Scholars@Duke
Roland Albert Matsouaka

Roland Albert Matsouaka

Associate Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics
Duke Box 17969, Durham, NC 27710
300 W. Morgan Street, Room 433, Durham, NC 27701

Scholarly Works - Journal articles

Estimation and inference of the win ratio for two hierarchical endpoints subject to censoring and missing data.

Journal article J Biopharm Stat · May 11, 2026 The win ratio (WR) is a widely used metric to compare treatments in randomized clinical trials with hierarchically ordered endpoints. Counting-based approaches, such as Pocock's algorithm, are the standard for WR estimation. However, this algorithm treats ... Full text Link to item Cite

A Tutorial for Propensity Score Weighting Methods Under Violations of the Positivity Assumption.

Journal article Stat Med · December 2025 Violations of the positivity assumption can render conventional causal estimands unidentifiable, including the average treatment effect (ATE), the average treatment effect on the treated (ATT), and the average treatment effect on the controls (ATC). Shifti ... Full text Link to item Cite

Variance Estimation for Weighted Average Treatment Effects.

Journal article Stat Biosci · September 15, 2025 Common variance estimation methods for weighted average treatment effects (WATEs) in observational studies include nonparametric bootstrap and model-based, closed-form sandwich variance estimation. However, the computational cost of bootstrap increases wit ... Full text Open Access Link to item Cite

Development of a natural language processing algorithm to extract social determinants of health from clinician notes.

Journal article Am J Transplant · June 2025 Disparities in access to the organ transplant waitlist are well-documented, but research into modifiable factors has been limited due to a lack of access to organized prewaitlisting data. This study aimed to develop a natural language processing (NLP) algo ... Full text Link to item Cite

Sample Size and Power Calculations With Win Measures Based on Hierarchical Endpoints.

Journal article Stat Med · May 2025 Win measures, such as win ratio, win odds, net benefit, and desirability of outcome ranking (DOOR), have become popular approaches for the analysis of hierarchical endpoints in clinical studies. Sample size and power calculations with win measures based on ... Full text Link to item Cite

Assessing racial disparities in healthcare expenditure using generalized propensity score weighting.

Journal article BMC Med Res Methodol · March 7, 2025 PURPOSE: This paper extends current propensity score weighting methods for causal inference to better understand disparities in healthcare access across multiple racial groups. By treating each racial group as a distinct entity (or "treatment") in the caus ... Full text Open Access Link to item Cite

Overlap, matching, or entropy weights: what are we weighting for?

Journal article Communications in Statistics Simulation and Computation · January 1, 2025 There has been a recent surge in statistical methods for handling the lack of adequate positivity when using inverse probability weights (IPW). However, these nascent developments have raised a number of questions. Thus, we demonstrate the ability of equip ... Full text Cite

Trial Design with Win Statistics for Multiple Time-to-Event Endpoints with Hierarchy

Journal article Statistics in Biopharmaceutical Research · January 1, 2025 The conventional approach to the analysis of composite endpoints is time-to-first event analysis. However, this approach has been criticized because it ignores the differences in clinical severity and may end up emphasizing the less severe time-to-event. T ... Full text Cite

A data pipeline for secure extraction and sharing of social determinants of health.

Journal article PLoS One · 2025 OBJECTIVES: Linking neighborhood- and patient-level data provides valuable information about the influence of upstream social determinants of health (SDOH). However, sharing of these data across health systems presents challenges. We set out to develop a p ... Full text Link to item Cite

Use of Predictive Models to Determine Transplant Eligibility.

Journal article Curr Transplant Rep · December 2024 PURPOSE OF REVIEW: This paper summarizes predictive models developed to determine transplant eligibility over the past 5 years, focusing on application of novel data sources and methodologic approaches. RECENT FINDINGS: The contemporary body of research em ... Full text Link to item Cite

When does adjusting covariate under randomization help? A comparative study on current practices.

Journal article BMC Med Res Methodol · October 26, 2024 PURPOSE: We aim to thoroughly compare past and current methods that leverage baseline covariate information to estimate the average treatment effect (ATE) using data from of randomized clinical trials (RCTs). We especially focus on their performance, effic ... Full text Link to item Cite

Average treatment effect on the treated, under lack of positivity.

Journal article Stat Methods Med Res · October 2024 The use of propensity score methods has become ubiquitous in causal inference. At the heart of these methods is the positivity assumption. Violation of the positivity assumption leads to the presence of extreme propensity score weights when estimating aver ... Full text Link to item Cite

Food insecurity among university students in the United States amidst the COVID-19 pandemic.

Journal article J Am Coll Health · July 2024 OBJECTIVE: This study reports on food insecurity (FI) amidst the COVID-19 pandemic. PARTICIPANTS AND METHODS: College students in four regions of the US completed the two-item validated Hunger Vital Sign™ screening tool on Qualtrics. RESULTS: FI increased ... Full text Link to item Cite

Characteristics of High-Performing Hospitals in Cardiogenic Shock Following Acute Myocardial Infarction.

Journal article Am J Cardiol · June 15, 2024 Cardiogenic shock after acute myocardial infarction (AMI-CS) carries significant mortality despite advances in revascularization and mechanical circulatory support. We sought to identify the process-based and structural characteristics of centers with lowe ... Full text Link to item Cite

Causal inference in the absence of positivity: The role of overlap weights.

Journal article Biom J · June 2024 How to analyze data when there is violation of the positivity assumption? Several possible solutions exist in the literature. In this paper, we consider propensity score (PS) methods that are commonly used in observational studies to assess causal treatmen ... Full text Link to item Cite

Observations from Statistical Review Editors: A Commentary

Journal article JID INNOVATIONS · 2024 Cite

Defining the Need for Causal Inference to Understand the Impact of Social Determinants of Health: A Primer on Behalf of the Consortium for the Holistic Assessment of Risk in Transplantation (CHART).

Journal article Ann Surg Open · December 2023 OBJECTIVE: This study aims to introduce key concepts and methods that inform the design of studies that seek to quantify the causal effect of social determinants of health (SDOH) on access to and outcomes following organ transplant. BACKGROUND: The causal ... Full text Open Access Link to item Cite

Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction.

Journal article JACC Heart Fail · August 2023 BACKGROUND: Initiation of evidence-based medications for patients with heart failure with reduced ejection fraction (HFrEF) during hospitalization in contemporary practice is unknown. OBJECTIVES: This study characterized opportunities for and achievement o ... Full text Link to item Cite

Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke.

Journal article JAMA · June 20, 2023 IMPORTANCE: Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion at increased risk of complications. OBJECTIVE: To determine the association betwee ... Full text Link to item Cite

Variance estimation for the average treatment effects on the treated and on the controls.

Journal article Stat Methods Med Res · February 2023 Common causal estimands include the average treatment effect, the average treatment effect of the treated, and the average treatment effect on the controls. Using augmented inverse probability weighting methods, parametric models are judiciously leveraged ... Full text Link to item Cite

Addressing substantial covariate imbalance with propensity score stratification and balancing weights: connections and recommendations.

Journal article Epidemiol Methods · January 2023 OBJECTIVES: Propensity score (PS) weighting methods are commonly used to adjust for confounding in observational treatment comparisons. However, in the setting of substantial covariate imbalance, PS values may approach 0 and 1, yielding extreme weights and ... Full text Link to item Cite

US Surveillance of Acute Ischemic Stroke Patient Characteristics, Care Quality, and Outcomes for 2019.

Journal article Stroke · November 2022 BACKGROUND: The United States lacks a timely and accurate nationwide surveillance system for acute ischemic stroke (AIS). We use the Get With The Guidelines-Stroke registry to apply poststratification survey weights to generate national assessment of AIS e ... Full text Link to item Cite

Neighborhood Socioeconomic Disadvantage and Hospitalized Heart Failure Outcomes in the American Heart Association Get With The Guidelines-Heart Failure Registry.

