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- Blood Thinners (1)
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- Obesity: Weight Management (1)
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- Patient Self-Management (1)
- Practice Patterns (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedFuery MA, Kadhim B, Samsky MD
Electronic health record embedded strategies for improving care of patients with heart failure.
This article reviews recent findings from randomized clinical trials examining the impact of electronic health record (HER) alerts (called nudges) on quality of care for heart failure patients. These clinical trials demonstrated that some EHR alerts can improve care for heart failure patients. The trials described utilized default options, involved clinicians in the alert design process, provided actionable recommendations, and aimed to minimize disruptions to typical workflow.
AHRQ-funded; HS027626.
Citation: Fuery MA, Kadhim B, Samsky MD .
Electronic health record embedded strategies for improving care of patients with heart failure.
Curr Heart Fail Rep 2023 Aug; 20(4):280-86. doi: 10.1007/s11897-023-00614-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions
Kimchi A, Aronow HU, Ni YM
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
The purpose of this study was to explore how comorbidity burden modulates the effectiveness of Noninvasive telemonitoring and nurse telephone coaching (NTM-NTC) and identify patients with HF who may benefit from postdischarge NTM-NTC based on their burden of comorbidity. METHODS AND RESULTS: In the Better Effectiveness After Transition - Heart Failure trial, patients hospitalized for acute decompensated HF were randomized to postdischarge NTM-NTC or usual care. In this secondary analysis of 1313 patients with complete data, comorbidity burden was assessed by scoring complication and coexisting diagnoses from index admissions. Clinical outcomes included 30-day and 180-day readmissions, mortality, days alive, and combined days alive and out of the hospital. Patients had a mean of 5.7 comorbidities and were stratified into low (0-2), moderate (3-8), and high comorbidity (≥9) subgroups. Increased comorbidity burden was associated with worse outcomes. NTM-NTC was not associated with readmission rates in any comorbidity subgroup. Among high comorbidity patients, NTM-NTC was associated with significantly lower mortality at 30 days (hazard ratio 0.25, 95% confidence interval 0.07-0.90) and 180 days (hazard ratio 0.51, 95% confidence interval 0.27-0.98), as well as more days alive (160.1 vs 140.3, P = .029) and days alive out of the hospital (152.0 vs 133.2, P = .044) compared with usual care. CONCLUSIONS: Postdischarge NTM-NTC improved survival among patients with HF with a high comorbidity burden. Comorbidity burden may be useful for identifying patients likely to benefit from this management strategy.
AHRQ-funded; HS019311.
Citation: Kimchi A, Aronow HU, Ni YM .
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
J Card Fail 2023 May; 29(5):774-83. doi: 10.1016/j.cardfail.2022.11.012..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Hospital Discharge
Ofoma UR, Drewry AM, Maddox TM
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
This study compared survival rates for inpatients who suffered in-hospital cardiac arrest (IHCA) who had access to Telemedicine Critical Care (TCC) during nights and weekends (off-hours) compared to those who did not. The authors identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. The majority (60.6%) of IHCAs occurred in an ICU, and 32.2% participants suffered IHCA at hospitals with TCC. No difference was found in acute resuscitation survival rates or survival to discharge rates for either IHCA between TCC and non-TCC hospitals. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival or survival to discharge.
AHRQ-funded; HS019455.
Citation: Ofoma UR, Drewry AM, Maddox TM .
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
Resuscitation 2022 Aug;177:7-15. doi: 10.1016/j.resuscitation.2022.06.008..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Outcomes, Critical Care, Intensive Care Unit (ICU)
Gallo T, Heise CW, Woosley RL
Clinician responses to a clinical decision support advisory for high risk of Torsades de pointes.
The purpose of this study was to assess provider actions taken in response to a Clinical decision support (CDS) advisory for Torsade de pointes (TdP) that uses a modified Tisdale QT risk score and presents single click management options. The researchers implemented an inpatient TdP risk advisory across a large, 30 hospital health care system. The CDS advisory was programmed to appear when prescribers attempted to order medications with a known risk of TdP in a patient. The CDS advisory displayed patient-specific information and offered related management options including canceling the requested medication and ordering relevant protocols. The study found that 7794 TdP risk advisories were issued during an 8-month period. The most frequent advisory trigger was antibiotics (33.1%.) The most frequent action taken as a result of the advisory was ordering an ECG (20.3%). Incoming medication orders were canceled in 10.2% of the advisories. The researchers concluded that a single-click, modified Tisdale QT risk score-based CDS resulted in a high action/response rate.
AHRQ-funded; HS026662.
Citation: Gallo T, Heise CW, Woosley RL .
