Journal articleStat Med · September 30, 2020
With heighted interest in causal inference based on real-world evidence, this empirical study sought to understand differences between the results of observational analyses and long-term randomized clinical trials. We hypothesized that patients deemed "eli ...
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Journal articleAm Heart J · August 2018
Depression and acute coronary syndromes (ACS) are both common public health challenges. Patients with ACS often develop depression, which in turn adversely affects prognosis. Low-cost, sustainable, and effective service models that integrate depression car ...
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Journal articleStat Med · October 30, 2017
Group-randomized trials are randomized studies that allocate intact groups of individuals to different comparison arms. A frequent practical limitation to adopting such research designs is that only a limited number of groups may be available, and therefor ...
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Journal articleClin Trials · October 2016
BACKGROUND/AIMS: Pragmatic clinical trials embedded within health care systems provide an important opportunity to evaluate new interventions and treatments. Networks have recently been developed to support practical and efficient studies. Pragmatic trials ...
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Journal articleStat Med · May 10, 2016
In group-randomized trials, a frequent practical limitation to adopting rigorous research designs is that only a small number of groups may be available, and therefore, simple randomization cannot be relied upon to balance key group-level prognostic factor ...
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Journal articleAcad Med · October 2015
Criteria for evaluating faculty are traditionally based on a triad of scholarship, teaching, and service. Research scholarship is often measured by first or senior authorship on peer-reviewed scientific publications and being principal investigator on extr ...
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Journal articleAnn Thorac Surg · June 2014
BACKGROUND: Recent observational studies show that patients with multivessel coronary disease have a long-term survival advantage with coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI). Important nonfatal outcome ...
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Journal articleBMC Public Health · April 11, 2014
BACKGROUND: The high-risk strategy has been proven effective in preventing cardiovascular disease; however, the population benefits from these interventions remain unknown. This study aims to assess, at the population level, the effects of an evidence-base ...
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Journal articleCirc Cardiovasc Interv · February 2014
BACKGROUND: The goal of this study was to compare angiographic interpretation of coronary arteriograms by sites in community practice versus those made by a centralized angiographic core laboratory. METHODS AND RESULTS: The study population consisted of 20 ...
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Journal articleCirculation · March 27, 2012
BACKGROUND: Most survival prediction models for coronary artery bypass grafting surgery are limited to in-hospital or 30-day end points. We estimate a long-term survival model using data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database ...
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Journal articleCirculation · March 27, 2012
BACKGROUND: The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease. METHODS AND R ...
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Journal articleCirculation · September 27, 2011
Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardi ...
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Journal articleJ Am Coll Cardiol · September 27, 2011
Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardi ...
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Journal articleCirculation · January 4, 2011
BACKGROUND: Despite evidence supporting the use of aspirin, β-blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering therapies in eligible patients, adoption of these secondary prevention measures after coronary artery bypass grafting has b ...
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Journal articleArch Intern Med · November 8, 2010
BACKGROUND: Secular trends and factors associated with delay time from symptom onset to hospital presentation are known for patients with ST-segment elevation myocardial infarction (STEMI) but are less well-described for non-STEMI. METHODS: We studied 104 ...
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Journal articleRevista Portuguesa De Cardiologia · November 1, 2010
Objectives: We sought to create contemporary models for predicting mortality risk following percutaneous coronary intervention (PCI). Background: There is a need to identifiy PCI risk factors and accurately quantify procedural risks to facilitate comparati ...
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Journal articleAm Heart J · September 2010
BACKGROUND: Clinical predictive models leave gaps in our ability to stratify cardiovascular risk. High-throughput molecular profiling promises to improve risk classification. METHODS: Horizon 1 of the Measurement to Understand the Reclassification of Disea ...
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Journal articleJ Am Coll Cardiol · May 4, 2010
OBJECTIVES: We sought to create contemporary models for predicting mortality risk following percutaneous coronary intervention (PCI). BACKGROUND: There is a need to identify PCI risk factors and accurately quantify procedural risks to facilitate comparativ ...
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Journal articleClin Cardiol · March 2010
BACKGROUND: Results from the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial showed that the low-molecular-weight heparin (LMWH) enoxaparin was non-inferior compared with unfractiona ...
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Journal articlePhysical Therapy · January 1, 2010
Endorsed by the American College of Chest Physicians, the American College of Sports Medicine, the American Physical Therapy Association, the Canadian Association of Cardiac Rehabilitation, the European Association for Cardiovascular Prevention and Rehabil ...
