Tierney, Aaron A.
Research interests include equity in health information technology.
Escobar, Gabriel J.
Research interests include the outcomes of neonatal intensive care.
Reed, Mary E.
Research interests include health information technology.
Kuzniewicz, Michael W
Research interests include perinatal health services research and perinatal clinical epidemiology
Lieu, Tracy A.
Research interest include child health services research; effectiveness and delivery of primary care; and decision sciences, including decision analysis
Liu, Vincent
Research interests include health services research and health information technology
Grant, Richard W.
Research interests include diabetes and health services research
Herrinton, Lisa J.
Research interests include inflammatory bowel disease epidemiology.
Karter, Andrew J.
Research interests include epidemiology and health services research in diabetes.
Detection and Mitigation of Algorithmic Bias in Predictive Models of Suicide Risk
This project will assess the potential impact of algorithmic bias on the allocation of preventive care for suicide and compare…
Predictive modeling of adverse mental health outcomes following acute hospitalizations for serious illness: A machine learning approach with natural language processing
This study addresses predicting risk of post-traumatic stress disorder and other mental health conditions following hospitalization for life-threatening conditions. We…
Optimizing Care to Prevent Diabetes and Promote Cardiovascular Health Among Younger Adults with Severe Mental Illness
This K23 career development project seeks to leverage electronic health record data from KPNC and 2 health system collaborators within…
Economic analysis of automated insulin delivery (AID) systems
Our aim is to determine if automated insulin delivery (AID) systems provide good value compared with standard insulin delivery. We…
Radiomic and genomic predictors of breast cancer risk
Improving breast cancer risk prediction models could enable more personalized screening. This would enhance the benefits of screening while limiting…
Analysis to evaluate the effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhea
The goal of this study is to use electronic medical records from 2016 to 2020 to evaluate the protective effect…
A Natural Language Processing-Based Approach for Identifying Hospitalizations for Worsening Heart Failure Within an Integrated Health Care Delivery System
The current understanding of epidemiological mechanisms and temporal trends in hospitalizations for worsening heart failure (WHF) is based on claims…
Validation of Natural Language Processing to Determine the Presence and Size of Abdominal Aortic Aneurysms in a Large Integrated Health System
Previous studies of the natural history of abdominal aortic aneurysms (AAAs) have been limited by small cohort sizes or heterogeneous…
Using predictive analytics to tailor care for patients with newly diagnosed type 2 diabetes
In a population of adults newly diagnosed with type 2 diabetes (T2D) from 2010-2015 and followed for 5 years this…
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…
Influence of patient immigrant status on physician trainee diabetes treatment decisions: a virtual patient experimental study
To determine the effect of patient immigrant status on physician trainees' diabetes treatment decisions. Participants were 140 physician trainees ('providers').…
Natural language processing for the accurate identification of colorectal cancer mismatch repair status in Lynch syndrome screening
Lynch syndrome (LS) is the most common type of hereditary colorectal cancer (CRC) syndrome caused by pathogenic variants in mismatch…
Building an Evidence Case for Capturing Educational Attainment in the EHR as a Social Determinant of Health
Educational attainment is an important social determinant of health, but it is not included in the electronic health records of…
The Use of Natural Language Processing to Characterize Episodes of Outpatient Worsening Heart Failure within an Integrated Health Care Delivery System
This study will assess the accuracy of using a natural language processing-based approach to retrospectively identify episodes of outpatient worsening…
Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study
To develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing. With…
A descriptive pilot study of structural and functional social network ties among women in the women’s health initiative (WHI) study
Few studies examine the network structure and function of older women's health discussion networks. We sought to assess the feasibility…
Predicting preventable hospital readmissions with causal machine learning
To assess both the feasibility and potential impact of predicting preventable hospital readmissions using causal machine learning applied to data…
Validity of diagnosis and procedure codes for identifying neural tube defects in infants
The use of validated criteria to identify birth defects in electronic healthcare databases can avoid the cost and time-intensive efforts…
Clinical Trial of Expanded Advance Care Planning to Address Regimen Intensity in Older Patients at High Risk for Treatment-Induced Hypoglycemia
The goal of this study is to apply the patient-centered advance care planning paradigm of values elicitation and decision-making and…
Deep learning method for localization and segmentation of abdominal CT
Computed Tomography (CT) imaging is widely used for studying body composition, i.e., the proportion of muscle and fat tissues with…
Informatics approaches to assessing patient frailty in surgical care
Patient frailty increases the risk for surgical complications, which are common, costly, and deadly, especially for older Americans. To improve…
A Transparent and Adaptable Method to Extract Colonoscopy and Pathology Data Using Natural Language Processing
Key variables recorded as text in colonoscopy and pathology reports have been extracted using natural language processing (NLP) tools that…
Transcatheter Mitral-Valve Repair in Patients with Heart Failure and Functional Mitral Regurgitation – Potential Scope and Clinical Benefit of Early Adoption at an Integrated Healthcare Delivery System
This study will look at the clinical benefit of early adoption of the MitraClip device in patients with heart failure…
The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients With Alcohol Problems: Development and Implementation
Electronic health record (EHR)-based disease registries have aided health care professionals and researchers in increasing their understanding of chronic illnesses,…
MAESTRA: Maternal Antecedents of Encephalopathy in Term Infants