Journal article Circ Heart Fail · November 2022 BACKGROUND: Neighborhood socioeconomic status (SES) is associated with worse health outcomes, yet its relationship with in-hospital heart failure (HF) outcomes and quality metrics are underexplored. We examined the association between socioeconomic neighbo ... Full text Link to item Cite

Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines-Stroke Registry.

Journal article Stroke · October 2022 BACKGROUND: In 2015, endovascular therapy (EVT) for large vessel occlusions became standard of care for acute ischemic stroke. Lower utilization of IV alteplase has been reported in women, but whether sex differences in EVT use in the United States exists ... Full text Link to item Cite

Robust statistical inference for matched win statistics.

Journal article Stat Methods Med Res · August 2022 As alternatives to the time-to-first-event analysis of composite endpoints, the win statistics, that is, the net benefit, the win ratio, and the win odds have been proposed to assess treatment effects, using a hierarchy of prioritized component outcomes ba ... Full text Link to item Cite

Outcomes After Endovascular Thrombectomy With or Without Alteplase in Routine Clinical Practice.

Journal article JAMA Neurol · August 1, 2022 IMPORTANCE: The effectiveness and safety of intravenous alteplase given before or concurrently with endovascular thrombectomy (EVT) is uncertain. Randomized clinical trials suggest there is little difference in outcomes but with only modest precision and i ... Full text Open Access Link to item Cite

Patterns of care for first-detected atrial fibrillation: Insights from the Get With The Guidelines® - Atrial Fibrillation registry.

Journal article Heart Rhythm · July 2022 BACKGROUND: Despite multiple trials comparing rate with rhythm control, there is no consensus on the optimal management of first-detected atrial fibrillation (AF). OBJECTIVE: We analyzed current patterns of care for first-detected AF in the nationwide Get ... Full text Link to item Cite

Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke.

Journal article JAMA Netw Open · July 1, 2022 IMPORTANCE: After the publication of the CHANCE (Clopidogrel in High Risk Patients With Acute Nondisabling Cerebrovascular Events) and POINT (Platelet-Oriented Inhibition in New Transient Ischemic Attack and Minor Ischemic Stroke) clinical trials, the Amer ... Full text Link to item Cite

Trends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients.

Journal article JAMA Netw Open · June 1, 2022 IMPORTANCE: Patients aged 80 years and older were often excluded or underrepresented in pivotal endovascular thrombectomy (EVT) trials. Accordingly, trends in frequency, outcomes, and disparities of EVT use merit close analysis. OBJECTIVE: To delineate tem ... Full text Link to item Cite

Race-Ethnic Disparities in Rates of Declination of Thrombolysis for Stroke.

Journal article Neurology · April 19, 2022 BACKGROUND AND OBJECTIVES: Prior regional or single-center studies have noted that 4% to 7% of eligible patients with acute ischemic stroke (AIS) decline IV tissue plasminogen activator (tPA). We sought to determine the prevalence of tPA declination in a n ... Full text Open Access Link to item Cite

Association of readmission penalty amount with subsequent 30-day risk standardized readmission and mortality rates among patients hospitalized with heart failure: An analysis of get with the guidelines - heart failure participating centers.

Journal article Am Heart J · April 2022 BACKGROUND: The Hospital Readmissions Reduction Program penalizes hospitals with excess 30-day risk-standardized readmission rates (RSRR) for heart failure (HF). The association of financial penalty amount with subsequent short-term clinical outcomes is un ... Full text Link to item Cite

Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke.

Journal article J Am Heart Assoc · March 15, 2022 Introduction Endovascular therapy (EVT) use increased following clinical trials publication in 2015, but limited data suggest there may be persistent race and ethnicity differences. Methods and Results We included all patients with acute ischemic stroke ar ... Full text Link to item Cite

Clinical Outcomes With Metformin and Sulfonylurea Therapies Among Patients With Heart Failure and Diabetes.

Journal article JACC Heart Fail · March 2022 OBJECTIVES: The authors sought to characterize associations between initiation of metformin and sulfonylurea therapy and clinical outcomes among patients with comorbid heart failure (HF) and diabetes (overall and by ejection fraction [EF] phenotype). BACKG ... Full text Open Access Link to item Cite

Achievement and quality measure attainment in patients hospitalized with atrial fibrillation: Results from The Get With The Guidelines - Atrial Fibrillation (GWTG-AFIB) registry.

Journal article Am Heart J · March 2022 BACKGROUND: The Get With The Guidelines - Atrial Fibrillation (GWTG-AFIB) Registry uses achievement and quality measures to improve the care of patients with atrial fibrillation (AF). We sought to evaluate overall and site-level variation in attainment of ... Full text Link to item Cite

Association of Recent Use of Non-Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase.

Journal article JAMA · February 22, 2022 IMPORTANCE: Current guidelines recommend against use of intravenous alteplase in patients with acute ischemic stroke who are taking non-vitamin K antagonist oral anticoagulants (NOACs). OBJECTIVE: To evaluate the safety and functional outcomes of intraveno ... Full text Link to item Cite

Seasonal Variation of Atrial Fibrillation Admission and Quality of Care in the United States.

Journal article J Am Heart Assoc · February 15, 2022 Background Currently, little is known regarding seasonal variation for atrial fibrillation (AF) in the United States and whether quality of care for AF varies between seasons. Methods and Results The GWTG-AFib (Get With The Guidelines-AFib) registry was in ... Full text Link to item Cite

Is the affordable care act medicaid expansion associated with receipt of heart failure guideline-directed medical therapy by race and ethnicity?

Journal article Am Heart J · February 2022 BACKGROUND: Uninsurance is a known contributor to racial/ethnic health inequities. Insurance is often needed for prescriptions and follow-up appointments. Therefore, we determined whether the Affordable Care Act(ACA) Medicaid Expansion was associated with ... Full text Link to item Cite

Trimethoprim-Sulfamethoxazole Versus Levofloxacin for Stenotrophomonas maltophilia Infections: A Retrospective Comparative Effectiveness Study of Electronic Health Records from 154 US Hospitals.

Journal article Open Forum Infect Dis · February 2022 BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMX) is considered first-line therapy for Stenotrophomonas maltophilia infections based on observational data from small studies. Levofloxacin has emerged as a popular alternative due to tolerability concerns ... Full text Link to item Cite

Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines-Stroke Registry.

Journal article Stroke Vasc Interv Neurol · January 2022 BACKGROUND: Early administration of intravenous tissue plasminogen activator (IV alteplase) improves functional outcomes in patients with acute ischemic stroke, yet many patients are not treated with IV alteplase. There is a need to understand the reasons ... Full text Open Access Link to item Cite

Comfort Measures Only in Myocardial Infarction: Prevalence of This Status, Change Over Time, and Predictors From a Nationwide Study.

Journal article Circ Cardiovasc Qual Outcomes · January 2022 BACKGROUND: Patients hospitalized with acute myocardial infarction (AMI) have a high mortality rate. Despite increasing recognition of the role for comfort focused care, little is known about the prevalence of comfort measures only (CMO) care among patient ... Full text Link to item Cite

The Implementation of Farm-to-University Program in Historically Black Colleges and Universities: Assessment of Feasibility and Barriers

Journal article American Journal of Health Education · January 1, 2022 Background: Farm-to-University (Farm2U) programs make healthy eating accessible, easier, and the default option. Yet, few published studies have focused on Farm2U implementations in Historically Black Colleges and Universities (HBCUs) in conjunction with m ... Full text Cite

Patient characteristics, care patterns, and outcomes of atrial fibrillation associated hospitalizations in patients with chronic kidney disease and end-stage renal disease.

Journal article Am Heart J · December 2021 BACKGROUND: Chronic Kidney Disease (CKD) and end-stage renal disease (ESRD) are associated with poor outcomes in patients with cardiovascular disease. There is a paucity of contemporary data on in-hospital outcomes and care patterns of atrial fibrillation ... Full text Link to item Cite

Frequency, Characteristics, and Outcomes of Endovascular Thrombectomy in Patients With Stroke Beyond 6 Hours of Onset in US Clinical Practice.

