Scholars@Duke
Valerie A. Smith

Valerie A. Smith

Associate Professor in Population Health Sciences
Population Health Sciences

Selected Publications

Health Expenditures After Bariatric Surgery: A Retrospective Cohort Study.

Journal Article Ann Surg · December 1, 2024 OBJECTIVE: To compare expenditures between surgical and matched nonsurgical patients in a retrospective cohort study. BACKGROUND: Bariatric surgery leads to substantial improvements in weight and weight-related conditions, but prior literature on postsurgi ... Full text Link to item Cite

A comparison of time-varying propensity score vs sequential stratification approaches to longitudinal matching with a time-varying treatment.

Journal Article BMC Med Res Methodol · November 13, 2024 BACKGROUND: Methods for matching in longitudinal cohort studies, such as sequential stratification and time-varying propensity scores, facilitate causal inferences in the context of time-dependent treatments that are not randomized where patient eligibilit ... Full text Link to item Cite

Outcomes of Community-Acquired Acute Kidney Injury: A Cohort Study of US Veterans.

Journal Article Med Care · November 12, 2024 BACKGROUND: Community-acquired acute kidney injury (CA-AKI) occurs outside of the hospital and is the most common form of AKI. CA-AKI is not well understood, which hinders efforts to prevent, identify, and manage CA-AKI. OBJECTIVE: Examine 30-day outcomes ... Full text Link to item Cite

Change in frailty among older COVID-19 survivors.

Journal Article J Am Geriatr Soc · November 9, 2024 INTRODUCTION: COVID-19 survivors are at greater risk for new medical conditions. Among older adults, where multimorbidity and functional impairment are common, frailty measurement provides a tool for understanding how infection impacts future health beyond ... Full text Link to item Cite

Demographic, Social, Behavioral, and Clinical Characteristics Associated with Long-Term Opioid Therapy and Any Opioid Prescription in High-Risk VA Patients.

Journal Article J Gen Intern Med · October 22, 2024 BACKGROUND: Social risks (individual social and economic conditions) have been implicated as playing a major role in the opioid epidemic and may be more prevalent in the most medically vulnerable patients. However, the extent to which specific social risks ... Full text Link to item Cite

The association between social risks and days at home for older veterans.

Journal Article J Am Geriatr Soc · October 2024 BACKGROUND: Many health systems are trying to support the ability of older adults to remain in their homes for as long as possible. Little is known about the relationship between patient-reported social risks and length of time spent at home. We assessed h ... Full text Link to item Cite

Is more care recipient time at home also a family caregiver-centered quality of life measure?

Journal Article J Am Geriatr Soc · October 2024 BACKGROUND: Time in healthcare facilities is associated with worse patient quality of life (QoL); however, impact on family caregiver QoL is unknown. We evaluate care recipient days not at home-days in the emergency department (ED), inpatient (IP) care, an ... Full text Link to item Cite

Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study.

Journal Article BMC Health Serv Res · August 19, 2024 BACKGROUND: Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or a ... Full text Link to item Cite

Impact of comprehensive medication reviews on potentially inappropriate medication discontinuation in Medicare beneficiaries.

Journal Article J Am Geriatr Soc · August 2024 BACKGROUND: The use of potentially inappropriate medications (PIMs) is associated with increased risk of hospitalizations and emergency room visits and varies by racial and ethnic subgroups. Medicare's nationwide medication therapy management (MTM) program ... Full text Link to item Cite

Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans.

Journal Article J Gen Intern Med · June 2024 BACKGROUND: Prior research demonstrates that SARS-COV-2 infection can be associated with a broad range of mental health outcomes including depression symptoms. Veterans, in particular, may be at elevated risk of increased depression following SARS-COV-2 in ... Full text Link to item Cite

Regional variation in financial hardship among US veterans during the COVID-19 pandemic.

Journal Article Health Aff Sch · June 2024 Geographic variation in hardship, especially health-related hardship, was identified prior to and during the pandemic, but we do not know whether this variation is consistent among Veterans Health Administration (VHA)-enrolled veterans, who reported marked ... Full text Link to item Cite

Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure.

Journal Article JAMA Health Forum · May 3, 2024 IMPORTANCE: Comprehensive medication reviews (CMRs) are offered to qualifying US Medicare beneficiaries annually to optimize medication regimens and therapeutic outcomes. In 2016, Medicare adopted CMR completion as a Star Rating quality measure to encourag ... Full text Link to item Cite

Associations Between a Primary Care-Delivered Alcohol-Related Brief Intervention and Subsequent Opioid-Related Outcomes.

Journal Article Am J Psychiatry · May 1, 2024 OBJECTIVE: The co-occurrence of unhealthy alcohol use and opioid misuse is high and associated with increased rates of overdose, emergency health care utilization, and death. The current study examined whether receipt of an alcohol-related brief interventi ... Full text Link to item Cite

Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain.

Journal Article Med Care Res Rev · April 2024 Disabled Veterans commonly experience pain. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides training, a stipend, and services to family caregivers of eligible Veterans to support their caregiving role. We compared ascertainme ... Full text Link to item Cite

Association Between a National Behavioral Weight Management Program and Veterans Affairs Health Expenditures.

Journal Article Med Care · April 1, 2024 OBJECTIVE: The association between participation in a behavioral weight intervention and health expenditures has not been well characterized. We compared Veterans Affairs (VA) expenditures of individuals participating in MOVE!, a VA behavioral weight loss ... Full text Link to item Cite

Risk of Potentially Preventable Hospitalizations After SARS-CoV-2 Infection.

Journal Article JAMA Netw Open · April 1, 2024 IMPORTANCE: Research demonstrates that SARS-CoV-2 infection is associated with increased risk of all-cause hospitalization. However, no prior studies have assessed the association between SARS-CoV-2 and potentially preventable hospitalizations-that is, hos ... Full text Link to item Cite

Self-Reported Everyday Functioning After COVID-19 Infection.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection. OBJECTIVE: To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histor ... Full text Link to item Cite

Nurse-Led Strategy to Improve Blood Pressure and Cholesterol Level Among People With HIV: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: Despite higher atherosclerotic cardiovascular disease (ASCVD) risk, people with HIV (PWH) experience unique barriers to ASCVD prevention, such as changing models of HIV primary care. OBJECTIVE: To test whether a multicomponent nurse-led strateg ... Full text Open Access Link to item Cite

Risk of Suicide-Related Outcomes After SARS-COV-2 Infection: Results from a Nationwide Observational Matched Cohort of US Veterans.

