2024
Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing
Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.Peer-Reviewed Original ResearchReduced ejection fractionEjection fractionHeart failureLeft ventricular ejection fractionVentricular ejection fractionYale-New Haven HospitalIdentification of patientsCommunity hospitalIdentification of heart failureLanguage modelNorthwestern MedicineMeasure care qualityQuality of careNew Haven HospitalDeep learning-based natural language processingHFrEFGuideline-directed careDeep learning language modelsMIMIC-IIIDetect HFrEFNatural language processingReclassification improvementHospital dischargePatientsCare quality
2023
National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020
Lu Y, Liu Y, Dhingra L, Caraballo C, Mahajan S, Massey D, Spatz E, Sharma R, Rodriguez F, Watson K, Masoudi F, Krumholz H. National Trends in Racial and Ethnic Disparities in Use of Recommended Therapies in Adults with Atherosclerotic Cardiovascular Disease, 1999-2020. JAMA Network Open 2023, 6: e2345964. PMID: 38039001, PMCID: PMC10692850, DOI: 10.1001/jamanetworkopen.2023.45964.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseHistory of ASCVDCross-sectional studyLifestyle modificationPharmacological medicationsOptimal careCurrent careUS adultsEthnic differencesWhite individualsGuideline-recommended therapiesTotal cholesterol controlNon-Hispanic white individualsNutrition Examination SurveyLatino individualsQuality of careSelf-reported raceStatin useRecommended TherapiesSecondary preventionCholesterol controlOptimal regimensSmoking cessationEligible participantsExamination Survey
2022
Clinical decision support in cardiovascular medicine
Lu Y, Melnick ER, Krumholz HM. Clinical decision support in cardiovascular medicine. The BMJ 2022, 377: e059818. PMID: 35613721, DOI: 10.1136/bmj-2020-059818.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseCardiovascular careEffectiveness of CDSRisk factor modificationClinical decision support toolQuality of careClinical decision supportClinical outcomesFactor modificationHealth information technologyClinical practicePatient careDiseaseCardiovascular medicineCDS effectivenessCareEffectiveness of deliveryMissed opportunityTreatmentFailureProper evidenceHealthcare processesMedicineEvidencePreventionSex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomen
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospital
2020
The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction
Raparelli V, Pilote L, Behlouli H, Dziura J, Bueno H, D'Onofrio G, Krumholz H, Dreyer R. The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction. European Heart Journal 2020, 41: ehaa946.3175. DOI: 10.1093/ehjci/ehaa946.3175.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careYoung adultsMyocardial infarctionHealthcare systemHigher risk factor burdenRisk factor burdenPost-discharge carePhases of careMultipayer systemImpact of sexSystem-level factorsHospital phaseAMI careCare scoresSingle-payer systemCareWomenCanadian InstituteSexAdultsMenInfarctionHospitalLinear regression modelsQuality of Care for Patients Hospitalized for Heart Failure in China
Gupta A, Yu Y, Tan Q, Liu S, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J. Quality of Care for Patients Hospitalized for Heart Failure in China. JAMA Network Open 2020, 3: e1918619. PMID: 31913489, PMCID: PMC6991250, DOI: 10.1001/jamanetworkopen.2019.18619.Peer-Reviewed Original ResearchConceptsQuality of careHospital levelHF careEligible patientsComposite performance scoreEvidence-based β-blockersAngiotensin-converting enzyme inhibitorRetrospective cross-sectional studyVentricular ejection fraction assessmentMedian rateAngiotensin receptor blockersMedian patient ageHeart failure epidemicCross-sectional studyEjection fraction assessmentMedian odds ratioPerformance scoresHF hospitalizationReceptor blockersPatient ageHeart failureHospital admissionMedical recordsOdds ratioMAIN OUTCOME
2019
Twenty-Year Trends in Outcomes for Older Adults With Acute Myocardial Infarction in the United States
