A5033266914- Health Systems, Economic Evaluations, Quality of Life
- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Health and Disease Prevention
- Pharmaceutical Economics and Policy
- Lipoproteins and Cardiovascular Health
- Healthcare Policy and Management
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Intracranial Aneurysms: Treatment and Complications
- Cardiac Imaging and Diagnostics
- Healthcare cost, quality, practices
- Traumatic Brain Injury and Neurovascular Disturbances
- Advanced MRI Techniques and Applications
- Blood Pressure and Hypertension Studies
- Clinical practice guidelines implementation
- Advanced Causal Inference Techniques
- Primary Care and Health Outcomes
- Peripheral Artery Disease Management
- Hemoglobinopathies and Related Disorders
- Global Public Health Policies and Epidemiology
- Chronic Disease Management Strategies
- Global Cancer Incidence and Screening
- Malaria Research and Control
- HIV, Drug Use, Sexual Risk
Harvard University
2016-2025
Abbott Northwestern Hospital
2024
Ente Ospedaliero Cantonale
2024
Inova Fairfax Hospital
2024
McGill University
2024
Decision Sciences (United States)
2022-2023
Queen Alexandra Hospital
2021-2023
Salisbury University
2023
Massachusetts Mental Health Center
2022
Beth Israel Deaconess Medical Center
2022
The American College of Cardiology and the Heart Association (ACC/AHA) cholesterol treatment guidelines have wide-scale implications for treating adults without history atherosclerotic cardiovascular disease (ASCVD) with statins.To estimate cost-effectiveness various 10-year ASCVD risk thresholds that could be used in ACC/AHA guidelines.Microsimulation model, including lifetime time horizon, US societal perspective, 3% discount rate costs, health outcomes. In hypothetical individuals from a...
Stress cardiac magnetic resonance imaging (CMR) has demonstrated excellent diagnostic and prognostic value in single-center studies.This study sought to investigate the of stress CMR downstream costs from subsequent testing a retrospective multicenter United States.In this study, consecutive patients 13 centers across 11 states who presented with chest pain syndrome were referred for followed target period 4 years. The authors associated findings primary outcome cardiovascular death or...
Mechanical thrombectomy helps prevent disability in patients with acute ischemic stroke involving occlusion of a large cerebral vessel. Thrombectomy requires procedural expertise and not all hospitals have the staff to perform this intervention. Few population-wide data exist regarding access mechanical thrombectomy.We examined for using discharge from calendar years 2016 2018 nonfederal emergency departments care across 11 US states encompassing 80 million residents. Facilities were...
This Viewpoint points out that many definitions of low-value health care are based exclusively on efficacy or harm, and argues inclusion cost cost-effectiveness measures is necessary to define service value.
Abstract Many epidemiological models of the COVID‐19 pandemic have focused on preventing deaths. Questions been raised as to frailty those succumbing infection. In this paper we employ standard life table methods illustrate how potential quality‐adjusted life‐year (QALY) losses associated with fatalities could be estimated, while adjusting for comorbidities in terms impact both mortality and quality life. Contrary some suggestions media, find that even relatively elderly patients high levels...
Increasing evidence suggests that carotid artery imaging can identify vulnerable plaque elements increase stroke risk. We correlated recently proposed markers, soft and hard thickness measurements on axial computed tomography angiography source images, with symptomatic disease status (ipsilateral or transient ischemic attack) in high-grade disease.Soft were measured a validated technique using images subjects ≥70% extracranial stenosis. Logistic regression analyses used to assess the...
National and international primary CVD risk screening guidelines focus on using total scores. Recently, we developed a non-laboratory-based score (inputs: age, sex, smoking, diabetes, systolic blood pressure, treatment of hypertension, body-mass index), which can assess faster at lower costs compared to laboratory-based scores (inputs include cholesterol values). We aimed the exchangeability four commonly used (Framingham [2008, 1991 versions], Systematic COronary Risk Evaluation [SCORE] for...
In the past several decades, some risk factors for cardiovascular disease have improved, while others worsened. For example, smoking rates dropped and treatment increased—factors that made less fatal. At same time, Americans' average body mass index incidence of diabetes increased as population continues to live longer—factors more prevalent. To assess aggregate impact these opposing trends, we used nine National Health Nutrition Examination Survey waves from 1973 2010 forecast total...
In low-resource settings, a physician is not always available. We recently demonstrated that community health workers-instead of physicians or nurses-can efficiently screen adults for cardiovascular disease in South Africa, Mexico, and Guatemala. this analysis we sought to determine the economic impacts shifting screening workers equipped with either paper-based mobile phone-based tool. found by was very cost-effective even cost-saving all three countries, compared usual clinic-based...
Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles determine their rank order in reducing 10-year
This economic evaluation analyzes retrospective and prospective data in 9 quality measures to determine their value improving care for patients who have had a stroke.
Decision-analytic models (DAMs) are essentially informative yet complex tools for solving questions in medical decision making. When their complexity grows, the need causal inference techniques becomes evident as relationships between variables become unclear. In this methodological commentary, we argue that graphical representations of assumptions on such relationships, directed acyclic graphs (DAGs), can enhance transparency and aid parameter selection estimation through visually...
Introduced in 2004, the United Kingdom's (UK) Quality and Outcomes Framework (QOF) is world's largest primary-care pay-for-performance programme. Given some evidence of benefits substantial costs associated with QOF, it remains unclear whether programme cost-effective. Therefore, we assessed cost-effectiveness continuing versus stopping QOF. We developed a lifetime simulation model to estimate quality-adjusted life years (QALYs) for UK population cohort aged 40–74 (n = 27,070,862) exposed...
<h3>Importance</h3> Two 2018 randomized controlled trials (DAWN and DEFUSE 3) demonstrated the clinical benefit of mechanical thrombectomy (MT) more than 6 hours after onset in acute ischemic stroke (AIS). Health-economic evidence is needed to determine whether short-term health benefits late MT translate a cost-effective option during lifetime United States. <h3>Objective</h3> To compare cost-effectiveness 2 strategies (MT added standard medical care [SMC] vs SMC alone) for various...
<h3>BACKGROUND AND PURPOSE:</h3> Emerging evidence indicates that plaque imaging can improve stroke risk stratification in patients with carotid artery atherosclerosis. We studied the association between soft and hard (calcified) thickness measurements on CTA symptomatic disease status (ipsilateral or TIA) moderate-grade stenosis. <h3>MATERIALS METHODS:</h3> measured soft-plaque hard-plaque axial source images each subjects NASCET 50%–69% ICA used logistic regression receiver operating...
Background B abesia microti is the leading reported cause of red blood cell ( RBC ) transfusion‐transmitted infection in U nited S tates. Donor screening assays are development. Study Design and Methods A decision analytic model estimated cost‐effectiveness strategies for preventing babesiosis TTB a hypothetical cohort transfusion recipients ‐endemic areas Strategies included: 1) no screening; 2) niform D onor H ealth istory Q uestionnaire UDHQ ), “status quo”; 3) recipient risk targeting...