Rabbani, Juleon
Expertise in group (race/ethnicity, gender, sexual orientation) differences and disparities in health risk factors, and biostatistics
A demonstration of Modified Treatment Policies to evaluate shifts in mobility and COVID-19 case rates in U.S. counties
Mixed evidence exists of associations between mobility data and coronavirus disease 2019 (COVID-19) case rates. We aimed to evaluate the…
Effectiveness of BNT162b2 COVID-19 Vaccination in Children and Adolescents
We assessed BNT162b2 vaccine effectiveness (VE) against mild to moderate and severe coronavirus disease 2019 (COVID-19) in children and adolescents…
Blood donor, component, and recipient-specific factors associated with venous thromboembolism in transfused hospitalized adult patients: Data from the recipient epidemiology and donor evaluation Study-III (REDS-III)
Growing evidence suggests multiple pathophysiological mechanisms linking red blood cells (RBC) transfusions to thrombosis. This study examined blood donor, component,…
Current tobacco smoking and risk of SARS-CoV-2 infection and hospitalization: Evaluating the role of socio-demographic factors and comorbidities
Our recently published study of >2.4 million adults in Northern California indicated that current versus never-tobacco smoking was associated with…
Impact of a scalable training program on the quality of colonoscopy performance and risk of post-colonoscopy colorectal cancer
Endoscopist adenoma detection rates (ADR) vary widely and are associated with patients' risk of post-colonoscopy colorectal cancers (PCCRC). However, few…
Protection of 2 and 3 mRNA Vaccine Doses Against Severe Outcomes Among Adults Hospitalized with COVID-19 – VISION Network, August 2021 – March 2022
We assessed coronavirus disease 2019 (COVID-19) vaccination impact on illness severity among adults hospitalized with COVID-19, August 2021-March 2022. We…
Glycemic Control Over Multiple Decades and Dementia Risk in People With Type 2 Diabetes
The levels of glycemic control associated with the lowest risk of dementia in people with type 2 diabetes are unknown.…
Association of primary lifetime occupational cognitive complexity and cognitive decline in a diverse cohort: Results from the KHANDLE study
Higher occupational complexity has been linked to favorable cognitive outcomes, but rarely examined in racially and ethnically diverse populations. In…
Associations of dietary isothiocyanate exposure from cruciferous vegetable consumption with recurrence and progression of non-muscle-invasive bladder cancer: findings from the Be-Well Study
High recurrence and progression rates are major clinical challenges for non-muscle-invasive bladder cancer (NMIBC). Dietary isothiocyanates (ITCs), phytochemicals primarily from…
The prospective association of hyperandrogenism, oligomenorrhea and polycystic ovary syndrome with incident gestational diabetes: The coronary artery risk development in young adults women’s study
In this 28-year prospective study of 455 women (mean age: 26 years), polycystic ovary syndrome (PCOS) was associated with a 2.6-fold…
State-Level Indicators of Childhood Educational Quality and Incident Dementia in Older Black and White Adults
Higher educational attainment is associated with reduced dementia risk, but the role of educational quality is understudied, presenting a major…
Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression
The adverse consequences of untreated perinatal depression highlight the need to identify populations to target in order to increase treatment…
Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer
Studies comparing the effect of aromatase inhibitor (AI) and tamoxifen use on cardiovascular disease (CVD) risk factors in hormone-receptor positive…
Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19-Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults – VISION Network, Nine States, September-November 2022
During June-October 2022, the SARS-CoV-2 Omicron BA.5 sublineage accounted for most of the sequenced viral genomes in the United States,…
TRENDS IN SMOKING-SPECIFIC LUNG CANCER INCIDENCE RATES WITHIN A U.S. INTEGRATED HEALTH SYSTEM, 2007-2018
At least 10% of lung cancers arise in adults who have never smoked. Data remain inconclusive on whether lung cancer…
Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study
Patients with atopic dermatitis (AD), also known as eczema, may be at an increased risk for malignancies compared with patients…
Associations between antidepressant use patterns during pregnancy and birth outcomes among periconception antidepressant users
Little is known about antidepressant medication use patterns during pregnancy among periconception (before and immediately following conception) users. Additionally, the…
Human Immunodeficiency Virus Status, Tenofovir Exposure, and the Risk of Poor Coronavirus Disease 19 (COVID-19) Outcomes: Real-World Analysis From 6 United States Cohorts Before Vaccine Rollout
People with human immunodeficiency virus (HIV) (PWH) may be at increased risk for severe coronavirus disease 2019 (COVID-19) outcomes. We…
Estimation of COVID-19 mRNA Vaccine Effectiveness and COVID-19 Illness and Severity by Vaccination Status During Omicron BA.4 and BA.5 Sublineage Periods
Recent SARS-CoV-2 Omicron variant sublineages, including BA.4 and BA.5, may be associated with greater immune evasion and less protection against…
Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation
Practice patterns and outcomes associated with the use of oral anticoagulation for arterial thromboembolism prevention following a hospitalization with new-onset…
Perinatal Outcomes After Bariatric Surgery Compared With a Matched Control Group
To evaluate perinatal outcomes associated with pregnancy after bariatric surgery within a large integrated health care system using propensity score…
Long-term Trajectories of Physical Function Decline in Women With and Without Cancer
Patients with cancer experience acute declines in physical function, hypothesized to reflect accelerated aging driven by cancer-related symptoms and effects…
Natural history of multiple recurrences in intermediate-risk non-muscle invasive bladder cancer: lessons from a prospective cohort
To describe the risk of multiple recurrences in intermediate-risk non-muscle invasive bladder cancer (IR-NMIBC) and their impact on progression. Prognostic…
Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life
We examined the effectiveness of maternal vaccination against SARS-CoV-2 infection in 30,311 infants born at Kaiser Permanente Northern California from…
Protection from COVID-19 mRNA vaccination and prior SARS-CoV-2 infection against COVID-19-associated encounters in adults during Delta and Omicron predominance
Data assessing protection conferred from COVID-19 mRNA vaccination and/or prior SARS-CoV-2 infection during Delta and Omicron predominance periods in the…
Sex- and ethnic-specific patterns in the incidence of hip fracture among older US Asian and non-Hispanic White adults
Asian and Pacific Islander (Asian/PI) adults have lower hip fracture incidence than non-Hispanic White (NHW) adults, but data regarding Asian/PI…
Maternal and neonatal outcomes associated with treating hypertension in pregnancy at different thresholds
In the United States, there has been controversy over whether treatment of mild-to-moderate hypertension during pregnancy conveys more benefit than…
Association of the COVID-19 Pandemic With Unstable and/or Unsafe Living Situations and Intimate Partner Violence Among Pregnant Individuals
The social, behavioral, and economic consequences of the COVID-19 pandemic may be associated with unstable and/or unsafe living situations and…
Association of Long-term Exposure to Particulate Air Pollution With Cardiovascular Events in California
Long-term exposure to fine particulate air pollution (PM2.5) is a known risk factor for cardiovascular events, but controversy remains as…
High-dimensional propensity scores for empirical covariate selection in secondary database studies: Planning, implementation, and reporting
Real-world evidence used for regulatory, payer, and clinical decision-making requires principled epidemiology in design and analysis, applying methods to minimize…
Association of cannabis use during pregnancy with severe acute respiratory syndrome coronavirus 2 infection: a retrospective cohort study
Cannabis use is increasingly common among pregnant individuals and might be a risk factor for severe acute respiratory syndrome coronavirus…
A prospective study of lifestyle factors and bone health in breast cancer patients who received aromatase inhibitors in an integrated healthcare setting
Fracture and osteoporosis are known side effects of aromatase inhibitors (AIs) for postmenopausal hormone receptor positive (HR+) breast cancer (BC)…
Vaccine effectiveness against influenza-associated urgent care, emergency department, and hospital encounters during the 2021-2022 season, VISION Network
Following historically low influenza activity during the 2020-2021 season, the United States saw an increase in influenza circulating during the…
MiXcan: a framework for cell-type-aware transcriptome-wide association studies with an application to breast cancer
Human bulk tissue samples comprise multiple cell types with diverse roles in disease etiology. Conventional transcriptome-wide association study approaches predict…
A broad assessment of covid-19 vaccine safety using tree-based data-mining in the vaccine safety datalink
Except for spontaneous reporting systems, vaccine safety monitoring generally involves pre-specifying health outcomes and post-vaccination risk windows of concern. Instead,…
A safety study evaluating non-COVID-19 mortality risk following COVID-19 vaccination
The safety of COVID-19 vaccines plays an important role in addressing vaccine hesitancy. We conducted a large cohort study to…
A mid-level health manager intervention to promote uptake of isoniazid preventive therapy among people with HIV in Uganda: a cluster randomised trial.
BACKGROUND: Despite longstanding guidelines endorsing isoniazid preventive therapy (IPT) for people with HIV, uptake is low across sub-Saharan Africa. Mid-level…
HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda.
BACKGROUND: Oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but data are limited on HIV incidence among PrEP…
Type I error control for cluster randomized trials under varying small sample structures.
BACKGROUND: Linear mixed models (LMM) are a common approach to analyzing data from cluster randomized trials (CRTs). Inference on parameters…
Tree-based data mining for safety assessment of first COVID-19 booster doses in the Vaccine Safety Datalink
The Centers for Disease Control and Prevention's Vaccine Safety Datalink (VSD) has been performing safety surveillance for COVID-19 vaccines since…
Cigarette Smoking and Risk of SARS-CoV-2 infection and Disease Severity Among Adults in an Integrated Health Care System in California
The relationship between tobacco smoking status and SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) severity is highly debated. We conducted…
Pregnancy post-bariatric surgery: Improved outcomes with telephonic nutritional management program
Pregnancies post-bariatric surgery are increasingly common. It is important to understand how to manage prenatal care in this high-risk population…
Association between anaemia and hospital readmissions in patients undergoing major surgery requiring postoperative intensive care
Anaemia is a common sequela of surgery, although its relationship with patient recovery is unclear. The goal of this investigation…
Survival Associated With Consolidated Multidisciplinary Care in Head and Neck Cancer: A Retrospective Cohort Study
To compare survival among patients with head and neck cancer before and after implementing a weekly multidisciplinary clinic and case…
Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19-Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults – VISION Network, Nine States, September-November 2022
During June-October 2022, the SARS-CoV-2 Omicron BA.5 sublineage accounted for most of the sequenced viral genomes in the United States,…
Metabolic abnormalities and survival among patients with non-metastatic breast cancer
Research on the impact of metabolic abnormalities on breast cancer prognosis is limited by small samples and assessment of laboratory…
Trends in Self-reported and Biochemically Verified Cocaine and Methamphetamine Use Among Pregnant Individuals in Northern California, 2011-2019
This cross-sectional study uses data from the Kaiser Permanente Northern California health care system with universal screening via self-report and…
High-sensitivity troponin I is associated with cardiovascular outcomes but not with breast arterial calcification among postmenopausal women
Prior studies support the utility of high sensitivity troponin I (hsTnI) for cardiovascular disease (CVD) risk stratification among asymptomatic populations;…
Demographic, Reproductive, and Medical Risk Factors for Intrauterine Device Expulsion
To explore to what extent intrauterine device (IUD) expulsion is associated with demographic and clinical risk factors. The APEX-IUD (Association…
Urinary Phenols in Early to Mid-Pregnancy and Risk of Gestational Diabetes: A Longitudinal Study in a Multiracial Cohort
Environmental phenols are ubiquitous endocrine disruptors and putatively diabetogenic. However, data during pregnancy are scant. We investigated the prospective associations…
A large genome-wide association study of QT interval length utilizing electronic health records
QT interval length is an important risk factor for adverse cardiovascular outcomes; however, the genetic architecture of QT interval remains…
Nugent, Joshua R.
Research interests include causal inference methods, with a focus on clustered data and machine learning.
Marafino, Ben J.
Research interests include machine learning and quasi-experimental methods.
Lee, Catherine
Research interests include time-to-event outcomes, analysis of semi-competing risks data, and risk prediction.
Quesenberry, Charles P.
Research interests include epidemiologic and statistical methods.
Neugebauer, Romain S.
Research focuses on the development, application, and dissemination of statistical methodologies.
Fireman, Bruce H.
Research interests include assessment of the effectiveness and safety of vaccines and drugs.
Alexeeff, Stacey
Research interests include risk factors for disease and prediction modeling
Armstrong, Mary Anne
Research interests include alcohol and health and perinatal substance abuse.
