Scholars@Duke
Benjamin Alan Goldstein

Benjamin Alan Goldstein

Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Translational Biomedical
ben.goldstein@duke.edu
Duke Box 2721, Durham, NC 27710
2424 Erwin Road Ste 902, 9023 Hock Plaza, Durham, NC 27705

Selected Publications

Linking Electronic Health Record Prescribing Data and Pharmacy Dispensing Records to Identify Patient-Level Factors Associated With Psychotropic Medication Receipt: Retrospective Study.

Journal Article JMIR Med Inform · March 4, 2025 BACKGROUND: Pharmacoepidemiology studies using electronic health record (EHR) data typically rely on medication prescriptions to determine which patients have received a medication. However, such data do not affirmatively indicate whether these prescriptio ... Full text Link to item Cite

Machine learning-based prediction models in medical decision-making in kidney disease: patient, caregiver, and clinician perspectives on trust and appropriate use.

Journal Article J Am Med Inform Assoc · January 1, 2025 OBJECTIVES: This study aims to improve the ethical use of machine learning (ML)-based clinical prediction models (CPMs) in shared decision-making for patients with kidney failure on dialysis. We explore factors that inform acceptability, interpretability, ... Full text Link to item Cite

Distinguishing Among Causes of Death for Patients with Kidney Failure on Hemodialysis.

Journal Article Kidney360 · December 16, 2024 BACKGROUND: Patients treated with maintenance hemodialysis (HD) are at high risk of death from a variety of causes. METHODS: To identify markers (i.e., risk phenotypes) that distinguish among causes of death, we used dialysis electronic health record data ... Full text Link to item Cite

Enhancing Clinical Decision Support in Nephrology: Addressing Algorithmic Bias Through Artificial Intelligence Governance.

Journal Article Am J Kidney Dis · December 2024 There has been a steady rise in the use of clinical decision support (CDS) tools to guide nephrology as well as general clinical care. Through guidance set by federal agencies and concerns raised by clinical investigators, there has been an equal rise in u ... Full text Link to item Cite

Sudden Cardiac Death Reporting in US Patients on Dialysis: Comparison of United States Renal Data System and National Death Index Data.

Journal Article Clin J Am Soc Nephrol · December 1, 2024 KEY POINTS: For patients with ESKD treated with hemodialysis, the causes of death reported by the United States Renal Data System and the National Death Index show substantial disagreement. In particular, the proportion of sudden cardiac death was almost t ... Full text Link to item Cite

Breast and Prostate Cancer Screening by Life Expectancy in Patients with Kidney Failure on Dialysis.

Journal Article Clin J Am Soc Nephrol · December 1, 2024 KEY POINTS: Breast and prostate cancer screening were more frequent among patients on hemodialysis waitlisted for kidney transplant. Among patients not waitlisted for transplant, we found that screening rates were generally higher among patients with highe ... Full text Link to item Cite

Addressing cost barriers to healthy eating with Eat Well, a prescription produce subsidy, for patients with diabetes and at risk for food insecurity: Study protocol for a type 1 hybrid effectiveness-implementation pragmatic randomized controlled trial.

Journal Article Contemp Clin Trials · October 2024 BACKGROUND: Patients with diabetes at risk of food insecurity face cost barriers to healthy eating and, as a result, poor health outcomes. Population health management strategies are needed to improve food security in real-world health system settings. We ... Full text Link to item Cite

Factors Associated with Caregivers' Decisions to Pursue a Diagnostic Evaluation After a Positive Autism Screen in Primary Care.

Journal Article Journal of autism and developmental disorders · October 2024 PurposeWe sought to understand whether a child's sex, age, race, ethnicity, caregiver education, family income, and/or number of endorsed autism signs are associated with a caregiver's decision to pursue an autism diagnostic evaluation after their ... Full text Cite

A conditional multi-label model to improve prediction of a rare outcome: An illustration predicting autism diagnosis.

Journal Article J Biomed Inform · September 2024 OBJECTIVE: This study aimed to develop a novel approach using routinely collected electronic health records (EHRs) data to improve the prediction of a rare event. We illustrated this using an example of improving early prediction of an autism diagnosis, gi ... Full text Link to item Cite

Incorporating informatively collected laboratory data from EHR in clinical prediction models.

Journal Article BMC Med Inform Decis Mak · July 24, 2024 BACKGROUND: Electronic Health Records (EHR) are widely used to develop clinical prediction models (CPMs). However, one of the challenges is that there is often a degree of informative missing data. For example, laboratory measures are typically taken when ... Full text Open Access Link to item Cite

Designing an Implementable Clinical Prediction Model for Near-Term Mortality and Long-Term Survival in Patients on Maintenance Hemodialysis.

Journal Article Am J Kidney Dis · July 2024 RATIONALE & OBJECTIVE: The life expectancy of patients treated with maintenance hemodialysis (MHD) is heterogeneous. Knowledge of life-expectancy may focus care decisions on near-term versus long-term goals. The current tools are limited and focus on near- ... Full text Link to item Cite

Contrastive Learning for Clinical Outcome Prediction with Partial Data Sources.

Journal Article Proc Mach Learn Res · July 2024 The use of machine learning models to predict clinical outcomes from (longitudinal) electronic health record (EHR) data is becoming increasingly popular due to advances in deep architectures, representation learning, and the growing availability of large E ... Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical and Functional Outcomes Following Moderate-Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · April 1, 2024 OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ... Full text Link to item Cite

Impact of preeclampsia on infant and maternal health among women with rheumatic diseases.

Journal Article Lupus · April 2024 OBJECTIVES: We sought to identify the impact of preeclampsia on infant and maternal health among women with rheumatic diseases. METHODS: A retrospective single-center cohort study was conducted to describe pregnancy and infant outcomes among women with sys ... Full text Link to item Cite

Translating ethical and quality principles for the effective, safe and fair development, deployment and use of artificial intelligence technologies in healthcare.

Journal Article J Am Med Inform Assoc · February 16, 2024 OBJECTIVE: The complexity and rapid pace of development of algorithmic technologies pose challenges for their regulation and oversight in healthcare settings. We sought to improve our institution's approach to evaluation and governance of algorithmic techn ... Full text Link to item Cite

Interactive visualization tool to understand and monitor health disparities in diabetes care and outcomes.

Journal Article J Clin Transl Sci · 2024 OBJECTIVE: Type 2 diabetes (T2DM) poses a significant public health challenge, with pronounced disparities in control and outcomes. Social determinants of health (SDoH) significantly contribute to these disparities, affecting healthcare access, neighborhoo ... Full text Link to item Cite

Data analysis protocol for early autonomic dysfunction characterization after severe traumatic brain injury.

Journal Article Front Neurol · 2024 BACKGROUND: Traumatic brain injury (TBI) disrupts normal brain tissue and functions, leading to high mortality and disability. Severe TBI (sTBI) causes prolonged cognitive, functional, and multi-organ dysfunction. Dysfunction of the autonomic nervous syste ... Full text Link to item Cite

Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Explor · September 2023 OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ... Full text Open Access Link to item Cite

Comparing Natural Language Processing and Structured Medical Data to Develop a Computable Phenotype for Patients Hospitalized Due to COVID-19: Retrospective Analysis.

