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Mary K. Goldstein
Journal Articles
Predicting inpatient clinical order patterns with probabilistic topic models vs conventional order sets
Jonathan Chen, Mary K. Goldstein, Steven M. Asch, Lester Mackey, Russ B. Altman
Journal of the American Medical Informatics Association,
2016
September 1, 2016
Objective
Build probabilistic topic model representations of hospital admissions processes and compare the ability of such models to predict clinical order patterns as compared to preconstructed order sets.
Materials and Methods
Journal Articles
Test Case Selection in Pre-Deployment Testing of Complex Clinical Decision Support Systems
Geoffrey T. Tso, Kaeli Yuen, Susana Martins, Samson W. Tu, Michael Ashcraft, Paul A. Heidenreich, Brian B. Hoffman, Mary K. Goldstein
AMIA Joint Summits on Translational Science Proceedings,
2016
July 20, 2016
Clinical decision support (CDS) systems with complex logic are being developed. Ensuring the quality of CDS is imperative, but there is no consensus on testing standards. We tested ATHENA-HTN CDS after encoding updated hypertension guidelines into the system. A logic flow and a complexity analysis of the encoding were performed to guide testing. 100 test cases were selected to test the major pathways in the CDS logic flow, and the effectiveness of the testing was analyzed. The encoding contained 26 decision points and 3120 possible output combinations.
Journal Articles
Prospective Analysis of Health and Mortality Risk in Veteran and Non-Veteran Participants in the Women's Health Initiative
Julie C. Weitlauf, Andrea Z. LaCroix, Chloe E. Bird, Nancy F. Woods, Donna L. Washington, Jodie G. Katon, Michael J. LaMonte, Mary K. Goldstein, Shari S. Bassuk, Gloria E. Sarto, Marcia L. Stefanick
Women's Health Issues,
2015
December 1, 2015
Background
The health of postmenopausal women veterans is a neglected area of study. A stronger empirical evidence base is needed, and would inform the provision of health care for the nearly 1 million U.S. women veterans currently 50 years of age or older. To this end, the present work compares salient health outcomes and risk of all-cause mortality among veteran and non-veteran participants of the Women's Health Initiative (WHI).
Journal Articles
Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry
Daniel W. Kaiser, Vivian Tsai, Paul A. Heidenreich, Mary K. Goldstein, Yongfei Wang, Jeptha Curtis, Mintu Turakhia
Heart Rhythm,
2015
October 1, 2015
Background
Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria.
Objective
We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs.
Abstracts
Automating Quality Review For Heart Failure Through a Performance Measurement System
Hwang TS, Martins SB, Tu SW, Wang DY, Paul A. Heidenreich, Mary K. Goldstein
Society for Medical Decision Making Annual Meeting,
2013
October 1, 2013
Journal Articles
Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure
Garvin JH, Duvall SL, South BR, Bray BE, Bolton D, Heavirland J, Pickard S, Heidenreich P, Shen S, Weir C, Samore M, Mary Goldstein
J Am Med Inform Assoc,
2012
December 31, 2012
ObjectivesLeft ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review.
Journal Articles
EHR Data for Complex Clinical Decision Support (CDS) and Quality Improvement: opportunities and challenges
Mary K. Goldstein,
Mary Goldstein
Stanford Medical School,
2012
January 1, 2012
Journal Articles
Knowing loved ones' end-of-life health care wishes: Attachment security predicts caregivers' accuracy
Turan B, Mary K. Goldstein, Alan M. Garber, Carstensen LL
Health Psychology,
2011
December 31, 2011
Journal Articles
Home blood pressure management and improved blood pressure control: results from a randomized controlled trial
Bosworth HB, Powers BJ, Olsen MK, McCant F, Grubber J, Smith V, Gentry PW, Rose C, Van Houtven C, Wang V, Mary Goldstein, Oddone EZ
Archives of Internal Medicine,
2011
December 31, 2011
Abstract
BACKGROUND:
To determine which of 3 interventions was most effective in improving blood pressure (BP) control, we performed a 4-arm randomized trial with 18-month follow-up at the primary care clinics at a Veterans Affairs Medical Center.
