Kevin J. Anstrom

Journal article Health Policy · December 2008 Featured Publication OBJECTIVES: We sought to determine whether dialysis patient mortality rates are associated with differences in dialysis facility size, and whether this relationship differs among higher risk diabetic and lower-risk non-diabetic patients. METHODS: Using 186 ... Full text Link to item Cite

Challenges in enrollment of minority, pediatric, and geriatric patients in emergency and acute care clinical research.

Journal article Ann Emerg Med · June 2008 Featured Publication STUDY OBJECTIVE: Emergency department (ED) -based clinical research has the potential to include patient populations that are typically underrepresented in clinical research. The objective of this study is to assess how emergency clinical care and research ... Full text Link to item Cite

A global ranking approach to end points in trials of mechanical circulatory support devices.

Journal article J Card Fail · June 2008 Featured Publication BACKGROUND: Although previous studies of mechanical circulatory support devices (MCSDs) have used all-cause mortality as a primary end point, trends in device technology and implementation will increasingly necessitate the use of composite end points for M ... Full text Link to item Cite

Safety of open food challenges in the office setting.

Journal article Ann Allergy Asthma Immunol · May 2008 Featured Publication BACKGROUND: Open food challenges are a practical alternative to double-blind, placebo-controlled food challenges in confirming clinical sensitivity or tolerance to a food, and the risks associated with open challenges are unknown. OBJECTIVE: To examine the ... Full text Link to item Cite

Outcomes of second revascularization procedures after stent implantation.

Journal article J Med Syst · April 2008 Featured Publication Drug-eluting stents (DES) reduce subsequent revascularization procedures. Although randomized trials have compared DES to brachytherapy and balloon angioplasty (PTCA) for in-stent restenosis, few long-term comparisons have been made to bare metal stents (B ... Full text Link to item Cite

Incidence and prevalence of heart failure in elderly persons, 1994-2003.

Journal article Arch Intern Med · February 25, 2008 Featured Publication BACKGROUND: Recent analyses have presented conflicting evidence regarding the incidence and prevalence of heart failure in the United States. We sought to estimate the annual incidence and prevalence of heart failure and associated survival in elderly pers ... Full text Link to item Cite

Incidence and prognostic significance of thrombocytopenia in patients treated with prolonged heparin therapy.

Journal article Arch Intern Med · January 14, 2008 Featured Publication BACKGROUND: Despite widespread heparin use in clinical practice, the associated development of thrombocytopenia is an underrecognized and undertreated complication. METHODS: We analyzed data from consecutive hospitalized patients treated with heparin (unfr ... Full text Link to item Cite

Pancreatic beta-cell function as a predictor of cardiovascular outcomes and costs: findings from the Cardiovascular Health Study.

Journal article Curr Med Res Opin · January 2008 Featured Publication OBJECTIVE: To explore relationships between beta-cell function and incident cardiovascular events, death, and medical costs among elderly individuals. RESEARCH DESIGN AND METHODS: In a prospective, population-based cohort of 4555 elderly individuals, we ex ... Full text Link to item Cite

Updated estimates of survival and cost effectiveness for imatinib versus interferon-alpha plus low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukaemia.

Journal article Pharmacoeconomics · 2008 Featured Publication BACKGROUND: For trials in which participants are followed beyond the main study period to assess long-term outcomes, economic evaluations conducted using short-term data should be systematically updated to reflect new information. METHODS: We used 60-month ... Full text Link to item Cite

Clinical characteristics of peanut-allergic children: recent changes.

Journal article Pediatrics · December 2007 Featured Publication OBJECTIVE: The goal was to determine whether patients seen in a referral clinic are experiencing initial allergic reactions to peanuts earlier, compared with a similar population profiled at a different medical center 10 years ago, and to investigate other ... Full text Link to item Cite

Implementation of a statewide system for coronary reperfusion for ST-segment elevation myocardial infarction.