Journal Article JMIR Med Inform · August 22, 2023 BACKGROUND: Throughout the COVID-19 pandemic, many hospitals conducted routine testing of hospitalized patients for SARS-CoV-2 infection upon admission. Some of these patients are admitted for reasons unrelated to COVID-19 and incidentally test positive fo ... Full text Link to item Cite

Comparing Natural Language Processing and Structured Medical Data to Develop a Computable Phenotype for Patients Hospitalized Due to COVID-19: Retrospective Analysis.

Journal Article JMIR Med Inform · June 17, 2023 BACKGROUND: Throughout the COVID-19 pandemic, many hospitals conducted routine testing of hospitalized patients for SARS-CoV-2 infection upon admission. Some of these patients are admitted for reasons unrelated to COVID-19, and incidentally test positive f ... Full text Link to item Cite

Impact of state legislation and institutional protocols on opioid prescribing practices following pediatric tonsillectomy.

Journal Article Laryngoscope Investig Otolaryngol · June 2023 OBJECTIVES: Tonsillectomy is a common pediatric surgery, and pain is an important consideration in recovery. Due to the opioid epidemic, individual states, medical societies, and institutions have all taken steps to limit postoperative opioids, yet few stu ... Full text Link to item Cite

A universal AutoScore framework to develop interpretable scoring systems for predicting common types of clinical outcomes.

Journal Article STAR Protoc · May 12, 2023 The AutoScore framework can automatically generate data-driven clinical scores in various clinical applications. Here, we present a protocol for developing clinical scoring systems for binary, survival, and ordinal outcomes using the open-source AutoScore ... Full text Link to item Cite

Utilization and Outcomes of Extracorporeal Membrane Oxygenation Following Traumatic Brain Injury in the United States.

Journal Article J Intensive Care Med · May 2023 Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ... Full text Link to item Cite

Predictive Modeling to Identify Children With Complex Health Needs At Risk for Hospitalization.

Journal Article Hosp Pediatr · May 1, 2023 BACKGROUND: Identifying children at high risk with complex health needs (CCHN) who have intersecting medical and social needs is challenging. This study's objectives were to (1) develop and evaluate an electronic health record (EHR)-based clinical predicti ... Full text Link to item Cite

Use of Structured Electronic Health Records Data Elements for the Development of Computable Phenotypes to Identify Potential Adverse Events Associated with Intravenous Immunoglobulin Infusion.

Journal Article Drug Saf · March 2023 INTRODUCTION: Detection of adverse reactions to drugs and biologic agents is an important component of regulatory approval and post-market safety evaluation. Real-world data, including insurance claims and electronic health records data, are increasingly u ... Full text Link to item Cite

The Current Landscape in Biostatistics of Real-World Data and Evidence: Clinical Study Design and Analysis

Journal Article Statistics in Biopharmaceutical Research · January 1, 2023 Real-world data (RWD), such as electronic health records, reimbursement requests as adjudicated by health insurance companies, and health survey data as collected by government agencies or other research organizations, are increasingly used in drug develop ... Full text Cite

Biostatistical Considerations When Using RWD and RWE in Clinical Studies for Regulatory Purposes: A Landscape Assessment

Journal Article Statistics in Biopharmaceutical Research · January 1, 2023 Real-world evidence (RWE), derived from data from “real-world” clinical practice and medical product utilization, is an increasingly important source of evidence that holds great potential to increase efficiency and improve clinical development and life cy ... Full text Cite

Early Vasopressor Utilization Strategies and Outcomes in Critically Ill Patients With Severe Traumatic Brain Injury.

Journal Article Anesth Analg · December 1, 2022 BACKGROUND: Early hypotension after severe traumatic brain injury (sTBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors, commonly norepinephrine and phenylephrine, to suppo ... Full text Link to item Cite

Association between Gentrification and Health and Healthcare Utilization.

Journal Article J Urban Health · December 2022 There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighbor ... Full text Link to item Cite

Transition from pediatric to adult care in type 1 diabetes mellitus: a longitudinal analysis of age at transfer and gap in care.

Journal Article BMJ Open Diabetes Res Care · November 2022 INTRODUCTION: Adolescents and young adults (AYAs) with type 1 diabetes (T1D) are at risk of suboptimal glycemic control and high acute care utilization. Little is known about the optimal age to transfer people with T1D to adult care, or time gap between co ... Full text Link to item Cite

Risk Factors and Neurological Outcomes Associated With Circulatory Shock After Moderate-Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article Neurosurgery · September 1, 2022 BACKGROUND: Extracranial multisystem organ failure is a common sequela of severe traumatic brain injury (TBI). Risk factors for developing circulatory shock and long-term functional outcomes of this patient subset are poorly understood. OBJECTIVE: To ident ... Full text Link to item Cite

A framework for the oversight and local deployment of safe and high-quality prediction models.

Journal Article J Am Med Inform Assoc · August 16, 2022 Artificial intelligence/machine learning models are being rapidly developed and used in clinical practice. However, many models are deployed without a clear understanding of clinical or operational impact and frequently lack monitoring plans that can detec ... Full text Link to item Cite

Asthma and the Risk of SARS-CoV-2 Infection Among Children and Adolescents.

Journal Article Pediatrics · June 1, 2022 OBJECTIVES: Over 6 million pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have occurred in the United States, but risk factors for infection remain poorly defined. We sought to evaluate the association between asthma and ... Full text Link to item Cite

AutoScore-Imbalance: An interpretable machine learning tool for development of clinical scores with rare events data.

Journal Article J Biomed Inform · May 2022 BACKGROUND: Medical decision-making impacts both individual and public health. Clinical scores are commonly used among various decision-making models to determine the degree of disease deterioration at the bedside. AutoScore was proposed as a useful clinic ... Full text Link to item Cite

Proper Use of Multiple Imputation and Dealing with Missing Covariate Data.

Journal Article World Neurosurg · May 2022 BACKGROUND: Missing data is a typical problem in clinical studies, where the value of variables of interest is not measured or collected for some patients. This article aimed to review imputation approaches for missing values and their application in neuro ... Full text Link to item Cite

Predicting in-hospital length of stay: a two-stage modeling approach to account for highly skewed data.

Journal Article BMC Med Inform Decis Mak · April 24, 2022 BACKGROUND: In the early stages of the COVID-19 pandemic our institution was interested in forecasting how long surgical patients receiving elective procedures would spend in the hospital. Initial examination of our models indicated that, due to the skewed ... Full text Link to item Cite

Environmental and clinical data utility in pediatric asthma exacerbation risk prediction models.

Journal Article BMC Med Inform Decis Mak · April 22, 2022 BACKGROUND: Asthma exacerbations are triggered by a variety of clinical and environmental factors, but their relative impacts on exacerbation risk are unclear. There is a critical need to develop methods to identify children at high-risk for future exacerb ... Full text Link to item Cite

Observability and its impact on differential bias for clinical prediction models.

Journal Article J Am Med Inform Assoc · April 13, 2022 OBJECTIVE: Electronic health records have incomplete capture of patient outcomes. We consider the case when observability is differential across a predictor. Including such a predictor (sensitive variable) can lead to algorithmic bias, potentially exacerba ... Full text Link to item Cite

Shapley variable importance cloud for interpretable machine learning.

