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234 results on '"Kociol, Robb D."'

2. Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure: Rationale and design of CONNECT-HF

Author

DeVore, Adam D., Granger, Bradi B., Fonarow, Gregg C., Al-Khalidi, Hussein R., Albert, Nancy M., Lewis, Eldrin F., Butler, Javed, Piña, Ileana L., Heidenreich, Paul A., Allen, Larry A., Yancy, Cyde W., Cooper, Lauren B., Felker, G. Michael, Kaltenbach, Lisa A., McRae, A. Thomas, Lanfear, David E., Harrison, Robert W., Kociol, Robb D., Disch, Maghee, Ariely, Dan, Miller, Julie M., Granger, Christopher B., and Hernandez, Adrian F.

Published
2020
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3. Activities and Compensation of Advanced Heart Failure Specialists: Results of the Heart Failure Society of America (HFSA) Survey

Author

Klein, Liviu, Greenberg, Barry H, Konstam, Marvin A, Gregory, Douglas, Kociol, Robb D, Johnson, Maryl R, and de Marco, Teresa

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Cardiovascular, Heart Disease, Academic Medical Centers, Adult, Aged, Attitude of Health Personnel, Benchmarking, Cardiology, Female, Health Care Surveys, Heart Failure, Hospitals, Private, Humans, Income, Male, Middle Aged, Outcome Assessment, Health Care, Practice Patterns, Physicians', Severity of Illness Index, Societies, Medical, Specialization, Surveys and Questionnaires, United States, Compensation, relative value units, heart failure specialists, academic medical center, Cardiorespiratory Medicine and Haematology, Nursing, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundIn the current era, where advanced heart failure (AHF) has become an American Board of Internal Medicine-certified subspecialty, new data are needed to benchmark and value levels of clinical effort performed by AHF specialists (AHFMDs).Methods and resultsA 36-question survey was sent to 728 AHFMDs, members of the Heart Failure Society of America, and 224 (31%) responded. Overall, 56% worked in academic medical centers (AMCs) and were younger (48 ± 9 y vs 52 ± 10 y; P < .01) and were represented by a higher proportion of women (34% vs 21%, P < .01) compared with non-AMCs. The percentage of time in clinical care was lower in AMCs (64 ± 19% vs 78 ± 18%; P = .002), with similar concentration on evaluation and management services (79 ± 18% in AMCs vs 72 ± 18 % in non-AMCs; P = NS). The majority of nonclinical time was spent in program administration (10% in both AMCs and non-AMCs) and education/research (15% in AMC vs 5% in non-AMCs). Although 69% of respondents were compensated by work-relative value units (wRVUs), only a small percentage knew their target or the amount of RVUs generated. The mean annual wRVUs generated were lower in AMCs compared to non-AMCs (5,452 ± 1,961 vs 9,071 ± 3,484; P < .001). The annual compensation in AMCs was lower than in non-AMCs (45% vs 10% $350,000; P < .001) and the satisfaction with compensation was higher in non-AMCs.ConclusionsAHFMDs' compensation is largely dependent by practice type (AMC vs non-AMC) and clinical productivity as measured by wRVUs. These data provide an opportunity for benchmarking work effort and compensation for AHFMDs, allowing distinction from segments of cardiologists with greater opportunity to accrue procedural wRVUs. They also show several differences between AMCs and non-AMCs that should be considered when formulating work assignment and compensation for AHFMDs.

Published
2015

6. Contributors

Author

Allen, Larry A., primary, Arabia, Francisco A., additional, Atluri, Pavan, additional, Baldwin, J. Timothy, additional, Bermudez, Christian A., additional, Birks, Emma, additional, Bostic, Robin, additional, Cowger, Jennifer, additional, Daneshmand, Mani A., additional, Dembitsky, Walter, additional, Dew, Mary Amanda, additional, Drakos, Stavros G., additional, Elgudin, Yakov L., additional, Goldstein, Daniel J., additional, Grady, Kathleen L., additional, Gregoric, Igor D., additional, Gustafsson, Finn, additional, Heywood, J. Thomas, additional, Holman, William L., additional, Ivovic, Tina Cady, additional, Kirklin, James K., additional, Kociol, Robb D., additional, Larose, Jeff, additional, Long, James W., additional, Middlebrook, Donald A., additional, Moazami, Nader, additional, Morales, David Luís Simón, additional, Pagani, Francis D., additional, Park, Soon J., additional, Pinney, Sean, additional, Rame, J. Eduardo, additional, Riggs, Kyle William, additional, Rosenthal, David N., additional, Russell, Stuart D., additional, Schumer, Erin M., additional, Selzman, Craig H., additional, Slaughter, Mark S., additional, Starling, Randall C., additional, Stevenson, Lynne Warner, additional, Stewart, Garrick C., additional, Teuteberg, Jeffrey, additional, Timms, Daniel, additional, Uriel, Nir, additional, Wampler, Richard, additional, Watson, John T., additional, and Young, James B., additional