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Journal articleClin Cardiol · September 2009
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BACKGROUND: Hypercholesterolemia is a risk factor for coronary artery disease, yet is associated with lower risk of adverse outcomes in patients with acute coronary syndromes (ACS). HYPOTHESIS: We explored this paradox in 84,429 patients with non-ST-segmen ...
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Journal articleJ Med Syst · August 2009
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Chronic kidney disease (CKD) is associated with increased morbidity and mortality in coronary artery disease (CAD) patients. We compared the economic attractiveness of CAD revascularization procedures in patients with and without CKD. Our population includ ...
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Journal articleAnn Thorac Surg · July 2009
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BACKGROUND: The first version of The Society of Thoracic Surgeons National Adult Cardiac Surgery Database (STS NCD) was developed nearly 2 decades ago. Since its inception, the number of participants has grown dramatically, patient acuity has increased, an ...
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Journal articleAnn Thorac Surg · July 2009
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BACKGROUND: Adjustment for case-mix is essential when using observational data to compare surgical techniques or providers. That is most often accomplished through the use of risk models that account for preoperative patient factors that may impact outcome ...
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Journal articleAnn Thorac Surg · July 2009
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BACKGROUND: Since 1999, The Society of Thoracic Surgeons (STS) has published two risk models that can be used to adjust the results of valve surgery combined with coronary artery bypass graft surgery (CABG). The most recent was developed from data for pati ...
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Journal articleStat Med · December 20, 2008
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Frequently, studies are conducted in a real clinic setting. When the outcome of interest is collected longitudinally over a specified period of time, this design can lead to unequally spaced intervals and varying numbers of assessments. In our study, these ...
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Journal articleJ Am Coll Cardiol · December 9, 2008
The American College of Cardiology (ACC) and the American Heart Association (AHA) have provided leadership in enhancing the quality of cardiovascular care, including the development of clinical performance measures and clinical registries that permit the e ...
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Journal articleCirculation · December 9, 2008
The American College of Cardiology (ACC) and the American Heart Association (AHA) have provided leadership in enhancing the quality of cardiovascular care, including the development of clinical performance measures and clinical registries that permit the e ...
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Journal articleAm Heart J · July 2008
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BACKGROUND: Practice guidelines for non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive management (cardiac catheterization and revascularization within 48 hours of hospital presentation) for high-risk patients, but interh ...
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Journal articleArch Intern Med · June 23, 2008
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BACKGROUND: Process performance measures are increasingly used to assess and reward hospital quality. The impact of small hospital case volumes on such measures is not clear. METHODS: Using data from the Hospital Quality Alliance, we examined hospital perf ...
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Journal articleCirculation · December 18, 2007
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BACKGROUND: Composite scores that combine several performance measures into a single ranking are becoming the accepted metric for assessing hospital performance. In particular, the Centers for Medicare & Medicaid Services Hospital Quality Incentive Demonst ...
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Journal articleJAMA · June 6, 2007
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CONTEXT: Pay for performance has been promoted as a tool for improving quality of care. In 2003, the Centers for Medicare & Medicaid Services (CMS) launched the largest pay-for-performance pilot project to date in the United States, including indicators fo ...
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Journal articleAnn Thorac Surg · January 2007
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BACKGROUND: Postoperative stays after coronary artery bypass graft surgery (CABG) decreased substantially in the 1990s. Although shorter stays offer clinical benefits, premature discharge could increase adverse events and offset initial savings. This study ...
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Journal articleAm Heart J · December 2006
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BACKGROUND: Although single-site studies have reported reductions in coronary artery bypass graft (CABG) surgery length of stay (LOS) over the last 15 years, less information is available regarding overall temporal trends and interhospital variability. Thi ...
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Journal articleAnn Intern Med · November 21, 2006
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BACKGROUND: The impact of insurance coverage on the care of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) is unclear. OBJECTIVE: To compare NSTE ACS care patterns by insurance type. DESIGN: Comparison of Medicaid patients young ...
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Journal articleAnn Thorac Surg · October 2006
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BACKGROUND: Treatment of coronary artery disease (CAD) is evolving with better medications, improvements in percutaneous coronary intervention (PCI), and enhanced techniques for coronary artery bypass grafting (CABG). METHODS: In this study, 18,481 patient ...
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Journal articleAm Heart J · May 2006
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BACKGROUND: Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS: Medical practices with > or = 15 patients with heart failure (HF) in ...
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Journal articleAm Heart J · May 2006
BACKGROUND: B-type natriuretic peptide (BNP) is valuable in diagnosing heart failure (HF), but its utility in obese patients is unknown. Studies have suggested a cut-point of BNP > or = 100 pg/mL for the diagnosis of HF; however, there is an inverse relati ...
