Michael Benigno - Academia.edu (original) (raw)

Papers by Michael Benigno

Research paper thumbnail of Ceftaroline Fosamil for the Treatment of Methicillin-Resistant Staphylococcus Aureus Bacteremia: A Real-World Comparative Clinical Outcomes Study

Drugs - real world outcomes, Apr 2, 2024

Background and Objective Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in... more Background and Objective Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in substantial morbidity and mortality. As current treatments often lead to unsatisfactory outcomes, evidence guiding alternative treatment options is needed. This study evaluated real-world clinical outcomes of ceftaroline fosamil for the treatment of MRSA bacteremia. Methods This retrospective study included adults hospitalized with MRSA bacteremia between 2011 and 2019. Patients were classified according to treatment with ceftaroline fosamil (ceftaroline), vancomycin, or daptomycin: Group 1, ceftaroline; Group 2, vancomycin or daptomycin (without ceftaroline); Group 3, combination therapy with ≥ 2 of these three agents. Clinical outcomes were compared using propensity-score-adjusted odds ratios (ORs) from logistic regression models.

Research paper thumbnail of Substantial health and economic burden of COVID-19 during the year after acute illness among US adults not at high risk of severe COVID-19

BMC medicine, Feb 2, 2024

Research paper thumbnail of 522. Real-World, Retrospective Descriptive Study of COVID-19 Outpatient Therapeutic Uptake in High-Risk Patients Subsequently Hospitalized for COVID-19 During the Omicron Period in the US

Open Forum Infectious Diseases, Nov 26, 2023

Research paper thumbnail of Substantial health and economic burden of COVID-19 during the year after acute illness among US adults at high risk of severe COVID-19

BMC medicine, Feb 1, 2024

Research paper thumbnail of Subphenotypes of Self-Reported Symptoms and Outcomes in Long COVID: a prospective cohort study with latent class analysis

Objective: To characterize subphenotypes of self-reported symptoms and outcomes(SRSOs) in Post-ac... more Objective: To characterize subphenotypes of self-reported symptoms and outcomes(SRSOs) in Post-acute sequelae of COVID-19(PASC). Design: Prospective, observational cohort study of PASC subjects. Setting: Academic tertiary center from five clinical referral sources. Participants: Adults with COVID-19 ≥ 20 days before enrollment and presence of any new self-reported symptoms following COVID-19. Exposures: We collected data on clinical variables and SRSOs via structured telephone interviews and performed standardized assessments with validated clinical numerical scales to capture psychological symptoms, neurocognitive functioning, and cardiopulmonary function. We collected saliva and stool samples for quantification of SARS-CoV-2 RNA via qPCR. Primary and Secondary outcomes of measure: Description of PASC SRSOs burden and duration, derivation of distinct PASC subphenotypes via latent class analysis (LCA), and relationship between viral load with SRSOs and PASC subphenotypes. Results: B...

Research paper thumbnail of Real-World Evidence of the Top 100 Prescribed Drugs in the USA and Their Potential for Drug Interactions with Nirmatrelvir; Ritonavir

The AAPS Journal

Nirmatrelvir (coadministered with ritonavir as PAXLOVIDTM) reduces the risk of COVID-19-related h... more Nirmatrelvir (coadministered with ritonavir as PAXLOVIDTM) reduces the risk of COVID-19-related hospitalizations and all-cause death in individuals with mild-to-moderate COVID-19 at high risk of progression to severe disease. Ritonavir is coadministered as a pharmacokinetic enhancer. However, ritonavir may cause drug-drug interactions (DDIs) due to its interactions with various drug-metabolizing enzymes and transporters, including cytochrome P450 (CYP) 3A, CYP2D6, and P-glycoprotein transporters. To better understand the extent of DDIs (or lack thereof) of nirmatrelvir; ritonavir in a clinical setting, this study used real-world evidence (RWE) from the Optum Clinformatics Data Mart database to identify the top 100 drugs most commonly prescribed to US patients at high risk of progression to severe COVID-19 disease. The top 100 drugs were identified based on total counts associated with drugs prescribed to high-risk patients (i.e., ≥ 1 medical condition associated with an increased r...

Research paper thumbnail of Risk factors in people with mold infections that have spread to different parts of the body: a plain language summary

Future Microbiology, Aug 31, 2022

Research paper thumbnail of Use of the Postacute Sequelae of COVID-19 Diagnosis Code in Routine Clinical Practice in the US

JAMA Network Open

ImportanceA new International Classification of Diseases, Tenth Revision, Clinical Modification (... more ImportanceA new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021.ObjectiveTo examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice.Design, Setting, and ParticipantsThis cohort study of US patients with an ICD-10-CM code for post–COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post–COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post–COVID-19 diagnosis date was required.Main Outcomes and MeasuresPresence of the ICD-10-CM U09.9 code.ResultsThere were 56 143 p...