Journal Articles
Influence of Age on Perioperative Complications Among Patients Undergoing Implantable Cardioverter-Defibrillators for Primary Prevention in the United States
Vivian Tsai, Mary K. Goldstein, Hsia HH, Wang Y, Curtis J, Heidenreich PA
Circulation: Cardiovascular Quality and Outcomes,
2011
December 31, 2011
Journal Articles
Age Differences in Primary Prevention Implantable Cardioverter-Defibrillator Use in U.S. Individuals
Vivian Tsai, Mary K. Goldstein, Hsia HH, Wang Y, Curtis J, Heidenreich PA
Journal of the American Geriatrics Society,
2011
December 31, 2011
Abstract
OBJECTIVES:
To estimate the potentially inappropriate use of implantable cardioverter-defibrillator ICDs in older U.S. adults.
DESIGN:
Retrospective study.
SETTING:
The National Cardiovascular Data ICD Registry.
PARTICIPANTS:
Forty-four thousand eight hundred five individuals in the National Cardiovascular Data's ICD Registry(™) who had received ICDs for primary prevention from January 2006 to December 2008. Individuals with a prior myocardial infarction and ejection fraction less than 30% were included.
Journal Articles
Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain
Trafton, J. A., Martins, S. B., Michel, M. C., Wang, D., Tu, S. W., Clark, D. J., Elliott J, Vucic B, Balt S
Balt S, Clark ME
Clark ME, Sintek CD, Rosenberg J, Daniels D, Mary Goldstein
Implementation Science,
2010
December 31, 2010
Abstract
Background
Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients.
Working Papers
Natural Language Processing for Lines and Devices in Portable Chest X-Rays
Rubin D, Wang D, Chambers DA, Chambers JG, South BR, Goldstein MK
AMIA Annual Symposium Proceedings,
2010
November 13, 2010
Policy Briefs
When Tight Blood Pressure Control is not for Everyone: A New Model for Performance Measurement in Hypertension
Steinman MA, Mary Goldstein
Joint Commission Journal on Quality and Patient Safety,
2010
April 1, 2010
Background: Many patients with hypertension have legitimate reasons to forego standard blood pressure targets yet are nonetheless included in performance measurement systems. An approach to performance measurement incorporating clinical reasoning was developed to determine which patients to include in a performance measure.
Design: A 10-member multispecialty advisory panel refined a taxonomy of situations in which the balance of benefits and harms of anti-hypertensive treatment does not clearly favor tight blood pressure control (< 140/90 mm Hg).
Journal Articles
Evaluation of the Acceptability and Usability of a Decision Support System to Encourage Safe and Effective Use of Opioid Therapy for Chronic, Noncancer Pain by Primary Care Providers.
Jodie Trafton, Susana B. Martins, Michel M, Lewis E, Wang D, Combs A, Scates N, Tu S, Mary Goldstein
Pain Medicine,
2010
March 1, 2010
Abstract Objective. To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. Design. CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Results.
Journal Articles
Following Your Heart or Your Head: Focusing on Emotions versus Information Differentially Influences the Decisions of Younger and Older Adults
Joseph A. Mikels, Lockenhoff CE, Maglio SJ, Laura L. Carstensen, Mary K. Goldstein, Alan M. Garber
Journal of Experimental Psychology Applied,
2010
March 1, 2010
Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information.
Journal Articles
Preferences for dialysis withdrawal and engagement in advance care planning within a diverse sample of dialysis patients.
Kurella Tamura M, Mary Goldstein, Perez-Stable EJ
Nephrology, Dialysis, Transplant,
2010
January 1, 2010
BACKGROUND AND OBJECTIVES: Rates of dialysis withdrawal are higher among the elderly and lower among Blacks, yet it is unknown whether preferences for withdrawal and engagement in advance care planning also vary by age and race or ethnicity. DESIGN, SETTING, PARTICIPANTS AND METHODS: We recruited 61 participants from two dialysis clinics to complete questionnaires regarding dialysis withdrawal preferences in five different health states.
Books
Can physicians structure clinical guidelines? experiments with a mark-up-process methodology
Erez Shalom, Yuval Shahar, Meirav Taieb-Maimon, Guy Bar, Susana B. Martins, Ohad Young, Laszlo Vaszar, Yair Liel, Avi Yarkoni, Mary Goldstein, Et al.
Knowledge Management for Health Care Procedures,
2009
December 31, 2009
Abstract
Journal Articles
Preferences for Dialysis Withdrawal and Engagement in Advance Care Planning within a Diverse Sample of Dialysis Patients.
