A5043922891- Atrial Fibrillation Management and Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Machine Learning in Healthcare
- Advanced Causal Inference Techniques
- Antiplatelet Therapy and Cardiovascular Diseases
- Heart Failure Treatment and Management
- Frailty in Older Adults
- Healthcare Policy and Management
- Venous Thromboembolism Diagnosis and Management
- Blood Pressure and Hypertension Studies
- COVID-19 Clinical Research Studies
- Cardiac Arrhythmias and Treatments
- Diabetes Treatment and Management
- Primary Care and Health Outcomes
- Cardiovascular Function and Risk Factors
- Cardiac, Anesthesia and Surgical Outcomes
- Sepsis Diagnosis and Treatment
- Medication Adherence and Compliance
- Statistical Methods and Bayesian Inference
- Pregnancy and Medication Impact
- Economic and Financial Impacts of Cancer
- Liver Disease and Transplantation
- Intensive Care Unit Cognitive Disorders
- Dementia and Cognitive Impairment Research
Brigham and Women's Hospital
2017-2025
Harvard University
2013-2025
Massachusetts General Hospital
2017-2025
Mass General Brigham
2024-2025
Hebrew SeniorLife
2023
Novem (Netherlands)
2022
Centers for Medicare and Medicaid Services
2019
University of Alabama at Birmingham
2015
University of Michigan
1998-2015
Centro Español de Investigación Farmacoepidemiológica
2011-2013
Importance Nonrandomized studies using insurance claims databases can be analyzed to produce real-world evidence on the effectiveness of medical products. Given lack baseline randomization and measurement issues, concerns exist about whether such unbiased treatment effect estimates. Objective To emulate design 30 completed 2 ongoing randomized clinical trials (RCTs) medications with database observational analogues RCT parameters (population, intervention, comparator, outcome, time [PICOT])...
This study evaluated the risk of upper gastrointestinal bleeding (UGIB) associated with use low-dose acetylsalicylic acid (ASA) alone and in combination other gastrotoxic medications.The Health Improvement Network UK primary care database was used to identify individuals 40 84 years age a UGIB diagnosis 2000 2007 (n = 2049). An age-, sex-, calendar year-matched control group 20,000) identified from same source population. The relative (RR) ASA (75 300 mg/d), clopidogrel, commonly...
Apixaban and rivaroxaban are the most commonly prescribed direct oral anticoagulants for adults with atrial fibrillation, but head-to-head data comparing their safety effectiveness lacking.
Importance Undertreatment of older adults with atrial fibrillation anticoagulation therapy is an important practice gap. It has been posited that the availability direct oral anticoagulants (DOACs) would improve anticoagulant (OAC) initiation in given their superior safety profile compared warfarin. Objectives To systematically examine trends OAC and nonadherence coexisting geriatric conditions. Design, Setting, Participants This retrospective cohort study uses administrative claims data...
Importance People living with HIV and atrial fibrillation (AF) often receive anticoagulation that may interact their antiretroviral therapy (ART). No studies exist comparing the safety of oral anticoagulants in this population. Objective To compare bleeding risks among warfarin, rivaroxaban, apixaban users a national US cohort AF HIV. Design, Setting, Participants A new-user, active-comparator, propensity score overlap-weighted study using target trial emulation framework including Medicare...
Background Many patients with cirrhosis have concurrent nonvalvular atrial fibrillation (NVAF). Data are lacking regarding recent oral anticoagulant (OAC) usage trends among US and NVAF. Methods Results Using MarketScan claims data (2012-2019), we identified NVAF eligible for OACs (CHA2DS2-VASc score ≥2 [men] or ≥3 [women]). We calculated the yearly proportion of prescribed a direct OAC (DOAC), warfarin, no OAC. stratified by high-risk features (decompensated cirrhosis, thrombocytopenia,...
Previous studies suggested that early pregnancy exposure to specific oral decongestants increases the risks of several birth defects. Using January 1993–January 2010 data from Slone Epidemiology Center Birth Defects Study, we tested those hypotheses among 12,734 infants with malformations (cases) and 7,606 nonmalformed control in United States Canada. Adjusted odds ratios 95% confidence intervals were estimated for defects, controlling potential confounders. Findings did not replicate but...
