2024
A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System
Haque L, Tate J, Chew M, Caniglia E, Taddei T, Re V. A Validated Algorithm to Identify Hepatic Decompensation in the Veterans Health Administration Electronic Health Record System. Pharmacoepidemiology And Drug Safety 2024, 33: e70024. PMID: 39477692, DOI: 10.1002/pds.70024.Peer-Reviewed Original ResearchConceptsVeterans Health Administration dataHealth administrative dataAdministrative dataElectronic health record systemsHealth record systemsInternational Classification of DiseasesCoding algorithmOutpatient International Classification of DiseasesPositive predictive valueClassification of DiseasesHepatic decompensationDiagnosis codesPharmacoepidemiologic researchMedical recordsVeteransRecording systemValidation algorithmAlgorithmChronic liver diseaseDecompensationLiver diseasePredictive valueRecordsDiagnosisScreening for Hepatocellular Carcinoma and Survival in Patients With Cirrhosis After Hepatitis C Virus Cure
Mezzacappa C, Kim N, Vutien P, Kaplan D, Ioannou G, Taddei T. Screening for Hepatocellular Carcinoma and Survival in Patients With Cirrhosis After Hepatitis C Virus Cure. JAMA Network Open 2024, 7: e2420963. PMID: 38985470, PMCID: PMC11238019, DOI: 10.1001/jamanetworkopen.2024.20963.Peer-Reviewed Original ResearchConceptsHepatitis C virus cureHepatitis C virusAssociated with improved overall survivalHepatocellular carcinoma diagnosisEarly-stage hepatocellular carcinomaImproved overall survivalOverall survivalHepatocellular carcinomaFollow-upHCC screeningCurative treatmentCumulative incidence of hepatocellular carcinomaDirect-acting antiviral (DAA) therapyCohort studyVeterans Affairs health care systemIncidence of hepatocellular carcinomaRisk of hepatocellular carcinomaCohort study of personsHepatitis C virus cirrhosisDiagnosis of hepatocellular carcinomaLikelihood of curative treatmentYears of follow-upHealth care systemHepatocellular carcinoma screeningHCV-related cirrhosis
2023
The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study
Shaffer L, Kaplan D, Taddei T, Mahmud N. The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study. Hepatology Communications 2023, 7: e0129. PMID: 36996031, PMCID: PMC10069831, DOI: 10.1097/hc9.0000000000000129.Peer-Reviewed Original ResearchConceptsMental health diagnosesAUD/SUDCause mortalityMental health visitsRetrospective cohort studyCohort studyHealth diagnosisHealth visitsSUD diagnosisMental illnessMental health clinic visitsMental health-related diagnosisOutpatient mental health visitsOutpatient mental health careVeterans Health AdministrationHealth-related careHealth-related diagnosesClinical practice changesHealth clinic visitsMental health careClinic visitsClinic utilizationCox regressionPsychiatric comorbiditySubgroup analysisEnhanced Identification of Hispanic Ethnicity Using Clinical Data
Ochoa-Allemant P, Tate J, Williams E, Gordon K, Marconi V, Bensley K, Rentsch C, Wang K, Taddei T, Justice A, Cohorts F. Enhanced Identification of Hispanic Ethnicity Using Clinical Data. Medical Care 2023, 61: 200-205. PMID: 36893404, PMCID: PMC10114212, DOI: 10.1097/mlr.0000000000001824.Peer-Reviewed Original ResearchConceptsBurden of diseaseHispanic patientsCountry of birthClinical dataHispanic ethnicityNon-Hispanic white patientsSex-adjusted prevalenceChronic liver diseaseHuman immunodeficiency virusDemographic characteristicsElectronic health record dataHealth careHealth record dataPrevalence of conditionsUS health care systemMedicare administrative dataHealth care systemWhite patientsLiver diseaseImmunodeficiency virusSelf-reported ethnicityHigh prevalenceGastric cancerHepatocellular carcinomaVeteran population
2022
Quality measures in HCC care by the Practice Metrics Committee of the American Association for the Study of Liver Diseases
