Featured Publications
Disparities in Excess Mortality Associated with COVID-19 — United States, 2020
Rossen LM, Ahmad FB, Anderson RN, Branum AM, Du C, Krumholz HM, Li SX, Lin Z, Marshall A, Sutton PD, Faust JS. Disparities in Excess Mortality Associated with COVID-19 — United States, 2020. MMWR Morbidity And Mortality Weekly Report 2021, 70: 1114-1119. PMID: 34411075, PMCID: PMC8375709, DOI: 10.15585/mmwr.mm7033a2.Peer-Reviewed Original ResearchConceptsMortality incidence ratesIncidence rateExcess mortalityAge groupsHighest excess mortality ratesExcess Mortality AssociatedGreater excess mortalityExcess mortality ratesAI/AN populationsNon-Hispanic American IndianNon-Hispanic blacksNational Vital Statistics SystemCOVID-19 pandemicPublic health messagingNon-Hispanic white populationRace/ethnicityVital Statistics SystemMortality AssociatedLack of adjustmentMortality rateExcess deathsAN populationsEthnic groupsHealth messagingHispanic personsAll-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020
Faust JS, Krumholz HM, Du C, Mayes KD, Lin Z, Gilman C, Walensky RP. All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020. JAMA 2021, 325: 785-787. PMID: 33325994, PMCID: PMC7745134, DOI: 10.1001/jama.2020.24243.Peer-Reviewed Original ResearchHospital-Readmission Risk — Isolating Hospital Effects from Patient Effects
Krumholz HM, Wang K, Lin Z, Dharmarajan K, Horwitz LI, Ross JS, Drye EE, Bernheim SM, Normand ST. Hospital-Readmission Risk — Isolating Hospital Effects from Patient Effects. New England Journal Of Medicine 2017, 377: 1055-1064. PMID: 28902587, PMCID: PMC5671772, DOI: 10.1056/nejmsa1702321.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesReadmission ratesObserved readmission ratesSimilar diagnosesHospital effectsDifferent hospitalsHospital readmission performanceRate of readmissionHospital readmission ratesLower readmission ratesStudy sampleYears of ageSignificant differencesMultiple admissionsReadmission outcomesOnly significant differencePatient effectsSame patientMedicare recipientsPatientsReadmission performanceRisk-standardized hospital readmission ratesHospitalHospital qualityQuartileAssociation of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge
Dharmarajan K, Wang Y, Lin Z, Normand ST, Ross JS, Horwitz LI, Desai NR, Suter LG, Drye EE, Bernheim SM, Krumholz HM. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. JAMA 2017, 318: 270-278. PMID: 28719692, PMCID: PMC5817448, DOI: 10.1001/jama.2017.8444.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesRisk-adjusted mortality ratesAcute myocardial infarctionHeart failureReadmission ratesMortality rateMyocardial infarctionMedicare feeService beneficiariesHospital readmission ratesMean hospitalHospital mortalityPostdischarge mortalityHospital dischargeHospital readmissionRetrospective studyAffordable Care ActReadmission reductionMAIN OUTCOMEPneumoniaHospitalSecondary analysisWeighted Pearson correlation coefficientMortalityCare ActAccounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates
Bernheim SM, Parzynski CS, Horwitz L, Lin Z, Araas MJ, Ross JS, Drye EE, Suter LG, Normand SL, Krumholz HM. Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates. Health Affairs 2016, 35: 1461-1470. PMID: 27503972, PMCID: PMC7664840, DOI: 10.1377/hlthaff.2015.0394.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramPatients' socioeconomic statusMedicare's Hospital Readmissions Reduction ProgramLow socioeconomic statusReadmission ratesSocioeconomic statusRisk-standardized readmission ratesHospital readmission ratesReadmissions Reduction ProgramMedicaid Services methodologyReadmission measuresHospital resultsPatientsHospitalSuch hospitalsPayment penaltiesReduction programsStatusCurrent CentersLower proportionLarge proportionPercentAdjustmentProportionRelationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia
