Nilay D Shah
Dados Biográficos
| ID | 5534609 |
|---|---|
| NOME | Nilay D Shah |
| PRENOMES | Nilay D |
| SOBRENOME | Shah |
| ASSINATURA | SHAH N D |
| AFILIAÇÕES | Mayo Clinic in Florida |
| ORCID | 0000-0002-8597-3447 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 13 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 13 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2008 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2022 |
| ÍNDICE H | 0 |
Midwest rural‐urban disparities in use of patient online services for Covid‐19
PURPOSE: Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest. METHODS: We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-ru…
What is the effect of a decision aid in potentially vulnerable parents? Insights from the head CT choice randomized trial
Objective To test the hypotheses that use of the Head CT Choice decision aid would be similarly effective in all parent/patient dyads but parents with high (vs low) numeracy experience a greater increase in knowledge while those with low (vs high) health literacy experience a greater increase in trust. Methods This was a secondary analysis of a cluster randomized trial conducted at seven sites. One hundred seventy‐two clinicians caring for 971 ch…
Response to Propoxyphene Market Withdrawal
OBJECTIVE: Experts cautioned that patients affected by the November 2010 withdrawal of the opioid analgesic propoxyphene might receive riskier prescriptions. To explore this, we compared drug receipts and outcomes among propoxyphene users before and aftermarket withdrawal. STUDY DESIGN: Using OptumLabs data, we studied 3 populations: commercial, Medicare Advantage (MA) aged (age 65+ y) and MA disabled (age below 65 y) enrollees. The exposed enrol…
Feeding Tubes and Health Care Service Utilization in Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurologic disorder with predictable challenges regarding disease progression and end-of-life care. These include need for respiratory and nutritional support. Little is known about how such choices impact end-of-life health service utilization for these patients. Using OptumLabs Data Warehouse, a large administrative claims database with more than 150 million privately insured, geograph…
Trajectories of Glycemic Change in a National Cohort of Adults With Previously Controlled Type 2 Diabetes
BACKGROUND: Individualized diabetes management would benefit from prospectively identifying well-controlled patients at risk of losing glycemic control. OBJECTIVES: To identify patterns of hemoglobin A1c (HbA1c) change among patients with stable controlled diabetes. RESEARCH DESIGN: Cohort study using OptumLabs Data Warehouse, 2001-2013. We develop and apply a machine learning framework that uses a Bayesian estimation of the mixture of generalize…
An observational study of socioeconomic and clinical gradients among diabetes patients hospitalized for avoidable causes
Among hospitalized diabetic patients, socioeconomic factors such as lower education attainment, rural residence and lack of full insurance are associated with avoidable hospitalizations or worse indicators of health. Although we cannot definitively rule out selection bias, these findings are consistent with health disparities observable even at the inpatient level. Future studies should study the underlying mechanism by which traditionally vulner…
Out of Context
BACKGROUND: Poor fidelity to practice guidelines in the care of people with multiple chronic conditions (MCC) may result from patients and clinicians struggling to apply recommendations that do not consider the interplay of MCC, socio-personal context, and patient preferences. OBJECTIVE: The objective of the study was to assess the quality of guideline development and the extent to which guidelines take into account 3 important factors: the impac…
Perceptions of Active Surveillance and Treatment Recommendations for Low-risk Prostate Cancer
BACKGROUND: With the growing concerns about overtreatment in prostate cancer, the extent to which radiation oncologists and urologists perceive active surveillance (AS) as effective and recommend it to patients are unknown. OBJECTIVE: To assess opinions of radiation oncologists and urologists about their perceptions of AS and treatment recommendations for low-risk prostate cancer. RESEARCH DESIGN: National survey of specialists. PARTICIPANTS: Rad…
Ambulatory Diagnosis and Treatment of Nonmalignant Pain in the United States, 2000–2010
BACKGROUND: Escalating rates of prescription opioid use and abuse have occurred in the context of efforts to improve the treatment of nonmalignant pain. OBJECTIVE: The aim of the study was to characterize the diagnosis and management of nonmalignant pain in ambulatory, office-based settings in the United States between 2000 and 2010. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional and multivariate regression analyses of the National Amb…
Challenges in Using Electronic Health Record Data for CER
OBJECTIVE: To document the strengths and challenges of using electronic health records (EHRs) for comparative effectiveness research (CER). METHODS: A replicated case study of comparative effectiveness in hypertension treatment was conducted across 4 health systems, with instructions to extract data and document problems encountered using a specified list of required data elements. Researchers at each health system documented successes and challe…
Cumulative complexity
Translating Comparative Effectiveness Into Practice
BACKGROUND: In recent years, there has been significant interest and investment in conducting comparative effectiveness research (CER) of medical treatments to improve the quality of care and reduce costs. The Agency for Healthcare Research and Quality (AHRQ) has been leading this effort and has invested a significant amount of resources to advance CER. However, little is known about translating the findings from CER into routine practice such th…
Effect of Premium, Copayments, and Health Status on the Choice of Health Plans
Various factors affect decision making of employees regarding the choice of plan with different levels of cost-sharing. In a natural experiment setting where all options were redesigned, the health status of employees and their dependents played a very significant role in plan choice
