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51. Deployment of an Interdisciplinary Predictive Analytics Task Force to Inform Hospital Operational Decision-Making During the COVID-19 Pandemic

Author

Pollock, Benjamin D., primary, Carter, Rickey E., additional, Dowdy, Sean C., additional, Dunlay, Shannon M., additional, Habermann, Elizabeth B., additional, Kor, Daryl J., additional, Limper, Andrew H., additional, Liu, Hongfang, additional, Franco, Pablo Moreno, additional, Neville, Matthew R., additional, Noe, Katherine H., additional, Poe, John D., additional, Sampathkumar, Priya, additional, Storlie, Curtis B., additional, Ting, Henry H., additional, Shah, Nilay D., additional, Amrami, Kimberly, additional, Domnick, Robert, additional, Heinzen, Ethan, additional, Helfinstine, Karen, additional, Jayakumar, Ajay, additional, Johnson, Patrick, additional, Knepper, Camille, additional, Marcelletti, David, additional, Mickelson, Mindy, additional, Rojas, Ricardo, additional, St. George, Mark, additional, Tande, Aaron, additional, Walvatne, Kelli, additional, and Wutthisirisart, Phichet, additional

Published
2021
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52. Outcomes of COVID-19 With the Mayo Clinic Model of Care and Research

Author

O’Horo, John Charles, primary, Cerhan, James R., additional, Cahn, Elliot J., additional, Bauer, Philippe R., additional, Temesgen, Zelalem, additional, Ebbert, Jon, additional, Abril, Andy, additional, Abu Saleh, Omar M., additional, Assi, Mariam, additional, Berbari, Elie F., additional, Bierle, Dennis M., additional, Bosch, Wendelyn, additional, Burger, Charles D., additional, Cano Cevallos, Edison J., additional, Clements, Casey M., additional, Carmona Porquera, Eva M., additional, Castillo Almeida, Natalia E., additional, Challener, Douglas W., additional, Chesdachai, Supavit, additional, Comba, Isin Y., additional, Corsini Campioli, Cristina G., additional, Crane, Sarah J., additional, Dababneh, Ala S., additional, Enzler, Mark J., additional, Fadel, Hind J., additional, Ganesh, Ravindra, additional, De Moraes, Alice Gallo, additional, Go, John R., additional, Gordon, Joel E., additional, Gurram, Pooja R., additional, Guru, Pramod K., additional, Halverson, Erika L., additional, Harrison, Michael F., additional, Heaton, Heather A., additional, Hurt, Ryan, additional, Kasten, Mary J., additional, Lee, Augustine S., additional, Levy, Emily R., additional, Libertin, Claudia R., additional, Mallea, Jorge M., additional, Marshall, William F., additional, Matcha, Gautam, additional, Meehan, Anne M., additional, Franco, Pablo Moreno, additional, Morice, William G., additional, O’Brien, Jennifer J., additional, Oeckler, Richard, additional, Ommen, Steve, additional, Oravec, Caitlin P., additional, Orenstein, Robert, additional, Ough, Natalie J., additional, Palraj, Raj, additional, Patel, Bhavesh M., additional, Pureza, Vincent S., additional, Pickering, Brian, additional, Phelan, David M., additional, Razonable, Raymund R., additional, Rizza, Stacey, additional, Sampathkumar, Priya, additional, Sanghavi, Devang K., additional, Sen, Ayan, additional, Siegel, Jason L., additional, Singbartl, Kai, additional, Shah, Aditya S., additional, Shweta, FNU, additional, Speicher, Leigh L., additional, Suh, Gina, additional, Tabaja, Hussam, additional, Tande, Aaron, additional, Ting, Henry H., additional, Tontz, Russell C., additional, Vaillant, James J., additional, Vergidis, Paschalis, additional, Warsame, Mohamed Y., additional, Yetmar, Zachary A., additional, Zomok, Catherine (Cate) D., additional, Williams, Amy W., additional, and Badley, Andrew D., additional

Published
2021
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55. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions

Author

Levine, Glenn N., Bates, Eric R., Blankenship, James C., Bailey, Steven R., Bittl, John A., Cercek, Bojan, Chambers, Charles E., Ellis, Stephen G., Guyton, Robert A., Hollenberg, Steven M., Khot, Umesh N., Lange, Richard A., Mauri, Laura, Mehran, Roxana, Moussa, Issam D., Mukherjee, Debabrata, Nallamothu, Brahmajee K., Ting, Henry H., Jacobs, Alice K., Anderson, Jeffrey L., Albert, Nancy, Creager, Mark A., Ettinger, Steven M., Halperin, Jonathan L., Hochman, Judith S., Kushner, Frederick G., Ohman, Magnus E., Stevenson, William, and Yancy, Clyde W.