Journal article JAMA · November 28, 2007 Featured Publication CONTEXT: Despite 2 decades of evidence demonstrating benefits from prompt coronary reperfusion, registries continue to show that many patients with ST-segment elevation myocardial infarction (STEMI) are treated too slowly or not at all. OBJECTIVE: To estab ... Full text Link to item Cite

Outpatient use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs for atrial fibrillation.

Journal article Am Heart J · November 2007 Featured Publication BACKGROUND: The first clinical practice guidelines for management of atrial fibrillation (AF) were published in 2001. We explored the use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs in patients with AF during the 4 years surrounding ... Full text Link to item Cite

Costs of the metabolic syndrome in elderly individuals: findings from the Cardiovascular Health Study.

Journal article Diabetes Care · October 2007 Featured Publication OBJECTIVE: The cardiovascular consequences of the metabolic syndrome and its component risk factors have been documented in elderly individuals. Little is known about how the metabolic syndrome and its individual components translate into long-term medical ... Full text Link to item Cite

Using inverse probability-weighted estimators in comparative effectiveness analyses with observational databases.

Journal article Med Care · October 2007 Featured Publication Inverse probability-weighted estimation is a powerful tool for use with observational data. In this article, we describe how this propensity score-based method can be used to compare the effectiveness of 2 or more treatments. First, we discuss the inherent ... Full text Link to item Cite

Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer.

Journal article Support Care Cancer · July 2007 Featured Publication GOALS OF WORK: Patients with prostate cancer metastasized to bone frequently experience skeletal morbidities as a result of their disease. We sought to quantify the longitudinal effects on patient-reported outcomes of skeletal-related events (SREs) and to ... Full text Link to item Cite

Sildenafil improves walk distance in idiopathic pulmonary fibrosis.

Journal article Chest · March 2007 Featured Publication Pulmonary hypertension is a common finding in patients with idiopathic pulmonary fibrosis (IPF), and is associated with increased morbidity and mortality. Therapy with sildenafil has been shown to decrease pulmonary vascular resistance in patients with pul ... Full text Link to item Cite

Comparative evaluation of Etest and sensititre yeastone panels against the Clinical and Laboratory Standards Institute M27-A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents.

Journal article J Clin Microbiol · March 2007 Featured Publication To assess their utility for antifungal susceptibility testing in our clinical laboratory, the Etest and Sensititre methods were compared with the Clinical and Laboratory Standards Institute (CLSI) M27-A2 reference broth microdilution method. Fluconazole (F ... Full text Link to item Cite

Trends in operator and hospital procedure volume and outcomes for percutaneous transluminal coronary angioplasty, 1996 to 2001.

Journal article Am J Cardiol · February 1, 2007 Featured Publication Although the volume/outcome relation for percutaneous transluminal coronary angioplasty (PTCA) is well established, it is unclear how the relation has changed over time. To examine trends in hospital and operator volume and outcomes for PTCA, we conducted ... Full text Link to item Cite

Long-term costs and resource use in elderly participants with congestive heart failure in the Cardiovascular Health Study.

Journal article Am Heart J · February 2007 Featured Publication BACKGROUND: Although heart failure (HF) afflicts nearly 5 million Americans, the long-term cost of HF care has not been described previously. In a prospective, longitudinal cohort of community-dwelling elderly from 4 regions, we examined the long-term cost ... Full text Link to item Cite

Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation.

Journal article JAMA · January 10, 2007 Featured Publication CONTEXT: Recent studies of drug-eluting intracoronary stents suggest that current antiplatelet regimens may not be sufficient to prevent late stent thrombosis. OBJECTIVE: To assess the association between clopidogrel use and long-term clinical outcomes of ... Full text Link to item Cite

Racial/ethnic variation in perceptions of medical information sources in Durham County, North Carolina.