Asrani SK, Ghabril MS, Kuo A, Merriman RB, Morgan T, Parikh ND, Ovchinsky N, Kanwal F, Volk ML, Ho C, Serper M, Mehta S, Agopian V, Cabrera R, Chernyak V, El‐Serag H, Heimbach J, Ioannou GN, Kaplan D, Marrero J, Mehta N, Singal A, Salem R, Taddei T, Walling AM, Tapper EB. Quality measures in HCC care by the Practice Metrics Committee of the American Association for the Study of Liver Diseases. Hepatology 2022, 75: 1289-1299. PMID: 34778999, DOI: 10.1002/hep.32240.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesHigh-risk populationHCC careCare continuumBarcelona Clinic Liver Cancer (BCLC) stagingData System (BI-RADS) 4 lesionsBurden of HCCLiver transplantation candidacyTumor board reviewLiver Imaging ReportingFear of treatmentStructured scoping reviewExplicit quality measuresAmerican AssociationTransplantation candidacyBest individual treatmentPalliative therapyGuideline recommendationsLiver diseaseAFP elevationAppropriate referralTreatment optionsTreatment recommendationsCancer stagingOutcome measuresOral Cyanobacteria and Hepatocellular Carcinoma
Hernandez BY, Zhu X, Risch HA, Lu L, Ma X, Irwin ML, Lim JK, Taddei TH, Pawlish KS, Stroup AM, Brown R, Wang Z, Wong LL, Yu H. Oral Cyanobacteria and Hepatocellular Carcinoma. Cancer Epidemiology Biomarkers & Prevention 2022, 31: 221-229. PMID: 34697061, PMCID: PMC8755591, DOI: 10.1158/1055-9965.epi-21-0804.Peer-Reviewed Original ResearchConceptsHepatitis B virusHepatitis C virusHepatocellular carcinomaRisk factorsLiver diseaseHCC casesOral microbiomeU.S. case-control studyIndependent risk factorChronic liver diseaseFatty liver diseaseHCC risk factorsGut microbial alterationsType 2 diabetesCase-control studyLiver cancer developmentNSAID useAspirin useC virusB virusHCC riskNegative historyOral samplesSignificant associationCancer development
2021
Evaluation Within 30 Days of Referral for Liver Transplantation is Associated with Reduced Mortality: A Multicenter Analysis of Patients Referred Within the VA Health System
John BV, Schwartz K, Scheinberg AR, Dahman B, Spector S, Deng Y, Goldberg D, Martin P, Taddei TH, Kaplan DE. Evaluation Within 30 Days of Referral for Liver Transplantation is Associated with Reduced Mortality: A Multicenter Analysis of Patients Referred Within the VA Health System. Transplantation 2021, 106: 72-84. PMID: 33587434, PMCID: PMC8239056, DOI: 10.1097/tp.0000000000003615.Peer-Reviewed Original ResearchConceptsLiver transplantationTransplant centersPretransplant mortalityMultivariable Cox hazard modelTransplant evaluation processSuccessful liver transplantationMulticenter retrospective studyEvaluation of patientsVA health systemDays of referralCox hazard modelPosttransplant deathTransplant evaluationPosttransplant mortalityHigher MELDMulticenter analysisRetrospective studyList dropoutReduced mortalityHazards modelPatientsTransplantationReferralHealth systemMortalityAssociation of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis
John BV, Deng Y, Scheinberg A, Mahmud N, Taddei TH, Kaplan D, Labrada M, Baracco G, Dahman B. Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis. JAMA Internal Medicine 2021, 181: 1306-1314. PMID: 34254978, PMCID: PMC8278308, DOI: 10.1001/jamainternmed.2021.4325.Peer-Reviewed Original ResearchConceptsCOVID-19 infectionCOVID-19-related hospitalizationBNT162b2 mRNAFirst doseCohort studySecond doseMRNA vaccinesClinical trialsControl groupPropensity-matched control groupPhase 3 clinical trialsCOVID-19 mRNA vaccinesAssociation of vaccinationRetrospective cohort studyUS veteran populationAssociation of receiptVeterans Health AdministrationCoronavirus disease 2019COVID-19 hospitalizationMRNA vaccine administrationCOVID-19Vaccine recipientsImmune dysregulationModerna mRNAMedian ageMale Sex Is Associated With Higher Rates of Liver‐Related Mortality in Primary Biliary Cholangitis and Cirrhosis