Krumholz HM, Lin Z, Keenan PS, Chen J, Ross JS, Drye EE, Bernheim SM, Wang Y, Bradley EH, Han LF, Normand SL. Relationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 2013, 309: 587-593. PMID: 23403683, PMCID: PMC3621028, DOI: 10.1001/jama.2013.333.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesHospital risk-standardized mortality ratesHeart failureMyocardial infarctionHospital characteristicsMortality rateReadmission ratesProportion of hospitalsHospital readmissionMedicare feePneumoniaInfarctionService beneficiariesHospitalPatientsMedicaid ServicesHospital performanceSubgroupsFailureCauseReadmissionSignificant negative linear relationshipAn Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure
Keenan PS, Normand SL, Lin Z, Drye EE, Bhat KR, Ross JS, Schuur JD, Stauffer BD, Bernheim SM, Epstein AJ, Wang Y, Herrin J, Chen J, Federer JJ, Mattera JA, Wang Y, Krumholz HM. An Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2008, 1: 29-37. PMID: 20031785, DOI: 10.1161/circoutcomes.108.802686.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesCause readmission rateReadmission ratesHeart failureHospital-level readmission ratesAdjusted readmission ratesAdministrative Claims MeasureUnadjusted readmission ratesHeart failure patientsHospital risk-standardized readmission ratesMedical record dataProfiling Hospital PerformanceHierarchical logistic regression modelsUse of MedicareMedical record modelNational Quality ForumLogistic regression modelsCause readmissionClaims-based modelsHospital dischargeFailure patientsC-statisticPreventable eventsPatientsQuality Forum
2024
Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageProcedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion
Friedman D, Du C, Zimmerman S, Tan Z, Lin Z, Vemulapalli S, Kosinski A, Piccini J, Pereira L, Minges K, Faridi K, Masoudi F, Curtis J, Freeman J. Procedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion. Circulation Cardiovascular Interventions 2024, 17: e013466. PMID: 38889251, PMCID: PMC11189610, DOI: 10.1161/circinterventions.123.013466.Peer-Reviewed Original ResearchConceptsVolume-outcome relationshipLikelihood of procedural successLeft atrial appendage occlusionProcedural successProcedure volumeAppendage occlusionNational Cardiovascular Data Registry LAAO RegistryVolume quartilesLeft atrial appendage occlusion devicesThree-level hierarchical generalized linear modelsMinimum volume thresholdsWatchman FLX deviceProcedural success rateHierarchical generalized linear modelsAssociated with outcomePhysician volumeWATCHMAN procedureFLX deviceOcclusion deviceVolume thresholdCardiovascular proceduresPhysiciansHospitalNational analysisSuccess rateCalculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Gettel C, Bagshaw K, Qin L, Lin Z, Rothenberg E, Omotosho P, Goutos D, Herrin J, Suter L, Schreiber M, Fleisher L, Myers R, Spivack S, Venkatesh A. Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step. JAMA Network Open 2024, 7: e2411933. PMID: 38753326, PMCID: PMC11099678, DOI: 10.1001/jamanetworkopen.2024.11933.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesCross-sectional studyHospital characteristicsHigher star ratingsStar ratingsOverall hospital qualityLowest-performing hospitalsOverall star ratingQuality star ratingsHospital star ratingsStar Ratings scoresHospital qualityHospital performanceStratified hospitalsMedicaid ServicesMain OutcomesFace validityPeer groupPeer group approachPrimary outcomePeer comparisonHospitalRating scoresPeerMeasurement groupPre-COVID-19 hospital quality and hospital response to COVID-19: examining associations between risk-adjusted mortality for patients hospitalised with COVID-19 and pre-COVID-19 hospital quality
Peter D, Li S, Wang Y, Zhang J, Grady J, McDowell K, Norton E, Lin Z, Bernheim S, Venkatesh A, Fleisher L, Schreiber M, Suter L, Triche E. Pre-COVID-19 hospital quality and hospital response to COVID-19: examining associations between risk-adjusted mortality for patients hospitalised with COVID-19 and pre-COVID-19 hospital quality. BMJ Open 2024, 14: e077394. PMID: 38553067, PMCID: PMC10982775, DOI: 10.1136/bmjopen-2023-077394.Peer-Reviewed Original ResearchConceptsHospital qualityPatient experiencePre-COVID-19Medicare patientsShort-term acute care hospitalsCritical access hospitalsAcute care hospitalsFuture public health emergenciesHigher odds of mortalityIn-hospitalRisk-adjusted mortalityOdds of mortalityCare deliveryAccess hospitalsEffective careCOVID-19-related deathsAssociated with mortalityCare structuresHospital characteristicsPublic health emergencySummary scoreMedicare beneficiariesHigher oddsHospital responseRSMRsMeasuring Equity in Readmission as a Distinct Assessment of Hospital Performance