Clinician responses to a clinical decision support advisory for high risk of Torsades de pointes.
J Am Heart Assoc 2022 Jun 7;11(11):e024338. doi: 10.1161/jaha.122.024338..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions
Wells R, Dionne-Odom JN, Azuero A
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
The objective of this study was to examine the "dose" effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks. The investigators concluded that higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF.
AHRQ-funded; HS013852.
Citation: Wells R, Dionne-Odom JN, Azuero A .
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
J Pain Symptom Manage 2021 Sep;62(3):471-81. doi: 10.1016/j.jpainsymman.2021.01.136..
Keywords: Palliative Care, Heart Disease and Health, Cardiovascular Conditions, Quality of Life, Telehealth, Health Information Technology (HIT)
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Shah NR, Eisman AS, Winchester DE
E-consult protocoling to improve the quality of cardiac stress tests.
Rarely appropriate cardiac stress tests remain prevalent in the range of 10% to 20% and unnecessarily prolong wait times. To address this ongoing problem, the investigators designed the EPIQ-Stress workflow, which included a structured electronic consult (“econsult”) with all outpatient stress test orders. In this study, the investigators assessed whether EPIQ-Stress implementation was associated with a reduction in rarely appropriate testing and in order-to-report wait times.
AHRQ-funded; HS022998.
Citation: Shah NR, Eisman AS, Winchester DE .
E-consult protocoling to improve the quality of cardiac stress tests.
JACC Cardiovasc Imaging 2021 Feb;14(2):512-14. doi: 10.1016/j.jcmg.2020.08.009..
Keywords: Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Bobo WV, Ryu E, Petterson TM
Bi-directional association between depression and HF: an electronic health records-based cohort study.
This study examined whether heart failure (HF) patients were more likely to be diagnosed with depression, or patients with depression were more likely to be diagnosed with HF. This retrospective cohort study utilized electronic health records (EHRs) from a large healthcare system in 2006 for adults who received primary care services. The EHR identified 10,649 people with depression, and 5,911 people with HF between 2006 to 2018. In the depression cohort there were 2,024 newly diagnosed occurrences of HF, and 944 occurrences of newly diagnosed depression in the HF cohort over 4-6 years of follow-up. There was a significantly higher risk of developing HF in the depression cohort than vice versa.
AHRQ-funded; HS023077.
Citation: Bobo WV, Ryu E, Petterson TM .
Bi-directional association between depression and HF: an electronic health records-based cohort study.
J Comorb 2020 Jan-Dec;10:2235042x20984059. doi: 10.1177/2235042x20984059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Miller AC, Ward MM, Ullrich F
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
The objective of this study was to evaluate the impact of telemedicine on the timeliness of emergency acute myocardial infarction (AMI) care for patients presenting to rural emergency departments (EDs) with chest pain. Findings showed that, in telemedicine networks, telemedicine consultation during the ED visit was associated with improved timeliness of electrocardiogram evaluation and increased use of fibrinolytic reperfusion therapy for rural AMI patients.
AHRQ-funded; HS025753.
Citation: Miller AC, Ward MM, Ullrich F .
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
Telemed J E Health 2020 Dec;26(12):1440-48. doi: 10.1089/tmj.2019.0273..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, Rural Health, Heart Disease and Health, Cardiovascular Conditions
Byrd TF, Ahmad FS, Liebovitz DM
Defragmenting heart failure care: medical records integration.
This article discusses the need to improve interoperability of software systems so that so that providers and patients can access clinical information needed to help coordinate care of heart failure patients. New data standards currently being proposed in legislation would make it possible to guide clinical decision-making.
AHRQ-funded; HS026385.
Citation: Byrd TF, Ahmad FS, Liebovitz DM .
Defragmenting heart failure care: medical records integration.
Heart Fail Clin 2020 Oct;16(4):467-77. doi: 10.1016/j.hfc.2020.06.007..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Data
Shah RU, Mutharasan RK, Ahmad FS
Development of a portable tool to identify patients with atrial fibrillation using clinical notes from the electronic medical record.
The electronic medical record contains a wealth of information buried in free text. In this study, the investigators created a natural language processing algorithm to identify patients with atrial fibrillation (AF) using text alone. The authors concluded that this approach allowed better use of the clinical narrative and created an opportunity for precise, high-throughput cohort identification.
AHRQ-funded; HS026385.
Citation: Shah RU, Mutharasan RK, Ahmad FS .
Development of a portable tool to identify patients with atrial fibrillation using clinical notes from the electronic medical record.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006516. doi: 10.1161/circoutcomes.120.006516..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality
Cornet VP, Toscos T, Bolchini D
Untold stories in user-centered design of mobile health: practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure.
