2024
Renalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19
Safdar B, Sobiesk M, Bertsimas D, Nowroozpoor A, Deng Y, D’Onofrio G, Dziura J, El-Khoury J, Guo X, Simonov M, Taylor R, Wang M, Desir G. Renalase Identified by Machine Learning Methods as A Novel Independent Predictor of Mortality in Hospitalized Patients with COVID-19. Journal Of Biotechnology And Biomedicine 2024, 07 DOI: 10.26502/jbb.2642-91280139.Peer-Reviewed Original Research“SafetyNet”: Evaluation of a Recovery Coach and Paramedic Intervention Following Naloxone Resuscitation From an Opioid Overdose
Joseph D, Brokowski C, D’Onofrio G, Bogucki S, McGovern J, Allen R, Dziura J, Cone D, Pantalon M. “SafetyNet”: Evaluation of a Recovery Coach and Paramedic Intervention Following Naloxone Resuscitation From an Opioid Overdose. Substance Use & Addiction Journal 2024, 46: 302-312. PMID: 39171791, DOI: 10.1177/29767342241266412.Peer-Reviewed Original ResearchOverdose eventsRecovery coachesOpioid overdoseFollow-up encountersReducing illicit drug useFifty-five participantsIllicit drug useParamedic interventionsTrained paramedicsPeer recoveryFollow-upHealth educationOpioid use disorderSample size estimationParamedicsOpioid-positive urine testsPositive urine toxicology screenMOUD engagementMedical concernsMOUDUrine toxicology screenDrug useParticipantsPositive urine testInterventionExtended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal
D’Onofrio G, Herring A, Perrone J, Hawk K, Samuels E, Cowan E, Anderson E, McCormack R, Huntley K, Owens P, Martel S, Schactman M, Lofwall M, Walsh S, Dziura J, Fiellin D. Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal. JAMA Network Open 2024, 7: e2420702. PMID: 38976265, PMCID: PMC11231806, DOI: 10.1001/jamanetworkopen.2024.20702.Peer-Reviewed Original ResearchConceptsClinical Opiate Withdrawal ScaleExtended-release buprenorphineOpioid use disorderPrecipitated withdrawalOpioid withdrawalOpioid use disorder treatmentCow scoreClinical Opiate Withdrawal Scale scoreAdverse eventsNonrandomized trialsSevere opioid use disorderDays of opioid useOpiate Withdrawal ScaleModerate to severe opioid use disorderFormulation of buprenorphineOpioid use disorder careWithdrawal ScaleUse disorderAssociated with medicationsNonprescribed opioidsPain scoresExtended-releaseInjection painOpioid useAdult patients
2022
User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial
Melnick ER, Nath B, Dziura JD, Casey MF, Jeffery MM, Paek H, Soares WE, Hoppe JA, Rajeevan H, Li F, Skains RM, Walter LA, Patel MD, Chari SV, Platts-Mills TF, Hess EP, D'Onofrio G. User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial. The BMJ 2022, 377: e069271. PMID: 35760423, PMCID: PMC9231533, DOI: 10.1136/bmj-2021-069271.Peer-Reviewed Original ResearchConceptsOpioid use disorderUsual care armEmergency departmentUse disordersCare armPragmatic clusterClinical decision supportIntervention armRoutine emergency careSecondary implementation outcomesSeverity of withdrawalTertiary care centerClinical decision support toolInitiation of buprenorphineElectronic health record tasksElectronic health record workflowsRE-AIM frameworkElectronic health record platformsHealth record platformsClinical decision support systemElectronic health recordsVisit documentationTreatment of addictionUsual careAdult patients
2021
High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder
Herring AA, Vosooghi AA, Luftig J, Anderson ES, Zhao X, Dziura J, Hawk KF, McCormack RP, Saxon A, D’Onofrio G. High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder. JAMA Network Open 2021, 4: e2117128. PMID: 34264326, PMCID: PMC8283555, DOI: 10.1001/jamanetworkopen.2021.17128.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentBuprenorphine inductionRespiratory depressionAdverse eventsUse disordersUntreated opioid use disorderSerious adverse eventsFurther prospective investigationLength of stayUrban emergency departmentSafety-net hospitalAdvanced practice practitionersElectronic health recordsUnique cliniciansSublingual buprenorphineBuprenorphine doseED visitsED encountersCase seriesED patientsED physiciansSupplemental oxygenMedian lengthUnique patientsThe design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation
