A5081670901- Emergency and Acute Care Studies
- Cardiac Imaging and Diagnostics
- Diabetes Treatment and Management
- Statistical Methods in Clinical Trials
- Diabetes Management and Research
- Geriatric Care and Nursing Homes
- Acute Myocardial Infarction Research
- Coronary Interventions and Diagnostics
- Primary Care and Health Outcomes
- Computational Drug Discovery Methods
- Adipokines, Inflammation, and Metabolic Diseases
- Chronic Kidney Disease and Diabetes
- Lung Cancer Diagnosis and Treatment
- Cardiac Health and Mental Health
- Surgical site infection prevention
- Health Policy Implementation Science
- Pelvic floor disorders treatments
- Statistics Education and Methodologies
- Heart Failure Treatment and Management
- Urinary Tract Infections Management
- Global Health Workforce Issues
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Metabolism, Diabetes, and Cancer
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Health and Risk Factors
VA Eastern Colorado Health Care System
2020-2025
Center for Innovation
2021-2025
University of Colorado Anschutz Medical Campus
2020-2023
Colorado School of Public Health
2020-2022
United States Department of Veterans Affairs
2022
University of Colorado Denver
2022
Veterans Health Administration
2020
Denver VA Medical Center
2019
Background: Nurse-driven protocols (NDPs) for urinary catheter removal are proven tools decreasing catheter-associated tract infections (CAUTIs); however, they not used consistently in acute care settings. Objective: To determine the impact of a NDP on CAUTI rates and device utilization ratio. Design: Pre/postintervention, observational study at 160-bed, level 1a academically affiliated Veterans Affairs (VA) hospital. Methods: ratios were examined before after implementation NDP. Results:...
<h3>Importance</h3> Monitoring emergency care quality requires understanding which conditions benefit most from timely, care. <h3>Objectives</h3> To identify a set of care–sensitive (ECSCs) that are treated in departments (EDs), associated with spectrum adult age groups, and represent common reasons for seeking to provide benchmark national estimates ECSC acute utilization. <h3>Design, Setting, Participants</h3> A modified Delphi method was used ECSCs. In cross-sectional analysis,...
Abstract Background Veterans are often transferred from rural areas to urban VA Medical Centers for care. The transition hospital home is vulnerable postdischarge adverse events. Objective To evaluate the effectiveness of Transitions Nurse Program (TNP). Design, Setting, and Participants National hybrid‐effectiveness‐implementation study, within site propensity‐matched cohort in 11 hospitals. 3001 were enrolled TNP April 2017 September 2019, 6002 matched controls. Intervention Outcomes...
Ensuring safe transitions of care around hospital discharge requires effective relationships and communication between health teams. Relational coordination (RC) is a process communicating relating for the purpose task integration that predicts desirable outcomes patients providers. RC can be measured using validated survey.The aim study was to demonstrate application practices within rural Transitions Nurse Program (TNP), nationwide intervention Veterans, assess mechanisms developing in...
Background The significant morbidity associated with systolic heart failure makes it imperative to identify patients a reversible cause. We thus sought evaluate the proportion of who received an ischemic evaluation after hospitalization for new-onset failure. Methods and Results Patients admitted new diagnosis reduction in left ventricular ejection fraction (≤40%) were identified VA Healthcare System from January 2006 August 2017. Among those survived 90 days without readmission, we...
Abstract Background Previous studies suggested that pre‐treatment of coronary artery calcification (CAC) with rotational atherectomy (RA) prior to stent deployment improved procedural success but was not associated a concomitant improvement in clinical outcomes. Orbital (OA) has demonstrated similar benefits, though there are few data comparing the safety and efficacy two modalities. Methods Patients who underwent PCI native lesion RA or OA from 2014 2018 within Veterans Affairs Healthcare...
Therapeutic inertia threatens the potential long-term benefits of achieving early glycemic control after type 2 diabetes diagnosis. We evaluated temporal trends in second-line medication initiation among individuals initially treated with metformin.
Mental illness and obesity are highly prevalent in patients with coronary disease frequently comorbid. While mental is an established risk factor for major adverse cardiac cerebrovascular events (MACCEs), prior studies suggest improved outcomes people obesity. It unknown if interact to affect or they independently influence MACCE. We identified 55 091 undergoing percutaneous intervention (PCI) between 2009 2014, using the Veterans Affairs (VA) Clinical Assessment Reporting Tracking (CART)...
To assess whether contrast media type is associated with outcomes in veterans undergoing percutaneous coronary intervention (PCI).There uncertainty about the impact of iso-osmolar medium (IOCM) versus low-osmolar (LOCM) on acute kidney injury (AKI) and other major adverse renal or cardiovascular events (MARCE) after PCI. We assessed association between MARCE patients who underwent PCI within Veterans Administration Healthcare System.We reviewed PCIs performed 2009 2019 using data from...
We present a case study for implementing machine learning algorithm with an incremental value framework in the domain of lung cancer research. Machine methods have often been shown to be competitive prediction models some domains; however, implementation these is early development. Often are only directly compared existing methods; here we assessing model by value. developed identify and classify nodules assessed added risk models. Multiple external datasets were used validation. found that...
Background: Fewer than 60% of US adults with diabetes achieve low-density lipoprotein cholesterol (LDL) targets for atherosclerotic cardiovascular disease (ASCVD) prevention. Examining initiation ASCVD primary prevention measures after diagnosis may reveal actionable gaps in care. Methods: We studied individuals the VA Health Care System newly diagnosed based on codes and medications without known a prior statin prescription at time diagnosis. categorized 10-year risk using AHA/ACC pooled...
<b>Objective:</b> Therapeutic inertia threatens the potential long-term benefits of achieving early glycemic control after type 2 diabetes diagnosis. We evaluated temporal trends in second-line medication initiation among individuals initially treated with metformin. <p><b> </b></p> <p><b>Research design and methods:</b> included data from 199,042 adults US Veterans Affairs Health Care System metformin monotherapy 2005 to 2013. used...
<b>Objective:</b> Therapeutic inertia threatens the potential long-term benefits of achieving early glycemic control after type 2 diabetes diagnosis. We evaluated temporal trends in second-line medication initiation among individuals initially treated with metformin. <p><b> </b></p> <p><b>Research design and methods:</b> included data from 199,042 adults US Veterans Affairs Health Care System metformin monotherapy 2005 to 2013. used...
Diabetes patient heterogeneity is well recognized. Statistical clustering methods are gaining popularity as a precision medicine tool for identifying diabetes subgroups. We evaluated data-driven clusters among individuals with newly diagnosed and examined associations glycemic response to initial treatment in real-world care. studied the US Veterans Affairs Health Care System based on diagnosis codes medications who were initially treated single medication from 2005-2013. performed k -means...
Background The rural transitions nurse programme (TNP) is a care coordination intervention for high-risk veterans. An interactive dashboard was used to provide real-time performance metrics sites as an audit and feedback tool. One-year post implementation, enrolment goals were not met. Nudge emails introduced increase TNP veteran enrolment. This study evaluated whether increased when occurred through plus weekly nudge email versus alone. Setting/population observational included veterans who...
The discussion paper "Statistical Modeling: the Two Cultures" (Statistical Science, Vol 16, 2001) by late Leo Breiman sent shockwaves throughout statistical community and subsequently redirected efforts of much field towards machine learning, highdimensional analysis data mining approaches.In this discussion, we discuss some implications work in sphere causal inference.In particular, define concept comparability, which is fundamental to ability draw inferences reinterpret concepts...