John BV, Aitcheson G, Schwartz KB, Khakoo NS, Dahman B, Deng Y, Goldberg D, Martin P, Taddei T, Levy C, Kaplan DE. Male Sex Is Associated With Higher Rates of Liver‐Related Mortality in Primary Biliary Cholangitis and Cirrhosis. Hepatology 2021, 74: 879-891. PMID: 33636012, DOI: 10.1002/hep.31776.Peer-Reviewed Original ResearchConceptsPrimary biliary cholangitisLiver-related deathHepatocellular carcinomaBiliary cholangitisMale sexTime-updated Cox proportional hazards modelsCox proportional hazards modelUrsodeoxycholic acid responseLiver-related mortalityHigher unadjusted ratesRisk of deathVeterans Health AdministrationProportional hazards modelAssociation of sexImpact of sexPBC cirrhosisMale patientsUnadjusted ratesWorse outcomesTotal bilirubinCirrhosisLarge cohortHigh riskHazards modelTransplantationProtease inhibitor-based direct-acting antivirals are associated with increased risk of aminotransferase elevations but not hepatic dysfunction or decompensation
Torgersen J, Newcomb CW, Carbonari DM, Rentsch CT, Park LS, Mezochow A, Mehta RL, Buchwalder L, Tate JP, Bräu N, Bhattacharya D, Lim JK, Taddei TH, Justice AC, Lo Re V. Protease inhibitor-based direct-acting antivirals are associated with increased risk of aminotransferase elevations but not hepatic dysfunction or decompensation. Journal Of Hepatology 2021, 75: 1312-1322. PMID: 34333102, PMCID: PMC8604762, DOI: 10.1016/j.jhep.2021.07.021.Peer-Reviewed Original ResearchConceptsSevere hepatic dysfunctionBaseline FIB-4Acute liver injuryHepatic dysfunctionInhibitor-based treatmentHepatic decompensationFIB-4Liver injuryHigh riskDAA therapyHazard ratioAdvanced liver fibrosis/cirrhosisRisk of ALIProtease inhibitor-based regimensProtease inhibitor-based treatmentLiver fibrosis/cirrhosisInhibitor-based regimensHepatitis C infectionSevere liver dysfunctionFibrosis/cirrhosisInhibitor-based therapyAminotransferase elevationChronic HCVALT elevationC infectionImpact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin
Saffo S, Kaplan DE, Mahmud N, Serper M, John BV, Ross JS, Taddei T. Impact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin. Diabetes Obesity And Metabolism 2021, 23: 2402-2408. PMID: 34227216, PMCID: PMC8429193, DOI: 10.1111/dom.14488.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsDipeptidyl peptidase-4 inhibitorsPeptidase-4 inhibitorsDiabetes mellitusLiver diseaseNon-alcoholic fatty liver diseaseCotransporter 2 inhibitorsChronic liver diseaseFatty liver diseaseVeterans Affairs hospitalIncidence of ascitesAdditional pharmacotherapyTreat analysisElectronic health dataSGLT2 inhibitorsSGLT2i usersSurrogate biomarkerDPP4 inhibitorsMetabolic effectsPatientsCirrhosisPropensity scoreAscitesConfirmatory studiesMetforminRisk Prediction Models for Post‐Operative Mortality in Patients With Cirrhosis
Mahmud N, Fricker Z, Hubbard RA, Ioannou GN, Lewis JD, Taddei TH, Rothstein KD, Serper M, Goldberg DS, Kaplan DE. Risk Prediction Models for Post‐Operative Mortality in Patients With Cirrhosis. Hepatology 2021, 73: 204-218. PMID: 32939786, PMCID: PMC7902392, DOI: 10.1002/hep.31558.Peer-Reviewed Original ResearchConceptsMayo risk scoreVeterans Affairs Surgical Quality Improvement ProgramEnd-stage liver diseaseLiver diseaseSurgical proceduresMELD-NaPostoperative mortalitySurgical Quality Improvement ProgramLiver disease cohortSurgical risk modelsPost-operative mortalityRetrospective cohort studyFatty liver diseasePreoperative risk stratificationMultivariable logistic regressionU.S. medical centersQuality Improvement ProgramRisk prediction modelPopulation-level dataPugh scoreAnesthesiologists classificationChild-TurcottePreoperative albuminCohort studyPostoperative riskMortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation
Serper M, Weinberg EM, Cohen JB, Reese PP, Taddei TH, Kaplan DE. Mortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation. Hepatology 2021, 73: 219-232. PMID: 32267547, PMCID: PMC7541418, DOI: 10.1002/hep.31264.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsEffect of anticoagulationAtrial fibrillationCause mortalityMarginal structural modelsHepatic decompensationIschemic strokeMajor adverse cardiovascular eventsAdvanced liver diseaseAdverse cardiovascular eventsIncident atrial fibrillationSplanchnic vein thrombosisPropensity-score matchingCardiovascular eventsOral anticoagulantsVein thrombosisFinal cohortLiver diseaseTime-dependent confoundingAnticoagulationLower incidenceMedical CenterCirrhosisWarfarinU.S. veterans