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Journal articleJAMA · April 26, 2006
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CONTEXT: Selected care processes are increasingly being used to measure hospital quality; however, data regarding the association between hospital process performance and outcomes are limited. OBJECTIVES: To evaluate contemporary care practices consistent ...
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Journal articleJ Thorac Cardiovasc Surg · March 2006
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OBJECTIVE: In some respects, outcome reporting in valvular surgery has been hampered by focusing on specific populations, reluctance to publish high-risk subgroups, and possibly skewed or inadequate samples. The goal of this study was to evaluate risk fact ...
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Journal articleCirculation · January 17, 2006
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BACKGROUND: Studies have examined the use of evidence-based therapies for coronary artery disease (CAD) in the short term and at hospital discharge, but few have evaluated long-term use. METHODS AND RESULTS: Using the Duke Databank for Cardiovascular Disea ...
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Journal articleAnn Surg · January 2006
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OBJECTIVE: To define the most sensitive biochemical test to establish the diagnosis of pheochromocytoma and also to assess the potential role of iodine 131-labeled metaiodobenzylguanidine scintigraphy (I-MIBG) in the diagnosis of this tumor. SUMMARY BACKGR ...
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Journal articleBiometrics · December 2005
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Many standards of medical care are based on the demonstrated effects of various treatment strategies or processes. Unlike pharmacological treatments, these strategies or processes are not necessarily subjected to rigorous clinical trials and their benefit ...
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Journal articleCirculation · November 15, 2005
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BACKGROUND: Recent studies indicate that a routine invasive approach for patients with unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) yields improved outcomes compared with a conservative approach, but the optimal timing o ...
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Journal articleMed Care · July 2005
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BACKGROUND: In recent years, several studies in the medical and health service research literature have advocated the use of hierarchical statistical models (multilevel models or random-effects models) to analyze data that are nested (eg, patients nested w ...
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Journal articleCirculation · March 15, 2005
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BACKGROUND: Although black cardiac patients receive fewer revascularization procedures than whites, it is unclear whether this has a detrimental impact on outcomes. The objective of our study was to compare 6-month functional status and angina outcomes amo ...
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Journal articleJournal of Clinical Outcomes Management · March 1, 2005
• Objective: To illustrate the impact of increased patient privacy concerns on the conduct of research on managed care patients and to suggest mechanisms for successful collaboration between managed care organizations and academic research organizations. • ...
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Journal articleJ Perinatol · March 2004
OBJECTIVE: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. STUDY DESIGN: Multicenter cohort study of premature infants. RESULTS: First blood culture was negative for 464 ...
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Journal articleJ Perinatol · March 2004
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BACKGROUND: Neonatal nosocomial Gram-negative rod bacteremia (GNR-b) is considered ominous. DESIGN: Multi-center cohort study of premature infants (N=6172) who had a blood culture after day of life 3 and whose birthweight was < or =1250 g. RESULTS: A total ...
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Journal articleAm J Med · January 15, 2004
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PURPOSE: Studies suggest that beta-blockers improve outcomes in heart failure patients and may be cost saving to society. However, many heart failure patients are not treated with beta-blockers. Economic incentives facing hospitals, physicians, payers, and ...
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Journal articleJAMA · January 14, 2004
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CONTEXT: There have been recent calls for using hospital procedural volume as a quality indicator for coronary artery bypass graft (CABG) surgery, but further research into analysis and policy implication is needed before hospital procedural volume is acce ...
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Journal articleAmbul Pediatr · 2004
BACKGROUND: There is no gold standard readily available in several components of the routine physical exam: one example is the otoscopic exam, where the gold standard is confirmation by tympanocentesis. Resident education does not typically include routine ...
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Journal articleStat Med · November 30, 2003
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Receiver operating characteristic (ROC) methodology is widely used to evaluate and compare diagnostic tests. Generally, each diagnostic test is applied once to each subject in a population and the results, reported on a continuous scale, are used to constr ...
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Journal articleAm Heart J · November 2003
BACKGROUND: Dose-dependent torsades de pointes has been shown to occur with dofetilide (Tikosyn) and sotalol HCl (Betapace AF); thus, detailed dosing and monitoring recommendations to minimize this risk are included in the product labeling for both drugs. ...
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Journal articlePediatrics · September 2003
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OBJECTIVE: Neonatal candidemia is often fatal. Empirical antifungal therapy is associated with improved survival in neonates and patients with fever and neutropenia. Although guidelines for empirical therapy exist for patients with fever and neutropenia, t ...
