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Clinical Epidemiology Commons

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Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. McManus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg 2016 University of Massachusetts Medical School

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all ...


Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. McManus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg 2016 University of Massachusetts Medical School

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all ...


Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. McManus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg 2016 University of Massachusetts Medical School

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

David D. McManus

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all ...


"What's App?" Utilizing Evidence Based Medicine Apps In The Clinical Setting, Kathryn C. O'Donovan 2016 Butler University

"What's App?" Utilizing Evidence Based Medicine Apps In The Clinical Setting, Kathryn C. O'Donovan

BU Well

The medical community has utilized evidence-based medicine, or EBM, in practice for decades, and healthcare personnel are used to the idea of utilizing research and statistics to determine the treatment of patients. However, as technology advances, the use of electronics and EBM apps has increased in the clinical setting. While there are advantages to clinicians having resources at their fingertips as they talk with patients, there are also hurdles that could harm or offend patients. So as healthcare inevitably becomes more and more electronic, can providers strike the balance needed to effectively use EBM apps in practice to provide optimum ...


Cohort Profile: The Nicotine Dependence In Teens (Ndit) Study, Jennifer O'Loughlin, Joseph R. DiFranza, Robert J. Wellman 2016 University of Montreal

Cohort Profile: The Nicotine Dependence In Teens (Ndit) Study, Jennifer O'Loughlin, Joseph R. Difranza, Robert J. Wellman

Robert J. Wellman

The Nicotine Dependence in Teens (NDIT) study is a prospective cohort investigation of 1294 students recruited in 1999-2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Its primary objectives were to study the natural course and determinants of cigarette smoking and nicotine dependence in novice smokers. The main source of data was self-report questionnaires administered in class at school every 3 months from grade 7 to grade 11 (1999-2005), for a total of 20 survey cycles during high school education. Questionnaires were also completed after graduation from high school in 2007-08 and ...


Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke 2016 Aurora Health Care

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Dennis J. Baumgardner. MD

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305 ...


Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke 2016 Aurora Research Institute, Aurora Health Care

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Dennis J. Baumgardner. MD

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored ...


Association Between First Trimester Pregnancy Associated Plasma Protein–A (Papp-A) And Gestational Diabetes Mellitus Development, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas 2016 University of Massachusetts Medical School

Association Between First Trimester Pregnancy Associated Plasma Protein–A (Papp-A) And Gestational Diabetes Mellitus Development, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas

Senior Scholars Program

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism.

Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk.

Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014 ...


Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke 2016 Aurora Research Institute, Aurora Health Care

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored ...


Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke 2016 Aurora Health Care

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305 ...


Predictive Value Of The Functional Movement Screen As It Relates To Anterior Cruciate Ligament Injury, Daniel A. Herring, Kyle D. Cherry, Hannah L. Stedge 2016 Cedarville University

Predictive Value Of The Functional Movement Screen As It Relates To Anterior Cruciate Ligament Injury, Daniel A. Herring, Kyle D. Cherry, Hannah L. Stedge

The Research and Scholarship Symposium

Introduction: Anterior cruciate ligament injuries occur over 200,000 times annually in the United States alone (Brophy, et al. 2009). This injury strains the healthcare system and affects the players, teams, parents, and the organization they are a part of. There have been, however, clinically researched risk factors that predispose athletes to ACL injury (Gignac, et al. 2015; Laible, et al. 2014). As a result, there is a clinical need for an effective screening tool to identify those athletes at risk for ACL injury. The Functional Movement Screen has been shown to be an effective screening tool for detecting athletes ...


The Role Of Mathematical Modeling In Designing And Evaluating Antimicrobial Stewardship Programs, Lester Caudill, Joanna R. Wares 2016 University of Richmond

The Role Of Mathematical Modeling In Designing And Evaluating Antimicrobial Stewardship Programs, Lester Caudill, Joanna R. Wares

Math and Computer Science Faculty Publications

Antimicrobial agent effectiveness continues to be threatened by the rise and spread of pathogen strains that exhibit drug resistance. This challenge is most acute in healthcare facilities where the well-established connection between resistance and sub-optimal antimicrobial use has prompted the creation of antimicrobial stewardship programs (ASPs). Mathematical models offer tremendous potential for serving as an alternative to controlled human experimentation for assessing the effectiveness of ASPs. Models can simulate controlled randomized experiments between groups of virtual patients, some treated with the ASP measure under investigation, and some without. By removing the limitations inherent in human experimentation, including health risks, study ...


Nortex Spring 2016 Newsletter, North Texas Primary Care Practice-Based Research Network 2016 University of North Texas Health Science Center

Nortex Spring 2016 Newsletter, North Texas Primary Care Practice-Based Research Network

North Texas Primary Care Practice-Based Research Network (NorTex) Newsletter

No abstract provided.


Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David McManus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe 2016 University of Massachusetts Medical School

Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David Mcmanus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe

Jeroan J. Allison

Early rehospitalization after discharge for an acute coronary syndrome, including acute myocardial infarction (AMI), is generally considered undesirable. The Centers for Medicare and Medicaid Services (CMS) base hospital financial incentives on risk-adjusted readmission rates after AMI, using claims data in its adjustment models. Little is known about the contribution to readmission risk of factors not captured by claims. For 804 consecutive patients > 65 years discharged in 2011 to 2013 from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome, we compared a CMS-like readmission prediction model with an enhanced model incorporating additional clinical, psychosocial, and sociodemographic characteristics, after ...


Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David McManus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe 2016 University of Massachusetts Medical School

Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David Mcmanus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe

David D. McManus

Early rehospitalization after discharge for an acute coronary syndrome, including acute myocardial infarction (AMI), is generally considered undesirable. The Centers for Medicare and Medicaid Services (CMS) base hospital financial incentives on risk-adjusted readmission rates after AMI, using claims data in its adjustment models. Little is known about the contribution to readmission risk of factors not captured by claims. For 804 consecutive patients > 65 years discharged in 2011 to 2013 from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome, we compared a CMS-like readmission prediction model with an enhanced model incorporating additional clinical, psychosocial, and sociodemographic characteristics, after ...


Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David McManus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe 2016 University of Massachusetts Medical School

Reliability Of Predicting Early Hospital Readmission After Discharge For An Acute Coronary Syndrome Using Claims-Based Data, David Mcmanus, Jane Saczynski, Darleen Lessard, Molly Waring, Jeroan Allison, David Parish, Robert Goldberg, Arlene Ash, Catarina Kiefe

Arlene S. Ash

Early rehospitalization after discharge for an acute coronary syndrome, including acute myocardial infarction (AMI), is generally considered undesirable. The Centers for Medicare and Medicaid Services (CMS) base hospital financial incentives on risk-adjusted readmission rates after AMI, using claims data in its adjustment models. Little is known about the contribution to readmission risk of factors not captured by claims. For 804 consecutive patients > 65 years discharged in 2011 to 2013 from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome, we compared a CMS-like readmission prediction model with an enhanced model incorporating additional clinical, psychosocial, and sociodemographic characteristics, after ...


Bidirectional Data Collaborations In Distributed Research, Kevin Haynes, Nandini Selvam, Mark J. Cziraky 2016 HealthCore, Inc.

Bidirectional Data Collaborations In Distributed Research, Kevin Haynes, Nandini Selvam, Mark J. Cziraky

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: The need for collaborations with bidirectional data exchange within and across distributed research networks has increased.

Currently Existing Activities: This commentary will present currently publically available activities including the Sentinel Initiative, the Patient-Centered Outcomes Research Network (PCORnet), and the NIH Research Collaboratory.

Current Technical and Governance Challenges: Even with the advances made in this arena, several technical and governance challenges remain including the evolution of clinically rich data sources and modes of care, availability of longitudinal data resources through data linkage, and the processes to share data and link data resources while ensuring privacy and proprietary control of data ...


Prenatal Triptan Exposure And Parent-Reported Early Childhood Neurodevelopmental Outcomes: An Application Of Propensity Score Calibration To Adjust For Unmeasured Confounding By Migraine Severity, Mollie Wood, Jean Frazier, Hedvig Nordeng, Kate Lapane 2016 University of Massachusetts Medical School

Prenatal Triptan Exposure And Parent-Reported Early Childhood Neurodevelopmental Outcomes: An Application Of Propensity Score Calibration To Adjust For Unmeasured Confounding By Migraine Severity, Mollie Wood, Jean Frazier, Hedvig Nordeng, Kate Lapane

Jean A. Frazier

PURPOSE: Triptan medications are serotonin agonists used to treat migraine, a chronic pain condition highly prevalent in women of reproductive age. Data on the safety of triptans during pregnancy are scant. We sought to quantify the association of prenatal triptan exposure on neurodevelopment in 3-year-old children. METHODS: Using data from the Norwegian Mother and Child Cohort Study, we used propensity score matching to examine associations between prenatal triptan exposure and psychomotor function, communication, and temperament. We used an external validation study to perform propensity calibration to adjust effect estimates for confounders unmeasured in the main study (migraine severity, type, and ...


Prenatal Triptan Exposure And Internalising And Externalising Behaviour Problems In 3-Year-Old Children: Results From The Norwegian Mother And Child Cohort Study, Mollie Wood, Kate Lapane, Jean Frazier, Eivind Ystrom, Eric Mick, Hedvig Nordeng 2016 University of Massachusetts Medical School

Prenatal Triptan Exposure And Internalising And Externalising Behaviour Problems In 3-Year-Old Children: Results From The Norwegian Mother And Child Cohort Study, Mollie Wood, Kate Lapane, Jean Frazier, Eivind Ystrom, Eric Mick, Hedvig Nordeng

Jean A. Frazier

BACKGROUND: Triptans are commonly prescribed for migraine, a pain condition that is highly prevalent in women of childbearing age. No prior studies have investigated associations between exposure to triptans during fetal life and risk of externalising and internalising behaviours in children.

METHODS: This study was set in the Norwegian Mother and Child Cohort study, a prospective birth cohort. A total of 41 173 live, singleton births without major malformations present at 36-month post-partum follow-up were included in this study; 396 used a triptan during pregnancy, 798 used a triptan prior to pregnancy only, 3291 reported migraine without triptan use, and ...


Defining Quality In Medical Practice, Nicholas E. Boggs 2016 Oakwood Family Medicine Residency

Defining Quality In Medical Practice, Nicholas E. Boggs

Clinical Research in Practice: The Journal of Team Hippocrates

We need physicians who are willing to participate in creating the standard of care, and to hold insurance companies accountable for real evidence-based quality markers. Only then will patients receive adequate care and we as educators in medicine be able to adequately teach the next generation of physicians.


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