Journal Article J Gen Intern Med · March 2024 BACKGROUND: Negative mental health-related effects of SARS-COV-2 infection are increasingly evident. However, the impact on suicide-related outcomes is poorly understood, especially among populations at elevated risk. OBJECTIVE: To determine risk of suicid ... Full text Link to item Cite

Real World Use of Anti-Obesity Medications and Weight Change in Veterans.

Journal Article J Gen Intern Med · March 2024 BACKGROUND: Anti-obesity medications (AOMs) can be initiated in conjunction with participation in the VA national behavioral weight management program, MOVE!, to help achieve clinically meaningful weight loss. OBJECTIVE: To compare weight change between Ve ... Full text Link to item Cite

Association between results of an amyloid PET scan and healthcare utilization in individuals with cognitive impairment.

Journal Article J Am Geriatr Soc · March 2024 BACKGROUND: The Imaging Dementia Evidence for Amyloid Scanning (IDEAS) study reports that amyloid PET scans help providers diagnose and manage Alzheimer's disease and related dementias (ADRD). Using CARE-IDEAS, an IDEAS supplemental study, we examined the ... Full text Link to item Cite

Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance studies rather than comparing outpatient health care use between COVID-19-infected and uninfected cohorts. OBJECTIV ... Full text Link to item Cite

Association between patient-reported social and behavioral risks and health care costs in high-risk Veterans health administration patients.

Journal Article Health Serv Res · February 2024 OBJECTIVE: Social risks complicate patients' ability to manage their conditions and access healthcare, but their association with health expenditures is not well established. To identify patient-reported social risk, behavioral, and health factors associat ... Full text Link to item Cite

Azathioprine metabolite levels and outcomes during pregnancies with rheumatic disease.

Journal Article Lupus Sci Med · January 3, 2024 OBJECTIVE: Despite widespread use of azathioprine (AZA) during pregnancy, no studies evaluated the impact of pregnancy on AZA metabolites 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine nucleotide (6-MMPN) disposition in rheumatic diseases. Thi ... Full text Link to item Cite

Elevated Amyloid-β PET Scan and Cognitive and Functional Decline in Mild Cognitive Impairment and Dementia of Uncertain Etiology.

Journal Article J Alzheimers Dis · 2024 BACKGROUND: Elevated amyloid-β (Aβ) on positron emission tomography (PET) scan is used to aid diagnosis of Alzheimer's disease (AD), but many prior studies have focused on patients with a typical AD phenotype such as amnestic mild cognitive impairment (MCI ... Full text Link to item Cite

Differences in healthcare costs over 10 years following discharge from military service by weight trajectory.

Journal Article Obes Res Clin Pract · 2024 The prevalence of overweight and obesity among military personnel has increased substantially in the past two decades. Following military discharge many personnel can receive integrated health care from the Veterans Health Administration. Prior research re ... Full text Link to item Cite

Association between a national behavioral weight management program and real-world weight change.

Journal Article Obes Res Clin Pract · 2024 OBJECTIVE: In a national cohort of Veterans, weight change was compared between participants in a US Department of Veterans Affairs (VA) behavioral weight management program (MOVE!) and matched non-participants, and between high-intensity and low-intensity ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal Article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial.

Journal Article HIV Res Clin Pract · December 2023 Background: Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV.Objective: Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ... Open Access Link to item Cite

Economic costs of family caregiving for persons with advanced stage cancer: a longitudinal cohort study.

Journal Article J Cancer Surviv · October 12, 2023 PURPOSE: To form a multifaceted picture of family caregiver economic costs in advanced cancer. METHODS: A multi-site cohort study collected prospective longitudinal data from caregivers of patients with advanced solid tumor cancers. Caregiver survey and ou ... Full text Link to item Cite

Bariatric Surgery and Suicide Risk in Patients With Obesity.

Journal Article Ann Surg · October 1, 2023 OBJECTIVE: In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy, we compared the 5-year suicidal ideation and attempt rates with matched nonsurgical controls. BACKGROUND: Bariatric surgery has si ... Full text Link to item Cite

Late Mortality After COVID-19 Infection Among US Veterans vs Risk-Matched Comparators: A 2-Year Cohort Analysis.

Journal Article JAMA Intern Med · October 1, 2023 IMPORTANCE: Despite growing evidence of persistent problems after acute COVID-19, how long the excess mortality risk associated with COVID-19 persists is unknown. OBJECTIVE: To measure the time course of differential mortality among Veterans who had a firs ... Full text Link to item Cite

Are Geriatrics-Focused Primary Care Clinics Better at Diagnosing Dementia Than Traditional Clinics? A Matched Cohort Study.

Journal Article J Gen Intern Med · September 2023 BACKGROUND: Dementia and mild cognitive impairment (MCI) are prevalent but underdiagnosed. OBJECTIVE: To compare new dementia/MCI diagnosis rates in geriatrics-focused primary care clinics and traditional primary care clinics. DESIGN: Secondary analysis of ... Full text Link to item Cite

Epidemiology of Community-Acquired Acute Kidney Injury Among US Veterans.

Journal Article Am J Kidney Dis · September 2023 RATIONALE & OBJECTIVE: Community-acquired acute kidney injury (CA-AKI) develops outside of the hospital and is the most common form of AKI globally. National estimates of CA-AKI in the United States are absent due to limited availability of laboratory data ... Full text Link to item Cite

Impact of primary care usual provider type and provider interdependence on outcomes for patients with diabetes: a cohort study.

Conference BMJ Open Qual · June 2023 BACKGROUND: Interprofessional primary care (PC) teams are key to the provision of high-quality care. PC providers often 'share' patients (eg, a patient may see multiple providers in the same clinic), resulting in between-visit interdependence between provi ... Full text Link to item Cite

Exploring the importance of predisposing, enabling, and need factors for promoting Veteran engagement in mental health therapy for post-traumatic stress: a multiple methods study.

Journal Article BMC Psychiatry · May 27, 2023 PURPOSE: This study explored Veteran and family member perspectives on factors that drive post-traumatic stress disorder (PTSD) therapy engagement within constructs of the Andersen model of behavioral health service utilization. Despite efforts by the Depa ... Full text Link to item Cite

BMI Trends for Veterans Up to 10 Years After VA Enrollment Following Military Discharge.

