Doctor talking to patient and writing down notes

Sociodemographics and hypertension control among young adults

Sociodemographics and hypertension control among young adults

Young adults ages 18-39 have low hypertension control rates compared to young adults. Using electronic health record data, Dr. Heather Johnson et al. evaluated the role of sociodemographic factors in hypertension control among young adults with primary care access and incident hypertension. They found that young men had a 39% lower rate of hypertension control compared to young women, and that people for whom English was not their primary language and unmarried people also had lower control rates.

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Nurse checking senior woman's blood pressure

Frequency and predictors of communication about high blood pressure in RA visits

Frequency and predictors of communication about high blood pressure in RA visits

Patients with rheumatoid arthritis (RA) have a heightened risk of cardiovascular disease. Dr. Christie Bartels et al. conducted a retrospective cohort study to determine whether having high blood pressure increased the likelihood of communication about blood pressure in rheumatology visits. The investigators identified patients in the electronic health record who had both RA and uncontrolled hypertension and who received both primary and rheumatology care, and then trained abstractors reviewed the RA visit notes to determine whether blood pressure communication occurred. They found that only 22% of RA clinic visits contained documented communication about blood pressure, and that patients with stage II elevation of blood pressure were not singificantly more likely to have documented communication. Action steps recommending follow-up for high blood pressure were documented in less than 10% of eligible visits. 

Press about the article was featured in Rheumatology News and Healio.

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Doctor with arms crossed and blue ribbon on medical coat

Primary care colorectal cancer screening correlates with breast cancer screening

Primary care colorectal cancer screening correlates with breast cancer screening

In a retrospective cohort study, Dr. Jennifer Weiss et al. examined 90 primary care providers (PCPs) and over 33,000 patients eligible for colorectal cancer (CRC) screening to determine whether PCP colorectal cancer screening practices correlate with other preventive and chronic care needs. The investigators looked at CRC screening rates in comparison to five other PCP quality metrics—breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control—and found that PCP CRC screening rates have a strong correlation with breast cancer screening rates and a weak correlation with the other metrics. These results indicate that efforts to increase PCPs' CRC screening rates could be bundled with breast cancer screening improvement interventions to increase their impact.

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Blood pressure cuff and pills

Hypertension control after an initial cardiac event among Medicare patients with diabetes

Hypertension control after an initial cardiac event among Medicare patients with diabetes

In this study co-authored by Drs. Heather Johnson and Maureen Smith, investigators used EHR and Chronic Conditions Warehouse Medicare data to determine rates & predictors of achieving hypertension control among patients with diabetes and hypertension after they were discharged from the hospital for an initial cardiac event. They found that Medicare patients with diabetes were more likely to achieve hypertension control when prescribed beta-blockers at discharge, or if they had a history of more specialty visits., and adults who were 80 years or older were more likely to achieve control with diuretics.

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File folder marked "Claims" in front of computer keyboard

Can claims data algorithms identify the physician of record?

Can claims data algorithms identify the physician of record?

Eva DuGoff and co-authors investigated the agreement of primary care providers (PCPs) identified by claims algorithms and in EHR data. This study looked at Medicare fee-for-service beneficiaries with diabetes age 65+ and found agreement was higher for algorithms based on primary care visits. The algorithms perform less well among vulnerable populations and those experiencing fragmented care.

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Diabetes monitoring tools

Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions

Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions

Dr. Elizabeth Magnan et al. looked at combinations of chronic conditions among patients with diabetes to examine their relationships with diabetes quality metrics. They analyzed 12 conditions concordant with diabetes care to define classes based on co-occurrence: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. Patients had distinct quality metric achievement by condition class, and patients in less sever chronic condition classes were less likely to achieve diabetes metrics.

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Risk gauge

Risk prediction for heterogeneous populations with application to hospital admission prediction

Risk prediction for heterogeneous populations with application to hospital admission prediction

There is an increasing need to model risk for large hospital and health care systems that provide services to diverse and complex patients. In this paper co-authored by Drs. Menggang Yu and Maureen Smith, the investigators imposed structural constraints on the importance of variables in predicting outomes such as hospital admission, and demonstrated that their method performs well upon application in hospital admission prediction and validation for the Medicare population of a large helath care provider.

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CT Scan

Insurance Coverage for CT Colonography Screening: Impact on Overall Colorectal Cancer Screening Rates.

Insurance Coverage for CT Colonography Screening: Impact on Overall Colorectal Cancer Screening Rates.

Dr. Maureen Smith et al. compared colorectal cancer (CRC) screening rates for patients with and without insurance coverage for CT colonography. Using longitudinal electronic health record data, the investigators found that among patients who became due for CRC screening, there was a 48% greater likelihood of them getting screened by any method if they had insurance coverage for CT colonography when compared to those who did not have insurance coverage.

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Ultrasound machine

Utilization of preoperative endoscopic ultrasound for pancreatic adenocarcinoma

Utilization of preoperative endoscopic ultrasound for pancreatic adenocarcinoma

In this study, Dr. Ryan Schmocker et al. examined patterns of preoperative endoscopic ultrasound (EUS) for pancreatic adenocarcinoma and the impact on downstream treatment. The investigators used the SEER-Medicare database to conduct the study and found the factors most associated with receipt of EUS were: earlier year of diagnosis, SEER area, and an NCI or academic hospital. EUS was associated with a longer time to surgery and higher number of staging tests.

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technician talking to patient before scan

PCP adoption of CT colonography for colorectal cancer screening

PCP adoption of CT colonography for colorectal cancer screening

In a recent study by Dr. Jennifer Weiss et al. to examine factors influencing primary care provider adoption of CT colonography (CTC) for colorectal cancer screening, the authors linked survey responses with electronic health record data and found that substantial variation in the use of CTC for screening existed among primary care providers and clinics.

Primary care providers were more likely to recommend CTC for screening if they specialized in Internal Medicine, perceived that it was effective in reducing mortality from colorectal cancer, or thought that CTC had a higher number of perceived advantages.

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