This study tests the hypothesis that established NICHD-approved electronic fetal monitoring (EFM) features used as standard care in the U.S. and…
Individualized Relative Intensity Physical Activity Accelerometer Cut-points
Physical activity (PA) intensity is expressed as either absolute or relative intensity. Absolute intensity refers to the energy required to…
Use of Digital Information Technologies and Health Information Resources by Limited English Proficient Latino and Chinese Adult Members
The goal of this research is to learn about use of digital information technologies (DIT) and the kp.org website and…
Sepsis on FHIR
Overall goal is to define and refine the current epidemiology, clinical characteristics, and treatment practices in respiratory failure in late…
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…
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…
Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine
Human papillomavirus is the most common sexually transmitted infection in the United States and causes certain anogenital and oropharyngeal cancers.…
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…
Assessing clinical heterogeneity in sepsis through treatment patterns and machine learning
To use unsupervised topic modeling to evaluate heterogeneity in sepsis treatment patterns contained within granular data of electronic health records.…
Secure Messaging with Physicians by Proxies for Patients with Diabetes: Findings from the ECLIPPSE Study
Little is known about patients who have caregiver proxies communicate with healthcare providers via portal secure messaging (SM). Since proxy…
Text message alerts to emergency physicians identifying potential study candidates increase clinical trial enrollment
Prospective enrollment of research subjects in the fast-paced emergency department (ED) is challenging. We sought to develop a software application…
Portal Use Among Patients With Chronic Conditions: Patient-reported Care Experiences
Personal health records offer patients access to view their own health information and to manage their care online through secure…
Development of an algorithm to detect methotrexate wrong frequency error using computerized health care data
We validated an algorithm to detect frequency errors in computerized healthcare data and estimated the incidence of these errors in…
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…
Care System Analytics to Support Primary Care Patients with Complex Medical and Social Needs
This study will leverage the rich electronic data sources within Kaiser Permanente to create pragmatic tools for improving health and…
Fetal Programming of Growth and Obesity: A Metabolomics Approach
This proposal uses a novel holistic framework that leverages both targeted and untargeted metabolomics approach, electronic health records data, and…
Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreatic Cancer (CPDPC) and the National Community Oncology Research Program (NCORP)
The New-Onset Diabetes Cohort Study is designed to help develop and test early detection tests and processes. Kaiser Permanente Northern…
Cluster-randomized Trial of a Mobile Health Intervention to Achieve Appropriate Gestational Weight Gain in Overweight and Obese Women
This randomized trial will test whether the implementation of an mHealth tool in the health-plan setting increases the proportion of…
Community-based, Longitudinal Cohort of Patients with Interstitial Lung Disease (ILD) in the Kaiser Permanente Northern California (KPNC) Health System
The KPNC-ILD cohort will consist of approximately 10,000 patients with interstitial lung disease. It will be built through electronic health…
Trends in Use of Medical Imaging in US Health Care Systems and in Ontario, Canada, 2000-2016
Medical imaging increased rapidly from 2000 to 2006, but trends in recent years have not been analyzed. To evaluate recent…
Do no harm: a roadmap for responsible machine learning for health care
Interest in machine-learning applications within medicine has been growing, but few studies have progressed to deployment in patient care. We…
Expanding the Scope and Reach of Adolescent Substance Use Early Intervention Research
This study explores the enduring impact of screening, brief intervention, and referral to treatment (SBIRT) delivered in pediatric primary care,…
Community-Based, Longitudinal cohort of Patients with Interstitial Lung Disease in the Kaiser Permanente Northern California Health System
The study aim is to optimize the Kaiser Permanente Northern California (KPNC) Interstitial Lung Disease (ILD) algorithm and establish the…
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…
Association of imputed prostate cancer transcriptome with disease risk reveals novel mechanisms
Here we train cis-regulatory models of prostate tissue gene expression and impute expression transcriptome-wide for 233,955 European ancestry men (14,616…
Trends in Medical Imaging During Pregnancy in the United States and Ontario, Canada, 1996 to 2016
The use of medical imaging has sharply increased over the last 2 decades. Imaging rates during pregnancy have not been…
An Exploratory Analysis of Real-World End Points for Assessing Outcomes Among Immunotherapy-Treated Patients With Advanced Non-Small-Cell Lung Cancer
This pilot study examined the ability to operationalize the collection of real-world data to explore the potential use of real-world…
Muscle segmentation in axial computed tomography (CT) images at the lumbar (L3) and thoracic (T4) levels for body composition analysis
In diseases such as cancer, patients suffer from degenerative loss of skeletal muscle (cachexia). Muscle wasting and loss of muscle…
Opportunities to encourage mail order pharmacy delivery service use for diabetes prescriptions: a qualitative study
Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of…
Multiple Stakeholder Views on Data Sharing in a Biobank in an Integrated Healthcare Delivery System: Implications for Biobank Governance
Beginning in 2005, researchers at Kaiser Permanente Northern California (KPNC) Division of Research developed the Research Program on Genes, Environment,…
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…
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…
Strategies for Building Delivery Science in an Integrated Health Care System
Health systems today have increasing opportunities and imperatives to conduct delivery science, which is applied research that evaluates clinical or…
Geospatial, Multilevel, and Contextual Approaches in Cancer Control and Population Sciences
This funding expands on neighborhood resources developed under the U01 grant (geocoded residential histories, linkage to census and area databases,…
