2024
Association of deployment characteristics and exposures with persistent ill health among 1990-1991 Gulf War veterans in the VA Million Veteran Program
Steele L, Quaden R, Ahmed S, Harrington K, Duong L, Ko J, Gifford E, Polimanti R, Gaziano J, Aslan M, Helmer D, Hauser E. Association of deployment characteristics and exposures with persistent ill health among 1990-1991 Gulf War veterans in the VA Million Veteran Program. Environmental Health 2024, 23: 92. PMID: 39456027, PMCID: PMC11520114, DOI: 10.1186/s12940-024-01118-7.Peer-Reviewed Original ResearchConceptsMillion Veteran ProgramVA Million Veteran ProgramGulf War veteransIll healthHealth outcomesGulf War IllnessVeteran ProgramMilitary characteristicsWar veteransChronic ill healthCenters for Disease Control and Prevention criteriaGulf War serviceEvaluation of genetic factorsGulf War exposureVeterans' healthPopulation of U.S.Pyridostigmine bromide pillsHealthcare providersWartime exposuresGulf War deploymentResultsThe final cohortVeteran cohortDeployment exposuresHealth problemsVeteransDevelopment of a prediction model for 30-day COVID-19 hospitalization and death in a national cohort of Veterans Health Administration patients–March 2022—April 2023
Bui D, Bajema K, Huang Y, Yan L, Li Y, Rajeevan N, Berry K, Rowneki M, Argraves S, Hynes D, Huang G, Aslan M, Ioannou G. Development of a prediction model for 30-day COVID-19 hospitalization and death in a national cohort of Veterans Health Administration patients–March 2022—April 2023. PLOS ONE 2024, 19: e0307235. PMID: 39365775, PMCID: PMC11451987, DOI: 10.1371/journal.pone.0307235.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCOVID-19 hospitalizationArea under the receiver operating characteristic curveComprehensive electronic health recordNational cohortElectronic health recordsAll-cause mortalityNational cohort of patientsFull modelHealth recordsHealth AdministrationReceipt of COVID-19 vaccineMortality riskEpidemiology of COVID-19COVID-19High-risk patientsBrier scoreCohort of patientsAnti-SARS-CoV-2 treatmentCOVID-19 vaccineReceiver operating characteristic curveCalibration interceptHospitalAntiviral treatmentAvailability of effective vaccinesPredicting clinical outcomes of SARS-CoV-2 infection during the Omicron wave using machine learning
Cogill S, Nallamshetty S, Fullenkamp N, Heberer K, Lynch J, Lee K, Aslan M, Shih M, Lee J. Predicting clinical outcomes of SARS-CoV-2 infection during the Omicron wave using machine learning. PLOS ONE 2024, 19: e0290221. PMID: 38662748, PMCID: PMC11045098, DOI: 10.1371/journal.pone.0290221.Peer-Reviewed Original ResearchConceptsHigh-risk groupSARS-CoV-2 infectionAnticoagulant useAdverse outcomesPredictor of adverse outcomesHigher risk of adverse outcomesLower body mass indexRisk of adverse outcomesVaccination of high-risk groupsOral anticoagulant useOutcome of SARS-CoV-2 infectionRetrospective longitudinal observational studySARS-CoV-2U.S. Veterans Health AdministrationClinical outcomes of SARS-CoV-2 infectionIdentification of patientsBody mass indexVeterans Health AdministrationPredictors of hospitalizationEscalation of careLongitudinal observational studyClinical outcomesOmicron SARS-CoV-2 variantSARS-CoV-2 variantsUnvaccinated patients
2023
Metformin prescription for U.S. veterans with prediabetes, 2010–2019
Gulanski B, Goulet J, Radhakrishnan K, Ko J, Li Y, Rajeevan N, Lee K, Heberer K, Lynch J, Streja E, Mutalik P, Cheung K, Concato J, Shih M, Lee J, Aslan M. Metformin prescription for U.S. veterans with prediabetes, 2010–2019. Journal Of Investigative Medicine 2023, 72: 139-150. PMID: 37668313, DOI: 10.1177/10815589231201141.Peer-Reviewed Original ResearchConceptsBody mass indexVeterans Health AdministrationIncident prediabetesHigh riskHealth AdministrationRetrospective observational cohort studyType 2 diabetes mellitusUse of metforminObservational cohort studyProportion of veteransMetformin prescribingGestational diabetesCohort studyMetformin prescriptionDiabetes mellitusDiabetes preventionMass indexCardiovascular diseaseMultivariable modelPrediabetesSubset of individualsMetforminU.S. veteransHealthcare systemVeteransEffectiveness of Nirmatrelvir-Ritonavir Against the Development of Post-COVID-19 Conditions Among U.S. Veterans : A Target Trial Emulation.