Journal article N C Med J · 2007 Featured Publication BACKGROUND: Concerns about health and health care disparities have led some groups to promote better communication of medical information as a potential means of empowering patients to overcome barriers to health care and to practice healthy behaviors. We ... Link to item Cite

Patient receipt and understanding of written information provided with isotretinoin and estrogen prescriptions.

Journal article J Gen Intern Med · January 2007 Featured Publication BACKGROUND: Medication guides (MG) and mandatory patient package inserts (MPPI) are required with some prescription medications. OBJECTIVE: We sought to determine how many patients receive, read, and understand these mandated materials. DESIGN AND PARTICIP ... Full text Link to item Cite

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

Journal article Stud Health Technol Inform · 2007 Featured Publication Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, th ... Link to item Cite

National evaluation of adherence to beta-blocker therapy for 1 year after acute myocardial infarction in patients with commercial health insurance.

Journal article Am Heart J · September 2006 Featured Publication BACKGROUND: Quality measures of evidence-based medications post-myocardial infarction have focused on prescription at hospital discharge. Yet survival benefits of these medications are best realized with sustained therapy. We sought to examine long-term be ... Full text Link to item Cite

Cost-effectiveness of defibrillator therapy or amiodarone in chronic stable heart failure: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT).

Journal article Circulation · July 11, 2006 Featured Publication BACKGROUND: In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), implantable cardioverter-defibrillator (ICD) therapy significantly reduced all-cause mortality rates compared with medical therapy alone in patients with stable, moderately symptoma ... Full text Link to item Cite

Effect of zoledronic acid on pain associated with bone metastasis in patients with prostate cancer.

Journal article Ann Oncol · June 2006 Featured Publication BACKGROUND: Zoledronic acid reduces skeletal-related events associated with prostate cancer and has long-term efficacy in pain outcomes. Findings of treatment group differences in pain early in treatment are less reliable. We used a recently recommended an ... Full text Link to item Cite

Costs for heart failure with normal vs reduced ejection fraction.

Journal article Arch Intern Med · January 9, 2006 Featured Publication BACKGROUND: Among the elderly population, heart failure (HF) with normal ejection fraction (EF) is more common than classic HF with low EF. However, there are few data regarding the costs of HF with normal EF. In a prospective, population-based cohort of e ... Full text Link to item Cite

Assessing the quality of medical information technology economic evaluations: room for improvement.

Journal article AMIA Annu Symp Proc · 2006 Featured Publication Medical information systems are being recognized for their ability to improve patient outcomes. While standards for the economic evaluation of medical technologies were instituted in the mid-1990s, little is known about their application in medical informa ... Link to item Cite

Perceptions of Medicaid beneficiaries regarding the usefulness of accessing personal health information and services through a patient Internet portal.

Journal article AMIA Annu Symp Proc · 2006 Featured Publication Increasing emphasis is being placed on the importance of information technology to improve the safety and quality of healthcare. However, concern is growing that these potential benefits will not be equally distributed across the population because of a wi ... Link to item Cite

Economic evaluation in medical information technology: why the numbers don't add up.

Journal article AMIA Annu Symp Proc · 2006 Featured Publication Standards for the economic evaluation of medical technologies were instituted in the mid-1990s, yet little is known about their application in medical information technology studies. In a review of evaluation studies published between 1982 and 2002, we fou ... Link to item Cite

Perceptions about use of a patient Internet portal among Medicaid beneficiaries.

Journal article AMIA Annu Symp Proc · 2006 Featured Publication Patient Internet portals that allow patients to access their personal health information are an emerging form of enabling technology. The purported benefits from increasing use of information technology in healthcare, however, may not be universal because ... Link to item Cite

Use of surgery in patients with native valve infective endocarditis: results from the International Collaboration on Endocarditis Merged Database.

Journal article Am Heart J · November 2005 Featured Publication BACKGROUND: Early surgery has been shown to be beneficial for patients with infective endocarditis (IE), yet surgery is not used in most patients. Evidence of the uncertainty around the use of surgery can be found in the wide variations in the use of cardi ... Full text Link to item Cite

The use and effect of surgical therapy for prosthetic valve infective endocarditis: a propensity analysis of a multicenter, international cohort.