Krumholz HM, Normand ST, Wang Y. Twenty-Year Trends in Outcomes for Older Adults With Acute Myocardial Infarction in the United States. JAMA Network Open 2019, 2: e191938. PMID: 30874787, PMCID: PMC6484647, DOI: 10.1001/jamanetworkopen.2019.1938.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent acute myocardial infarctionPercutaneous coronary interventionAMI dischargeCause readmissionCoronary interventionMyocardial infarctionMedicare feeCoronary artery bypass graft surgery ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryInpatient percutaneous coronary interventionRate of catheterizationBypass graft surgeryShort-term mortalityInpatient paymentsQuality of careTwenty-year trendsEvolution of outcomesHospital mortalityHospital stayInpatient outcomesCause mortalityGraft surgeryCohort studyTrends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care
Desai NR, Udell JA, Wang Y, Spatz ES, Dharmarajan K, Ahmad T, Julien HM, Annapureddy A, Goyal A, de Lemos JA, Masoudi FA, Bhatt DL, Minges KE, Krumholz HM, Curtis JP. Trends in Performance and Opportunities for Improvement on a Composite Measure of Acute Myocardial Infarction Care. Circulation Cardiovascular Quality And Outcomes 2019, 12: e004983. PMID: 30871375, DOI: 10.1161/circoutcomes.118.004983.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiology Service, HospitalFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRacial GroupsRegistriesSex FactorsSocioeconomic FactorsTreatment OutcomeUnited StatesConceptsProportion of patientsAcute myocardial infarctionDefect-free careHispanic patientsAMI careOlder patientsCare measuresNational Cardiovascular Data Registry Acute Coronary TreatmentIntervention Outcomes Network RegistryAcute myocardial infarction careGuideline-recommended pharmacotherapyMedicaid insurance coverageSociodemographic groupsMyocardial infarction careSafety-net statusGreatest absolute improvementComposite measureQuality of careHospital-level performanceCessation counselingEvidence-based processReperfusion therapyCardiac rehabilitationCoronary TreatmentVentricular functionAssociation of Income Disparities with Patient-Reported Healthcare Experience
Okunrintemi V, Khera R, Spatz ES, Salami JA, Valero-Elizondo J, Warraich HJ, Virani SS, Blankstein R, Blaha MJ, Pawlik TM, Dharmarajan K, Krumholz HM, Nasir K. Association of Income Disparities with Patient-Reported Healthcare Experience. Journal Of General Internal Medicine 2019, 34: 884-892. PMID: 30783877, PMCID: PMC6544715, DOI: 10.1007/s11606-019-04848-4.Peer-Reviewed Original ResearchConceptsPatient healthcare experienceHealthcare experiencesHigher oddsMedical Expenditure Panel Survey cohortHealthcare providersRepresentative US adult populationUS adult populationTimes higher oddsQuality of careTimes greater oddsLow incomePoor healthcare experiencesRetrospective studyPatient incomePatient levelPatient reportsUS adultsProvider satisfactionGreater oddsPatientsHealth outcomesSurvey cohortAdult populationStudy participantsAspects of accessThe China Patient-centred Evaluative Assessment of Cardiac Events (PEACE) prospective heart failure study design
Huang X, Yu Y, Li X, Masoudi FA, Spertus JA, Yan X, Krumholz HM, Jiang L, Li J. The China Patient-centred Evaluative Assessment of Cardiac Events (PEACE) prospective heart failure study design. BMJ Open 2019, 9: e025144. PMID: 30782925, PMCID: PMC6377534, DOI: 10.1136/bmjopen-2018-025144.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesHeart failureChina PatientMedical historyCardiac Events Prospective Heart Failure StudyDisease-specific health statusEthics CommitteeCardiovascular risk factorsProspective cohort studyMin walk testHeart Failure StudyPatient's medical historyLocal ethics committeeQuality of careCollection of bloodHF hospitalisationHospitalisation eventsHospital outcomesCohort studyPatient demographicsTransthoracic echocardiogramWalk testHospital treatmentMedical recordsRisk factors
2018
The China Patient-centered Evaluative Assessment of Cardiac Events (China PEACE) retrospective heart failure study design