This study’s goal was to characterize the practical challenges encountered and propose strategies when implementing user-centered design (UCD) for mHealth. Challenges identified included the timing of stakeholder involvement, overcoming designers' assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, this article provided practical recommendations to UCD researchers and practitioners.
AHRQ-funded; HS025232.
Citation: Cornet VP, Toscos T, Bolchini D .
Untold stories in user-centered design of mobile health: practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure.
JMIR Mhealth Uhealth 2020 Jul 21;8(7):e17703. doi: 10.2196/17703..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT)
Haynes SC, Tancredi DJ, Tong K
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
This study examined if heart failure patients who had lower adherence to weight telemonitoring had higher hospitalization and death rates. This study was a post hoc secondary analysis of the Better Effectiveness After Transition-Heart Failure randomized clinical trial which included patients from 6 academic medical centers in California. Criteria for eligibility was if they were hospitalized for decompensated heart failure. Exclusion criteria included if they were discharged to a skilled nursing facility, were expected to improve because of a medical procedure, or did not have the cognitive or physical ability to participate. The trial compared a telemonitoring intervention with usual care for patients with heart failure after hospital discharge from October 12, 2011 to September 30, 2013. The cohort of 538 eligible participants had a mean age of 70.9, was 53.8% male and 50.7% white. Adherence got better from week to week, and they found that every increase in adherence by 1 day was associated with a 19% decrease in the rate of death the following week and an 11% decrease in the rate of hospitalization. However, weight adherence is unlikely to be a result of the telemonitoring intervention.
AHRQ-funded; HS019311.
Citation: Haynes SC, Tancredi DJ, Tong K .
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2020 Jul;3(7):e2010174. doi: 10.1001/jamanetworkopen.2020.10174..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Obesity: Weight Management, Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization
Angraal S, Mortazavi BJ, Gupta A
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
This study developed models to predict the risk of death and hospitalization in patients with heart failure (HF) with preserved ejection fraction (HFpEF). Data was used from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) clinical trial. Five methods: logistic regression with a forward selection of variables; logistic regression with a lasso regularization for variable selection; random forest (RF); gradient descent boosting; and support vector machine, were used to train models for assessing risks of mortality and HF hospitalization through 3 years of follow-up and were validated using 5-fold cross-validation. RF was found to be the best performing model for predicting mortality and HF hospitalization. Blood urea nitrogen levels, body mass index, and Kansas City Cardiomyopathy Questionnaire (KCCQ) subscale scores were strongly associated with mortality, while hemoglobin level, blood urea nitrogen, time since previous HF hospitalization, and KCCQ scores were the most significant predictors of HF hospitalization.
AHRQ-funded; HS023000.
Citation: Angraal S, Mortazavi BJ, Gupta A .
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
JACC Heart Fail 2020 Jan;8(1):12-21. doi: 10.1016/j.jchf.2019.06.013..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Mortality, Hospitalization, Risk, Health Status, Health Information Technology (HIT)
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Shared Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Knierim KE, Hall TL, Dickinson LM
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
The objective of this study was to determine how quickly primary care practices can report electronic clinical quality measures (eCQMs) and to identify the practice characteristics associated with faster reporting. Examining the EvidenceNOW Southwest initiative, the researchers’ results showed that the time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Additional support for practices to succeed in new programs that require eCQM reporting was recommended.
AHRQ-funded; HS023904.
Citation: Knierim KE, Hall TL, Dickinson LM .
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
JAMA Netw Open 2019 Aug 2;2(8):e198569. doi: 10.1001/jamanetworkopen.2019.8569..
Keywords: Primary Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT)
Baik D, Reading M, Jia H
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
This cross-sectional study was conducted at an urban academic medical center to measure health status and symptom burdens of heart failure patients using a mHealth application called mi.Symptoms. Patients were diverse, with a mean age of 58.7, and were 37% women, 36% Black, and 36% Hispanic/Latino. Almost half were classified as New York Heart Association class III, and 44% reported not having enough income to make ends meet. Health status was measured with the Kansas City cardiomyopathy questionnaire clinical summary score. Predictors of better health status included higher physical function and ability to participate in social functions and activities. Predictors of poorer health status was New York Heart Association class IV status and dyspnea.
AHRQ-funded; HS021816.
Citation: Baik D, Reading M, Jia H .