Associations between childhood obesity and pubertal timing stratified by sex and race/ethnicity
Earlier puberty has been associated with numerous adverse mental, emotional, and physical health outcomes. Obesity is a known risk factor…
Association of serum folate levels during pregnancy and prenatal depression
To evaluate the association between serum folate levels during pregnancy and prenatal depression and the extent to which obesity may…
Smoking Behaviors and Prognosis in Patients With Non-Muscle-Invasive Bladder Cancer in the Be-Well Study
Tobacco smoking is an established risk factor associated with bladder cancer, yet its impact on bladder cancer prognosis is unclear.…
Geographic Accessibility of Retail Cannabis in Northern California and Prenatal Cannabis Use During the COVID-19 Pandemic
Prenatal cannabis use is associated with health risks for mothers and their children. Prior research suggests that rates of prenatal…
Association of Thoracic Aortic Aneurysm Size With Long-term Patient Outcomes: The KP-TAA Study
The risk of adverse events from ascending thoracic aorta aneurysm (TAA) is poorly understood but drives clinical decision-making. To evaluate…
Retrospective cohort study to assess the association between treatment with tocilizumab and mortality among mechanically ventilated patients with COVID-19
Assess the association between tocilizumab administration and clinical outcomes among mechanically ventilated patients with COVID-19 pneumonia. Retrospective cohort study. Large…
Prescribing for different antibiotic classes across age groups in the Kaiser Permanente Northern California population in association with influenza incidence, 2010-2018
There is limited information on the volume of antibiotic prescribing that is influenza-associated, resulting from influenza infections and their complications…
Effectiveness of COVID-19 mRNA Vaccines Against COVID-19-Associated Hospitalizations Among Immunocompromised Adults During SARS-CoV-2 Omicron Predominance – VISION Network, 10 States, December 2021-August 2022
Persons with moderate-to-severe immunocompromising conditions might have reduced protection after COVID-19 vaccination, compared with persons without immunocompromising conditions (1-3). On…
Maternal SARS-CoV-2 Vaccination and Infant Protection Against SARS-CoV-2 During the First 6 Months of Life
We examined the effectiveness of maternal vaccination against SARS-CoV-2 infection in 30,288 infants born at Kaiser Permanente Northern California from…
Patterns of Substance Use During Early Pregnancy and Associations With Behavioral Health Characteristics
The aims of the study are to identify patterns of early pregnancy substance use and to examine how these patterns…
Assessment of genetic susceptibility to multiple primary cancers through whole-exome sequencing in two large multi-ancestry studies
Up to one of every six individuals diagnosed with one cancer will be diagnosed with a second primary cancer in…
Waning of vaccine effectiveness against moderate and severe covid-19 among adults in the US from the VISION network: test negative, case-control study
To estimate the effectiveness of mRNA vaccines against moderate and severe covid-19 in adults by time since second, third, or…
Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system
Evidence is limited characterizing sociodemographically diverse patient populations with lung cancer in relation to smoking status. In a cross-sectional analysis…
Disparities in the Incidence of Ectopic Pregnancy in a Large Health Care System in California, 2010-2019
IntroductionEctopic pregnancy leads to reproductive health morbidity, including greater risk of another ectopic pregnancy, infertility, and, in rare cases, mortality.…
Estimation of COVID-19 mRNA Vaccine Effectiveness Against Medically Attended COVID-19 in Pregnancy During Periods of Delta and Omicron Variant Predominance in the United States
Pregnant people are at high risk for severe COVID-19 but were excluded from mRNA vaccine trials; data on COVID-19 vaccine…
Electronic cigarette use and risk of COVID-19 among young adults without a history of cigarette smoking
It is unknown whether use of e-cigarettes increases susceptibility to COVID-19. In a large clinical sample of young adults, we…
Maternal autoantibody profiles as biomarkers for ASD and ASD with co-occurring intellectual disability
Maternal autoantibody-related ASD (MAR ASD) is a subtype of autism in which pathogenic maternal autoantibodies (IgG) cross the placenta, access…
Risk of myocarditis and pericarditis following BNT162b2 and mRNA-1273 COVID-19 vaccination
Evidence indicates that mRNA COVID-19 vaccination is associated with risk of myocarditis and possibly pericarditis, especially in young males. It…
Prolactin and maternal metabolism in women with a recent GDM pregnancy and links to future T2D: the SWIFT study
Prolactin is a multifaceted hormone known to regulate lactation. In women with gestational diabetes mellitus (GDM) history, intensive lactation has…
Risk of severe COVID-19 infection among adults with prior exposure to children
Susceptibility and severity of COVID-19 infection vary widely. Prior exposure to endemic coronaviruses, common in young children, may protect against…
Safety of COVID-19 Vaccination in US Children Ages 5-11 Years
Limited postauthorization safety data for the Pfizer-BioNTech coronavirus disease 2019 vaccination among children ages 5 to 11 years are available,…
Predictive Metabolomic Markers in Early to Mid-Pregnancy for Gestational Diabetes: A Prospective Test and Validation Study
Gestational diabetes mellitus (GDM) predisposes pregnant individuals to perinatal complications and long-term diabetes and cardiovascular diseases. We developed and validated…
Adults hospitalized with breakthrough COVID-19 have lower mortality than matched unvaccinated adults
Coronavirus disease 2019 (COVID-19) breakthrough infections are common. Evaluate in-hospital mortality of patients with COVID-19 by vaccination status using retrospective…
Myocarditis and/or pericarditis risk after mRNA COVID-19 vaccination: A Canadian head to head comparison of BNT162b2 and mRNA-1273 vaccines
Canadian and international data suggest the risk of myocarditis and/or pericarditis is elevated during the week after mRNA COVID-19 vaccination,…
Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated – VISION Network, 10 States, December 2021-June 2022
The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was first identified in the United States in November…
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial
Patients with gestational diabetes mellitus and from racial/ethnic minority groups face disproportionate risk for type 2 diabetes. Lifestyle interventions, if…
Association Between Intrauterine Device Type and Risk of Perforation and Device Expulsion: Results From the APEX-IUD Study
Intrauterine devices, including levonorgestrel-releasing and copper devices, are highly effective long-acting reversible contraceptives. The potential risks associated with intrauterine devices…
Association Between Menorrhagia and Risk of Intrauterine Device-Related Uterine Perforation and Device Expulsion: Results from the APEX-IUD Study
Intrauterine devices are effective instruments for contraception, and 1 levonorgestrel-releasing device is also indicated for the treatment of heavy menstrual…
Lessons from a mature acellular pertussis vaccination program and strategies to overcome suboptimal vaccine effectiveness
Despite high vaccination coverage among children and adolescents, pertussis remains a public health problem, with large outbreaks occurring periodically in…
Prevalence of Depression and Anxiety Disorders Following Mild Traumatic Brain Injury
Previous studies have identified an association between traumatic brain injuries and the development of psychiatric disorders in general. However, these…
A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial
Pregnant patients with overweight or obesity are at high risk for perinatal complications. Excess gestational weight gain (GWG) further exacerbates…
Risk of severe clinical outcomes among persons with SARS-CoV-2 infection with differing levels of vaccination during widespread Omicron (B.1.1.529) and Delta (B.1.617.2) variant circulation in Northern California: A retrospective cohort study
The incidence of and risk factors for severe clinical outcomes with the Omicron (B.1.1.529) SARS-CoV-2 variant have not been well-defined.…
Association of Physician Adenoma Detection Rates With Postcolonoscopy Colorectal Cancer
Although colonoscopy is frequently performed in the United States, there is limited evidence to support threshold values for physician adenoma…
Intrauterine device-related uterine perforation incidence and risk (APEX-IUD): a large multisite cohort study
Reports of perforation risk related to intrauterine devices (IUDs) inserted immediately post partum and among non-post-partum individuals are scarce, and…
Uptake of guideline-recommended postpartum diabetes screening among diverse women with gestational diabetes: associations with patient factors in an integrated health system in USA
Clinical guidelines urge timely postpartum screening for diabetes among women with gestational diabetes mellitus (GDM), yet patient factors associated with…
Effect of Electronic and Mail Outreach From Primary Care Physicians for COVID-19 Vaccination of Black and Latino Older Adults: A Randomized Clinical Trial
COVID-19 morbidity is highest in Black and Latino older adults. These racial and ethnic groups initially had lower vaccination uptake…
Trends in Cannabis Polysubstance Use During Early Pregnancy Among Patients in a Large Health Care System in Northern California
Rates of prenatal cannabis use are increasing alongside perceptions that cannabis is a harmless therapeutic for pregnancy-related ailments, while rates…
Predicting obstructive sleep apnea severity in children referred for polysomnography: use of the Pediatric Sleep Questionnaire and Subscales
This study evaluated the role of the Pediatric Sleep Questionnaire (PSQ) and associated subscales in predicting the severity of obstructive…
Risk of Cardiovascular Disease in Women With and Without Breast Cancer: The Pathways Heart Study
To examine cardiovascular disease (CVD) and mortality risk in women with breast cancer (BC) by cancer therapy received relative to…
Risk of Cardiometabolic Risk Factors in Women With and Without a History of Breast Cancer: The Pathways Heart Study
The incidence of cardiometabolic risk factors in breast cancer (BC) survivors has not been well described. Thus, we compared risk…
Exploratory analysis of novel electronic health record variables for quantification of healthcare delivery strain, prediction of mortality, and prediction of imminent discharge
To explore the relationship between novel, time-varying predictors for healthcare delivery strain (eg, counts of patient orders per hour) and…
Effect of Lifestyle Coaching or Enhanced Pharmacotherapy on Blood Pressure Control Among Black Adults With Persistent Uncontrolled Hypertension: A Cluster Randomized Clinical Trial
Greater difficulty in controlling blood pressure (BP) and adverse lifestyle practices such as higher salt intake or less physical activity…
Contribution of Maternal Cardiometabolic Risk Factors to Racial-Ethnicity Disparities in Preterm Birth Subtypes
There are recognized racial-ethnic disparities in preterm birth and in maternal cardiometabolic risk factors likely linked to systemic racism. However,…
Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons
Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential…
Perinatal Complications in Individuals in California With or Without SARS-CoV-2 Infection During Pregnancy
Additional research from population-based studies is needed to inform the treatment of SARS-CoV-2 infection during pregnancy and to provide health…
Safety of measles and pertussis-containing vaccines in children with autism spectrum disorders
To determine whether children aged 4-7 years with a diagnosis of autism spectrum disorders (ASD) were at increased risk of fever,…
Incidence of Guillain-Barré Syndrome After COVID-19 Vaccination in the Vaccine Safety Datalink
Postauthorization monitoring of vaccines in a large population may detect rare adverse events not identified in clinical trials such as…
Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction
Fine particulate matter (PM2.5) is a known risk factor for cardiovascular disease (CVD). Neighborhood walkability and greenness may also be…
Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults – VISION Network, 10 States, December 2021-March 2022
CDC recommends that all persons aged ≥18 years receive a single COVID-19 vaccine booster dose ≥2 months after receipt of…
Primary care telemedicine during the COVID-19 pandemic: patient’s choice of video versus telephone visit
The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated…
Association of teledermatology workflows with standardising co-management of rashes by primary care physicians and dermatologists
For patients with a rash, the effect of teledermatology workflow on utilization has not been defined. We compared utilization across…
Associations between infant growth and pubertal onset timing in a multiethnic prospective cohort of girls
Early puberty increases risk of adverse health conditions throughout the life course. US girls are experiencing earlier puberty without clear…
Effectiveness of COVID-19 Pfizer-BioNTech BNT162b2 mRNA Vaccination in Preventing COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Nonimmunocompromised Children and Adolescents Aged 5-17 Years – VISION Network, 10 States, April 2021-January 2022
The efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine against laboratory-confirmed COVID-19 exceeded 90% in clinical trials that included children and adolescents…
Comparison of dementia incidence and prevalence between individuals with and without HIV infection in primary care from 2000 to 2016
To compare dementia incidence and prevalence after age 50 years by HIV status. Observational cohort, 2000-2016. People with HIV (PWH)…
Breast Arterial Calcification: a Novel Cardiovascular Risk Enhancer Among Postmenopausal Women
Breast arterial calcification (BAC), a common incidental finding in mammography, has been shown to be associated with angiographic coronary artery…
Association of Glyburide and Subcutaneous Insulin With Perinatal Complications Among Women With Gestational Diabetes
Nearly 30% of individuals with gestational diabetes (GDM) do not achieve glycemic control with lifestyle modification alone and require medication…
Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups
Hypertensive disorders of pregnancy are a leading cause of severe maternal morbidity and mortality and confer 4-fold higher perinatal mortality…
Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality
The Patient Protection and Affordable Care Act eliminated cost sharing for preventive services, including colorectal cancer screening for individuals aged…
Cohort and Nested Case-Control Study of Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Recipients, by Medication
Knowledge is needed about the risk of cutaneous squamous cell carcinoma (cSCC) in solid organ transplant recipients (SOTRs) using contemporary…
Antibiotic prescribing across age groups in the Kaiser Permanente Northern California population in association with different diagnoses, and with influenza incidence, 2010-2018
There is limited information on the volume of antibiotic prescribing that is influenza-associated, resulting from influenza infections and their complications…
Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance – VISION Network, 10 States, August 2021-January 2022
CDC recommends that all persons aged ≥12 years receive a booster dose of COVID-19 mRNA vaccine ≥5 months after completion…
Impact of wildfire air pollution on rates of cardiovascular events and mortality
There is an increasing frequency of large wildfires in California. Smoke from these wildfires can drastically increase short-term exposure to…
Understanding the risk of ectopic pregnancies among people seeking abortion: a retrospective case control study
This study aims to assess the incidence of ectopic pregnancy among people wanting pregnancy compared to people seeking abortion. The…
Association of the Timing of Postpartum Intrauterine Device Insertion and Breastfeeding With Risks of Intrauterine Device Expulsion
Intrauterine device (IUD) expulsion increases the risk of unintended pregnancy; how timing of postpartum IUD insertion and breastfeeding are associated…
Self-controlled assessment of thromboembolic event (TEE) risk following intravenous immune globulin (IGIV) in the U.S. (2006-2012)
Since 2013, the U.S. Food and Drug administration (FDA) has required that intravenous immune globulin (IGIV) products carry a boxed…
Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance – VISION Network, 10 States, August 2021-January 2022
Estimates of COVID-19 mRNA vaccine effectiveness (VE) have declined in recent months (1,2) because of waning vaccine induced immunity over…
TP53 Gain-of-Function and Non-Gain-of-Function Mutations Are Differentially Associated With Sidedness-Dependent Prognosis in Metastatic Colorectal Cancer
To examine the association of gain-of-function (GOF) and non-gain-of-function (non-GOF) TP53 mutations with prognosis of metastatic right-sided (RCC) versus left-sided…
Identifying hypertensive disorders of pregnancy, a comparison of two epidemiologic definitions
Studies of hypertension in pregnancy that use electronic health care data generally identify hypertension using hospital diagnosis codes alone. We…
Maternal and neonatal outcomes of antihypertensive treatment in pregnancy: A retrospective cohort study
To compare maternal and infant outcomes with different antihypertensive medications in pregnancy. Retrospective cohort study. Kaiser Permanente, a large healthcare…
Rates of cardiovascular events among patients with moderate-to-severe atopic dermatitis in an integrated health care system: A retrospective cohort study
Patients with versus without atopic dermatitis may have a greater risk of cardiovascular events, and the risk increases with severity…
Parent-focused prevention of adolescent health risk behavior: Study protocol for a multisite cluster-randomized trial implemented in pediatric primary care
Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC)…
Ectopic Pregnancy Prevention: Further Evidence of Benefits of Prescription Contraceptives