Yu Y, Zhang H, Li X, Lu Y, Masoudi FA, Krumholz HM, Li J. The China Patient-centered Evaluative Assessment of Cardiac Events (China PEACE) retrospective heart failure study design. BMJ Open 2018, 8: e020918. PMID: 29748344, PMCID: PMC5950642, DOI: 10.1136/bmjopen-2017-020918.Peer-Reviewed Original ResearchConceptsHeart failureChina PatientEthics CommitteeRetrospective cohort studyHeart Failure StudyCardiovascular disease prevalenceEthics committee approvalQuality of careHospital outcomesCohort studyPatient characteristicsLeading causeMedical recordsCardiovascular diseaseCase ascertainmentTreatment outcomesCurrent burdenCommittee approvalData abstractionDiagnostic testingPatient recordsCentral Ethics CommitteeLocal approvalPatientsStudy designTraditional Chinese Medicine for Acute Myocardial Infarction in Western Medicine Hospitals in China
Spatz ES, Wang Y, Beckman AL, Wu X, Lu Y, Du X, Li J, Xu X, Davidson PM, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Traditional Chinese Medicine for Acute Myocardial Infarction in Western Medicine Hospitals in China. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004190. PMID: 29848478, PMCID: PMC5882246, DOI: 10.1161/circoutcomes.117.004190.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionTraditional Chinese medicineTCM useWestern Medicine HospitalMyocardial infarctionHospital bleedingMedicine HospitalChinese medicineCardiovascular risk factorsHospital-level factorsHours of hospitalizationMultivariable hierarchical modelsQuality of careLack of evidenceChart reviewChina PatientRetrospective studySecondary hospitalsEarly managementRisk factorsIntravenous useCardiovascular diseasePatientsSignificant associationHospital
2017
The primary health-care system in China
Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q, Mossialos E, Xu DR, Yip W, Zhang H, Krumholz HM, Jiang L, Hu S. The primary health-care system in China. The Lancet 2017, 390: 2584-2594. PMID: 29231837, DOI: 10.1016/s0140-6736(17)33109-4.Peer-Reviewed Original ResearchConceptsPrimary health care systemHealth care systemChronic non-communicable diseasesEvidence-based performance indicatorsNon-communicable diseasesEveryday clinical practiceQuality of careHealth information technology systemsRisk factorsClinical practiceCare deliveryVillage doctorsHealth care reformInadequate educationCost savingsWorld populationPopulationPrevalenceDiseaseQuality of Care in the United States Territories, 1999–2012
Nuti SV, Wang Y, Masoudi FA, Nunez-Smith M, Normand ST, Murugiah K, Rodríguez-Vilá O, Ross JS, Krumholz HM. Quality of Care in the United States Territories, 1999–2012. Medical Care 2017, 55: 886-892. PMID: 28906314, PMCID: PMC6482857, DOI: 10.1097/mlr.0000000000000797.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureHospitalization ratesMedicare beneficiariesMortality rateService Medicare beneficiariesQuality of careRecent study periodPneumonia hospitalizationsMyocardial infarctionPatient outcomesMillions of AmericansMedicare feeHealth outcomesPneumoniaService beneficiariesHospital reimbursementUnique beneficiariesHealth equityStudy periodPatient paymentsInpatient paymentsHealth careMortalityCareProtocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey
Su M, Zhang Q, Lu J, Li X, Tian N, Wang Y, Yip W, Cheng KK, Mensah GA, Horwitz RI, Mossialos E, Krumholz HM, Jiang L. Protocol for a nationwide survey of primary health care in China: the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) MPP (Million Persons Project) Primary Health Care Survey. BMJ Open 2017, 7: e016195. PMID: 28851781, PMCID: PMC5629739, DOI: 10.1136/bmjopen-2017-016195.Peer-Reviewed Original ResearchConceptsPrimary health careMillion Persons ProjectQuality of careCardiac Events Million Persons ProjectHealth carePrimary care servicesEssential medicines programmeHealth Care SurveyChina PatientCare SurveyPatient satisfactionPHC servicesPHC workforceCardiovascular diseaseCare servicesObservational designPHC institutionsCentral Ethics CommitteeInformed consentChina National CenterEthics CommitteeCarePerson interviewsMedicine programsNationwide surveyQuality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction
Downing NS, Wang Y, Dharmarajan K, Nuti SV, Murugiah K, Du X, Zheng X, Li X, Li J, Masoudi FA, Spertus JA, Jiang L, Krumholz HM. Quality of Care in Chinese Hospitals: Processes and Outcomes After ST‐segment Elevation Myocardial Infarction. Journal Of The American Heart Association 2017, 6: e005040. PMID: 28645937, PMCID: PMC5669155, DOI: 10.1161/jaha.116.005040.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionRisk-standardized mortality ratesQuality of careGuideline-recommended careGuideline-recommended treatmentMyocardial infarctionMortality rateST-segment elevation myocardial infarctionChina PEACE-Retrospective AMI StudyComposite rateMedian risk-standardized mortality rateProportion of patientsElevation myocardial infarctionQuality improvement initiativesProportion of opportunitiesDefect-free rateHospital levelInfarctionHospitalChinese hospitalsPatientsCareAMI studyImprovement initiativesHigh rateThe State of the Science on Integrating Palliative Care in Heart Failure
Gelfman L, Bakitas M, Warner Stevenson L, Kirkpatrick J, Goldstein N, Ahluwalia S, Allen L, Allen K, Arnold B, Bakitas M, Bekelman D, Buck H, Dionne-Odom J, Dougherty C, Dunbar S, Evangelista L, Fahlberg B, Fendler T, Gelfman L, Goldstein N, Hanson L, Hauptman P, Karlekar M, Kavalieratos D, Kirkpatrick J, Kirkwood P, Kono A, Krumholz H, Kutner J, Lala A, Lindenfeld J, Mancarella G, Matlock D, Matzo M, Maurer M, Morrison S, O'Donnell A, Pamboukian S, Pinney S, Prince S, Reigel B, Ritchie C, Rogers J, Spertus J, Steinhauser K, Stevenson L, Strömberg A, Sudore R, Swetz K, Teuteberg W, Teuteberg J, Tucker R, Tulsky J, Wiegand D. The State of the Science on Integrating Palliative Care in Heart Failure. Journal Of Palliative Medicine 2017, 20: 592-603. PMID: 29493362, PMCID: PMC5455612, DOI: 10.1089/jpm.2017.0178.Peer-Reviewed Original ResearchConceptsHeart failurePalliative careUncontrolled symptomsIntegrating Palliative CarePalliative care integrationAdvanced heart failureAdvanced HF patientsChronic progressive illnessLife-prolonging therapiesCare of patientsAdvance care planningQuality of careQuality of lifeHF diseaseHF patientsHealthcare utilizationProgressive illnessHF populationHigh morbidityInterdisciplinary careInterdisciplinary working groupCare planningLife careCurrent evidenceFamily caregivers
2016
Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study
Zheng X, Curtis JP, Hu S, Wang Y, Yang Y, Masoudi FA, Spertus JA, Li X, Li J, Dharmarajan K, Downing NS, Krumholz HM, Jiang L. Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study. JAMA Internal Medicine 2016, 176: 512. PMID: 26974883, PMCID: PMC5459379, DOI: 10.1001/jamainternmed.2016.0166.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngina, UnstableCardiac CatheterizationChinaCoronary Artery DiseaseDrug-Eluting StentsFemaleHospital MortalityHospitals, UrbanHumansLength of StayMaleMedical RecordsMiddle AgedMyocardial InfarctionOdds RatioOutcome Assessment, Health CarePercutaneous Coronary InterventionPostoperative ComplicationsPostoperative HemorrhageQuality of Health CareRetrospective StudiesStentsTime-to-TreatmentConceptsPercutaneous coronary interventionDrug-eluting stentsQuality of careCoronary catheterizationCoronary interventionNonobstructive coronary artery diseasePrimary percutaneous coronary interventionFuture quality improvement initiativesEvidence-based medicationsOutcomes of patientsCoronary artery diseaseClinical observational studyUse of catheterizationQuality improvement initiativesCalendar year 2001Hospital mortalityArtery diseasePatient characteristicsStable patientsTreatment patternsMedian lengthMean agePCI proceduresMedical recordsObservational studySex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study
Du X, Spatz ES, Dreyer RP, Hu S, Wu C, Li X, Li J, Wang S, Masoudi FA, Spertus JA, Nasir K, Krumholz HM, Jiang L, Group F. Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study. Journal Of The American Heart Association 2016, 5: e002157. PMID: 26903002, PMCID: PMC4802449, DOI: 10.1161/jaha.115.002157.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careEvidence-based therapiesMyocardial infarctionClinical profileHospitalization ratesST-segment elevation myocardial infarction presentationSex differencesMyocardial infarction presentationYounger age groupsProportion of womenMyocardial infarction hospitalizationsEarly aspirinHospital deathCardiac eventsHospital admissionMedian ageSymptom onsetChina PatientRetrospective studyAdmission timeHigh riskSex disparitiesPatients