Journal article Stroke · December 2021 BACKGROUND AND PURPOSE: In 2018, 2 randomized controlled trials showed the benefit of endovascular thrombectomy (EVT) in acute ischemic stroke patients treated 6 to 24 hours from last known well using imaging-guided selection. However, little is known abou ... Full text Link to item Cite

Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure.

Journal article Stroke · December 2021 BACKGROUND AND PURPOSE: Many older patients presenting with acute ischemic stroke were already taking aspirin before admission. However, the management strategy for patients with aspirin treatment failure has not been fully established. METHODS: We used da ... Full text Link to item Cite

Noninvasive Risk Score to Screen for Pulmonary Hypertension With Elevated Pulmonary Vascular Resistance in Diseases of Chronic Volume Overload.

Journal article Am J Cardiol · November 15, 2021 Volume overload promotes pulmonary hypertension (PH) through pulmonary venous hypertension. However, PH with elevated pulmonary vascular resistance (hereafter PH-PVR) may develop in patients with diseases of volume overload, such as heart failure or chroni ... Full text Link to item Cite

Sex Differences in Ablation Strategy, Lesion Sets, and Complications of Catheter Ablation for Atrial Fibrillation: An Analysis From the GWTG-AFIB Registry.

Journal article Circ Arrhythm Electrophysiol · November 2021 BACKGROUND: When presenting for atrial fibrillation (AF) ablation, women, compared with men, tend to have more nonpulmonary vein triggers and advanced atrial disease. Whether this informs differences in AF ablation strategy is not well described. We aimed ... Full text Link to item Cite

Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke.

Journal article Circ Cardiovasc Qual Outcomes · October 2021 BACKGROUND: Multiple states have not expanded Medicaid under the Affordable Care Act, resulting in higher uninsured rates in states with high stroke burdens. This study aimed to evaluate the association of Medicaid expansion with changes in health insuranc ... Full text Link to item Cite

Patterns of etanercept use in juvenile idiopathic arthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry.

Journal article Pediatr Rheumatol Online J · August 21, 2021 BACKGROUND: We aimed to characterize etanercept (ETN) use in juvenile idiopathic arthritis (JIA) patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. METHODS: The CARRA Registry is a convenience cohort of patien ... Full text Link to item Cite

Association Between 2010 Medicare Reform and Inpatient Rehabilitation Access in People With Intracerebral Hemorrhage.

Journal article J Am Heart Assoc · August 17, 2021 Background Evidence suggests intracerebral hemorrhage survivors have earlier recovery compared with ischemic stroke survivors. The Centers for Medicare and Medicaid Services prospective payment system instituted documentation rules for inpatient rehabilita ... Full text Link to item Cite

Racial differences in patient perception of interactions with providers are associated with health outcomes in type II diabetes.

Journal article Patient Educ Couns · August 2021 OBJECTIVES: Examine the association of patient perceptions of care with hemoglobin A1c (HbA1c), medication adherence, and missed appointments in non-Hispanic Black (NHB) and White (NHW) patients with type 2 diabetes (T2DM). METHODS: We used linear and logi ... Full text Link to item Cite

Oral Anticoagulation and Adverse Outcomes after Ischemic Stroke in Heart Failure Patients without Atrial Fibrillation.

Journal article J Card Fail · August 2021 BACKGROUND: The safety and effectiveness of oral anticoagulation (OAC) after an ischemic stroke in older patients with heart failure (HF) without atrial fibrillation remains uncertain. METHODS: Utilizing Get With The Guidelines Stroke national clinical reg ... Full text Link to item Cite

Association Between 2010 Medicare Reforms and Utilization of Postacute Inpatient Rehabilitation in Ischemic Stroke.

Journal article Am J Phys Med Rehabil · July 1, 2021 OBJECTIVE: The aim of the study was to investigate whether the elimination of trial admissions and the initiation of documentation requirements, via the 2010 Centers for Medicare and Medicaid Services Inpatient Rehabilitation Facility Prospective Payment S ... Full text Link to item Cite

Juvenile Spondyloarthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: High Biologic Use, Low Prevalence of HLA-B27, and Equal Sex Representation in Sacroiliitis.

Journal article Arthritis Care Res (Hoboken) · July 2021 OBJECTIVE: To describe characteristics of children with enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (PsA) who were enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. METHODS: All children with E ... Full text Link to item Cite

Association of Dual Eligibility for Medicare and Medicaid With Heart Failure Quality and Outcomes Among Get With The Guidelines-Heart Failure Hospitals.

Journal article JAMA Cardiol · July 1, 2021 IMPORTANCE: The Centers for Medicare & Medicaid Services uses a new peer group-based payment system to compare hospital performance as part of its Hospital Readmissions Reduction Program, which classifies hospitals into quintiles based on their share of du ... Full text Link to item Cite

Profile of Patients Hospitalized for Heart Failure Who Leave Against Medical Advice.

Journal article J Card Fail · July 2021 BACKGROUND: There is a paucity of information on patients hospitalized with heart failure (HF) who leave against medical advice (AMA). We sought to identify patient and hospital characteristics and outcomes of patients with HF who left AMA compared with th ... Full text Link to item Cite

Racial and Ethnic Differences in Presentation and Outcomes for Patients Hospitalized With COVID-19: Findings From the American Heart Association's COVID-19 Cardiovascular Disease Registry.

Journal article Circulation · June 15, 2021 BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has exposed longstanding racial and ethnic inequities in health risks and outcomes in the United States. We aimed to identify racial and ethnic differences in presentation and outcomes for patien ... Full text Open Access Link to item Cite

Regional Variations in Heart Failure Quality and Outcomes: Get With The Guidelines-Heart Failure Registry.

Journal article J Am Heart Assoc · April 6, 2021 Background Regional patient characteristics, care quality, and outcomes may differ based on a variety of factors among patients hospitalized for heart failure (HF). Regional disparities in outcomes of cardiovascular disease have been suggested across vario ... Full text Link to item Cite

Pharmacoepidemiology of Ceftazidime-Avibactam Use: A Retrospective Cohort Analysis of 210 US Hospitals.

Journal article Clin Infect Dis · February 16, 2021 BACKGROUND: Ceftazidime-avibactam has in vitro activity against some carbapenem-resistant gram-negative infections (GNIs), and therefore may be a useful alternative to more toxic antibiotics such as colistin. Understanding ceftazidime-avibactam uptake and ... Full text Link to item Cite

National surveillance of stroke quality of care and outcomes by applying post-stratification survey weights on the Get With The Guidelines-Stroke patient registry.

Journal article BMC Med Res Methodol · February 4, 2021 BACKGROUND: The U.S. lacks a stroke surveillance system. This study develops a method to transform an existing registry into a nationally representative database to evaluate acute ischemic stroke care quality. METHODS: Two statistical approaches are used t ... Full text Link to item Cite

Temporal trends in risk profiles among patients hospitalized for heart failure.

Journal article Am Heart J · February 2021 BACKGROUND: Postdischarge mortality following hospitalization for heart failure with reduced ejection fraction (HFrEF) has remained high and unchanged over the past 2 decades, despite effective therapies for HFrEF. We aimed to explore whether these pattern ... Full text Link to item Cite

Procedure characteristics and outcomes of atrial fibrillation ablation procedures using cryoballoon versus radiofrequency ablation: A report from the GWTG-AFIB registry.

Journal article J Cardiovasc Electrophysiol · February 2021 INTRODUCTION: Cryoballoon ablation (CBA) is an alternative to radiofrequency ablation (RFA) for ablation of atrial fibrillation (AF) and real-world comparisons of this strategy are lacking. As such, we sought to compare patient and periprocedural character ... Full text Link to item Cite

Guideline-Concordant Antiarrhythmic Drug Use in the Get With The Guidelines-Atrial Fibrillation Registry.