D'Onofrio G, Hawk KF, Herring AA, Perrone J, Cowan E, McCormack RP, Dziura J, Taylor RA, Coupet E, Edelman EJ, Pantalon MV, Owens PH, Martel SH, O'Connor PG, Van Veldhuisen P, DeVogel N, Huntley K, Murphy SM, Lofwall MR, Walsh SL, Fiellin DA. The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation. Contemporary Clinical Trials 2021, 104: 106359. PMID: 33737199, PMCID: PMC9153252, DOI: 10.1016/j.cct.2021.106359.Peer-Reviewed Original ResearchConceptsOpioid use disorderRandomized clinical trialsPrimary outcomeFormal addiction treatmentOpioid withdrawalClinical trialsAncillary studiesUse disordersSelf-reported opioid useAddiction treatmentEmergency department initiationIncremental cost-effectiveness ratioReceipt of medicationEmergency department studyHealth service utilizationCost-effectiveness ratioOpioid useSecondary outcomesService utilizationTreatment accessEligibility criteriaImplementation facilitationBuprenorphineOverdose eventsDepartment studyVariations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospitalUse of peripheral arterial tonometry in detection of abnormal coronary flow reserve
Gaeta M, Nowroozpoor A, Dziura J, D'Onofrio G, Sinusas AJ, Safdar B. Use of peripheral arterial tonometry in detection of abnormal coronary flow reserve. Microvascular Research 2021, 138: 104223. PMID: 34256085, PMCID: PMC10227886, DOI: 10.1016/j.mvr.2021.104223.Peer-Reviewed Original ResearchConceptsLower coronary flow reserveCoronary flow reserveCoronary microvascular dysfunctionCoronary artery diseaseClinical screening toolPET/CTFlow reserveRubidium-82 positron emission tomography/Large vessel coronary artery diseaseNormal coronary flow reserveTraditional CAD risk factorsVessel coronary artery diseaseAbnormal coronary flow reservePositron emission tomography/Screening toolPeripheral arterial tonometryCAD risk factorsEmission tomography/Presence of calcificationLower RHIHyperemia indexArterial tonometryMicrovascular dysfunctionArtery diseaseAugmentation indexA Brief Negotiation Interview Adherence Scale for Smoking Cessation: A psychometric evaluation
Pantalon MV, Dziura J, Li FY, D'Onofrio G, Weiss J, Bernstein SL. A Brief Negotiation Interview Adherence Scale for Smoking Cessation: A psychometric evaluation. Journal Of Substance Use And Addiction Treatment 2021, 126: 108398. PMID: 34116807, DOI: 10.1016/j.jsat.2021.108398.Peer-Reviewed Original ResearchConceptsBrief Negotiation InterviewNicotine replacement therapySmoking cessationAdherence ScaleQuitline referralHigh-risk alcohol consumptionOpioid use disorderPsychometric propertiesReplacement therapyEmergency departmentExcellent internal consistencyTobacco abstinenceClinical trialsInter-rater reliabilityUse disordersAlcohol consumptionPsychometric evaluationCessationFactor 1Behavioral contractingDiscriminant validityFactor 2Independent ratersPredictive validityInternal consistency
2020
Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †
Melnick ER, Nath B, Ahmed OM, Brandt C, Chartash D, Dziura JD, Hess EP, Holland WC, Hoppe JA, Jeffery MM, Katsovich L, Li F, Lu CC, Maciejewski K, Maleska M, Mao JA, Martel S, Michael S, Paek H, Patel MD, Platts-Mills TF, Rajeevan H, Ray JM, Skains RM, Soares WE, Deutsch A, Solad Y, D’Onofrio G. Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †. Journal Of Psychiatry And Brain Science 2020, 2: e200003. PMID: 32309637, PMCID: PMC7164817, DOI: 10.20900/jpbs.20200003.Peer-Reviewed Original ResearchBuprenorphine/naloxoneOpioid use disorderClinical decision supportPragmatic trialElectronic health recordsUse disordersEmergency Department-Initiated BuprenorphineMulti-centre pragmatic trialRoutine emergency careHealthcare systemRates of EDNaloxone prescribingPilot testingSingle EDEmergency departmentPhysicians' perceptionsEmergency careMortality rateEarly identificationComputable phenotypeUnique physiciansInformed consentCare paradigmHealth recordsIntervention effectiveness
2018
Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, Reynolds HR, Geda M, Bueno H, Dziura JD, Krumholz HM, D'Onofrio G. Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e009174. PMID: 29954744, PMCID: PMC6064896, DOI: 10.1161/jaha.118.009174.Peer-Reviewed Original ResearchConceptsMI-CAD patientsNonobstructive coronary arteriesMI-CADYounger patientsClinical profileCoronary arteryMyocardial infarctionTraditional cardiac risk factorsAcute myocardial infarction patientsCardiac risk factorsGestational diabetes mellitusMyocardial infarction patientsTimes higher oddsMINOCA patientsSAQ qualityVIRGO StudyClinical characteristicsHypercoaguable stateDiabetes mellitusObstructive diseaseClinical outcomesInfarction patientsRisk factorsMINOCAPsychosocial statusPrevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Prevalence and characteristics of coronary microvascular dysfunction among chest pain patients in the emergency department. European Heart Journal Acute Cardiovascular Care 2018, 9: 5-13. PMID: 29543037, DOI: 10.1177/2048872618764418.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary artery diseaseCardiac positron emission tomography/Positron emission tomography/Chest pain patientsArtery diseaseAcute myocardial infarctionEmission tomography/Chest painMyocardial infarctionMicrovascular dysfunctionPain patientsEmergency departmentTomography/General emergency department populationLower coronary flow reserveNon-obstructive coronary arteriesPrior emergency department visitsTraditional cardiac risk factorsCardiac risk factorsModerate-risk patientsEmergency department visitsEmergency department patientsCoronary flow reserveEmergency department population
