2024
Prescription Medication Use Among Older Adults in the US
Innes G, Ogden C, Crentsil V, Concato J, Fakhouri T. Prescription Medication Use Among Older Adults in the US. JAMA Internal Medicine 2024, 184: 1121-1123. PMID: 38949837, PMCID: PMC11217884, DOI: 10.1001/jamainternmed.2024.2781.Peer-Reviewed Original Research
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 systemVeteransEvaluating and improving real-world evidence with Targeted Learning
Gruber S, Phillips R, Lee H, Concato J, van der Laan M. Evaluating and improving real-world evidence with Targeted Learning. BMC Medical Research Methodology 2023, 23: 178. PMID: 37533017, PMCID: PMC10394864, DOI: 10.1186/s12874-023-01998-2.Peer-Reviewed Original Research
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 directionsGenesLoci
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 alcohol consumption and use disorder in 274,424 individuals from multiple populations
Kranzler HR, Zhou H, Kember RL, Vickers Smith R, Justice AC, Damrauer S, Tsao PS, Klarin D, Baras A, Reid J, Overton J, Rader DJ, Cheng Z, Tate JP, Becker WC, Concato J, Xu K, Polimanti R, Zhao H, Gelernter J. Genome-wide association study of alcohol consumption and use disorder in 274,424 individuals from multiple populations. Nature Communications 2019, 10: 1499. PMID: 30940813, PMCID: PMC6445072, DOI: 10.1038/s41467-019-09480-8.Peer-Reviewed Original ResearchConceptsGenome-wide association studiesAssociation studiesMillion Veteran Program sampleGenetic correlationsWide significant lociSignificant genetic correlationsPolygenic risk scoresCell type groupSignificant lociHeritable traitEnrichment analysisTraitsMultiple populationsLociPhenotypeProgram samples
2015
Million Veteran Program: A mega-biobank to study genetic influences on health and disease
Gaziano JM, Concato J, Brophy M, Fiore L, Pyarajan S, Breeling J, Whitbourne S, Deen J, Shannon C, Humphries D, Guarino P, Aslan M, Anderson D, LaFleur R, Hammond T, Schaa K, Moser J, Huang G, Muralidhar S, Przygodzki R, O'Leary TJ. Million Veteran Program: A mega-biobank to study genetic influences on health and disease. Journal Of Clinical Epidemiology 2015, 70: 214-223. PMID: 26441289, DOI: 10.1016/j.jclinepi.2015.09.016.Peer-Reviewed Original ResearchConceptsMillion Veteran ProgramVeterans Affairs Health Care SystemObservational cohort studyVA electronic health recordVeteran ProgramHealth care deliverySelf-reported raceHealth care systemElectronic health recordsCohort studyAfrican American populationBlood samplesPeer-reviewed research studiesCare deliveryClinical decisionGenetic testingStudy designRecruiting sitesCare systemHealth recordsMost participantsPrecision medicineGenetic influencesAmerican populationParticipants
2007
Gender and non‐medical use of prescription opioids: results from a national US survey*
Tetrault JM, Desai RA, Becker WC, Fiellin DA, Concato J, Sullivan LE. Gender and non‐medical use of prescription opioids: results from a national US survey*. Addiction 2007, 103: 258-268. PMID: 18042194, DOI: 10.1111/j.1360-0443.2007.02056.x.Peer-Reviewed Original ResearchConceptsPast-year non-medical useNon-medical usePrescription opioidsDrug useSedative/tranquilizer useIllicit drug use disordersAlcohol abuse/dependenceDrug use disordersSerious mental illnessAbuse/dependenceIllicit drug useIllicit substance useSelf-reported alcoholGender-specific factorsCigarette smokingPrescription medicationsRisk factorsOpioidsUse disordersTranquilizer useGender-related factorsMental illnessUS residenceGreater riskSubstance use
2005
Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice
Dorsey KB, Wells C, Krumholz HM, Concato J. Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice. JAMA Pediatrics 2005, 159: 632-638. PMID: 15996996, DOI: 10.1001/archpedi.159.7.632.Peer-Reviewed Original ResearchConceptsBody mass indexRisk of overweightHospital-based clinicsHealth maintenance visitsRate of diagnosisType of treatmentComorbid diseasesMass indexOverweight childrenChildhood obesityMedical recordsTreatment recommendationsHigh burdenPediatric practiceRoutine screeningOverweightClinical practiceMaintenance visitsDiagnosisEncounter notesFormal diagnosisTreatmentChildrenSingle-parent householdsRisk
2003
Hyperglycaemia in patients with acute ischaemic stroke: how often do we screen for undiagnosed diabetes?