Journal article Am Heart J · November 2005 Featured Publication BACKGROUND: Although surgical intervention is often used in the treatment of prosthetic valve infective endocarditis (PVIE), an understanding of its effect on survival has been limited by the biases of observational studies and lack of controlled trials. M ... Full text Link to item Cite

Staphylococcus aureus endocarditis: a consequence of medical progress.

Journal article JAMA · June 22, 2005 Featured Publication CONTEXT: The global significance of infective endocarditis (IE) caused by Staphylococcus aureus is unknown. OBJECTIVES: To document the international emergence of health care-associated S aureus IE and methicillin-resistant S aureus (MRSA) IE and to evalua ... Full text Link to item Cite

Clinical and economic implications of the Multicenter Automatic Defibrillator Implantation Trial-II.

Journal article Ann Intern Med · April 19, 2005 Featured Publication BACKGROUND: The Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II demonstrated that implantable cardioverter defibrillators (ICDs) save lives when used in patients with a history of myocardial infarction (MI) and an ejection fraction of 0.3 ... Full text Link to item Cite

Conducting economic evaluations alongside multinational clinical trials: toward a research consensus.

Journal article Am Heart J · March 2005 Featured Publication Demand for economic evaluations in multinational clinical trials is increasing, but there is little consensus about how such studies should be conducted and reported. At a workshop in Durham, North Carolina, we sought to identify areas of agreement about h ... Full text Link to item Cite

Identification, diagnosis and treatment of heparin-induced thrombocytopenia and thrombosis: a registry of prolonged heparin use and thrombocytopenia among hospitalized patients with and without cardiovascular disease. The Complication After Thrombocytopenia Caused by Heparin (CATCH) Registry steering committee.

Journal article J Thromb Thrombolysis · February 2005 Featured Publication BACKGROUND: Heparin-induced thrombocytopenia (HIT) is estimated to occur in 1-5% of all patients receiving heparin, and 25-50% of such cases develop heparin-induced thrombocytopenia with thrombosis (HITT) A conservative estimate based only on cardiovascula ... Full text Link to item Cite

Costs and outcomes among hemodialysis-dependent patients with methicillin-resistant or methicillin-susceptible Staphylococcus aureus bacteremia.

Journal article Infect Control Hosp Epidemiol · February 2005 Featured Publication OBJECTIVE: Comorbid conditions have complicated previous analyses of the consequences of methicillin resistance for costs and outcomes of Staphylococcus aureus bacteremia. We compared costs and outcomes of methicillin resistance in patients with S. aureus ... Full text Link to item Cite

Perceived racial/ethnic bias in healthcare in Durham County, North Carolina: a comparison of community and national samples.

Journal article N C Med J · 2005 Featured Publication BACKGROUND: We sought to compare findings of a national survey of perceptions of racial/ethnic discrimination in healthcare to those of a community survey, with emphasis on the perceptions of Latinos. METHODS: Responses from a national survey were compared ... Link to item Cite

Assessing the potential economic value of health information technology interventions in a community-based health network.

Journal article AMIA Annu Symp Proc · 2005 Featured Publication Health information professionals recognize the need to demonstrate that the benefits of health information technological (HIT) interventions outweigh their costs. However, such cost-benefit analyses are rarely conducted for HIT interventions, due in part t ... Link to item Cite

Developing a framework for conducting economic evaluations of community-based health information technology interventions.

Journal article AMIA Annu Symp Proc · 2005 Featured Publication This study describes a framework for conducting economic analyses for health information technology (HIT) interventions, in the context of three interventions that are currently being implemented in a community-based health network caring for 17,779 Medica ... Link to item Cite

Cost-effectiveness of imatinib versus interferon-alpha plus low-dose cytarabine for patients with newly diagnosed chronic-phase chronic myeloid leukemia.