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Journal articleJAMA · July 2, 2003
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CONTEXT: A rigorous evaluation of continuous quality improvement (CQI) in medical practice has not been carried out on a national scale. OBJECTIVE: To test whether low-intensity CQI interventions can be used to speed the national adoption of 2 coronary art ...
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Journal articleAnn Thorac Surg · June 2003
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BACKGROUND: Although 30 day risk-adjusted operative mortality (ROM) has been used for quality assessment, it is not sufficient to describe the outcomes after coronary artery bypass grafting (CABG) surgery. Risk-adjusted major morbidity may differentially i ...
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Journal articleJ Med Syst · August 2002
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Assessing the effectiveness of newer treatments for rare diseases can be challenging because of the small number of patients treated at individual centers. We enrolled patients undergoing percutaneous transluminal septal myocardial ablation (PTSMA) for hyp ...
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Journal articleAnn Thorac Surg · August 2002
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BACKGROUND: There is growing interest in comparing resource, as well as patient outcome metrics among coronary artery bypass graft surgery (CABG) providers, yet few tools exist for adjusting these provider comparisons for patient case-mix. In this study, w ...
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Journal articleAm J Cardiol · May 1, 2002
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Despite the established benefits of antiplatelet agents in coronary artery disease (CAD), many appropriate patients are not receiving them. We investigated the prevalence of and factors associated with aspirin use and nonuse within a large referral populat ...
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Journal articleJAMA · March 27, 2002
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CONTEXT: Although increased blood pressure is associated with adverse outcomes in the general population, elevated blood pressure is associated with decreased mortality in patients with end-stage renal disease undergoing maintenance hemodialysis. Recent in ...
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Journal articleAm J Cardiol · March 15, 2002
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Despite substantial evidence that antiplatelet therapy saves lives and reduces adverse events in patients with coronary artery disease (CAD), use of the most widely available and lowest cost antiplatelet agent, aspirin, continues to be disappointingly low. ...
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Journal articleAnn Thorac Surg · February 2002
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BACKGROUND: The Society of Thoracic Surgeons National Adult Cardiac Database is the largest voluntary clinical database in medicine. Using this database we examined changes in the risk profile of patients undergoing isolated coronary artery bypass grafting ...
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Journal articleAm Heart J · January 2002
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OBJECTIVE: Previous analyses of variability in bypass resource use have not focused on hospital-level variation or adequately explored the influence of patient risk. We combined a clinical database with claims data to fully characterize patient level and h ...
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Journal articleJ Am Coll Cardiol · November 1, 2001
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OBJECTIVES: The objective of this study was to identify preprocedure patient factors associated with percutaneous intervention costs and to examine the impact of these patient factors on economic profiles of interventional cardiologists. BACKGROUND: There ...
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Journal articleStat Med · August 30, 2001
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With the proliferation of clinical data registries and the rising expense of clinical trials, observational data sources are increasingly providing evidence for clinical decision making. These data are viewed as complementary to randomized clinical trials ...
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Journal articleCirculation · May 1, 2001
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BACKGROUND: The purpose of this study was to evaluate whether women undergoing cardiac surgery are more likely to suffer neurological complications than men and whether these complications could explain, at least in part, their higher perioperative mortali ...
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Journal articleJ Am Coll Cardiol · March 1, 2001
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OBJECTIVES: We sought to develop national benchmarks for valve replacement surgery by developing statistical risk models of operative mortality. BACKGROUND: National risk models for coronary artery bypass graft surgery (CABG) have gained widespread accepta ...
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Journal articleBiometrics · December 2000
Changes in maximum likelihood parameter estimates due to deletion of individual observations are useful statistics, both for regression diagnostics and for computing robust estimates of covariance. For many likelihoods, including those in the exponential f ...
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Journal articleJ Am Coll Cardiol · December 2000
OBJECTIVES: We sought to evaluate the predictive accuracy of four bypass surgery mortality clinical risk models and to examine the extent to which hospitals' risk-adjusted surgical outcomes vary depending on which risk-adjustment method is applied. BACKGRO ...
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Journal articleAnesthesiology · June 1999
BACKGROUND: Remifentanil is a new opioid with properties similar to other mu-specific agonists. To establish its pharmacologic profile relative to other known opioids, it is important to determine its potency. This study investigated the relative potency o ...