Journal Article J Gen Intern Med · May 2023 BACKGROUND: Obesity (body mass index [BMI]≥30kg/m2) among US adults has tripled over the past 45 years, but it is unclear how this population-level weight change has occurred. OBJECTIVE: We sought to identify distinct long-term BMI trajectories and examine ... Full text Link to item Cite

Design and analysis of outcomes following SARS-CoV-2 infection in veterans.

Journal Article BMC Med Res Methodol · April 4, 2023 BACKGROUND: Understanding how SARS-CoV-2 infection impacts long-term patient outcomes requires identification of comparable persons with and without infection. We report the design and implementation of a matching strategy employed by the Department of Vet ... Full text Link to item Cite

Association between patient-reported social, behavioral, and health factors and emergency department visits in high-risk VA patients.

Journal Article Health Serv Res · April 2023 RESEARCH OBJECTIVE: To identify patient-reported social risk, behavioral, and health factors associated with emergency department (ED) utilization in high-risk Veterans Affairs (VA) patients. DATA SOURCES: Patient survey, VA, Medicare data. STUDY DESIGN: P ... Full text Link to item Cite

Racial inequality in functional trajectories between Black and White U.S. veterans.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans ... Full text Link to item Cite

Short-term effects of comprehensive caregiver supports on caregiver outcomes.

Journal Article Health Serv Res · February 2023 OBJECTIVE: To estimate the association of the Veterans Health Administration (VHA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) implemented in 2011 with caregiver health and health care use. DATA SOURCES: VHA claims and electronic heal ... Full text Link to item Cite

Reactions to Amyloid PET Scan Results and Levels of Anxious and Depressive Symptoms: CARE IDEAS Study.

Journal Article Gerontologist · January 24, 2023 BACKGROUND AND OBJECTIVES: Few studies have examined care partners' reactions to their loved ones receiving amyloid-β positron emission tomography (PET) scan results, which can be indicative of Alzheimer's disease. We explored care partners' reactions qual ... Full text Link to item Cite

When is caring sharing? Primary care provider interdependence and continuity of care.

Journal Article JAAPA · January 1, 2023 Efforts to improve access to high-quality, efficient primary care have highlighted the need for team-based care. Most primary care teams are designed to maintain continuity of care between patients and primary care providers (PCPs), because continuity of c ... Full text Link to item Cite

Quality of Care and Quality of Life in GeriPACT: A Comparative Effectiveness Study

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · 2023 Cite

Digital Medicine System in Veterans With Severe Mental Illness: Feasibility and Acceptability Study.

Journal Article JMIR Form Res · December 22, 2022 BACKGROUND: Suboptimal medication adherence is a significant problem for patients with serious mental illness. Measuring medication adherence through subjective and objective measures can be challenging, time-consuming, and inaccurate. OBJECTIVE: The prima ... Full text Open Access Link to item Cite

Effectiveness of mRNA COVID-19 Vaccine Boosters Against Infection, Hospitalization, and Death: A Target Trial Emulation in the Omicron (B.1.1.529) Variant Era.

Journal Article Annals of internal medicine · December 2022 BackgroundThe effectiveness of a third mRNA COVID-19 vaccine dose (booster dose) against the Omicron (B.1.1.529) variant is uncertain, especially in older, high-risk populations.ObjectiveTo determine mRNA booster vaccine effectiveness (VE ... Full text Cite

Consensus elements for observational research on COVID-19-related long-term outcomes.

Journal Article Medicine · November 2022 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its long-term outcomes may be jointly caused by a wide range of clinical, social, and economic characteristics. Studies aiming to identify mechanisms for SARS-CoV-2 morbidity and mo ... Full text Cite

Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.

Journal Article J Gen Intern Med · September 2022 BACKGROUND: Rural patients with type 2 diabetes (T2D) may experience poor glycemic control due to limited access to T2D specialty care and self-management support. Telehealth can facilitate delivery of comprehensive T2D care to rural patients, but implemen ... Full text Open Access Link to item Cite

Effect of a Comprehensive Telehealth Intervention vs Telemonitoring and Care Coordination in Patients With Persistently Poor Type 2 Diabetes Control: A Randomized Clinical Trial.

Journal Article JAMA Intern Med · September 1, 2022 IMPORTANCE: Persistently poorly controlled type 2 diabetes (PPDM) is common and causes poor outcomes. Comprehensive telehealth interventions could help address PPDM, but effectiveness is uncertain, and barriers impede use in clinical practice. OBJECTIVE: T ... Full text Open Access Link to item Cite

Relative contribution of pharmacists and primary care providers to shared quality measures.

Journal Article Explor Res Clin Soc Pharm · September 2022 BACKGROUND: Alternative payment models are common for both primary care providers and pharmacies. These models rely on quality measures to determine reimbursement, and pharmacists and primary care providers can contribute to performance on a similar set of ... Full text Link to item Cite

The Effect of Bariatric Surgery on Long-term Depression Treatment in Patients With Obesity.

Journal Article Ann Surg · August 1, 2022 OBJECTIVE: In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), initiation of (ie, incident) and persistence of (ie, continuation of preoperative) depression treatment are compared ... Full text Link to item Cite

Predictors of discharge from the VA Caregiver Support Program.

Journal Article Am J Manag Care · August 1, 2022 OBJECTIVES: The Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) is a clinical program providing training, a monthly stipend, and other services to caregivers of qualifying post-9/11 veterans with servic ... Full text Link to item Cite

Making the Informal Formal: Discussing and Completing Advance Care Plans in Care Dyads with Cognitive Impairment.

Journal Article J Palliat Care · July 2022 Background: Discussing advance care planning (ACP) with care partners may be a steppingstone to the completion of advance directives (ADs) for persons with cognitive impairment (PwCIs). Objectives: To examine whether PwCI-reported occurrence of and PwCI-ca ... Full text Link to item Cite

Family Caregivers of Veterans Experience Clinically Significant Levels of Distress Prepandemic and During Pandemic: Implications for Caregiver Support Services.

Journal Article Med Care · July 1, 2022 BACKGROUND: Of the 26.4 million family caregivers in the United States, nearly 40% report high levels of emotional strain and subjective burden. However, for the 5 million caregivers of Veterans, little is known about the experiences of caregivers of Veter ... Full text Link to item Cite

Potential Targets for Deprescribing in Medically Complex Older Adults with Suspected Cognitive Impairment.