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
Eur J Cardiovasc Nurs 2019 Apr;18(4):325-31. doi: 10.1177/1474515119825704..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Health Status, Telehealth, Health Information Technology (HIT)
Cykert S, DeWalt DA, Weiner BJ
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
Investigators estimated cholesterol scores for patients between the ages of 40 and 79 in large practice electronic health networks who did not have that in their electronic health record (EHR). This data was used to calculate 10-year Assessment of Cardiovascular Disease Risk (ASCVD) risk scores for patients in 219 practices. They estimated the scores using both “good value’ estimation methodology and formal imputation. The “good value” estimation methodology resulted in less patients with risk scores than imputation but it had higher specificity and a lower false positive rate.
AHRQ-funded; HS023912.
Citation: Cykert S, DeWalt DA, Weiner BJ .
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
J Am Med Inform Assoc 2019 Feb;26(2):155-58. doi: 10.1093/jamia/ocy151..
Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Heart Disease and Health, Evidence-Based Practice, Health Information Technology (HIT), Patient-Centered Outcomes Research, Quality Improvement
Dowding DW, Russell D, Onorato N
Technology solutions to support care continuity in home care: a focus group study.
The purpose of this study was to explore perceptions among home care clinicians of the barriers they face and the information they need to improve care continuity for patients with heart failure. The study highlighted areas of improvement for health information technology solutions that could support care delivery for patients with heart failure in a home care setting.
AHRQ-funded; HS023855.
Citation: Dowding DW, Russell D, Onorato N .
Technology solutions to support care continuity in home care: a focus group study.
J Healthc Qual 2018 Jul/Aug;40(4):236-46. doi: 10.1097/jhq.0000000000000104..
Keywords: Healthcare Delivery, Health Information Technology (HIT), Heart Disease and Health, Home Healthcare, Quality Improvement
Blecker S, Sontag D, Horwitz LI
Early identification of patients with acute decompensated heart failure.
The purpose of this study was to develop and test accuracies of various approaches to identify patients with acute decompensated heart failure (ADHF) with the use of data derived from the electronic health record. The authors concluded that machine learning algorithms with unstructured notes had the best performance for identification of ADHF and can improve provider efficiency for delivery of quality improvement interventions.
AHRQ-funded; HS023683.
Citation: Blecker S, Sontag D, Horwitz LI .
Early identification of patients with acute decompensated heart failure.
J Card Fail 2018 Jun;24(6):357-62. doi: 10.1016/j.cardfail.2017.08.458..
Keywords: Cardiovascular Conditions, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health
Wang SV, Rogers JR, Jin Y
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
The researchers tested algorithms for identifying atrial fibrillation (AF) patients who also have known risk factors for stroke and major bleeding using electronic healthcare records (EHRs) data. The performance of candidate algorithms in 1000 bootstrap resamples was compared to a gold standard of manual chart review by experienced resident physicians of 480 patient charts. For 11 conditions, the median positive predictive value of the EHR-derived algorithms was greater than 0.90.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
J Am Med Inform Assoc 2017 Mar 1;24(2):339-44. doi: 10.1093/jamia/ocw082.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk
Masterson Creber RM, Hickey KT, Maurer MS
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
The authors discussed the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Hickey KT, Maurer MS .
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
Curr Cardiovasc Risk Rep 2016 Oct;10(10). doi: 10.1007/s12170-016-0511-8.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Patient Self-Management
Taslimitehrani V, Dong G, Pereira NL
Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.
The authors proposed to apply a classification algorithm, Contrast Pattern Aided Logistic Regression (CPXR(Log)) with the probabilistic loss function, to develop and validate prognostic risk models to predict 1, 2, and 5 year survival in heart failure (HF). They found that the new loss function used in the algorithm outperforms other functions used in previous studies and that HF is a highly heterogeneous disease (different subgroups of patients require different types of considerations with their diagnosis and treatment). They concluded that logistic risk models often make systematic prediction errors and that it is prudent to use subgroup based prediction models such as those given by CPXR(Log) when investigating heterogeneous diseases.
AHRQ-funded; HS023077.
Citation: Taslimitehrani V, Dong G, Pereira NL .
Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.
J Biomed Inform 2016 Apr;60:260-9. doi: 10.1016/j.jbi.2016.01.009.
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Keywords: Electronic Health Records (EHRs), Heart Disease and Health, Health Information Technology (HIT), Risk
Black JT, Romano PS, Sadeghi B
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
The objective of this randomized controlled comparative effectiveness study was to evaluate the effectiveness of a care transition intervention that included pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure.
AHRQ-funded; HS019311.
Citation: Black JT, Romano PS, Sadeghi B .
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
Trials 2014 Apr 13;15:124. doi: 10.1186/1745-6215-15-124..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Health Information Technology (HIT), Heart Disease and Health, Hospital Readmissions, Telehealth, Transitions of Care