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Journal articleJ Am Coll Cardiol · May 1999
OBJECTIVES: We compared the acute and one year medical costs and outcomes of coronary stenting with those for balloon angioplasty (percutaneous transluminal coronary angioplasty) in contemporary clinical practice. BACKGROUND: While coronary stent implantat ...
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Journal articleAnesth Analg · December 1998
UNLABELLED: The onset time and duration of action of ropivacaine during an interscalene block are not known. The potentially improved safety profile of ropivacaine may allow the use of higher concentrations to try and speed onset time. We compared bupivaca ...
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Journal articleJ Clin Monit Comput · December 1998
INTRODUCTION: We evaluated whether automated anesthesia information systems can be used to calculate reference limits (population-based "normal values") for vital signs. We considered four populations of women undergoing cesarean section: healthy under spi ...
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Journal articleJ Am Coll Cardiol · November 15, 1998
OBJECTIVES: We sought to determine the ability of a treadmill score to provide accurate diagnostic and prognostic risk estimates in women. BACKGROUND: Treadmill testing has been reported to have a lower accuracy for diagnosis of chest pain in women. The di ...
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Journal articleCirculation · October 20, 1998
BACKGROUND: Exercise testing is useful in the assessment of symptomatic patients for diagnosis of significant or extensive coronary disease and to predict their future risk of cardiac events. The Duke treadmill score (DTS) is a composite index that was des ...
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Journal articleJ Am Coll Cardiol · October 1998
OBJECTIVE: The aim of this study was to examine the effects of provider profiling on bypass surgery access and outcomes in elderly patients in New York. BACKGROUND: Since 1989, New York (NY) has compiled provider-specific bypass surgery mortality reports. ...
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Journal articleCirculation · May 5, 1998
BACKGROUND: In the ESSENCE trial, subcutaneous low-molecular-weight heparin (enoxaparin) reduced the 30-day incidence of death, myocardial infarction, and recurrent angina relative to intravenous unfractionated heparin in 3171 patients with acute coronary ...
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Journal articleStat Med · December 15, 1997
Risk-adjustment and provider profiling have become common terms as the medical profession attempts to measure quality and assess value in health care. One of the areas of care most thoroughly developed in this regard is quality assessment for coronary arte ...
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Journal articleOsteoarthritis Cartilage · November 1997
OBJECTIVE: To examine the correlation between synovial fluid cartilage markers and degree of cartilage damage determined by arthroscopic evaluation in subjects with acute knee injury. DESIGN: Chondral damage was quantified using a validated arthroscopic sc ...
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Journal articleCirculation · October 21, 1997
BACKGROUND: Recent subgroup analyses of randomized trials have suggested that percutaneous intervention in diabetic patients with multivessel disease results in higher mortality than coronary artery bypass graft surgery (CABG). We studied the relationship ...
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Journal articleJ Am Coll Cardiol · October 1997
OBJECTIVES: This study examined the impact of early hospital discharge on short-term clinical outcomes of elderly patients treated with coronary artery bypass graft surgery (CABG) in the United States in 1992. BACKGROUND: Protocols that encourage earlier d ...
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Journal articleCirculation · June 3, 1997
BACKGROUND: With the expectation that physicians who perform larger numbers of coronary angioplasty procedures will have better outcomes, the American College of Cardiology/ American Heart Association guidelines recommend minimum physician volumes of 75 pr ...
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Journal articleMed Care · April 1997
OBJECTIVES: The purpose of this study was to examine the national variability in patient-level cost and length of stay for coronary artery bypass grafting (CABG) in Medicare patients. METHODS: Retrospective multivariate regression analysis was done using M ...
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Journal articleN Engl J Med · February 13, 1997
BACKGROUND: Studies have reported that blacks undergo fewer coronary-revascularization procedures than whites, but it is not clear whether the clinical characteristics of the patients account for these differences or whether they indicate underuse of the p ...
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Journal articleN Engl J Med · December 19, 1996
BACKGROUND: In order to limit costs, health care organizations in the United States are shifting medical care from specialists to primary care physicians. Although primary care physicians provide less resource-intensive care, there is little information co ...
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Journal articleJ Am Coll Cardiol · November 15, 1996
OBJECTIVES: The purpose of this consensus effort was to define and prioritize the importance of a set of clinical variables useful for monitoring and improving the short-term mortality of patients undergoing coronary artery bypass graft surgery (CABG). BAC ...
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Journal articleJ Gen Intern Med · June 1996
An experimental pilot study using repeated measures to examine the impact of an interactive video program on the decision making of patients with ischemic heart disease was carried on at a tertiary care center and a Veterans Affairs hospital. The patients ...