Ioannou G, Berry K, Rajeevan N, Li Y, Mutalik P, Yan L, Bui D, Cunningham F, Hynes D, Rowneki M, Bohnert A, Boyko E, Iwashyna T, Maciejewski M, Osborne T, Viglianti E, Aslan M, Huang G, Bajema K. Effectiveness of Nirmatrelvir-Ritonavir Against the Development of Post-COVID-19 Conditions Among U.S. Veterans : A Target Trial Emulation. Annals Of Internal Medicine 2023, 176: 1486-1497. PMID: 37903369, PMCID: PMC10620954, DOI: 10.7326/m23-1394.Peer-Reviewed Original ResearchConceptsAcute COVID-19Veterans Health AdministrationUntreated comparatorsThromboembolic eventsCOVID-19Severe COVID-19Target trial emulationSARS-CoV-2Post COVID-19 conditionIndex dateVenous thromboembolismBaseline characteristicsCumulative incidencePulmonary embolismAcute infectionMedian ageOral antiviralsTrial emulationVHA careOutpatient treatmentInternational ClassificationHealth AdministrationU.S. veteransVeterans AffairsOrgan systemsAnti–SARS-CoV-2 Pharmacotherapies Among Nonhospitalized US Veterans, January 2022 to January 2023
Yan L, Streja E, Li Y, Rajeevan N, Rowneki M, Berry K, Hynes D, Cunningham F, Huang G, Aslan M, Ioannou G, Bajema K. Anti–SARS-CoV-2 Pharmacotherapies Among Nonhospitalized US Veterans, January 2022 to January 2023. JAMA Network Open 2023, 6: e2331249. PMID: 37651140, PMCID: PMC10472184, DOI: 10.1001/jamanetworkopen.2023.31249.Peer-Reviewed Original ResearchConceptsCOVID-19 pharmacotherapyVeterans Health AdministrationVeterans Integrated Service NetworkSARS-CoV-2Higher Charlson Comorbidity Index scoresCharlson Comorbidity Index scoreNon-Hispanic veteransComorbidity Index scoreProportion of patientsSymptomatic COVID-19Multivariable logistic regressionCOVID-19 vaccinationCohort studyMedicare databaseVHA careUS veteransMAIN OUTCOMEMedical conditionsHispanic veteransPharmacotherapyHealth AdministrationIndex scoreCommunity careNonhospitalized personsWhite veteransEffectiveness of COVID-19 Treatment With Nirmatrelvir–Ritonavir or Molnupiravir Among U.S. Veterans: Target Trial Emulation Studies With One-Month and Six-Month Outcomes
Bajema K, Berry K, Streja E, Rajeevan N, Li Y, Mutalik P, Yan L, Cunningham F, Hynes D, Rowneki M, Bohnert A, Boyko E, Iwashyna T, Maciejewski M, Osborne T, Viglianti E, Aslan M, Huang G, Ioannou G. Effectiveness of COVID-19 Treatment With Nirmatrelvir–Ritonavir or Molnupiravir Among U.S. Veterans: Target Trial Emulation Studies With One-Month and Six-Month Outcomes. Annals Of Internal Medicine 2023, 176: m22-3565. PMID: 37276589, PMCID: PMC10243488, DOI: 10.7326/m22-3565.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCOVID-19 symptom onsetCOVID-19-related outcomesSevere COVID-19Six-month outcomesCOVID-19 vaccinationCOVID-19 treatmentCOVID-19SARS-CoV-2Percent of participantsUntreated control participantsCause mortalitySymptom onsetMedian ageOral antiviralsVHA careOutpatient treatmentHospitalizationHealth AdministrationDay 31U.S. veteransVariant transmissionMost veteransVeterans AffairsOne monthModeling the longitudinal changes of ancestry diversity in the Million Veteran Program