Evaluation of commonly used ectoderm markers in iPSC trilineage differentiation
Patient-derived induced pluripotent stem cells (iPSCs) have become a promising resource for exploring genetics of complex diseases, discovering new drugs,…
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data
Use of electronic health records (EHRs) in health research may lead to the false assumption of complete event ascertainment. We…
Translating/Creating a Culturally Responsive Spanish-Language Mobile App for Visit Preparation: Case Study of “Trans-Creation”
Health information technology (IT) tools are increasingly used to improve patient care. However, implementation of English-only health IT tools could…
Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions
Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with…
SeqSQC: A Bioconductor Package for Evaluating the Sample Quality of Next-generation Sequencing Data
As next-generation sequencing (NGS) technology has become widely used to identify genetic causal variants for various diseases and traits, a…
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…
Association of Medical Scribes in Primary Care With Physician Workflow and Patient Experience
Widespread adoption of electronic health records (EHRs) in medical care has resulted in increased physician documentation workload and decreased interaction…
Collaborating on Data, Science, and Infrastructure: The 20-Year Journey of the Cancer Research Network
The Cancer Research Network (CRN) is a consortium of 12 research groups, each affiliated with a nonprofit integrated health care…
Prevalence and Factors Influencing Use of Internet and Electronic Health Resources by Middle-Aged and Older Adults in a US Health Plan Population: Cross-Sectional Survey Study
Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange health information and advice (HIA). There…
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…
Visit Planning Using a Waiting Room Health IT Tool: The Aligning Patients and Providers Randomized Controlled Trial
Time during primary care visits is limited. We tested the hypothesis that a waiting room health information technology (IT) tool…
ICLIC-MS for Enhancing Outcomes Research and Clinical Care in Multiple Sclerosis
The goal of this project is 1) to collect longitudinal measures of cognitive function, quality of life, and physical disability…
Using EHR Audit Logs to Capture Diagnostic Pathways and Time to Diagnosis
Rapid expansions in the use of electronic health record (EHR) systems also contribute to large expansions in the availability of…
Comparative Effectiveness of Virtual Care in Dermatology for Diagnosing Rash
The benefit of teledermatology for triaging skin rashes is not adequately understood. The study will assess how implementation of teledermatology…
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…
Using natural language processing and machine learning to classify health literacy from secure messages: The ECLIPPSE study
Limited health literacy is a barrier to optimal healthcare delivery and outcomes. Current measures requiring patients to self-report limitations are…
Inpatient electronic health record maintenance from 2010 to 2015
To describe the scale and scope of inpatient electronic health record (EHR) maintenance following initial implementation. A retrospective study reviewing EHR…
The health information technology special issue: new real-world evidence and practical lessons
As technology applications in healthcare continue to grow, electronic health records are maturing, interoperability is developing, and patient-facing technology use…
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…
Accurate Identification of Colonoscopy Quality and Polyp Findings Using Natural Language Processing
The aim of this study was to test the ability of a commercially available natural language processing (NLP) tool to…
A framework for research on vaccine effectiveness
The need for a systematic approach to research on vaccine effectiveness (VE) is increasing with growing numbers of vaccines and…
Developing a Prescription Opioid Registry in Diverse Health Systems
Building on past research, this project will establish the infrastructure to expand a prescription opioid registry across diverse health systems…
Incidence and Trend of Ectopic Pregnancy and Contraceptive Use
Incidence and management of ectopic pregnancy have undergone significant changes in recent decades. There is a general consensus that available…
It Takes a Network: A Network Science- and Command Center-Based Approach to Hospital Error Detection, Prevention, and Mitigation
This project aims to develop a set of algorithms for generic error detection, prevention, and mitigation in the hospital setting.…
Mobile-accessible personal health records increase the frequency and timeliness of PHR use for patients with diabetes
Personal health records (PHRs) offer patients a portal to view lab results, communicate with their doctors, and refill medications. Expanding…
Incorporating machine learning approaches to assess putative environmental risk factors for multiple sclerosis
Multiple sclerosis (MS) incidence has increased recently, particularly in women, suggesting a possible role of one or more environmental exposures…
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…
Care Pathways Before First Diagnosis of a Psychotic Disorder in Adolescents and Young Adults
The authors sought to describe patterns of health care use prior to first diagnosis of a psychotic disorder in a…
Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system
It is unclear whether use of electronic nicotine delivery systems (ENDS) precedes cigarette smoking initiation, relapse, and/or quitting. Healthcare systems…
Development, Validation, and Dissemination of a Breast Cancer Recurrence Detection and Timing Informatics Algorithm
This study developed, validated, and disseminated a generalizable informatics algorithm for detecting breast cancer recurrence and timing using a gold…
Flexible, Cluster-Based Analysis of the Electronic Medical Record of Sepsis with Composite Mixture Models
The widespread adoption of electronic medical records (EMRs) in healthcare has provided vast new amounts of data for statistical machine…
Recovery or Disability? Trajectories After Pneumonia: Integrating 12 Months of Frequent Patient-Reported Measures with EMR Data
This is a pilot study to determine the feasibility of conducting a prospective study that aims to characterize longitudinal trajectories…
Expanded algorithm for managing patients with acute decompensated heart failure.
