2021
Association of Physician Characteristics With Early Adoption of Virtual Health Care
Zachrison K, Yan Z, Samuels-Kalow M, Licurse A, Zuccotti G, Schwamm L. Association of Physician Characteristics With Early Adoption of Virtual Health Care. JAMA Network Open 2021, 4: e2141625. PMID: 34967876, PMCID: PMC8719243, DOI: 10.1001/jamanetworkopen.2021.41625.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesEthnicityFemaleHumansMaleMiddle AgedNew EnglandPractice Patterns, Physicians'Primary Health CareSex FactorsUser-Computer InterfaceConceptsVirtual health careCross-sectional studyHealth care systemPatient characteristicsHealth carePhysician characteristicsLarge regional health care systemRetrospective cross-sectional studyBehavioral healthCare systemSurgical specialtiesHealth system databasePhysician-level variationRegional health care systemAmbulatory visitsPrimary careHealth physiciansPatient's abilityAmbulatory careMAIN OUTCOMEGreater oddsAmbulatory practiceBivariate comparisonsPhysiciansHospital affiliationNational Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic
Zachrison KS, Sharma R, Wang Y, Mehrotra A, Schwamm LH. National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106035. PMID: 34419836, PMCID: PMC8494566, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106035.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCOVID-19Databases, FactualFemaleFibrinolytic AgentsHumansMaleMiddle AgedPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRemote ConsultationStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsIschemic stroke patientsTelestroke consultationAlteplase deliveryStroke patientsNumber of patientsNumber of consultsCOVID-19 public health emergencyPublic health emergencyAlteplase useMedian doorNeedle timeStroke severityED arrivalEmergency departmentImaging reviewHospital characteristicsTelestroke networkCT scanHospital participationSpoke sitesProvider groupsPatientsHospital sizeStudy periodHealth emergency
2020
What Drives Greater Assimilation of Telestroke in Emergency Departments?
Uscher-Pines L, Sousa J, Zachrison K, Guzik A, Schwamm L, Mehrotra A. What Drives Greater Assimilation of Telestroke in Emergency Departments? Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105310. PMID: 32992169, PMCID: PMC7686253, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105310.Peer-Reviewed Original ResearchAttitude of Health PersonnelClinical ProtocolsDelivery of Health Care, IntegratedEmergency Service, HospitalHealth Knowledge, Attitudes, PracticeHumansInterviews as TopicLeadershipPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareReferral and ConsultationStrokeTelemedicineWorkflow
2019
Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States
Zachrison K, Onnela J, Reeves M, Hernandez A, Camargo C, Zhao X, Matsouaka R, Goldstein J, Metlay J, Schwamm L. Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States. Journal Of The American Heart Association 2019, 9: e011575. PMID: 31888430, PMCID: PMC6988147, DOI: 10.1161/jaha.118.011575.Peer-Reviewed Original ResearchMeSH KeywordsCatchment Area, HealthDatabases, FactualDelivery of Health Care, IntegratedFibrinolytic AgentsHospitalsHospitals, High-VolumeHospitals, Low-VolumeHumansMedicarePatient TransferPractice Patterns, Physicians'Quality Indicators, Health CareRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorUnited StatesConceptsAcute ischemic strokeAlteplase administrationIschemic strokeUS hospitalsHospital qualityHospital stroke volumeTransfer destinationsHospital referral regionsHospital factorsNumber of hospitalsStroke patientsHospital characteristicsStroke volumeMedicare claimsReferral regionsHospitalLogistic regressionStrokePatientsHospital performancePotential strategyAdministrationHome timeResult dataConnected dyads
2018
Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke
Wang Y, Li Z, Zhao X, Liu L, Wang C, Wang C, Peterson E, Schwamm L, Fonarow G, Smith S, Bettger J, Wang D, Li H, Xian Y, Wang Y. Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2018, 11: e001968. PMID: 30557048, DOI: 10.1161/circoutcomes.115.001968.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaChinaClinical CompetenceDisability EvaluationEvidence-Based MedicineFemaleFibrinolytic AgentsGuideline AdherenceHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk FactorsSmoking CessationStrokeStroke RehabilitationThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeConceptsAcute ischemic strokeIschemic strokeOptimal complianceStroke careChina National Stroke RegistryEvidence-based performance measuresMultivariable Cox modelNational Stroke RegistryFavorable functional outcomeProspective cohort studyEvidence-based guidelinesRoutine clinical practiceCause of deathIntravenous tPAStroke recurrenceStroke RegistryCohort studyNationwide registryClinical outcomesFunctional outcomeCare measuresImproved outcomesHospital measuresCox modelClinical practice
