2024
Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure
Lu Y, Arowojolu O, Qiu X, Liu Y, Curry L, Krumholz H. Barriers to Optimal Clinician Guideline Adherence in Management of Markedly Elevated Blood Pressure. JAMA Network Open 2024, 7: e2426135. PMID: 39106065, PMCID: PMC11304113, DOI: 10.1001/jamanetworkopen.2024.26135.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntihypertensive AgentsElectronic Health RecordsFemaleGuideline AdherenceHumansHypertensionMaleMiddle AgedPractice Guidelines as TopicQualitative ResearchConceptsBarriers to guideline adherenceElectronic health recordsGuideline adherenceClinician adherenceEHR dataElevated blood pressureHypertension managementAnalysis of EHR dataYale New Haven Health SystemSevere hypertensionClinical practice guidelinesAdherence scenariosQualitative content analysisPublic health challengeThematic saturationHealth recordsHealth systemBlood pressureThematic analysisTargeted interventionsManagement of severe hypertensionQualitative studyHealth challengesPractice guidelinesPatient outcomesLearning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial
Song J, Wang X, Wang B, Ge Y, Bi L, Jing F, Jin H, Li T, Gu B, Wang L, Hao J, Zhao Y, Liu J, Zhang H, Li X, Li J, Ma W, Wang J, Normand S, Herrin J, Armitage J, Krumholz H, Zheng X. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. The BMJ 2024, 386: e079143. PMID: 39043397, PMCID: PMC11265211, DOI: 10.1136/bmj-2023-079143.Peer-Reviewed Original ResearchConceptsClinical decision support systemsPrimary care practicesElectronic health recordsIntervention groupSystolic blood pressurePrimary careCare practicesBlood pressure <Health recordsPragmatic cluster randomised controlled trialCluster randomised controlled trialImproving hypertension treatmentPrimary care settingBlood pressure control ratesBlood pressureProportion of visitsProportion of participantsRandomised controlled trialsSystolic blood pressure <Control groupInjurious fallsRelated visitsCare settingsDiastolic blood pressure <Follow-up
2021
Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial
Wang L, Lu Y, Wang H, Gu J, J Z, Lian Z, Zhang Z, Krumholz H, Sun N. Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial. Open Heart 2021, 8: e001719. PMID: 34580169, PMCID: PMC8477318, DOI: 10.1136/openhrt-2021-001719.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAntihypertensive AgentsBlood PressureCardiography, ImpedanceChinaClinical Decision-MakingFemaleFollow-Up StudiesHumansHypertensionIncidenceMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTherapy, Computer-AssistedTime FactorsTreatment OutcomeYoung AdultConceptsBody mass indexPeking University People's HospitalStandard care groupBlood pressure controlSystolic BPHaemodynamic groupsTreatment strategiesImpedance cardiographyBaseline BPBP goalHypertension clinicHaemodynamic profileBP levelsCare groupPeople's HospitalMean baseline systolic BPPressure controlReal-world clinical practiceBaseline systolic BPMean systolic BPDiastolic BP levelsProportion of patientsPragmatic clinical trialsReal-world populationBaseline DBPContemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes
Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Utilization of Novel Cardioprotective Anti‐hyperglycemic agents in Type 2 Diabetes. Journal Of The American Heart Association 2021, 10: e021084. PMID: 33998258, PMCID: PMC8403287, DOI: 10.1161/jaha.121.021084.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersBlood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationEligibility DeterminationFemaleGlucagon-Like Peptide-1 ReceptorGuideline AdherenceHeart Disease Risk FactorsHumansIncretinsMaleMiddle AgedNutrition SurveysPractice Guidelines as TopicPractice Patterns, Physicians'Risk AssessmentSodium-Glucose Transporter 2 InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsSGLT-2 inhibitorsType 2 diabetes mellitusAtherosclerotic cardiovascular diseaseChronic kidney diseaseLarge clinical trialsGLP-1RAsDiabetes mellitusCardiovascular diseaseHeart failureKidney diseaseClinical trialsHigh-risk atherosclerotic cardiovascular diseaseGLP-1RA useAmerican Diabetes AssociationNutrition Examination SurveyAnti-hyperglycemic agentsPublic health benefitsComplex survey designCardiovascular riskGuideline recommendationsDiabetes AssociationExamination SurveyProtective therapyNational HealthAmerican College