Journal article Circ Arrhythm Electrophysiol · February 2021 BACKGROUND: Antiarrhythmic drug (AAD) therapy for atrial fibrillation (AF) can be associated with both proarrhythmic and noncardiovascular toxicities. Practice guidelines recommend tailored AAD therapy for AF based on patient-specific characteristics, such ... Full text Link to item Cite

Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage.

Journal article JAMA Netw Open · February 1, 2021 IMPORTANCE: Although the use of factor Xa (FXa) inhibitors has increased substantially over the past decade, there are limited data on characteristics and outcomes of FXa inhibitor-associated intracerebral hemorrhage (ICH). OBJECTIVE: To investigate the as ... Full text Link to item Cite

Implantable Cardioverter Defibrillator Utilization and Mortality Among Patients ≥65 Years of Age With a Low Ejection Fraction After Coronary Revascularization.

Journal article Am J Cardiol · January 1, 2021 The purpose of this analysis was to assess implantable cardioverter-defibrillator (ICD) utilization and its association with mortality among patients ≥65 years of age after coronary revascularization. Patients in the National Cardiovascular Database Regist ... Full text Link to item Cite

The Patient's Point of View: Characterizing Patient-Level Factors Associated with Perceptions of Health Care.

Journal article Health Equity · 2021 Purpose: We explored the association between perception of care, as measured by the Interpersonal Processes of Care (IPC) survey, and patient-level factors, including (1) Trust in physicians; (2) Perceived empathy; (3) Stereotype threat; (4) Perceived ever ... Full text Link to item Cite

Association of Provider Perspectives on Race and Racial Health Care Disparities with Patient Perceptions of Care and Health Outcomes.

Journal article Health Equity · 2021 Purpose: Research suggests that providers contribute to racial disparities in health outcomes. Identifying modifiable provider perspectives that are associated with decreased racial disparities will help in the design of effective educational interventions ... Full text Link to item Cite

Antiplatelet patterns and outcomes in patients with atrial fibrillation not prescribed an anticoagulant after stroke.

Journal article Int J Cardiol · December 15, 2020 BACKGROUND: To determine association of discharge antiplatelet therapy prescription with 1-year outcomes among patients with AF admitted with acute ischemic stroke and discharged without oral anticoagulation. METHODS: In a retrospective cohort study from t ... Full text Link to item Cite

Propensity score weighting under limited overlap and model misspecification.

Journal article Stat Methods Med Res · December 2020 Propensity score weighting methods are often used in non-randomized studies to adjust for confounding and assess treatment effects. The most popular among them, the inverse probability weighting, assigns weights that are proportional to the inverse of the ... Full text Open Access Link to item Cite

Home Health Care Use and Post-Discharge Outcomes After Heart Failure Hospitalizations.

Journal article JACC Heart Fail · December 2020 OBJECTIVES: This study compared the characteristics of Medicare beneficiaries who were hospitalized for heart failure (HF) and then discharged home who received home health care (HHC) to the characteristics of those who did not, and examined associations a ... Full text Link to item Cite

Quality of Care and Outcomes Among Medicare Advantage vs Fee-for-Service Medicare Patients Hospitalized With Heart Failure.

Journal article JAMA Cardiol · December 1, 2020 IMPORTANCE: Medicare Advantage (MA), a private insurance plan option, now covers one-third of all Medicare beneficiaries. Although patients with cardiovascular disease enrolled in MA have been reported to receive higher quality of care in the ambulatory se ... Full text Link to item Cite

Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era.

Journal article JAMA Neurol · December 1, 2020 IMPORTANCE: A significant proportion of acute ischemic strokes occur while patients are hospitalized. Limited contemporary data exist on the utilization rates of intravenous thrombolysis or endovascular therapy for in-hospital stroke. OBJECTIVE: To use a n ... Full text Open Access Link to item Cite

Management of Atrial Fibrillation in Older Patients by Morbidity Burden: Insights From Get With The Guidelines-Atrial Fibrillation.

Journal article J Am Heart Assoc · December 2020 Background Knowledge is scarce regarding how multimorbidity is associated with therapeutic decisions regarding oral anticoagulants (OACs) in patients with atrial fibrillation. Methods and Results We conducted a cross-sectional study of hospitalized patient ... Full text Open Access Link to item Cite

Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries.

Journal article Circ Cardiovasc Qual Outcomes · December 2020 BACKGROUND: The benefit of intravenous thrombolytic therapy for acute ischemic stroke is time dependent. To assist hospitals in providing faster thrombolytic treatment, the American Heart Association launched target: stroke quality initiative in January 20 ... Full text Link to item Cite

Regression with a right-censored predictor using inverse probability weighting methods.

Journal article Stat Med · November 30, 2020 In a longitudinal study, measures of key variables might be incomplete or partially recorded due to drop-out, loss to follow-up, or early termination of the study occurring before the advent of the event of interest. In this paper, we focus primarily on th ... Full text Open Access Link to item Cite

Robust statistical inference for the matched net benefit and the matched win ratio using prioritized composite endpoints

Journal article · November 20, 2020 As alternatives to the time-to-first-event analysis of composite endpoints, the {\it net benefit} (NB) and the {\it win ratio} (WR) -- which assess treatment effects using prioritized component outcomes based on clinical importance -- have been proposed. H ... Link to item Cite

A framework for causal inference in the presence of extreme inverse probability weights: the role of overlap weights

Journal article · November 2, 2020 In this paper, we consider recent progress in estimating the average treatment effect when extreme inverse probability weights are present and focus on methods that account for a possible violation of the positivity assumption. These methods aim at estimat ... Link to item Cite

Procedural Patterns and Safety of Atrial Fibrillation Ablation: Findings From Get With The Guidelines-Atrial Fibrillation.

Journal article Circ Arrhythm Electrophysiol · September 2020 BACKGROUND: Catheter ablation is an increasingly used treatment for symptomatic atrial fibrillation (AF). However, there are limited prospective, nationwide data on patient selection and procedural characteristics. This study describes patient characterist ... Full text Link to item Cite

Outcomes and cost among Medicare beneficiaries hospitalized for heart failure assigned to accountable care organizations.

Journal article Am Heart J · August 2020 UNLABELLED: Little is known about the impact of accountable care organizations (ACO) on hospitalized heart failure (HF) patients, a high-cost and high-risk population. OBJECTIVE: We linked Medicare fee-for-service claims from 2013 to 2015 with data from Am ... Full text Link to item Cite

Reoperation After Transcatheter Aortic Valve Replacement: An Analysis of the Society of Thoracic Surgeons Database.

Journal article JACC Cardiovasc Interv · July 13, 2020 OBJECTIVES: This study sought to report the largest series of patients receiving a surgical reoperation after transcatheter aortic valve replacement (TAVR) using the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database. BACKGROUND: TAVR has be ... Full text Link to item Cite

Comparative Effectiveness of Primary Prevention Implantable Cardioverter-Defibrillators in Older Heart Failure Patients With Diabetes Mellitus.

Journal article J Am Heart Assoc · June 16, 2020 Background There are conflicting data regarding the benefit of primary prevention implantable cardioverter-defibrillators (ICDs) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative ef ... Full text Link to item Cite

Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke.

Journal article JAMA · June 2, 2020 IMPORTANCE: Earlier administration of intravenous tissue plasminogen activator (tPA) in acute ischemic stroke is associated with reduced mortality by the time of hospital discharge and better functional outcomes at 3 months. However, it remains unclear whe ... Full text Open Access Link to item Cite

Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure.

Journal article Circ Heart Fail · April 2020 BACKGROUND: Current guidelines recommend evaluation for underlying heart disease and reversible conditions for patients with new-onset heart failure (HF). There are limited data on contemporary testing for coronary artery disease (CAD) in patients with new ... Full text Link to item Cite

Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized With Heart Failure and Reduced Ejection Fraction.

