The Cardiovascular Research Network

Go, Alan S.; Magid, David J.; Wells, Barbara L.; Sung, Sue Hee; Cassidy‐Bushrow, Andrea E.; Greenlee, Robert T.; Langer, Róbert; Lieu, Tracy A.; Margolis, Karen L.; Masoudi, Frederick A.; McNeal, Catherine J.; Murata, Glen H.; Newton, Katherine M.; Novotny, Rachel; Reynolds, Kristi; Roblin, Douglas W.; Smith, David H.; Vupputuri, Suma; White, Rob; Olson, Jean L.; Rumsfeld, John S.; Gurwitz, Jerry H.

doi:10.1161/circoutcomes.108.801654

Cited by 123 publications

(91 citation statements)

References 38 publications

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“…These healthcare systems represent demographically and socioeconomically diverse community‐based populations in the specific geographic areas 11. Research divisions from these healthcare delivery systems each created site‐specific virtual data warehouses containing individual patient information from electronic medical records and administrative databases to promote interinstitutional research 10.…”

Section: Methodsmentioning

confidence: 99%

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Baumgartner

Fan

Fang

et al. 2018

JAHA

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BackgroundAnxiety and depression are associated with worse outcomes in several cardiovascular conditions, but it is unclear whether they affect outcomes in atrial fibrillation (AF). In a large diverse population of adults with AF, we evaluated the association of diagnosed anxiety and/or depression with stroke and bleeding outcomes.Methods and ResultsThe Cardiovascular Research Network WAVE (Community‐Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism) Study included adults with AF newly starting warfarin between 2004 and 2007 within 5 health delivery systems in the United States. Diagnosed anxiety and depression and other patient characteristics were identified from electronic health records. We identified stroke and bleeding outcomes from hospitalization databases using validated International Classification of Diseases, Ninth Revision (ICD‐9), codes. We used multivariable Cox regression to assess the relation between anxiety and/or depression with outcomes after adjustment for stroke and bleeding risk factors. In 25 570 adults with AF initiating warfarin, 490 had an ischemic stroke or intracranial hemorrhage (1.52 events per 100 person‐years). In multivariable analyses, diagnosed anxiety was associated with a higher adjusted rate of combined ischemic stroke and intracranial hemorrhage (hazard ratio, 1.52; 95% confidence interval, 1.01–2.28). Results were not materially changed after additional adjustment for patient‐level percentage of time in therapeutic anticoagulation range on warfarin (hazard ratio, 1.56; 95% confidence interval, 1.03–2.36). In contrast, neither isolated depression nor combined depression and anxiety were significantly associated with outcomes.ConclusionsDiagnosed anxiety was independently associated with increased risk of combined ischemic stroke and intracranial hemorrhage in adults with AF initiating warfarin that was not explained by differences in risk factors or achieved anticoagulation quality.

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Section: Methodsmentioning

confidence: 99%

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Baumgartner

Fan

Fang

et al. 2018

JAHA

Self Cite

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“…Although new national and international registries of patients who are at risk for or experience AKI would be ideal to construct, the cost and time needed are probably prohibitive for providing short-term insights needed for current trial planning. Multiple data sources could be leveraged to inform clinical trial planning for selected AKI prevention and treatment populations (Table 2) (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Depending on the data source, insights into the likely proportion of eligible patients as well as preliminary outcome rates at different follow-up times would be available to assist in sample size and power calculations.…”

Section: Power and Sample Size Issuesmentioning

confidence: 99%

Design of Clinical Trials in Acute Kidney Injury

Palevsky

Molitoris²,

Okusa³

et al. 2012

Clinical Journal of the American Society of Nephrology

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121

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SummaryAcute kidney injury (AKI) remains a complex clinical problem associated with significant short-term morbidity and mortality and lacking effective pharmacologic interventions. Patients with AKI experience longer-term risks for progressive chronic ESRD, which diminish patients' health-related quality of life and create a larger burden on the healthcare system. Although experimental models have yielded numerous promising agents, translation into clinical practice has been unsuccessful, possibly because of issues in clinical trial design, such as delayed drug administration, masking of therapeutic benefit by adverse events, and inadequate sample size. To address issues of clinical trial design, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a workshop titled "Clinical Trials in Acute Kidney Injury: Current Opportunities and Barriers" in December 2010. Workshop participants included representatives from academia, industry, and government agencies whose areas of expertise spanned basic science, clinical nephrology, critical care medicine, biostatistics, pharmacology, and drug development. This document summarizes the discussions of collaborative workgroups that addressed issues related to patient selection, study endpoints, the role of novel biomarkers, sample size and power calculations, and adverse events and pilot/feasibility studies in prevention and treatment of AKI. Companion articles outline the discussions of workgroups for model trials related to prevention or treatment of established AKI in different clinical settings, such as in patients with sepsis.

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“…The following questions were addressed: All HMORN sites maintain a Virtual Data Warehouse (VDW) consisting of electronic medical record (EMR) and insurance claim data for their enrolled members. 24,25 Data on encounters, pharmacy fills, diagnoses, medical tests, and demographics are organized using the same definitions across sites and are quality checked locally. These data are matched to official regional mortality records using Social Security Numbers or patient names, birthdates, and demographic profiles.…”

Section: Introductionmentioning

confidence: 99%

Health Care Contacts in the Year Before Suicide Death

et al. 2014

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. Medical record, insurance claim, and mortality records were linked via the Virtual Data Warehouse, a federated data system at each site. KEY RESULTS: Nearly all individuals received health care in the year prior to death (83 %), but half did not have a mental health diagnosis. Only 24 % had a mental health diagnosis in the 4-week period prior to death. Medical specialty and primary care visits without a mental health diagnosis were the most common visit types. The individuals more likely to make a visit in the year prior to death (p<0.05) tended to be women, individuals of older age (65+ years), those where the neighborhood income was over $40,000 and 25 % were college graduates, and those who died by non-violent means. CONCLUSIONS: This study indicates that opportunities for suicide prevention exist in primary care and medical settings, where most individuals receive services prior to death. Efforts may target improved identification of mental illness and suicidal ideation, as a large proportion may remain undiagnosed at death.

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The Cardiovascular Research Network

Cited by 123 publications

References 38 publications

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Design of Clinical Trials in Acute Kidney Injury

Health Care Contacts in the Year Before Suicide Death

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