Published
2020
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17. HEALTHCARE RESOURCE USE, INTENSITY AND COSTS AMONG PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION TREATED WITH OMECAMTIV MECARBIL IN GALACTIC-HF

Author

Desai, Nihar R., primary, Diaz, Rafael, additional, Felker, Michael, additional, Metra, Marco, additional, Solomon, Scott D., additional, Binder, Gary, additional, Divanji, Punag, additional, Gomes, Daniel, additional, Kociol, Robb D., additional, Meng, Lisa, additional, and Teerlink, John R., additional

Published
2022
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26. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association

Author

Konstam, Marvin A., primary, Kiernan, Michael S., additional, Bernstein, Daniel, additional, Bozkurt, Biykem, additional, Jacob, Miriam, additional, Kapur, Navin K., additional, Kociol, Robb D., additional, Lewis, Eldrin F., additional, Mehra, Mandeep R., additional, Pagani, Francis D., additional, Raval, Amish N., additional, and Ward, Carey, additional

Published
2018
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28. When the VEST Does Not Fit

Author

Allen, Larry A., primary, Adler, Eric D., additional, Bayés-Genis, Antoni, additional, Brisco-Bacik, Meredith A., additional, Chirinos, Julio A., additional, Claggett, Brian, additional, Cook, Jennifer L., additional, Fang, James C., additional, Gustafsson, Finn, additional, Ho, Carolyn Y., additional, Kapur, Navin K., additional, Klewer, Scott E., additional, Kociol, Robb D., additional, Lanfear, David E., additional, Vardeny, Orly, additional, and Sweitzer, Nancy K., additional

Published
2018
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29. When the VEST Does Not Fit:Representations of Trial Results Deviating From Rigorous Data Interpretation

Author

Allen, Larry A, Adler, Eric D, Bayés-Genis, Antoni, Brisco-Bacik, Meredith A, Chirinos, Julio A, Claggett, Brian, Cook, Jennifer L, Fang, James C, Gustafsson, Finn, Ho, Carolyn Y, Kapur, Navin K, Klewer, Scott E, Kociol, Robb D, Lanfear, David E, Vardeny, Orly, Sweitzer, Nancy K, Allen, Larry A, Adler, Eric D, Bayés-Genis, Antoni, Brisco-Bacik, Meredith A, Chirinos, Julio A, Claggett, Brian, Cook, Jennifer L, Fang, James C, Gustafsson, Finn, Ho, Carolyn Y, Kapur, Navin K, Klewer, Scott E, Kociol, Robb D, Lanfear, David E, Vardeny, Orly, and Sweitzer, Nancy K

Published
2018

31. Substantial discrepancy between fluid and weight loss during acute decompensated heart failure treatment: Important lessons for research and clinical care

Author

Testani, Jeffrey M., Brisco, Meredith A., Kociol, Robb D., Jacoby, Daniel, Bellumkonda, Lavanya, Parikh, Chirag R., Coca, Steven G., and Wilson Tang, W. H.