Heart failure is a complex disease process, the manifestation of various cardiac and noncardiac abnormalities. General treatment approaches for heart…
The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes
Severe hyperglycemia and hypoglycemia ("severe dysglycemia") are serious complications of type 1 diabetes (T1D). Depression has been associated with severe…
Breast Cancer Chemoprevention in an Integrated Health Care Setting
National guidelines encourage counseling high-risk women about pharmacologic breast cancer risk reduction. We evaluated the use of integrated health care…
Code-Based Diagnostic Algorithms for Idiopathic Pulmonary Fibrosis: Case Validation and Improvement
Population-based studies of idiopathic pulmonary fibrosis (IPF) in the United States have been limited by reliance on diagnostic code-based algorithms…
A Digital Tool to Promote Alcohol and Drug Use Screening, Brief Intervention, and Referral to Treatment Skill Translation: A Mobile App Development and Randomized Controlled Trial Protocol
Translation of knowledge and skills from classroom settings to clinical practice is a major challenge in healthcare training, especially for…
Primary Care-Based Interventions to Reduce Alcohol Use among HIV Patients
This randomized clinical trial uses a health plan’s electronic medical record (EMR) alcohol screen and examines innovative behavioral interventions and…
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…
A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy
The American Academy of Pediatrics provides little guidance on when to discontinue phototherapy in newborns treated for hyperbilirubinemia. We sought…
Video Consultation to Increase Integration of Primary Care and Addiction Medicine and Improve Alcohol-Related Health Outcomes
KPNC has been a leader in implementing alcohol SBIRT as part of routine primary care with its Alcohol as a…
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,…
BioBank Northern California – Regional
The KP Research Bank aims to recruit 280,000 members (200,000 in the general cohort, 30,000 in the cancer cohort, and…
Implementing Computerized Substance Use and Depression Screening and Evidence-Based Treatments in an HIV Primary Care Population
This proposal will develop and test the delivery of integrated, sustainable, evidence-based interventions to improve health outcomes of people living…
CESR Regional Data Infrastructure Support and Website Maintenance
The Regional Data Infrastructure Support (RDIS) Budget covers the costs associated with a number of Virtual Data Warehouse (VDW) tasks,…
Impact of Electronic Provider Reminders on Hepatitis B Vaccination Rate Among Adults with Diagnosed Diabetes Mellitus
This study has two main objectives: 1) To examine the impact of electronic provider reminders on HepB vaccine initiation rate…
Advance Alert Monitor Operations
The Systems Research Initiative will provide project management and operational consultation for the spread of the Advance Alert Monitor within…
The Safety and Effectiveness of Diabetes Quality Metrics in Elderly Patients
Improving health care quality for seniors with complex chronic conditions is a critical issue for health services and health policy…
Development, Reevaluation and Implementation of Outcome/Efficiency Measures
This project aims to test the feasibility of employing clinical data from comprehensive electronic medical record systems (such as the…
Delivery Science Rapid Analysis Program II
The purpose of the Delivery Science Rapid Analysis Program is to create a mechanism that will solicit, prioritize and address…
CAREER: Managing Patient Flows with Congestion Effects
This project will employ simulation methods to analyze emergency department, hospital, and ICU data, including physiologic markers of severity of…
Interactive Personal Health Records: Use of a Web-Portal by Patients with Complex Chronic Conditions
Patient use of health IT tools to interact with healthcare providers and delivery systems, including exchanging secure messages with their…
Optimizing Personalized Care Using Economic Studies of Genomic Testing
Personalized medicine uses diagnostic tests to improve patient outcomes and reduce harms of therapy. This project's objective is to develop…
Impact of Integrated Patient-Facing Health IT Tools on Quality and Resource Use for Patients with Diabetes
This is a quasi-experimental study of the effect of Health IT use on the quality and efficiency of outpatient care…
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…
Evaluating the Use of Electronic Health Records for Type 2 Diabetes Surveillance in 2 California Counties, 2010-2014
Electronic health records (EHRs) and electronic laboratory records (ELRs) are increasingly seen as a rich source of data for performing…
Data that drive: Closing the loop in the learning hospital system
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture…
Development and Validation of an Electronic Medical Record-Based Alert Score for Detection of Inpatient Deterioration Outside the ICU
Patients in general medical-surgical wards who experience unplanned transfer to the intensive care unit (ICU) show evidence of physiologic derangement…
Big data in health care: using analytics to identify and manage high-risk and high-cost patients
The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data…
Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey
More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in…
Association Among ICU Congestion, ICU Admission Decision, and Patient Outcomes
To employ automated bed data to examine whether ICU occupancy influences ICU admission decisions and patient outcomes. Retrospective study using…
A Description of Midlife Women Experiencing Intimate Partner Violence Using Electronic Medical Record Information
Intimate partner violence (IPV) is an important health problem affecting women of all ages, but is often not addressed during…
Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study.
