A5015624122- Frailty in Older Adults
- Geriatric Care and Nursing Homes
- Health Systems, Economic Evaluations, Quality of Life
- Health disparities and outcomes
- Palliative Care and End-of-Life Issues
- Traumatic Brain Injury and Neurovascular Disturbances
- Healthcare Policy and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Dementia and Cognitive Impairment Research
- Emergency and Acute Care Studies
- Nutrition and Health in Aging
- Pharmaceutical Practices and Patient Outcomes
- Intensive Care Unit Cognitive Disorders
- Traumatic Brain Injury Research
- Pelvic floor disorders treatments
- Statistical Methods and Bayesian Inference
- Chronic Disease Management Strategies
- HIV Research and Treatment
- Cardiac Arrest and Resuscitation
- Machine Learning in Healthcare
- Heart Failure Treatment and Management
- Nonmelanoma Skin Cancer Studies
- Primary Care and Health Outcomes
- Global Cancer Incidence and Screening
- Immune Cell Function and Interaction
University of California, San Francisco
2016-2025
San Francisco VA Health Care System
2018-2025
San Francisco VA Medical Center
2015-2024
Northern California Institute for Research and Education
2024
Medical College of Wisconsin
2022
Neurological Surgery
2022
University of Pennsylvania
2022
Human Longevity (United States)
2022
University of California, San Diego
2022
Cancer Research And Biostatistics
2000-2022
EART FAILURE CAUSES CONsiderable morbidity and mortality is responsible for a tremendous burden on the health care system in United States. 1 It accounted approximately million hospital discharges 2001, an increase of 164% since 1979, associated with overall annual cost nearly $29 billion. Reported in-hospital ranges from as low 2.3% among patients enrolled clinical trials to 19% referral series. 2,3espite this dramatic public hospitalization heart failure, models risk stratification during...
Mortality from all causes is higher for persons with fewer years of education and blacks, but it unknown which diseases contribute most to these disparities.
The association between industry payments to physicians and prescribing rates of the brand-name medications that are being promoted is controversial. In United States, payment data Medicare records recently became publicly available.To study physicians' receipt industry-sponsored meals, which account for roughly 80% total number payments, drug beneficiaries.Cross-sectional analysis from federal Open Payments Program August 1 through December 31, 2013, individual Part D, all 2013....
Object. Progressive intracranial hemorrhage after head injury is often observed on serial computerized tomography (CT) scans but its significance uncertain. In this study, patients in whom two CT were obtained within 24 hours of analyzed to determine the incidence, risk factors, and clinical progressive hemorrhagic (PHI). Methods. The diagnosis PHI was determined by comparing first second categorized as epidural hematoma (EDH), subdural (SDH), intraparenchymal contusion or (IPCH),...
Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified the Model for End‐Stage Liver Disease (MELD) Sodium (MELDNa) score. We aimed to develop a frailty index capture these extrahepatic complications of cirrhosis enhance prediction in patients with cirrhosis. Consecutive outpatients listed liver transplantation at single transplant center without MELD exceptions were assessed candidate measures. Best subset...
Readmission penalties have catalyzed efforts to improve care transitions, but few programs incorporated viewpoints of patients and health professionals determine readmission preventability or prioritize opportunities for improvement.To readmissions use these estimates areas improvement.An observational study was conducted 1000 general medicine readmitted within 30 days discharge 12 US academic medical centers between April 1, 2012, March 31, 2013. We surveyed physicians, reviewed...
Traumatic brain injury (TBI) is common in both veteran and civilian populations. Prior studies have linked moderate severe TBI with increased dementia risk, but the association between mild TBI, particularly without loss of consciousness (LOC), remains unclear.To examine severity, LOC, diagnosis veterans.This cohort study all patients diagnosed a Veterans Health Administration health care system from October 1, 2001, to September 30, 2014, propensity-matched comparison group. Patients at...
To determine the adjusted effect of hospital level care and volume on mortality very low birth weight (VLBW) infants in state California, where deregionalization perinatal has occurred.Secondary data analysis California maternal-infant discharge from 1997 to 2002 was performed. Logistic regression used evaluate odds among VLBW by neonatal intensive deliveries, context differences antenatal delivery factors site delivery.Both maternal fetal risk profiles characteristics vary delivery. After...
Chronic pain is common among the elderly and associated with cognitive deficits in cross-sectional studies; population-level association between chronic longitudinal cognition unknown.To determine persistent pain, which may reflect subsequent decline.Cohort study biennial interviews of 10 065 community-dwelling older adults nationally representative Health Retirement Study who were 62 years or 2000 answered questions both 1998 2000. Data analysis was conducted June 24 October 31,...