Journal Article Patterns (N Y) · April 8, 2022 Interpretable machine learning has been focusing on explaining final models that optimize performance. The state-of-the-art Shapley additive explanations (SHAP) locally explains the variable impact on individual predictions and has recently been extended t ... Full text Link to item Cite

Combining adult with pediatric patient data to develop a clinical decision support tool intended for children: leveraging machine learning to model heterogeneity.

Journal Article BMC Med Inform Decis Mak · March 29, 2022 BACKGROUND: Clinical decision support (CDS) tools built using adult data do not typically perform well for children. We explored how best to leverage adult data to improve the performance of such tools. This study assesses whether it is better to build CDS ... Full text Open Access Link to item Cite

Using Electronic Health Records to understand the population of local children captured in a large health system in Durham County, NC, USA, and implications for population health research.

Journal Article Soc Sci Med · March 2022 Although local policies aimed at reducing childhood health inequities can benefit from local data, sample size constraints in population representative health surveys often prevent rigorous evaluations of child health disparities and health care patterns a ... Full text Link to item Cite

Inpatient pharmacists using a readmission risk model in supporting discharge medication reconciliation to reduce unplanned hospital readmissions: a quality improvement intervention.

Journal Article BMJ Open Qual · March 2022 INTRODUCTION: Reducing unplanned hospital readmissions is an important priority for all hospitals and health systems. Hospital discharge can be complicated by discrepancies in the medication reconciliation and/or prescribing processes. Clinical pharmacist ... Full text Link to item Cite

Association of Vasopressor Choice with Clinical and Functional Outcomes Following Moderate to Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article Neurocrit Care · February 2022 BACKGROUND: Early hypotension following moderate to severe traumatic brain injury (TBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors to support blood pressure following T ... Full text Link to item Cite

AutoScore-Survival: Developing interpretable machine learning-based time-to-event scores with right-censored survival data.

Journal Article Journal of biomedical informatics · January 2022 BackgroundScoring systems are highly interpretable and widely used to evaluate time-to-event outcomes in healthcare research. However, existing time-to-event scores are predominantly created ad-hoc using a few manually selected variables based on ... Full text Cite

Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity.

Journal Article J Pediatr Health Care · 2022 OBJECTIVES: To evaluate feasibility and acceptability of post-hospitalization telemedicine video visits (TMVV) during hospital-to-home transitions for children with medical complexity (CMC); and explore associations with hospital utilization, caregiver sel ... Full text Open Access Link to item Cite

Impact of a clinical pharmacist on provider prescribing patterns in a primary care clinic.

Journal Article J Am Pharm Assoc (2003) · 2022 BACKGROUND: Sodium-glucose transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists have demonstrated beneficial outcomes in patients with type 2 diabetes at high cardiovascular risk. Unfortunately, these agents are still underutilized ... Full text Link to item Cite

Vitals are Vital: Simpler Clinical Data Model Predicts Decompensation in COVID-19 Patients

Journal Article ACI Open · January 2022 Abstract Objective Several risk scores have been developed and tested on coronavirus disease 2019 (COVID-19) patients to predict clinical decompensation. We aimed to compare an institutional, automated, custom-bui ... Full text Open Access Cite

Pragmatic Randomized Trials Using Claims or Electronic Health Record Data

Chapter · January 1, 2022 Randomized clinical trials have been the accepted standard for addressing key questions in medicine for well over 60 years. The structure and process, while well documented and characterized, have been historically described in the context of “efficacy” in ... Full text Cite

The importance of weight stabilization amongst those with overweight or obesity: Results from a large health care system.

Journal Article Prev Med Rep · December 2021 Data on patterns of weight change among adults with overweight or obesity are minimal. We aimed to examine patterns of weight change and associated hospitalizations in a large health system, and to develop a model to predict 2-year significant weight gain. ... Full text Link to item Cite

Supercharging Imbalanced Data Learning With Energy-based Contrastive Representation Transfer.

Conference Adv Neural Inf Process Syst · December 2021 Dealing with severe class imbalance poses a major challenge for many real-world applications, especially when the accurate classification and generalization of minority classes are of primary interest. In computer vision and NLP, learning from datasets wit ... Link to item Cite

Association of Early Multiple Organ Dysfunction With Clinical and Functional Outcomes Over the Year Following Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · October 1, 2021 OBJECTIVES: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ ... Full text Link to item Cite

Reduced pediatric urgent asthma utilization and exacerbations during the COVID-19 pandemic.

Journal Article Pediatr Pulmonol · October 2021 The COVID-19 pandemic has had a profound impact on healthcare access and utilization, which could have important implications for children with chronic diseases, including asthma. We sought to evaluate changes in healthcare utilization and outcomes in chil ... Full text Link to item Cite

Development and Assessment of an Interpretable Machine Learning Triage Tool for Estimating Mortality After Emergency Admissions.

Journal Article JAMA Netw Open · August 2, 2021 IMPORTANCE: Triage in the emergency department (ED) is a complex clinical judgment based on the tacit understanding of the patient's likelihood of survival, availability of medical resources, and local practices. Although a scoring tool could be valuable i ... Full text Open Access Link to item Cite

Variational Disentanglement for Rare Event Modeling.

Journal Article Proc AAAI Conf Artif Intell · May 18, 2021 Combining the increasing availability and abundance of healthcare data and the current advances in machine learning methods have created renewed opportunities to improve clinical decision support systems. However, in healthcare risk prediction applications ... Link to item Cite

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.

Journal Article JAMA Netw Open · April 1, 2021 IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical ... Full text Open Access Link to item Cite

Development of a Machine Learning Model Using Electronic Health Record Data to Identify Antibiotic Use Among Hospitalized Patients.

Journal Article JAMA Netw Open · March 1, 2021 IMPORTANCE: Comparisons of antimicrobial use among hospitals are difficult to interpret owing to variations in patient case mix. Risk-adjustment strategies incorporating larger numbers of variables haves been proposed as a method to improve comparisons for ... Full text Link to item Cite

Statins and atherosclerotic cardiovascular outcomes in patients on incident dialysis and with atherosclerotic heart disease.

Journal Article Am Heart J · January 2021 UNLABELLED: Statins failed to reduce cardiovascular (CV) events in trials of patients on dialysis. However, trial populations used criteria that often excluded those with atherosclerotic heart disease (ASHD), in whom statins have the greatest benefit, and ... Full text Link to item Cite

Well-Child Care Attendance and Risk of Asthma Exacerbations.

Journal Article Pediatrics · December 2020 BACKGROUND: Asthma remains a leading cause of hospitalization in US children. Well-child care (WCC) visits are routinely recommended, but how WCC adherence relates to asthma outcomes is poorly described. METHODS: We conducted a retrospective longitudinal c ... Full text Link to item Cite

Testing Clinical Prediction Models.

Journal Article JAMA · November 17, 2020 Full text Link to item Cite

Development and Performance of a Clinical Decision Support Tool to Inform Resource Utilization for Elective Operations.