Wendt F, Pathak G, Vahey J, Qin X, Koller D, Cabrera-Mendoza B, Haeny A, Harrington K, Rajeevan N, Duong L, Levey D, De Angelis F, De Lillo A, Bigdeli T, Pyarajan S, Gaziano J, Gelernter J, Aslan M, Provenzale D, Helmer D, Hauser E, Polimanti R. Modeling the longitudinal changes of ancestry diversity in the Million Veteran Program. Human Genomics 2023, 17: 46. PMID: 37268996, PMCID: PMC10239111, DOI: 10.1186/s40246-023-00487-3.Peer-Reviewed Original Research
2022
Association of Gulf War Illness with Characteristics in Deployed vs. Non-Deployed Gulf War Era Veterans in the Cooperative Studies Program 2006/Million Veteran Program 029 Cohort: A Cross-Sectional Analysis
Duong L, Djotsa A, Vahey J, Steele L, Quaden R, Harrington K, Ahmed S, Polimanti R, Streja E, Gaziano J, Concato J, Zhao H, Radhakrishnan K, Hauser E, Helmer D, Aslan M, Gifford E. Association of Gulf War Illness with Characteristics in Deployed vs. Non-Deployed Gulf War Era Veterans in the Cooperative Studies Program 2006/Million Veteran Program 029 Cohort: A Cross-Sectional Analysis. International Journal Of Environmental Research And Public Health 2022, 20: 258. PMID: 36612580, PMCID: PMC9819371, DOI: 10.3390/ijerph20010258.Peer-Reviewed Original ResearchConceptsGulf War IllnessGulf War Era VeteransChronic multisymptom illnessStudy inclusion criteriaCross-sectional analysisGW theaterGW veteransMultisymptom illnessEligible participantsUncertain etiologyInclusion criteriaKS symptomsDisease controlIllnessEra veteransMilitary characteristicsVeteransCohortPersistent presencePhenotypeFurther explorationPathophysiologyEtiologySymptomsPrevalenceEarly Adoption of Anti–SARS-CoV-2 Pharmacotherapies Among US Veterans With Mild to Moderate COVID-19, January and February 2022
Bajema K, Wang X, Hynes D, Rowneki M, Hickok A, Cunningham F, Bohnert A, Boyko E, Iwashyna T, Maciejewski M, Viglianti E, Streja E, Yan L, Aslan M, Huang G, Ioannou G. Early Adoption of Anti–SARS-CoV-2 Pharmacotherapies Among US Veterans With Mild to Moderate COVID-19, January and February 2022. JAMA Network Open 2022, 5: e2241434. PMID: 36367727, PMCID: PMC9652752, DOI: 10.1001/jamanetworkopen.2022.41434.Peer-Reviewed Original ResearchConceptsCOVID-19 pharmacotherapySevere COVID-19SARS-CoV-2Health care systemCohort studyRisk factorsCare systemMedical conditionsCOVID-19Positive SARS-CoV-2 testVeterans Affairs Health Care SystemCOVID-19-related hospitalizationCOVID-19-related symptomsLarge integrated health care systemSARS-CoV-2 testVA health care systemIntegrated health care systemNon-Hispanic veteransModerate COVID-19Odds of receiptMultivariable logistic regressionCOVID-19 vaccinationMedical comorbiditiesMedian ageAnti-SARS
2021
Bi-ancestral depression GWAS in the Million Veteran Program and meta-analysis in >1.2 million individuals highlight new therapeutic directions
Levey DF, Stein MB, Wendt FR, Pathak GA, Zhou H, Aslan M, Quaden R, Harrington KM, Nuñez YZ, Overstreet C, Radhakrishnan K, Sanacora G, McIntosh AM, Shi J, Shringarpure SS, Concato J, Polimanti R, Gelernter J. Bi-ancestral depression GWAS in the Million Veteran Program and meta-analysis in >1.2 million individuals highlight new therapeutic directions. Nature Neuroscience 2021, 24: 954-963. PMID: 34045744, PMCID: PMC8404304, DOI: 10.1038/s41593-021-00860-2.Peer-Reviewed Original ResearchConceptsTranscriptome-wide association