The racial and ethnic diversity of the US, including among patients receiving their care at Veterans Health Administration (VHA), is increasing. Dementia a significant public health challenge may have greater incidence older adults from underrepresented minority groups.To determine dementia across 5 groups by US geographical region within large, diverse, national cohort veterans who received in largest integrated system US.Retrospective study VHA random sample (5% selected for each fiscal...
Importance Mechanisms contributing to disability accumulation in multiple sclerosis (MS) are poorly understood. Blood neurofilament light chain (NfL) level, a marker of neuroaxonal injury, correlates robustly with disease activity people MS (MS); however, data on the association between NfL level and have been conflicting. Objective To determine whether when levels elevated context confirmed worsening (CDW). Design, Setting, Participants This study included 2 observational cohorts: results...
The purpose of this study was to determine if the relationship between abnormalities in glucose, lactate, and oxygen metabolism were predictive neurologic outcome after moderate or severe head injury, relative other known prognostic factors. Serial assessments cerebral metabolic rates for performed using a modified Kety-Schmidt method. In total, 31 normal control subjects studied once, 49 TBI patients (mean age 36±16 years, median GCS 7) five times per patient from postinjury days 0 9....
Object. The purpose of this prospective study was to evaluate the cumulative incidence, duration, and time course cerebral vasospasm after traumatic brain injury (TBI) in a cohort 299 patients. Methods. Transcranial Doppler (TCD) ultrasonography studies blood flow velocity middle basilar arteries (V MCA V BA , respectively) were performed at regular intervals during first 2 weeks posttrauma association with 133 Xe (CBF) measurements. According current definitions vasospasm, five different...
Background Our goal was to compare hospital scores from the most widely used commercial website in USA more systematic measures of patient experience and outcomes, assess what drives variation scores. Methods For a national sample US hospitals, we compared on Yelp.com, which aggregates visitor ratings (1–5 stars), with traditional quality. We calculated correlations between Yelp following: percent high (9 or 10, scale 0–10) ‘Overall’ item Hospital Consumer Assessment Healthcare Providers...
IMPORTANCE Advance care planning improves the receipt of medical aligned with patients' values; however, it remains suboptimal among diverse patient populations.To mitigate literacy, cultural, and language barriers to advance planning, easy-to-read directives a patient-directed, online program called PREPARE For Your Care (PREPARE) were created in English Spanish.OBJECTIVE To compare efficacy plus an directive alone increase documentation patient-reported engagement. DESIGN, SETTING, AND...
Background: The epidemiology of pain during the last years life has not been well described. Objective: To describe prevalence and correlates 2 life. Design: Observational study. Data from participants who died while enrolled in Health Retirement Study were analyzed. survey interview closest to death was used. Each participant or proxy interviewed once 24 months classified into 1 cohorts on basis number between death. relationship time before modeled adjusted for age, sex, race ethnicity,...
To examine the association between presence of individual principal investigators' financial ties to manufacturer study drug and trial's outcomes after accounting for source research funding. Cross sectional randomized controlled trials (RCTs). Studies published in "core clinical" journals, as identified by Medline, 1 January 2013 31 December 2013. Random sample RCTs focused on efficacy. Association investigators outcome. A total 190 papers describing 195 studies met inclusion criteria....
Routine preoperative testing is not recommended for patients undergoing cataract surgery, because neither decreases adverse events nor improves outcomes. We sought to assess adherence this guideline, estimate expenditures from potentially unnecessary testing, and identify patient health care system characteristics associated with testing.
OBJECTIVE: To assess variation among hospitals on pediatric readmission and revisit rates to determine the number of high- low-performing hospitals. METHODS: In a retrospective analysis using State Inpatient Emergency Department Databases from Healthcare Cost Utilization Project with linkages available, we identified (ages 1–20 years) visits 1 7 common inpatient conditions (asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders, epilepsy). For each condition,...
Objectives To determine patterns of co‐occurring diseases in older adults and the extent to which these vary between young‐old old‐old. Design Observational study. Setting Department Veterans Affairs. Participants aged 65 years (1.9 million male, mean age 76 ± 7; 39,000 female, 77 8) with two or more visits D epartment V eterans A ffairs ( VA ) M edicare settings 2007 2008. Measurements The presence 23 common conditions was assessed using hospital discharge diagnoses outpatient encounter...