Journal Article JAMA Netw Open · November 2, 2020 IMPORTANCE: Hospitals ceased most elective procedures during the height of coronavirus disease 2019 (COVID-19) infections. As hospitals begin to recommence elective procedures, it is necessary to have a means to assess how resource intensive a given case m ... Full text Link to item Cite

Provision and Utilization of Team- and Community-Based Operative Care for Patients With Cleft Lip/Palate in North Carolina.

Journal Article Cleft Palate Craniofac J · November 2020 OBJECTIVE: To characterize operative care for cleft lip and/or palate (CL/P) based on location (ie, from American Cleft Palate Craniofacial Association [ACPA]-approved multidisciplinary teams or from community providers). DESIGN: Cross-sectional analysis o ... Full text Open Access Link to item Cite

Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data.

Journal Article BMC Public Health · October 29, 2020 BACKGROUND: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primaril ... Full text Link to item Cite

AutoScore: A Machine Learning-Based Automatic Clinical Score Generator and Its Application to Mortality Prediction Using Electronic Health Records.

Journal Article JMIR Med Inform · October 21, 2020 BACKGROUND: Risk scores can be useful in clinical risk stratification and accurate allocations of medical resources, helping health providers improve patient care. Point-based scores are more understandable and explainable than other complex models and are ... Full text Link to item Cite

Variational Disentanglement for Rare Event Modeling.

Conference ArXiv · September 17, 2020 Combining the increasing availability and abundance of healthcare data and the current advances in machine learning methods have created renewed opportunities to improve clinical decision support systems. However, in healthcare risk prediction applications ... Link to item Cite

Unanticipated Respiratory Compromise and Unplanned Intubations on General Medical and Surgical Floors.

Journal Article Respir Care · September 2020 BACKGROUND: Unanticipated respiratory compromise that lead to unplanned intubations is a known phenomenon in hospitalized patients. Most events occur in patients at high risk in well-monitored units; less is known about the incidence, risk factors, and tra ... Full text Link to item Cite

No-Shows in Adult Urology Outpatient Clinics: Economic and Operational Implications.

Journal Article Urol Pract · September 2020 INTRODUCTION: We analyzed trends and explored implications of no-show rates in adult urology from provider related characteristics at an academic program. METHODS: No-show rates were determined from electronic health records of appointments in adult urolog ... Full text Link to item Cite

Evaluation of ML-Based Clinical Decision Support Tool to Replace an Existing Tool in an Academic Health System: Lessons Learned.

Journal Article J Pers Med · August 27, 2020 There is increasing application of machine learning tools to problems in healthcare, with an ultimate goal to improve patient safety and health outcomes. When applied appropriately, machine learning tools can augment clinical care provided to patients. How ... Full text Open Access Link to item Cite

Implementation and Continuous Monitoring of an Electronic Health Record Embedded Readmissions Clinical Decision Support Tool.

Journal Article J Pers Med · August 26, 2020 Unplanned hospital readmissions represent a significant health care value problem with high costs and poor quality of care. A significant percentage of readmissions could be prevented if clinical inpatient teams were better able to predict which patients w ... Full text Link to item Cite

Five analytic challenges in working with electronic health records data to support clinical trials with some solutions.

Journal Article Clin Trials · August 2020 Electronic health records data are becoming a key data resource in clinical research. Owing to issues of data efficiency, electronic health records data are being used for clinical trials. This includes both large-scale pragmatic trails and smaller-more fo ... Full text Link to item Cite

Development of an electronic health records datamart to support clinical and population health research.

Journal Article J Clin Transl Sci · June 23, 2020 INTRODUCTION: Electronic health record (EHR) data have emerged as an important resource for population health and clinical research. There have been significant efforts to leverage EHR data for research; however, given data security concerns and the comple ... Full text Link to item Cite

Identified themes of interactive visualizations overlayed onto EHR data: an example of improving birth center operating room efficiency.

Journal Article J Am Med Inform Assoc · May 1, 2020 OBJECTIVE: While electronic health record (EHR) systems store copious amounts of patient data, aggregating those data across patients can be challenging. Visual analytic tools that integrate with EHR systems allow clinicians to gain better insight and unde ... Full text Link to item Cite

Investigating sources of inaccuracy in wearable optical heart rate sensors.

Journal Article NPJ Digit Med · February 10, 2020 As wearable technologies are being increasingly used for clinical research and healthcare, it is critical to understand their accuracy and determine how measurement errors may affect research conclusions and impact healthcare decision-making. Accuracy of w ... Full text Link to item Cite

Use of Hospital Referral Regions in Evaluating End-of-Life Care.

Journal Article J Palliat Med · January 2020 Background: Hospital referral regions (HRRs) are often used to characterize inpatient referral patterns, but it is unknown how well these geographic regions are aligned with variation in Medicare-financed hospice care, which is largely provided at home. Ob ... Full text Link to item Cite

Prediction of appointment no-shows using electronic health records.

Journal Article J Appl Stat · 2020 Appointment no-shows have a negative impact on patient health and have caused substantial loss in resources and revenue for health care systems. Intervention strategies to reduce no-show rates can be more effective if targeted to the subpopulations of pati ... Full text Link to item Cite

Development, Implementation, and Evaluation of an In-Hospital Optimized Early Warning Score for Patient Deterioration.

Journal Article MDM Policy Pract · 2020 Background. Identification of patients at risk of deteriorating during their hospitalization is an important concern. However, many off-shelf scores have poor in-center performance. In this article, we report our experience developing, implementing, and ev ... Full text Open Access Link to item Cite

Investigating sources of inaccuracy in wearable optical heart rate sensors.

Journal Article NPJ Digit Med · 2020 As wearable technologies are being increasingly used for clinical research and healthcare, it is critical to understand their accuracy and determine how measurement errors may affect research conclusions and impact healthcare decision-making. Accuracy of w ... Full text Open Access Link to item Cite

How and when informative visit processes can bias inference when using electronic health records data for clinical research.

Journal Article J Am Med Inform Assoc · December 1, 2019 OBJECTIVE: Electronic health records (EHR) data have become a central data source for clinical research. One concern for using EHR data is that the process through which individuals engage with the health system, and find themselves within EHR data, can be ... Full text Link to item Cite

The effect of treatment on patient-reported distress after breast cancer diagnosis.

Journal Article Cancer · September 1, 2019 BACKGROUND: The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) uses a 10-point scale (in which 0 indicates no distress and 10 indicates extreme distress) to measure patient-reported distress. In the current study, the authors sought ... Full text Link to item Cite

Advancing the HIV Pre-Exposure Prophylaxis Continuum: A Collaboration Between a Public Health Department and a Federally Qualified Health Center in the Southern United States.

Journal Article AIDS Patient Care STDS · August 2019 Uptake of pre-exposure prophylaxis (PrEP) has been limited among black and Latino men who have sex with men (MSM), especially in the southern United States. Public health departments and federally qualified health centers (FQHCs) serving predominantly unin ... Full text Link to item Cite

DIFFERENCES IN ACHIEVING HBA1C GOALS AMONG PATIENTS SEEN BY ENDOCRINOLOGISTS AND PRIMARY CARE PROVIDERS.

Journal Article Endocr Pract · May 2019 Objective: This study evaluated whether there is a difference in the proportion of patients with type 2 diabetes who achieve a hemoglobin A1c (HbA1c) <7% within one year following treatment by an endocrinologist or primary care physician (PCP). Methods: We ... Full text Link to item Cite

An outcome model approach to transporting a randomized controlled trial results to a target population.