Journal article Cancer · December 1, 2004 Featured Publication BACKGROUND: Despite a lack of long-term data, imatinib has become standard therapy for patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML) who are not candidates for allogeneic stem cell transplantation. In the current study, the aut ... Full text Link to item Cite

Long-term survival estimates for imatinib versus interferon-alpha plus low-dose cytarabine for patients with newly diagnosed chronic-phase chronic myeloid leukemia.

Journal article Cancer · December 1, 2004 Featured Publication BACKGROUND: The authors estimated survival among patients with chronic myeloid leukemia for a cost-effectiveness analysis of imatinib versus interferon-alpha plus low-dose cytarabine (IFN+LDAC). METHODS: Two-year survival and cytogenetic response were dete ... Full text Link to item Cite

Native valve endocarditis due to coagulase-negative staphylococci: report of 99 episodes from the International Collaboration on Endocarditis Merged Database.

Journal article Clin Infect Dis · November 15, 2004 Featured Publication Using a large cohort of patients from the International Collaboration on Endocarditis Merged Database, we compared coagulase-negative staphylococcal (CoNS) native-valve endocarditis (NVE) to NVE caused by more common pathogens. Rates of heart failure and m ... Full text Link to item Cite

Usefulness of myocardial viability or ischemia in predicting long-term survival for patients with severe left ventricular dysfunction undergoing revascularization.

Journal article Am J Cardiol · May 15, 2004 Featured Publication In 107 patients with coronary disease and severe left ventricular dysfunction, we examined the prognostic power of viability identified by dobutamine stress echocardiography. At a mean follow-up of 27 months, patients with viable myocardium who underwent r ... Full text Link to item Cite

The insurance effect on prescription drug expenditures among the elderly: findings from the 1997 Medical Expenditure Panel Survey.

Journal article Med Care · May 2004 Featured Publication BACKGROUND: Despite continuing debate over a prescription drug benefit for the Medicare program, there has been relatively little research estimating the potential cost of providing such a benefit. OBJECTIVE: The objective of this study was to estimate the ... Full text Link to item Cite

Outcomes of early extubation after bypass surgery in the elderly.

Journal article Ann Thorac Surg · March 2004 Featured Publication BACKGROUND: While early extubation after coronary artery bypass grafting (CABG) has been associated with resource savings, its effect on patient outcomes remains unclear. The goal of the present investigation was to evaluate whether early extubation can be ... Full text Link to item Cite

Importance of echocardiography in patients with severe nonischemic heart failure: the second Prospective Randomized Amlodipine Survival Evaluation (PRAISE-2) echocardiographic study.

Journal article Am Heart J · January 2004 Featured Publication BACKGROUND: Echocardiography is used commonly in clinical practice when caring for patients with heart failure. It is unknown whether the presence of certain findings provides an incremental ability to predict survival beyond the use of baseline clinical f ... Full text Link to item Cite

Survival after coronary revascularization, with and without mitral valve surgery, in patients with ischemic mitral regurgitation.

Journal article Circulation · September 9, 2003 Featured Publication BACKGROUND: The most appropriate treatment for patients with ischemic mitral regurgitation (IMR) is often debated. We compared the survival rates of patients with IMR undergoing different treatment strategies, namely: medical therapy, percutaneous coronary ... Full text Link to item Cite

Influence of the Angioplasty Revascularization Investigation National Heart, Lung, and Blood Institute Diabetic Clinical Alert on practice patterns: results from the National Cardiovascular Network Database.

Journal article Circulation · April 15, 2003 Featured Publication BACKGROUND: In 1995, the Bypass Angioplasty Revascularization Investigation (BARI) found that patients with diabetes had a survival benefit when treated with surgical revascularization versus balloon angioplasty, prompting a National Heart Lung and Blood I ... Full text Link to item Cite

Obesity and long-term clinical and economic outcomes in coronary artery disease patients.