Published
2013
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56. Safety of abciximab in patients with chronic renal insufficiency who are undergoing percutaneous coronary interventions

Author

Best, Patricia J.M., Lennon, Ryan, Gersh, Bernard J., Ting, Henry H., Rihal, Charanjit S., Bell, Malcolm R., Herzog, Charles A., Holmes, David R., and Berger, Peter B.

Subjects
Coronary heart disease -- Research, Coronary heart disease -- Care and treatment, Chronic kidney failure -- Research, Chronic kidney failure -- Care and treatment, Abciximab -- Research, Health
Published
2003

57. Low-risk percutaneous coronary interventions without on-site cardiac surgery: Two years' observational experience and follow-up

Author

Ting, Henry H., Garratt, Kirk N., Singh, Mandeep, Kjelsberg, Michael, Timimi, Farris K., Cragun, Kevin T., Houlihan, Robert J., Boutchee, Katherine L., Crocker, Christopher H., Cusma, Jack T., Wood, Douglas L., and Holmes, David R.

Subjects
Heart attack -- Prognosis, Prognosis -- Evaluation, Cardiovascular instruments, Implanted -- Prognosis, Health
Published
2003

60. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions

Author

Levine, Glenn N., Bates, Eric R., Blankenship, James C., Bailey, Steven R., Bittl, John A., Cercek, Bojan, Chambers, Charles E., Ellis, Stephen G., Guyton, Robert A., Hollenberg, Steven M., Khot, Umesh N., Lange, Richard A., Mauri, Laura, Mehran, Roxana, Moussa, Issam D., Mukherjee, Debabrata, Nallamothu, Brahmajee K., Ting, Henry H., Jacobs, Alice K., Anderson, Jeffrey L., Albert, Nancy, Creager, Mark A., Ettinger, Steven M., Guyton, Robert A., Halperin, Jonathan L., Hochman, Judith S., Kushner, Frederick G., Ohman, Magnus E., Stevenson, William, and Yancy, Clyde W.

Published
2012
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84. The success of opening single chronic total occlusion lesions to improve myocardialviabilitytrial (SOS-COMEDY)

Author

Huang, Rongchong, Song, Xiantao, Zhang, Haishan, Tian, Wen, Huang, Zheng, Zhang, Xingwei, Yang, Junqing, Zhang, Dongfeng, Wu, Jian, Zhong, Lei, and Ting, Henry H.

Subjects
Adult, Aged, 80 and over, Adolescent, Diet, Reducing, Anticholesteremic Agents, decision aid, Middle Aged, Decision Support Techniques, noninvasive imaging, Young Adult, Percutaneous Coronary Intervention, Coronary Occlusion, Study Protocol Clinical Trial, Positron Emission Tomography Computed Tomography, Humans, coronary intervention, Smoking Cessation, Prospective Studies, chronic total occlusion, Antihypertensive Agents, Platelet Aggregation Inhibitors, Research Article, Aged
Abstract

Aims: Success of opening single (SOS)-comedy is a prospective multicenter study to compare the improvement in the decrease of myocardial viability by percutaneous coronary intervention (PCI) with that by optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. Methods and results: The risks and the benefits of both options (PCI and OMT) were listed in a CTO decision aid (DA). Eligible participants detected by invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) were divided into PCI or OMT groups according to patients’ choice after shared-decision making process with DA. Participants will undergo positron emission tomography/computed tomography (PET/CT), cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE), and proceed to ICA and revascularization if possible. Blinded core laboratory interpretation will be performed for ICA, CCTA, PET/CT, CMR, and TTE. All participants will be followed up for 12 months. The primary endpoint is the improvement to the decrease of myocardial viability from baseline assessed with the use of PET/CT after 12-month follow-up. Conclusions: All of the patients are appropriately consented before enrolling in this study, which has been approved by the Ethics Committee. Results of SOS-COMEDY will be helpful to develop a strategy for single CTO patients.