Journal Article J Am Med Inform Assoc · May 1, 2019 OBJECTIVE: Participants enrolled into randomized controlled trials (RCTs) often do not reflect real-world populations. Previous research in how best to transport RCT results to target populations has focused on weighting RCT data to look like the target da ... Full text Link to item Cite

Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care.

Journal Article Clin Pediatr (Phila) · April 2019 The impact of the Patient Protection and Affordable Care Act (PPACA) on children's access to surgical care is not well-defined. Our objective was to describe the early impact of PPACA on children's surgical care before and after Medicaid expansion in 2014. ... Full text Link to item Cite

Abstract 017: Impact of Gentrification on Cardiovascular Disease Surveillance Using Data from the Electronic Health Record

Conference Circulation · March 5, 2019 Introduction: Current static approaches of CVD surveillance may not capture the true health of neighborhoods as the influx of younger, healthier, and wealthier individuals (i.e., gentrification) can i ... Full text Cite

Minimal Impact of Implemented Early Warning Score and Best Practice Alert for Patient Deterioration.

Journal Article Crit Care Med · January 2019 OBJECTIVES: Previous studies have looked at National Early Warning Score performance in predicting in-hospital deterioration and death, but data are lacking with respect to patient outcomes following implementation of National Early Warning Score. We sough ... Full text Link to item Cite

Documenting or Operating: Where Is Time Spent in General Surgery Residency?

Journal Article J Surg Educ · November 2018 OBJECTIVE: The utilization of electronic health records (EHR) has become essential in the daily activities of physicians for documentation and as an information source. However, the amount of time spent by residents utilizing the EHR has not been thoroughl ... Full text Link to item Cite

Value of Neighborhood Socioeconomic Status in Predicting Risk of Outcomes in Studies That Use Electronic Health Record Data.

Journal Article JAMA Netw Open · September 7, 2018 IMPORTANCE: Data from electronic health records (EHRs) are increasingly used for risk prediction. However, EHRs do not reliably collect sociodemographic and neighborhood information, which has been shown to be associated with health. The added contribution ... Full text Link to item Cite

Risk profiles for acute health events after incident atrial fibrillation in patients with end-stage renal disease on hemodialysis.

Journal Article Nephrol Dial Transplant · September 1, 2018 BACKGROUND: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). METHODS: We studied older US patients who newly initiated HD for ESRD (200 ... Full text Link to item Cite

Designing risk prediction models for ambulatory no-shows across different specialties and clinics.

Journal Article J Am Med Inform Assoc · August 1, 2018 OBJECTIVE: As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed the ability to derive a risk score for a patient no-showing to a clinic visit. METHODS: Using data from 2  ... Full text Open Access Link to item Cite

Adversarial time-to-event modeling

Journal Article 35th International Conference on Machine Learning, ICML 2018 · January 1, 2018 Modern health data science applications leverage abundant molecular and electronic health data; providing opportunities for machine learning to build statistical models to support clinical practice. Time-to-event analysis, also called survival analysis, st ... Cite

Illustrating Informed Presence Bias in Electronic Health Records Data: How Patient Interactions with a Health System Can Impact Inference.

Journal Article EGEMS (Wash DC) · December 6, 2017 Electronic health record (EHR) data are becoming a primary resource for clinical research. Compared to traditional research data, such as those from clinical trials and epidemiologic cohorts, EHR data have a number of appealing characteristics. However, be ... Full text Link to item Cite

Serum Potassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease.

Journal Article Kidney Int Rep · November 2017 INTRODUCTION: Chronic kidney disease (CKD) patients have increased risks of sudden cardiac arrest and sudden cardiac death (SCA/SCD) that are not explained by traditional risk factors. We examined associations between serum potassium and SCA/SCD in a large ... Full text Link to item Cite

Racial/Ethnic Disparity in NICU Quality of Care Delivery.

Journal Article Pediatrics · September 2017 BACKGROUND: Differences in NICU quality of care provided to very low birth weight (<1500 g) infants may contribute to the persistence of racial and/or ethnic disparity. An examination of such disparities in a population-based sample across multiple dimensi ... Full text Link to item Cite

A comparison of risk prediction methods using repeated observations: an application to electronic health records for hemodialysis.

Journal Article Stat Med · July 30, 2017 An increasingly important data source for the development of clinical risk prediction models is electronic health records (EHRs). One of their key advantages is that they contain data on many individuals collected over time. This allows one to incorporate ... Full text Link to item Cite

Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges.

Journal Article Eur Heart J · June 14, 2017 Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operat ... Full text Link to item Cite

Safety of Intravenous Iron in Hemodialysis: Longer-term Comparisons of Iron Sucrose Versus Sodium Ferric Gluconate Complex.

Journal Article Am J Kidney Dis · June 2017 BACKGROUND: Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy ... Full text Link to item Cite

Assessing electronic health record phenotypes against gold-standard diagnostic criteria for diabetes mellitus.

Journal Article J Am Med Inform Assoc · April 1, 2017 OBJECTIVE: We assessed the sensitivity and specificity of 8 electronic health record (EHR)-based phenotypes for diabetes mellitus against gold-standard American Diabetes Association (ADA) diagnostic criteria via chart review by clinical experts. MATERIALS ... Full text Link to item Cite

Opportunities and challenges in developing risk prediction models with electronic health records data: a systematic review.

Journal Article J Am Med Inform Assoc · January 2017 OBJECTIVE: Electronic health records (EHRs) are an increasingly common data source for clinical risk prediction, presenting both unique analytic opportunities and challenges. We sought to evaluate the current state of EHR based risk prediction modeling thr ... Full text Link to item Cite

Predicting mortality over different time horizons: which data elements are needed?

Journal Article J Am Med Inform Assoc · January 2017 OBJECTIVE: Electronic health records (EHRs) are a resource for "big data" analytics, containing a variety of data elements. We investigate how different categories of information contribute to prediction of mortality over different time horizons among pati ... Full text Link to item Cite

Impact of a Genetic Risk Score for Coronary Artery Disease on Reducing Cardiovascular Risk: A Pilot Randomized Controlled Study.

Journal Article Front Cardiovasc Med · 2017 PURPOSE: We tested whether providing a genetic risk score (GRS) for coronary artery disease (CAD) would serve as a motivator to improve adherence to risk-reducing strategies. METHODS: We randomized 94 participants with at least moderate risk of CAD to rece ... Full text Link to item Cite

Genomic correlates of glatiramer acetate adverse cardiovascular effects lead to a novel locus mediating coronary risk.

Journal Article PLoS One · 2017 Glatiramer acetate is used therapeutically in multiple sclerosis but also known for adverse effects including elevated coronary artery disease (CAD) risk. The mechanisms underlying the cardiovascular side effects of the medication are unclear. Here, we mad ... Full text Link to item Cite

Characterization of Young Adult Emergency Department Users: Evidence to Guide Policy.