Journal article Obes Res · February 2002 Featured Publication OBJECTIVE: Obesity is an important risk factor for coronary artery disease (CAD); however, its effect on acute coronary syndrome (ACS) patients' long-term clinical and economic outcomes has not been quantified. We assessed the impact of increasing body mas ... Full text Link to item Cite

Utilizing propensity scores to estimate causal treatment effects with censored time-lagged data.

Journal article Biometrics · December 2001 Featured Publication Observational studies frequently are conducted to compare long-term effects of treatments. Without randomization, patients receiving one treatment are not guaranteed to be prognostically comparable to those receiving another treatment. Furthermore, the res ... Full text Link to item Cite

Effect of gender on the outcomes of contemporary percutaneous coronary intervention.

Journal article Am J Cardiol · August 15, 2001 Featured Publication Limited information exists regarding the outcomes of newer percutaneous coronary intervention (PCI) technologies in women. This study sought to determine whether female gender is an independent risk factor for PCI mortality and/or complications in contempo ... Full text Link to item Cite

Assessing the clinical and economic burden of coronary artery disease: 1986-1998.

Journal article Med Care · August 2001 Featured Publication BACKGROUND: The acute phase of coronary artery disease (CAD) is dramatic and receives much attention because of its high mortality and associated treatment cost. However, the acute phase typically resolves within 30 days whereas CAD is a chronic disease, w ... Full text Link to item Cite

Alabama coronary artery bypass grafting project: results of a statewide quality improvement initiative.

Journal article JAMA · June 20, 2001 Featured Publication CONTEXT: Efforts to improve quality of care in the cardiac surgery field have focused on reducing the risk-adjusted mortality associated with common surgical procedures, such as coronary artery bypass grafting (CABG). However, the best methodological appro ... Full text Link to item Cite

Association between selective serotonin-reuptake inhibitor therapy and heart valve regurgitation.

Journal article Am J Cardiol · April 15, 2001 Featured Publication The identification of an association between fenfluramines and valvular disease has raised the possibility of a similar association between another class of medications that increases local levels of serotonin, the selective serotonin-reuptake inhibitors ( ... Full text Link to item Cite

The progression of fenfluramine-associated valvular heart disease assessed by echocardiography.

Journal article Ann Intern Med · February 20, 2001 Featured Publication BACKGROUND: An association between the dietary suppressants fenfluramine and dexfenfluramine and valvular heart disease was first described in patients from North Dakota and Minnesota in 1997. Limited data are available on the natural history of this valvu ... Full text Link to item Cite

Contemporary outcome trends in the elderly undergoing percutaneous coronary interventions: results in 7,472 octogenarians. National Cardiovascular Network Collaboration.

Journal article J Am Coll Cardiol · September 2000 Featured Publication OBJECTIVES: We sought to define the risks facing octogenarians undergoing contemporary percutaneous coronary interventions (PCIs). BACKGROUND: The procedural risks of PCI for octogenarians have not been well established. METHODS: We compared the clinical c ... Full text Link to item Cite

Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network.

Journal article J Am Coll Cardiol · March 1, 2000 Featured Publication OBJECTIVES: The purpose of this study was to evaluate characteristics and outcomes of patients age > or =80 undergoing cardiac surgery. BACKGROUND: Prior single-institution series have found high mortality rates in octogenarians after cardiac surgery. Howe ... Full text Link to item Cite

Evolving trends in interventional device use and outcomes: results from the National Cardiovascular Network Database.

Journal article Am Heart J · February 2000 Featured Publication BACKGROUND: Although multiple new coronary interventional devices have been approved for marketing in the United States, use of these technologies in general clinical practice and their associated outcomes have not been reported. METHODS AND RESULTS: Using ... Full text Link to item Cite

Translation of clinical evidence into medical practice.

Journal article Am Heart J · December 1999 Featured Publication Full text Link to item Cite