Take a deeper look into all the publications produced by researchers at The Dartmouth Institute.

Solomon RJ, Brown JR

2018 Jan;29(1):4-5doi: 10.1097/MCA.0000000000000580

Coron Artery Dis|2018 Jan

Hill DA, Haas JS, Wellman R, Hubbard RA, Lee CI, Alford-Teaster J, Wernli KJ, Henderson LM, Stout NK, Tosteson ANA, Kerlikowske K, Onega T

2017 Dec 6;doi: 10.1007/s11606-017-4224-6

Breast cancer screening with magnetic resonance imaging (MRI) may be a useful adjunct to screening mammography in high-risk women, but MRI uptake may be increasing rapidly among low- and average-risk women for whom benefits are unestablished. Comparatively little is known about use of screening MRI in community practice.

J Gen Intern Med|2017 Dec 6

Fraze TK, Lewis VA, Tierney E, Colla CH

2017 Dec 6;doi: 10.1089/pop.2017.0102

Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.

Popul Health Manag|2017 Dec 6

An C, O'Malley AJ, Rockmore DN, Stock CD

2017 Dec 4;doi: 10.1002/sim.7565

In this paper, we analyze the US Patient Referral Network (also called the Shared Patient Network) and various subnetworks for the years 2009 to 2015. In these networks, two physicians are linked if a patient encounters both of them within a specified time interval, according to the data made available by the Centers for Medicare and Medicaid Services. We find power law distributions on most state-level data as well as a core-periphery structure. On a national and state level, we discover a so-called small-world structure as well as a "gravity law" of the type found in some large-scale economic networks. Some physicians play the role of hubs for interstate referral. Strong correlations between certain network statistics with health care system statistics at both the state and national levels are discovered. The patterns in the referral network evinced using several statistical analyses involving key metrics derived from the network illustrate the potential for using network analysis to provide new insights into the health care system and opportunities or mechanisms for catalyzing improvements.

Stat Med|2017 Dec 4

Easterwood RM, Bostock IC, Nammalwar S, McCullough JN, Iribarne A

2017 Dec 4;doi: 10.2217/fca-2017-0048

The field of minimally invasive cardiac surgery has undergone rapid transformation over recent years. In this review, we provide a summary of the most current evidence supporting the use of minimally invasive aortic and mitral valve replacement techniques, as well as transcatheter approaches for aortic and mitral valve disease. As an adjunct, the use of robotically assisted coronary bypass surgery and hybrid coronary revascularization procedures is discussed. In order to obtain optimal patient outcomes, a collaborative, heart-team approach between cardiac surgeons and interventional cardiologists is necessary.

Future Cardiol|2017 Dec 4

Riblet NBV, Shiner B, Watts BV

2017 Dec;211(6):396-397doi: 10.1192/bjp.211.6.396a

Br J Psychiatry|2017 Dec

Vermunt NP, Harmsen M, Elwyn G, Westert GP, Burgers JS, Olde Rikkert MG, Faber MJ

2017 Nov 28;doi: 10.1111/hex.12647

To meet the challenge of multimorbidity in decision making, a switch from a disease-oriented to a goal-oriented approach could be beneficial for patients and clinicians. More insight about the concept and the implementation of this approach in clinical practice is needed.

Health Expect|2017 Nov 28

Martínez-Camblor P, Pardo-Fernández JC

2017 Jan 1;:962280217740786doi: 10.1177/0962280217740786

The receiver operating characteristic curve is a popular graphical method often used to study the diagnostic capacity of continuous (bio)markers. When the considered outcome is a time-dependent variable, two main extensions have been proposed: the cumulative/dynamic receiver operating characteristic curve and the incident/dynamic receiver operating characteristic curve. In both cases, the main problem for developing appropriate estimators is the estimation of the joint distribution of the variables time-to-event and marker. As usual, different approximations lead to different estimators. In this article, the authors explore the use of a bivariate kernel density estimator which accounts for censored observations in the sample and produces smooth estimators of the time-dependent receiver operating characteristic curves. The performance of the resulting cumulative/dynamic and incident/dynamic receiver operating characteristic curves is studied by means of Monte Carlo simulations. Additionally, the influence of the choice of the required smoothing parameters is explored. Finally, two real-applications are considered. An R package is also provided as a complement to this article.

Stat Methods Med Res|2017 Jan 1

Trentham-Dietz A, Ergun MA, Alagoz O, Stout NK, Gangnon RE, Hampton JM, Dittus K, James TA, Vacek PM, Herschorn SD, Burnside ES, Tosteson ANA, Weaver DL, Sprague BL

2017 Nov 28;doi: 10.1007/s10549-017-4582-0

Due to limitations in the ability to identify non-progressive disease, ductal carcinoma in situ (DCIS) is usually managed similarly to localized invasive breast cancer. We used simulation modeling to evaluate the potential impact of a hypothetical test that identifies non-progressive DCIS.

Breast Cancer Res Treat|2017 Nov 28

Goodman DC, Little GA

2017 Nov 27;doi: 10.1001/jamapediatrics.2017.4042

JAMA Pediatr|2017 Nov 27


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