studyMillion Veteran ProgramTranscriptome-wide association study (TWAS) analysisGenomic risk lociComplex psychiatric traitsGenetic architectureRisk lociGene expressionAssociation studiesLikely pathogenicityPsychiatric traitsVeteran ProgramNew therapeutic directionEuropean ancestryNew insightsAncestryUK BiobankAfrican ancestrySubstantial replicationExpressionLarge independent cohortsGWASTherapeutic directionsGenesLociGenome-wide association analyses of post-traumatic stress disorder and its symptom subdomains in the Million Veteran Program
Stein MB, Levey DF, Cheng Z, Wendt FR, Harrington K, Pathak GA, Cho K, Quaden R, Radhakrishnan K, Girgenti MJ, Ho YA, Posner D, Aslan M, Duman RS, Zhao H, Polimanti R, Concato J, Gelernter J. Genome-wide association analyses of post-traumatic stress disorder and its symptom subdomains in the Million Veteran Program. Nature Genetics 2021, 53: 174-184. PMID: 33510476, PMCID: PMC7972521, DOI: 10.1038/s41588-020-00767-x.Peer-Reviewed Original ResearchConceptsGenome-wide association analysisAssociation analysisMillion Veteran ProgramGenomic structural equation modelingSignificant lociGenetic varianceGene expressionDrug repositioning candidatesBiological coherenceVeteran ProgramMultiple testing correctionSymptom phenotypeLociRepositioning candidatesAfrican ancestryHeritabilityPhenotypeAncestryExpressionPTSD symptom factorsRegionSubdomainsEnrichment
2020
Reproducible Genetic Risk Loci for Anxiety: Results From ∼200,000 Participants in the Million Veteran Program
Levey DF, Gelernter J, Polimanti R, Zhou H, Cheng Z, Aslan M, Quaden R, Concato J, Radhakrishnan K, Bryois J, Sullivan PF, Stein M. Reproducible Genetic Risk Loci for Anxiety: Results From ∼200,000 Participants in the Million Veteran Program. American Journal Of Psychiatry 2020, 177: 223-232. PMID: 31906708, PMCID: PMC7869502, DOI: 10.1176/appi.ajp.2019.19030256.Peer-Reviewed Original ResearchConceptsNovel genome-wide significant associationsGene expressionGenome-wide significant signalsGenome-wide significant associationMillion Veteran ProgramWide association studyGenetic risk lociSignificant genetic correlationsGenetic risk mechanismsGenetic architectureGlobal regulatorChromosome 3Risk lociChromosome 6Chromosome 7Association studiesLargest GWASLarge biobanksGlobal regulationGenetic correlationsContinuous traitsVeteran ProgramGWASsLociPrevious GWASs
2019
Genome-wide association study of post-traumatic stress disorder reexperiencing symptoms in >165,000 US veterans
Gelernter J, Sun N, Polimanti R, Pietrzak R, Levey DF, Bryois J, Lu Q, Hu Y, Li B, Radhakrishnan K, Aslan M, Cheung KH, Li Y, Rajeevan N, Sayward F, Harrington K, Chen Q, Cho K, Pyarajan S, Sullivan PF, Quaden R, Shi Y, Hunter-Zinck H, Gaziano JM, Concato J, Zhao H, Stein MB. Genome-wide association study of post-traumatic stress disorder reexperiencing symptoms in >165,000 US veterans. Nature Neuroscience 2019, 22: 1394-1401. PMID: 31358989, PMCID: PMC6953633, DOI: 10.1038/s41593-019-0447-7.Peer-Reviewed Original ResearchConceptsGenome-wide association studiesAssociation studiesHigh linkage disequilibrium regionLinkage disequilibrium regionWide association studyDisequilibrium regionBioinformatics analysisTranscriptomic profilesMillion Veteran ProgramChromosome 17Genetic risk factorsNew insightsUK Biobank dataReexperiencing of traumaStriatal medium spiny neuronsVeteran ProgramSignificant regionsCAMKVEuropean AmericansBiobank dataMedium spiny neuronsTCF4BiologyKANSL1African American cohortGenome-wide Association Study of Maximum Habitual Alcohol Intake in >140,000 U.S. European and African American Veterans Yields Novel Risk Loci
