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  1. Article ; Online: Improving Outcomes after a Chronic Obstructive Pulmonary Disease Hospitalization: Lessons in Population Health from the U.S. Department of Veterans Affairs.

    Lindenauer, Peter K / Williams, Mark V

    American journal of respiratory and critical care medicine

    2022  Volume 205, Issue 11, Page(s) 1257–1258

    MeSH term(s) Hospitalization ; Hospitals ; Humans ; Patient Discharge ; Population Health ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Disease, Chronic Obstructive/therapy ; Veterans
    Language English
    Publishing date 2022-04-19
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202203-0613ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Electronic Health Record-Based Algorithms as Part of the Solution for Improving Lung Cancer Screening.

    Núñez, Eduardo R / Lindenauer, Peter K / Wiener, Renda Soylemez

    JCO clinical cancer informatics

    2023  Volume 7, Page(s) e2300222

    MeSH term(s) Humans ; Electronic Health Records ; Early Detection of Cancer ; Lung Neoplasms/diagnosis ; Algorithms
    Language English
    Publishing date 2023-12-06
    Publishing country United States
    Document type Editorial
    ISSN 2473-4276
    ISSN (online) 2473-4276
    DOI 10.1200/CCI.23.00222
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  3. Article ; Online: Web Exclusive. Annals for Hospitalists Inpatient Notes - A Critical Look at Procalcitonin Testing in Pneumonia.

    Pulia, Michael S / Lindenauer, Peter K

    Annals of internal medicine

    2021  Volume 174, Issue 6, Page(s) HO2–HO3

    Language English
    Publishing date 2021-06-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M21-1913
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  4. Article ; Online: Notice of Retraction and Replacement. Stefan et al. Association of antibiotic treatment with outcomes in patients hospitalized for an asthma exacerbation treated with systemic corticosteroids. JAMA Intern Med. 2019;179(3):333-340.

    Stefan, Mihaela S / Pekow, Penelope S / Lindenauer, Peter K

    JAMA internal medicine

    2021  Volume 181, Issue 4, Page(s) 569–570

    Language English
    Publishing date 2021-02-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2020.7599
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  5. Article ; Online: Reply to Albert: Informing Healthcare Decisions with Observational Research Assessing Causal Effects: An American Thoracic Society Statement Not Ready for Implementation.

    Gershon, Andrea S / Lindenauer, Peter K / Krishnan, Jerry A

    American journal of respiratory and critical care medicine

    2021  Volume 204, Issue 3, Page(s) 376

    MeSH term(s) Causality ; Delivery of Health Care ; Humans ; Societies ; United States
    Language English
    Publishing date 2021-06-03
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202104-0851LE
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  6. Article ; Online: Differences in Health Care Utilization for Asthma by Children with Medicaid versus Private Insurance.

    Goff, Sarah L / Shieh, Meng-Shiou / Lindenauer, Peter K / Ash, Arlene S / Krishnan, Jerry A / Geissler, Kimberley H

    Population health management

    2024  Volume 27, Issue 2, Page(s) 105–113

    Abstract: Asthma is the most common chronic disease in children, disproportionately affects families with lower incomes, and is a leading reason for acute care visits and hospitalizations. This retrospective cohort study used the Massachusetts All Payer Claims ... ...

    Abstract Asthma is the most common chronic disease in children, disproportionately affects families with lower incomes, and is a leading reason for acute care visits and hospitalizations. This retrospective cohort study used the Massachusetts All Payer Claims Database (2014-2018) to examine differences in acute care utilization and quality of care for asthma between Medicaid- and privately insured children in Massachusetts. Outcomes included acute care use (emergency department [ED] or hospitalization), ED visits with asthma, routine asthma visits, and filled prescriptions for asthma medications. Multivariable logistic regression was used to account for differences in demographics, ZIP codes, health status, and asthma severity. Overall, 10.0% of Medicaid-insured children and 5.6% of privately insured were classified as having asthma. Among 317,596 child-year observations for children with asthma, 64.4% were insured by Medicaid. Medicaid-insured children had higher rates of any acute care use (50.4% vs. 30.0%) and ED visits with an asthma diagnosis (27.2% vs. 13.3%) compared to privately insured children. Only 65.4% of Medicaid enrollees had at least one routine asthma visit compared to 74.3% of privately insured children. Most children received at least one asthma medication (88.6% Medicaid vs. 83.3% privately insured), but a higher percentage of Medicaid-insured children received at least one rescue medication (84.0% vs. 73.7%), and a lower percentage of Medicaid-insured (46.1% vs. 49.2%) received a controller medication. These results suggest that opportunities for improvement in childhood asthma persist, particularly for children insured by Medicaid.
    MeSH term(s) United States ; Humans ; Medicaid ; Retrospective Studies ; Asthma/drug therapy ; Patient Acceptance of Health Care ; Insurance ; Insurance, Health
    Language English
    Publishing date 2024-03-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2454546-6
    ISSN 1942-7905 ; 1942-7891
    ISSN (online) 1942-7905
    ISSN 1942-7891
    DOI 10.1089/pop.2023.0244
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  7. Article ; Online: Stepped care versus center-based cardiopulmonary rehabilitation for older frail adults living in rural MA: Design of a feasibility randomized controlled trial.