Journal Article J Adolesc Health · December 2016 PURPOSE: The purpose of this study was to characterize young adult patients aged 19-25 years who are emergency department (ED) frequent users and study factors associated with frequent ED use. METHODS: ED visits among 19- to 25-year olds were identified fr ... Full text Link to item Cite

Controlling for Informed Presence Bias Due to the Number of Health Encounters in an Electronic Health Record.

Journal Article Am J Epidemiol · December 1, 2016 Electronic health records (EHRs) are an increasingly utilized resource for clinical research. While their size allows for many analytical opportunities, as with most observational data there is also the potential for bias. One of the key sources of bias in ... Full text Link to item Cite

Assessment of Heart Transplant Waitlist Time and Pre- and Post-transplant Failure: A Mixed Methods Approach.

Journal Article Epidemiology · July 2016 BACKGROUND: Over the past two decades, there have been increasingly long waiting times for heart transplantation. We studied the relationship between heart transplant waiting time and transplant failure (removal from the waitlist, pretransplant death, or d ... Full text Link to item Cite

Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults.

Journal Article Ann Emerg Med · June 2016 STUDY OBJECTIVE: The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promo ... Full text Link to item Cite

Testing the Relative Performance of Data Adaptive Prediction Algorithms: A Generalized Test of Conditional Risk Differences.

Journal Article Int J Biostat · May 1, 2016 Comparing the relative fit of competing models can be used to address many different scientific questions. In classical statistics one can, if appropriate, use likelihood ratio tests and information based criterion, whereas clinical medicine has tended to ... Full text Link to item Cite

The Association of Level of Care With NICU Quality.

Journal Article Pediatrics · March 2016 BACKGROUND: Regionalized care delivery purportedly optimizes care to vulnerable very low birth weight (VLBW; <1500 g) infants. However, a comprehensive assessment of quality of care delivery across different levels of NICUs has not been done. METHODS: We c ... Full text Link to item Cite

Gene by Environment Investigation of Incident Lung Cancer Risk in African-Americans.

Journal Article EBioMedicine · February 2016 BACKGROUND: Genome-wide association studies have identified polymorphisms linked to both smoking exposure and risk of lung cancer. The degree to which lung cancer risk is driven by increased smoking, genetics, or gene-environment interactions is not well u ... Full text Open Access Link to item Cite

The agreement of patient-reported versus observed medication adherence in type 2 diabetes mellitus (T2DM).

Journal Article BMJ Open Diabetes Res Care · 2016 OBJECTIVE: Medication adherence in type 2 diabetes mellitus (T2DM) improves glycemic control and is associated with reduced adverse clinical events, and accurately assessing adherence assessment is important. We aimed to determine agreement between two com ... Full text Link to item Cite

Comparative outcomes of predominant facility-level use of ferumoxytol versus other intravenous iron formulations in incident hemodialysis patients.

Journal Article Nephrol Dial Transplant · December 2015 BACKGROUND: Ferumoxytol was first approved for clinical use in 2009 solely based on data from trial comparisons with oral iron on biochemical anemia efficacy end points. To compare the rates of important patient outcomes (infection, cardiovascular events a ... Full text Link to item Cite

Susceptibility Loci for Clinical Coronary Artery Disease and Subclinical Coronary Atherosclerosis Throughout the Life-Course.

Journal Article Circ Cardiovasc Genet · December 2015 BACKGROUND: Recent genome-wide association studies have identified 49 single nucleotide polymorphisms associated with clinical coronary artery disease. The mechanism by which these loci influence risk remains largely unclear. METHODS AND RESULTS: We examin ... Full text Link to item Cite

Mental Illness Drives Hospitalizations for Detained California Youth.

Journal Article J Adolesc Health · November 2015 PURPOSE: The purpose of the study was to describe inpatient hospitalization patterns among detained and nondetained youth in a large, total population of hospitalized adolescents in California. METHODS: We examined the unmasked California Office of Statewi ... Full text Link to item Cite

Substance use and mental diagnoses among adults with and without type 2 diabetes: Results from electronic health records data.

Journal Article Drug Alcohol Depend · November 1, 2015 BACKGROUND: Comorbid diabetes and substance use diagnoses (SUD) represent a hazardous combination, both in terms of healthcare cost and morbidity. To date, there is limited information about the association of SUD and related mental disorders with type 2 d ... Full text Open Access Link to item Cite

Classifying individuals based on a densely captured sequence of vital signs: An example using repeated blood pressure measurements during hemodialysis treatment.

Journal Article J Biomed Inform · October 2015 Electronic Health Records (EHRs) present the opportunity to observe serial measurements on patients. While potentially informative, analyzing these data can be challenging. In this work we present a means to classify individuals based on a series of measur ... Full text Link to item Cite

Contemporary Considerations for Constructing a Genetic Risk Score: An Empirical Approach.

Journal Article Genet Epidemiol · September 2015 Genetic risk scores are an increasingly popular tool for summarizing the cumulative risk of a set of Single Nucleotide Polymorphisms (SNPs) with disease. Typically only the set of the SNPs that have reached genome-wide significance compose these scores. Ho ... Full text Link to item Cite

Early-Life State-of-Residence Characteristics and Later Life Hypertension, Diabetes, and Ischemic Heart Disease.

Journal Article Am J Public Health · August 2015 OBJECTIVES: We examined how state characteristics in early life are associated with individual chronic disease later in life. METHODS: We assessed early-life state of residence using the first 3 digits of social security numbers from blue- and white-collar ... Full text Link to item Cite

Longer-term outcomes of darbepoetin alfa versus epoetin alfa in patients with ESRD initiating hemodialysis: a quasi-experimental cohort study.

Journal Article Am J Kidney Dis · July 2015 BACKGROUND: Adequately powered studies directly comparing hard clinical outcomes of darbepoetin alfa (DPO) versus epoetin alfa (EPO) in patients undergoing dialysis are lacking. STUDY DESIGN: Observational, registry-based, retrospective cohort study; we mi ... Full text Link to item Cite

Detecting clinically meaningful biomarkers with repeated measurements: An illustration with electronic health records.

Journal Article Biometrics · June 2015 Featured Publication Data sources with repeated measurements are an appealing resource to understand the relationship between changes in biological markers and risk of a clinical event. While longitudinal data present opportunities to observe changing risk over time, these ana ... Full text Link to item Cite

Comparative health services research across populations: the unused opportunities in big data.

Journal Article Kidney Int · June 2015 Large population registries present opportunities to understand the epidemiology of disease, study patters of care, and compare the effectiveness of different care practices. While these 'big data' tempt investigators to examine all available individuals, ... Full text Link to item Cite

The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.

Journal Article J Acad Nutr Diet · April 2015 BACKGROUND: Latino immigrants have high rates of obesity and face barriers to weight loss. OBJECTIVE: To evaluate the effectiveness of a case-management (CM) intervention with and without community health workers (CHWs) for weight loss. DESIGN: This was a ... Full text Link to item Cite

National decline in donor heart utilization with regional variability: 1995-2010.

Journal Article Am J Transplant · March 2015 Featured Publication The severe shortage of donor hearts limits the availability of transplantation for the growing population of patients with end-stage heart disease. We examined national trends in donor heart acceptance for transplant. OPTN data were analyzed for all potent ... Full text Link to item Cite

Genetic studies of body mass index yield new insights for obesity biology.