Most studies of sleep and health outcomes rely on self-reported sleep duration, although correlation with objective measures is poor. In…
Evaluation Following Staggered Implementation of the “Rethinking Critical Care” ICU Care Bundle in a Multicenter Community Setting
To evaluate process metrics and outcomes after implementation of the "Rethinking Critical Care" ICU care bundle in a community setting.…
Differences in Access to and Preferences for Using Patient Portals and Other eHealth Technologies Based on Race, Ethnicity, and Age: A Database and Survey Study of Seniors in a Large Health Plan
Patients are being encouraged to go online to obtain health information and interact with their health care systems. However, a…
Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting
Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings.…
Implementation of Computerized Physician Order Entry Is Associated With Increased Thrombolytic Administration for Emergency Department Patients With Acute Ischemic Stroke
Electronic health record systems with computerized physician order entry and condition-specific order sets are intended to standardize patient management and…
External Validation of Early Weight Loss Nomograms for Exclusively Breastfed Newborns
Nomograms that show hour-by-hour percentiles of weight loss during the birth hospitalization were recently developed to aid clinical care of…
The impact of electronic health records and teamwork on diabetes care quality
Evidence of the impact electronic health records (EHRs) have on clinical outcomes remains mixed. The impact of EHRs likely depends…
An algorithm to identify medication nonpersistence using electronic pharmacy databases
Identifying patients who are medication nonpersistent (fail to refill in a timely manner) is important for healthcare operations and research.…
Why the C-statistic is not informative to evaluate early warning scores and what metrics to use
Metrics typically used to report the performance of an early warning score (EWS), such as the area under the receiver…
Electronic Health Records and the Evolution of Diabetes Care: A Narrative Review
Adoption of electronic health records (EHRs) has increased dramatically since the 2009 implementation of the Health Information Technology for Economic…
Early weight loss nomograms for formula fed newborns
To develop nomograms depicting percentiles of weight loss by hour of age for both vaginal and cesarean-delivered newborns who are…
Determinants of Adherence to Diabetes Medications: Findings From a Large Pharmacy Claims Database
Adults with diabetes typically take multiple medications for hyperglycemia, diabetes-associated conditions, and other comorbidities. Medication adherence is associated with improved…
A hybrid approach to identify subsequent breast cancer using pathology and automated health information data
Many cancer registries do not capture recurrence; thus, outcome studies have often relied on time-intensive and costly manual chart reviews.…
Preliminary Development and Evaluation of an Algorithm to Identify Breast Cancer Chemotherapy Toxicities Using Electronic Medical Records and Administrative Data
Breast cancer chemotherapy toxicity is not well documented outside of randomized trials. We developed and conducted preliminary evaluation of an…
Big Data, Miniregistries: A Rapid-Turnaround Solution to Get Quality Improvement Data into the Hands of Medical Specialists
The cost to build and to maintain traditional registries for many dire, complex, low-frequency conditions is prohibitive. The authors used…
The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente
Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However,…
Early weight loss nomograms for exclusively breastfed newborns
The majority of newborns are exclusively breastfed during the birth hospitalization, and weight loss is nearly universal for these neonates.…
Representativeness of breast cancer cases in an integrated health care delivery system
Integrated health care delivery systems, with their comprehensive and integrated electronic medical records (EMR), are well-poised to conduct research that…
The Accuracy of an Electronic Pulmonary Embolism Severity Index Auto-Populated from the Electronic Health Record: Setting the stage for computerized clinical decision support
The Pulmonary Embolism (PE) Severity Index identifies emergency department (ED) patients with acute PE that can be safely managed without…
Advances in Fecal Occult Blood Tests: the FIT revolution.