Journal article Circ Heart Fail · April 2020 BACKGROUND: In PIONEER-HF (Comparison of Sacubitril/Valsartan Versus Enalapril on Effect on NT-pro BNP in Patients Stabilized From an Acute Heart Failure Episode), the in-hospital initiation of sacubitril/valsartan in patients hospitalized for acute decomp ... Full text Link to item Cite

Strict Versus Lenient Versus Poor Rate Control Among Patients With Atrial Fibrillation and Heart Failure (from the Get With The Guidelines - Heart Failure Program).

Journal article Am J Cardiol · March 15, 2020 Randomized data suggest lenient rate control (resting heart rate <110 beats/min) is noninferior to strict rate control (resting heart rate <80 beats/min) in patients with atrial fibrillation (AF). However, the optimal rate control strategy in patients with ... Full text Link to item Cite

In-Hospital Cardiac Arrest Resuscitation Practices and Outcomes in Maintenance Dialysis Patients.

Journal article Clin J Am Soc Nephrol · February 7, 2020 BACKGROUND AND OBJECTIVES: Patients on maintenance dialysis with in-hospital cardiac arrest have been reported to have worse outcomes relative to those not on dialysis; however, it is unknown if poor outcomes are related to the quality of resuscitation. Us ... Full text Link to item Cite

Temporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries.

Journal article JAMA Cardiol · February 1, 2020 IMPORTANCE: The association of the Hospital Readmission Reduction Program (HRRP) with reductions in racial disparities in 30-day outcomes for myocardial infarction (MI), is unknown, including whether this varies by HRRP hospital penalty status. OBJECTIVE: ... Full text Link to item Cite

The Win Ratio: On Interpretation and Handling of Ties

Journal article Statistics in Biopharmaceutical Research · January 2, 2020 To handle composite endpoints, the win ratio has been applied to data analysis and design of clinical trials. Its interpretation, however, is not always clear, and it could handle ties differently. We address these two aspects. First, we express the win ra ... Full text Cite

Relationship of Body Mass Index With Outcomes After Transcatheter Aortic Valve Replacement: Results From the National Cardiovascular Data-STS/ACC TVT Registry.

Journal article Mayo Clin Proc · January 2020 OBJECTIVE: To investigate the relationship of body mass index (BMI) with short- and long-term outcomes after transcatheter aortic valve replacement (TAVR). PATIENTS AND METHODS: The relationship between BMI and baseline characteristics and procedural chara ... Full text Link to item Cite

Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States.

Journal article Journal of the American Heart Association · January 2020 Background We aimed to determine if there is an association between hospital quality and the likelihood of a given hospital being a preferred transfer destination for stroke patients. Methods and Results Data from Medicare claims identified acute ischemic ... Full text Open Access Cite

Incidence, Temporal Trends, and Associated Outcomes of Vascular and Bleeding Complications in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry.

Journal article Circ Cardiovasc Interv · January 2020 BACKGROUND: Vascular and bleeding complications were commonly reported in transcatheter aortic valve replacement clinical trials. Little is known about complication rates in contemporary US clinical practice or clinical outcomes associated with these compl ... Full text Link to item Cite

Probing the Effective Treatment Thresholds for Alteplase in Acute Ischemic Stroke With Regression Discontinuity Designs.

Journal article Front Neurol · 2020 Randomized Controlled Trials (RCTs) are considered the gold standard for measuring the efficacy of medical interventions. However, RCTs are expensive, and use a limited population. Techniques to estimate the effects of stroke interventions from observation ... Full text Open Access Link to item Cite

The Medicare Shared Savings Program and Outcomes for Ischemic Stroke Patients: a Retrospective Cohort Study.

Journal article J Gen Intern Med · December 2019 BACKGROUND: Post-stroke care delivery may be affected by provider participation in Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) through systematic changes to discharge planning, care coordination, and transitional care. OBJE ... Full text Link to item Cite

Representativeness of a Heart Failure Trial by Race and Sex: Results From ASCEND-HF and GWTG-HF.

Journal article JACC Heart Fail · November 2019 OBJECTIVES: This study sought to determine the degree to which U.S. patients enrolled in a heart failure (HF) trial represent patients in routine U.S. clinical practice according to race and sex. BACKGROUND: Black patients and women are frequently under-re ... Full text Link to item Cite

A Study of Practice Behavior for Endotracheal Intubation Site for Children With Congenital Heart Disease Undergoing Surgery: Impact of Endotracheal Intubation Site on Perioperative Outcomes-An Analysis of the Society of Thoracic Surgeons Congenital Cardiac Anesthesia Society Database.

Journal article Anesth Analg · October 2019 BACKGROUND: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to percei ... Full text Open Access Link to item Cite

Hospital distance, socioeconomic status, and timely treatment of ischemic stroke.

Journal article Neurology · August 20, 2019 OBJECTIVE: To determine whether lower socioeconomic status (SES) and longer home to hospital driving time are associated with reductions in tissue plasminogen activator (tPA) administration and timeliness of the treatment. METHODS: We conducted a retrospec ... Full text Open Access Link to item Cite

Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice.

Journal article JAMA · July 16, 2019 IMPORTANCE: Randomized clinical trials suggest benefit of endovascular-reperfusion therapy for large vessel occlusion in acute ischemic stroke (AIS) is time dependent, but the extent to which it influences outcome and generalizability to routine clinical p ... Full text Open Access Link to item Cite

Medicare Shared Savings ACOs and Hospice Care for Ischemic Stroke Patients.

Journal article J Am Geriatr Soc · July 2019 OBJECTIVES: Palliative care services have the potential to improve the quality of end-of-life care and reduce cost. Services such as the Medicare hospice benefit, however, are often underutilized among stroke patients with a poor prognosis. We tested the h ... Full text Link to item Cite

Cox regression model with randomly censored covariates.

Journal article Biom J · July 2019 This paper deals with a Cox proportional hazards regression model, where some covariates of interest are randomly right-censored. While methods for censored outcomes have become ubiquitous in the literature, methods for censored covariates have thus far re ... Full text Link to item Cite

Thrombolysis in young adults with stroke: Findings from Get With The Guidelines-Stroke.

Journal article Neurology · June 11, 2019 OBJECTIVE: To determine whether young adults (≤40 years old) with acute ischemic stroke are less likely to receive IV tissue plasminogen activator (tPA) and more likely to have longer times to brain imaging and treatment. METHODS: We analyzed data from the ... Full text Open Access Link to item Cite

Association of post-discharge specialty outpatient visits with readmissions and mortality in high-risk heart failure patients.

Journal article Am Heart J · June 2019 UNLABELLED: Heart failure (HF) outcomes are especially poor in high-risk patients with certain comorbidities including diabetes mellitus (DM), chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). Whether early specialty or primar ... Full text Link to item Cite

The Incidence and Outcomes of Surgical Pulmonary Embolectomy in North America.

Journal article Ann Thorac Surg · May 2019 BACKGROUND: There has been renewed interest in surgical pulmonary embolectomy (SPE) for the treatment of pulmonary embolism, but the real-world incidence and outcomes of SPE have yet to be well described using a large, granular data set. We examined the mo ... Full text Link to item Cite

Long-term outcomes for heart failure patients with and without diabetes: From the Get With The Guidelines-Heart Failure Registry.

Journal article Am Heart J · May 2019 BACKGROUND: Diabetes mellitus is an increasingly prevalent condition among heart failure (HF) patients. The long-term morbidity and mortality among patients with and without diabetes with HF with reduced (HFrEF), borderline (HFbEF), and preserved ejection ... Full text Link to item Cite

A paradoxical relationship between hemoglobin A1C and in-hospital mortality in intracerebral hemorrhage patients.