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Journal articleAm J Gastroenterol · April 1996
OBJECTIVES: Accurate preoperative prediction of choledocholithiasis is essential in order to minimize patient risk and curtail health care expenditures. This study was designed to identify independent risk factors for choledocholithiasis in patients who ha ...
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Journal articleCirculation · November 1, 1995
BACKGROUND: Coronary artery bypass graft surgery is increasingly common in patients of age > or = 80 years. Single-institution reviews have cited a wide range of mortality results after bypass surgery in this age group, in part because of limited sample si ...
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Journal articleHealth Serv Res · February 1995
OBJECTIVE: We compare 30-day and 180-day postadmission hospital mortality rates for all Medicare patients and those in three categories of cardiac care: coronary artery bypass graft surgery, acute myocardial infarction, and congestive heart failure. DATA S ...
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Journal articleHealth Services Research · January 1, 1995
Objective. We compare 30-day and 180-day postadmission hospital mortality rates for all Medicare patients and those in three categories of cardiac care: coronary artery bypass graft surgery, acute myocardial infarction, and congestive heart failure. Data S ...
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Journal articleN Engl J Med · December 15, 1994
BACKGROUND: Previous studies have found that hospitals at which more procedures, such as coronary-artery bypass grafting (CABG) and other vascular surgery, are performed have lower rates of mortality related to these procedures than hospitals where fewer s ...
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Journal articleAnn Intern Med · December 15, 1994
OBJECTIVE: To examine secular changes in the use and outcome of percutaneous transluminal coronary angioplasty and cardiac bypass graft surgery in the elderly. DESIGN: A retrospective cohort study based on a longitudinal database created from the administr ...
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Journal articleCirculation · May 1994
BACKGROUND: Survival after coronary artery bypass graft surgery (CABG) and medical therapy in patients with coronary artery disease (CAD) has been studied in both randomized trials and observational treatment comparisons. Over the past decade, the use of c ...
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Journal articleN Engl J Med · April 21, 1994
BACKGROUND: It has been suggested that women with clinical evidence of coronary artery disease are less often referred for cardiac catheterization than are men. To determine whether there is sex-related bias in referral for cardiac catheterization, we pros ...
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Journal articleAm J Cardiol · March 10, 1994
The spiraling cost of health care has created a health care crisis. Concerns about the appropriate use of expensive medical technologies have been heightened by health services research studies that demonstrate widespread and dramatic geographic variabilit ...
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Journal articleAnn Intern Med · October 15, 1993
OBJECTIVE: To determine the suitability of insurance claims information for use in clinical outcomes research in ischemic heart disease. DESIGN: Concordance study of two databases. SETTING: Tertiary care referral center. PATIENTS: A total of 12,937 consecu ...
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Journal articleDiabetes Care · October 1990
The goal of this study was to compare the relative efficacy and cost of self-monitoring of blood glucose (SMBG) with routine urine testing in the management of patients with type II (non-insulin-dependent) diabetes mellitus not treated with insulin. Fifty- ...
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Journal articleJ Am Acad Dermatol · September 1990
Fifty-seven men were randomly assigned for treatment of androgenetic alopecia with viprostol, vehicle, or placebo twice daily for 24 weeks. Nonvellus hair growth was assessed subjectively by both patient and investigator and objectively through hair counts ...
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Journal articleJ Infect Dis · April 1990
To explore further topical antiviral therapy for recurrent genital herpes, 188 culture-proven patients were randomized to receive treatment with topical interferon-alpha in high-dose (10(6) IU/g with 1% nonoxynol-9 in 3.5% methylcellulose) or low-dose (10( ...
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Journal articleJ Am Acad Dermatol · April 1990
Thirty-one men with androgenetic alopecia completed 4 1/2 to 5 years of therapy with 2% and 3% topical minoxidil. Hair regrowth with topical minoxidil tended to peak at 1 year with a slow decline in regrowth over subsequent years. However, at 4 1/2 to 5 ye ...
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Journal articleObstet Gynecol · April 1990
Venous thromboembolism is a serious complication following gynecologic surgery and is particularly common in patients with malignancy. A previous study of subcutaneous low-dose heparin given as one dose preoperatively and every 12 hours postoperatively fai ...
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Journal articleClin Exp Dermatol · January 1990
Twenty-two men with patterns III-Va androgenetic alopecia were entered into a 10-month study aimed at establishing information on the natural progression of hair loss over a period of time typical of studies of hair growth promoters. The methodology employ ...