2017
The American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care
Ormseth CH, Sheth KN, Saver JL, Fonarow GC, Schwamm LH. The American Heart Association’s Get With the Guidelines (GWTG)-Stroke development and impact on stroke care. Stroke And Vascular Neurology 2017, 2: 94. PMID: 28959497, PMCID: PMC5600018, DOI: 10.1136/svn-2017-000092.Peer-Reviewed Original ResearchConceptsStroke care deliveryAmerican Heart AssociationHeart AssociationCare deliveryEvidence-based careContinuous quality improvement initiativesQuality improvement initiativesInpatient outcomesStroke ProgramPatient characteristicsStroke outcomeStroke careStroke developmentVoluntary registryPatient outcomesHospital adherenceImprovement initiativesOutcomesCareGuidelinesAssociationGWTGDeliveryRegistry
2016
Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age
Arora R, Salamon E, Katz J, Cox M, Saver J, Bhatt D, Fonarow G, Peterson E, Smith E, Schwamm L, Xian Y, Libman R. Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age. Stroke 2016, 47: 2347-2354. PMID: 27491734, DOI: 10.1161/strokeaha.116.012241.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdolescentAdultAge FactorsAgedAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesMaleMiddle AgedPractice Patterns, Physicians'PrognosisRegistriesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorAcute ischemic strokeSymptomatic hemorrhageTPA useIschemic strokeYounger patientsFunctional outcomeQuality improvement registryGood functional outcomeYears of ageYounger age groupsIntravenous thrombolysisHospital mortalityFibrinolytic therapyAcute rehabilitationIndependent ambulationDischarge outcomesMultivariable analysisHospice dischargePatientsAge groupsHemorrhagePlasminogen activatorMortality
2015
Association of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke
Masrur S, Cox M, Bhatt D, Smith E, Ellrodt G, Fonarow G, Schwamm L. Association of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2015, 4: e002193. PMID: 26408015, PMCID: PMC4845108, DOI: 10.1161/jaha.115.002193.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overBiomarkersBlood GlucoseBrain IschemiaChi-Square DistributionChronic DiseaseFemaleFibrinolytic AgentsGlycated HemoglobinGuideline AdherenceHospital MortalityHumansHyperglycemiaLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicPractice Patterns, Physicians'RegistriesRetrospective StudiesRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorAssociation of acuteAcute ischemic strokeHistory of diabetesWorse clinical outcomesChronic hyperglycemiaClinical outcomesGuidelines-StrokeHospital mortalityAIS patientsBlood glucoseGlucose levelsPlasma glucose levelsBlood glucose levelsAdmission glucoseNondiabetic patientsPost thrombolysisIschemic strokeAcute hyperglycemiaDL increaseAcute correctionPoor outcomeAdverse outcomesOdds ratioHyperglycemiaPerception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke
Lin C, Cox M, Olson D, Britz G, Constable M, Fonarow G, Schwamm L, Peterson E, Shah B. Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke. Journal Of The American Heart Association 2015, 4: e001298. PMID: 26201547, PMCID: PMC4608060, DOI: 10.1161/jaha.114.001298.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAttitude of Health PersonnelBrain IschemiaDelivery of Health CareDrug Administration ScheduleFemaleFibrinolytic AgentsGuideline AdherenceHealth Care SurveysHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPerceptionPractice Guidelines as TopicPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRegistriesStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorIntravenous tissue plasminogen activatorAcute ischemic strokeAcute stroke careMinutes of arrivalLow annual volumeEligible patientsGuidelines hospitalsTPA administrationIschemic strokeStroke outcomeStroke careThrombolytic therapySmall percentageUS hospitalsDifferent hospitalsHospitalPatientsPlasminogen activatorTelephone surveyOne-thirdAdministrationMinutesAnnual volumePercentage