Journal article Heliyon · May 2019 OBJECTIVES: The relationship between prior glycemic status and outcomes in intracerebral hemorrhage (ICH) is not established. We hypothesized that higher hemoglobin (Hb) A1c is associated with worse outcomes in ICH. PATIENTS AND METHODS: Using the GWTG-Str ... Full text Open Access Link to item Cite

Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke.

Journal article JAMA Neurol · April 1, 2019 IMPORTANCE: Although overall stroke incidence and mortality in the United States is improving, little is known about the characteristics and clinical outcomes of acute ischemic stroke in Asian American individuals. OBJECTIVE: To compare the characteristics ... Full text Open Access Link to item Cite

Adherence to Guideline-Directed Stroke Prevention Therapy for Atrial Fibrillation Is Achievable.

Journal article Circulation · March 19, 2019 BACKGROUND: Efforts to improve prescription of oral anticoagulation (OAC) drugs in patients with atrial fibrillation have had limited success in improving guideline adherence. METHODS: We evaluated adherence to the American College of Cardiology/American H ... Full text Link to item Cite

Visit-to-Visit Glycemic Variability and Risks of Cardiovascular Events and All-Cause Mortality: The ALLHAT Study.

Journal article Diabetes Care · March 2019 OBJECTIVE: The prognostic value of long-term glycemic variability is incompletely understood. We evaluated the influence of visit-to-visit variability (VVV) of fasting blood glucose (FBG) on incident cardiovascular disease (CVD) and mortality. RESEARCH DES ... Full text Link to item Cite

Glycated Hemoglobin and Outcomes of Heart Failure (from Get With the Guidelines-Heart Failure).

Journal article Am J Cardiol · February 15, 2019 Glycated hemoglobin (HbA1C) is a risk factor for new onset heart failure (HF). There is however a paucity of data evaluating its association with outcomes in patients with established HF. We assessed the relation of HbA1C with outcomes among hospitalized H ... Full text Link to item Cite

Heart Failure With Preserved Ejection Fraction and Diabetes: JACC State-of-the-Art Review.

Journal article J Am Coll Cardiol · February 12, 2019 Heart failure with preserved ejection fraction (HFpEF) is now the most common form of HF, affecting over 3 million adults in the United States alone. HFpEF is a heterogenous syndrome. One important phenotype may be related to comorbid conditions, including ... Full text Link to item Cite

Ischemic Stroke Transfer Patterns in the Northeast United States.

Journal article J Stroke Cerebrovasc Dis · February 2019 BACKGROUND: Little is known about how hospitals are connected in the transfer of ischemic stroke (IS) patients. We aimed to describe differences in characteristics of transferred versus nontransferred patients and between transferring and receiving hospita ... Full text Link to item Cite

Components and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals.

Journal article Circulation · January 8, 2019 BACKGROUND: Endovascular therapy (EVT) is standard of care in patients with acute disabling ischemic stroke attributable to large-vessel occlusion and is more effective when delivered quickly. It is currently unclear whether time targets achieved in clinic ... Full text Link to item Cite

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement.

Journal article JAMA · December 4, 2018 Featured Work IMPORTANCE: Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function. OBJECTIVE: ... Full text Link to item Cite

Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States.

Journal article J Am Heart Assoc · November 20, 2018 Featured Work Background There is disagreement in the literature about the relationship between strokes and seasonal conditions. We sought to (1) describe seasonal patterns of stroke in the United States, and (2) determine the relationship between weather variables and ... Full text Open Access Link to item Cite

Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference.

Journal article J Am Heart Assoc · November 6, 2018 Featured Work Background Patients presenting to hospitals during non-weekday hours experience worse outcomes, often attributed to reduced staffing. The American Heart Association International Stroke Conference ( ISC ) is well attended by stroke clinicians. We sought to ... Full text Open Access Link to item Cite

Collaborative Quality Improvement Reduces Postoperative Pneumonia After Isolated Coronary Artery Bypass Grafting Surgery.

Journal article Circ Cardiovasc Qual Outcomes · November 2018 BACKGROUND: To date, studies evaluating outcome improvements associated with participation in physician-led collaboratives have been limited by the absence of a contemporaneous control group. We examined post cardiac surgery pneumonia rates associated with ... Full text Link to item Cite

International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines--Stroke Program.

Journal article J Am Heart Assoc · October 16, 2018 Background Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results We analyzed 19 604 patients with ... Full text Open Access Link to item Cite

Aortic clamping strategy and postoperative stroke.

Journal article J Thorac Cardiovasc Surg · October 2018 OBJECTIVE: The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) tech ... Full text Link to item Cite

Vaccination Trends in Patients With Heart Failure: Insights From Get With The Guidelines-Heart Failure.

Journal article JACC Heart Fail · October 2018 OBJECTIVES: This study sought to evaluate and contribute to the limited data on U.S. hospital practice patterns with respect to respiratory vaccination in patients hospitalized with heart failure (HF). BACKGROUND: Respiratory infection is a major driver of ... Full text Link to item Cite

Trends in Hospice Discharge and Relative Outcomes Among Medicare Patients in the Get With The Guidelines-Heart Failure Registry.

Journal article JAMA Cardiol · October 1, 2018 IMPORTANCE: While 1 in 10 older patients hospitalized with heart failure (HF) die within 30 days, end-of-life care for this population is not well described. OBJECTIVE: To assess rates of discharge to hospice, readmission after hospice, and survival in hos ... Full text Link to item Cite

Use of Oral Anticoagulation in Eligible Patients Discharged With Heart Failure and Atrial Fibrillation.

Journal article Circ Heart Fail · October 2018 BACKGROUND: Stroke prophylaxis in patients with atrial fibrillation (AF) and heart failure (HF) in the era of direct oral anticoagulants is not well characterized. Using data from American Heart Association Get With The Guidelines-AFIB, we sought to evalua ... Full text Link to item Cite

Predicting Quality of Life at 1 Year After Transcatheter Aortic Valve Replacement in a Real-World Population.

Journal article Circ Cardiovasc Qual Outcomes · October 2018 Background Among clinical trial patients at high surgical risk, a model has been developed and externally validated to estimate patient risk for poor outcomes after transcatheter aortic valve replacement (TAVR). How this model performs in lower risk and un ... Full text Link to item Cite

Shock Index Predicts Patient-Related Clinical Outcomes in Stroke.

Journal article J Am Heart Assoc · September 18, 2018 Background The prognostic value of shock index ( SI ), heart rate divided by systolic blood pressure, in stroke for clinical outcomes other than mortality is not well understood. Methods and Results We examined the Get With The Guidelines-Stroke ( GWTG -St ... Full text Open Access Link to item Cite

An optimal Wilcoxon-Mann-Whitney test of mortality and a continuous outcome.

Journal article Stat Methods Med Res · August 2018 We consider a two-group randomized clinical trial, where mortality affects the assessment of a follow-up continuous outcome. Using the worst-rank composite endpoint, we develop a weighted Wilcoxon-Mann-Whitney test statistic to analyze the data. We determi ... Full text Open Access Link to item Cite

Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke.

Journal article Eur Heart J · July 1, 2018 AIMS: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. METHODS AND RESULTS: Patients aged ≥65 years (n = 409  ... Full text Link to item Cite

Association of the Affordable Care Act's Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure.

Journal article Circ Cardiovasc Qual Outcomes · July 2018 BACKGROUND: Heart failure (HF) is the leading cause of morbidity and mortality in the United States. Despite advancement in the management of HF, outcomes remain suboptimal, particularly among the uninsured. In 2014, the Affordable Care Act expanded Medica ... Full text Link to item Cite

A Hospital Level Analysis of 30-Day Readmission Performance for Heart Failure Patients and Long-Term Survival: Findings from Get With The Guidelines-Heart Failure.