Nash K, Weerahandi H, Yu H, Venkatesh A, Holaday L, Herrin J, Lin Z, Horwitz L, Ross J, Bernheim S. Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance. JAMA 2024, 331: 111-123. PMID: 38193960, PMCID: PMC10777266, DOI: 10.1001/jama.2023.24874.Peer-Reviewed Original ResearchConceptsBlack patientsPatient populationHospital characteristicsHospital-wide readmission measureDual-eligible patientsHospital patient populationCross-sectional studyMeasures of hospitalHealth care qualityPatient demographicsReadmission ratesClinical outcomesPatient raceEligible hospitalsReadmissionMAIN OUTCOMEReadmission measuresMedicare dataUS hospitalsHospitalCare qualityPatientsMedicaid ServicesOutcomesLower percentage
2023
Persistence on Novel Cardioprotective Antihyperglycemic Therapies in the United States
Nargesi A, Clark C, Aminorroaya A, Chen L, Liu M, Reddy A, Amodeo S, Oikonomou E, Suchard M, McGuire D, Lin Z, Inzucchi S, Khera R. Persistence on Novel Cardioprotective Antihyperglycemic Therapies in the United States. The American Journal Of Cardiology 2023, 196: 89-98. PMID: 37012183, PMCID: PMC11007258, DOI: 10.1016/j.amjcard.2023.03.002.Peer-Reviewed Original ResearchConceptsSGLT-2iGLP-1RAsGlucagon-like peptide-1 receptor agonistsUnited States administrative claims databasesSodium-glucose cotransporter 2 inhibitorsCommercial insurancePeptide-1 receptor agonistsType 2 diabetes mellitusSodium-glucose cotransporter-2 inhibitorsConsistent medication useHealth outcome benefitsCotransporter 2 inhibitorsElevated cardiovascular riskInitiation of therapyAdministrative claims databaseProportion of daysCotransporter-2 inhibitorsRate of prescriptionAntihyperglycemic therapyCardiovascular riskDiabetes mellitusMedication useCardioprotective effectsPrescription practicesClaims databaseDeveloping Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study
Bikdeli B, Lo Y, Khairani C, Bejjani A, Jimenez D, Barco S, Mahajan S, Caraballo C, Secemsky E, Klok F, Hunsaker A, Aghayev A, Muriel A, Wang Y, Hussain M, Appah-Sampong A, Lu Y, Lin Z, Aneja S, Khera R, Goldhaber S, Zhou L, Monreal M, Krumholz H, Piazza G. Developing Validated Tools to Identify Pulmonary Embolism in Electronic Databases: Rationale and Design of the PE-EHR+ Study. Thrombosis And Haemostasis 2023, 123: 649-662. PMID: 36809777, PMCID: PMC11200175, DOI: 10.1055/a-2039-3222.Peer-Reviewed Original ResearchConceptsElectronic health recordsNLP algorithmNatural language processing toolsLanguage processing toolsPrincipal discharge diagnosisICD-10 codesDischarge diagnosisNLP toolsChart reviewHealth systemProcessing toolsYale New Haven Health SystemPatient identificationElectronic databasesHealth recordsData validationHigh-risk PEPulmonary Embolism ResearchSecondary discharge diagnosisIdentification of patientsManual chart reviewNegative predictive valueCodeRadiology reportsAlgorithmAdjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions
Lipska K, Altaf F, Barthel A, Spatz E, Lin Z, Herrin J, Bernheim S, Drye E. Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions. JAMA Health Forum 2023, 4: e230081. PMID: 36897581, DOI: 10.1001/jamahealthforum.2023.0081.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsSocial risk factorsMedicare-Medicaid dual eligibilityRisk factorsChronic conditionsSocioeconomic status indexMeasure scoresAcute admissionsCohort studyDual eligibilityHealthcare ResearchDual-eligible patientsRetrospective cohort studyUnplanned hospital admissionsRisk of hospitalizationArea Health Resource FileService beneficiaries 65 yearsBeneficiaries 65 yearsRisk factor adjustmentStatus indexMedicare administrative claimsHospital admissionOutcome measuresAdministrative claimsMAIN OUTCOME
2022
Association of Initial SARS-CoV-2 Test Positivity With Patient-Reported Well-being 3 Months After a Symptomatic Illness