2014
Impact of an Expanded Hospital Recognition Program for Heart Failure Quality of Care
Heidenreich P, Zhao X, Hernandez A, Yancy C, Schwamm L, Albert N, Fonarow G. Impact of an Expanded Hospital Recognition Program for Heart Failure Quality of Care. Journal Of The American Heart Association 2014, 3: e000950. PMID: 25208954, PMCID: PMC4323821, DOI: 10.1161/jaha.114.000950.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiology Service, HospitalChi-Square DistributionCombined Modality TherapyDelivery of Health CareFemaleGuideline AdherenceHeart FailureHumansLogistic ModelsMaleMiddle AgedOdds RatioPractice Guidelines as TopicPractice Patterns, Physicians'Process Assessment, Health CareProgram EvaluationQuality ImprovementQuality Indicators, Health CareTime FactorsTreatment OutcomeUnited StatesConceptsBaseline useGuidelines-Heart Failure programImplantable cardioverter-defibrillator (ICD) useHeart Failure QualityInfluenza vaccination ratesSignificant greater increaseQuality of careHospital-level performanceTime 6 monthsHeart failureVaccination ratesCare measuresDefibrillator useHospitalHospital recognitionQuality measuresGreater increaseRate of increaseCareAdditional recognitionIntravenous Fibrinolysis Eligibility: A Survey of Stroke Clinicians' Practice Patterns and Review of the Literature
De Los Rios F, Kleindorfer D, Guzik A, Ortega-Gutierrez S, Sangha N, Kumar G, Grotta J, Lee J, Meyer B, Schwamm L, Khatri P, Investigators S. Intravenous Fibrinolysis Eligibility: A Survey of Stroke Clinicians' Practice Patterns and Review of the Literature. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2130-2138. PMID: 25113084, PMCID: PMC4157964, DOI: 10.1016/j.jstrokecerebrovasdis.2014.03.024.Peer-Reviewed Original ResearchConceptsStroke cliniciansPractice patternsEligible patientsSymptom onsetEuropean Cooperative Acute Stroke Study-III criteriaIntravenous recombinant tissue plasminogen activator useCurrent American Heart Association guidelinesRecombinant tissue plasminogen activator useTissue plasminogen activator useAmerican Heart Association guidelinesHealth Stroke ScaleHeart Association guidelinesHour time frameClinician practice patternsNational InstituteSevere strokeStroke ScaleIschemic strokeMild strokeAssociation guidelinesMost cliniciansElderly individualsEligibility criteriaDrug AdministrationInvestigator meeting
2013
Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
James M, Grau-Sepulveda M, Olson D, Smith E, Hernandez A, Peterson E, Schwamm L, Bhatt D, Fonarow G. Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke. Journal Of Stroke And Cerebrovascular Diseases 2013, 23: 283-292. PMID: 23537567, DOI: 10.1016/j.jstrokecerebrovasdis.2013.02.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral HemorrhageChi-Square DistributionFemaleGuideline AdherenceHealth Services AccessibilityHealthcare DisparitiesHumansInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Private SectorQuality of Health CareRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsInsurance statusIntracerebral hemorrhageCare measuresOdds ratioND groupHospital mortality rateProspective stroke registryPrivate insurance groupHigher mortality riskHigher odds ratioEvidence-based qualityInsurance groupsHospital-specific variablesGuidelines-StrokeHospital outcomesStroke RegistryDischarge destinationIndependent ambulationComorbid conditionsStroke databaseAdjusted analysisICH patientsFunctional statusCare indicatorsMedicare patients
2012
Assessing variability in neurointerventional practice patterns for acute ischemic stroke
Mehta B, Leslie-Mazwi T, Chandra R, Chaudhry Z, Rabinov J, Hirsch J, Schwamm L, Rost N, Yoo A. Assessing variability in neurointerventional practice patterns for acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: i52. PMID: 23235960, DOI: 10.1136/neurintsurg-2012-010565.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyPractice patternsHealth Stroke Scale scoreIntravenous tissue plasminogen activatorReal-world practice patternsEvidence-based practice guidelinesComprehensive stroke servicesPosterior circulation strokeStroke Scale scoreAcute ischemic strokeAnterior circulation strokeFirst-line therapyLarge vessel occlusionMedian annual volumeTissue plasminogen activatorAcute strokeIschemic strokeIndependent predictorsSymptom onsetConscious sedationStroke servicesTreatment indicationsVessel occlusionTreatment strategiesPractice guidelinesGuideline Adherence After ST-Segment Elevation Versus Non-ST Segment Elevation Myocardial Infarction