To estimate the incidence of ectopic pregnancy (EP) associated with prescription contraceptive use. We performed a retrospective cohort study of…
Torsade de pointes: A nested case-control study in an integrated healthcare delivery system
TdP is a form of polymorphic ventricular tachycardia which develops in the setting of a prolonged QT interval. There are…
Population-based assessment of risks for severe COVID-19 disease outcomes
Among approximately 4.6 million members of Kaiser Permanente Northern California, we examined associations of severe COVID-19 with demographic factors and…
Predicting adolescent alcohol and other drug problems using electronic health records data
Alcohol and other drug (AOD) use problems may cause significant burden on affected adolescents and their families, yet treatment providers…
Comanagement of Rashes by Primary Care Providers and Dermatologists: A Retrospective Study
There is a high demand for managing skin disease, and dermatologists are in short supply. To better understand how rashes…
Cancer in people with and without hepatitis C virus infection: comparison of risk before and after introduction of direct-acting antivirals
Chronic hepatitis C virus (HCV) infection is a leading cause of liver cancer. The association of HCV infection with extrahepatic…
Hypotonic-hyporesponsive Episodes After Diphtheria, Tetanus and Acellular Pertussis Vaccination
Hypotonic-hyporesponsive episode (HHE) after whole cell pertussis vaccination is a known adverse event. Less is known about the risk of…
Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19-Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity – Nine States, January-September 2021
Previous infection with SARS-CoV-2 (the virus that causes COVID-19) or COVID-19 vaccination can provide immunity and protection from subsequent SARS-CoV-2…
Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19-Associated Hospitalizations Among Immunocompromised Adults – Nine States, January-September 2021
Immunocompromised persons, defined as those with suppressed humoral or cellular immunity resulting from health conditions or medications, account for approximately…
Treatment and Follow-up Care Associated With Patient-Scheduled Primary Care Telemedicine and In-Person Visits in a Large Integrated Health System
Telemedicine visits can offer patients convenient access to a clinician, but it is unclear whether treatment differs from that with…
Prospective validation of the Kaiser Permanente prostate cancer risk calculator in a contemporary, racially diverse, referral population
To prospectively validate a new prostate cancer risk calculator in a racially diverse population. We recently developed, internally validated and…
Surveillance for Adverse Events After COVID-19 mRNA Vaccination
Safety surveillance of vaccines against COVID-19 is critical to ensure safety, maintain trust, and inform policy. To monitor 23 serious…
Intensive lactation among women with recent gestational diabetes significantly alters the early postpartum circulating lipid profile: the SWIFT study
Women with a history of gestational diabetes mellitus (GDM) have a 7-fold higher risk of developing type 2 diabetes (T2D). It…
Effectiveness of Covid-19 Vaccines in Ambulatory and Inpatient Care Settings
There are limited data on the effectiveness of the vaccines against symptomatic coronavirus disease 2019 (Covid-19) currently authorized in the…
QT Interval Dynamics and Cardiovascular Outcomes: A Cohort Study in an Integrated Health Care Delivery System
Background Long QT has been associated with ventricular dysrhythmias, cardiovascular disease (CVD) mortality, and sudden cardiac death. However, no studies…
Hydrochlorothiazide and risk of melanoma subtypes
Hydrochlorothiazide (HCTZ), a common diuretic known to be photosensitizing and previously associated with non-melanoma skin cancer, was recently reported to…
Association of Cardiovascular Outcomes and Mortality With Sustained Long-Acting Insulin Only vs Long-Acting Plus Short-Acting Insulin Treatment
Cardiovascular events and mortality are the principal causes of excess mortality and health care costs for people with type 2…
Lifestyle-related education and counseling resource utilization and cardiovascular biomarkers in midlife women with low physical activity
Health plan-based resources are promising avenues for decreasing cardiovascular disease risk. This study examined associations of lifestyle-related resource utilization within…
Healthy preconception and early-pregnancy lifestyle and risk of preterm birth: a prospective cohort study
Preterm birth (PTB) remains a leading cause of neonatal mortality and long-term morbidity. Individual factors have been linked to PTB…
Comparison of type 2 diabetes pharmacotherapy regimens using targeted learning
This study is designed to help patients with type 2 diabetes and their clinicians identify which glucose-lowering medications among SGLT2…
COVID-19 Vaccination Coverage Among Insured Persons Aged ≥16 Years, by Race/Ethnicity and Other Selected Characteristics – Eight Integrated Health Care Organizations, United States, December 14, 2020-May 15, 2021
COVID-19 vaccination is critical to ending the COVID-19 pandemic. Members of minority racial and ethnic groups have experienced disproportionate COVID-19-associated…
Particulate Matter and Cardiovascular Risk in Adults with Chronic Obstructive Pulmonary Disease
Rationale: People with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular disease and may be more susceptible…
Mediating Effects of Cardiometabolic Risk Factors on the Association Between Maternal Race-Ethnicity and Cesarean Delivery Among Low-Risk Women
Background: While racial-ethnic disparities in cesarean delivery rates among nulliparous women delivering a term singleton in the vertex position (NTSV)…
Separating Algorithms from Questions and Causal Inference with Unmeasured Exposures: An Application to Birth Cohort Studies of Early BMI Rebound
Observational studies reporting on adjusted associations between childhood body mass index (BMI; weight (kg)/height (m)2) rebound and subsequent cardiometabolic outcomes…
Visual Outcomes After Cataract Surgery: Topical NSAID Prophylaxis Compared with Prednisolone
To compare visual outcomes in patients without a history of macular edema after phacoemulsification using combination topical nonsteroidal anti-inflammatory drug…
Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California
The role of spousal education on dementia risk and how it may differ by gender or race/ethnicity is unknown. This…
Association of Type 1 Diabetes and Hypoglycemic and Hyperglycemic Events and Risk of Dementia
To determine whether severe hypoglycemic and hyperglycemic events are associated with longitudinal dementia risk in older adults with type 1…
A prognostic information system for real-time personalized care: Lessons for embedded researchers
Embedded researchers could play a central role in developing tools to personalize care using electronic medical records (EMRs). However, few…
Racial Disparities in COVID-19 Testing and Outcomes : Retrospective Cohort Study in an Integrated Health System
Racial disparities exist in outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To evaluate the contribution of race/ethnicity…
Design of the Association of Uterine Perforation and Expulsion of IUD (APEX-IUD) Study: A Multisite Retrospective Cohort Study
Intrauterine devices are effective and safe, long-acting reversible contraceptives, but the risk of uterine perforation occurs with an estimated incidence…
Timing of Antiretroviral Therapy Initiation and Risk of Cancer among Persons Living with HIV
Persons living with human immunodeficiency virus (HIV; PLWH) experience a high burden of cancer. It remains unknown which cancer types…
Particulate Air Pollution and Risk of Cardiovascular Events Among Adults With a History of Stroke or Acute Myocardial Infarction
Background Previous studies have found associations between fine particulate matter
The Association of Lactation Duration with Visceral and Pericardial Fat Volumes in Parous Women: the CARDIA Study
Lactation is associated with lower risks for cardiovascular disease in women. Organ-related adiposity, which plays significant roles in the development…
Ten-Year Follow-up of Persons With Sun-Damaged Skin Associated With Subsequent Development of Cutaneous Squamous Cell Carcinoma
Risk of cutaneous squamous cell carcinoma (cSCC) after the diagnosis of actinic keratosis (AK) has not been studied during long…
Intraocular Pressure Reduction After Phacoemulsification: A Matched Cohort Study
Phacoemulsification has been linked to lowered intraocular pressure (IOP) in patients with glaucoma, ocular hypertension, anatomic narrow angles, and in…
Comparison of dementia risk after age 50 between individuals with and without HIV infection
To compare risk of dementia after age 50 by HIV status among individuals in a primary care setting. Observational cohort…
Patterns and Factors Associated With Adherence to Lung Cancer Screening in Diverse Practice Settings
For lung cancer screening to confer mortality benefit, adherence to annual screening with low-dose computed tomography scans is essential. Although…
Clustering of Social and Physical Pain Variables and Their Association With Mortality in Two Population-Based Cohorts
Social pain and physical pain are related bidirectionally, but how these variables cluster in the population is unknown. This study…
Dual trajectories of physical activity and blood lipids in midlife women: The Study of Women’s Health Across the Nation
Physical activity (PA) has the potential to attenuate cardiovascular disease risk in midlife women through multiple pathways, including improving lipid…
mHealth Mindfulness Intervention for Women with Moderate-to-Moderately-Severe Antenatal Depressive Symptoms: a Pilot Study Within an Integrated Health Care System
Traditional mindfulness-based interventions have been shown to reduce depression symptoms in pregnant women, although in-person classes may pose significant accessibility…
A Risk Score to Predict Clostridioides difficile Infection
Clostridioides difficile infection (CDI) is a major cause of severe diarrhea. In this retrospective study, we identified CDI risk factors…
Gestational weight gain and adverse pregnancy outcomes by pre-pregnancy BMI category in women with chronic hypertension: A cohort study
It is important to understand relationships of gestational weight gain with adverse pregnancy outcomes in women with chronic hypertension, given…
Metalworking Fluids and Colon Cancer Risk: Longitudinal Targeted Minimum Loss-based Estimation
Metalworking fluids (MWFs) are a class of complex mixtures of chemicals and oils, including several known carcinogens that may pose…
Cross-cancer evaluation of polygenic risk scores for 16 cancer types in two large cohorts
Even distinct cancer types share biological hallmarks. Here, we investigate polygenic risk score (PRS)-specific pleiotropy across 16 cancers in European…
Development and Implementation of Evidence-based Risk Stratification Tools for Diabetic Retinopathy Screening and Population Management
This project aims to develop and implement evidence-based risk stratification tools for diabetic retinopathy screening and population management.
The relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system
Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination.…
Recruitment strategies and design considerations in a trial of resistance training to prevent dose-limiting toxicities in colon cancer patients undergoing chemotherapy
Low muscle is associated with an increased risk of chemotherapy-related dose limiting toxicities (DLT) in cancer patients. Resistance training (RT)…
Exercise During the First Trimester of Pregnancy and the Risks of Abnormal Screening and Gestational Diabetes Mellitus
To estimate the effects of exercise during the first trimester on the risks of abnormal screening and gestational diabetes mellitus…
PREDICTION OF OBSTETRIC AND FETAL COMPLICATIONS USING AUTOMATED ELECTRONIC HEALTH RECORD DATA
An increasing number of delivering women experience major morbidity and mortality. Limited work has been done on automated predictive models…
Fitting a shared frailty illness-death model to left-truncated semi-competing risks data to examine the impact of education level on incident dementia
Semi-competing risks arise when interest lies in the time-to-event for some non-terminal event, the observation of which is subject to…
Long-Term PM2.5 Exposure and Risks of Ischemic Heart Disease and Stroke Events: Review and Meta-Analysis
Background Fine particulate matter
Incidence and predictors of type 1 diabetes among younger adults aged 20-45 years: The diabetes in young adults (DiYA) study
To estimate incidence of type 1 diabetes (T1D) and to develop a T1D prediction model among young adults. Adults 20-45 years…
A Randomized Encouragement Trial to Increase Mail Order Pharmacy Use and Medication Adherence in Patients with Diabetes
Mail order pharmacy (MOP) use has been linked to improved medication adherence and health outcomes among patients with diabetes. However,…
Maternal immune response and air pollution exposure during pregnancy: insights from the Early Markers for Autism (EMA) study
Perinatal exposure to air pollution and immune system dysregulation are two factors consistently associated with autism spectrum disorders (ASD) and…
Risk of complete atypical femur fracture with Oral bisphosphonate exposure beyond three years
Bisphosphonate (BP) therapy has been associated with atypical femur fracture (AFF). However, the threshold of treatment duration leading to increased…
Development and Validation of Machine Learning Models: Electronic Health Record Data To Predict Visual Acuity After Cataract Surgery
To develop predictive models of final corrected distance visual acuity (CDVA) following cataract surgery using machine learning algorithms and electronic…
Validation Study of Kaiser Permanente Bedside Dysphagia Screening Tool in Acute Stroke Patients
Dysphagia occurs in up to 50% of patients with acute stroke symptoms, resulting in increased aspiration pneumonia rates and mortality.…
Bisphosphonate Treatment Beyond 5 Years and Hip Fracture Risk in Older Women
Clinical trials have demonstrated the antifracture efficacy of bisphosphonate drugs for the first 3 to 5 years of therapy. However,…
Associations between spousal caregiving and health among older adults in Mexico: A targeted estimation approach
To evaluate associations between spousal caregiving and mental and physical health among older adults in Mexico. Data come from the…
Health System-Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically-Matched Participants With and Without HIV
Unhealthy alcohol use among persons living with HIV (PLWH) is linked to significant morbidity, and use of alcohol services may…
Association of Valproic Acid Use, a Potent Histone Deacetylase Inhibitor, and Melanoma Risk
Histone deacetylase inhibitors, including valproic acid, selectively induce cellular differentiation and apoptosis in melanoma cells. No published pharmacoepidemiologic studies have…
Identifying Ectopic Pregnancy in a Large Integrated Health Care Delivery System: Algorithm Validation
Surveillance of ectopic pregnancy (EP) using electronic databases is important. To our knowledge, no published study has assessed the validity…
A Mobile Health Mindfulness Intervention for Women With Moderate to Moderately Severe Postpartum Depressive Symptoms: Feasibility Study
Approximately 20% of women suffer from postpartum depression (PPD). Due to barriers such as limited access to care, half of…
Individual and Neighborhood Factors Associated with Failure to Vaccinate against Influenza during Pregnancy
Uptake of influenza vaccine among pregnant women remains low. We investigated whether unvaccinated pregnant women were clustered geographically and determined…
Presentation of Rash in a Community-Based Health System
Coordination of care between primary care providers and dermatologists is important to ensure high quality and cost efficiency. In our…
Changing Provider PSA Screening Behavior Using Best Practice Advisories: Interventional Study in a Multispecialty Group Practice
Most guidelines recommend against PSA-based screening for prostate cancer in men ≥ 70 years of age. Adherence to these guidelines…
Bone Mineral Density in Older U.S. Filipino, Chinese, Japanese, and White Women
Bone mineral density (BMD) reference data exist for U.S. White, Black, and Hispanic (Mexican American) populations but not for U.S.…
Consequences of depletion of susceptibles for hazard ratio estimators based on propensity scores
We use simulated data to examine the consequences of depletion of susceptibles for hazard ratio (HR) estimators based on a…
Early Screening of African Americans (45-50 Years Old) in a Fecal Immunochemical Test-based Colorectal Cancer Screening Program
Some guidelines recommend starting colorectal cancer (CRC) screening before age 50 years for African Americans, but there are few data…
Prospective development of a prostate cancer risk calculator in a racially diverse population: The Kaiser Permanente Prostate Cancer Risk Calculator
To prospectively develop a prostate cancer (CaP) risk calculator in a racially diverse population. All patients referred for prostate biopsy…
Standardized reporting and management of suspicious findings on chest computed tomography is associated with improved lung cancer diagnosis in an observational study
Follow-up of chest CT scan findings suspicious for lung cancer may be delayed because of inadequate documentation. Standardized reporting and…
Early life household intactness and timing of pubertal onset in girls: a prospective cohort study
Girls who experience early-life familial stress may have heightened risk of early puberty, which has adverse implications for adolescent and…
Identification of 31 loci for mammographic density phenotypes and their associations with breast cancer risk
Mammographic density (MD) phenotypes are strongly associated with breast cancer risk and highly heritable. In this GWAS meta-analysis of 24,192…
Inpatient-outpatient shared electronic health records: telemedicine and laboratory follow-up after hospital discharge
Continuity of patient information across settings can improve transitions after hospital discharge, but outpatient clinicians often have limited access to…
Gestational weight gain, birthweight and early-childhood obesity: between- and within-family comparisons
Associations of excessive gestational weight gain (GWG) with greater birthweight and childhood obesity may be confounded by shared familial environment…
Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery
Given the risks of postoperative morbidity and its consequent economic burden and impairment to patients undergoing colon resection, evaluating risk…
Determining Which of Several Simultaneously Administered Vaccines Increase Risk of an Adverse Event
Childhood immunization schedules often involve multiple vaccinations per visit. When increased risk of an adverse event is observed after simultaneous…
Feasibility of Measuring Preferences for Chemotherapy Among Early-Stage Breast Cancer Survivors Using a Direct Rank Ordering Multicriteria Decision Analysis Versus a Time Trade-Off
Chemotherapy is increasingly a preference-based choice among women diagnosed with early-stage breast cancer. Multicriteria decision analysis (MCDA) is a promising…
History of Early Childhood Infections and Acute Lymphoblastic Leukemia Risk Among Children in a U.S. Integrated Health Care System
Surrogate measures of infectious exposures have been consistently associated with lower childhood acute lymphoblastic leukemia (ALL) risk. However, recent reports…
Pilot pragmatic randomized trial of mHealth mindfulness-based intervention for advanced cancer patients and their informal caregivers
Assess the feasibility of conducting a cluster randomized trial (RCT) comparing technology-delivered mindfulness-based intervention (MBI) programs against a waitlist control…
Pan-cancer study detects genetic risk variants and shared genetic basis in two large cohorts
Deciphering the shared genetic basis of distinct cancers has the potential to elucidate carcinogenic mechanisms and inform broadly applicable risk…
Trends and correlates of self-reported alcohol and nicotine use among women before and during pregnancy, 2009-2017
To examine trends and correlates of frequency of self-reported alcohol and nicotine use among pregnant women. Cross-sectional study of 363,240…
Variation in physician-directed immunohistochemistry screening among women with endometrial cancer
Immunohistochemistry screening is a reliable method for identifying women with endometrial cancer who are at risk for Lynch syndrome, but…
Evaluation of a Vaccine-Communication Tool for Physicians
To evaluate a Kaiser Permanente Northern California physician training tool entitled "Effective Communication without Confrontation" aimed at improving communication with…
Smoking and cessation treatment among persons with and without HIV in a U.S. integrated health system
Persons with HIV (PWH) are more likely to smoke and are more susceptible to the harmful effects of smoking than…
Increased Risk of Colorectal Cancer in Individuals With a History of Serrated Polyps
Serrated polyp (SPs) are precursors to 20% to 30% of cases of colorectal tumors, but patients' long-term risk after removal…
Leveraging Machine Learning to Improve Risk Prediction for Chemotherapy Induced Neuropathy
Chemotherapy-associated peripheral neuropathy (CPN) affects nearly 70% of cancer patients. An estimated 30% of cancer survivors have persistent CPN, which…
Comparison of two Lynch screening strategies in endometrial cancer in a California health system
Compare detection of Lynch syndrome in endometrial cancer between regions of a health care system with different screening strategies. A…
Cesarean Delivery and the Risk of Atopic Dermatitis in Children
Caesarean delivery (C-section) may disrupt maternal-infant microbial transfer and alter immune system development and subsequent risk for atopic dermatitis. Investigate…
Comparison of Overall and Comorbidity-Free Life Expectancy Between Insured Adults With and Without HIV Infection, 2000-2016
Antiretroviral therapy (ART) has improved life expectancy for individuals with HIV infection, but recent data comparing life span and comorbidity-free…
Association of Azithromycin Use With Cardiovascular Mortality
Azithromycin is one of the most commonly prescribed antibiotics in the US. It has been associated with an increased risk…
Patient Characteristics Associated With Choosing a Telemedicine Visit vs Office Visit With the Same Primary Care Clinicians
Video or telephone telemedicine can offer patients access to a clinician without arranging for transportation or spending time in a…
A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial
Excess gestational weight gain (GWG) among women with overweight or obesity synergistically increases their already elevated risk of having gestational…
Prenatal Depression and Diet Quality During Pregnancy
Maternal nutrition during pregnancy has a significant effect on the health of the offspring and mother, highlighting the need for…
Time-to-event analysis when the event is defined on a finite time interval
Acute graft-versus-host disease (GVHD) is a frequent complication following hematopoietic cell transplantation (HCT). Research on risk factors for acute GVHD…
Inverse probability weighted Cox model in multi-site studies without sharing individual-level data
The inverse probability weighted Cox proportional hazards model can be used to estimate the marginal hazard ratio. In multi-site studies,…
Comparative Effectiveness of 2 Diabetes Prevention Lifestyle Programs in the Workplace: The City and County of San Francisco Diabetes Prevention Trial
Data on the comparative effectiveness of Diabetes Prevention Programs (DPPs) in the workplace are limited. Between September 2015 and July…
Additive effects of blood donor smoking and gamma irradiation on outcome measures of red blood cell transfusion
Recent publications have reported conflicting results regarding the role of blood donor tobacco use on hemoglobin (Hb) levels in patients…
Proton Pump Inhibitor Use and Risk of Gastric, Colorectal, Liver, and Pancreatic Cancers in a Community-Based Population
Proton pump inhibitors (PPIs) are commonly used for gastrointestinal disorders; given they increase the systemic levels of gastrin, a trophic…
Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes
The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a…
Alcohol and tobacco use in relation to mammographic density in 23,456 women
Percent density (PD) is a strong risk factor for breast cancer that is potentially modifiable by lifestyle factors. PD is…
Prediction of Occult Uterine Sarcoma prior to Hysterectomy for Women with Leiomyoma or Abnormal Bleeding
To develop a risk prediction model for occult uterine sarcoma using preoperative clinical characteristics in women undergoing hysterectomy for presumed…
Exploiting nonsystematic covariate monitoring to broaden the scope of evidence about the causal effects of adaptive treatment strategies
In studies based on electronic health records (EHR), the frequency of covariate monitoring can vary by covariate type, across patients,…
Cumulative Adherence to Secondary Prevention Guidelines and Mortality After Acute Myocardial Infarction
Background The survival benefit associated with cumulative adherence to multiple clinical and lifestyle-related guideline recommendations for secondary prevention after acute…
Depletion of Susceptibles Bias in Analyses of Intra-season Waning of Influenza Vaccine Effectiveness
Bias arises in studies of waning vaccine effectiveness when higher-risk individuals are depleted from the at-risk population at different rates…
Association of immunosuppression and HIV viremia with anal cancer risk in persons living with HIV in the United States and Canada
People living with human immunodeficiency virus (HIV; PLWH) have a markedly elevated anal cancer risk, largely due to loss of…
Long-term Risk of Colorectal Cancer and Related Death After Adenoma Removal in a Large, Community-based Population
The long-term risks of colorectal cancer (CRC) and CRC-related death following adenoma removal are uncertain. Data are needed to inform…
Risk of Mortality between Untreated and Treated Papillary Thyroid Cancer: A Matched Cohort Analysis
To examine the association between treatment status and mortality risk among patients with papillary thyroid cancer (PTC). We identified 3,679…
Exercise During the First Trimester and Infant Size at Birth: Targeted Maximum Likelihood Estimation of the Causal Risk Difference
This cohort study sought to estimate the differences in risk of delivering infants who were small or large for gestational…
Learning to learn from data: Using deep adversarial learning to construct optimal statistical procedures
Traditionally, statistical procedures have been derived via analytic calculations whose validity often relies on sample size growing to infinity. We…
Association of Mobile Patient Portal Access With Diabetes Medication Adherence and Glycemic Levels Among Adults With Diabetes
Online patient portals support self-management, and mobile devices expand portal access, but whether this translates to improvements in diabetes outcomes…
Life Expectancy of Insured People With and Without Hepatitis C Virus Infection, 2007-2017
Among 25 291 and 4 921 830 people with and without hepatitis C, life expectancy at age 20 increased 1.8…
Determinants of Oral Bisphosphonate Use Beyond 5 Years
Few studies have examined factors that determine bisphosphonate (BP) continuation beyond 5 years in clinical practice. To investigate factors associated…
Adjuvant endocrine therapy for breast cancer patients: impact of a health system outreach program to improve adherence
Reports suggest that up to 50% of women with hormone receptor-positive (HR+) breast cancer (BC) do not complete the recommended…
Body Composition, Adherence to Anthracycline and Taxane-Based Chemotherapy, and Survival After Nonmetastatic Breast Cancer
Although most chemotherapies are dosed on body surface area or weight, body composition (ie, the amount and distribution of muscle…
Comparison of Mortality and Major Cardiovascular Events Among Adults With Type 2 Diabetes Using Human vs Analogue Insulins
The comparative cardiovascular safety of analogue and human insulins in adults with type 2 diabetes who initiate insulin therapy in…
Vaccine effectiveness of cell-culture relative to egg-based inactivated influenza vaccine during the 2017-18 influenza season
There is concern that influenza vaccine effectiveness (VE) may be attenuated by passage in eggs during manufacture. We compared quadrivalent…
Identifying hypertension in pregnancy using electronic medical records: The importance of blood pressure values
To incorporate blood pressure (BP), diagnoses codes, and medication fills from electronic medical records (EMR) to identify pregnant women with…
Use of Time-Dependent Propensity Scores to Adjust Hazard Ratio Estimates in Cohort Studies with Differential Depletion of Susceptibles
Estimating hazard ratios (HR) presents challenges for propensity score (PS)-based analyses of cohorts with differential depletion of susceptibles. When the…
Outcomes of Robotic Hysterectomy for Treatment of Benign Conditions: Influence of Patient Complexity
Robotic hysterectomy may offer advantages for complex cases over the conventional laparoscopic approach. To assess the association of surgical approach…
Changes in Prostate Cancer Presentation Following the 2012 USPSTF Screening Statement: Observational Study in a Multispecialty Group Practice
In 2012, the US Preventive Services Task Force (USPSTF) recommended against PSA-based screening for prostate cancer in men of all…
Effect of Sex, Age and Positivity Threshold on Fecal Immunochemical Test Accuracy: a Systematic Review and Meta-Analysis
Quantitative fecal immunochemical tests (FITs) for hemoglobin are commonly used for colorectal cancer (CRC) screening. We aimed to quantify the…
A primer on quantitative bias analysis with positive predictive values in research using electronic health data
In health informatics, there have been concerns with reuse of electronic health data for research, including potential bias from incorrect…
Risk Estimates for Diabetes and Hypertension with Different Physical Activity Methods
To estimate risks of incident type 2 diabetes (T2D) and stage 2 and greater hypertension associated with self-reported and accelerometer-determined…
Depletion-of-susceptibles bias in influenza vaccine waning studies: how to ensure robust results
Vaccine effectiveness studies are subject to biases due to depletion-of-persons at risk of infection, or at especially high risk of…
Haloperidol and Prostate Cancer Prevention: More Epidemiologic Research Needed
The antipsychotic drug haloperidol has antiproliferative and growth-inhibiting properties on prostate cancer cell lines in vitro by binding the sigma…
Validity of Self-reported Cannabis Use Among Pregnant Females in Northern California
Most clinical and epidemiologic estimates of prenatal cannabis use are based on self-report, and the validity of self-reported cannabis use…
Association of donor age, body mass index, hemoglobin, and smoking status with in-hospital mortality and length of stay among red blood cell-transfused recipients
Recent publications have reported conflicting findings regarding associations of blood donor demographics and mortality of transfused patients. We hypothesized that…
Comparative Effectiveness Study of Face-to-Face and Teledermatology Workflows for Diagnosing Skin Cancer
The effectiveness and value of teledermatology and face-to-face workflows for diagnosing lesions are not adequately understood. We compared the risks…
Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors
Cardiovascular disease (CVD) is a major source of morbidity and mortality among breast cancer survivors. Although body mass index (BMI)…
Use of electronic health record data and machine learning to identify candidates for HIV pre-exposure prophylaxis: a modelling study
The limitations of existing HIV risk prediction tools are a barrier to implementation of pre-exposure prophylaxis (PrEP). We developed and…
Effect of donor, component and recipient characteristics on hemoglobin increments following red blood cell transfusion
Significant research has focused individually on blood donors, product preparation and storage, and optimal transfusion practice. To better understand the…
Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery: A Quality Improvement Initiative
To evaluate implementation of an enhanced recovery after surgery (ERAS) program for patients undergoing elective cesarean delivery by comparing opioid…
Depot Medroxyprogesterone Acetate, Oral Contraceptive, Intrauterine Device Use, and Fracture Risk
To assess fracture risk among women with depot medroxyprogesterone acetate (DMPA), oral contraceptive pill (OCP), and intrauterine device (IUD) use.…
Pre- and Early Pregnancy Onset Depression and Subsequent Rate of Gestational Weight Gain
Background:Depression is associated with weight change outside of pregnancy. We assessed associations of prepregnancy or early pregnancy onset depression with…
Long-term effectiveness of zoster vaccine live for postherpetic neuralgia prevention
Postherpetic neuralgia (PHN) occurs in 5-30% of individuals with herpes zoster (HZ) and is characterized by long-lasting pain. Zoster vaccine…
Breastfeeding and timing of pubertal onset in girls: a multiethnic population-based prospective cohort study
Early puberty is associated with higher risk of adverse health and behavioral outcomes throughout adolescence and adulthood. US girls are…
Targeted learning with daily EHR data
Electronic health records (EHR) data provide a cost- and time-effective opportunity to conduct cohort studies of the effects of multiple…
Self-reported Daily, Weekly, and Monthly Cannabis Use Among Women Before and During Pregnancy
As the overall prevalence of prenatal cannabis use rises, it is vital to also monitor trends in the frequency of…
Acellular Pertussis Vaccine Effectiveness Over Time
To determine pertussis risk by diphtheria-tetanus-acellular pertussis (DTaP) vaccination status and time since last DTaP dose. Children born at Kaiser…
Colorectal Cancer Screening in People With and Without HIV in an Integrated Health Care Setting
As people with HIV (PWH) live longer, age-appropriate colorectal cancer (CRC) screening is increasingly important. Limited data exist on CRC…
Stressors in Midlife and Risk of Dementia: The Role of Race and Education
Posttraumatic stress disorder is associated with increased dementia risk but less is known about stress because of everyday problems in…
A Randomized Study of Values Affirmation to Promote Interest in Diabetes Prevention Among Women With a History of Gestational Diabetes
The objective of this study was to test whether 2 interventions promote interest in diabetes prevention among women with a…
Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients
Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting. To study associations…
Telomere length and socioeconomic status at neighborhood and individual levels among 80,000 adults in the Genetic Epidemiology Research on Adult Health and Aging cohort
Telomere length (TL) may serve as a biologic marker of aging. We examined neighborhood and individual-level socioeconomic status (SES) in…
Reproductive Factors and Mammographic Density: Associations Among 24,840 Women and Comparison of Studies Using Digitized Film-Screen Mammography and Full-Field Digital Mammography
Breast density is a modifiable factor that is strongly associated with breast cancer risk. We sought to understand the influence…
SemiCompRisks: An R Package for the Analysis of Independent and Cluster-correlated Semi-competing Risks Data
Semi-competing risks refer to the setting where primary scientific interest lies in estimation and inference with respect to a non-terminal…
Using Pharmacy Data and Adherence to Define Long-Term Bisphosphonate Exposure in Women
Assigning drug exposure is a necessary first step in examining bisphosphonate (BP) treatment in observational studies using pharmacy data. To…
Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer
Previous studies of breast cancer survival have not considered specific depots of adipose tissue such as subcutaneous adipose tissue (SAT)…
Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial
Most patients with diabetes do not meet all evidence-based goals of care, and many patients report poor communication and lack…
Evaluation of Complex Interventions on Drug (Re)Fill Behavior Using Electronic Health Care Data
This study develops generalized per-protocol analyses based on Inverse Probability Weighting and Targeted Learning to control for or evaluate the…
Hepatitis C treatment uptake and response among human immunodeficiency virus/hepatitis C virus-coinfected patients in a large integrated healthcare system.