2019
Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak associationTrends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular function
2018
Implications of coronary artery calcium testing on risk stratification for lipid-lowering therapy according to the 2016 European Society of Cardiology recommendations: The MESA study
Bittencourt MS, Blankstein R, Blaha MJ, Sandfort V, Agatston AS, Budoff MJ, Blumenthal RS, Krumholz HM, Nasir K. Implications of coronary artery calcium testing on risk stratification for lipid-lowering therapy according to the 2016 European Society of Cardiology recommendations: The MESA study. European Journal Of Preventive Cardiology 2018, 25: 1887-1898. PMID: 30043629, DOI: 10.1177/2047487318788930.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBiomarkersClinical Decision-MakingCoronary AngiographyCoronary Artery DiseaseDyslipidemiasFemaleHumansHypolipidemic AgentsIncidenceLipidsMaleMiddle AgedPractice Guidelines as TopicPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsUnited StatesVascular CalcificationConceptsLipid-lowering treatmentCoronary artery calciumLipid-lowering therapyArtery calciumHigher cardiovascular mortalityCardiovascular mortalityUncontrolled groupCoronary Artery Calcium TestingCoronary heart disease eventsEuropean SocietyHeart disease eventsCardiovascular mortality ratesCardiovascular risk assessmentLow-risk groupCardiology recommendationsCardiology guidelinesCardiovascular riskESC recommendationsRisk stratificationMESA participantsCalcium testingRisk groupsGroup 31Lower incidenceMESA studyImpact of 2017 ACC/AHA guidelines on prevalence of hypertension and eligibility for antihypertensive treatment in United States and China: nationally representative cross sectional study
Khera R, Lu Y, Lu J, Saxena A, Nasir K, Jiang L, Krumholz HM. Impact of 2017 ACC/AHA guidelines on prevalence of hypertension and eligibility for antihypertensive treatment in United States and China: nationally representative cross sectional study. The BMJ 2018, 362: k2357. PMID: 29997129, PMCID: PMC6039831, DOI: 10.1136/bmj.k2357.Peer-Reviewed Original ResearchConceptsACC/AHA guidelinesDiagnosis of hypertensionAge groupsHypertension guidelinesAHA guidelinesTreatment patternsCurrent guidelinesACC/AHA hypertension guidelinesHeart Association hypertension guidelinesCurrent treatment patternsIntensification of treatmentPrevalence of hypertensionNutrition Examination SurveyYears age groupUS National HealthYear old adultsSame age groupRetirement Longitudinal StudyAntihypertensive treatmentExamination SurveyNational HealthHypertensionAmerican CollegeChina HealthOlder adultsBlood pressure guidelines as starting point in clinical decisions
Krumholz HM. Blood pressure guidelines as starting point in clinical decisions. The BMJ 2018, 360: j5862. PMID: 29295826, DOI: 10.1136/bmj.j5862.Peer-Reviewed Original ResearchMeSH KeywordsBlood PressureCardiovascular DiseasesClinical Decision-MakingDiabetes ComplicationsHumansHypertensionPractice Guidelines as TopicRenal Insufficiency, ChronicRisk Factors
2017
Treatment of Cholesterol in 2017