Somma K, Bhatt D, Fonarow G, Cannon C, Cox M, Laskey W, Peacock W, Hernandez A, Peterson E, Schwamm L, Saxon L. Guideline Adherence After ST-Segment Elevation Versus Non-ST Segment Elevation Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2012, 5: 654-661. PMID: 22949493, DOI: 10.1161/circoutcomes.111.963959.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overCardiovascular AgentsChi-Square DistributionComorbidityCoronary Artery DiseaseDrug Administration ScheduleFemaleGuideline AdherenceHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionOdds RatioPractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionSTEMI patientsMedical therapyNSTEMI patientsMyocardial infarctionGuidelines-Coronary Artery Disease registryNon-ST segment elevation myocardial infarctionGuideline-based medical therapyPrior coronary artery diseaseSegment elevation myocardial infarctionLow-density lipoprotein levelsSegment elevation MISimilar medical therapyLipid-lowering medicationsCoronary artery diseaseST-segment elevationGWTG-CADMedical comorbiditiesDischarge medicationsGuideline adherenceArtery diseaseHeart failureAngiotensin receptorsElevation MI
2010
Patterns and Predictors of Discharge Statin Prescription Among Hospitalized Patients With Intracerebral Hemorrhage
Ovbiagele B, Schwamm L, Smith E, Hernandez A, Olson D, Pan W, Fonarow G, Saver J. Patterns and Predictors of Discharge Statin Prescription Among Hospitalized Patients With Intracerebral Hemorrhage. Stroke 2010, 41: 2271-2277. PMID: 20724709, DOI: 10.1161/strokeaha.110.593228.Peer-Reviewed Original ResearchConceptsDischarge statin prescriptionStatin prescriptionIntracerebral hemorrhageStatin useStatin treatmentPrior stroke/transient ischemic attackStroke/transient ischemic attackCholesterol Levels (SPARCL) trialStatin treatment armsLogistic multivariable regression modelsTransient ischemic attackHemorrhagic stroke riskHigher future riskMultivariable regression modelsGuidelines-StrokeIschemic attackEligible patientsStroke preventionIschemic eventsStroke riskHospitalized patientsHemorrhagic strokeTreatment armsMean ageFemale sexRapid Change in Prescribing Behavior in Hospitals Participating in Get With The Guidelines–Stroke After Release of the Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) Clinical Trial Results
Menon B, Frankel M, Liang L, LaBresh K, Ellrodt G, Hernandez A, Fonarow G, Schwamm L, Smith E. Rapid Change in Prescribing Behavior in Hospitals Participating in Get With The Guidelines–Stroke After Release of the Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) Clinical Trial Results. Stroke 2010, 41: 2094-2097. PMID: 20634476, DOI: 10.1161/strokeaha.110.584151.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackIschemic strokeHigh-risk patients trialAmerican Heart Association Guidelines UpdateManagement of AtherothrombosisPatient clinical trialsGuidelines-StrokeGWTG-StrokeAntithrombotic medicationAntithrombotic therapyStroke ProgramDischarge prescriptionsGuideline updateRandomized trialsConsensus guidelinesHospital characteristicsClinical trialsPrescribing behaviorSustained decreasePatient trialsSustained reductionClinical informationPatientsMatch Study
2009
The Adherence eValuation After Ischemic Stroke Longitudinal (AVAIL) Registry: Design, rationale, and baseline patient characteristics
Bushnell C, Zimmer L, Schwamm L, Goldstein L, Clapp-Channing N, Harding T, Drew L, Zhao X, Peterson E. The Adherence eValuation After Ischemic Stroke Longitudinal (AVAIL) Registry: Design, rationale, and baseline patient characteristics. American Heart Journal 2009, 157: 428-435.e2. PMID: 19249411, DOI: 10.1016/j.ahj.2008.11.002.Peer-Reviewed Original ResearchConceptsIschemic stroke Longitudinal (AVAIL) registryTransient ischemic attackIschemic attackRecurrent strokePrevention medicationsLongitudinal registryAdherence evaluationSecondary preventive therapyBaseline patient characteristicsModified Rankin scoreSecondary prevention measuresMedication-taking behaviorSystem-level barriersLevel of adherenceFuture strokeCardiovascular eventsRankin scoreVascular eventsAcute hospitalizationHospital dischargePatient characteristicsPreventive therapySecondary outcomesMedication usePrimary outcome