Published
2018

85. The Chest Pain Choice trial: a pilot randomized trial of a decision aid for patients with chest pain in the emergency department

Author

Branda Megan E, Breslin Maggie, Shah Nilay D, Kline Jeffrey A, Hess Erik P, Pierce Meghan A, Pencille Laurie J, Asplin Brent R, Nestler David M, Sadosty Annie T, Stiell Ian G, Ting Henry H, and Montori Victor M

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Chest pain is a common presenting complaint in the emergency department (ED). Despite the frequency with which clinicians evaluate patients with chest pain, accurately determining the risk of acute coronary syndrome (ACS) and sharing risk information with patients is challenging. The aims of this study are (1) to develop a decision aid (CHEST PAIN CHOICE) that communicates the short-term risk of ACS and (2) to evaluate the impact of the decision aid on patient participation in decision-making and resource use. Methods/Design This is a protocol for a parallel, 2-arm randomized trial to compare an intervention group receiving CHEST PAIN CHOICE to a control group receiving usual ED care. Adults presenting to the Saint Mary's Hospital ED in Rochester, MN USA with a primary complaint of chest pain who are being considered for admission for prolonged ED observation in a specialized unit and urgent cardiac stress testing will be eligible for enrollment. We will measure the effect of CHEST PAIN CHOICE on six outcomes: (1) patient knowledge regarding their short-term risk for ACS and the risks of radiation exposure; (2) quality of the decision making process; (3) patient and clinician acceptability and satisfaction with the decision aid; (4) the proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing; (5) economic costs and healthcare utilization; and (6) the rate of delayed or missed ACS. To capture these outcomes, we will administer patient and clinician surveys after each visit, obtain video recordings of the clinical encounters, and conduct 30-day phone follow-up. Discussion This pilot randomized trial will develop and evaluate a decision aid for use in ED chest pain patients at low risk for ACS and provide a preliminary estimate of its effect on patient participation in decision-making and resource use. Trial registration Clinical Trials.gov Identifier: NCT01077037

Published
2010
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88. Predictors and Variability of Drug-Eluting versus Bare Metal Stent Selection in Contemporary PCI: Insights from the PRISM study

Author

Shafiq, Ali, Gosch, Kensey, Amin, Amit P., Ting, Henry H., Spertus, John A., and Salisbury, Adam C.

Subjects
Male, Time Factors, Clinical Decision-Making, Hemorrhage, Comorbidity, Prosthesis Design, Risk Assessment, Article, Coronary Restenosis, Percutaneous Coronary Intervention, Risk Factors, Odds Ratio, Humans, Registries, Acute Coronary Syndrome, Healthcare Disparities, Practice Patterns, Physicians', Aged, Chi-Square Distribution, Insurance, Health, Patient Selection, Drug-Eluting Stents, Middle Aged, United States, Logistic Models, Treatment Outcome, Socioeconomic Factors, Metals, Multivariate Analysis, Drug Therapy, Combination, Female, Stents, Platelet Aggregation Inhibitors
Abstract

Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making. In a multicenter registry, 3295 consecutive patients underwent PCI by 158 interventional cardiologists across 10 US sites. Eighty percent of patients with treated with DES. Using hierarchical regression, diabetes mellitus, multivessel disease, health insurance, and white race were independently associated with greater DES use, whereas increasing age, history of hypertension, anticipated surgery, use of warfarin, lower hemoglobin, prior history of bleeding, and treatment of right coronary and left circumflex artery lesions as compared with PCI of left anterior descending artery were associated with lower likelihood of receiving DES. Adjusted rates of DES use across providers varied from 52.3% to 94.6%, and adjusted median odds ratio for DES selection was 1.69. DES selection appeared to reflect physicians' attempts to balance benefits of DES against risks of prolonged DAPT. Nevertheless, marked residual variability in DES selection across providers persisted after adjusting for predictors of restenosis, bleeding, and other factors. Further studies are needed to better understand drivers of this variability and identify the impact of patient and provider preferences on stent selection at the time of PCI.

Published
2017

89. Clostridium Difficile Infection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Author

Louh, Irene Kathryn Klein, Greendyke, William Garrett, Hermann, Emilia Adell, Davidson, Karina W., Falzon, Louise, Vawdrey, David K., Shaffer, Jonathan, Calfee, David P., Furuya, Yoko, and Ting, Henry H.

Subjects
Hospital care, genetic structures, Medical informatics, Nosocomial infections, Clostridium difficile, Hospitals
Abstract

Prevention of Clostridium difficile infection (CDI) in acute-care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, the ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. We included studies performed in acute-care hospitals. We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Of 3,236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% according to the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand-hygiene practices were not effective for reducing CDI rates. Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates.

