2024
Organizational and Implementation Factors Associated with Cirrhosis Care in the Veterans Health Administration
McCurdy H, Nobbe A, Scott D, Patton H, Morgan T, Bajaj J, Yakovchenko V, Merante M, Gibson S, Lamorte C, Baffy G, Ioannou G, Taddei T, Rozenberg-Ben-Dror K, Anwar J, Dominitz J, Rogal S. Organizational and Implementation Factors Associated with Cirrhosis Care in the Veterans Health Administration. Digestive Diseases And Sciences 2024, 69: 2008-2017. PMID: 38616215, DOI: 10.1007/s10620-024-08409-6.Peer-Reviewed Original ResearchVeterans Affairs (VA) medical centersCirrhosis careDashboard usePopulation management toolCare processesSurveillance ratesDepartment of Veterans Affairs (VA) medical centersFactors associated with high performanceVeterans Health AdministrationHCC surveillanceSpecialty carePerceived barriersData Warehouse dataHealth AdministrationImplementation evaluationLinear regression modelsCareGastroenterology serviceMedical CenterMultivariate modelRegression modelsQuality measuresVeteransRate differencesWarehouse data
2022
Patterns of Care Utilization and Hepatocellular Carcinoma Surveillance: Tracking Care Across the Pandemic
Serper M, Tapper EB, Kaplan DE, Taddei TH, Mahmud N. Patterns of Care Utilization and Hepatocellular Carcinoma Surveillance: Tracking Care Across the Pandemic. The American Journal Of Gastroenterology 2022, 118: 294-303. PMID: 36114778, PMCID: PMC9898115, DOI: 10.14309/ajg.0000000000002011.Peer-Reviewed Original ResearchConceptsOutpatient primary care providerHepatocellular carcinoma surveillancePrimary care providersHCC surveillanceCare providersHCC surveillance ratesGastroenterology/hepatologyFacility-level variablesCirrhosis cohortPatient demographicsClinical factorsTotal cohortCare utilizationNational cohortOutpatient utilizationSpecialty careInpatient careMultivariable modelPercentage of timePopulation-based approachSurveillance ratesAppointment ratesAdjusted modelVisit ratesCoronavirus disease
2019
Setting ambitious targets for surveillance and treatment rates among patients with hepatitis C related cirrhosis impacts the cost-effectiveness of hepatocellular cancer surveillance and substantially increases life expectancy: A modeling study
Uyei J, Taddei TH, Kaplan DE, Chapko M, Stevens ER, Braithwaite RS. Setting ambitious targets for surveillance and treatment rates among patients with hepatitis C related cirrhosis impacts the cost-effectiveness of hepatocellular cancer surveillance and substantially increases life expectancy: A modeling study. PLOS ONE 2019, 14: e0221614. PMID: 31449554, PMCID: PMC6709904, DOI: 10.1371/journal.pone.0221614.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioCost-effectiveness ratioHCC treatmentLife expectancyDifferent surveillance intervalsDecision-analytic Markov modelHepatitis C virusCause of deathAspirational scenarioCurrent HCVHCC surveillanceHCC incidenceHepatitis CSurveillance intervalsC virusCancer surveillanceVeteran outcomesLower incidenceStudy groupHCVTreatment useCirrhosisEpidemiologic studiesPatientsCompliance rateIncreased 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 riskCirrhosis
2017
Identifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis
Goldberg DS, Taddei TH, Serper M, Mehta R, Dieperink E, Aytaman A, Baytarian M, Fox R, Hunt K, Pedrosa M, Pocha C, Valderrama A, Kaplan DE. Identifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis. Hepatology 2017, 65: 864-874. PMID: 27531119, DOI: 10.1002/hep.28765.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedCarcinoma, HepatocellularCohort StudiesEarly Detection of CancerFemaleHumansLinear ModelsLiver CirrhosisLiver NeoplasmsMagnetic Resonance ImagingMaleMiddle AgedMultimodal ImagingPopulation SurveillancePrevalenceProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSex FactorsTomography, X-Ray ComputedUltrasonography, DopplerUnited StatesUnited States Department of Veterans AffairsConceptsHCC surveillanceHepatocellular carcinomaPatients 75 yearsHepatocellular carcinoma surveillancePrimary care physiciansHigh-risk populationVeterans Health AdministrationOverall health care systemVeterans Administration CenterHealth care systemAbdominal ultrasoundCirrhosis patientsPrimary outcomeCare physiciansInverse associationCirrhosis diagnosisLeading causeOdds ratioPercentage of timeSurveillance ratesNumber of visitsHealth AdministrationPatientsCirrhosisCare system