Journal Article Nature · February 12, 2015 Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and a ... Full text Link to item Cite

Regional variation in antenatal corticosteroid use: a network-level quality improvement study.

Journal Article Pediatrics · February 2015 BACKGROUND AND OBJECTIVES: Examination of regional care patterns in antenatal corticosteroid use (ACU) rates may be salient for the development of targeted interventions. Our objective was to assess network-level variation using California perinatal care r ... Full text Link to item Cite

Reliability of echocardiographic measurements of left ventricular systolic function in potential pediatric heart transplant donors.

Journal Article J Heart Lung Transplant · January 2015 BACKGROUND: Echocardiogram reports, but not images, are usually available for the evaluation of potential donor hearts. To assess the reliability of local reports of potential pediatric heart donors, we compared echocardiographic measurements of left ventr ... Full text Link to item Cite

Using "big data" to capture overall health status: properties and predictive value of a claims-based health risk score.

Journal Article PLoS One · 2015 BACKGROUND: Investigators across many fields often struggle with how best to capture an individual's overall health status, with options including both subjective and objective measures. With the increasing availability of "big data," researchers can now t ... Full text Link to item Cite

Leading Causes of Death among Asian American Subgroups (2003-2011).

Journal Article PLoS One · 2015 BACKGROUND: Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In ... Full text Link to item Cite

Cardiovascular disease mortality in Asian Americans.

Journal Article J Am Coll Cardiol · December 16, 2014 BACKGROUND: Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups. OBJECTIVES: The purpose ... Full text Link to item Cite

Impact of the lung allocation score on survival beyond 1 year.

Journal Article Am J Transplant · October 2014 Implementation of the lung allocation score (LAS) in 2005 led to transplantation of older and sicker patients without altering 1-year survival. However, long-term survival has not been assessed and emphasizing the 1-year survival metric may actually sustai ... Full text Link to item Cite

The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

Journal Article Health Aff (Millwood) · September 2014 The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young ... Full text Link to item Cite

Impact of San Francisco's toy ordinance on restaurants and children's food purchases, 2011-2012.

Journal Article Prev Chronic Dis · July 17, 2014 INTRODUCTION: In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were ... Full text Link to item Cite

State medicaid coverage, ESRD incidence, and access to care.

Journal Article J Am Soc Nephrol · June 2014 The proportion of low-income nonelderly adults covered by Medicaid varies widely by state. We sought to determine whether broader state Medicaid coverage, defined as the proportion of each state's low-income nonelderly adult population covered by Medicaid, ... Full text Link to item Cite

Trends in anemia care in older patients approaching end-stage renal disease in the United States (1995-2010).

Journal Article JAMA Intern Med · May 2014 IMPORTANCE: Anemia is common in patients with advanced chronic kidney disease. Whereas the treatment of anemia in patients with end-stage renal disease (ESRD) has attracted considerable attention, relatively little is known about patterns and trends in the ... Full text Link to item Cite

Clinical interpretation and implications of whole-genome sequencing.

Journal Article JAMA · March 12, 2014 IMPORTANCE: Whole-genome sequencing (WGS) is increasingly applied in clinical medicine and is expected to uncover clinically significant findings regardless of sequencing indication. OBJECTIVES: To examine coverage and concordance of clinically relevant ge ... Full text Link to item Cite

Contribution of health status and prevalent chronic disease to individual risk for workplace injury in the manufacturing environment.

Journal Article Occup Environ Med · March 2014 OBJECTIVES: An 'information gap' has been identified regarding the effects of chronic disease on occupational injury risk. We investigated the association of ischaemic heart disease, hypertension, diabetes, depression and asthma with acute occupational inj ... Full text Link to item Cite

Simple, standardized incorporation of genetic risk into non-genetic risk prediction tools for complex traits: coronary heart disease as an example.

Journal Article Front Genet · 2014 Featured Publication PURPOSE: Genetic risk assessment is becoming an important component of clinical decision-making. Genetic Risk Scores (GRSs) allow the composite assessment of genetic risk in complex traits. A technically and clinically pertinent question is how to most eas ... Full text Link to item Cite

Near-term prediction of sudden cardiac death in older hemodialysis patients using electronic health records.

Journal Article Clin J Am Soc Nephrol · January 2014 Featured Publication BACKGROUND AND OBJECTIVES: Sudden cardiac death is the most common cause of death among individuals undergoing hemodialysis. The epidemiology of sudden cardiac death has been well studied, and efforts are shifting to risk assessment. This study aimed to te ... Full text Link to item Cite

Impact Of The Lung Allocation Score On Survival Beyond One Year Post Lung Transplantation

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2014 Link to item Cite

Germline signaling mediates the synergistically prolonged longevity produced by double mutations in daf-2 and rsks-1 in C. elegans.

Journal Article Cell Rep · December 26, 2013 Inhibition of DAF-2 (insulin-like growth factor 1 [IGF-1] receptor) or RSKS-1 (S6K), key molecules in the insulin/IGF-1 signaling (IIS) and target of rapamycin (TOR) pathways, respectively, extend lifespan in Caenorhabditis elegans. However, it has not bee ... Full text Link to item Cite

Differences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.

Journal Article Clin J Am Soc Nephrol · December 2013 BACKGROUND AND OBJECTIVES: Hispanic patients undergoing chronic dialysis are less likely to receive a kidney transplant compared with non-Hispanic whites. This study sought to elucidate disparities in the path to receipt of a deceased donor transplant betw ... Full text Link to item Cite

Early acute lung injury: criteria for identifying lung injury prior to the need for positive pressure ventilation*.

Journal Article Crit Care Med · August 2013 OBJECTIVE: Mortality associated with acute lung injury remains high. Early identification of acute lung injury prior to onset of respiratory failure may provide a therapeutic window to target in future clinical trials. The recently validated Lung Injury Pr ... Full text Link to item Cite

Temporal trends in the incidence, treatment, and outcomes of hip fracture in older patients initiating dialysis in the United States.

Journal Article Clin J Am Soc Nephrol · August 2013 BACKGROUND AND OBJECTIVES: Patients with ESRD experience a fivefold higher incidence of hip fracture than the age- and sex-matched general population. Despite multiple changes in the treatment of CKD mineral bone disorder, little is known about long-term t ... Full text Link to item Cite

Trends in relative mortality between Hispanic and non-Hispanic whites initiating dialysis: a retrospective study of the US Renal Data System.

Journal Article Am J Kidney Dis · August 2013 BACKGROUND: Hispanic patients undergoing long-term dialysis experience better survival compared with non-Hispanic whites. It is unknown whether this association differs by age, has changed over time, or is due to differential access to kidney transplantati ... Full text Link to item Cite

Association between the chromosome 9p21 locus and angiographic coronary artery disease burden: a collaborative meta-analysis.

Journal Article J Am Coll Cardiol · March 5, 2013 OBJECTIVES: This study sought to ascertain the relationship of 9p21 locus with: 1) angiographic coronary artery disease (CAD) burden; and 2) myocardial infarction (MI) in individuals with underlying CAD. BACKGROUND: Chromosome 9p21 variants have been robus ... Full text Link to item Cite

Donor predictors of allograft use and recipient outcomes after heart transplantation.