Bravata D, Kim N, Concato J, Brass L. Hyperglycaemia in patients with acute ischaemic stroke: how often do we screen for undiagnosed diabetes? QJM 2003, 96: 491-497. PMID: 12881591, DOI: 10.1093/qjmed/hcg087.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeStroke patientsIschemic strokeUndiagnosed diabetesAcute ischemic stroke patientsOral glucose tolerance testingRetrospective medical record reviewPrevalence of hyperglycaemiaAcute stroke patientsAssociation of diabetesIschemic stroke patientsAcute stroke eventsGlucose tolerance testingMedical record reviewModifiable conditionsDiabetes mellitusHemoglobin A1cHyperglycaemic patientsStroke eventsPrior diagnosisRecord reviewPrevious diagnosisClinicians screenConnecticut hospitalsTolerance testing
2001
Risk adjustment for older hospitalized persons A comparison of two methods of data collection for the Charlson index
van Doorn C, Bogardus S, Williams C, Concato J, Towle V, Inouye S. Risk adjustment for older hospitalized persons A comparison of two methods of data collection for the Charlson index. Journal Of Clinical Epidemiology 2001, 54: 694-701. PMID: 11438410, DOI: 10.1016/s0895-4356(00)00367-x.Peer-Reviewed Original ResearchConceptsICD-9 dataCharlson indexMortality predictionComorbid conditionsOlder general medical patientsYale-New Haven HospitalRisk adjustmentOriginal Charlson indexSpecific comorbid conditionsGeneral medical patientsGeneral medicine wardsHospital admission dateCharlson scoreIndividual comorbiditiesConsecutive patientsMedicine wardsClinical evidenceMedical patientsAdmission dateChart-based dataMortality riskICD-9PatientsChart dataLow agreementInjury related infant death: the impact of race and birth weight
Jain A, Khoshnood B, Lee K, Concato J. Injury related infant death: the impact of race and birth weight. Injury Prevention 2001, 7: 135. PMID: 11428561, PMCID: PMC1730711, DOI: 10.1136/ip.7.2.135.Peer-Reviewed Original ResearchConceptsLow birthweight babiesBirth weightUnintentional injuriesRisk factorsOdds ratioSociodemographic factorsBirthweight babiesRisk of homicideInfant deathHigh riskImportant independent risk factorEffect of raceAfrican AmericansIndependent risk factorPreventable risk factorsAdjusted odds ratioRisk of deathMexican-American infantsLast pregnancyAlcohol intakePrenatal careMaternal ageMaternal raceInfant injuriesInfant's birthPreference for disclosure of information among patients with rheumatoid arthritis
Fraenkel L, Bogardus S, Concato J, Felson D. Preference for disclosure of information among patients with rheumatoid arthritis. Arthritis & Rheumatism 2001, 45: 136-139. PMID: 11324776, DOI: 10.1002/1529-0131(200104)45:2<136::aid-anr165>3.0.co;2-p.Peer-Reviewed Original ResearchConceptsRheumatoid arthritisRA patientsSex-specific analysesSex-specific correlatesInformation preferencesPatient characteristicsTherapeutic optionsFemale sexSide effectsPatientsBivariate analysisHigher education levelCurrent employmentArthritisMean scoreEducation levelAlternative optionRiskFull disclosureOptionsMultiple linear regressionLinear regressionStepwise multiple linear regressionMedicationsRheumatologists
2000
Randomized, Controlled Trials, Observational Studies, and the Hierarchy of Research Designs
Concato J, Shah N, Horwitz R. Randomized, Controlled Trials, Observational Studies, and the Hierarchy of Research Designs. New England Journal Of Medicine 2000, 342: 1887-1892. PMID: 10861325, PMCID: PMC1557642, DOI: 10.1056/nejm200006223422507.Peer-Reviewed Original ResearchConceptsCase-control studyObservational studyBacille Calmette-Guérin (BCG) vaccineCalmette-Guérin vaccineRandomized clinical trialsClinical topicsIndividual observational studiesEffect of vaccinationEffect of treatmentMEDLINE data baseActive tuberculosisControlled TrialsPercent confidence intervalsClinical trialsOdds ratioRelative riskSummary estimatesMajor medical journalsSame interventionTrialsResearch designConfidence intervalsHigh gradeTreatment effectsOriginal reportBeyond Diagnosis: Patient Mix and Challenges to Patient Care in Ambulatory Training Sites
