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Outcome of transcatheter atrial septal defect closure in a nationwide cohort
CONCLUSION: After TC closure of ASD, patients had a higher risk of new-onset atrial fibrillation and migraine than controls without ASD. As novel findings, we found an increased risk for ischemic heart disease, AV conduction disorders, and ventricular fibrillation/tachycardia.Key messagesEven though patients have an excellent overall prognosis after percutaneous ASD closure, the increased incidence of major comorbidities like atrial fibrillation and heart failure prompts more thorough lifelong follow-up.This study's novel findings revealed the increased risk for ischemic heart disease, AV conduction disorders, or ventricul...
Source: Annals of Medicine - February 14, 2023 Category: Internal Medicine Authors: V Muroke M Jalanko J Haukka J Hartikainen A Tahvanainen H Ukkonen K Ylitalo J Pihkala J Sinisalo Source Type: research

Intermountain chronic disease risk score (ICHRON) validation for prediction of incident chronic disease diagnoses in an australian primary prevention population.
CONCLUSION: ICHRON predicted ChrD diagnosis at 3-years among an external, geographically distant validation cohort. These findings show the value of ICHRON for primary care patients in distinct locales. Additionally, electronic calculation of ICHRON empowers the clinical use of this tool to identify and differentially manage and treat high-risk patients. PMID: 32563688 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - June 16, 2020 Category: Internal Medicine Authors: May HT, Anderson JL, Muhlestein JB, Knowlton KU, Horne BD Tags: Eur J Intern Med Source Type: research

Novel electronic health record (EHR) education intervention in large healthcare organization improves quality, efficiency, time, and impact on burnout
A novel approach to advanced electronic health record (EHR) skills training was developed in a large healthcare organization to improve high-quality EHR documentation, while reducing stressors linked to physician burnout. The 3-day intensive EHR education intervention covered best practices in EHR documentation and physician well-being. The specialty physician faculty used interactive teaching including demonstration, facilitation, and individual coaching. Laptops were provided for hands-on practice. Mixed-method evaluation included real-time feedback, daily surveys, and post-activity surveys to measure participant learni...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study)
ConclusionsThe present study demonstrates that a CDS can increase guideline adherence for anticoagulant therapy in patients with AF. Even though the observed difference was small, this is the first randomized study to our knowledge indicating beneficial effects with a CDS in patients with AF. Trial registrationClinicalTrials.gov NCT02635685
Source: PLoS Medicine - March 13, 2018 Category: Internal Medicine Authors: Lars O. Karlsson Source Type: research

Patterns and temporal trends of comorbidity among adult patients with incident cardiovascular disease in the UK between 2000 and 2014: A population-based cohort study
ConclusionsThe burden of multimorbidity and comorbidity in patients with incident non-fatal CVD increased between 2000 and 2014. On average, older patients, women, and socioeconomically deprived groups had higher numbers of comorbidities, but the type of comorbidities varied by age and sex. Cardiometabolic conditions contributed substantially to the burden, but 4 out of the 10 top comorbidities were non-cardiometabolic. The current single-disease paradigm in CVD management needs to broaden and incorporate the large and increasing burden of comorbidities.
Source: PLoS Medicine - March 6, 2018 Category: Internal Medicine Authors: Jenny Tran Source Type: research

Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database
The Sentinel Distributed Database (SDD) is a large database of patient-level medical and prescription records, primarily derived from insurance claims and electronic health records, and is sponsored by the U.S. Food and Drug Administration for drug safety assessments. In this chart validation study, we report on the positive predictive value (PPV) of inpatient ICD-9-CM acute ischemic stroke (AIS) administrative diagnosis codes (433.x1, 434.xx, and 436) in the SDD. As part of an assessment of the risk of thromboembolic adverse events following treatment with intravenous immune globulin (IGIV), charts were obtained for 131 ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study Source Type: research

Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position: A Retrospective Cohort Study.
Conclusion: Neighborhood disadvantage may be a powerful regulator of ASCVD event risk. In addition to supplemental risk models and clinical screening criteria, population-based solutions are needed to ameliorate the deleterious effects of neighborhood disadvantage on health outcomes. Primary Funding Source: The Clinical and Translational Science Collaborative of Cleveland and National Institutes of Health. PMID: 28847012 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - August 29, 2017 Category: Internal Medicine Authors: Dalton JE, Perzynski AT, Zidar DA, Rothberg MB, Coulton CJ, Milinovich AT, Einstadter D, Karichu JK, Dawson NV Tags: Ann Intern Med Source Type: research

Short-term hypertension management in community is associated with long-term risk of stroke and total death in China: A community controlled trial
Background: It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke Objectives: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. Design: Community controlled trail. Participants: Six community health centers (4 active, 2 control) in China, patients with hypertension. Control arm: Patients were treated with normally therapy method. Active arm: Patients were treated oriented by the Guideline for hypertension management. Randomization: Two centers (He...
Source: Medicine - November 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Validation of Stroke Meaningful Use Measures in a National Electronic Health Record System
Conclusions Stroke MU indicators can be relatively accurately generated from existing EHR systems (nearly 90 % match to chart review), but accuracy decreases slightly in central compared to local data sources. To improve stroke MU measure accuracy, EHRs should include standardized data elements for devices, discharge disposition (including hospice and comfort care status), and recording contraindications.
Source: Journal of General Internal Medicine - March 7, 2016 Category: Internal Medicine Source Type: research