There is a wide choice of fecal occult blood tests (FOBTs) for colorectal cancer screening. GOAL: To highlight the issues…
The Next Step Towards Making Use Meaningful: Electronic Information Exchange and Care Coordination Across Clinicians and Delivery Sites
Care for patients with chronic conditions often requires coordination between multiple physicians and delivery sites. Electronic Health Record (EHR) use…
Integrating database knowledge and epidemiological design to improve the implementation of data mining methods that evaluate vaccine safety in large healthcare databases
Large healthcare databases maintained by health plans have been widely used to conduct customized protocol-based epidemiological safety studies as well…
A multi-level model of postmenopausal breast cancer incidence
Breast cancer has a complex etiology that includes genetic, biologic, behavioral, environmental, and social factors. Etiologic factors are frequently studied…
Individualizing HbA1c targets for patients with diabetes: impact of an automated algorithm within a primary care network
To develop glycaemic goal individualization algorithms and assess potential impact on a healthcare system and different segments of the population…
Increased one-year health care utilization in survivors of severe sepsis
Hospitalizations for severe sepsis are common, and a growing number of patients survive to hospital discharge. Nonetheless, little is known…
Developing a data infrastructure for a learning health system: the PORTAL network
The Kaiser Permanente & Strategic Partners Patient Outcomes Research To Advance Learning (PORTAL) network engages four healthcare delivery systems (Kaiser…
Use of the Refill Function Through an Online Patient Portal is Associated With Improved Adherence to Statins in an Integrated Health System
Online patient portals are being widely implemented, but their impact on health behaviors are not well-studied. To determine whether statin…
The Association between EHRs and Care Coordination Varies by Team Cohesion
To examine whether primary care team cohesion changes the association between using an integrated outpatient-inpatient electronic health record (EHR) and…
Novel Use and Utility of Integrated Electronic Health Records to Assess Rates of Prediabetes Recognition and Treatment: Brief Report From an Integrated Electronic Health Records Pilot Study
This study uses novel methods to examine the frequency of diagnosis and treatment of prediabetes in real-world clinical settings using…
The DISTANCE model for collaborative research: distributing analytic effort using scrambled data sets
Data-sharing is encouraged to fulfill the ethical responsibility to transform research data into public health knowledge, but data sharing carries…
Establishing visit priorities for complex patients: A summary of the literature and conceptual model to guide innovative interventions
With the aging of the population and continuing advances in health care, patients seen in the primary care setting are…
Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values
Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking. To evaluate the…
Automated identification of pneumonia in chest radiograph reports in critically ill patients
Prior studies demonstrate the suitability of natural language processing (NLP) for identifying pneumonia in chest radiograph (CXR) reports, however, few…
Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases
OBJECTIVE: To propose a unifying set of definitions for prescription adherence research utilizing electronic health record prescribing databases, prescription dispensing…
Validity of diagnostic codes and prevalence of psoriasis and psoriatic arthritis in a managed care population, 1996-2009
Few population-based studies have reported the prevalence of psoriatic disease. We validated computerized diagnoses to estimate the prevalence of psoriasis…
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…
Methods of linking mothers and infants using health plan data for studies of pregnancy outcomes
Research on medication safety in pregnancy often utilizes health plan and birth certificate records. This study discusses methods used to…
Near real-time adverse drug reaction surveillance within population-based health networks: methodology considerations for data accrual
PURPOSE: This study describes practical considerations for implementation of near real-time medical product safety surveillance in a distributed health data…
Risk-adjusting Hospital Mortality Using a Comprehensive Electronic Record in an Integrated Health Care Delivery System
OBJECTIVE: Using a comprehensive inpatient electronic medical record, we sought to develop a risk-adjustment methodology applicable to all hospitalized patients.…
Addition of time-dependent covariates to a survival model significantly improved predictions for daily risk of hospital death
RATIONAL, AIMS AND OBJECTIVES: The study aims to determine the extent to which the addition of post-admission information via time-dependent…
Use of web-based shared medical records among patients with HIV
To compare use of 7 shared electronic medical record (SMR) features by adult HIV patients. Observational cohort study of adult…
Identifying primary and recurrent cancers using a SAS-based natural language processing algorithm
OBJECTIVE: Significant limitations exist in the timely and complete identification of primary and recurrent cancers for clinical and epidemiologic research.…
Use of an electronic medical record ‘dotphrase’ data template for a prospective head injury study
INTRODUCTION: The adoption of electronic medical records (EMRs) in emergency departments (EDs) has changed the way that healthcare information is…
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)…
Leveraging Epidemiology and Clinical Studies of Cancer Outcomes: Recommendations and Opportunities for Translational Research
As the number of cancer survivors continues to grow, research investigating the factors that affect cancer outcomes, such as disease…
An electronic simplified acute physiology score-based risk adjustment score for critical illness in an integrated healthcare system*
OBJECTIVE: Risk adjustment is essential in evaluating the performance of an ICU; however, assigning scores is time-consuming. We sought to…
Drug Adverse Event Detection in Health Plan Data Using the Gamma Poisson Shrinker and Comparison to the Tree-based Scan Statistic
Background: Drug adverse event (AE) signal detection using the Gamma Poisson Shrinker (GPS) is commonly applied in spontaneous reporting. AE…
