A5091054057- Health Systems, Economic Evaluations, Quality of Life
- Heart Failure Treatment and Management
- Healthcare Policy and Management
- Pharmaceutical Economics and Policy
- BRCA gene mutations in cancer
- Medication Adherence and Compliance
- Cardiac pacing and defibrillation studies
- Economic and Environmental Valuation
- Cardiovascular Function and Risk Factors
- Breast Cancer Treatment Studies
- Ovarian cancer diagnosis and treatment
- Diabetes Treatment and Management
- Thyroid Cancer Diagnosis and Treatment
- Economic and Financial Impacts of Cancer
- Healthcare cost, quality, practices
- Prostate Cancer Treatment and Research
- Hemoglobinopathies and Related Disorders
- Infective Endocarditis Diagnosis and Management
- Blood Pressure and Hypertension Studies
- Cardiac Health and Mental Health
- Patient-Provider Communication in Healthcare
- Thyroid and Parathyroid Surgery
- Cancer Genomics and Diagnostics
- Prostate Cancer Diagnosis and Treatment
- Lung Cancer Treatments and Mutations
Clinical Research Institute
2016-2025
Duke University
2016-2025
Durham University
2004-2024
Durham VA Medical Center
2019-2023
Duke University Hospital
2004-2023
Duke Medical Center
2010-2023
Duke Cancer Institute
2015-2021
University of Maryland, College Park
2020
University of York
2020
Cancer Institute (WIA)
2019
Older patients who are hospitalized for acute decompensated heart failure have high rates of physical frailty, poor quality life, delayed recovery, and frequent rehospitalizations. Interventions to address frailty in this population not well established.We conducted a multicenter, randomized, controlled trial evaluate transitional, tailored, progressive rehabilitation intervention that included four physical-function domains (strength, balance, mobility, endurance). The was initiated during,...
To examine the association between extent of surgery and overall survival in a large contemporary cohort patients with papillary thyroid cancer (PTC).Guidelines recommend total thyroidectomy for PTC tumors >1 cm, based on older data demonstrating an advantage over lobectomy.Adult 1.0-4.0 cm undergoing National Cancer Database, 1998-2006, were included. Cox proportional hazards models applied to measure while adjusting patient demographic clinical factors, including comorbidities,...
To determine the number of total thyroidectomies per surgeon year associated with lowest risk complications.The volume-outcome association has been established for thyroidectomy; however, a threshold cases defining "high-volume" remains unclear.Adults undergoing thyroidectomy were identified from Health Care Utilization Project-National Inpatient Sample (1998-2009). Multivariate logistic regression restricted cubic splines was utilized to examine between annual and complications.Among 16,954...
Cervical lymph node metastases are recognized as a prognostic indicator only in patients age 45 years or older with papillary thyroid cancer (PTC); younger than perceived to have low-risk disease. The current American Joint Committee on Cancer staging for PTC does not include cervical metastases. Our objective was test the hypothesis that presence and number of an adverse impact overall survival (OS) PTC.Adult undergoing surgery stage I (no distant metastases) were identified from National...
To describe national practice patterns regarding utilization of minimally invasive pancreaticoduodenectomy (MIPD) and compare short-term outcomes with those following open for cancer.There is increasing interest in use MIPD; however, published data are limited to single institutional experiences.Adult patients undergoing were identified from the National Cancer Database, 2010-2011. Descriptive statistics multivariable modeling employed characterize MIPD (laparoscopic or robotic)...
Introduction. Medical advances have led to an increase in the world's population of immunosuppressed individuals. The most severely immunocompromised patients are those who been diagnosed with a hematologic malignancy, solid organ tumor, or other conditions that require immunosuppressive therapies and/or stem cell transplants.
Background Digital therapeutics are patient-facing digital health interventions that can significantly alter the care landscape. Despite being used to successfully treat a range of conditions, their uptake in systems remains limited. Understanding full spectrum factors is essential identify ways which policy makers and providers facilitate adoption effective within system, as well steps developers take assist deployment products. Objective In this review, we aimed map most frequently...
Fewer than 40% of persons with hypertension in the United States have adequate blood pressure (BP) control.
Background— Hospital readmission is an important clinical outcome of patients with heart failure. Its relation to length stay for the initial hospitalization not clear. Methods and Results— We used hierarchical modeling data from a trial examine variations in across countries hospitals United States its association within 30 days randomization. Main outcomes included associations between country-level rates, after adjustment patient-level case mix; rates sites States. Across 27 389 6848...
The objective of this study was to determine the impact nonfatal cardiovascular (CV) events on changes in health-related quality life (HRQL). There is limited understanding CV long-term HRQL survivors myocardial infarction (MI). VALIANT (Valsartan In Acute Myocardial Infarction) trial enrolled 14,703 patients post-MI complicated by Killip class II or higher (scale measuring heart failure severity ranging from I IV) and/or reduced ejection fraction. substudy included 2,556 (17.4%) who...
A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, coping skills training (PCST), in patients' doctors' offices (N=129 patients); control group received usual care (N=127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: intensity, physical functioning, psychological...
Papillary thyroid cancer (PTC) patients <45 years old are considered to have an excellent prognosis; however, current guidelines recommend total thyroidectomy for PTC tumors >1.0 cm, regardless of age.
Key Points Depression was found in 35.2% of adult SCD patients and strongly associated with worse physical mental quality-of-life outcomes. Total health care costs for depression were more than double those without depression.
The clinical and economic impacts of bloodstream infections (BSI) due to multidrug-resistant (MDR) Gram-negative bacteria are incompletely understood. From 2009 2015, all adult inpatients with BSI at our institution were prospectively enrolled. MDR status was defined as resistance ≥3 antibiotic classes. Clinical outcomes inpatient costs associated the phenotype identified. Among 891 unique patients BSI, 292 (33%) infected bacteria. In an adjusted analysis, only history infection versus...
Background: Pain catastrophizing has been identified as a prognostic indicator of poor outcome following knee arthroplasty. Interventions to address pain catastrophizing, our knowledge, have not tested in patients undergoing The purpose this study was determine whether coping skills training persons with moderate high arthroplasty improves outcomes 12 months postoperatively compared usual care or arthritis education. Methods: A multicenter, 3-arm, single-blinded, randomized comparative...