Published
2017
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90. Long-term survival of emergency department patients with acute chest pain

Author

Lee, Thomas H., Ting, Henry H., Shammash, Jonathan B., Soukup, Jane R., and Goldman, Lee

Subjects
Coronary heart disease -- Research, Chest pain -- Case studies, Cardiac patients, Health
Abstract

To evaluate the long-term prognosis of patients with acute chest pain, prospective clinical data and long-term follow-up data (mean 30.1 [+ or -] 9.4 months) were collected for 1,956 patients who presented to the emergency department of an urban teaching hospital with this chief complaint. During follow-up of the 1,915 patients who were discharged alive from the emergency department or hospital, there were 113 (6%) cardiovascular deaths. No differences were detected in the post-discharge cardiovascular survival rates after 3 years of experience with patients who were discharged from the emergency department with a known prior diagnosis of angina or myocardial infarction (89%) and patients who had been admitted and found to have acute myocardial infarction (85%), angina (87%), or other cardiovascular diagnoses (87%). Patients who were discharged from either the hospital or the emergency department without cardiovascular diagnoses had an excellent prognosis. Multivariate Cox regression analysis identified 5 independent correlates of cardiovascular mortality after discharge: age, prior history of coronary disease, ischemic changes on the emergency department electrocardiogram, congestive heart failure and cardiogenic shock. These findings indicate that the postdischarge cardiovascular mortality of patients with chest pain who are discharged from the emergency department with a known history of coronary disease is similar to that of admitted patients with angina or myocardial infarction. These data suggest that the same types of prognostic evaluation strategies that have been developed for admitted patients with ischemic heart disease should also be considered when such patients present to the emergency department but are not admitted.

Published
1992

99. Abstract 189: Income Level Disparities in Consumer Reported Domains of Healthcare Experience Among Those With Established Atherosclerotic Cardiovascular Disease in United States: Insights From Medical Expenditure Panel Survey 2010-2013

Author

Okunrintemi, Victor, primary, Spatz, Erica, additional, Salami, Joseph, additional, Capua, Paul D, additional, Warraich, Haider, additional, Virani, Salim, additional, Blaha, Michael, additional, Blankstein, Ron, additional, Krumholz, Harlan, additional, Nasir, Khurram, additional, Ting, Henry H, additional, and Dharmarajan, Kumar, additional

Published
2017
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100. Assessing the feasibility and quality of shared decision making in China: evaluating a clinical encounter intervention for Chinese patients

Author

Huang,Rongchong, Song,Xiantao, Wu,Jian, Huang,Wei, Leppin,Aaron, Gionfriddo,Michael R., Liu,Yongxian, Boehmer,Kasey, Ting,Henry H., Montori,Victor M, Huang,Rongchong, Song,Xiantao, Wu,Jian, Huang,Wei, Leppin,Aaron, Gionfriddo,Michael R., Liu,Yongxian, Boehmer,Kasey, Ting,Henry H., and Montori,Victor M

Abstract

Rongchong Huang,1,* Xiantao Song,2,* Jian Wu,1 Wei Huang,2 Aaron L Leppin,3 Michael R Gionfriddo,3,4 Yongxian Liu,1 Kasey R Boehmer,3 Henry H Ting,5 Victor M Montori3,6 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 2Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Knowledge and Evaluation Research Unit, 4Mayo Graduate School, Mayo Clinic, Rochester, MN, 5Value Institute, New York-Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY, 6Division of Endocrinology, Mayo Clinic, Rochester, MN, USA *These authors contributed equally to this work Background: The aim of this study was to evaluate the feasibility of using the Statin Choice decision aid to have discussions about starting a statin medication for cardiovascular risk reduction in Chinese patients with stable coronary artery diseases.Methods: A prospective, pilot study of the Statin Choice decision aid in two teaching hospitals in Northern China was conducted. A total of seven clinicians were enrolled and underwent a 12-hour, group-based, in-person training on shared decision making (SDM) and the Statin Choice decision aid. Then, these clinicians used the Statin Choice decision aid in patients during a clinical encounter. A total of 86 patients aged 40-80 years, who had stable angina, were enrolled. All clinical encounters were video recorded. A team of three researchers viewed and scored all the encounter recordings to evaluate the SDM process and fidelity to the intervention using the OPTION scale and Fidelity scale, respectively. All the patients were followed up for 12 months to record adherence to statin and any major adverse cardiac events (MACEs).Results: The average scores on the OPTION normalized score and Fidelity scale were 21 (range, 3–32; out of a possible, 48) and 10 (range, 6–10; out of a possibl

Published
2016

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