Journal Article Geriatrics (Basel) · May 19, 2022 Deprescribing may be particularly beneficial in patients with medical complexity and suspected cognitive impairment (CI). We describe central nervous system (CNS) medication use and side effects in this population and explore the relationship between antic ... Full text Open Access Link to item Cite

Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities.

Journal Article Med Care Res Rev · April 2022 Support policies for caregivers improves care-recipient access to care and effects may generalize to nonhealth services. Using administrative data from the U.S. Department of Veterans Affairs (VA) for veterans <55 years, we assessed the association between ... Full text Link to item Cite

Pittsburgh Air Pollution Changes During the COVID-19 Lockdown.

Journal Article Environ Adv · April 2022 The rapid spread of COVID-19 resulted in various public lockdowns across the globe. Previous studies showed that resultant travel restrictions improved air quality. The novel results presented here focus on source-specific changes and compare air quality f ... Full text Link to item Cite

Does Long-Term Post-Bariatric Weight Change Differ Across Antidepressants?

Journal Article Ann Surg Open · March 2022 UNLABELLED: We sought to evaluate whether weight change up to 5 years after bariatric surgery differed by antidepressant class taken before surgery. BACKGROUND: Bariatric surgery induces significant weight loss, but outcomes are highly variable. The specif ... Full text Link to item Cite

Teaming up in primary care: Membership boundaries, interdependence, and coordination.

Journal Article JAAPA · February 1, 2022 OBJECTIVE: Increased demand for quality primary care and value-based payment has prompted interest in implementing primary care teams. Evidence-based recommendations for implementing teams will be critical to successful PA participation. This study sought ... Full text Link to item Cite

Amyloid-β PET Scan Results Disclosure and Care-Partner Emotional Well-Being Over Time.

Journal Article J Alzheimers Dis · 2022 BACKGROUND: Diagnostic tests, such as amyloid-β positron emission tomography (PET) scans, can increase appropriate therapeutic management for the underlying causes of cognitive decline. To evaluate the full utility of this diagnostic tool, information is n ... Full text Link to item Cite

Assessing a Digital Medicine System in Veterans with Severe Mental Illness: A provider-randomized clinical trial (Preprint)

Journal Article · December 9, 2021 BACKGROUNDSuboptimal medication adherence is a significant problem for patients with serious mental illness (SMI). Measuring medication adherence through subjective and objective measures ... Full text Open Access Cite

Evaluation of a geriatrics primary care model using prospective matching to guide enrollment.

Journal Article BMC Med Res Methodol · August 16, 2021 BACKGROUND: Few definitive guidelines exist for rigorous large-scale prospective evaluation of nonrandomized programs and policies that require longitudinal primary data collection. In Veterans Affairs (VA) we identified a need to understand the impact of ... Full text Open Access Link to item Cite

State variation in effects of state social distancing policies on COVID-19 cases.

Journal Article BMC Public Health · June 28, 2021 BACKGROUND: The novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021. Our objective was to describe state variation in the effect of initial social distancing policies and non-essential busi ... Full text Link to item Cite

Drivers of Long-Term Care Considerations by Persons With Cognitive Impairment.

Journal Article J Appl Gerontol · June 2021 Consideration of place of care is the first step in long-term care (LTC) planning and is critical for patients diagnosed with Alzheimer's disease; yet, drivers of consideration of place of care are unknown. We apply machine learning algorithms to cross-sec ... Full text Link to item Cite

Fitting marginalized two-part models to semicontinuous survey data arising from complex samples.

Journal Article Health Serv Res · June 2021 OBJECTIVE: To accurately model semicontinuous data from complex surveys, we extend marginalized two-part models to a design-based inferential framework and provide guidance on incorporating complex sample designs. DATA SOURCES: 2014 Medical Expenditure Pan ... Full text Link to item Cite

The association of alcohol use with all-cause and cardiovascular disease-related hospitalizations or death in older, high-risk Veterans.

Journal Article Alcohol Clin Exp Res · June 2021 BACKGROUND: The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population. METHODS: We examined the assoc ... Full text Link to item Cite

Annual wellness visits and care management before and after dialysis initiation.

Journal Article BMC Nephrol · May 5, 2021 INTRODUCTION: Demands of dialysis regimens may pose challenges for primary care provider (PCP) engagement and timely preventive care. This is especially the case for patients initiating dialysis adjusting to new logistical challenges and management of symp ... Full text Link to item Cite

Subgroups of High-Risk Veterans Affairs Patients Based on Social Determinants of Health Predict Risk of Future Hospitalization.

Journal Article Med Care · May 1, 2021 OBJECTIVE: Population segmentation has been recognized as a foundational step to help tailor interventions. Prior studies have predominantly identified subgroups based on diagnoses. In this study, we identify clinically coherent subgroups using social dete ... Full text Link to item Cite

Transportation as a barrier to colorectal cancer care.

Journal Article BMC Health Serv Res · April 13, 2021 BACKGROUND: Transportation barriers limit access to cancer care services and contribute to suboptimal clinical outcomes. Our objectives were to describe the frequency of Veterans reporting and the factors associated with transportation barriers to or from ... Full text Open Access Link to item Cite

Improving cardiovascular outcomes by using team-supported, EHR-leveraged, active management: Disseminating a successful quality improvement project.

Journal Article Contemp Clin Trials Commun · March 2021 BACKGROUND: Uncontrolled blood pressure (BP) is common among Veterans. Rural Veterans are at risk for suboptimal care coordination as successful programs may be implemented at lower rates due to individual- and system-level factors. There is strong evidenc ... Full text Open Access Link to item Cite

Opioid Prescribing in the 2016 Medicare Fee-for-Service Population.

Journal Article J Am Geriatr Soc · February 2021 BACKGROUND AND OBJECTIVES: Opioid use and misuse are prevalent and remain a national crisis. This study identified beneficiary characteristics associated with filling opioid prescriptions, variation in opioid dosing, and opioid use with average daily doses ... Full text Link to item Cite

Video-Enhanced Care Management for Medically Complex Older Adults with Cognitive Impairment.

Journal Article J Am Geriatr Soc · January 2021 OBJECTIVE: This pilot study assessed feasibility of video-enhanced care management for complex older veterans with suspected mild cognitive impairment (CI) and their care partners, compared with telephone delivery. DESIGN: Pilot randomized controlled trial ... Full text Link to item Cite

Disparities in Chronic Kidney Disease Progression by Medicare Advantage Enrollees.