Journal Article Circ Heart Fail · March 2013 BACKGROUND: Despite a national organ-donor shortage and a growing population of patients with end-stage heart disease, the acceptance rate of donor hearts for transplantation is low. We sought to identify donor predictors of allograft nonuse, and to determ ... Full text Link to item Cite

Determinants of peritoneal dialysis technique failure in incident US patients.

Journal Article Perit Dial Int · 2013 OBJECTIVES: Switching from peritoneal dialysis (PD) to hemodialysis (HD) is undesirable, because of complications from temporary vascular access, disruption of daily routine, and higher costs. Little is known about the role that social factors play in tech ... Full text Link to item Cite

Large-scale association analysis identifies new risk loci for coronary artery disease.

Journal Article Nat Genet · January 2013 Coronary artery disease (CAD) is the commonest cause of death. Here, we report an association analysis in 63,746 CAD cases and 130,681 controls identifying 15 loci reaching genome-wide significance, taking the number of susceptibility loci for CAD to 46, a ... Full text Link to item Cite

Beta-adrenergic receptor polymorphisms and cardiac graft function in potential organ donors.

Journal Article Am J Transplant · December 2012 Prior studies have demonstrated associations between beta-adrenergic receptor (βAR) polymorphisms and left ventricular dysfunction-an important cause of allograft nonutilization for transplantation. We hypothesized that βAR polymorphisms predispose donor h ... Full text Link to item Cite

Trends in the incidence of atrial fibrillation in older patients initiating dialysis in the United States.

Journal Article Circulation · November 6, 2012 BACKGROUND: One sixth of US dialysis patients 65 years of age have been diagnosed with atrial fibrillation/flutter (AF). Little is known, however, about the incidence of AF in this population. METHODS AND RESULTS: We identified 258 605 older patients (≥67 ... Full text Link to item Cite

Breast cancer risk factors differ between Asian and white women with BRCA1/2 mutations.

Journal Article Fam Cancer · September 2012 The prevalence and penetrance of BRCA1 and BRCA2 (BRCA1/2) mutations may differ between Asians and whites. We investigated BRCA1/2 mutations and cancer risk factors in a clinic-based sample. BRCA1/2 mutation carriers were enrolled from cancer genetics clin ... Full text Link to item Cite

Electrocardiographic characteristics of potential organ donors and associations with cardiac allograft use.

Journal Article Circ Heart Fail · July 1, 2012 BACKGROUND: Current regulations require that all cardiac allograft offers for transplantation must include an interpreted 12-lead electrocardiogram (ECG). However, little is known about the expected ECG findings in potential organ donors or the clinical si ... Full text Link to item Cite

Hispanic ethnicity and vascular access use in patients initiating hemodialysis in the United States.

Journal Article Clin J Am Soc Nephrol · February 2012 BACKGROUND AND OBJECTIVES: Hispanics are the largest minority in the United States (comprising 16.3% of the US population) and have 1.5 times the age-, sex-, and race-adjusted incidence of ESRD compared with non-Hispanics. Poor health care access and low-q ... Full text Link to item Cite

P4-10-10: Breast Cancer Risk Factors among Asian Versus Caucasian Women with BRCA1/2 Mutations.

Conference Cancer Research · December 15, 2011 AbstractBackgroundPrior research suggests that the prevalence and penetrance of BRCA1/2 mutations may be different in Asians compared with Caucasians. Such differences in pen ... Full text Cite

The rs4774 CIITA missense variant is associated with risk of systemic lupus erythematosus.

Journal Article Genes Immun · December 2011 The major histocompatibility complex (MHC) class II transactivator gene (CIITA) encodes an important transcription factor required for human leukocyte antigens (HLA) class II MHC-restricted antigen presentation. MHC genes, including the HLA class II DRB1*0 ... Full text Link to item Cite

Genome-wide association study of severity in multiple sclerosis.

Journal Article Genes Immun · December 2011 Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system with a strong genetic component. Several lines of evidence support a strong role for genetic factors influencing both disease susceptibility and clinical outcome in MS ... Full text Link to item Cite

Random forests for genetic association studies.

Journal Article Stat Appl Genet Mol Biol · 2011 The Random Forests (RF) algorithm has become a commonly used machine learning algorithm for genetic association studies. It is well suited for genetic applications since it is both computationally efficient and models genetic causal mechanisms well. With i ... Full text Link to item Cite

Evidence for CRHR1 in multiple sclerosis using supervised machine learning and meta-analysis in 12,566 individuals.

Journal Article Hum Mol Genet · November 1, 2010 The primary genetic risk factor in multiple sclerosis (MS) is the HLA-DRB1*1501 allele; however, much of the remaining genetic contribution to MS has yet to be elucidated. Several lines of evidence support a role for neuroendocrine system involvement in au ... Full text Link to item Cite

Variation within DNA repair pathway genes and risk of multiple sclerosis.

Journal Article Am J Epidemiol · July 15, 2010 Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system with a prominent genetic component. The primary genetic risk factor is the human leukocyte antigen (HLA)-DRB1*1501 allele; however, much of the remaining genetic contribu ... Full text Link to item Cite

An application of Random Forests to a genome-wide association dataset: methodological considerations & new findings.

Journal Article BMC Genet · June 14, 2010 BACKGROUND: As computational power improves, the application of more advanced machine learning techniques to the analysis of large genome-wide association (GWA) datasets becomes possible. While most traditional statistical methods can only elucidate main e ... Full text Link to item Cite

Designing and implementing sample and data collection for an international genetics study: the Type 1 Diabetes Genetics Consortium (T1DGC).

Journal Article Clin Trials · 2010 BACKGROUND AND PURPOSE: The Type 1 Diabetes Genetics Consortium (T1DGC) is an international project whose primary aims are to: (a) discover genes that modify type 1 diabetes risk; and (b) expand upon the existing genetic resources for type 1 diabetes resea ... Full text Link to item Cite

Not all negative emotions are equal: the role of emotional expression in online support groups for women with breast cancer.

Journal Article Psychooncology · February 2006 The repression/suppression of negative emotions has long been considered detrimental for breast cancer (BC) patients, leading to poor coping, progression of symptoms, and general lower quality of life. Therapies have focused on encouraging the expression o ... Full text Link to item Cite

Self-help on-line: an outcome evaluation of breast cancer bulletin boards.

Journal Article J Health Psychol · November 2005 Many breast cancer patients find help from on-line self-help groups, consisting of self-directed, asynchronous, bulletin boards. These have yet to be empirically evaluated. Upon joining a group and 6 months later, new members (N=114) to breast cancer bulle ... Full text Link to item Cite

Etiological paradigms of depression: The relationship between perceived causes, empowerment, treatment preferences, and stigma

Journal Article Journal of Mental Health · December 1, 2003 Background: There is a growing trend to view depression as a biological illness rather than a psychosocial condition, even though there is no consensus as to what causes depression. Furthermore, there are mixed data on the impact of advocating the biologic ... Full text Cite

Pragmatic Randomized Trials Using Claims or Electronic Health Record Data

Chapter Randomized clinical trials have been the accepted standard for addressing key questions in medicine for well over 60 years. The structure and process, while well documented and characterized, have been historically described in the context of “efficacy” in ... Full text Link to item Cite