Prior studies have suggested an increased risk of oral clefts after exposure to amoxicillin in early pregnancy, but findings been inconsistent.Among participants the Slone Epidemiology Center Birth Defects Study from 1994 2008, we identified 877 infants with cleft lip with/without palate and 471 alone. Controls included 6952 nonmalformed infants. Mothers were interviewed about demographic, reproductive medical factors, details medication use. We estimated odds ratios (ORs) 95% confidence...
It is unclear how out-of-system care or electronic health record (EHR) discontinuity (i.e., receiving outside of an EHR system) may affect validity comparative effectiveness research using these data. We aimed to compare the misclassification key variables in patients with high versus low continuity.The study cohort comprised ages ≥65 identified records from two US provider networks linked Medicare insurance claims data 2007 2014. By comparing and data, we quantified continuity by proportion...
Electronic health record (EHR)-discontinuity, i.e., having medical information recorded outside of the study EHR system, is associated with substantial bias in EHR-based comparative effectiveness research (CER). We aimed to develop and validate a prediction model identifying patients high EHR-continuity reduce this bias. Based on 183,739 aged ≥65 EHRs from two US provider networks linked Medicare claims data 2007-2014, we quantified by mean proportion encounters captured (MPEC) system. built...
Ejection fraction (EF) class is an important predictor of treatment response in heart failure (HF); however, administrative claims databases lack information on EF, limiting their usefulness clinical and health services research HF.
To determine whether body mass index (BMI) can be accurately identified in epidemiological studies using claims databases.Using the Mass General Brigham Research Patient Data Repository-Medicare-linked database, we a cohort of patients with BMI measurement for periods January 1 to June 31, 2014 or 2016, capture both International Classification Disease (ICD)-9 and ICD-10 eras. Patients were divided into two groups, without an obesity-related ICD code 6 months before after date. We created...
Importance The development of an optimal stroke prevention strategy, including the use oral anticoagulant (OAC) therapy, is particularly important for patients with atrial fibrillation (AF) who are living dementia, a condition that increases risk adverse outcomes. However, data on role dementia in safety and effectiveness OACs limited. Objective To assess comparative specific by status among older AF. Design, Setting, Participants This retrospective study used 1:1 propensity score matching 1...
Apixaban, rivaroxaban, and warfarin have shown benefit for preventing major ischemic events, albeit with increased bleeding risk, among patients in the general population atrial fibrillation (AF). However, data are scarce cirrhosis AF.
Treatment decisions for Coronavirus Disease 2019 (COVID-19) depend on disease severity, but the prescribing pattern by severity and drivers of therapeutic choices remain unclear. The objectives study were to evaluate pharmacological treatment patterns COVID-19 identify determinants COVID-19. Using electronic health record data from a large Massachusetts-based healthcare system, we identified all patients aged ≥ 18 years hospitalized with laboratory-confirmed 1 March 24 May, 2020. We defined...
The emergence and global spread of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has resulted in an urgent need for evidence on medical interventions outcomes resulting disease, disease 2019 (COVID‐19). Although many randomized controlled trials (RCTs) evaluating treatments vaccines COVID‐19 are already progress, number clinical questions interest greatly outpaces available resources to conduct RCTs. Therefore, there is growing whether nonrandomized real‐world (RWE) can be...
Abstract Multiple imputation (MI) models can be improved with auxiliary covariates (AC), but their performance in high-dimensional data remains unclear. We aimed to develop and compare MI (HDMI) methods using structured natural language processing (NLP)-derived AC studies partially observed confounders. conducted a plasmode simulation acute kidney injury as outcome simulated 100 cohorts null treatment effect, incorporating creatinine labs, atrial fibrillation (AFib), other...
Objective To evaluate the validity of death ascertainment from publicly available internet media sources by benchmarking against state and Federal vital statics data for patients in two large healthcare systems US. Methods We extracted names dates birth including obituaries memorial websites using previously developed natural language processing models. These were probabilistically matched to electronic health records (EHRs) Mass General Brigham (MGB) Vanderbilt University Medical Center...