A5072881675- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
- Primary Care and Health Outcomes
- Heart Failure Treatment and Management
- Acute Myocardial Infarction Research
- Advanced Causal Inference Techniques
- Patient Satisfaction in Healthcare
- Cardiac, Anesthesia and Surgical Outcomes
- Statistical Methods and Bayesian Inference
- Schizophrenia research and treatment
- Emergency and Acute Care Studies
- Statistical Methods in Clinical Trials
- Healthcare cost, quality, practices
- Mental Health Treatment and Access
- Coronary Interventions and Diagnostics
- Statistical Methods and Inference
- Geriatric Care and Nursing Homes
- Meta-analysis and systematic reviews
- Global Health Care Issues
- Cardiac Health and Mental Health
- Cardiac Imaging and Diagnostics
- Cardiac pacing and defibrillation studies
- Antiplatelet Therapy and Cardiovascular Diseases
- Health disparities and outcomes
- Chronic Disease Management Strategies
Harvard University
2016-2025
Massachusetts General Hospital
2008-2025
Beth Israel Deaconess Medical Center
2005-2024
McLean Hospital
2003-2024
United States Department of Veterans Affairs
2024
New York State Department of Health
2024
University at Albany, State University of New York
2024
University of Oxford
2024
Cancer Research And Biostatistics
2003-2022
Boston University
2002-2021
Background. A 10-question screening scale of psychological distress and a six-question short-form embedded within the were developed for redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions administered in national mail survey ( N = 1401). reduced set was subsequently telephone 1574). The scales, which we refer to as K10 K6, constructed from based on Item Response Theory models. scales validated two-stage clinical reappraisal 1000 interviews first stage...
<h3>Background</h3> Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse Mental Health Services Administration (SAMHSA) to develop method estimate prevalence of SMI. <h3>Methods</h3> Three SMI screening scales were developed possible use in SAMHSA National Household Survey on Drug Abuse: Composite International Diagnostic Interview Short-Form (CIDI-SF) scale, K10/K6 nonspecific distress scales, World Organization...
Dual antiplatelet therapy is recommended after coronary stenting to prevent thrombotic complications, yet the benefits and risks of treatment beyond 1 year are uncertain.Patients were enrolled they had undergone a stent procedure in which drug-eluting was placed. After 12 months with thienopyridine drug (clopidogrel or prasugrel) aspirin, patients randomly assigned continue receiving receive placebo for another 18 months; all continued aspirin. The coprimary efficacy end points thrombosis...
There is increasing interest in utilizing novel markers of cardiovascular disease risk, and consequently, there a need to assess the value their use. This scientific statement reviews current concepts risk evaluation proposes standards for critical appraisal assessment methods. An adequate marker requires sound research design, representative at-risk population, an number outcome events. Studies should report degree which it adds prognostic information provided by standard markers. No single...
Dual antiplatelet therapy after percutaneous coronary intervention (PCI) reduces ischemia but increases bleeding.
Cardiac rehabilitation (CR) is effective in prolonging survival and reducing disability patients with coronary heart disease. However, national use patterns predictors of CR have not been evaluated thoroughly.Using Medicare claims, we analyzed outpatient (phase II) after hospitalizations for acute myocardial infarctions or artery bypass graft surgery 267,427 fee-for-service beneficiaries aged > = 65 years who survived at least 30 days hospital discharge. We used multivariable analyses to...
It is not known whether recent declines in ischemic heart disease and its risk factors have been accompanied by failure (HF) hospitalization mortality.
Background: Antipsychotic drugs are widely used to manage behavioral and psychological symptoms in dementia despite concerns about their safety. Objective: To examine the association between treatment with antipsychotics (both conventional atypical) all-cause mortality. Design: Population-based, retrospective cohort study. Setting: Ontario, Canada. Patients: Older adults who were followed 1 April 1997 31 March 2003. Measurements: The risk for death was determined at 30, 60, 120, 180 days...
Background— In 2009, the Centers for Medicare & Medicaid Services is publicly reporting hospital-level risk-standardized 30-day mortality and readmission rates after acute myocardial infarction (AMI) heart failure (HF). We provide patterns of hospital performance, based on these measures. Methods Results— calculated all fee-for-service beneficiaries ages 65 years or older with a primary diagnosis AMI HF, discharged between July 2005 June 2008. compared weighted across Hospital Referral...
Background— Readmission soon after hospital discharge is an expensive and often preventable event for patients with heart failure. We present a model approved by the National Quality Forum purpose of public reporting hospital-level readmission rates Centers Medicare & Medicaid Services. Methods Results— developed hierarchical logistic regression to calculate risk-standardized 30-day all-cause hospitalized The was derived use claims data 2004 cohort validated medical record data....
Background— A model using administrative claims data that is suitable for profiling hospital performance acute myocardial infarction would be useful in quality assessment and improvement efforts. We sought to develop a hierarchical regression Medicare produces risk-standardized 30-day mortality rates validate the estimates against those derived from medical record model. Methods Results— For data, we developed derivation 140 120 cases discharged 4664 hospitals 1998. comparison of models used...
Background— In July 2009, Medicare began publicly reporting hospitals’ risk-standardized 30-day all-cause readmission rates (RSRRs) among fee-for-service beneficiaries discharged after hospitalization for heart failure from all the US acute care nonfederal hospitals. No recent national trends in RSRRs have been reported, and it is not known whether hospital-specific performance improving or variation decreasing. Methods Results— We used 2004–2006 administrative data to identify admitted a...
Abstract Recent public debate on costs and effectiveness of health care in the United States has generated a growing emphasis "profiling" medical providers. The process profiling involves comparing resource use quality among providers to community or normative standard. This is valuable for targeting improvement strategies. For example, hospital profiles may be used determine whether institutions deviate important ways they deliver. In this article we propose class performance indices...
OBJECTIVE: Previous research on the prevalence of medical disorders among adults with mental illness has been inconclusive. In general, studies have found higher rates persons illness, but these did not account for comorbid substance use disorders. The authors examined whether certain are more prevalent severe and a disorder increases beyond effect alone. METHODS: Administrative data from Massachusetts Division Medical Assistance were used in cross-sectional observational study design....
A model using administrative claims data that is suitable for profiling hospital performance heart failure would be useful in quality assessment and improvement efforts.We developed a hierarchical regression Medicare from 1998 produces risk-standardized 30-day mortality rates. We validated the by comparing state-level standardized estimates with calculated medical record model. To determine stability of over time, we used annual cohorts discharged 1999-2001. The final included 24 variables...
ContextThe Centers for Medicare & Medicaid Services (CMS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) measure report quality process measures acute myocardial infarction (AMI), but little is known about how these are correlated with each other degree to which inferences a hospital's outcomes can be made from its performance publicly reported processes.ObjectiveTo determine correlations among AMI core they explain variation in hospital-specific,...