Journal article Am Heart J · June 2018 BACKGROUND: Medicare utilizes 30-day risk-standardized readmission rates (RSRR) as a measure of hospital quality and applies penalties based on this measure. The objective of this study was to identify the relationship between hospital performance on 30-da ... Full text Link to item Cite

Association of Hospital Performance Based on 30-Day Risk-Standardized Mortality Rate With Long-term Survival After Heart Failure Hospitalization: An Analysis of the Get With The Guidelines-Heart Failure Registry.

Journal article JAMA Cardiol · June 1, 2018 IMPORTANCE: Among patients hospitalized with heart failure (HF), the long-term clinical implications of hospitalization at hospitals based on 30-day risk-standardized mortality rates (RSMRs) is not known. OBJECTIVE: To evaluate the association of hospital- ... Full text Link to item Cite

Burden of preoperative atrial fibrillation in patients undergoing coronary artery bypass grafting.

Journal article J Thorac Cardiovasc Surg · June 2018 BACKGROUND: This study compares early and late outcomes in patients undergoing coronary artery bypass grafting with and without preoperative atrial fibrillation in a contemporary, nationally representative Medicare cohort. METHODS: In the Medicare-Linked S ... Full text Link to item Cite

Stroke and Cardiovascular Outcomes in Patients With Carotid Disease Undergoing Transcatheter Aortic Valve Replacement.

Journal article Circ Cardiovasc Interv · June 2018 BACKGROUND: Stroke is a serious complication of both transcatheter aortic valve replacement (TAVR) and carotid artery disease (CD). The implications of CD in patients undergoing TAVR are unclear. METHODS AND RESULTS: The Society of Thoracic Surgeons and Am ... Full text Link to item Cite

Medicare Expenditures by Race/Ethnicity After Hospitalization for Heart Failure With Preserved Ejection Fraction.

Journal article JACC Heart Fail · May 2018 OBJECTIVES: The purpose of this study was to analyze cumulative Medicare expenditures at index admission and after discharge by race or ethnicity. BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a growing proportion of heart failure ( ... Full text Link to item Cite

Prevalence and Outcomes of Mitral Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement: Findings From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry.

Journal article JACC Cardiovasc Interv · April 9, 2018 OBJECTIVES: This study sought to examine the prevalence of mitral stenosis (MS) and its impact on in-hospital and 1-year clinical outcomes among patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Patients with coexisting severe ... Full text Link to item Cite

Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long-Term Mortality.

Journal article J Am Heart Assoc · April 6, 2018 BACKGROUND: Cardiac rehabilitation (CR) referral is recommended for eligible patients, regardless of sex or race. It is unclear whether inequality in CR referral practices was associated with patients' long-term survival. METHODS AND RESULTS: We linked the ... Full text Link to item Cite

Association of Tricuspid Regurgitation With Transcatheter Aortic Valve Replacement Outcomes: A Report From The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal article Ann Thorac Surg · April 2018 BACKGROUND: The purpose of this study is to evaluate the association of tricuspid regurgitation (TR) severity with outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We analyzed data from 34,576 patients who underwent TAVR at 365 US hos ... Full text Link to item Cite

Timing of Postdischarge Follow-Up and Medication Adherence Among Patients With Heart Failure.

Journal article J Am Heart Assoc · April 1, 2018 BACKGROUND: Medication adherence improves outcomes for patients with heart failure, but adherence rates remain low. We examined the association between earlier postdischarge follow-up and medication adherence. METHODS AND RESULTS: We performed a retrospect ... Full text Link to item Cite

Association of Electronic Health Record Use With Quality of Care and Outcomes in Heart Failure: An Analysis of Get With The Guidelines-Heart Failure.

Journal article J Am Heart Assoc · March 30, 2018 BACKGROUND: Adoption of electronic health record (EHR) systems has increased significantly across the nation. Whether EHR use has translated into improved quality of care and outcomes in heart failure (HF) is not well studied. METHODS AND RESULTS: We exami ... Full text Link to item Cite

Association of Intracerebral Hemorrhage Among Patients Taking Non-Vitamin K Antagonist vs Vitamin K Antagonist Oral Anticoagulants With In-Hospital Mortality.

Journal article JAMA · February 6, 2018 IMPORTANCE: Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH). OBJECTIVE: To assess the association between preceding ... Full text Open Access Link to item Cite

Determinants of Variation in Pneumonia Rates After Coronary Artery Bypass Grafting.

Journal article Ann Thorac Surg · February 2018 BACKGROUND: Although conventional wisdom suggests that differences in patient risk profiles drive variability in postoperative pneumonia rates after coronary artery bypass grafting (CABG), this teaching has yet to be empirically tested. We determined to wh ... Full text Link to item Cite

Valve hemodynamic deterioration and cardiovascular outcomes in TAVR: A report from the STS/ACC TVT Registry.

Journal article Am Heart J · January 2018 BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) an ... Full text Link to item Cite

Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure.

Journal article JAMA Cardiol · January 1, 2018 IMPORTANCE: Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but hav ... Full text Link to item Cite

Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials.

Journal article Circulation · December 12, 2017 BACKGROUND: Beginning in December 2014, a series of pivotal trials showed that endovascular thrombectomy (EVT) was highly effective, prompting calls to reorganize stroke systems of care. However, there are few data on how these trials influenced the freque ... Full text Link to item Cite

Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis and Mitral Regurgitation.

Journal article Ann Thorac Surg · December 2017 BACKGROUND: Many patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis also have significant mitral regurgitation (MR). We sought to understand the association of concomitant MR with TAVR clinical outcomes, as well changes i ... Full text Link to item Cite

Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Insights from the National Cardiovascular Data Registry Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal article Circulation · November 28, 2017 BACKGROUND: Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. METHODS: The National Cardiovascular Data Registry Society of Thoracic Surgeons/American Colle ... Full text Link to item Cite

Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes.

Journal article J Am Coll Cardiol · November 14, 2017 BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection frac ... Full text Link to item Cite

Clinical Impact of Diabetes Mellitus on Outcomes After Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal article Circ Cardiovasc Interv · November 2017 BACKGROUND: Diabetes mellitus (DM) adversely affects morbidity and mortality for cardiovascular diseases and procedures. Data evaluating the outcomes of transcatheter aortic valve replacement (TAVR) in diabetic patients are limited by small sample size and ... Full text Link to item Cite

Death and Dialysis After Transcatheter Aortic Valve Replacement: An Analysis of the STS/ACC TVT Registry.

Journal article JACC Cardiovasc Interv · October 23, 2017 OBJECTIVES: The authors sought to elucidate the true incidence of renal replacement therapy (RRT) after transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a wide discrepancy in the reported rate of RRT after TAVR (1.4% to 40%). The true in ... Full text Link to item Cite

Linear regression model with a randomly censored predictor:Estimation procedures

Journal article · October 23, 2017 We consider linear regression model estimation where the covariate of interest is randomly censored. Under a non-informative censoring mechanism, one may obtain valid estimates by deleting censored observations. However, this comes at a cost of lost inform ... Open Access Link to item Cite

Conversion From Off-Pump Coronary Artery Bypass Grafting to On-Pump Coronary Artery Bypass Grafting.

Journal article Ann Thorac Surg · October 2017 BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) has been shown to be an effective strategy for surgical revascularization. The purpose of this study was to define the incidence of intraoperative conversion from OPCAB to on-pump coronary artery ... Full text Link to item Cite

Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data? Findings From Get With The Guidelines-Stroke.

Journal article Circ Cardiovasc Qual Outcomes · October 2017 BACKGROUND: Hospital profiling is typically undertaken using risk-standardized 30-day mortality, but obtaining these data for hospitals can be difficult. We sought to determine whether risk-standardized in-hospital mortality could serve as an adequate prox ... Full text Link to item Cite

Effect of Obesity and Underweight Status on Perioperative Outcomes of Congenital Heart Operations in Children, Adolescents, and Young Adults: An Analysis of Data From the Society of Thoracic Surgeons Database.