Fiellin D, Concato J. Beyond Diagnosis: Patient Mix and Challenges to Patient Care in Ambulatory Training Sites. The American Journal Of The Medical Sciences 2000, 319: 106. PMID: 10698095, DOI: 10.1097/00000441-200002000-00007.Peer-Reviewed Original ResearchConceptsPrimary care centersAmbulatory training sitesPatient mixPatient-physician communicationVA Medical CenterCommon medical diagnosesInternal medicine residentsVA subjectsComorbidity scoreCare centerMedical CenterHealth statusPatient carePatient spectrumAmbulatory trainingPatientsMedicine residentsDiagnosisGroup practiceAmbulatory medicineCareTraining sitesMedical decisionsVA
1999
Differences in Cervical Cancer Mortality Among Black and White Women
HOWELL E, CHEN Y, CONCATO J. Differences in Cervical Cancer Mortality Among Black and White Women. Obstetrics And Gynecology 1999, 94: 509-515. DOI: 10.1097/00006250-199910000-00005.Peer-Reviewed Original ResearchConceptsStage of diseaseHazard ratioWhite womenFIGO stageTreatment patternsBlack womenAdjusted hazard ratioUnadjusted hazard ratioCervical cancer survivalLymph node statusCervical cancer mortalityEnd Results ProgramRacial differencesAdvanced diseaseObstetrics stageIndependent predictorsTumor characteristicsCervical cancerNode statusResults ProgramCancer mortalityCancer survivalClinical severityRadiation therapyMortality differences
1998
Physician Awareness of Alcohol Use Disorders Among Older Patients
Reid M, Tinetti M, Brown C, Concato J. Physician Awareness of Alcohol Use Disorders Among Older Patients. Journal Of General Internal Medicine 1998, 13: 729-734. PMID: 9824517, PMCID: PMC1497030, DOI: 10.1046/j.1525-1497.1998.00223.x.Peer-Reviewed Original ResearchConceptsAlcohol use disorderOlder patientsPrimary care physiciansInternal medicine physiciansCare physiciansPhysician awarenessMedicine physiciansUse disordersPrevalence estimatesPrimary care physicians' awarenessAnnual screening ratesQuantity-frequency questionsCross-sectional telephone surveyFamily practice physiciansGroup of physiciansCAGE questionsScreening ratesRegular screeningMiddle-aged physiciansPrevalence ratesPractice physiciansPhysician educationPatientsOlder physiciansBiochemical markersPrognostic Staging System for Recurrent, Persistent, and Second Primary Cancers of the Oral Cavity and Oropharynx
Yueh B, Feinstein A, Weaver E, Sasaki C, Concato J. Prognostic Staging System for Recurrent, Persistent, and Second Primary Cancers of the Oral Cavity and Oropharynx. JAMA Otolaryngology - Head & Neck Surgery 1998, 124: 975-981. PMID: 9738805, DOI: 10.1001/archotol.124.9.975.Peer-Reviewed Original ResearchConceptsStaging systemOral cavityRecurrent tumorsTNM stageWeight lossMajor prognostic importanceOne-year mortalityMortality of patientsSecond primary cancerSecond primary tumorsEvidence of recurrentPrognostic staging systemMedian survival timeSquamous cell tumorsAcademic medical centerComposite staging systemPractical staging systemTNM statusInception cohortMultivariable analysisOropharyngeal mucosaPrimary cancerRecurrent headMuscle invasionPrognostic importance
1997
Screening for Skin Cancer in Primary Care Settings
Federman D, Concato J, Caralis P, Hunkele G, Kirsner R. Screening for Skin Cancer in Primary Care Settings. JAMA Dermatology 1997, 133: 1423-1425. PMID: 9371027, DOI: 10.1001/archderm.1997.03890470101016.Peer-Reviewed Original ResearchConceptsPrimary care settingSkin examinationSkin cancerCare settingsFecal occult blood testingRetrospective observational cohort studyVeterans Affairs Medical CenterOccult blood testingObservational cohort studyPrimary care visitsMedical record reviewSkin cancer screeningOutpatient medical clinicSkin-related complaintsCare visitsCohort studyAmbulatory visitsRecord reviewRectal examinationBlood testingPhysical examinationCancer screeningProstate examinationMedical CenterMAIN OUTCOMEAsking Patients What They Like: Overlooked Attributes of Patient Satisfaction with Primary Care
Concato J, Feinstein A. Asking Patients What They Like: Overlooked Attributes of Patient Satisfaction with Primary Care. The American Journal Of Medicine 1997, 102: 399-406. PMID: 9217623, DOI: 10.1016/s0002-9343(97)00092-2.Peer-Reviewed Original ResearchConceptsPatient satisfactionVeterans Affairs Medical CenterPrimary care clinicsPrimary health careHealth care servicesClinic visitsCare clinicsSame clinicOpen-ended questionsPrimary careClinimetric methodsMedical CenterPatientsCare servicesPhysician staffNonphysician staffClinicHealth careCareFace validityPsychometric instrumentsResponseSatisfactionCliniciansStaff