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Effect of Premium, Copayments, and Health Status on the Choice of Health Plans
Various factors affect decision making of employees regarding the choice of plan with different levels of cost-sharing. In a natural experiment setting where all options were redesigned, the health status of employees and their dependents played a very significant role in plan choice
Translating Comparative Effectiveness Into Practice
BACKGROUND: In recent years, there has been significant interest and investment in conducting comparative effectiveness research (CER) of medical treatments to improve the quality of care and reduce costs. The Agency for Healthcare Research and Quality (AHRQ) has been leading this effort and has invested a significant amount of resources to advance CER. However, little is known about translating the findings from CER into routine practice such th…
Cumulative complexity
Ambulatory Diagnosis and Treatment of Nonmalignant Pain in the United States, 2000–2010
BACKGROUND: Escalating rates of prescription opioid use and abuse have occurred in the context of efforts to improve the treatment of nonmalignant pain. OBJECTIVE: The aim of the study was to characterize the diagnosis and management of nonmalignant pain in ambulatory, office-based settings in the United States between 2000 and 2010. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional and multivariate regression analyses of the National Amb…
Challenges in Using Electronic Health Record Data for CER
OBJECTIVE: To document the strengths and challenges of using electronic health records (EHRs) for comparative effectiveness research (CER). METHODS: A replicated case study of comparative effectiveness in hypertension treatment was conducted across 4 health systems, with instructions to extract data and document problems encountered using a specified list of required data elements. Researchers at each health system documented successes and challe…
An observational study of socioeconomic and clinical gradients among diabetes patients hospitalized for avoidable causes
Among hospitalized diabetic patients, socioeconomic factors such as lower education attainment, rural residence and lack of full insurance are associated with avoidable hospitalizations or worse indicators of health. Although we cannot definitively rule out selection bias, these findings are consistent with health disparities observable even at the inpatient level. Future studies should study the underlying mechanism by which traditionally vulner…
Out of Context
BACKGROUND: Poor fidelity to practice guidelines in the care of people with multiple chronic conditions (MCC) may result from patients and clinicians struggling to apply recommendations that do not consider the interplay of MCC, socio-personal context, and patient preferences. OBJECTIVE: The objective of the study was to assess the quality of guideline development and the extent to which guidelines take into account 3 important factors: the impac…
Perceptions of Active Surveillance and Treatment Recommendations for Low-risk Prostate Cancer
BACKGROUND: With the growing concerns about overtreatment in prostate cancer, the extent to which radiation oncologists and urologists perceive active surveillance (AS) as effective and recommend it to patients are unknown. OBJECTIVE: To assess opinions of radiation oncologists and urologists about their perceptions of AS and treatment recommendations for low-risk prostate cancer. RESEARCH DESIGN: National survey of specialists. PARTICIPANTS: Rad…
Feeding Tubes and Health Care Service Utilization in Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurologic disorder with predictable challenges regarding disease progression and end-of-life care. These include need for respiratory and nutritional support. Little is known about how such choices impact end-of-life health service utilization for these patients. Using OptumLabs Data Warehouse, a large administrative claims database with more than 150 million privately insured, geograph…
Trajectories of Glycemic Change in a National Cohort of Adults With Previously Controlled Type 2 Diabetes
BACKGROUND: Individualized diabetes management would benefit from prospectively identifying well-controlled patients at risk of losing glycemic control. OBJECTIVES: To identify patterns of hemoglobin A1c (HbA1c) change among patients with stable controlled diabetes. RESEARCH DESIGN: Cohort study using OptumLabs Data Warehouse, 2001-2013. We develop and apply a machine learning framework that uses a Bayesian estimation of the mixture of generalize…
What is the effect of a decision aid in potentially vulnerable parents? Insights from the head CT choice randomized trial
Objective To test the hypotheses that use of the Head CT Choice decision aid would be similarly effective in all parent/patient dyads but parents with high (vs low) numeracy experience a greater increase in knowledge while those with low (vs high) health literacy experience a greater increase in trust. Methods This was a secondary analysis of a cluster randomized trial conducted at seven sites. One hundred seventy‐two clinicians caring for 971 ch…
Response to Propoxyphene Market Withdrawal
OBJECTIVE: Experts cautioned that patients affected by the November 2010 withdrawal of the opioid analgesic propoxyphene might receive riskier prescriptions. To explore this, we compared drug receipts and outcomes among propoxyphene users before and aftermarket withdrawal. STUDY DESIGN: Using OptumLabs data, we studied 3 populations: commercial, Medicare Advantage (MA) aged (age 65+ y) and MA disabled (age below 65 y) enrollees. The exposed enrol…
Midwest rural‐urban disparities in use of patient online services for Covid‐19
PURPOSE: Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest. METHODS: We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-ru…
Medicine (12 obras) · Internal Medicine (8 obras) · Internal Medicine (5 obras) · Computer Science (4 obras) · Emergency Medicine (4 obras) · Family medicine (4 obras) · Health care (4 obras) · MEDLINE (4 obras) · Alternative medicine (3 obras) · Chronic Disease Management Strategies (3 obras)