Subjects
Male, Risk Assessment, Severity of Illness Index, Article, Drug Administration Schedule, Statistics, Nonparametric, Cohort Studies, Sex Factors, Double-Blind Method, Weight Loss, Humans, Diuretics, Infusions, Intravenous, Aged, Randomized Controlled Trials as Topic, Aged, 80 and over, Heart Failure, Dose-Response Relationship, Drug, Age Factors, Middle Aged, Body Fluids, Survival Rate, Treatment Outcome, Acute Disease, Female, Follow-Up Studies
Abstract

Net fluid and weight loss are used ubiquitously to monitor diuretic response in acute decompensated heart failure research and patient care. However, the performance of these metrics has never been evaluated critically. The weight and volume of aqueous fluids such as urine should be correlated nearly perfectly and with very good agreement. As a result, significant discrepancy between fluid and weight loss during the treatment of acute decompensated heart failure would indicate measurement error in 1 or both of the parameters.The correlation and agreement (Bland-Altman method) between diuretic-induced fluid and weight loss were examined in 3 acute decompensated heart failure trials and cohorts: (1) Diuretic Optimization Strategies Evaluation (DOSE) (n = 254); (2) Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) (n = 348); and (3) Penn (n = 486).The correlation between fluid and weight loss was modest (DOSE r = 0.55; ESCAPE r = 0.48; Penn r = 0.51; P.001 for all), and the 95% limits of agreement were wide (DOSE -7.9 to 6.4 kg-L; ESCAPE -11.6 to 7.5 kg-L; Penn -14.5 to 11.3 kg-L). The median relative disagreement ranged from ±47.0% to 63.5%. A bias toward greater fluid than weight loss was found across populations (-0.74 to -2.1 kg-L, P ≤ .002). A consistent pattern of baseline characteristics or in-hospital treatment parameters that could identify patients at risk of discordant fluid and weight loss was not found.Considerable discrepancy between fluid balance and weight loss is common in patients treated for acute decompensated heart failure. Awareness of the limitations inherent to these commonly used metrics and efforts to develop more reliable measures of diuresis are critical for both patient care and research in acute decompensated heart failure.

Published
2015

35. The prognostic value of the relationship between right atrial and pulmonary capillary wedge pressure in diverse cardiovascular conditions.

Author

Jr.Brinkley, Douglas Marshall, Ho, Kalon K.L., Drazner, Mark H., Kociol, Robb D., and Brinkley, Douglas Marshall Jr

Abstract

Background: Physical examination of jugular venous pressure is used to estimate right atrial (RA) pressure and infer left-sided filling pressure to assist volume management. Previous studies in advanced heart failure patients showed about 75% concordance between RA and pulmonary capillary wedge (PCW) pressures. We sought to determine the relationship between mean RA and mean PCW pressure and assess the clinical significance in a broad population of patients undergoing invasive right heart catheterization (RHC).Methods: We examined 4135 RHC cases at a single academic medical center from February 2007 to December 2014, analyzing baseline variables, hemodynamic data, and in-hospital mortality.Results: The overall Pearson correlation for mean RA and PCW pressures was 0.68 with 70% concordance between dichotomized pressures (RA ≥10 and PCW ≥22 mmHg). Results were similar in subgroups with heart failure (r=0.67, 72%), STEMI/NSTEMI (r=0.60, 69%), unstable angina (r=0.78, 69%), stable/no angina (r=0.72, 67%), and valvular disease (r=0.61, 72%; Chi-square P=.15). Mean RA pressure was independently associated with in-hospital mortality in multivariate analysis (OR 1.12 [95% CI 1.081-1.157] per 1 mmHg increase, P<.001). The RA/PCW ratio was not independently associated with in-hospital mortality. Mean RA pressure was also weakly associated with worse renal function (rho=-0.16, P<.001).Conclusion: In patients undergoing right catheterization for diverse indications, the mean RA and PCW pressures correlated moderately well, but there was discordance in a sizable minority, in whom assessment of left-sided filling pressures using estimated jugular venous pressure may be misleading. Elevated right atrial pressure is a marker for in-hospital mortality. [ABSTRACT FROM AUTHOR]

Published
2018
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36. Admission, Discharge, or Change in BNP and Long-term Outcomes: Data from OPTIMIZE-HF Linked to Medicare Claims

Author

Kociol, Robb D., Horton, John R., Fonarow, Gregg C., Reyes, Eric M., Shaw, Linda K., O'Connor, Christopher M., Felker, G. Michael, and Hernandez, Adrian F.

