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62. Association Between Cardiovascular Health Status and Healthcare Utilization in a Large Integrated Healthcare System

Author

Lien, Irvin C., Moffet, Howard H., Liu, Jennifer Y., Karter, Andrew J., Solomon, Matthew D., Go, Alan S., Nasir, Khurram, Sidney, Stephen, and Rana, Jamal S.

Abstract

The American Heart Association Life's Simple 7 schema can be used to categorize patients’ cardiovascular health status as poor, intermediate, or ideal on the basis of smoking, BMI, physical activity, dietary patterns, blood pressure, cholesterol, and fasting blood sugar. This study examined the association between cardiovascular health status and subsequent healthcare utilization.

Published
2024
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75. Reply

Author

Hlatky, Mark A., primary, Andersson, Charlotte, additional, Chang, Tara I., additional, Kazi, Dhruv, additional, Solomon, Matthew D., additional, and Go, Alan S., additional

Published
2014
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87. Eligibility and Potential Benefit of Transcatheter Edge-to-Edge Repair in a Contemporary Cohort with Heart Failure: Evidence from a Large Integrated Health Care Delivery System

Author

Ambrosy, Andrew P., Yang, Jingrong, Tai, Andrew S., Dimbil, Sadia J., Garcia, Elisha A., Sung, Sue Hee, Bhatt, Ankeet S., Solomon, Matthew D., Ku, Ivy A., Mishell, Jacob M., McNulty, Edward J., Zaroff, Jonathan G., Rassi, Andrew N., Kong, Jeremy, and Go, Alan S.

Abstract

The eligibility and potential benefit of transcatheter edge-to-edge repair (TEER) in addition to guideline-directed medical therapy to treat moderate-severe or severe secondary mitral regurgitation (MR) has not been reported in a contemporary heart failure (HF) population. In this study 50,841 adults with HF identified between 2013-2018 were screened for TEER eligibility based on the Food and Drug Administration (FDA) labeling. After applying the FDA eligibility criteria, 2,461 of these patients (4.8%) qualified for TEER (FDA+). These patients had higher natriuretic peptide levels and were more likely to have had a prior 1-year HF hospitalization. The estimated number needed to treat to prevent or postpone all-cause hospitalization was 4.4, 8.8 for HF hospitalization, and 5.3 for all-cause death at 24 months. The low prevalence of FDA eligibility for TEER treatment was primarily due to absence of moderate-severe or severe MR. Additional research is necessary to validate the scope of eligibility and comparative effectiveness of TEER.

Published
2023
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89. Dialysis Practices That Distinguish Top- Versus Bottom-Performing Facilities by Hemoglobin Outcomes

Author

Spiegel, Brennan M.R., primary, Bolus, Roger, additional, Desai, Amar A., additional, Zager, Philip, additional, Parker, Tom, additional, Moran, John, additional, Bolus, Sally, additional, Solomon, Matthew D., additional, Khawar, Osman, additional, Gitlin, Matthew, additional, Sul, Hack, additional, Talley, Jennifer, additional, and Nissenson, Allen, additional

Published
2010
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96. Abstract 12926: Using Natural Language Processing to Accurately Identify Aortic Stenosis in a Large, Integrated Healthcare Delivery System

Author

Solomon, Matthew D, Tabada, Grace, Allen, Amanda, Sung, Sue Hee, and Go, Alan S

Abstract

Introduction:Administrative claims data are often used for population management and quality reporting, but diagnosis codes for conditions such as valvular heart disease can be inaccurate and vary across health systems. Echocardiography (echo) data contain detailed clinical information but are generally unstructured and not feasible to extract manually in large scale.Methods:We developed and validated natural language processing (NLP) algorithms to identify aortic stenosis (AS) from echo reports in Kaiser Permanente Northern California (KPNC) and compared AS identification using NLP vs. administrative codes. Using NLP software (Linguamatics i2e), we initially developed algorithms to identify AS from a development set of >100 echo reports manually confirmed with AS, with iterative refinement using additional development sets (>100 echo reports each) until the NLP algorithm achieved positive and negative predictive values (PPV and NPV) of >95%. We then applied the NLP algorithm to all 2008-2018 echo reports (transthoracic, transesophageal or stress) in KPNC adults and compared results to ICD-9/10 diagnostic code-based definitions from 14 days before to 6 months after the echo date.Results:The NLP algorithm was developed and refined among >500 echo reports to achieve >95% PPV and NPV. Application of NLP to 957,505 echo reports (N=522,653 patients with mean age 63.3 years, 51% women, 8.5% black, 13.5% Asian/Pacific Islander, 12.9% Hispanic and median [interquartile range] 1 [1 to 2] echoes per person) yielded 104,090 echoes (10.9%) with AS (N=53,791 patients). Among echoes identified by NLP as positive for AS, 36,070 (34.7%) had diagnosis codes for AS between 14 days prior and 6 months after echo. Among echo?s without AS via NLP, 12,626 (1.5%) had diagnosis codes for AS between 14 days before to 6 months after the echo.Conclusions:An NLP algorithm applied to a large echo database was more accurate than using diagnosis codes for identifying AS and can facilitate more effective individual and population management than relying on administrative data alone. Future NLP development to characterize AS severity will further advance personalized and population-based care strategies for surveillance and treatment.

Published
2019
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