U.S. guidelines recommend that patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) be prioritized for HCV…
Intra-season Waning of Influenza Vaccine Effectiveness
In the United States, it is recommended that healthcare providers offer influenza vaccination by October, if possible. However, if the…
Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus
Infant temperament is associated with excess weight gain or childhood obesity risk in samples of healthy individuals, although the evidence…
Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity
Excess gestational weight gain (GWG) is common among women with overweight or obesity, increasing their risks for pregnancy complications, delivering…
Reproductive period and risk of dementia in a diverse cohort of health care members
Women have >50% greater lifetime risk of dementia than men but the role of female-specific endocrine milieu is not well-understood.…
Association of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study
Research is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer…
Incidence of dementia after age 90 in a multiracial cohort
Little is known about dementia incidence in diverse populations of oldest-old, the age group with highest dementia incidence. Incident dementia…
Visual outcomes after cataract surgery in patients with type 2 diabetes
To assess the relation between diabetic retinopathy (DR) severity, duration of diabetes, insulin dependence, and preoperative hemoglobin A1c (HbA1c) with…
Privacy-Protecting Analytical Methods Using Only Aggregate-Level Information to Conduct Multivariable-Adjusted Analysis in Distributed Data Networks
Distributed data networks enable large-scale epidemiologic studies, but protecting privacy while adequately adjusting for a large number of covariates continues…
Comparative effectiveness of treatment of actinic keratosis with topical fluorouracil and imiquimod in the prevention of keratinocyte carcinoma: a cohort study
The effectiveness of 5-fluorouracil compared with that of imiquimod for preventing keratinocyte carcinoma is unknown. To compare the effectiveness of…
Developing a Prognostic Information System for Personalized Care in Real Time
Electronic medical records hold promise to transform clinical practice. However, technological and other barriers may preclude using them to guide…
Study of Healthy Aging in African Americans (STAR)
Rates of dementia and Alzheimer’s disease are 40% to 100% higher among African Americans compared to non-Hispanic whites. STAR is a…
Study of Longevity in Diabetes (SOLID)
Type 1 diabetes is a complicated disease requiring constant adherence to glycemic targets and meticulous attention and vigilance of blood…
Kaiser Healthy Aging and Diverse Life Experiences Study (KHANDLE)
Although there are marked ethnic disparities in rates of dementia, almost nothing is known about early-life contributors to dementia in…
Life After 90
Alzheimer’s disease and other dementias affect 15 percent of those aged 65 and older, by age 90 and older this…
Maternal Gestational Weight Gain, Obesity, and the Timing of Pubertal Onset in Daughters
Early puberty is associated with adverse health outcomes, but little is known regarding early life determinants influencing pubertal timing. We…
The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer
Sarcopenia and low skeletal muscle radiodensity (SMD) have been associated with adverse outcomes in patients with colorectal cancer (CRC); however,…
Trends in marijuana use among pregnant women with and without nausea and vomiting in pregnancy, 2009-2016
Cross-sectional studies indicate an elevated prevalence of prenatal marijuana use in women with nausea and vomiting in pregnancy (NVP). However,…
Lifecourse Health, Cerebral Pathology, and Ethnic Disparities in Dementia
Although there are marked ethnic disparities in rates of dementia, almost nothing is known about early-life contributors to dementia in…
Use of three summary measures of pediatric vaccination for studying the safety of the childhood immunization schedule
Summary measures such as number of vaccine antigens, number of vaccines, and vaccine aluminum exposure by the 2nd birth day…
The Be-Well Study: a prospective cohort study of lifestyle and genetic factors to reduce the risk of recurrence and progression of non-muscle-invasive bladder cancer
Bladder cancer is one of the top five cancers diagnosed in the U.S. with a high recurrence rate, and also…
Long-term Risk of Colorectal Cancer and Related Deaths After a Colonoscopy With Normal Findings
Guidelines recommend a 10-year rescreening interval after a colonoscopy with normal findings (negative colonoscopy results), but evidence supporting this recommendation…
Long-Term Outcomes Among Patients Discharged From the Hospital With Moderate Anemia: A Retrospective Cohort Study
Randomized clinical trial findings support decreased red blood cell (RBC) transfusion and short-term tolerance of in-hospital anemia. However, long-term outcomes…
Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal
For patients with diabetes, many with multiple complex chronic conditions, using a patient portal can support self-management and coordination of…
Potential Effects Of Eliminating The Individual Mandate Penalty In California
The tax penalty for noncompliance with the Affordable Care Act's individual mandate is to be eliminated starting in 2019. We…
Kidney function, proteinuria and breast arterial calcification in women without clinical cardiovascular disease: The MINERVA study
Breast arterial calcification (BAC) may be a predictor of cardiovascular events and is highly prevalent in persons with end-stage kidney…
Shake Rattle & Roll – Design and rationale for a pragmatic trial to improve blood pressure control among blacks with persistent hypertension
In Kaiser Permanente Northern California (KPNC), members had similar access to care and a very high overall rate of hypertension…
Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial
To evaluate the effectiveness of automated symptom and side effect monitoring on quality of life among individuals with symptomatic diabetic…
Recurrence after hospitalization for acute coronary syndrome among HIV-infected and HIV-uninfected individuals
We evaluated the association of HIV infection and immunodeficiency with acute coronary syndrome (ACS) recurrence, and with all-cause mortality as…
Index colonoscopy-related risk factors for postcolonoscopy colorectal cancers
Postcolonoscopy colorectal cancers (PCCRCs) are defined as those detected ≤10 years after an index colonoscopy negative for cancer, but modifiable risk…
Birth in High Infant Mortality States and Dementia Risk in a Cohort of Elderly African American and White Health Care Members
Birth in areas with high infant mortality rates (IMRs) has been linked to worse long-term health outcomes, yet it is…
Particulate Air Pollution, Cardiovascular Events, and Susceptibility Factors (PACES)
This is a retrospective cohort study of 5 million adult members of Kaiser Permanente Northern California during 2000 to 2012,…
Study on the Association of Uterine Perforation and IUD expulsion With Breastfeeding Status at the Time of IUD insertion and Postpartum Timing of IUD Insertion in Electronic Medical Record Databases – A Post-marketing Requirement for Mirena
The Food and Drug Administration (FDA) has required Bayer AG to conduct a post-marketing study in the U.S. to determine…
Patterns of medication adherence in a multi-ethnic cohort of prevalent statin users diagnosed with breast, prostate, or colorectal cancer
To investigate the implications of a cancer diagnosis on medication adherence for pre-existing comorbid conditions, we explored statin adherence patterns…
Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study
To examine the prevalence and person-level predictors of undiagnosed Type 2 diabetes among adults with elevated HbA1c values. We identified…
Central Obesity Increases the Risk of Gestational Diabetes Partially Through Increasing Insulin Resistance
This study examined the associations of central obesity measures, waist to hip ratio (WHR) and waist circumference (WC), in early…
Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members
To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage…
Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large, Community-based Population
Little information is available on the effectiveness of organized colorectal cancer (CRC) screening on screening uptake, incidence, and mortality in…
Association of raltegravir use with long-term health outcomes in HIV-infected patients: an observational post-licensure safety study in a large integrated healthcare system
Raltegravir became the first integrase inhibitor to gain FDA approval; but with limited evidence documenting long-term risks in real world…
A Pre-Pregnancy Biomarker Risk Score Improves Prediction of Future Gestational Diabetes
Previous studies have not examined the ability of multiple preconception biomarkers, considered together, to improve prediction of gestational diabetes mellitus…
Adverse Selection into and within the Individual Health Insurance Market in California in 2014
The Affordable Care Act (ACA) introduced reforms to mitigate adverse selection into and within the individual insurance market. We examined…
Early Midlife Pulmonary Function and Dementia Risk
Poor pulmonary function (PPF) is associated with increased risk of dementia, yet it is unclear if PPF in early adulthood…
Traumatic brain injury associated with dementia risk among people with type 1 diabetes
To examine the association between traumatic brain injury (TBI) and dementia risk among a cohort of middle-aged and elderly individuals…
Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes
Individuals with type 1 diabetes have experienced an increase in life expectancy; yet, it is unknown what level of glycemic…
Comparison of privacy-protecting analytic and data-sharing methods: A simulation study
Privacy-protecting analytic and data-sharing methods that minimize the disclosure risk of sensitive information are increasingly important due to the growing…
Use of non-steroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage
Nonsteroidal antiinflammatory drugs are among the medications most widely used by pregnant women, and previous studies have reported an increased…
Cutaneous Melanoma Risk among People with HIV in the United States and Canada
Cutaneous melanoma incidence may be modestly elevated in people with HIV (PWH) vs. people without HIV. However, little is known…
Relative Performance of Propensity Score Matching Strategies for Subgroup Analyses
Postapproval drug safety studies often use propensity scores (PSs) to adjust for a large number of baseline confounders. These studies…
Disparities in Initiation of Direct-Acting Antiviral Agents for Hepatitis C Virus Infection in an Insured Population
The cost of direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection may contribute to treatment disparities. However, few…
Associations Between Maternal Obesity and Pregnancy Hyperglycemia and Timing of Pubertal Onset in Adolescent Girls: A Population-Based Study
Early puberty is associated with adverse health outcomes. We investigated whether in utero exposure to maternal obesity is associated with…
Association of Muscle and Adiposity Measured by Computed Tomography With Survival in Patients With Nonmetastatic Breast Cancer
Sarcopenia (low muscle mass), poor muscle quality (low muscle radiodensity), and excess adiposity derived from computed tomography (CT) has been…
High-resolution mapping of traffic related air pollution with Google street view cars and incidence of cardiovascular events within neighborhoods in Oakland, CA
Some studies have linked long-term exposure to traffic related air pollutants (TRAP) with adverse cardiovascular health outcomes; however, previous studies…
A Cohort Study of Metformin and Colorectal Cancer Risk among Patients with Diabetes Mellitus
Background: Several epidemiologic studies have reported strong inverse associations between metformin use and risk of colorectal cancer, although time-related biases,…
Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings
In recent years, rates of vaccination have been declining. Whether this phenomenon disproportionately affects children with autism spectrum disorder (ASD)…
Prospective surveillance pilot of rivaroxaban safety within the US Food and Drug Administration Sentinel System
The US Food and Drug Administration's Sentinel system developed tools for sequential surveillance. In patients with non-valvular atrial fibrillation, we…
Methods for addressing “innocent bystanders” when evaluating safety of concomitant vaccines
The need to develop methods for studying the safety of childhood immunization schedules has been recognized by the Institute of…
Bias from outcome misclassification in immunization schedule safety research
The Institute of Medicine recommended conducting observational studies of childhood immunization schedule safety. Such studies could be biased by outcome…
Liver Enzymes in Early to Mid-pregnancy, Insulin Resistance, and Gestational Diabetes Risk: A Longitudinal Analysis
Background: Liver enzymes may be implicated in glucose homeostasis; liver enzymes progressively change during pregnancy but longitudinal data during pregnancy…
An Observational Study of Cardiovascular Risks Associated with Rheumatoid Arthritis Therapies: A Comparison of Two Analytical Approaches
Comparative safety studies typically use hierarchical treatment categories that lump monotherapy and combination therapy. The consequence of this approach on…
A cohort study of maternal cardiometabolic risk factors and primary cesarean delivery in an integrated health system
Maternal cardiometabolic risk factors (i.e., hyperglycemia, pre-existing hypertension and high body mass index) impact fetal growth and risk of having…
Prospective Postmarketing Surveillance of Acute Myocardial Infarction in New Users of Saxagliptin: A Population-Based Study
The cardiovascular safety of saxagliptin, a dipeptidyl-peptidase 4 inhibitor, compared with other antihyperglycemic treatments is not well understood. We prospectively…
A real-world, community-based cohort study comparing the effectiveness of topical fluoruracil vs. topical imiquimod for the treatment of actinic keratosis
The most widely used topical agents for the field-based treatment of multiple actinic keratoses (AKs) are 5-fluorouracil and imiquimod, but…
Exposure to Magnetic Field Non-Ionizing Radiation and the Risk of Miscarriage: A Prospective Cohort Study
Magnetic field (MF) non-ionizing radiation is widespread and everyone is exposed to some degree. This prospective cohort study of 913…
Disparities in Prostate, Lung, Breast, and Colorectal Cancer Survival and Comorbidity Status among Urban American Indians and Alaskan Natives
Cancer is the second leading cause of death among American Indians and Alaskan Natives (AIAN), although cancer survival information in…
A review of the performance of different methods for propensity score matched subgroup analyses and a summary of their application in peer-reviewed research studies
When evaluating safety signals, there is often interest in understanding safety in all patients for whom compared treatments are reasonable…
Serious infections among a large cohort of subjects with systemically treated psoriasis
Biologic therapy is effective for treatment of moderate-to-severe psoriasis but may be associated with an increased risk for serious infection.…
Age at menarche and late adolescent adiposity associated with mammographic density on processed digital mammograms in 24,840 women
Background: High mammographic density is strongly associated with increased breast cancer risk. Some, but not all, risk factors for breast…
Survival after dementia diagnosis in five racial/ethnic groups
Information on anticipated survival time after dementia diagnosis among racially/ethnically diverse patients is needed to plan for care and evaluate…
Estimating outcomes and cost effectiveness using a single-arm clinical trial: ofatumumab for double-refractory chronic lymphocytic leukemia.