    Fraenkel, Liana / Pack, Quinn / Drager, Leslie / Patel, Jagruti / Pontier, Paulette / Lindenauer, Peter K

    Contemporary clinical trials communications

    2023  Volume 33, Page(s) 101147

    Abstract: Background: Cardiac and pulmonary rehabilitation programs are grossly underutilized, and participation is particularly low in rural regions.: Methods: We are conducting a 2-arm, randomized controlled feasibility trial. Eligible participants include ... ...

    Abstract Background: Cardiac and pulmonary rehabilitation programs are grossly underutilized, and participation is particularly low in rural regions.
    Methods: We are conducting a 2-arm, randomized controlled feasibility trial. Eligible participants include older frail adults with cardiac or pulmonary disease living in a predominantly rural county in western Massachusetts. Participants are randomized 1:1 to treatment as usual or stepped care. Patients randomized to treatment as usual participate in twice weekly center-based rehabilitation sessions over eight weeks and are encouraged to exercise at home in between sessions. Patients randomized to the stepped-care arm are offered/enrolled in the center-based rehabilitation program followed by possible step up to three interventions based on prespecified non-response criteria: 1) Transportation-assisted center-based rehabilitation, 2) Home-based telerehabilitation, and 3) Community health worker-supported home-based telerehabilitation. The primary feasibility outcomes are average number of eligible patients randomized per month, baseline measure completion, proportion attending at least 70% of the prescribed sessions, average number of sessions attended in the stepped-care arm, and proportion in the stepped-care arm completing patient reported outcome measures. Each of these process indicators is evaluated by preset "Stop" and "Go" thresholds.
    Conclusion: The proposed stepped-care model is an efficient, patient-centered, approach to expanding access to cardiac and pulmonary rehabilitation. Meeting the "Go" thresholds for the prespecified process indicators will justify conducting a definitive full-scale randomized controlled trial to compare the effectiveness and value (cost-effectiveness) of stepped-care versus center-based rehabilitation in older frail adults living rural counties.
    Language English
    Publishing date 2023-04-23
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2451-8654
    ISSN (online) 2451-8654
    DOI 10.1016/j.conctc.2023.101147
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  8. Article ; Online: The Impact of Principal Diagnosis on Readmission Risk among Patients Hospitalized for Community-Acquired Pneumonia.

    Ruhnke, Gregory W / Lindenauer, Peter K / Lyttle, Christopher S / Meltzer, David O

    American journal of medical quality : the official journal of the American College of Medical Quality

    2022  Volume 37, Issue 4, Page(s) 307–313

    Abstract: Coding variation distorts performance/outcome statistics not eliminated by risk adjustment. Among 1596 community-acquired pneumonia patients hospitalized from 1998 to 2012 identified using an evidence-based algorithm, the authors measured the association ...

