A5076886998- Statistical Methods and Bayesian Inference
- Statistical Methods and Inference
- Prostate Cancer Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Statistical Methods in Clinical Trials
- Prostate Cancer Treatment and Research
- Bladder and Urothelial Cancer Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Patient Safety and Medication Errors
- Advanced Statistical Methods and Models
- Global Cancer Incidence and Screening
- Healthcare Policy and Management
- Economic and Financial Impacts of Cancer
- Electronic Health Records Systems
- Bayesian Methods and Mixture Models
- Global Maternal and Child Health
- Medical Malpractice and Liability Issues
- Palliative Care and End-of-Life Issues
- Chemotherapy-induced cardiotoxicity and mitigation
- Advanced Causal Inference Techniques
- Childhood Cancer Survivors' Quality of Life
- Urinary and Genital Oncology Studies
- Emergency and Acute Care Studies
- Colorectal Cancer Screening and Detection
- Surgical Simulation and Training
Brigham and Women's Hospital
2016-2025
Harvard University
2016-2025
Boston University
1995-2025
National Patient Safety Foundation
2014-2025
Boston Children's Hospital
2012-2025
Boston Children's Museum
1999-2024
Massachusetts General Hospital
2009-2024
Ariadne Diagnostics (United States)
2013-2024
Woman's Hospital
1997-2024
Servicio Canario de la Salud
2023
Surgery has become an integral part of global health care, with estimated 234 million operations performed yearly. Surgical complications are common and often preventable. We hypothesized that a program to implement 19-item surgical safety checklist designed improve team communication consistency care would reduce deaths associated surgery.Between October 2007 September 2008, eight hospitals in cities (Toronto, Canada; New Delhi, India; Amman, Jordan; Auckland, Zealand; Manila, Philippines;...
The combination of streptozocin and fluorouracil has become the standard therapy for advanced islet-cell carcinoma. However, doxorubicin also been shown to be active against this type tumor, as chlorozotocin, a drug that is structurally similar but less frequently causes vomiting.
Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff information about patient care lacking.We conducted prospective intervention study resident handoff-improvement program in nine hospitals, measuring rates errors, preventable adverse events, and miscommunications, as well workflow. The included mnemonic standardize oral written handoffs, communication training, faculty development observation program,...
Late cardiotoxic effects of doxorubicin are increasingly a problem for patients who survive childhood cancer. Cardiotoxicity is often progressive, and some have disabling symptoms. Our objective was to identify risk factors late cardiotoxicity.
Cross-sectional studies show that cardiac abnormalities are common in long-term survivors of doxorubicin-treated childhood malignancies. Longitudinal data, however, rare.Serial echocardiograms (N = 499) were obtained from 115 acute lymphoblastic leukemia (median age at diagnosis, 4.8 years; median follow-up after completion doxorubicin, 11.8 years). Results expressed as z scores to indicate the number standard deviations (SDs) above (+) or below (-) normal predicted value. Median individual...
Doxorubicin chemotherapy is very effective in children with acute lymphoblastic leukemia (ALL) but also injures myocardial cells. Dexrazoxane, a free-radical scavenger, may protect the heart from doxorubicin-associated damage.To determine whether dexrazoxane decreases injury of cardiomyocytes, we randomly assigned 101 ALL to receive doxorubicin alone (30 mg per square meter body-surface area every three weeks for 10 doses) and 105 (300 meter) followed immediately by doxorubicin. Serial...
Missing data frequently complicates analysis for scientific investigations. The development of statistical methods to address missing has been an active area research in recent decades. Multiple imputation, originally proposed by Rubin a public use dataset setting, is general purpose method analyzing datasets with that broadly applicable variety settings. We review multiple imputation as analytic strategy formissing data. Wedescribe and evaluate number software packages implement this...
Objective To estimate global surgical volume in 2012 and compare it with estimates from 2004.Methods For the 194 Member States of World Health Organization, we searched PubMed for studies contacted key informants reports on volumes between 2005 2012.We obtained data population total health expenditure per capita categorized as very-low, low, middle high expenditure.Data caesarean delivery were validated statistical reports.For without recorded data, estimated by multiple imputation using...
Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification within an electronic medication-administration system (bar-code eMAR).We conducted a before-and-after, quasi-experimental study academic medical center that was implementing the eMAR. We assessed rates on units before after implementation Errors...
Operating-room crises (e.g., cardiac arrest and massive hemorrhage) are common events in large hospitals but can be rare for individual clinicians. Successful management is difficult complex. We sought to evaluate a tool improve adherence evidence-based best practices during such events.Operating-room teams from three institutions (one academic medical center two community hospitals) participated series of surgical-crisis scenarios simulated operating room. Each team was randomly assigned...
<h3>Objectives</h3> To assess the relationship between changes in clinician attitude and postoperative outcomes following a checklist-based surgical safety intervention. <h3>Design</h3> Pre- post intervention survey. <h3>Setting</h3> Eight hospitals participating trial of WHO checklist. <h3>Participants</h3> Clinicians actively working designated study operating rooms at eight hospitals. <h3>Survey instrument</h3> Modified operating-room version Safety Attitudes Questionnaire (SAQ). <h3>Main...
Background: Acellular dermal matrix has been popularized as an adjunct to tissue expander or implant breast reconstruction given its utility in providing additional coverage and support for the inferior pole. This study was performed assess risk of postoperative complications associated with use acellular matrix–assisted implant-based reconstruction. Methods: The authors a retrospective analysis consecutive immediate reconstructions over 6-year period. A total 415 were divided into two...
Based on older analyses, the World Health Organization (WHO) recommends that cesarean delivery rates should not exceed 10 to 15 per 100 live births optimize maternal and neonatal outcomes.To estimate contemporary relationship between national levels of mortality.Cross-sectional, ecological study estimating annual from data collected during 2005 2012 for all 194 WHO member states. The year analysis was 2012. Cesarean were available 54 countries For 118 which available, rate imputed other...
Cardiovascular status was assessed in 48 Hodgkin's disease (HD) survivors at a median of 14.3 years (range, 5.9 to 27.5 years) after diagnosis because they may be increased risk for cardiovascular abnormalities.Patients completed the Short-Form 36 quality-of-life instrument and were screened by echocardiography, exercise stress testing, resting 24-hour ECG.All patients received mediastinal irradiation (median, 40.0 Gy; range, 27.0 51.7 Gy) age 16.5 6.4 25.0 years). Four an anthracycline....
Missing data is a major issue in many applied problems, especially the biomedical sciences. We review four common approaches for inference generalized linear models (GLMs) with missing covariate data: maximum likelihood (ML), multiple imputation (MI), fully Bayesian (FB), and weighted estimating equations (WEEs). There considerable interest how these methodologies are related, properties of each approach, advantages disadvantages methodology, computational implementation. examine that at...
Abstract Moment methods for analysing repeated binary responses have been proposed by Liang and Zeger, extended Prentice Zhao Prentice. In these estimating equations, models are the correlation between responses. We extend Zeger's method to nominal or ordinal categorical responses; in particular, when binary, our reduce method. Our is illustrated with two datasets. One dataset contains observations of self‐assessment arthritis, an ordered variable three categories, collected during a...
To assess whether implementation of a 19-item World Health Organization (WHO) Surgical Safety Checklist in urgent surgical cases would improve compliance with basic standards care and reduce rates deaths complications.Use the WHO has been shown to be associated significant reductions complications deaths. Before evaluation this safety tool, concern was raised about its use practical or beneficial during procedures.We prospectively collected clinical process outcome data for 1750...
Moment methods for analyzing repeated binary responses have been proposed by Liang & Zeger (1986), and extended Prentice (1988). In their generalized estimating equations, both (1986) (1988) estimate the parameters associated with expected value of an individual's vector as well correlations between pairs responses. Because odds ratio has many desirable properties, some investigators may find is easier to interpret, we discuss modelling association at times ratio. We then modify equations...
Background Biochemical markers have not been routinely used in children at risk for myocardial damage. Yet, because of somatic growth and the duration survival, a low level damage may ultimately be more consequence than adults. Methods Results We investigated utility cardiac troponin T (cTnT) blood levels (CARDIAC ELISA Troponin T, Boehringer Mannheim Corp) 51 consecutively sampled patients from 1 day to 34 years age (median=5.7 years) undergoing cardiovascular (n=19) or noncardiovascular...