Patient perceptions of a personal health record: a test of the diffusion of innovation model
BACKGROUND: Personal health records (PHRs) have emerged as an important tool with which patients can electronically communicate with their doctors…
Longitudinal study of implantable cardioverter-defibrillators: methods and clinical characteristics of patients receiving implantable cardioverter-defibrillators for primary prevention in contemporary practice
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are increasingly used for primary prevention after randomized, controlled trials demonstrating that they reduce the risk…
A Web-Delivered Care Management and Patient Self-Management Program for Recurrent Depression: A Randomized Trial
OBJECTIVE This study assessed the impact of an Internet-delivered care management and patient self-management program, eCare for Moods, on patients…
Adverse outcomes associated with delayed intensive care unit transfers in an integrated healthcare system
BACKGROUND: Patients with intensive care unit (ICU) transfers from hospital wards have higher mortality than those directly admitted from the…
Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus
BACKGROUND: Physicians can receive federal payments for meaningful use of complete certified electronic health records (EHRs). Evidence is limited on…
Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial
OBJECTIVE: To determine the effects of a personal health record (PHR)-linked medications module on medication accuracy and safety. DESIGN: From…
Validation of AJCC TNM staging for breast tumors diagnosed before 2004 in cancer registries
PURPOSE: American Joint Committee on Cancer (AJCC) Tumor (T), Nodal (N), and Metastatic (M) staging is commonly used in clinical…
Gastrointestinal Disease Outbreak Detection Using Multiple Data Streams from Electronic Medical Records
BACKGROUND: Passive reporting and laboratory testing delays may limit gastrointestinal (GI) disease outbreak detection. Healthcare systems routinely collect clinical data…
Validity of Eight Integrated Healthcare Delivery Organizations’ Administrative Clinical Data to Capture Breast Cancer Chemotherapy Exposure
BACKGROUND: Cancer Research Network (CRN) sites use administrative data to populate their Virtual Data Warehouse (VDW). However, information on VDW…
A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies
BACKGROUND: The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection.…
Antithrombotic Therapy for Atrial Fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
BACKGROUND: The risk of stroke varies considerably across different groups of patients with atrial fibrillation (AF). Antithrombotic prophylaxis for stroke…
Risk of cancer in patients exposed to gabapentin in two electronic medical record systems
PURPOSE: High doses of gabapentin were associated with pancreatic acinar cell tumors in male Wistar rats, but there is little…
Closing the gap: eliminating health care disparities among Latinos with diabetes using health information technology tools and patient navigators
Latinos have higher rates of diabetes and diabetes-related complications compared to non-Latinos. Clinical diabetes self-management tools that rely on innovative…
OBAYA (obesity and adverse health outcomes in young adults): feasibility of a population-based multiethnic cohort study using electronic medical records
ABSTRACT: BACKGROUND: Although obesity is a risk factor for many chronic diseases, we have only limited knowledge of the magnitude…
Targeted maximum likelihood estimation for prediction calibration
Estimators of the conditional expectation, i.e., prediction, function involve a global bias-variance trade off. In some cases, an estimator that…
Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP) for blood pressure control
BACKGROUND: Informatics tools may help support hypertension management. OBJECTIVE: To design, implement and evaluate a web-based system for patient anti-hypertensive…
Colon Cancer Survival With Herbal Medicine and Vitamins Combined With Standard Therapy in a Whole-Systems Approach: Ten-Year Follow-up Data Analyzed With Marginal Structural Models and Propensity Score Methods
Although localized colon cancer is often successfully treated with surgery, advanced disease requires aggressive systemic therapy that has lower effectiveness.…
Lung Cancer Survival With Herbal Medicine and Vitamins in a Whole-Systems Approach: Ten-Year Follow-up Data Analyzed With Marginal Structural Models and Propensity Score Methods
Complementary and alternative medicines are used by up to 48% of lung cancer patients but have seen little formal assessment…
Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access
The authors investigated use of the internet-based patient portal, kp.org, among a well-characterized population of adults with diabetes in Northern…
The digital divide in adoption and use of a personal health record
BACKGROUND:Personal health records (PHRs) offer the potential to improve the patient experience and the quality of patient care. However, the…
The reliability of diagnostic coding and laboratory data to identify tuberculosis and nontuberculous mycobacterial disease among rheumatoid arthritis patients using anti-tumor necrosis factor therapy
PURPOSE: Anti-tumor necrosis factor-alpha (anti-TNF) therapies are associated with severe mycobacterial infections in rheumatoid arthritis patients. We developed and validated…
Length of stay and imminent discharge probability distributions from multistage models: variation by diagnosis, severity of illness, and hospital
Multistage models have been effective at describing length of stay (LOS) distributions for diverse patient groups. Our study objective was…
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…
Privacy-maintaining propensity score-based pooling of multiple databases applied to a study of biologics
INTRODUCTION: A large study on the safety of biologics required pooling of data from multiple data sources, but while extensive…
System-based participatory research in health care: an approach for sustainable translational research and quality improvement
Translational research seeks to improve health care by promoting action and change in real-world health care settings. Although translational research…
Intra-hospital transfers to a higher level of care: contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)
BACKGROUND: Patients who experience intra-hospital transfers to a higher level of care (eg, ward to intensive care unit [ICU]) are…