Wisk L, Gottlieb M, Spatz E, Yu H, Wang R, Slovis B, Saydah S, Plumb I, O’Laughlin K, Montoy J, McDonald S, Lin Z, Lin J, Koo K, Idris A, Huebinger R, Hill M, Gentile N, Chang A, Anderson J, Hota B, Venkatesh A, Weinstein R, Elmore J, Nichol G, Santangelo M, Ulrich A, Li S, Kinsman J, Krumholz H, Dorney J, Stephens K, Black K, Morse D, Morse S, Fernandes A, Sharma A, Stober T, Geyer R, Lyon V, Adams K, Willis M, Ruiz L, Park J, Malone K, Shughart H, Schaeffer K, Shughart L, Arab A, Grau D, Patel A, Watts P, Kelly M, Hunt A, Hannikainen P, Chalfin M, Cheng D, Miao J, Shutty C, Chavez S, Kane A, Marella P, Gallegos G, Martin K, L'Hommedieu M, Chandler C, Diaz Roldan K, Villegas N, Moreno R, Eguchi M, Rodriguez R, Kemball R, Chan V, Chavez C, Wong A, Hall A, Briggs-Hagen M. Association of Initial SARS-CoV-2 Test Positivity With Patient-Reported Well-being 3 Months After a Symptomatic Illness. JAMA Network Open 2022, 5: e2244486. PMID: 36454572, PMCID: PMC9716377, DOI: 10.1001/jamanetworkopen.2022.44486.Peer-Reviewed Original ResearchConceptsCOVID-19 positive groupCOVID-19-negative groupSARS-CoV-2 infectionCOVID-19 testCOVID-19 resultsSymptomatic illnessSymptomatic SARS-CoV-2 infectionNegative COVID-19 resultsSARS-CoV-2 statusSARS-CoV-2 test positivityPositive COVID-19 testSARS-CoV-2 testNegative COVID-19 testLongitudinal registry studyOutcomes Measurement Information SystemPatient-reported outcomesHealth care usePositive COVID-19 resultMultivariable regression analysisMeasurement Information SystemCOVID-19 testingNegative test resultsCohort studyRegistry studyPROMIS scoresComparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices
Price M, Friedman D, Du C, Wang Y, Lin Z, Curtis J, Freeman J. Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices. JACC Cardiovascular Interventions 2022, 15: 2115-2123. PMID: 36357014, DOI: 10.1016/j.jcin.2022.09.002.Peer-Reviewed Original ResearchConceptsHospital major adverse eventsMajor adverse eventsWatchman FLXMajor vascular complicationsMajor bleedingPericardial effusionCardiac arrestDevice embolizationVascular complicationsMyocardial infarctionLower ratesSystemic arterial embolismComposite of deathTransient ischemic attackAtrial appendage occlusionSignificant lower rateBalance of risksHospital mortalityIschemic attackArterial embolismHospital outcomesPrimary endpointStroke preventionAdverse eventsProcedural complicationsUncoupling of all-cause excess mortality from COVID-19 cases in a highly vaccinated state
Faust JS, Renton B, Chen AJ, Du C, Liang C, Li SX, Lin Z, Krumholz HM. Uncoupling of all-cause excess mortality from COVID-19 cases in a highly vaccinated state. The Lancet Infectious Diseases 2022, 22: 1419-1420. PMID: 36007530, PMCID: PMC9395168, DOI: 10.1016/s1473-3099(22)00547-3.Peer-Reviewed Original Research
2021
Mortality From Drug Overdoses, Homicides, Unintentional Injuries, Motor Vehicle Crashes, and Suicides During the Pandemic, March-August 2020
Faust JS, Du C, Mayes KD, Li SX, Lin Z, Barnett ML, Krumholz HM. Mortality From Drug Overdoses, Homicides, Unintentional Injuries, Motor Vehicle Crashes, and Suicides During the Pandemic, March-August 2020. JAMA 2021, 326: 84-86. PMID: 34019096, PMCID: PMC8140390, DOI: 10.1001/jama.2021.8012.Peer-Reviewed Original ResearchTemporal relationship of computed and structured diagnoses in electronic health record data
Schulz WL, Young HP, Coppi A, Mortazavi BJ, Lin Z, Jean RA, Krumholz HM. Temporal relationship of computed and structured diagnoses in electronic health record data. BMC Medical Informatics And Decision Making 2021, 21: 61. PMID: 33596898, PMCID: PMC7890604, DOI: 10.1186/s12911-021-01416-x.Peer-Reviewed Original ResearchConceptsElectronic health recordsStructured diagnosisOutpatient blood pressureElectronic health record dataAcademic health systemLow-density lipoproteinHealth record dataBlood pressureStructured data elementsAdministrative claimsHypertensionClinical informationHyperlipidemiaClinical phenotypeEquivalent diagnosisVital signsHealth systemDiagnosisProblem listAdditional studiesHealth recordsRecord dataTimely accessEHR dataPatients