Gelernter J, Sun N, Polimanti R, Pietrzak RH, Levey DF, Lu Q, Hu Y, Li B, Radhakrishnan K, Aslan M, Cheung KH, Li Y, Rajeevan N, Sayward F, Harrington K, Chen Q, Cho K, Honerlaw J, Pyarajan S, Lencz T, Quaden R, Shi Y, Hunter-Zinck H, Gaziano JM, Kranzler HR, Concato J, Zhao H, Stein MB, Program D, Program M. Genome-wide Association Study of Maximum Habitual Alcohol Intake in >140,000 U.S. European and African American Veterans Yields Novel Risk Loci. Biological Psychiatry 2019, 86: 365-376. PMID: 31151762, PMCID: PMC6919570, DOI: 10.1016/j.biopsych.2019.03.984.Peer-Reviewed Original ResearchConceptsAdditional genome-wide significant lociRisk lociWide association study (GWAS) analysisAssociation studiesGenome-wide significant lociGenome-wide association studiesGenetic correlationsWide association studyNovel risk lociAlcohol-related traitsStrong statistical supportSmoking-related traitsAdditional genomesSignificant lociPancreatic delta cellsChromosome 4Chromosome 11Protein productsChromosome 8Quantitative phenotypesMillion Veteran ProgramVeterans Affairs Million Veteran ProgramLociCell typesChromosome 17
2005
Validity of Using an Electronic Medical Record for Assessing Quality of Care in an Outpatient Setting
Benin AL, Vitkauskas G, Thornquist E, Shapiro ED, Concato J, Aslan M, Krumholz HM. Validity of Using an Electronic Medical Record for Assessing Quality of Care in an Outpatient Setting. Medical Care 2005, 43: 691-698. PMID: 15970784, DOI: 10.1097/01.mlr.0000167185.26058.8e.Peer-Reviewed Original ResearchConceptsElectronic medical recordsManagement of pharyngitisMedical recordsHealth Plan Employer DataDiagnostic testsEpisode of pharyngitisOutpatient electronic medical recordsProportion of episodesDiagnosis of pharyngitisOutpatient settingTotal episodesPharyngitisEmployer DataElectronic databasesDiagnostic testingClinical encountersMeasures of qualityEpisodesComplete evaluationCareAssessing QualityPediatricsYearsProportionDiagnosis
2004
Childhood maltreatment as a risk factor for adult cardiovascular disease and depression.
Batten SV, Aslan M, Maciejewski PK, Mazure CM. Childhood maltreatment as a risk factor for adult cardiovascular disease and depression. The Journal Of Clinical Psychiatry 2004, 65: 249-54. PMID: 15003081, DOI: 10.4088/jcp.v65n0217.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseRisk factorsChildhood maltreatmentAdult depressionMultiple logistic regression modelAdult cardiovascular diseasePotent risk factorEffective clinical assessmentNational Comorbidity SurveySignificant increaseU.S. National Comorbidity SurveyLogistic regression modelsSex differencesCardiovascular eventsRepresentative sampleClinical assessmentLifetime depressionDiseaseAdult HealthPhysical outcomesWomenDepressionChildhood abuseMenDemographic factors