2020
Patterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study
Rentsch CT, Kidwai-Khan F, Tate JP, Park LS, King JT, Skanderson M, Hauser RG, Schultze A, Jarvis CI, Holodniy M, Re V, Akgün KM, Crothers K, Taddei TH, Freiberg MS, Justice AC. Patterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study. PLOS Medicine 2020, 17: e1003379. PMID: 32960880, PMCID: PMC7508372, DOI: 10.1371/journal.pmed.1003379.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBetacoronavirusBlack or African AmericanClinical Laboratory TechniquesCohort StudiesCoronavirus InfectionsCOVID-19COVID-19 TestingEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedPandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2United StatesVeteransWhite PeopleYoung AdultConceptsCOVID-19 testingRace/ethnicityCohort studyWhite individualsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionAcute respiratory syndrome coronavirus 2 infectionSyndrome coronavirus 2 infectionSARS-CoV-2 infectionCOVID-19Large integrated healthcare systemCoronavirus 2 infectionNationwide cohort studyRetrospective cohort studyCoronavirus disease 2019Site of careIntegrated healthcare systemNon-Hispanic blacksPositive test resultsNon-Hispanic whitesClinical characteristicsMultivariable adjustmentComorbid conditionsMedication historyEthnic minority communitiesDisease 2019Models for acute on chronic liver failure development and mortality in a veterans affairs cohort
Xiao KY, Hubbard RA, Kaplan DE, Taddei TH, Goldberg DS, Mahmud N. Models for acute on chronic liver failure development and mortality in a veterans affairs cohort. Hepatology International 2020, 14: 587-596. PMID: 32519219, PMCID: PMC7656856, DOI: 10.1007/s12072-020-10060-y.Peer-Reviewed Original ResearchConceptsACLF mortalityCompensated cirrhosisChronic liver failure developmentEnd-stage liver diseaseHigh short-term mortalityLarge North American cohortDevelopment of ACLFVeterans Affairs cohortAsian Pacific AssociationChronic liver failureEscalation of careNovel risk prediction modelShort-term mortalityMultivariable logistic regressionNorth American cohortRisk prediction modelGood discriminationACLF developmentACLF patientsACLF scoreLiver (APASL) definitionsMELD-sodiumTransplant evaluationRisk patientsCirrhosis patientsDifferences in Pathology, Staging, and Treatment between HIV+ and Uninfected Patients with Microscopically Confirmed Hepatocellular Carcinoma
Torgersen J, Taddei TH, Park LS, Carbonari DM, Kallan MJ, Richards K, Zhang X, Jhala D, Bräu N, Homer R, D'Addeo K, Mehta R, Skanderson M, Kidwai-Khan F, Justice AC, Re V. Differences in Pathology, Staging, and Treatment between HIV+ and Uninfected Patients with Microscopically Confirmed Hepatocellular Carcinoma. Cancer Epidemiology Biomarkers & Prevention 2020, 29: 71-78. PMID: 31575557, PMCID: PMC6980754, DOI: 10.1158/1055-9965.epi-19-0503.Peer-Reviewed Original ResearchMeSH KeywordsAblation TechniquesCarcinoma, HepatocellularFemaleHepatectomyHIV InfectionsHospitals, VeteransHumansImmunologic SurveillanceKaplan-Meier EstimateLiverLiver CirrhosisLiver NeoplasmsLiver TransplantationMaleMiddle AgedNeoplasm StagingRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsBarcelona Clinic Liver Cancer stageHIV statusHepatocellular carcinomaUninfected patientsHIV infectionTumor characteristicsUninfected personsPathology reportsVeterans Aging Cohort StudyLiver tissue samplingCohort of HIVMultivariable Cox regressionAdvanced hepatic fibrosisAging Cohort StudyLiver Cancer stageRisk of deathBackground hepatic parenchymaCohort studyHazard ratioLymphovascular invasionBCLC stageImproved survivalCox regressionHistologic featuresHepatic fibrosisSurvival Benefit of Liver Transplantation for Hepatocellular Carcinoma.
