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  1. Article ; Online: Questioning a Sensible Result.

    Normand, Sharon-Lise T

    NEJM evidence

    2024  Volume 3, Issue 3, Page(s) EVIDe2300324

    Abstract: Contemporary data collection strategies, storage capabilities, and modern statistical methodology have made retrospective analyses of observational databases commonplace. Such databases afford opportunities to learn about the effectiveness and risks of ... ...

    Abstract Contemporary data collection strategies, storage capabilities, and modern statistical methodology have made retrospective analyses of observational databases commonplace. Such databases afford opportunities to learn about the effectiveness and risks of interventions or health behaviors that generally cannot be randomized. In this issue of
    MeSH term(s) Female ; Humans ; Male ; Data Collection ; Databases, Factual ; Health Behavior ; Learning ; Retrospective Studies ; Observational Studies as Topic
    Language English
    Publishing date 2024-02-27
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ISSN 2766-5526
    ISSN (online) 2766-5526
    DOI 10.1056/EVIDe2300324
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Predicting Risk or Adjusting for Risk?

    Normand, Sharon-Lise T

    Circulation. Cardiovascular quality and outcomes

    2022  Volume 15, Issue 8, Page(s) e009082

    MeSH term(s) Acute Kidney Injury ; Benchmarking ; Humans
    Language English
    Publishing date 2022-08-12
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.122.009082
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    Zs.A 6744: Show issues Location:
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  3. Article ; Online: The RECOVERY Platform.

    Normand, Sharon-Lise T

    The New England journal of medicine

    2020  Volume 384, Issue 8, Page(s) 757–758

    MeSH term(s) COVID-19/drug therapy ; Dexamethasone ; Humans ; SARS-CoV-2
    Chemical Substances Dexamethasone (7S5I7G3JQL)
    Keywords covid19
    Language English
    Publishing date 2020-07-21
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMe2025674
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  4. Article ; Online: Correction to: Healthcare Access for a Diverse Population with Schizophrenia Following the Onset of the COVID‑19 Pandemic.

    Horvitz-Lennon, Marcela / Leckman-Westin, Emily / Finnerty, Molly / Jeong, Junghye / Tsuei, Jeannette / Zelevinsky, Katya / Chen, Qingxian / T Normand, Sharon-Lise

    Community mental health journal

    2024  Volume 60, Issue 1, Page(s) 81

    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 215855-3
    ISSN 1573-2789 ; 0010-3853
    ISSN (online) 1573-2789
    ISSN 0010-3853
    DOI 10.1007/s10597-023-01150-w
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    Zs.B 557: Show issues Location:
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  6. Article ; Online: Classification Algorithm to Distinguish Between Type 1 and Type 2 Myocardial Infarction in Administrative Claims Data.

    Wasfy, Jason H / Price, Mary / Normand, Sharon-Lise T / Januzzi, James L / McCarthy, Cian P / Hsu, John

    Circulation. Cardiovascular quality and outcomes

    2024  Volume 17, Issue 2, Page(s) e009986

    Abstract: Background: Type 2 myocardial infarction (T2MI) and type 1 myocardial infarction (T1MI) differ with respect to demographics, comorbidities, treatments, and clinical outcomes. Reliable quality and outcomes assessment depends on the ability to distinguish ...

    Abstract Background: Type 2 myocardial infarction (T2MI) and type 1 myocardial infarction (T1MI) differ with respect to demographics, comorbidities, treatments, and clinical outcomes. Reliable quality and outcomes assessment depends on the ability to distinguish between T1MI and T2MI in administrative claims data. As such, we aimed to develop a classification algorithm to distinguish between T1MI and T2MI that could be applied to claims data.
    Methods: Using data for beneficiaries in a Medicare accountable care organization contract in a large health care system in New England, we examined the distribution of MI diagnosis codes between 2018 to 2021 and the patterns of care and coding for beneficiaries with a hospital discharge diagnosis
    Results: After application of inclusion and exclusion criteria, 7759 hospitalizations for myocardial infarction remained (46.5% T1MI and 53.5% T2MI; mean age, 79±10.3 years; 47% female). In the classification algorithm, female gender (odds ratio, 1.26 [95% CI, 1.11-1.44]), Black race relative to White race (odds ratio, 2.48 [95% CI, 1.76-3.48]), and diagnoses of COVID-19 (odds ratio, 1.74 [95% CI, 1.11-2.71]) or hypertensive emergency (odds ratio, 1.46 [95% CI, 1.00-2.14]) were associated with higher odds of the hospitalization being for T2MI versus T1MI. When applied to the testing sample, the C-statistic of the full model was 0.83. Comparison of classified T2MI and observed T2MI suggest the possibility of substantial misclassification both before and after the T2MI code.
    Conclusions: A simple classification algorithm appears to be able to differentiate between hospitalizations for T1MI and T2MI before and after the T2MI code was introduced. This could facilitate more accurate longitudinal assessments of acute myocardial infarction quality and outcomes.
    MeSH term(s) Aged ; Humans ; Female ; United States/epidemiology ; Aged, 80 and over ; Male ; Medicare ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Myocardial Infarction/therapy ; Comorbidity ; Algorithms ; New England
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.123.009986
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  7. Article ; Online: Trends in Use of Telemedicine for Stimulant Initiation Among Children and Adults.

