2021
How Total Performance Scores of Medicare Value-Based Purchasing Program Hospitals Change Over Time
Ramirez A, Marsh K, McMurry T, Turrentine F, Tracci M, Jones R. How Total Performance Scores of Medicare Value-Based Purchasing Program Hospitals Change Over Time. Journal For Healthcare Quality 2021, 44: 78-87. PMID: 34469925, DOI: 10.1097/jhq.0000000000000321.Peer-Reviewed Original ResearchConceptsPhysician-owned surgical hospitalsTotal performance scoreAccountable care organizationsValue-based purchasingHospital typeCenters for MedicareMedicare Value-Based PurchasingGeneral HospitalPerformance scoresPerformance-based financial incentivesSurgical hospitalsDisproportionate share hospital paymentsLongitudinal linear mixed-effects modelsCase mix indexIndividual domain scoresCare organizationsMedicare daysLinear mixed-effects modelsHospital changesInpatient daysPatient dischargeDomain scoresHospital paymentsPatient satisfactionKaiser hospitals
2018
General Thoracic Surgery in Rwanda: An Assessment of Surgical Volume and of Workforce and Material Resource Deficits
Ramirez A, Nuradin N, Byiringiro F, Ntakiyiruta G, Giles A, Riviello R. General Thoracic Surgery in Rwanda: An Assessment of Surgical Volume and of Workforce and Material Resource Deficits. World Journal Of Surgery 2018, 43: 36-43. PMID: 30132227, PMCID: PMC6318006, DOI: 10.1007/s00268-018-4771-y.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnesthesiologyChildChild, PreschoolEquipment and Supplies, HospitalFemaleHealth WorkforceHospitals, PrivateHospitals, UniversityHumansInfantInfant, NewbornMaleMiddle AgedNeeds AssessmentRetrospective StudiesRwandaSimulation TrainingThoracic SurgeryThoracic Surgical ProceduresYoung AdultConceptsUniversity Teaching HospitalHuman Resources for Health (HRH) ProgramThoracic casesSurgical volumeSimulation trainingUniversity Teaching Hospital of KigaliUniversity Teaching Hospital of ButareWorld Health Organization formBaseline patient characteristicsOperative volumeRetrospective cohort studyGeneral surgery proceduresThoracic surgical careGeneral thoracic surgeryOperating room registriesHRH ProgramPearson chi-square testKing Faisal HospitalAddress barriersCapacity building programsChi-square testKruskal-Wallis testNeeds assessmentPatient accessReferral centerPreoperative Gastroesophageal Reflux Disorder Is Associated With Increased Morbidity in Patients Undergoing Abdominal Surgery
Tilak A, Ramirez A, Turrentine F, Sohn M, Jones R. Preoperative Gastroesophageal Reflux Disorder Is Associated With Increased Morbidity in Patients Undergoing Abdominal Surgery. Journal Of Surgical Research 2018, 232: 587-594. PMID: 30463778, PMCID: PMC6251493, DOI: 10.1016/j.jss.2018.07.051.Peer-Reviewed Original ResearchConceptsGastroesophageal reflux disorderPostoperative complication rateEsophageal diseaseReflux disorderComplication rateAbdominal operationsProcedure groupAmerican College of Surgeons National Surgical Quality Improvement ProgramSurgeons National Surgical Quality Improvement ProgramAbdominal aortic aneurysm repairNational Surgical Quality Improvement ProgramAssociated with increased postoperative complication ratesAssociated with increased morbiditySurgical Quality Improvement ProgramIntra-abdominal casesAortic aneurysm repairIntra-abdominal proceduresRisk of morbidityMultivariate logistic regressionVentral hernia repairAortoiliac repairQuality Improvement ProgramAneurysm repairEsophageal strictureWound complications
2016
Clinical efficacy of 2-phase versus 4-phase computed tomography for localization in primary hyperparathyroidism
Ramirez A, Shada A, Martin A, Raghavan P, Durst C, Mukherjee S, Gaughen J, Ornan D, Hanks J, Smith P. Clinical efficacy of 2-phase versus 4-phase computed tomography for localization in primary hyperparathyroidism. Surgery 2016, 160: 731-737. PMID: 27302106, PMCID: PMC4975639, DOI: 10.1016/j.surg.2016.04.016.Peer-Reviewed Original ResearchConceptsPositive predictive valueFour-dimensional computed tomographyComputed tomography protocolComputed tomographyMultiglandular diseaseParathyroid localizationOperative findingsPredictive valueFour-phase computed tomographyLocalization of abnormal glandsRadiation doseTechnical surgical successEffective radiation doseFisher's exact testTomography protocolAbnormal glandsPrimary hyperparathyroidismSurgical successReoperative casesParathyroid weightSurgical outcomesTechnical successClinical efficacyOperative treatmentClinical outcomes
2015
Defining the effects of age and gender on immune response and outcomes to melanoma vaccination: a retrospective analysis of a single-institution clinical trials’ experience
Ramirez A, Wages N, Hu Y, Smolkin M, Slingluff C. Defining the effects of age and gender on immune response and outcomes to melanoma vaccination: a retrospective analysis of a single-institution clinical trials’ experience. Cancer Immunology, Immunotherapy 2015, 64: 1531-1539. PMID: 26392296, PMCID: PMC4644444, DOI: 10.1007/s00262-015-1758-5.Peer-Reviewed Original ResearchConceptsDisease-free survivalT cell responsesOverall survivalImmune responseOlder patientsCancer vaccinesClinical outcomesResected stage IIB-IV melanomaCD8+ T cell responsesStage IIB-IV melanomaLonger disease-free survivalImpact of patient ageMelanoma-associated peptidesCancer vaccine trialsClinical trial experienceIncidence of IRCumulative incidence rateKaplan-Meier estimatesClass I MHCMelanoma vaccineMenopausal statusPatient ageSurvival outcomesStratify patientsFemale patients