BACKGROUND:Ofatumumab (Arzerra®, Novartis) is a treatment for chronic lymphocytic leukemia refractory to fludarabine and alemtuzumab [double refractory (DR-CLL)]. Ofatumumab was…
Malignancy rates in a large cohort of patients with systemically treated psoriasis in a managed care population
Moderate to severe psoriasis often requires treatment with systemic agents, many of which have immunosuppressive properties and could increase cancer…
Association of Testosterone Replacement With Cardiovascular Outcomes Among Men With Androgen Deficiency
Controversy exists regarding the safety of testosterone replacement therapy (TRT) following recent reports of an increased risk of adverse cardiovascular…
Software to Automate Implementation of Causal Inference Methods with Time-Varying Interventions
This project aims to develop SAS macros to automate the data structuring required for implementation of Causal Inference methods with…
Feasibility and Performance Assessments of TMLE and hdPS Methodologies to Fit MSM in a Real-World CER Study
This study aims to evaluate the practicability and practical advantages of: 1) Targeted Minimum Loss based Estimation (TMLE), and 2)…
Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN)
Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health…
Identification of the joint effect of a dynamic treatment intervention and a stochastic monitoring intervention under the no direct effect assumption
The management of chronic conditions is characterized by frequent re-assessment of therapy decisions in response to the patient's changing condition…
Proton Pump Inhibitor and Histamine-2 Receptor Antagonist Use and Iron Deficiency
Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) suppress gastric acid production, which can inhibit iron absorption. However, few…
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes
To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women…
Supporting Better Choices in California’s Individual Market
Assess "adverse selection" in California's Individual Health Insurance Market by surveying samples of individuals who go online to Covered California…
Privacy-Preserving Analytic and Data-Sharing Methods for Clinical and Patient-Powered Data Network
Develop privacy-protecting analytic tools for PCOR networks to perform rigorous analyses without sharing potentially identifiable patient-level information. Assess benefits of,…
Risk of Uterine Perforation among Women Using different types of IUDs and the Association with Timing of Insertion and Breastfeeding
The goal of the study is to compare the incidence of uterine perforation within 12 months after IUD insertion between:…
Screening Mammography for Free: Impact of Eliminating Cost Sharing on Cancer Screening Rates
To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA)…
simcausal R Package: Conducting Transparent and Reproducible Simulation Studies of Causal Effect Estimation with Complex Longitudinal Data
The simcausal R package is a tool for specification and simulation of complex longitudinal data structures that are based on…
Acute demyelinating events following vaccines – a case centered analysis
Case reports have suggested that vaccines may trigger transverse myelitis (TM) or acute disseminated encephalomyelitis (ADEM), but the evidence for…
Semi-Parametric Estimation and Inference for the Mean Outcome of the Single Time-Point Intervention in a Causally Connected Population.
AbstractWe study the framework for semi-parametric estimation and statistical inference for the sample average treatment-specific mean effects in observational settings…
Invasive Pneumococcal Disease Among HIV-Infected and HIV-Uninfected Adults in a Large Integrated Healthcare System
It is unclear whether HIV-infected individuals remain at higher risk of invasive pneumococcal disease (IPD) compared with HIV-uninfected individuals. We…
Risk of cancer in Asian Americans: a Kaiser Permanente cohort study
To supplement published cohort data about incident cancer in Asian Americans (Asians) including risk of specific Asian ethnic groups. A…
Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care
It is unknown if a survival gap remains between HIV-infected and HIV-uninfected individuals with access to care. We conducted a…
Risks and Predictors of Gastric Adenocarcinoma in Patients with Gastric Intestinal Metaplasia and Dysplasia: A Population-Based Study
Gastric intestinal metaplasia and dysplasia are precursor lesions for adenocarcinoma. The risks of progression to malignancy from these lesions are…
Prevalence of childhood and adolescent overweight and obesity from 2003 to 2010 in an integrated health care delivery system
An observational study of the Kaiser Permanente Northern California (KPNC) BMI coding distributions was conducted to ascertain the trends in…
Case centered analysis of Optic Neuritis following vaccines
We evaluated the risk of optic neuritis (ON) after vaccines, using a case-centered analysis, comparing the time since vaccination for…
Pre-pregnancy adverse lipid profile and subsequent risk of gestational diabetes
Lower low-density lipoprotein (LDL) peak diameter and a predominance of small, dense LDL are associated with type 2 diabetes, but…
Risk for Hospitalized Heart Failure Among New Users of Saxagliptin, Sitagliptin, and Other Antihyperglycemic Drugs: A Retrospective Cohort Study
Recent postmarketing trials produced conflicting results about the risk for hospitalized heart failure (hHF) associated with dipeptidyl peptidase-4 (DPP-4) inhibitors,…
Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes
Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain…
Intravenous immune globulin and thromboembolic adverse events: A systematic review and meta-analysis of RCTs
Prior case reports and observational studies indicate that intravenous immune globulin (IVIg) products may cause thromboembolic events (TEEs), leading the…
A Case Study of the Impact of Data-Adaptive Versus Model-Based Estimation of the Propensity Scores on Causal Inferences from Three Inverse Probability Weighting Estimators
Consistent estimation of causal effects with inverse probability weighting estimators is known to rely on consistent estimation of propensity scores.…
Evaluation of propensity scores, disease risk scores, and regression in confounder adjustment for the safety of emerging treatment with group sequential monitoring
The objective of this study was to evaluate regression, matching, and stratification on propensity score (PS) or disease risk score…
Waning Tdap Effectiveness in Adolescents
Because the effectiveness of diphtheria-tetanus-acellular pertussis (DTaP) vaccine wanes substantially after the fifth dose at ages 4 to 6 years,…
Gene by Environment Investigation of Incident Lung Cancer Risk in African-Americans
Genome-wide association studies have identified polymorphisms linked to both smoking exposure and risk of lung cancer. The degree to which…
Adherence to Metformin, Statins, and ACE/ARBs Within the Diabetes Health Plan (DHP)
Reducing patient cost-sharing and engaging patients in disease management activities have been shown to increase uptake of evidence-based care. To…
Balancing Score Adjusted Targeted Minimum Loss-based Estimation
Adjusting for a balancing score is sufficient for bias reduction when estimating causal effects including the average treatment effect and…
Breastfeeding, PAM50 Tumor Subtype, and Breast Cancer Prognosis and Survival
Breastfeeding is associated with decreased breast cancer risk, yet associations with prognosis and survival by tumor subtype are largely unknown.…
Significant Racial Disparities Exist in Noncardia Gastric Cancer Outcomes Among Kaiser Permanente’s Patient Population
Racial and ethnic differences in gastric cancer are not well understood. This study sought to compare the clinicopathological features and…
High-dimensional propensity score algorithm in comparative effectiveness research with time-varying interventions
The high-dimensional propensity score (hdPS) algorithm was proposed for automation of confounding adjustment in problems involving large healthcare databases. It…
Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study
This study examined whether adopting a standardized prenatal substance use protocol (protocol) in a hospital labor and delivery unit reduced…
Risk of Cardiovascular Disease Associated With a Restless Legs Syndrome Diagnosis in a Retrospective Cohort Study from Kaiser Permanente Northern California
Recent cross-sectional studies suggest that restless legs syndrome (RLS) may be associated with an increased prevalence of cardiovascular disease (CVD)…
Alcohol Intake, Beverage Choice, and Cancer: A Cohort Study in a Large Kaiser Permanente Population
The authors studied incident cancer risk from 1978 to 1985 and through follow-up in 2012 relative to light-to-moderate and heavy…
Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities
Network meta-analysis is increasingly used to allow comparison of multiple treatment alternatives simultaneously, some of which may not have been…
Impact of age on clinicopathological features and survival of patients with noncardia gastric adenocarcinoma
Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors…
Higher Levels of Cystatin C Are Associated with Worse Cognitive Function in Older Adults with Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort Cognitive Study
To determine the association between cognition and levels of cystatin C in persons with chronic kidney disease (CKD). Prospective observational…
Targeted learning in real-world comparative effectiveness research with time-varying interventions
In comparative effectiveness research (CER), often the aim is to contrast survival outcomes between exposure groups defined by time-varying interventions.…
Intensive residential treatment for severe obsessive-compulsive disorder: characterizing treatment course and predictors of response.
BACKGROUND:Intensive residential treatment (IRT) is effective for severe, treatment-resistant obsessive-compulsive disorder (OCD). We sought to characterize predictors and course of…
Intrinsic subtypes from PAM50 gene expression assay in a population-based breast cancer cohort: Differences by age, race, and tumor characteristics
Data are lacking to describe gene expression-based breast cancer intrinsic subtype patterns for population-based patient groups. We studied a diverse…
Long-term outcomes among African-American and white women with breast cancer: what is the impact of comorbidity?
OBJECTIVES: We examined the association between comorbidity and long-term mortality from breast cancer and other causes among African-American and white…
A pragmatic cluster randomized clinical trial of diabetes prevention strategies for women with gestational diabetes: design and rationale of the Gestational Diabetes’ Effects on Moms (GEM) study
Women with gestational diabetes (GDM) are at high risk of developing diabetes later in life. After a GDM diagnosis, women…
Accuracy of hemoglobin A1c imputation using fasting plasma glucose in diabetes research using electronic health records data
In studies that use electronic health record data, imputation of important data elements such as Glycated hemoglobin (A1c) has become…
Prevalence and Neonatal Factors Associated with Autism Spectrum Disorders in Preterm Infants
To determine the prevalence of autism spectrum disorders (ASD) across gestational age, examine the risk of ASD by gestational age…
Do Medicare Advantage plans select enrollees in higher margin clinical categories?
The CMS-HCC risk adjustment system for Medicare Advantage (MA) plans calculates weights, which are effectively relative prices, for beneficiaries with…
Impact of Specific Glucose-Control Strategies on Microvascular and Macrovascular Outcomes in 58,000 Adults With Type 2 Diabetes
Comparative effectiveness research methods are used to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and…
Multivariable confounding adjustment in distributed data networks without sharing of patient-level data
It is increasingly necessary to analyze data from multiple sources when conducting public health safety surveillance or comparative effectiveness research.…
Socioeconomic Status and Lung Cancer: Unraveling the Contribution of Genetic Admixture
OBJECTIVES: We examined the relationship between genetic ancestry, socioeconomic status (SES), and lung cancer among African Americans and Latinos. METHODS:…
Implementation of an outpatient electronic health record and emergency department visits, hospitalizations, and office visits among patients with diabetes
IMPORTANCE: The US federal government is spending billions of dollars in physician incentives to encourage the meaningful use of electronic…
Super learning to hedge against incorrect inference from arbitrary parametric assumptions in marginal structural modeling
OBJECTIVE: Clinical trials are unlikely to ever be launched for many comparative effectiveness research (CER) questions. Inferences from hypothetical randomized…
Confounding adjustment in comparative effectiveness research conducted within distributed research networks
BACKGROUND: A distributed research network (DRN) of electronic health care databases, in which data reside behind the firewall of each…
Targeted maximum likelihood estimation in safety analysis
OBJECTIVES: To compare the performance of a targeted maximum likelihood estimator (TMLE) and a collaborative TMLE (CTMLE) to other estimators…
Adverse Clinical Events Among Medicare Beneficiaries Using Antipsychotic Drugs: Linking Health Insurance Benefits and Clinical Needs
OBJECTIVE: Medicare Part D provides formulary protections for antipsychotics but does not exempt these drugs from cost-sharing. We investigated the…
Effectiveness and Reach of the FLU-FIT Program in an Integrated Health Care System: A Multisite Randomized Trial
OBJECTIVES: We tested the effectiveness of offering home fecal immunochemical tests (FITs) during influenza vaccination clinics to increase colorectal cancer…
Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases.
BACKGROUND:Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN)…
Retinopathy and Cognitive Impairment in Adults With CKD
BACKGROUND: Retinal microvascular abnormalities have been associated with cognitive impairment, possibly serving as a marker of cerebral small-vessel disease. This…
Impact of type 2 diabetes on lower urinary tract symptoms in men: a cohort study
BACKGROUND: Studies of the impact of type 2 diabetes on the prevalence and incidence of lower urinary tract symptoms (LUTS)…
Social networks, social support, and burden in relationships, and mortality after breast cancer diagnosis in the Life After Breast Cancer Epidemiology (LACE) Study
Larger social networks have been associated with lower breast cancer mortality. The authors evaluated how levels of social support and…
Neisseria gonorrhea and Chlamydia trachomatis Screening at Intrauterine Device Insertion and Pelvic Inflammatory Disease
OBJECTIVE: To evaluate the relationship between Neisseria gonorrhea and Chlamydia trachomatis screening strategies and risk of pelvic inflammatory disease (PID)…
Patient awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery system
Breast cancer patients have voiced dissatisfaction regarding their education on breast cancer-related lymphedema risk and risk reduction strategies from their…
Cigarette Smoking Associated With Lung Adenocarcinoma In Situ in a Large Case-Control Study (SFBALCS)
INTRODUCTION:: Adenocarcinoma in situ (AIS), formerly bronchioloalveolar carcinoma, is an uncommon subtype of lung adenocarcinoma and accounts for approximately 3%…
Influence of breastfeeding during the postpartum oral glucose tolerance test on plasma glucose and insulin
OBJECTIVE: To examine the effect of breastfeeding during the postpartum oral glucose tolerance test (OGTT) on maternal blood glucose and…
Causal inference in epidemiological studies with strong confounding
One of the identifiability assumptions of causal effects defined by marginal structural model (MSM) parameters is the experimental treatment assignment…
Plasma signaling proteins in persons at genetic risk for Alzheimer disease: influence of APOE genotype.