Journal Article Am J Nephrol · 2021 INTRODUCTION: The prevalence of chronic kidney disease (CKD) in Medicare beneficiaries has quadrupled in the past 2 decades, but little is known about risk factors affecting the progression of CKD. This study aims to understand the progression in Medicare ... Full text Link to item Cite

Advancing the science of population-based measures of home-time.

Journal Article Healthc (Amst) · December 2020 The "home time" measure is gaining appeal in evaluating outcomes for multiple patient populations including post-surgery or intervention and the last 6 months of life. Advancing the science of home time measures will require obtaining the perspectives of p ... Full text Link to item Cite

Comparing Associations of State Reopening Strategies with COVID-19 Burden.

Journal Article J Gen Intern Med · December 2020 BACKGROUND: The novel coronavirus disease 2019 (COVID-19) infected over 5 million United States (US) residents resulting in more than 180,000 deaths by August 2020. To mitigate transmission, most states ordered shelter-in-place orders in March and reopenin ... Full text Link to item Cite

Association of Bariatric Surgical Procedures With Changes in Unhealthy Alcohol Use Among US Veterans.

Journal Article JAMA Netw Open · December 1, 2020 IMPORTANCE: Bariatric surgical procedures have been associated with increased risk of unhealthy alcohol use, but no previous research has evaluated the long-term alcohol-related risks after laparoscopic sleeve gastrectomy (LSG), currently the most used bar ... Full text Link to item Cite

Correction to: Comparing Associations of State Reopening Strategies with COVID-19 Burden.

Journal Article J Gen Intern Med · November 9, 2020 In the original version of this paper, an author was misidentified. The corrected author listing appears here, and has been updated in the online version. ... Full text Link to item Cite

Family Caregivers of Veterans Experience High Levels of Burden, Distress, and Financial Strain.

Journal Article J Am Geriatr Soc · November 2020 BACKGROUND/OBJECTIVES: To describe the caregiving experiences and physical and emotional needs of family members and friends who provide care to veterans with mental, physical, and cognitive comorbidities. DESIGN: Cross-sectional study. SETTING: National t ... Full text Link to item Cite

Practical telehealth to improve control and engagement for patients with clinic-refractory diabetes mellitus (PRACTICE-DM): Protocol and baseline data for a randomized trial.

Journal Article Contemp Clin Trials · November 2020 BACKGROUND: Persistent poorly-controlled type 2 diabetes mellitus (PPDM), or maintenance of a hemoglobin A1c (HbA1c) ≥8.5% despite receiving clinic-based diabetes care, contributes disproportionately to the national diabetes burden. Comprehensive telehealt ... Full text Open Access Link to item Cite

Comprehensive support of family caregivers: Are there health system cost offsets?

Journal Article Health Serv Res · October 2020 OBJECTIVES: To examine the effect of the Department of Veterans Affairs' (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans. DATA SOURCES: VA claims. STUDY DESIGN: Using a pre-post cohort design with ... Full text Link to item Cite

Patient-Reported Social and Behavioral Determinants of Health and Estimated Risk of Hospitalization in High-Risk Veterans Affairs Patients.

Journal Article JAMA Netw Open · October 1, 2020 IMPORTANCE: Despite recognition of the association between individual social and behavioral determinants of health (SDH) and patient outcomes, little is known regarding the value of SDH in explaining variation in outcomes for high-risk patients. OBJECTIVE: ... Full text Link to item Cite

Measurement Properties of the CAPACITY Instrument to Assess Perceived Communication With the Health Care Team Among Care Partners of Patients With Cognitive Impairment.

Journal Article Med Care · September 2020 BACKGROUND: The CAregiver Perceptions About CommunIcaTion with Clinical Team members (CAPACITY) instrument measures how care partners perceive themselves to be supported by the patient's health care team and their experiences communicating with the team. O ... Full text Link to item Cite

Utilization and Costs by Primary Care Provider Type: Are There Differences Among Diabetic Patients of Physicians, Nurse Practitioners, and Physician Assistants?

Journal Article Med Care · August 2020 OBJECTIVE: The objective of this study was to compare health care utilization and costs among diabetes patients with physician, nurse practitioner (NP), or physician assistant (PA) primary care providers (PCPs). RESEARCH DESIGN AND METHODS: Cohort study us ... Full text Link to item Cite

Long-term opioid use after bariatric surgery.

Journal Article Surg Obes Relat Dis · August 2020 BACKGROUND: Opioid analgesics are often prescribed to manage pain after bariatric surgery, which may develop into chronic prescription opioid use (CPOU) in opioid-naïve patients. Bariatric surgery may affect opioid use in those with or without presurgical ... Full text Link to item Cite

Identifying treatment effects of an informal caregiver education intervention to increase days in the community and decrease caregiver distress: a machine-learning secondary analysis of subgroup effects in the HI-FIVES randomized clinical trial.

Journal Article Trials · February 14, 2020 BACKGROUND: Informal caregivers report substantial burden and depressive symptoms which predict higher rates of patient institutionalization. While caregiver education interventions may reduce caregiver distress and decrease the use of long-term institutio ... Full text Open Access Link to item Cite

Author Correction: Atypical postural control can be detected via computer vision analysis in toddlers with autism spectrum disorder.

Journal Article Sci Rep · January 14, 2020 An amendment to this paper has been published and can be accessed via a link at the top of the paper. ... Full text Link to item Cite

Cognitive Screening and Dementia Diagnoses in Primary Care Settings

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · 2020 Cite

Association Between Bariatric Surgery and Long-term Health Care Expenditures Among Veterans With Severe Obesity.

Journal Article JAMA Surg · December 1, 2019 IMPORTANCE: Bariatric surgery has been associated with improvements in health in patients with severe obesity; however, it is unclear whether these health benefits translate into lower health care expenditures. OBJECTIVE: To examine 10-year health care exp ... Full text Link to item Cite

Family Caregiver Skills Training to Improve Experiences of Care: a Randomized Clinical Trial.

Journal Article J Gen Intern Med · October 2019 OBJECTIVE: To evaluate the effectiveness of Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES), a skills training program for caregivers of persons with functional or cognitive impairments. DESIGN: A two-arm RCT. SETTING: Single Veter ... Full text Link to item Cite

Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD).

