J, Castaneda-Guarderas A, Montori VM. Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial. The BMJ 2016, 355: i6165. PMID: 27919865, PMCID: PMC5152707, DOI: 10.1136/bmj.i6165.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAdultAftercareAmbulatory CareAttitude of Health PersonnelChest PainChoice BehaviorConflict, PsychologicalDecision MakingDecision Support TechniquesEmergency Service, HospitalFemaleHealth Knowledge, Attitudes, PracticeHospital UnitsHospitalizationHumansMaleMiddle AgedMyocardial InfarctionObservationPatient Acceptance of Health CarePatient ParticipationPatient SatisfactionRisk AssessmentTrustConceptsAcute coronary syndromeMajor adverse cardiac eventsAdverse cardiac eventsCardiac testingCoronary syndromeChest painUsual careCardiac eventsPatient knowledgeLow-risk chest painPossible acute coronary syndromeDecision aid armFurther cardiac testingRandomized pragmatic trialRisk chest painUsual care armObservation unitProportion of patientsRate of admissionCare armSecondary outcomesPrimary outcomePrimary complaintTRIAL REGISTRATIONEmergency clinicians
2014
Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial
Anderson RT, Montori VM, Shah ND, Ting HH, Pencille LJ, Demers M, Kline JA, Diercks DB, Hollander JE, Torres CA, Schaffer JT, Herrin J, Branda M, Leblanc A, Hess EP. Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial. Trials 2014, 15: 166. PMID: 24884807, PMCID: PMC4031497, DOI: 10.1186/1745-6215-15-166.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAngina, UnstableCardiology Service, HospitalClinical ProtocolsCommunicationConflict, PsychologicalDecision Support TechniquesEmergency Service, HospitalHealth Knowledge, Attitudes, PracticeHealth ResourcesHumansMyocardial InfarctionPatient Education as TopicPhysician-Patient RelationsPredictive Value of TestsPrognosisResearch DesignRisk AssessmentRisk FactorsSurveys and QuestionnairesTime FactorsUnited StatesVideo RecordingConceptsAdvanced cardiac testingAcute coronary syndromeDiverse emergency departmentsEmergency departmentCardiac testingHealthcare utilizationLow-risk chest pain patientsLow-risk chest painMajor adverse cardiac eventsMethods/designThisAdverse cardiac eventsLow-risk patientsProportion of patientsChest pain patientsCommon reason patientsEmergency department patientsPatient-clinician discussionsHospital billing recordsPatient-centered outcomesElectronic medical recordsAvailable management optionsDecision aidChest painCoronary syndromeUsual care