OBJECTIVE:To study the effect of familial Alzheimer disease (FAD) mutations and APOE genotype on plasma signaling protein levels.DESIGN:Cross-sectional comparison of…
The value of additional pathology comments indicating suspicion of adenocarcinoma among women diagnosed preoperatively with complex atypical endometrial hyperplasia
Over 40% of women with a preoperative diagnosis of complex atypical hyperplasia (CAH) will have endometrial cancer at hysterectomy. CAH…
Dynamic marginal structural modeling to evaluate the comparative effectiveness of more or less aggressive treatment intensification strategies in adults with type 2 diabetes
PURPOSE: Chronic disease care typically involves treatment decisions that are frequently adjusted to the patient's evolving clinical course (e.g., hemoglobin…
Estimating sample sizes for predementia Alzheimer’s trials based on the Alzheimer’s Disease Neuroimaging Initiative
This study modeled predementia Alzheimer's disease clinical trials. Longitudinal data from cognitively normal (CN) and mild cognitive impairment (MCI) participants…
Single-institution, multidisciplinary experience with surgical resection of primary chest wall sarcomas.
INTRODUCTION:Primary chest wall sarcomas are rare mesenchymal tumors and their mainstay of therapy is wide surgical resection. We report our…
Evaluation of a Cell Phone-Based Physical Activity Diary
PURPOSE: Physical activity (PA) diaries reduce the recall error inherent in self-reported PA but are burdensome. The purpose of this…
Provision of Contraceptive Services to Women with Diabetes Mellitus
BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes.…
Clinician awareness and knowledge of breast cancer-related lymphedema in a large, integrated health care delivery setting
Breast cancer survivors have reported dissatisfaction regarding their education on risk of breast cancer-related lymphedema (BCRL) from clinicians. We describe…
Lactation Intensity and Postpartum Maternal Glucose Tolerance and Insulin Resistance in Women With Recent GDM: The SWIFT cohort
OBJECTIVE: To examine the association between breastfeeding intensity in relation to maternal blood glucose and insulin and glucose intolerance based…
Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic
Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns…
Challenges in the design and analysis of sequentially monitored postmarket safety surveillance evaluations using electronic observational health care data
PURPOSE: Many challenges arise when conducting a sequentially monitored medical product safety surveillance evaluation using observational electronic data captured during…
Design considerations in an active medical product safety monitoring system
Active medical product monitoring systems, such as the Sentinel System, will utilize electronic healthcare data captured during routine health care.…
When should case-only designs be used for safety monitoring of medical products?
PURPOSE: To assess case-only designs for surveillance with administrative databases. METHODS: We reviewed literature on two designs that are observational…
Early start: a cost-beneficial perinatal substance abuse program
OBJECTIVE: To conduct a cost-benefit analysis of Early Start, an integrated prenatal intervention program for stopping substance use in pregnancy.…
A case-control study of asphalt and tar exposure and lung cancer in minorities
OBJECTIVES: Considerable controversy surrounds the carcinogenic potential of asphalt and tar. Since minority individuals may have had relatively high historical…
Robust extraction of covariate information to improve estimation efficiency in randomized trials
In randomized trials, investigators typically rely upon an unadjusted estimate of the mean outcome within each treatment arm to draw…
A predictive model to help identify intimate partner violence based on diagnoses and phone calls
BACKGROUND: Intimate partner violence (IPV) is a significant health problem but goes largely undiagnosed, undisclosed, and clinically undocumented. PURPOSE: To…
Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab.
BACKGROUND:In a phase III trial of women with HER2+ metastatic breast cancer (MBC) previously treated with trastuzumab, an anthracycline, and…
Development of disability in chronic obstructive pulmonary disease: beyond lung function
BACKGROUND: COPD is a major cause of disability, but little is known about how disability develops in this condition. METHODS:…
Coffee, caffeine, and risk of hospitalization for arrhythmias
Context: Population study data about relations of coffee drinking to arrhythmia are sparse.Objective: To study relations of coffee drinking to…
The MCCB impairment profile for schizophrenia outpatients: results from the MATRICS psychometric and standardization study
The MATRICS Psychometric and Standardization Study was conducted as a final stage in the development of the MATRICS Consensus Cognitive…
Fixing flaws in Medicare drug coverage that prompt insurers to avoid low-income patients
Since 2006 numerous insurers have stopped serving the low-income segment of the Medicare Part D program, forcing millions of beneficiaries…
Mammographic density and risk of second breast cancer after ductal carcinoma in situ
BACKGROUND: We examined whether mammographic density predicts risk of second breast cancers among patients with ductal carcinoma in situ (DCIS).…
Fine mapping of chromosome 15q25.1 lung cancer susceptibility in African-Americans
Several genome-wide association studies identified the chr15q25.1 region, which includes three nicotinic cholinergic receptor genes (CHRNA5-B4) and the cell proliferation…
Cost-effectiveness of zoledronic acid plus endocrine therapy in premenopausal women with hormone-responsive early breast cancer.
PURPOSE:The aim of this study was to estimate the cost-effectiveness of adding zoledronic acid 4 mg intravenously every 6 months…
Availability and accuracy of medical record information on language usage of cancer patients from a multi-ethnic population
Documentation of language usage in medical settings could be effective in identifying and addressing language barriers and would improve understanding…
Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients
BACKGROUND & AIMS: Drugs that inhibit gastric acid might increase the risk of hip fracture. However, little long-term exposure data…
Ambient ozone concentrations and cardiac mortality in Southern California 1983-2000: application of a new marginal structural model approach
The authors evaluated the association between ambient ozone levels and cardiac mortality in California's South Coast Air Basin during the…
Association of prediagnostic serum vitamin D levels with the development of basal cell carcinoma
We investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels and basal cell carcinoma (BCC) risk in a nested case-control…
Pregnancy outcomes by pregnancy intention in a managed care setting
OBJECTIVES: Published studies show poor pregnancy outcomes associated with unintended pregnancies are disproportionately higher than in planned pregnancies and place…
Clinical features in early Parkinson disease and survival
OBJECTIVE: To examine the association between demographic and clinical features in early Parkinson disease (PD) and length of survival in…
Alcohol consumption and risk of hematologic malignancies
PURPOSE: Limited data suggest that alcohol drinking may have an inverse relation to risk of non-Hodgkin's lymphoma (NHL). Prospective data…
Cost-effectiveness of aliskiren in type 2 diabetes, hypertension, and albuminuria.
The Aliskiren in the Evaluation of Proteinuria in Diabetes (AVOID) trial demonstrated that adding aliskiren, an oral direct renin inhibitor,…
Complex atypical endometrial hyperplasia: the risk of unrecognized adenocarcinoma and value of preoperative dilation and curettage
OBJECTIVE: To evaluate whether preoperative dilation and curettage (D&C) lowers the risk of unexpected cancer at hysterectomy. METHODS: Women with…
Cost of routine immunization of young children against rotavirus infection with Rotarix versus RotaTeq.
Using a probabilistic model of the clinical and economic burden of rotavirus gastroenteritis (RVGE), we estimated the expected impact of…
Cost-effectiveness of pregabalin versus venlafaxine in the treatment of generalized anxiety disorder: findings from a Spanish perspective.
The objective of the present study was to describe a new model of the cost-effectiveness of treatment of generalized anxiety…
Improving diet and physical activity with ALIVE: a worksite randomized trial
CONTEXT: Healthy diets and regular physical activity confer many health benefits, but the prevalence of these behaviors is relatively low.…
Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus
CONTEXT: Although acute hypoglycemia may be associated with cognitive impairment in children with type 1 diabetes, no studies to date…
Cigarette smoking and the risk of Barrett’s esophagus
INTRODUCTION: We examined the association between smoking and the risk of Barrett's esophagus (BE), a metaplastic precursor to esophageal adenocarcinoma.…
CYP1A1/2 haplotypes and lung cancer and assessment of confounding by population stratification
Prior studies of lung cancer and CYP1A1/2 in African-American and Latino populations have shown inconsistent results and have not yet…
Distributing $800 billion: an early assessment of Medicare Part D risk adjustment
The viability and stability of the Medicare Part D prescription drug program depend on accurate risk-adjusted payments. The current approach,…
Using drink size to talk about drinking during pregnancy: a randomized clinical trial of Early Start Plus
This clinical trial compared two brief alcohol use interventions in prenatal clinics: Early Start (ES), a substance-abuse screening and treatment…
Base excision repair genes and risk of lung cancer among San Francisco Bay Area Latinos and African-Americans
Base excision repair (BER) is the primary DNA damage repair mechanism for repairing small base lesions resulting from oxidation and…
Iron intake and body iron stores as risk factors for Barrett’s esophagus: a community-based study
OBJECTIVE: High iron stores are a proposed modifiable risk factor for esophageal adenocarcinoma, but minimal human data exist. We evaluated…
Comparison of statistical methods for estimating genetic admixture in a lung cancer study of African Americans and Latinos
A variety of methods are available for estimating genetic admixture proportions in populations; however, few investigators have conducted detailed comparisons…
Nucleotide excision repair genes and risk of lung cancer among San Francisco Bay Area Latinos and African Americans
Few studies on the association between nucleotide excision repair (NER) variants and lung cancer risk have included Latinos and African…
Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard
OBJECTIVE: To evaluate the impact of Early Start, an obstetric clinic-based prenatal substance abuse treatment program, on perinatal outcomes. STUDY…
Cost-effectiveness of abatacept in patients with moderately to severely active rheumatoid arthritis and inadequate response to tumor necrosis factor-alpha antagonists.
OBJECTIVE:To assess cost-effectiveness of abatacept in patients with rheumatoid arthritis (RA) with inadequate response to tumor necrosis factor-alpha antagonists (anti-TNF).METHODS:We…
Medicare beneficiaries’ knowledge of Part D prescription drug program benefits and responses to drug costs
CONTEXT: Medicare Part D drug benefits include substantial cost sharing. OBJECTIVE: To determine beneficiaries' knowledge of benefits and cost responses.…
Cost-effectiveness of abatacept in patients with moderately to severely active rheumatoid arthritis and inadequate response to methotrexate.
OBJECTIVE:To assess cost-effectiveness of abatacept in patients with moderately to severely active RA and inadequate response to MTX.METHODS:We developed a…
Dietary patterns and the risk of Barrett’s esophagus
The objective of this study was to examine the associations between dietary patterns and the risk of Barrett's esophagus, a…
Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients
OBJECTIVES: To determine the impact of depression on highly active antiretroviral therapy (HAART) adherence and clinical measures and investigate if…
Development of Alive! (A Lifestyle Intervention Via Email), and its effect on health-related quality of life, presenteeism, and other behavioral outcomes: randomized controlled trial
BACKGROUND: Cost-effective interventions to improve diet and physical activity are a public health priority. Alive! is an email-based intervention to…
Medical therapy for diabetes is associated with increased use of lower endoscopy
BACKGROUND: Diabetes mellitus is associated with an increased risk of colorectal neoplasia and diabetes medications may further influence the risk.…
Documentation of contraception and pregnancy when prescribing potentially teratogenic medications for reproductive-age women
BACKGROUND: Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they…
Cost-effectiveness of letrozole versus tamoxifen as initial adjuvant therapy in postmenopausal women with hormone-receptor positive early breast cancer from a Canadian perspective.
BACKGROUND:In the primary core analysis of BIG 1-98, a randomized, double-blind trial comparing 5 years of initial adjuvant therapy with…
Cost-effectiveness of letrozole versus tamoxifen as initial adjuvant therapy in hormone receptor-positive postmenopausal women with early-stage breast cancer.
BACKGROUND:In Breast International Group (BIG) 1-98, a randomized, double-blind trial comparing 5 years of initial adjuvant therapy with letrozole versus…
Changes in rates of hysterectomy and uterine conserving procedures for treatment of uterine leiomyoma
OBJECTIVE: The purpose of this study was to investigate treatment of uterine leiomyoma by hysterectomy and uterine conserving procedures (UCPs).…
Predictors of hysterectomy after uterine artery embolization for leiomyoma
OBJECTIVE: This study was undertaken to describe long-term outcomes after uterine artery embolization for leiomyoma. STUDY DESIGN: Data from Kaiser…
The prevalence, burden, and treatment of urinary incontinence among women in a managed care plan
OBJECTIVE: Urinary incontinence (UI) symptoms are common among women, yet only a small proportion of women with incontinence receive a…
Intrauterine contraception: evaluation of clinician practice patterns in Kaiser Permanente Northern California
BACKGROUND: Despite the medical evidence, few women of reproductive age in the United States use intrauterine contraception (IUC) in comparison…
Cost effectiveness of once-daily oral chelation therapy with deferasirox versus infusional deferoxamine in transfusion-dependent thalassaemia patients: US healthcare system perspective.