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Journal articleJ Clin Oncol · July 1989
We conducted a phase II study of intravenous (IV) melphalan in the treatment of children with recurrent medulloblastoma and in the initial treatment of children with poor-prognosis medulloblastoma and pineoblastoma. There was one complete response (CR) and ...
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Journal articleArch Intern Med · February 1989
Concurrent charge feedback has gained widespread acceptance as a method of minimizing hospitals' losses under the Medicare prospective payment system despite the fact that its effect on patient outcomes, physician behavior, or charges has not been studied ...
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Journal articleJAMA · November 4, 1988
The journal club is an established teaching modality in many house-staff training programs. To determine if a journal club improves house-staff reading habits, knowledge of epidemiology and biostatistics, and critical appraisal skills, we randomized 44 med ...
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Journal articleBiometrics · September 1988
Methods of evaluating and comparing the performance of diagnostic tests are of increasing importance as new tests are developed and marketed. When a test is based on an observed variable that lies on a continuous or graded scale, an assessment of the overa ...
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Journal articleCrit Care Med · July 1988
Patients with hepatic failure admitted to the medical ICU (MICU) generally have a poor prognosis. To determine if there were readily identifiable clinical factors associated with a high predictive value for outcome, we reviewed retrospectively the charts o ...
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Journal articleArch Intern Med · April 1988
An improved anemia classification may be available by combining measures of red blood cell size variability with mean corpuscular volume. Visual inspection of the peripheral blood film allows semiquantitative description of anisocytosis while quantitative ...
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Journal articleArch Surg · January 1988
Intestinal obstruction is frequently encountered in patients with ovarian cancer. Surgical correction of intestinal obstruction may allow the prolonged survival of some patients. We identified prognostic factors associated with operative complications and ...
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Journal articleJ Clin Periodontol · January 1988
This investigation was designed to determine the reproducibility of probing pocket depths in maxillary facial and mandibular facial and lingual grade II and III molar furcation sites. 80 untreated molar teeth with 102 furcation invasions due to periodontit ...
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Journal articleJ Am Acad Dermatol · May 1987
Nine healthy men with type IVa or Va male pattern baldness completed a 4-month single-blinded controlled pilot study designed to assess the effect of ultraviolet light (UVL) on topical minoxidil-induced hair growth. Subjects applied 2% topical minoxidil so ...
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Journal articleHypertension · May 1987
Epidemiological and experimental data suggest blood pressure-lowering effects of dietary potassium. A randomized, double-blind clinical trial was used to assess blood pressure response to orally administered potassium, 120 mEq/day, and to placebo in 101 ad ...
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Journal articleJ Clin Oncol · March 1987
We treated 103 patients with histologically confirmed anaplastic supratentorial astrocytic neoplasms with either diaziquone (AZQ) and carmustine (BCNU) or AZQ and procarbazine. There were 74 patients with glioblastoma multiforme (GBM) and 29 patients with ...
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Journal articleJ Am Acad Dermatol · March 1987
Forty-one men with male pattern baldness completed 132 study weeks (2 years 9 months) with topical minoxidil and had follow-up 1-inch target-area vertex scalp hair counts. Initially these men were treated with either twice-daily 2% topical minoxidil for 12 ...
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Journal articleJ Am Geriatr Soc · February 1987
With the increasing incidence of cancer in elderly patients, decisions to adopt palliative care become particularly relevant to this patient population. In order to define characteristics of decisions to adopt palliative care, including those factors influ ...
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Journal articleObstet Gynecol · February 1987
Deep venous thrombosis is a major complication following gynecologic surgery. Assessing a patient's risk of developing deep venous thrombosis is important for patient selection and in choosing appropriate prophylactic methods. Four hundred eleven patients ...
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Journal articleMed Decis Making · 1987
Diagnostic tests do not always yield positive or negative results; sometimes the results are intermediate, indeterminate, or uninterpretable. No consensus exists for the incorporation of such results into data assessment. Conventional Bayesian analysis lea ...
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Journal articleGynecol Oncol · January 1987
The results of surgery to relieve intestinal obstruction in 49 patients who were known to have ovarian cancer were studied. All patients had received adjunctive chemotherapy and/or radiation therapy prior to bowel obstruction. Thirty patients had small bow ...
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Journal articleJAMA · November 7, 1986
Using data from over 10 000 men, women, and children who participated in the Lipid Research Clinics prevalence studies, we have examined the formula adopted by Friedewald et al for estimating plasma or serum concentrations of low-density lipoprotein choles ...