Journal article Circulation · August 22, 2017 BACKGROUND: Extreme body mass index (BMI; either very high or very low) has been associated with increased risk of adverse perioperative outcome in adults undergoing cardiac surgery. The effect of BMI on perioperative outcomes in congenital heart disease p ... Full text Link to item Cite

Transcatheter Versus Surgical Aortic Valve Replacement: Propensity-Matched Comparison.

Journal article J Am Coll Cardiol · July 25, 2017 BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. ... Full text Link to item Cite

Procedural Experience for Transcatheter Aortic Valve Replacement and Relation to Outcomes: The STS/ACC TVT Registry.

Journal article J Am Coll Cardiol · July 4, 2017 BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been introduced into U.S. clinical practice with efforts to optimize outcomes and minimize the learning curve. OBJECTIVES: The goal of this study was to assess the degree to which increasing exp ... Full text Link to item Cite

Instrumental variable estimation of causal odds ratios using structural nested mean models.

Journal article Biostatistics · July 1, 2017 We consider estimating causal odds ratios using an instrumental variable under a logistic structural nested mean model (LSNMM). Current methods for LSNMMs either rely heavily on possible "uncongenial" modeling assumptions or involve intricate numerical cha ... Full text Link to item Cite

Race/Ethnic Differences in Outcomes Among Hospitalized Medicare Patients With Heart Failure and Preserved Ejection Fraction.

Journal article JACC Heart Fail · July 2017 OBJECTIVES: This study analyzed HFpEF patient characteristics and clinical outcomes according to race/ethnicity and adjusted for patient and hospital characteristics along with socioeconomic status (SES). BACKGROUND: The proportion of hospitalizations for ... Full text Link to item Cite

Association Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes.

Journal article Stroke · July 2017 BACKGROUND AND PURPOSE: Although the use of antiplatelet therapy (APT) is associated with the risk of intracerebral hemorrhage (ICH), there are limited data on prestroke APT and outcomes, particularly among patients on combination APT (CAPT). We hypothesiz ... Full text Link to item Cite

Association of Surgeon Age and Experience With Congenital Heart Surgery Outcomes.

Journal article Circ Cardiovasc Qual Outcomes · July 2017 BACKGROUND: Surgeon experience concerns both families of children with congenital heart disease and medical providers. Relationships between surgeon seniority and patient outcomes are often assumed, yet there are little data. METHODS AND RESULTS: This nati ... Full text Link to item Cite

Quality-of-Life Outcomes After Transcatheter Aortic Valve Replacement in an Unselected Population: A Report From the STS/ACC Transcatheter Valve Therapy Registry.

Journal article JAMA Cardiol · April 1, 2017 IMPORTANCE: In clinical trials, transcatheter aortic valve replacement (TAVR) has been shown to improve symptoms and quality of life. As this technology moves into general clinical practice, evaluation of the health status outcomes among unselected patient ... Full text Link to item Cite

Delays in Door-to-Needle Times and Their Impact on Treatment Time and Outcomes in Get With The Guidelines-Stroke.

Journal article Stroke · April 2017 BACKGROUND AND PURPOSE: Despite quality improvement programs such as the American Heart Association/American Stroke Association Target Stroke initiative, a substantial portion of acute ischemic stroke patients are still treated with tissue-type plasminogen ... Full text Link to item Cite

Initiation, Continuation, or Withdrawal of Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers and Outcomes in Patients Hospitalized With Heart Failure With Reduced Ejection Fraction.

Journal article J Am Heart Assoc · February 11, 2017 BACKGROUND: Guidelines recommend continuation or initiation of guideline-directed medical therapy, including angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARB), in hospitalized patients with heart failure with reduced ejec ... Full text Open Access Link to item Cite

Association of 30-Day Readmission Metric for Heart Failure Under the Hospital Readmissions Reduction Program With Quality of Care and Outcomes.

Journal article JACC Heart Fail · December 2016 OBJECTIVES: This study sought to determine whether processes of care and long-term clinical outcomes for heart failure (HF) admissions across Get With The Guidelines-Heart Failure (GWTG-HF) program participating centers differ according to HF-specific risk ... Full text Link to item Cite

Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines-Stroke.

Journal article J Am Heart Assoc · November 14, 2016 BACKGROUND: Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ische ... Full text Open Access Link to item Cite

Temporal Trends in Care and Outcomes of Patients Receiving Fibrinolytic Therapy Compared to Primary Percutaneous Coronary Intervention: Insights From the Get With The Guidelines Coronary Artery Disease (GWTG-CAD) Registry.

Journal article J Am Heart Assoc · October 6, 2016 BACKGROUND: Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysi ... Full text Open Access Link to item Cite

Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement: Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Journal article Circulation · April 5, 2016 BACKGROUND: Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. METHODS AND RESULTS: We assessed the assoc ... Full text Link to item Cite

Does Mother Know Best? Treatment Adherence as a Function of Anticipated Treatment Benefit.

Journal article Epidemiology · March 2016 BACKGROUND: We describe bias resulting from individualized treatment selection, which occurs when treatment has heterogeneous effects and individuals selectively choose treatments of greatest benefit to themselves. This pernicious bias may confound estimat ... Full text Link to item Cite

Power and sample size calculations for the Wilcoxon-Mann-Whitney test in the presence of death-censored observations.

Journal article Stat Med · February 10, 2015 We consider a clinical trial of a potentially lethal disease in which patients are randomly assigned to two treatment groups and are followed for a fixed period of time; a continuous endpoint is measured at the end of follow-up. For some patients; however, ... Full text Open Access Link to item Cite

Evaluating marker-guided treatment selection strategies.

Journal article Biometrics · September 2014 A potential venue to improve healthcare efficiency is to effectively tailor individualized treatment strategies by incorporating patient level predictor information such as environmental exposure, biological, and genetic marker measurements. Many useful st ... Full text Open Access Link to item Cite

Inhibition of the NFAT pathway alleviates amyloid β neurotoxicity in a mouse model of Alzheimer's disease.

Journal article J Neurosci · February 29, 2012 Amyloid β (Aβ) peptides, the main pathological species associated with Alzheimer's disease (AD), disturb intracellular calcium homeostasis, which in turn activates the calcium-dependent phosphatase calcineurin (CaN). CaN activation induced by Aβ leads to p ... Full text Link to item Cite

Calcineurin activation causes retinal ganglion cell degeneration.

Journal article Mol Vis · 2012 Featured Work PURPOSE: We previously reported that calcineurin, a Ca(2+)/calmodulin-dependent serine/threonine phosphatase, is activated and proposed that it participates in retinal ganglion cell (RGC) apoptosis in two rodent ocular hypertension models. In this study, w ... Open Access Link to item Cite

Calcineurin inhibition with systemic FK506 treatment increases dendritic branching and dendritic spine density in healthy adult mouse brain.

Journal article Neurosci Lett · January 10, 2011 Calcineurin has been implicated as part of a critical signaling pathway for learning and memory, and recent data suggest that calcineurin activation mediates some of the neurotoxicity of the Alzheimer related neurotoxin Aβ. Immunosuppression via calcineuri ... Full text Link to item Cite

Simvastatin treatment improves functional recovery after experimental spinal cord injury by upregulating the expression of BDNF and GDNF.

Journal article Neurosci Lett · January 10, 2011 The aim of this study was to determine the therapeutic efficacy of simvastatin treatment starting 1 day after spinal cord injury (SCI) in rat and to investigate the underlying mechanism. Spinal cord injury was induced in adult female Sprague-Dawley rats af ... Full text Link to item Cite

Urinary biomarkers for sensitive and specific detection of acute kidney injury in humans.

Journal article Clin Transl Sci · December 2008 Acute kidney injury (AKI) is associated with high morbidity and mortality. The lack of sensitive and specific injury biomarkers has greatly impeded the development of therapeutic strategies to improve outcomes of AKI.The unique objective of this study was ... Full text Link to item Cite

does mother know best

Journal article Epidemiology Cite