Kanneganti M, Mahmud N, Kaplan DE, Taddei TH, Goldberg DS. Survival Benefit of Liver Transplantation for Hepatocellular Carcinoma. Transplantation 2020, 104: 104-112. PMID: 31283688, PMCID: PMC6928443, DOI: 10.1097/tp.0000000000002816.Peer-Reviewed Original ResearchConceptsIncremental survival benefitLiver transplantSurvival benefitHepatocellular carcinomaEnd-stage liver disease (MELD) scoreOverall long-term survivalIntermediate-stage hepatocellular carcinomaLiver Disease scoreRetrospective cohort studyStage hepatocellular carcinomaHazard of deathVeterans Health AdministrationImmortal time biasLong-term survivalUnderwent resectionLiver transplantationAnalytic cohortCohort studyCurative optionMultivariable modelHCC diagnosisDisease scoreResectionPatientsHealth Administration
2019
HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status
Torgersen J, Kallan MJ, Carbonari DM, Park LS, Mehta RL, D’Addeo K, Tate JP, Lim JK, Goetz MB, Rodriguez-Barradas MC, Gibert CL, Bräu N, Brown ST, Roy JA, Taddei TH, Justice AC, Re V. HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status. Journal Of The National Cancer Institute 2019, 112: 747-755. PMID: 31687755, PMCID: PMC7357318, DOI: 10.1093/jnci/djz214.Peer-Reviewed Original ResearchConceptsRisk of HCCHigher HIV RNAHCC risk factorsHIV RNAHIV viremiaHepatocellular carcinomaBaseline cirrhosisCirrhosis statusCohort studyRisk factorsCell percentageVeterans Aging Cohort StudyDevelopment of HCCCurrent HIV RNADetectable HIV viremiaHepatitis C coinfectionAging Cohort StudyDiagnosis of cirrhosisLonger durationDetectable HIVLow CD4C coinfectionCurrent CD4Hazard ratioCancer RegistryIncreased Risk for Hepatocellular Carcinoma Persists Up to 10 Years After HCV Eradication in Patients With Baseline Cirrhosis or High FIB-4 Scores
Ioannou GN, Beste LA, Green PK, Singal AG, Tapper EB, Waljee AK, Sterling RK, Feld JJ, Kaplan DE, Taddei TH, Berry K. Increased Risk for Hepatocellular Carcinoma Persists Up to 10 Years After HCV Eradication in Patients With Baseline Cirrhosis or High FIB-4 Scores. Gastroenterology 2019, 157: 1264-1278.e4. PMID: 31356807, PMCID: PMC6815714, DOI: 10.1053/j.gastro.2019.07.033.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntiviral AgentsCarcinoma, HepatocellularFemaleHepatitis CHumansIncidenceLiver CirrhosisLiver NeoplasmsMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsVeterans Health ServicesConceptsFIB-4 scoreSustained virologic responseAnnual HCC riskHCC riskHCV eradicationAnnual incidenceLower riskHepatitis C virus eradicationHigh FIB-4 scoreAbsolute annual riskHCV antiviral treatmentFibrosis-4 scoreInterferon-treated patientsVeterans Health AdministrationHepatocellular carcinoma riskHigh enough riskBaseline cirrhosisIncident HCCVirologic responseFIB-4HCC surveillanceHCV infectionAntiviral treatmentCarcinoma riskCirrhosisComparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people
Torgersen J, So-Armah K, Freiberg MS, Goetz MB, Budoff MJ, Lim JK, Taddei T, Butt AA, Rodriguez-Barradas MC, Justice AC, Kostman JR, Lo Re V. Comparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people. BMC Gastroenterology 2019, 19: 52. PMID: 30987601, PMCID: PMC6466708, DOI: 10.1186/s12876-019-0969-1.Peer-Reviewed Original ResearchConceptsAdvanced hepatic fibrosisSeverity of steatosisHepatic steatosisHIV infectionHIV statusHepatic fibrosisLiver attenuationCardiovascular diseaseSteatosis severityUninfected individualsGreater severityVeterans Aging Cohort StudyNoncontrast abdominal CTAging Cohort StudySpleen attenuation ratioHepatic steatosis severityCross-sectional studyMultivariable linear regressionUninfected participantsAntiretroviral therapyCohort studyAbdominal CTUninfected personsOverall prevalenceRisk factors