Krumholz HM. Treatment of Cholesterol in 2017. JAMA 2017, 318: 417-418. PMID: 28738130, DOI: 10.1001/jama.2017.6753.Peer-Reviewed Original ResearchImplications of Coronary Artery Calcium Testing for Treatment Decisions Among Statin Candidates According to the ACC/AHA Cholesterol Management Guidelines A Cost-Effectiveness Analysis
Hong JC, Blankstein R, Shaw LJ, Padula WV, Arrieta A, Fialkow JA, Blumenthal RS, Blaha MJ, Krumholz HM, Nasir K. Implications of Coronary Artery Calcium Testing for Treatment Decisions Among Statin Candidates According to the ACC/AHA Cholesterol Management Guidelines A Cost-Effectiveness Analysis. JACC Cardiovascular Imaging 2017, 10: 938-952. PMID: 28797417, DOI: 10.1016/j.jcmg.2017.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationBayes TheoremClinical Decision-MakingComputer SimulationCoronary AngiographyCoronary Artery DiseaseCoronary VesselsCost-Benefit AnalysisDecision Support TechniquesDrug CostsFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedModels, EconomicMonte Carlo MethodMultivariate AnalysisPractice Guidelines as TopicPredictive Value of TestsQuality of LifeQuality-Adjusted Life YearsTime FactorsTreatment OutcomeUnited StatesVascular CalcificationConceptsCoronary artery calciumQuality-adjusted life yearsStatin therapyArtery calciumLong-term statin therapyAtherosclerotic cardiovascular disease eventsCholesterol management guidelinesIncremental cost-effectiveness ratioCardiovascular disease eventsAtherosclerotic cardiovascular diseaseCost-effectiveness ratioCost-effectiveness analysisStatin candidatesCholesterol managementCardiovascular diseaseTreatment decisionsAmerican CollegeDisease eventsLifetime horizonLife yearsAmerican HeartSocietal perspectiveManagement guidelinesStatinsPatientsQuality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction
Downing NS, Wang Y, Dharmarajan K, Nuti SV, Murugiah K, Du X, Zheng X, Li X, Li J, Masoudi FA, Spertus JA, Jiang L, Krumholz HM. Quality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction. Journal Of The American Heart Association 2017, 6: e005040. PMID: 28645937, PMCID: PMC5669155, DOI: 10.1161/jaha.116.005040.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionRisk-standardized mortality ratesQuality of careGuideline-recommended careGuideline-recommended treatmentMyocardial infarctionMortality rateST-segment elevation myocardial infarctionChina PEACE-Retrospective AMI StudyComposite rateMedian risk-standardized mortality rateProportion of patientsElevation myocardial infarctionQuality improvement initiativesProportion of opportunitiesDefect-free rateHospital levelInfarctionHospitalChinese hospitalsPatientsCareAMI studyImprovement initiativesHigh rateIs Hemoglobin A1c the Right Outcome for Studies of Diabetes?
Lipska KJ, Krumholz HM. Is Hemoglobin A1c the Right Outcome for Studies of Diabetes? JAMA 2017, 317: 1017-1018. PMID: 28125758, PMCID: PMC5350060, DOI: 10.1001/jama.2017.0029.Commentaries, Editorials and LettersACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Chan WV, Pearson TA, Bennett GC, Cushman WC, Gaziano TA, Gorman PN, Handler J, Krumholz HM, Kushner RF, MacKenzie TD, Sacco RL, Smith SC, Stevens VJ, Wells BL. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal Of The American College Of Cardiology 2017, 69: 1076-1092. PMID: 28132746, DOI: 10.1016/j.jacc.2016.11.004.Peer-Reviewed Original ResearchConceptsEducational outreach visitsClinical practice guidelinesProcess of careClinical outcomesOutreach visitsPractice guidelinesSystematic reviewImplementation interventionsCardiology/American Heart Association Task ForceAmerican Heart Association Task ForceLow baseline adherenceOverweight/obesityGuideline implementation strategiesMixed effectivenessGuideline implementation interventionsCost-effectiveness outcomesProvider incentivesEvidence-based strategiesBlood pressureBlood InstituteImplementation science literatureNational HeartClinicians' knowledgeAmerican CollegeExclusion criteria