    Huskamp, Haiden A / Uscher-Pines, Lori / Raja, Pushpa / Normand, Sharon-Lise T / Mehrotra, Ateev / Busch, Alisa B

    Psychiatric services (Washington, D.C.)

    2024  , Page(s) appips20230421

    Abstract: Objective: The authors sought to examine trends in stimulant initiation and follow-up care for attention-deficit hyperactivity disorder (ADHD) via telemedicine.: Methods: This retrospective longitudinal study used national, deidentified commercial ... ...

    Abstract Objective: The authors sought to examine trends in stimulant initiation and follow-up care for attention-deficit hyperactivity disorder (ADHD) via telemedicine.
    Methods: This retrospective longitudinal study used national, deidentified commercial health insurance outpatient claims among children (ages 2-17 years; N=535,629) and adults (ages 18-64 years; N=2,116,160) from January 2019 through April 2022. Regression analyses were used to examine risk for stimulant initiation, whether initiation occurred via telemedicine or in-person care, and receipt of a follow-up visit.
    Results: The mean monthly adjusted number of stimulant initiations per 100,000 enrollees was similar for children before and during the COVID-19 pandemic (prepandemic, 57 initiations; during pandemic, 56 initiations) but increased for adults (prepandemic, 27 initiations; during pandemic, 33 initiations). Initiations via telemedicine peaked at 53%-57% in April 2020 and dropped to about 14% among children and 28% among adults in April 2022. Telemedicine initiations were significantly more common among psychiatrists than among other prescribers (OR=3.70, 95% CI=3.38-4.06 [children]; OR=3.02, 95% CI=2.87-3.17 [adults]) and less common for rural residents (OR=0.57, 95% CI=0.40-0.82 [children]; OR=0.75, 95% CI=0.61-0.92 [adults]). Follow-up care was significantly more common among individuals whose care was initiated via telemedicine than among those receiving in-person care (OR=1.09, 95% CI=1.00-1.19 [children]; OR=1.61, 95% CI=1.53-1.69 [adults]).
    Conclusions: Many stimulant treatments were initiated via telemedicine. Proposed rules to prohibit controlled substance prescribing without an in-person evaluation would require significant changes in current practice, potentially limiting access to stimulant medications for ADHD.
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1220173-x
    ISSN 1557-9700 ; 1075-2730
    ISSN (online) 1557-9700
    ISSN 1075-2730
    DOI 10.1176/appi.ps.20230421
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  8. Article: Assessing Geographical Variations in Hospital Processes of Care Using Multilevel Item Response Models.

    He, Yulei / Wolf, Robert E / Normand, Sharon-Lise T

    Health services & outcomes research methodology

    2020  Volume 10, Issue 3-4, Page(s) 111–133

    Abstract: With health care reform passing in the United States, much effort is directed toward developing and disseminating comparative information on standardized processes of care for health care providers. We propose the use of Bayesian multilevel item response ...

    Abstract With health care reform passing in the United States, much effort is directed toward developing and disseminating comparative information on standardized processes of care for health care providers. We propose the use of Bayesian multilevel item response theory models to estimate hospital quality from multiple process measures and to assess geographical variation in hospital quality. Our approach fully incorporates the nesting structure of measures, patients, hospitals, and various levels of geographical units to provide a summary of hospital quality. A national dataset of patients treated for a heart attack, heart failure, or pneumonia illustrates our methods. We find considerable geographical differences in hospital quality for these conditions with variations across census regions and states accounting for slightly more than 10% of the total variation. Some states performed well for all three conditions (e.g., the respective posterior probabilities of having better than the national average performance was close to 1 in Iowa, New Jersey, South Dakota, and Wisconsin). In contrast, quality of other states varied across conditions (e.g., the corresponding posterior probability was close to 1 in Massachusetts for heart attack and heart failure quality, but less than 0.5 for pneumonia care). Our framework provides a comprehensive approach to assessment of hospital performance at both regional and national levels, and might be informative for policy development.
    Language English
    Publishing date 2020-09-17
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1454630-9
    ISSN 1387-3741
    ISSN 1387-3741
    DOI 10.1007/s10742-010-0065-z
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    Zs.A 6488: Show issues Location:
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  9. Article ; Online: All-Cause Mortality and Progression to End-Stage Kidney Disease Following Percutaneous Revascularization or Surgical Coronary Revascularization in Patients with CKD.

