Institution
VA Palo Alto Healthcare System
Healthcare•Palo Alto, California, United States•
About: VA Palo Alto Healthcare System is a healthcare organization based out in Palo Alto, California, United States. It is known for research contribution in the topics: Population & Health care. The organization has 2548 authors who have published 4605 publications receiving 209938 citations.
Topics: Population, Health care, Veterans Affairs, Poison control, Mental health
Papers published on a yearly basis
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University of Sydney1, St George's Hospital2, Johns Hopkins University3, Population Health Research Institute4, Karolinska Institutet5, Ruijin Hospital6, Brigham and Women's Hospital7, The George Institute for Global Health8, Barts Health NHS Trust9, Boston University10, University of Modena and Reggio Emilia11, National Yang-Ming University12, University Hospital of Basel13, François Rabelais University14, University of Birmingham15, Mayo Clinic16, University of Toronto17, University of Western Australia18, Trinity College, Dublin19, Cornell University20, Lankenau Institute for Medical Research21, The Chinese University of Hong Kong22, Aalborg University23, Edinburgh Napier University24, Duke University25, University of Auckland26, University of Belgrade27, University of Groningen28, University of Alberta29, University of Hong Kong30, University of Copenhagen31, Stanford University32, VA Palo Alto Healthcare System33, University of Göttingen34
TL;DR: A strong case for AF screening now is provided while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
Abstract: Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country- and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
437 citations
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TL;DR: The evidence for the prevalence and management of food allergy is greatly limited by a lack of uniformity for criteria for making a diagnosis and a failure to recommend use of immunotherapy.
Abstract: Context There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies. Objective To perform a systematic review of the available evidence on the prevalence, diagnosis, management, and prevention of food allergies. Data Sources Electronic searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials. Searches were limited to English-language articles indexed between January 1988 and September 2009. Study Selection Diagnostic tests were included if they had a prospective, defined study population, used food challenge as a criterion standard, and reported sufficient data to calculate sensitivity and specificity. Systematic reviews and randomized controlled trials (RCTs) for management and prevention outcomes were also used. For foods where anaphylaxis is common, cohort studies with a sample size of more than 100 participants were included. Data Extraction Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles and resolved discrepancies by repeated review and discussion. Quality of systematic reviews and meta-analyses was assessed using the AMSTAR criteria, the quality of diagnostic studies using the QUADAS criteria most relevant to food allergy, and the quality of RCTs using the Jadad criteria. Data Synthesis A total of 12 378 citations were identified and 72 citations were included. Food allergy affects more than 1% to 2% but less than 10% of the population. It is unclear if the prevalence of food allergies is increasing. Summary receiver operating characteristic curves comparing skin prick tests (area under the curve [AUC], 0.87; 95% confidence interval [CI], 0.81-0.93) and serum food-specific IgE (AUC, 0.84; 95% CI, 0.78-0.91) to food challenge showed no statistical superiority for either test. Elimination diets are the mainstay of therapy but have been rarely studied. Immunotherapy is promising but data are insufficient to recommend use. In high-risk infants, hydrolyzed formulas may prevent cow's milk allergy but standardized definitions of high risk and hydrolyzed formula do not exist. Conclusion The evidence for the prevalence and management of food allergy is greatly limited by a lack of uniformity for criteria for making a diagnosis.
433 citations
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TL;DR: This document challenges historical policy by acknowledging the need for more explicit and transparent assessment of the value of health care and suggesting a strategy to address this issue.
Abstract: Traditionally, resource utilization and value considerations have been explicitly excluded from practice guidelines and performance measures formulations, although they often are implicitly considered. This document challenges this historical policy. With accelerating healthcare costs and the desire to achieve the best value (health benefit for every dollar spent), there is growing recognition of the need for more explicit and transparent assessment of the value of health care. Thus, from a societal policy perspective, a critical healthcare …
432 citations
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TL;DR: Kappa coefficients are measures of correlation between categorical variables often used as reliability or validity coefficients, and development and definitions of the K by M (ratings) kappas (K x M) are recapitulate and the use of the recommended kappa with applications in medical research is illustrated.
Abstract: Kappa coefficients are measures of correlation between categorical variables often used as reliability or validity coefficients. We recapitulate development and definitions of the K (categories) by M (ratings) kappas (K x M), discuss what they are well- or ill-designed to do, and summarize where kappas now stand with regard to their application in medical research. The 2 x M(M>/=2) intraclass kappa seems the ideal measure of binary reliability; a 2 x 2 weighted kappa is an excellent choice, though not a unique one, as a validity measure. For both the intraclass and weighted kappas, we address continuing problems with kappas. There are serious problems with using the K x M intraclass (K>2) or the various K x M weighted kappas for K>2 or M>2 in any context, either because they convey incomplete and possibly misleading information, or because other approaches are preferable to their use. We illustrate the use of the recommended kappas with applications in medical research.
426 citations
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TL;DR: Patients with BE were no more likely to be obese, consumers of tobacco or alcohol, report a family history of GERD, show association with toxic exposure, or use antacids more than once a month, compared with those without BE.
421 citations
Authors
Showing all 2575 results
Name | H-index | Papers | Citations |
---|---|---|---|
Gregg C. Fonarow | 161 | 1676 | 126516 |
Jongmin Lee | 150 | 2257 | 134772 |
Roger J. Davis | 147 | 498 | 103478 |
Eugene C. Butcher | 146 | 446 | 72849 |
Gerald M. Reaven | 133 | 799 | 80351 |
Paul G. Shekelle | 132 | 601 | 101639 |
Helena C. Kraemer | 132 | 562 | 65755 |
Glenn M. Chertow | 128 | 764 | 82401 |
Lawrence Steinman | 119 | 639 | 55583 |
Rudolf H. Moos | 119 | 622 | 49816 |
Cornelia M. Weyand | 116 | 460 | 44948 |
Jiahuai Han | 111 | 379 | 49379 |
Jörg J. Goronzy | 111 | 420 | 37634 |
Adolf Pfefferbaum | 109 | 530 | 40358 |
Michael F. Green | 106 | 485 | 45707 |