2025
Adaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial
Iscoe M, Hooper C, Levy D, Buchanan L, Dziura J, Meeker D, Taylor R, D’Onofrio G, Oladele C, Sarpong D, Paek H, Wilson F, Heagerty P, Delgado M, Hoppe J, Melnick E. Adaptive decision support for addiction treatment to implement initiation of buprenorphine for opioid use disorder in the emergency department: protocol for the ADAPT Multiphase Optimization Strategy trial. BMJ Open 2025, 15: e098072. PMID: 39979056, PMCID: PMC11842997, DOI: 10.1136/bmjopen-2024-098072.Peer-Reviewed Original ResearchConceptsClinical decision supportMultiphase optimization strategyOpioid use disorderEmergency departmentInitiation of buprenorphineClinical decision support usePlan-Do-Study-Act cyclesLearning health system approachPlan-Do-Study-ActClinical decision support toolHealth system approachAdaptive decision supportUse disorderDecision supportAddiction treatmentPeer-reviewed journalsBuprenorphine initiationOpioid use disorder treatment initiationOpioid-related mortalityIntervention componentsED settingClinician feedbackInstitute Institutional Review BoardTreatment of opioid use disorderParticipating sites
2019
User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial
Melnick ER, Jeffery MM, Dziura JD, Mao JA, Hess EP, Platts-Mills TF, Solad Y, Paek H, Martel S, Patel MD, Bankowski L, Lu C, Brandt C, D’Onofrio G. User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial. BMJ Open 2019, 9: e028488. PMID: 31152039, PMCID: PMC6550013, DOI: 10.1136/bmjopen-2018-028488.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCluster AnalysisDecision Support Systems, ClinicalEmergency Service, HospitalFemaleHumansMaleMiddle AgedMulticenter Studies as TopicNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicUnited StatesYoung AdultConceptsOpioid use disorderEmergency departmentSecondary outcomesUse disordersEmergency department-initiated buprenorphineWestern Institutional Review BoardData Safety Monitoring BoardIndependent study monitorsRates of cliniciansRoutine emergency careSafety monitoring boardInstitutional review boardClinical decision support systemClinician prescribingPragmatic clusterPatient characteristicsPeer-reviewed journalsClinical decision supportPrimary outcomeED cliniciansWithdrawal symptomsOngoing treatmentPatients' willingnessMonitoring boardBuprenorphine
2017
Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial
Safdar B, D’Onofrio G, Dziura J, Russell RR, Johnson C, Sinusas AJ. Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial. Clinical Therapeutics 2017, 39: 55-63. PMID: 28081848, PMCID: PMC10345862, DOI: 10.1016/j.clinthera.2016.12.002.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionCoronary flow reserveCoronary artery diseaseChest painSymptomatic patientsArtery diseasePrimary outcomeEmergency departmentNonobstructive coronary artery diseaseRb-82 positron emission tomographyEffect of ranolazineRate-pressure productEmergency department patientsQTc-prolonging drugsRobust clinical trialsPositron emission tomographyHypertensive urgencyMicrovascular anginaMicrovascular dysfunctionUnderdiagnosed causeControlled TrialsDepartment patientsHeart failureAcute symptomsPressure product
2014
Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients
Safdar B, Bezek SK, Sinusas AJ, Russell RR, Klein MR, Dziura JD, D’onofrio G. Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2014, 13: 14-19. PMID: 24526146, DOI: 10.1097/hpc.0000000000000001.Peer-Reviewed Original ResearchConceptsAdverse cardiac eventsCPU patientsNormal troponinAdverse eventsCardiac eventsMultiple logistic regression modelComposite adverse eventsElevated creatinine kinaseObservation unit patientsSerial troponin testingStandardized chart reviewRetrospective cohort studyAcute coronary syndromeNational Death RegistryCoronary artery diseaseLogistic regression modelsPositive troponinPrior CADRenal insufficientCoronary syndromeHemodynamic instabilityChart reviewCohort studyDeath RegistryIschemic electrocardiogram
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