    Charytan, David M / Zelevinsky, Katya / Wolf, Robert / Normand, Sharon-Lise T

    Kidney international reports

    2021  Volume 6, Issue 6, Page(s) 1580–1591

    Abstract: Introduction: Relative impacts of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) on mortality and end-stage kidney disease (ESKD) in chronic kidney disease (CKD) are uncertain.: Methods: Data from Massachusetts ... ...

    Abstract Introduction: Relative impacts of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) on mortality and end-stage kidney disease (ESKD) in chronic kidney disease (CKD) are uncertain.
    Methods: Data from Massachusetts residents with CKD undergoing CABG or PCI from 2003 to 2012 were linked to the United States Renal Data System. Associations with death, ESKD, and combined death and ESKD were analyzed in propensity score-matched multivariable survival models.
    Results: We identified 6805 CABG and 17,494 PCI patients. Among 3775 matched-pairs, multi-vessel disease was present in 97%, and stage 4 CKD was present in 11.9% of CABG and 12.2% of PCI patients. One-year mortality (CABG 7.7%, PCI 11.0%) was more frequent than ESKD (CABG 1.4%, PCI 1.7%). Overall survival was improved and ESKD risk decreased with CABG compared to PCI, but effects differed in the presence of left main disease and prior myocardial infarction (MI). Survival was worse following PCI than following CABG among patients with left main disease and without MI (hazard ratio = 3.7, 95% confidence interval = 1.3-10.5). ESKD risk was higher with PCI for individuals with left main disease and prior infarction (hazard ratio = 8.1, 95% confidence interval = 1.7-39.2).
    Conclusion: Risks following CABG and PCI were modified by left main disease and prior MI. In individuals with CKD, survival was greater after CABG than after PCI in patients with left main disease but without MI, whereas ESKD risk was lower with CABG in those with left main and MI. Absolute risks of ESKD were markedly lower than for mortality, suggesting prioritizing mortality over ESKD in clinical decision making.
    Language English
    Publishing date 2021-03-25
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2021.03.882
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  10. Article ; Online: Healthcare Access for a Diverse Population with Schizophrenia Following the Onset of the COVID-19 Pandemic.

    Horvitz-Lennon, Marcela / Leckman-Westin, Emily / Finnerty, Molly / Jeong, Junghye / Tsuei, Jeannette / Zelevinsky, Katya / Chen, Qingxian / Normand, Sharon-Lise T

    Community mental health journal

    2023  Volume 60, Issue 1, Page(s) 72–80

    Abstract: COVID-19 has had a disproportionate impact on the most disadvantaged members of society, including minorities and those with disabling chronic illnesses such as schizophrenia. We examined the pandemic's impacts among New York State's Medicaid ... ...

    Abstract COVID-19 has had a disproportionate impact on the most disadvantaged members of society, including minorities and those with disabling chronic illnesses such as schizophrenia. We examined the pandemic's impacts among New York State's Medicaid beneficiaries with schizophrenia in the immediate post-pandemic surge period, with a focus on equity of access to critical healthcare. We compared changes in utilization of key behavioral health outpatient services and inpatient services for life-threatening conditions between the pre-pandemic and surge periods for White and non-White beneficiaries. We found racial and ethnic differences across all outcomes, with most differences stable over time. The exception was pneumonia admissions-while no differences existed in the pre-pandemic period, Black and Latinx beneficiaries were less likely than Whites to be hospitalized in the surge period despite minorities' heavier COVID-19 disease burden. The emergence of racial and ethnic differences in access to scarce life-preserving healthcare may hold lessons for future crises.
    MeSH term(s) United States/epidemiology ; Humans ; Ethnicity ; Pandemics ; Schizophrenia/epidemiology ; Schizophrenia/therapy ; COVID-19/epidemiology ; Healthcare Disparities ; Health Services Accessibility
    Language English
    Publishing date 2023-05-18
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 215855-3
    ISSN 1573-2789 ; 0010-3853
    ISSN (online) 1573-2789
    ISSN 0010-3853
    DOI 10.1007/s10597-023-01105-1
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