Department of Epidemiology

MS


November 18, 2020

Non-inferiority of a non-contrast MRI follow up protocol for isolated optic pathway gliomas

BACKGROUND Pediatric optic pathway gliomas (OPGs) are typically indolent, but have variable clinical course. Treatment is dictated by symptoms and changes on contrast-enhanced magnetic resonance (CEMR) examinations. Gadolinium retention in children has motivated parsimonious use of gadolinium-based contrast agents (GBCAs). OBJECTIVES 1) Determine surveillance MR factors that motivate changes in tumor-directed therapies (TDTs), establish GBCA…


Risk Factors for Severe Acute Kidney Injury after Pediatric Hematopoietic Stem Cell Transplantation

Background: Acute Kidney Injury (AKI) is common after Hematopoietic Stem Cell Transplantation (HSCT) and is associated with increased morbidity and mortality. Risk factors for AKI after HSCT are not fully understood, and there are limited pediatric studies that describe post HSCT AKI. Objective: To assess unique risk factors for AKI in the HSCT population. Design/Methods:…


Genetic variation in telomere maintenance genes and survival after colorectal cancer diagnosis

INTRODUCTION Telomeres are the repetitive nucleotide sequences capping the end of chromosomes and are regulated by telomerase. Both telomere length and telomerase initiate carcinogenesis and prognosis in patients diagnosed with cancer, including colorectal cancer (CRC). Genome-wide association studies (GWAS) have identified several loci related to telomere length or telomerase activity, but the association between those…


Hospital Resource Utilization and Presence of Advance Directives at the End of Life for Adults with Congenital Heart Disease

OBJECTIVE Overall healthcare resource utilization by adults with congenital heart disease has increased dramatically in the last two decades. No prior studies have examined utilization at the end of life. The objective of this study is to better understand the patterns and influences on the intensity of care at the end of life for adults…


Transplant-Associated Thrombotic Microangiopathy (TA-TMA) is a Multifactorial Disease Unresponsive to Immunosuppressant Withdrawal

Background: Transplant-associated thrombotic microangiopathy (TA-TMA) after allogeneic hematopoietic cell transplantation (HCT) has not been well-characterized in large population studies with clinically adjudicated cases. Methods: We performed a retrospective cohort study of adults who underwent allogeneic HCT between 2006 and 2015 to determine the incidence of and risk factors for TA-TMA, and to describe its natural…


POLST-Discordant Intensive Care Near the End of Life: A Retrospective Cohort Study

Importance: Patients with chronic life-limiting illness frequently use the Physician Orders for Life Sustaining Treatment (POLST) to document preferences for limiting intensive care. However, the incidence and predictors of POLST-discordant care near the end of life are not known. Objective: To describe the incidence, predictors, and intensity of POLST-discordant intensive care among patients hospitalized near…


Health care service utilization of individuals in permanent supportive housing in Seattle, WA accessing care through Public Health – Seattle and King County’s Health Care for the Homeless Network

Introduction: Permanent supportive housing (PSH) programs combine non-time limited housing with optional supportive services, including case management and health care, and are designed for those facing barriers to housing stability. Prior studies suggest that PSH can reduce emergency room visits and health care expenditures for an individual while improving their housing stability and well-being. However,…


Racial/Ethnic Disparities in Risk of Breast Cancer Mortality by Molecular Subtype and Stage at Diagnosis

Previous research has found significant survival disparities between African-American and white women among select stages and subtypes of breast cancer, however other racial/ethnic groups have been less well-studied. This study expands on previous research, examining differences in breast cancer-specific mortality across multiple racial and ethnic groups. Women diagnosed with a first primary invasive breast cancer…


Hepatocellular carcinoma screening reduces cancer-related mortality in patients with chronic hepatitis B infection: a case-control study

Background: Patients with chronic hepatitis B (CHB) infection often undergo screening for hepatocellular carcinoma (HCC), but the efficacy of such screening remains unclear. We aimed to evaluate the impact of screening with ultrasound (USS) and/or serum alpha-fetoprotein (AFP) on HCC-related mortality in Veterans Affairs (VA) patients with CHB. Methods: We performed a matched case-control study….


November 17, 2020

Association of Guideline-recommended COPD Inhaler Regimens with Respiratory Exacerbations, Exercise Performance, and Quality of Life

Background: Although inhaled therapy reduces exacerbations among patients with COPD, the effectiveness of providing inhaled treatment according to recent risk-stratification models remains unclear. Research Question: Are inhaled regimens that align with the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy associated with clinically important outcomes? Study Design and Methods: We conducted secondary analyses…



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