2016
Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries
Bucholz EM, Butala NM, Normand SL, Wang Y, Krumholz HM. Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries. Journal Of The American College Of Cardiology 2016, 67: 2378-2391. PMID: 27199062, PMCID: PMC5097252, DOI: 10.1016/j.jacc.2016.03.507.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAspirinFemaleFollow-Up StudiesGuideline AdherenceHospitalizationHumansLife ExpectancyMaleMedicareMyocardial InfarctionPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPractice Guidelines as TopicThrombolytic TherapyTime-to-TreatmentUnited StatesConceptsAcute myocardial infarctionPrimary percutaneous coronary interventionGuideline-based therapyYears of lifeAdmission therapyLife expectancyMyocardial infarctionMedicare beneficiariesCox proportional hazards regressionAcute reperfusion therapyLate survival benefitReceipt of aspirinPercutaneous coronary interventionLong-term outcomesProportional hazards regressionCooperative Cardiovascular ProjectElderly Medicare beneficiariesDose-response relationshipAssociation of GuidelineShort life expectancyLonger life expectancyReperfusion therapyCoronary interventionD2B timeElderly patientsThe China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design
Rao C, Bongiovanni T, Li X, Gao H, Zhang H, Li J, Zhao Y, Yuan X, Hua K, Hu S, Krumholz HM, Jiang L, Zheng Z. The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design. BMJ Open 2016, 6: e009743. PMID: 26880670, PMCID: PMC4762131, DOI: 10.1136/bmjopen-2015-009743.Peer-Reviewed Original ResearchConceptsComplex coronary artery diseaseCoronary artery diseaseArtery diseaseLarge cardiovascular centresCardiac eventsProspective studyCardiovascular CenterTreatment strategiesCoronary revascularisation proceduresSYNTAX score calculationThree-vessel diseaseElective coronary angiographyMedical record abstractionPatient-reported outcomesAppropriateness of treatmentQuality improvement initiativesQuality of lifeEligible patientsRevascularisation proceduresAdverse eventsGuideline adherenceHospital factorsProspective cohortSecondary preventionCoronary angiography
2015
2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures
Drozda J, Ferguson T, Jneid H, Krumholz H, Nallamothu B, Olin J, Ting H, Heidenreich P, Albert N, Chan P, Curtis L, Ferguson T, Fonarow G, Ho P, O'Brien S, Russo A, Thomas R, Ting H, Varosy P. 2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures. Circulation Cardiovascular Quality And Outcomes 2015, 9: 68-95. PMID: 26666514, DOI: 10.1161/hcq.0000000000000014.Peer-Reviewed Original ResearchPatterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes
Desai NR, Parzynski CS, Krumholz HM, Minges KE, Messenger JC, Nallamothu BK, Curtis JP. Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes. JAMA Internal Medicine 2015, 175: 1988. PMID: 26551259, PMCID: PMC5584388, DOI: 10.1001/jamainternmed.2015.6217.Peer-Reviewed Original Research2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction
Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Ting HH, O’Gara P, Kushner FG, Ascheim DD, Brindis RG, Casey DE, Chung MK, de Lemos JA, Diercks DB, Fang JC, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX. 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. Journal Of The American College Of Cardiology 2015, 67: 1235-1250. PMID: 26498666, DOI: 10.1016/j.jacc.2015.10.005.Peer-Reviewed Original ResearchMeSH KeywordsCongresses as TopicDisease ManagementElectrocardiographyHumansMyocardial InfarctionPercutaneous Coronary InterventionPractice Guidelines as TopicUnited StatesStroke Issue 2015
Krumholz HM. Stroke Issue 2015. Circulation Cardiovascular Quality And Outcomes 2015, 8: s65. PMID: 26515210, PMCID: PMC6481163, DOI: 10.1161/circoutcomes.115.002345.Peer-Reviewed Original Research