Subjects
Aged, 80 and over, Heart Failure, Male, Models, Statistical, Medicare, Prognosis, Sensitivity and Specificity, Article, Patient Discharge, United States, Survival Rate, Insurance Claim Review, Patient Admission, Predictive Value of Tests, Risk Factors, Natriuretic Peptide, Brain, Humans, Female, Biomarkers, Aged, Retrospective Studies
Abstract

B-type natriuretic peptide (BNP) has been associated with short- and long-term postdischarge prognosis among hospitalized patients with heart failure. It is unknown if admission, discharge, or change from admission to discharge BNP measure is the most important predictor of long-term outcomes.We linked patients ≥65 years of age from hospitals in Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) to Medicare claims. Among patients with recorded admission and discharge BNP, we compared Cox models predicting 1-year mortality and/or rehospitalization, including clinical variables and clinical variables plus BNP. We calculated the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) for the best-fit model for each outcome versus the model with clinical variables alone. Among 7039 patients in 220 hospitals, median (25th, 75th) admission and discharge BNP were 832 pg/mL (451, 1660) and 534 pg/mL (281, 1111). Observed 1-year mortality and 1-year mortality or rehospitalization rates were 35.2% and 79.4%. The discharge BNP model had the best performance and was the most important characteristic for predicting 1-year mortality (hazard ratio for log transformation, 1.34; 95% confidence interval, 1.28 to 1.40) and 1-year death or rehospitalization (hazard ratio, 1.15; 95% confidence interval, 1.12 to 1.18). Compared with a clinical variables only model, the discharge BNP model improved risk reclassification and discrimination in predicting each outcome (1-year mortality: NRI, 5.5%, P0.0001; IDI, 0.023, P0.0001; 1-year mortality or rehospitalization: NRI, 4.2%, P0.0001; IDI, 0.010, P0.0001).Discharge BNP best predicts 1-year mortality and/or rehospitalization among older patients hospitalized with heart failure. Discharge BNP plus clinical variables modestly improves risk classification and model discrimination for long-term outcomes.

Published
2011

39. Racial Disparities in Comorbidities, Complications, and Maternal and Fetal Outcomes in Women With Preeclampsia/eclampsia

Author

Shahul, Sajid, primary, Tung, Avery, additional, Minhaj, Mohammed, additional, Nizamuddin, Junaid, additional, Wenger, Julia, additional, Mahmood, Eitezaz, additional, Mueller, Ariel, additional, Shaefi, Shahzad, additional, Scavone, Barbara, additional, Kociol, Robb D., additional, Talmor, Daniel, additional, and Rana, Sarosh, additional

Published
2015
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45. Do Countries or Hospitals With Longer Hospital Stays for Acute Heart Failure Have Lower Readmission Rates?

Author

Eapen, Zubin J., primary, Reed, Shelby D., additional, Li, Yanhong, additional, Kociol, Robb D., additional, Armstrong, Paul W., additional, Starling, Randall C., additional, McMurray, John J., additional, Massie, Barry M., additional, Swedberg, Karl, additional, Ezekowitz, Justin A., additional, Fonarow, Gregg C., additional, Teerlink, John R., additional, Metra, Marco, additional, Whellan, David J., additional, O’Connor, Christopher M., additional, Califf, Robert M., additional, and Hernandez, Adrian F., additional

Published
2013
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47. National Survey of Hospital Strategies to Reduce Heart Failure Readmissions

Author

Kociol, Robb D., primary, Peterson, Eric D., additional, Hammill, Bradley G., additional, Flynn, Kathryn E., additional, Heidenreich, Paul A., additional, Piña, Ileana L., additional, Lytle, Barbara L., additional, Albert, Nancy M., additional, Curtis, Lesley H., additional, Fonarow, Gregg C., additional, and Hernandez, Adrian F., additional

Published
2012
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50. Abstract 16818: Circulating Cardiac Troponin I as Detected By a High-Sensitivity Assay among Patients Hospitalized with Acute Decompensated Heart Failure

Author

Kociol, Robb D, primary, McNulty, Steven E, additional, Lee, Kerry L, additional, Apple, Fred S, additional, Tracy, Russell P, additional, Hernandez, Adrian F, additional, Mentz, Robert J, additional, Braunwald, Eugene, additional, O'Connor, Christopher M, additional, and Felker, G. Michael, additional

Published
2011
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