BACKGROUND:Deferasirox is a recently approved once-daily oral iron chelator that has been shown to reduce liver iron concentrations and serum…
Causal inference in longitudinal studies with history-restricted marginal structural models
A new class of Marginal Structural Models (MSMs), History-Restricted MSMs (HRMSMs), was recently introduced for longitudinal data for the purpose…
Using drink size to talk about drinking during pregnancy: Early start plus
Heavy drinking during pregnancy can cause birth defects and other alcohol-related effects. Because costs associated with fetal complications are high,…
Early start: an integrated model of substance abuse intervention for pregnant women
Untreated perinatal substance abuse is associated with serious adverse maternal and neonatal outcomes. Historically, many barriers have prevented pregnant women…
Surgical outcomes in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy
HYPOTHESIS: Matched patients who test positive or negative for human immunodeficiency virus (HIV) who are undergoing comparable operations have similar…
Cost-sharing for emergency care and unfavorable clinical events: findings from the safety and financial ramifications of ED copayments study
OBJECTIVE: To evaluate the effect of emergency department (ED) copayment levels on ED use and unfavorable clinical events. Data Source/Study…
Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit
BACKGROUND: Newborns of 30-34 weeks gestation comprise 3.9% of all live births in the United States and 32% of all…
Hemoglobin level, chronic kidney disease, and the risks of death and hospitalization in adults with chronic heart failure: the Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study
BACKGROUND: Previous studies have associated reduced hemoglobin levels with increased adverse events in heart failure. It is unclear, however, whether…
Unintended consequences of caps on Medicare drug benefits
BACKGROUND: Little information exists about the consequences of limits on prescription-drug benefits for Medicare beneficiaries. METHODS: We compared the clinical…
Hysterectomy rates for benign indications
OBJECTIVE: To investigate the annual rates, types, and indications for hysterectomies performed for benign disease in Kaiser Permanente Northern California…
Early experiences with e-health services (1999-2002): promise, reality, and implications
BACKGROUND: E-health services may improve the quality and efficiency of care; however, there is little quantitative data on e-health use.…
An observational study examining the impact of capecitabine on warfarin antithrombotic activity and bleeding complications
OBJECTIVE: The objectives of this study are to quantify the frequency of concomitant use of capecitabine and warfarin, and to…
Sex and racial/ethnic disparities in outcomes after acute myocardial infarction: a cohort study among members of a large integrated health care delivery system in northern California
BACKGROUND: Previous studies have documented sex and racial/ethnic disparities in outcomes after acute myocardial infarction (AMI), but the explanation of…
TPMG Northern California appointments and advice call center
Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of…
Organizational barriers to physician participation in cancer clinical trials
OBJECTIVE: To assess barriers to physician participation in cancer clinical trials among oncologists, oncology leaders, and health plan leaders. STUDY…
Menopause, physical activity, and body composition/fat distribution in midlife women
PURPOSE: Hormonal changes associated with menopause, chronological aging, and lifestyle, specifically physical activity, may all influence the changes in body…
Medicaid chemical dependency patients in a commercial health plan: do high medical costs come down over time?
A cohort of 197 Medicaid-insured patients presenting for treatment in Kaiser Permanente's outpatient chemical dependency treatment program were observed the…
Use of e-Health services between 1999 and 2002: a growing digital divide
OBJECTIVE: To evaluate the patterns of e-Health use over a four-year period and the characteristics of users. DESIGN: Longitudinal, population-based…
Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women’s Health Across the Nation
Controversy exists regarding the extent to which age, menopausal status, and/or lifestyle behaviors account for the increased weight, fat mass,…
Can disease management reduce health care costs by improving quality?
Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past…
Barriers to hospice care and referrals: survey of physicians’ knowledge, attitudes, and perceptions in a health maintenance organization
INTRODUCTION: Many proponents of hospice care believe that this service is underutilized. OBJECTIVE: To determine physicians' perceptions of hospice utilization…
Using chart reviews to assess postpartum substance abuse. A pilot study
The use of chart reviews to assess substance use one-year postpartum was examined in this pilot study by comparing interviews…
Risk of cesarean delivery in nulliparous women at greater than 41 weeks’ gestational age with an unengaged vertex
OBJECTIVE: The purpose of this study was to determine whether an unengaged vertex significantly increased the risk of cesarean delivery…
Outcomes of ostomy procedures in patients aged 70 years and older
HYPOTHESIS: Patients aged 70 years and older undergo proportionately more emergency and permanent fecal ostomy procedures than younger patients. Older…
Wine, liquor, beer, and mortality
A substantially increased risk for heavy drinkers and a slightly reduced risk for lighter drinkers results in the J-shaped alcohol-mortality…
The early repolarization normal variant electrocardiogram: correlates and consequences
PURPOSE: We compared the characteristics and outcomes of patients with 'early repolarization' electrocardiograms (ECGs) with those who had normal ECGs.…
Traits of persons who drink decaffeinated coffee
PURPOSE: Little is known about the traits of decaffeinated coffee drinkers, who are sometimes used to ascertain whether the health…
Reproducibility of increased blood pressure during an emergency department or urgent care visit
STUDY OBJECTIVE: We determine the reproducibility of increased blood pressure measurements among adults in the emergency department or minor injury…
A cohort study of the incidence of serious acute liver injury in diabetic patients treated with hypoglycemic agents
BACKGROUND: The incidence of acute liver failure or serious liver injury in diabetic patients is needed to evaluate the safety…
Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes
OBJECTIVE: To evaluate the effect of Early Start, a managed care organization's obstetric clinic-based perinatal substance abuse treatment program, on…
Physical activity and menstrual cycle characteristics in two prospective cohorts
Relations between physical activity and prospectively collected menstrual cycle characteristics were examined in two large cohorts. One cohort consisted of…
Life after a ventricular arrhythmia
BACKGROUND: There are few data from community-based evaluations of outcomes after a life-threatening ventricular arrhythmia (LTVA). We evaluated patients' quality…
Health-related quality of life and future health care utilization for asthma
BACKGROUND: Although health-related quality of life (HRQL) has been increasingly used as an outcome in asthma, its utility for identifying…
Foot problems as risk factors of fractures
This case-control study examines whether foot problems are risk factors of fractures of five sites among people aged 45 years…
Treatment decisions about lumbar herniated disk in a shared decision-making program
BACKGROUND: An explicit process of collaborative (shared) decision making involving the patient and physician has been recommended for discretionary surgical…
Different slopes for different folks: socioeconomic and racial/ethnic disparities in asthma and hay fever among 173,859 U.S. men and women
Although allergic diseases such as asthma and hay fever are a major cause of morbidity in industrialized countries, most studies…
A multimedia breast cancer education intervention for low-income Latinas
This paper discusses the results from the field test of a multimedia health education intervention, designed to provide breast cancer…
Rehospitalization for neonatal dehydration: a nested case-control study
OBJECTIVES: To determine the incidence of neonatal dehydration leading to rehospitalization, whether clinical and health services data could predict its…
Medicaid patients in a private health maintenance organization: patterns of chemical dependency treatment
Although many Medicaid beneficiaries receive health care through commercial health maintenance organizations (HMOs), the impact of private managed care on…
Utilization of health services among patients referred to an alcohol treatment program
This study assessed utilization of health services among 1,317 adults referred to an outpatient Psychiatry Department alcohol treatment program from…
Safety of neonatal hepatitis B vaccine administration
OBJECTIVE: To determine whether hepatitis B vaccination of newborns increases the incidence of fever and/or suspected sepsis. METHODS: A prospective…
The prevalence of clinically recognized obsessive-compulsive disorder in a large health maintenance organization
OBJECTIVE: Little is known about the prevalence of obsessive-compulsive disorder (OCD) as recognized in clinical settings. The authors report data…
Correlates of breast cancer screening among low-income, low-education Latinas
INTRODUCTION: This paper discusses the factors associated with breast cancer screening among low-education, low-income Latinas. BACKGROUND: These data were collected…
Comparison of quality and cost-effectiveness in the evaluation of symptomatic cholelithiasis with different approaches to ultrasound availability in the ED
Ultrasound is the imaging study of choice for the detection of gallstones, but ultrasound through medical imaging departments (MI Sono)…
Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization
OBJECTIVES: This study compared the prevalence of cigarette smoking and alcohol use among lesbians and bisexual women with that among…
Impact of the change in polio vaccination schedule on immunization coverage rates: a study in two large health maintenance organizations
OBJECTIVE: In January 1997, one of the most significant changes to United States vaccine policy occurred when polio immunization guidelines…
Targeted testing of children for tuberculosis: validation of a risk assessment questionnaire
OBJECTIVE: Given the directive of the American Academy of Pediatrics to test children for tuberculosis (TB) only if they are…
Slow infusion for the prevention of akathisia induced by prochlorperazine: a randomized controlled trial
The utility of intravenous prochlorperazine (PCZ) in the treatment of nausea, vomiting, and headache may be limited by the akathisia…
Do surrogate decision makers provide accurate consent for intensive care research?
CONTEXT: ICU patients are often rendered incapable of making decisions as a result of their illness. The accuracy with which…
Early Start: an obstetric clinic-based, perinatal substance abuse intervention program
Maternal substance abuse is a serious problem with significant adverse effects to mothers, fetuses, and children. The Early Start Program…
Hormone replacement therapy and the risk of myocardial infarction in women with coronary risk factors
To assess the risk of myocardial infarction in users of post-menopausal hormone replacement therapy who are at high risk of…
Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care
BACKGROUND: Primary care treatment of depression needs improvement. OBJECTIVE: To evaluate the efficacy of 2 augmentations to antidepressant drug treatment.…
Ultrasound availability in the evaluation of ectopic pregnancy in the ED: comparison of quality and cost-effectiveness with different approaches
The liberal use of ultrasonography has been advocated in patients with first trimester cramping or bleeding to avoid misdiagnosis of…
Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans
Several reports from Asian countries suggest a low prevalence of pulmonary embolism (PE) and deep venous thrombosis (DVT) in Asians,…
Neonatal assisted ventilation: predictors, frequency, and duration in a mature managed care organization
OBJECTIVES: Reference data are lacking on the frequency and duration of assisted ventilation in neonates. This information is essential for…
Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group
OBJECTIVE: To determine the efficacy, safety and immunogenicity of the heptavalent CRM197 pneumococcal conjugate vaccine against invasive disease caused by…
The cost of health conditions in a health maintenance organization
In this retrospective cohort analysis of all adults who were members of Kaiser Permanente, Northern California, between July 1995 and…
Parents’ preferences for outcomes associated with childhood vaccinations
BACKGROUND: The number of shots in the childhood immunization schedule has been increasing and is likely to continue to increase…
Cost of care for patients in cancer clinical trials
BACKGROUND: Information on the costs of medical care for patients enrolled in clinical trials is needed by policymakers evaluating ways…
Spousal concordance for cancer incidence: A cohort study
BACKGROUND: Because married couples share at least their home environment, spousal aggregation of cancer might provide clues to unsuspected etiologic…
Frequency of neonatal bilirubin testing and hyperbilirubinemia in a large health maintenance organization
OBJECTIVE: To determine the frequency and interhospital variation of bilirubin testing and identified hyperbilirubinemia in a large health maintenance organization.…
Rehospitalization for respiratory syncytial virus among premature infants
OBJECTIVES: New interventions to prevent respiratory syncytial virus (RSV) have recently become available. Clinical decisions about the use of these…
Relationship of the facial nerve to the tympanic annulus: a direct anatomic examination
OBJECTIVE: To examine the relation of the facial nerve to the only identifiable surgical landmark in the external auditory canal.…
Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists
CONTEXT: Few data are available regarding how patients view the role of primary care physicians as 'gatekeepers' in managed care…
Rehospitalization in the first two weeks after discharge from the neonatal intensive care unit
BACKGROUND: High-risk newborns are known to have higher than average utilization of services after discharge from the neonatal intensive care…
Quality of primary care practice in a large HMO according to physician specialty
OBJECTIVE: To determine whether physician specialty was associated with differences in the quality of primary care practice and patient satisfaction…
Computer-based models to identify high-risk adults with asthma: is the glass half empty of half full?
This study developed and evaluated the performance of prediction models for asthma-related adverse outcomes based on the computerized hospital, clinic,…
Predicting advanced proximal colonic neoplasia with screening sigmoidoscopy
CONTEXT: Indications are not well defined for follow-up colonoscopy for all patients with distal colonic tubular adenomas (TAs) found at…
Physical activity patterns in a diverse population of women
BACKGROUND: Demographic and psychosocial correlates of activity in domains other than recreational activity have not been well characterized and may…
Habitual physical activity and menopausal symptoms: a case-control study
A case-control study design was used to examine whether habitual physical activity prior to the final menstrual period (FMP) was…
Alcohol consumption and utilization of health services in a health maintenance organization
OBJECTIVES: This study examined the relation between alcohol use and utilization of health services during a 3-year period in a…
Structured review of neonatal deaths in a managed care organisation
We sought to quantify neonatal mortality (< 28 days) in a 10-hospital system, determine what proportion was associated with suboptimal…
Neonatal group B streptococcal infection in a managed care population. Perinatal Group B Streptococcal Infection Study Group
OBJECTIVE: In a health maintenance organization population, we determined the incidence of early-onset (at less than or equal to 7…
Experience with a managed care approach to HIV infection: effectiveness of an interdisciplinary team
To evaluate the function and effectiveness of a multidisciplinary team for managing human immunodeficiency virus (HIV) infection, we conducted a…
Computer-based models to identify high-risk children with asthma
Effective management of populations with asthma requires methods for identifying patients at high risk for adverse outcomes. The aim of…
Obesity, health services use, and health care costs among members of a health maintenance organization
BACKGROUND: Obesity is an independent risk factor for a variety of chronic diseases and is therefore a potential source of…
Developmentally supportive care in a neonatal intensive care unit: a research utilization project
PURPOSE: To implement three aspects of developmental care: lower noise levels, decreased light levels, and flexed, midline positioning. DESIGN: Research…
Monitoring women at risk for preterm labor
BACKGROUND: Preterm birth is a major cause of perinatal morbidity and mortality. Whether the rate of preterm birth can be…
Cataract extraction. Risk factors in a health maintenance organization population under 60 years of age
Risk factors for cataract extraction in a young (less than 60 years of age) urban health maintenance organization population were…
Precursors of essential hypertension: body weight, alcohol and salt use, and parental history of hypertension
Body mass index, alcohol and salt consumption, and parental history of hypertension were examined as possible predictors of the development…
Cholecystectomy and large bowel cancer
The records of 5898 patients with colorectal cancer and 27,687 controls were examined for previous cholecystectomy. The estimated relative risks…
Serum retinol and retinol-binding protein levels do not predict subsequent lung cancer
Retinol and retinol-binding protein levels were measured in sera previously obtained, and stored in the frozen state, at multiphasic health…
Multiphasic Health Checkup Evaluation: a 16-year follow-up
The Multiphasic Health Checkup Evaluation Study, a long-term clinical trial, has been completed. A study group of 5156 men and…
Psychological questionnaire score, cigarette smoking, and myocardial infarction: a continuing enigma
The ability of a group of 94 psychological questions to discriminate between men in whom cigarette smoking was associated with…