Journal Article Am Heart J · October 2019 Persons living with human immunodeficiency virus (PLHIV) are at increased risk of atherosclerotic cardiovascular disease (ASCVD). In spite of this, uptake of evidence-based clinical interventions for ASCVD risk reduction in the HIV clinic setting is sub-op ... Full text Open Access Link to item Cite

Lab-based and diagnosis-based chronic kidney disease recognition and staging concordance.

Journal Article BMC Nephrol · September 14, 2019 BACKGROUND: Chronic kidney disease (CKD) is often under-recognized and poorly documented via diagnoses, but the extent of under-recognition is not well understood among Medicare beneficiaries. The current study used claims-based diagnosis and lab data to e ... Full text Link to item Cite

Primary care provider type: Are there differences in patients' intermediate diabetes outcomes?

Journal Article JAAPA · June 2019 Growing demand for services is leading primary care organizations to explore new delivery models. One approach incorporates multiple primary care providers on a team. Effective incorporation of multiple clinicians into teams requires well-defined roles, in ... Full text Link to item Cite

Impact Of Physicians, Nurse Practitioners, And Physician Assistants On Utilization And Costs For Complex Patients.

Journal Article Health Aff (Millwood) · June 2019 Because of workforce needs and demographic and chronic disease trends, nurse practitioners (NPs) and physician assistants (PAs) are taking a larger role in the primary care of medically complex patients with chronic conditions. Research shows good quality ... Full text Link to item Cite

A marginalized two-part model with heterogeneous variance for semicontinuous data.

Journal Article Stat Methods Med Res · May 2019 Semicontinuous data, characterized by a point mass at zero followed by a positive, continuous distribution, arise frequently in medical research. These data are typically analyzed using two-part mixtures that separately model the probability of incurring a ... Full text Link to item Cite

Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.

Journal Article Health Sci Rep · March 2019 BACKGROUND AND AIMS: Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, ... Full text Open Access Link to item Cite

Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs.

Journal Article Med Care Res Rev · February 2019 This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how ... Full text Link to item Cite

Using a geriatric oncology assessment to link with services (GOAL).

Journal Article J Geriatr Oncol · January 2019 OBJECTIVE: Geriatric screening tools assess functional limitations and inform clinical decision-making for older adults with cancer. Our objective was to evaluate the feasibility and effectiveness of a screener in community-based oncology clinics. MATERIAL ... Full text Link to item Cite

Geographic Variation in Obesity, Behavioral Treatment, and Bariatric Surgery for Veterans.

Journal Article Obesity (Silver Spring) · January 2019 OBJECTIVE: This study aims to describe geographic variation in veterans' prevalence of obesity, participation in Veterans Health Administration's behavioral weight management program (MOVE!), and receipt of bariatric surgery in fiscal year (FY) 2016. METHO ... Full text Link to item Cite

Clinical factors associated with persistently poor diabetes control in the Veterans Health Administration: A nationwide cohort study.

Journal Article PLoS One · 2019 OBJECTIVE: Patients with persistent poorly-controlled diabetes mellitus (PPDM) despite engagement in clinic-based care are at particularly high risk for diabetes complications and costs. Understanding this population's demographics, comorbidities and care ... Full text Open Access Link to item Cite

Comprehensive Family Caregiver Support and Caregiver Well-Being: Preliminary Evidence From a Pre-post-survey Study With a Non-equivalent Control Group.

Journal Article Front Public Health · 2019 Introduction: In May 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010, was signed into law in the United States, establishing the Program of Comprehensive Assistance for Family Caregivers (PCAFC) provided through the VA Caregiver Suppo ... Full text Open Access Link to item Cite

Cardiovascular disease-related chronic conditions among Veterans Affairs nonmetastatic colorectal cancer survivors: a matched case-control analysis.

Journal Article Cancer Manag Res · 2019 PURPOSE: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing nonmetastatic CRC survivors and matched noncancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with c ... Full text Open Access Link to item Cite

Intermediate Diabetes Outcomes in Patients Managed by Physicians, Nurse Practitioners, or Physician Assistants: A Cohort Study.

Journal Article Ann Intern Med · December 18, 2018 BACKGROUND: Primary care provided by nurse practitioners (NPs) and physician assistants (PAs) has been proposed as a solution to expected workforce shortages. OBJECTIVE: To examine potential differences in intermediate diabetes outcomes among patients of p ... Full text Link to item Cite

Atypical postural control can be detected via computer vision analysis in toddlers with autism spectrum disorder.

Journal Article Sci Rep · November 19, 2018 Evidence suggests that differences in motor function are an early feature of autism spectrum disorder (ASD). One aspect of motor ability that develops during childhood is postural control, reflected in the ability to maintain a steady head and body positio ... Full text Link to item Cite

Modeling Semicontinuous Longitudinal Expenditures: A Practical Guide.

Journal Article Health Serv Res · August 2018 OBJECTIVE: To compare different strategies for analyzing longitudinal expenditure data that have a point mass at $0. We provide guidance on parameter interpretation, research questions, and model selection. DATA SOURCES, STUDY DESIGN, AND DATA COLLECTION: ... Full text Link to item Cite

Interpersonal continuity of primary care of veterans with diabetes: a cohort study using electronic health record data.

Journal Article BMC Fam Pract · July 30, 2018 BACKGROUND: Continuity of care is a cornerstone of primary care and is important for patients with chronic diseases such as diabetes. The study objective was to examine patient, provider and contextual factors associated with interpersonal continuity of ca ... Full text Link to item Cite

The Effect of Support and Training for Family Members on Access to Outpatient Services for Veterans with Posttraumatic Stress Disorder (PTSD).

Journal Article Adm Policy Ment Health · July 2018 The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides landmark support for family caregivers of post-9/11 veterans. This study examines PCAFC support for veterans with and without PTSD and assesses whether program effect differs ... Full text Link to item Cite

Cardiovascular disease-related chronic conditions among Veterans Affairs colorectal cancer survivors: A matched case-control analysis.

Conference Journal of Clinical Oncology · March 1, 2018 4 Background: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing CRC survivors and matched non-cancer controls, our objectives were to determine the odds of CRC survivors bei ... Full text Cite

Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis.

Journal Article Inquiry · 2018 Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and communit ... Full text Open Access Link to item Cite

Family caregiver use and value of support services in the VA Program of Comprehensive Assistance for Family Caregivers

Journal Article Journal of Long-Term Care · January 1, 2018 Context: The US Congress in 2010 established the Program of Comprehensive Assistance for Family Caregivers (PCAFC) in the Department of Veterans Affairs’ (VA) healthcare system, expanding services for family caregivers of eligible veterans with injuries su ... Full text Cite

Direct and flexible marginal inference for semicontinuous data.