    Abstract Coding variation distorts performance/outcome statistics not eliminated by risk adjustment. Among 1596 community-acquired pneumonia patients hospitalized from 1998 to 2012 identified using an evidence-based algorithm, the authors measured the association of principal diagnosis (PD) with 30-day readmission, stratified by Pneumonia Severity Index risk class. The 152 readmitted patients were more ill (Pneumonia Severity Index class V 38.8% versus 25.8%) and less likely to have a pneumonia PD (52.6% versus 69.9%). Among patients with PDs of pneumonia, respiratory failure, sepsis, and aspiration, mortality/readmission rates were 3.9/8.5%, 28.8/14.0%, 24.7/19.6%, and 9.0/15.0%, respectively. The nonpneumonia PDs were associated with a greater risk of adjusted 30-day readmission: respiratory failure odds ratio (OR) 1.89 (95% confidence interval [CI], 1.13-3.15), sepsis OR 2.54 (95% CI, 1.52-4.26), and possibly aspiration OR 1.73 (95% CI, 0.88-3.41). With increasing use of alternative PDs among pneumonia patients, quality reporting must account for variations in condition coding practices. Rigorous risk adjustment does not eliminate the need for accurate, consistent case definition in producing valid quality measures.
    MeSH term(s) Community-Acquired Infections/diagnosis ; Community-Acquired Infections/epidemiology ; Hospital Mortality ; Humans ; Patient Readmission ; Pneumonia/diagnosis ; Pneumonia/epidemiology ; Respiratory Insufficiency ; Sepsis/diagnosis
    Language English
    Publishing date 2022-01-11
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 1131772-3
    ISSN 1555-824X ; 1062-8606
    ISSN (online) 1555-824X
    ISSN 1062-8606
    DOI 10.1097/JMQ.0000000000000042
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  9. Article ; Online: Pneumonia Outcome Measures Modified to Address Concerns about Coding-related Biases.

    Lindenauer, Peter K / Dorsey, Karen

    Annals of the American Thoracic Society

    2018  Volume 15, Issue 9, Page(s) 1113

    MeSH term(s) Bias ; Healthcare-Associated Pneumonia ; Humans ; Outcome Assessment (Health Care) ; Pneumonia ; Pneumonia, Aspiration
    Language English
    Publishing date 2018-08-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201805-320LE
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  10. Article ; Online: A risk model to identify Legionella among patients admitted with community-acquired pneumonia: A retrospective cohort study.

    Rothberg, Michael B / Imrey, Peter B / Guo, Ning / Deshpande, Abhishek / Higgins, Thomas L / Lindenauer, Peter K

    Journal of hospital medicine

    2022  Volume 17, Issue 8, Page(s) 624–632

    Abstract: Background: Guidelines recommend testing hospitalized patients with community-acquired pneumonia (CAP) for Legionella pneumophila only if the infection is severe or risk factors are present. There are no validated models for predicting Legionella.: ... ...

    Abstract Background: Guidelines recommend testing hospitalized patients with community-acquired pneumonia (CAP) for Legionella pneumophila only if the infection is severe or risk factors are present. There are no validated models for predicting Legionella.
    Objective: To derive and externally validate a model to predict a positive Legionella test.
    Design, setting and participants: Diagnostic study of adult inpatients with pneumonia using data from 177 US hospitals in the Premier Healthcare Database (training and hold-out validation sets) and 12 Cleveland Clinic Health System (CCHS) hospitals (external validation set). We used multiple logistic regression to predict positive Legionella tests in the training set, and evaluated performance in both validation sets.
    Main outcome and measures: The outcome was a positive Legionella test. Potential predictors included demographics and co-morbidities, disease severity indicators, season, region, and presence of a local outbreak.
    Results: Of 166,689 patients hospitalized for pneumonia, 43,070 were tested for Legionella and 642 (1.5%) tested positive. The strongest predictors of a positive test were a local outbreak (odds ratio [OR], 3.4), June-October occurrence (OR, 3.4), hyponatremia (OR, 3.3), smoking (OR, 2.4), and diarrhea (OR, 2.0); prior admission within 6 months (OR, 0.27) and chronic pulmonary disease (OR, 0.49) were associated with a negative test. Model c-statistics were 0.79 in the Premier and 0.77 in the CCHS validation samples. High-risk patients were only slightly more likely to have been tested than lower-risk patients. Compared to actual practice, the model-based testing strategy detected twice as many cases.
    Conclusions: Although Legionella is an uncommon cause of pneumonia, patient characteristics can identify individuals at high risk, allowing for more efficient testing.
    MeSH term(s) Adult ; Community-Acquired Infections/diagnosis ; Community-Acquired Infections/epidemiology ; Humans ; Legionella ; Legionnaires' Disease/diagnosis ; Legionnaires' Disease/epidemiology ; Pneumonia/diagnosis ; Pneumonia/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2022-07-26
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.1002/jhm.12919
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