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Journal articleJ Am Acad Dermatol · July 1986
Eighty-nine healthy men with male pattern baldness completed a 6-month double-blind, placebo-controlled study of 0.01%, 0.1%, 1%, and 2% topical minoxidil. Subjects on 2% topical minoxidil had a statistically significant increase in mean total target area ...
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Journal articleJ Gen Intern Med · 1986
To understand the effect that termination of an established physician-patient relationship has on patient attendance patterns in a medical clinic, appointment scheduling and patient attendance were measured for 210 patients before and after 11 senior resid ...
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Journal articleJ Gen Intern Med · 1986
Observer variability in the pulmonary examination was assessed by having four blindfolded observers (two medical students and two pulmonary physicians) twice examine 31 patients with abnormal pulmonary findings. Examiners were consistent in the repetitive ...
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Journal articleAnn Surg · January 1986
Adult dogs were previously prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of cannulae into the duodenum and stomach. After a 2-week period of postoperative recovery and an overnight fast, bile ducts were cannulated, gast ...
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Journal articleBiometrics · December 1985
The usefulness of a diagnostic test is generally assessed by calculating the sensitivity and specificity, or the predictive value positive and predictive value negative of the test. When subjects are monitored periodically for evidence of disease, these ca ...
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Journal articleCancer · October 15, 1985
A hospital-based case-control study was done to examine the hypothesis that persons with a family history of multiple myeloma (MM) or other cancers are at increased risk of multiple myeloma. Study members were 439 cases of multiple myeloma and 1317 matched ...
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Journal articleJ Am Acad Dermatol · August 1985
One-hundred twenty-six healthy men with early male pattern baldness completed a 12-month double-blind, controlled trial of 2% and 3% topical minoxidil. Subjects were initially randomly assigned to use placebo or 2% or 3% topical minoxidil. After 4 months o ...
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Journal articleJ Epidemiol Community Health · June 1985
A case control study was conducted to test the hypothesis that socioeconomic status is positively associated with multiple myeloma incidence. One hundred and fifty-three myeloma cases and 459 controls were identified at the Duke University Medical Center a ...
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Journal articleBreast Cancer Res Treat · 1985
Variability of tumor-associated antigens among and within human tumor cell groups presents a potential problem in the development and optimization of immunodiagnostic and therapeutic procedures for cancer. We determined the degree of expression of a tumor- ...
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Journal articleObstet Gynecol · November 1984
The clinical and laboratory effects of low-dose heparin prophylaxis was prospectively studied in a controlled trial of 182 patients undergoing major surgery for gynecologic malignancy. Low-dose heparin was given in 5000 U subcutaneously two hours preoperat ...
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Journal articleJ Clin Oncol · June 1984
Cooperative clinical trials groups offer exciting opportunities for conducting epidemiologic research for several reasons: they facilitate accrual of sufficient numbers of subjects in a short period of time, even for studies of rare diseases; they provide ...
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Journal articleCleft Palate J · April 1984
This longitudinal study analyzed the articulation development of 108 children with cleft lip/palate from three through eight years of age. The data suggest that as the severity of clefting increases the severity of the articulation deficit does also. Age a ...
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Journal articleJ Chronic Dis · 1984
This study examines the relative effects of climate and socioeconomic status (SES) on standard mortality ratios (SMR) from both young adult and older adult Hodgkin's disease (HD) in the United States. Climate variables explain a greater percentage of the v ...
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Journal articleCirculation · July 1983
We compared secular trends in ischemic heart disease (IHD) mortality in four southeastern states (North Carolina, Georgia, South Carolina, and Virginia) with those in three selected other states (California, New York, and Utah). Mortality data were obtaine ...
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Journal articleStatistics and Risk Modeling · January 1, 1983
The “two-samgle extended problem”, in which infer- ence concerning two distributions, F and G, is based on samples from distributions F* = Q1(F) and G* = Q2(G) (for known Q1, Q2 but unknown F and G), is viewed with respect to the estimation of P{X > Y} = ∫ ...
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Journal articleJ Natl Cancer Inst · January 1982
In a case-control study of childhood rhabdomyosarcoma (RMS), families of 33 cases and 99 controls were interviewed. A relative risk (RR) of 3.9 was found associated with fathers' (but not mothers') cigarette smoking (P = 0.003). Cases had had fewer immuniz ...
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Journal articleCommunications in Statistics Theory and Methods · January 1, 1981
Stochastic processes related to some generalized U-statistics (with especial emphasis on the Wilcoxon-Mann-Whitney (WMW-) statistic), under progressive right censoring, are considered for prediction purposes. Their weak convergence results are incorporated ...
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