Validation of an algorithm for categorizing the severity of hospital emergency department visits
BACKGROUND: Differentiating between appropriate and inappropriate resource use represents a critical challenge in health services research. The New York University…
The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE)
Internet-based patient portals are intended to improve access and quality, and will play an increasingly important role in health care,…
New prescription medication gaps: a comprehensive measure of adherence to new prescriptions
OBJECTIVE: Describe a novel approach to comprehensively summarize medication adherence. DATA SOURCES/STUDY SETTING: Kaiser Permanente Northern California Diabetes Registry (n…
Numbers needed to treat with phototherapy according to American Academy of Pediatrics guidelines
OBJECTIVES: Our aims were to estimate the efficacy of hospital phototherapy for neonatal jaundice and the number needed to treat…
Infant functional status: the timing of physiologic maturation of premature infants
OBJECTIVE: To describe the maturation of physiologic milestones in preterm infants born between 24 and 32 weeks' gestational age. METHODS:…
Treatment intensification and risk factor control: toward more clinically relevant quality measures
BACKGROUND: Intensification of pharmacotherapy in persons with poorly controlled chronic conditions has been proposed as a clinically meaningful process measure…
Time to send the preemie home? Additional maturity at discharge and subsequent health care costs and outcomes
OBJECTIVE: To determine whether longer stays of premature infants allowing for increased physical maturity result in subsequent postdischarge cost savings…
Care coordination and electronic health records: connecting clinicians
OBJECTIVE: To examine the association between use of electronic health records (EHR) and care coordination. STUDY DESIGN: Two surveys, in…
Incidental findings on cardiac multidetector row computed tomography among healthy older adults: prevalence and clinical correlates
BACKGROUND: With the widespread use of cardiac multidetector row computed tomography (MDCT), the issue of incidental findings is receiving increasing…
Risk-adjusting hospital inpatient mortality using automated inpatient, outpatient, and laboratory databases
OBJECTIVES: To develop a risk-adjustment methodology that maximizes the use of automated physiology and diagnosis data from the time period…
Risk adjusting community-acquired pneumonia hospital outcomes using automated databases
OBJECTIVE: To describe the development and assessment of the Abbreviated Fine Severity Score (AFSS), a simplified version of the Pneumonia…
Factors associated with the decision to hospitalize patients after transient ischemic attack before publication of prediction rules
BACKGROUND AND PURPOSE: One important criterion for hospitalizing patients after transient ischemic attack (TIA) is the short-term risk of stroke.…
Incorporation of physiological trend and interaction effects in neonatal severity of illness scores: an experiment using a variant of the Richardson score
OBJECTIVE: To evaluate whether physiological trends and interaction terms could enhance predictive ability in a variant of the Richardson Score.…
Clinical utility of the Stanford brief activity survey in men and women with early-onset coronary artery disease
PURPOSE: To determine the utility of the Stanford Brief Activity Survey (SBAS) as a quick screening tool in a 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…
Outcomes among newborns with total serum bilirubin levels of 25 mg per deciliter or more
BACKGROUND: The neurodevelopmental risks associated with high total serum bilirubin levels in newborns are not well defined. METHODS: We identified…
Place of birth and variations in management of late preterm (‘near-term’) infants
BACKGROUND: The purpose of this study is to characterize variations in management late preterm infants because such variations in such…
Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions
BACKGROUND: Newborns who are 35 to 36 weeks gestation comprise 7.0% of all live births and 58.3% of all premature…
Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom
OBJECTIVE: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal…
Brief report: The prevalence and use of chronic disease registries in physician organizations. A national survey
OBJECTIVE: Disease registries are lists of patients with a particular chronic illness, including clinical information, to improve the care of…
What have we learned from observational studies on neonatal sepsis?
OBJECTIVE: To assess how observational studies on neonatal sepsis can help define the knowledge base required for neonatal randomized, clinical…
Combining clinical risk factors with serum bilirubin levels to predict hyperbilirubinemia in newborns
OBJECTIVES: (1) To validate a previously reported risk index for predicting total serum bilirubin (TSB) levels of 25 mg/dL (428…
Infants with bilirubin levels of 30 mg/dL or more in a large managed care organization
OBJECTIVE: To describe the incidence, etiology, treatment, and outcome of newborns with total serum bilirubin (TSB) levels >or=30 mg/dL (513…
Electrocardiographic findings predict short-term cardiac morbidity after transient ischemic attack
BACKGROUND: Current guidelines recommend the use of electrocardiography (ECG) in the evaluation of transient ischemic attack (TIA), but the data…
Validation of diagnoses of peptic ulcers and bleeding from administrative databases: a multi-health maintenance organization study
The automated health plan data and data from medical chart abstractions from eight large health maintenance organizations were used to…
Implications of stroke risk criteria on the anticoagulation decision in nonvalvular atrial fibrillation: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study
BACKGROUND: Warfarin dramatically reduces the risk of stroke in patients with nonvalvular atrial fibrillation (NVAF) but increases the likelihood of…
How accurately does the medical record capture maternal history of cancer?
We sought to assess the reliability of information regarding the maternal history of cancer by comparing the medical records of…
Should the electrocardiogram be used to guide therapy for patients with left bundle-branch block and suspected myocardial infarction?
CONTEXT: Recently, an algorithm based on the electrocardiogram (ECG) was reported to predict myocardial infarction (MI) in patients with left…