Journal Article Stat Methods Med Res · December 2017 The marginalized two-part (MTP) model for semicontinuous data proposed by Smith et al. provides direct inference for the effect of covariates on the marginal mean of positively continuous data with zeros. This brief note addresses mischaracterizations of t ... Full text Link to item Cite

Two parts are better than one: modeling marginal means of semicontinuous data

Journal Article Health Services and Outcomes Research Methodology · December 1, 2017 In health services research, it is common to encounter semicontinuous data characterized by a point mass at zero followed by a continuous distribution with positive support. These are often analyzed using two-part mixtures that separately model the probabi ... Full text Cite

A marginalized two-part model for longitudinal semicontinuous data.

Journal Article Stat Methods Med Res · August 2017 In health services research, it is common to encounter semicontinuous data, characterized by a point mass at zero followed by a right-skewed continuous distribution with positive support. Examples include health expenditures, in which the zeros represent a ... Full text Link to item Cite

Examining dental expenditure and dental insurance accounting for probability of incurring expenses.

Journal Article Community Dent Oral Epidemiol · April 2017 OBJECTIVES: There are few studies of dental service expenditure in Australia. Although dental insurance status is strongly associated with a higher probability of dental visiting, some studies indicate that there is little variation in expenditure by insur ... Full text Link to item Cite

Factors Associated With Having a Physician, Nurse Practitioner, or Physician Assistant as Primary Care Provider for Veterans With Diabetes Mellitus.

Journal Article Inquiry · January 1, 2017 Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associ ... Full text Link to item Cite

Colorectal Cancer Statistics From the Veterans Affairs Central Cancer Registry.

Journal Article Clin Colorectal Cancer · December 2016 BACKGROUND: Colorectal cancer (CRC) is a common and potentially deadly disease. Although the United States has robust cancer data reporting, information from the Department of Veterans Affairs (VA) healthcare system has often been underrepresented in natio ... Full text Open Access Link to item Cite

Modeling zero-modified count and semicontinuous data in health services research part 2: case studies.

Journal Article Stat Med · November 30, 2016 This article is the second installment of a two-part tutorial on the analysis of zero-modified count and semicontinuous data. Part 1, which appears as a companion piece in this issue of Statistics in Medicine, provides a general background and overview of ... Full text Link to item Cite

Modeling zero-modified count and semicontinuous data in health services research Part 1: background and overview.

Journal Article Stat Med · November 30, 2016 Health services data often contain a high proportion of zeros. In studies examining patient hospitalization rates, for instance, many patients will have no hospitalizations, resulting in a count of zero. When the number of zeros is greater or less than exp ... Full text Link to item Cite

Bariatric Surgery and Long-term Durability of Weight Loss.

Journal Article JAMA Surg · November 1, 2016 IMPORTANCE: Bariatric surgery induces significant weight loss for severely obese patients, but there is limited evidence of the durability of weight loss compared with nonsurgical matches and across bariatric procedures. OBJECTIVES: To examine 10-year weig ... Full text Link to item Cite

Comparative Effectiveness of an Internet-Based Smoking Cessation Intervention Versus Clinic-Based Specialty Care for Veterans.

Journal Article J Subst Abuse Treat · October 2016 INTRODUCTION: The primary objective of this project was to examine the effectiveness of an Internet-based smoking cessation intervention combined with a tele-health medication clinic for nicotine replacement therapy (NRT) compared to referral to clinic-bas ... Full text Link to item Cite

Food preferences and weight change during low-fat and low-carbohydrate diets.

Journal Article Appetite · August 1, 2016 UNLABELLED: Understanding associations between food preferences and weight loss during various effective diets could inform efforts to personalize dietary recommendations and provide insight into weight loss mechanisms. We conducted a secondary analysis of ... Full text Open Access Link to item Cite

Colorectal cancer survivorship statistics: A Veterans Affairs Central Cancer Registry analysis.

Conference Journal of Clinical Oncology · January 20, 2016 e267 Background: Our objective was to evaluate VA CRC incidence and survival and compare with the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data. Methods: Data were obtained from VACCR for vet ... Full text Cite

Effect of Allowing Choice of Diet on Weight Loss: A Randomized Trial.

Journal Article Ann Intern Med · June 16, 2015 BACKGROUND: Choosing a diet rather than being prescribed one could improve weight loss. OBJECTIVE: To examine whether offering choice of diet improves weight loss. DESIGN: Double-randomized preference trial of choice between 2 diets (choice) versus random ... Full text Link to item Cite

Association between bariatric surgery and long-term survival.

Journal Article JAMA · January 6, 2015 IMPORTANCE: Accumulating evidence suggests that bariatric surgery improves survival among patients with severe obesity, but research among veterans has shown no evidence of benefit. OBJECTIVE: To examine long-term survival in a large multisite cohort of pa ... Full text Link to item Cite

A marginalized two-part model for semicontinuous data.

Journal Article Stat Med · December 10, 2014 In health services research, it is common to encounter semicontinuous data characterized by a point mass at zero followed by a right-skewed continuous distribution with positive support. Examples include health expenditures, in which the zeros represent a ... Full text Link to item Cite

Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention.

Journal Article Appetite · December 2014 Individuals undertaking a weight loss effort have a choice among proven dietary approaches. Factors contributing to choice of either a low-fat/low-calorie diet or a low-carbohydrate diet, two of the most studied and popular dietary approaches, are unknown. ... Full text Link to item Cite

The Haemophilus ducreyi trimeric autotransporter adhesin DsrA protects against an experimental infection in the swine model of chancroid.

Journal Article Vaccine · June 24, 2014 Adherence of pathogens to cellular targets is required to initiate most infections. Defining strategies that interfere with adhesion is therefore important for the development of preventative measures against infectious diseases. As an adhesin to host extr ... Full text Link to item Cite

ALLOWING PATIENT CHOICE BETWEEN TWO DIVERSE DIETS DID NO IMPROVE WEIGHT LOSS

Conference JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2014 Link to item Cite

Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care?

Journal Article Circ Cardiovasc Qual Outcomes · March 2014 BACKGROUND: Hypertension self-management has been shown to improve systolic blood pressure (BP) control, but longer-term economic and clinical impacts are unknown. The purpose of this article is to examine clinical and economic outcomes 18 months after com ... Full text Open Access Link to item Cite

Health services use of older veterans treated and released from veterans affairs medical center emergency departments.