Tamura MK, Mary Goldstein, Perez-Stable EJ
Nephrology Dialysis Transplantation,
2009
September 3, 2009
Background and objectives. Rates of dialysis withdrawal are higher among the elderly and lower among Blacks, yet it is unknown whether preferences for withdrawal and engagement in advance care planning also vary by age and race or ethnicity.
Journal Articles
Patient Education and Provider Decision Support to Control Blood Pressure in Primary Care: A Cluster Randomized Trial
Bosworth HB, Olsen MK, Orr M, Mary K. Goldstein, Datta SK, McCant F, Gentry P, Simel DL, Oddone EZ
American Heart Journal,
2009
March 1, 2009
BACKGROUND: Less than one third of the 65 million Americans with hypertension have adequate blood pressure (BP) control. This study examined the effectiveness of 2 interventions for improving patient BP control. METHODS: This was a 2-level (primary care provider and patient) cluster randomized trial with 2-year follow-up occurring among patients with hypertension enrolled from a Veterans Affairs Medical Center primary care clinic. Primary care providers (n = 17) in the intervention received computer-generated decision support designed to
Journal Articles
Evaluation of an architecture for intelligent query and exploration of time-oriented clinical data.
Susana B. Martins, Shahar Y, Goren-Bar D, Galperin M, Kaizer H, Basso LV, McNaughton D, Mary K. Goldstein
Artificial Intelligence in medicine,
2008
December 31, 2008
OBJECTIVE: Evaluate KNAVE-II, a knowledge-based framework for visualization, interpretation, and exploration of longitudinal clinical data, clinical concepts and patterns. KNAVE-II mediates queries to a distributed temporal-abstraction architecture (IDAN), which uses a knowledge-based problem-solving method specializing in on-the-fly computation of clinical queries. METHODS: A two-phase, balanced cross-over study to compare efficiency and satisfaction of a group of clinicians when answering queries of variable complexity about
Journal Articles
Simple counts of ADL dependencies do not adequately reflect older adults' preferences toward states of functional impairment.
Tamara L. Sims, Holmes TH, Dena M. Bravata, Alan Garber, Lorene Nelson, Mary Goldstein
Journal of Clinical Epidemiology,
2008
December 1, 2008
OBJECTIVE: To use unweighted counts of dependencies in activities of daily living (ADLs) to assess the impact of functional impairment requires an assumption of equal preferences for each ADL dependency. To test this assumption, we analyzed standard gamble (SG) utilities of single and combination ADL dependencies among older adults. STUDY DESIGN AND SETTING: Four hundred older adults used multimedia software (FLAIR1) to report SG utilities for their current health and hypothetical health states of dependency in each of 7 ADLs and 8 of 30
Journal Articles
The Impact of Chronic Hepatitis C and Co-Morbid Illnesses on Health-Related Quality of Life
Kwan JW, Ruth C. Cronkite, Yiu A, Mary Goldstein, Kazis L, Cheung RC
Quality of Life Research,
2008
June 1, 2008
OBJECTIVES: Determine the relative impact of chronic hepatitis C (CHC) and co-morbid illnesses on health-related quality of life (HRQoL) in 3023 randomly selected veterans with known hepatitis C virus antibody (anti-HCV) status who previously completed a veteran-specific HRQoL questionnaire (SF-36V).
METHODS: Multiple regression analyses were performed to measure the relative contribution of anti-HCV status, four demographic variables, and ten common medical and six psychiatric co-morbidities to HRQoL between 303 anti-HCV(+) and 2720 anti-HCV(-) patients.
Journal Articles
Using Health Information Technology to Improve Hypertension Management
Mary Goldstein
Current hypertensions report,
2008
June 1, 2008
High-quality medical care requires implementing evidence-based best practices, with continued monitoring to improve performance. Implementation science is beginning to identify approaches to developing, implementing, and evaluating quality improvement strategies across health care systems that lead to good outcomes for patients. Health information technology has much to contribute to quality improvement for hypertension, particularly as part of multidimensional strategies for improved care. Clinical reminders closely aligned with
Journal Articles
A Quantitative Assessment of a Methodology for Collaborative Specification and Evaluation of Clinical Guidelines
E Shalom, Y Shahar, M Taieb-Maimon, O Young, SB Martins
SB Martins, L Vaszar
L Vaszar, Mary K. Goldstein, Y Liel, A Leibowitz, T Marom, E Lunenfeld
Journal of biomedical informatics,
2008
May 6, 2008
We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains. A gold-standard mark-up was created, including 196 plans and subplans, and 326 instances of ontological knowledge roles (KRs).