Journal Article J Am Geriatr Soc · September 2013 OBJECTIVES: To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Medical Center (VAMC) EDs. PARTICIPANTS: Nationally re ... Full text Link to item Cite

Influence of filter choice on 18F-FDG PET segmentation accuracy determined using generalized estimating equations.

Journal Article Phys Med Biol · June 7, 2013 This study aims to quantify how filter choice affects several fluoro-deoxy-glucose (FDG)-positron emission tomography (PET) segmentation methods and present the use of model fitting via generalized estimating equations (GEEs) to appropriately account for t ... Full text Link to item Cite

TH-C-WAB-08: Modeling of the Dice Coefficient for PET Segmentation Studies.

Journal Article Med Phys · June 2013 PURPOSE: The Dice coefficient (DC) is a common accuracy metric in PET segmentation studies that is a measure of overlap between the segmented volume and ground truth. This work presents a methodology to model DC as a function of object shapes, sizes, contr ... Full text Link to item Cite

Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice.

Journal Article Contemp Clin Trials · May 2013 A variety of diet approaches achieve moderate weight loss in many individuals. Yet, most diet interventions fail to achieve meaningful weight loss in more than a few individuals, likely due to inadequate adherence to the diet. It is widely conjectured that ... Full text Link to item Cite

Predictors of initial weight loss after gastric bypass surgery in twelve Veterans Affairs Medical Centers.

Journal Article Obes Res Clin Pract · 2013 The objective of this study was to identify determinants of significant weight loss one year after gastric bypass surgery among United States veterans. Using data from the Veterans Affairs (VA) Surgical Quality Improvement Program, we identified 516 vetera ... Full text Link to item Cite

Cervical lymph node metastasis and papillary thyroid carcinoma: does the compartment involved affect survival? Experience from the SEER database.

Journal Article J Surg Oncol · September 15, 2012 PURPOSE: Determine how the location of cervical lymph node metastases affects survival in papillary thyroid carcinoma (PTC) patients. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients diagnosed with PTC. Dise ... Full text Link to item Cite

Reevaluating the prognostic significance of age in differentiated thyroid cancer.

Journal Article Otolaryngol Head Neck Surg · August 2012 OBJECTIVE: To determine the impact of age on disease-specific survival in differentiated thyroid cancer. STUDY DESIGN: Retrospective analysis of a large population database. Setting Surveillance, Epidemiology, and End Results (SEER) database/multiple setti ... Full text Link to item Cite

Health expenditures among high-risk patients after gastric bypass and matched controls.

Journal Article Arch Surg · July 2012 OBJECTIVE: To determine whether bariatric surgery is associated with reduced health care expenditures in a multisite cohort of predominantly older male patients with a substantial disease burden. DESIGN: Retrospective cohort study of bariatric surgery. Out ... Full text Link to item Cite

Merkel cell carcinoma: identification of prognostic factors unique to tumors located in the head and neck based on analysis of SEER data.

Conference Laryngoscope · June 2012 OBJECTIVES/HYPOTHESIS: Merkel cell carcinoma (MCC) is an aggressive cutaneous neoplasm that occurs most frequently in the head and neck region. Because of its rarity, prognostic factors are poorly characterized. Head and neck MCC (HN-MCC) may require separ ... Full text Link to item Cite

Economic evaluation of telephone self-management interventions for blood pressure control.

Journal Article Am Heart J · June 2012 BACKGROUND: Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs ... Full text Open Access Link to item Cite

MO‐G‐BRA‐01: Optimal Image Filtration Strategies for PET Segmentation

Conference Medical Physics · January 1, 2012 Purpose: Gaussian smoothing reduces noise in PET images but blurs edges impacting the achievable accuracy in radiotherapy target segmentation. Bilateral filters both provide smoothing while simultaneously preserving edges. We compared the accuracy of four ... Full text Cite

Treatment intensification in a hypertension telemanagement trial: clinical inertia or good clinical judgment?

Journal Article Hypertension · October 2011 Clinical inertia represents a barrier to hypertension management. As part of a hypertension telemanagement trial designed to overcome clinical inertia, we evaluated study physician reactions to elevated home blood pressures. We studied 296 patients from th ... Full text Open Access Link to item Cite

Home blood pressure management and improved blood pressure control: results from a randomized controlled trial.

Journal Article Arch Intern Med · July 11, 2011 BACKGROUND: To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center. METHODS: Eligible ... Full text Open Access Link to item Cite

Measuring blood pressure for decision making and quality reporting: where and how many measures?

Journal Article Ann Intern Med · June 21, 2011 BACKGROUND: The optimal setting and number of blood pressure (BP) measurements that should be used for clinical decision making and quality reporting are uncertain. OBJECTIVE: To compare strategies for home or clinic BP measurement and their effect on clas ... Full text Open Access Link to item Cite

Survival among high-risk patients after bariatric surgery.

Journal Article JAMA · June 15, 2011 CONTEXT: Existing evidence of the survival associated with bariatric surgery is based on cohort studies of predominantly younger women with a low inherent obesity-related mortality risk. The association of survival and bariatric surgery for older men is le ... Full text Link to item Cite

Emergency department visits in Veterans Affairs medical facilities.

Journal Article Am J Manag Care · June 1, 2011 OBJECTIVE: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-andrelease ED visit in patients from Veterans Affairs Medical Centers (VAMCs). STUDY DESIGN: Retrospective cohort ... Link to item Cite

Emergency department visits in veterans affairs medical facilities

Journal Article American Journal of Managed Care · June 1, 2011 Objective: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-and-release ED visit in patients from Veterans Affairs Medical Centers (VAMCs). Study Design: Retrospective cohort ... Cite

Older Veterans Treated and Released from VAMC Emergency Departments.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2011 Link to item Cite

Health care utilization and expenditure changes associated with bariatric surgery.

Journal Article Med Care · November 2010 CONTEXT: Bariatric surgery provides significant reductions in weight and comorbidity, and has the potential to reduce health care utilization. It is unknown whether health care utilization and expenditures are reduced for veterans after bariatric surgery. ... Full text Link to item Cite

The implementation of a translational study involving a primary care based behavioral program to improve blood pressure control: The HTN-IMPROVE study protocol (01295).

Journal Article Implement Sci · July 16, 2010 BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implemen ... Full text Open Access Link to item Cite