Research paper thumbnail of Characterizing patients with rare mucormycosis infections using real-world data

BMC Infectious Diseases, 2022

Background Invasive mucormycosis (IM) is a rare and often life-threatening fungal infection, for ... more Background Invasive mucormycosis (IM) is a rare and often life-threatening fungal infection, for which clinical and epidemiological understanding is lacking. Electronic health record (EHR) data can be utilized to elucidate large populations of patients with IM to address this unmet need. This study aimed to descriptively assess data on patients with IM using the Optum® EHR dataset. Methods US patient data from the Optum® deidentified EHR dataset (2007–2019) were analyzed to identify patients with IM. Patients with hematologic malignancies (HM), at high risk of IM, were selected and sorted by IM diagnosis (ICD9 117.7; ICD10 B46). Demographics, comorbidities/other diagnoses, and treatments were analyzed in patients with IM. Results In total, 1133 patients with HM and IM were identified. Most were between 40 and 64 years of age, Caucasian, and from the Midwest. Essential primary hypertension (50.31%) was the most common comorbidity. Of the 1133 patients, only 33.72% were prescribed an ...

Research paper thumbnail of Curating and Integrating Data from Multiple Sources to Support Healthcare Analytics

Studies in Health Technology and Informatics, 2015

As the volume and variety of healthcare related data continues to grow, the analysis and use of t... more As the volume and variety of healthcare related data continues to grow, the analysis and use of this data will increasingly depend on the ability to appropriately collect, curate and integrate disparate data from many different sources. We describe our approach to and highlight our experiences with the development of a robust data collection, curation and integration infrastructure that supports healthcare analytics. This system has been successfully applied to the processing of a variety of data types including clinical data from electronic health records and observational studies, genomic data, microbiomic data, self-reported data from surveys and self-tracked data from wearable devices from over 600 subjects. The curated data is currently being used to support healthcare analytic applications such as data visualization, patient stratification and predictive modeling.

Research paper thumbnail of Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

PLOS ONE

Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavir... more Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years. Methods Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region. Results The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between Marc...

Research paper thumbnail of Patient Characteristics and Risk Factors in Invasive Mold Infections: Comparison from a Systematic Review and Database Analysis

ClinicoEconomics and Outcomes Research: CEOR, 2021

Introduction Diagnosis and treatment of invasive mold infections (IMI) can be challenging and IMI... more Introduction Diagnosis and treatment of invasive mold infections (IMI) can be challenging and IMI is a significant source of morbidity and mortality. Invasive aspergillosis (IA) and invasive mucormycosis (IM) are two of the most common mold infections. A better understanding of patient comorbidities and risk factors that predispose IMI may help clinicians to refine the difficult diagnostic and treatment process. Methods A systematic literature review (SLR) was conducted (January 2008–October 2019) for studies reporting comorbidities/risk factors of patients with IA or IM (Phase I), followed by an analysis on the Optum® US EHR database of prominent risk factor cohorts based on SLR findings and expert opinion (Phase II). From the four identified patient cohorts: 1) patients undergoing solid organ transplant (SOT) and patients with 2) hematologic cancers, 3) diabetes, or 4) lung disease, rates of IA, IM, or concurrent IA and IM; patient comorbidities; and Charlson Comorbidity Index (CC...

Research paper thumbnail of Curating and integrating user-generated health data from multiple sources to support healthcare analytics

IBM Journal of Research and Development

As the volume and variety of healthcare-related data continue to grow, the analysis and use of th... more As the volume and variety of healthcare-related data continue to grow, the analysis and use of this data will increasingly depend on the ability to appropriately collect, curate, and integrate disparate data from many different sources including user-generated health data. We describe our approach to, and highlight our experiences with, the development of a robust data curation process that supports healthcare analytics. The process consists of the following steps: collection, understanding, validation, cleaning, integration, enrichment, and storage. It has been successfully applied to the processing of a variety of data types including clinical data from electronic health records and observational studies, genomic data, microbiome data, self-reported data from surveys, and self-tracked data from wearables from more than 600 subjects. The curated data have been used to support a number of healthcare analytic applications, including descriptive analytics, data visualization, patient stratification, and predictive modeling.

Research paper thumbnail of Prevention of Mother to Child Transmission (PMTCT) in Ethiopia

The Pfizer Global Health Fellows Program is an international corporate volunteer program. Through... more The Pfizer Global Health Fellows Program is an international corporate volunteer program. Through the GHF program, Pfizer colleagues are paired with leading international development organizations in short-term assignments in key emerging markets designed to transfer their professional expertise in ways that promote access, quality and

Research paper thumbnail of Treatment of Relapsed or Refractory Acute Lymphoblastic Leukemia in Real-World US Practices

Blood, 2017

BACKGROUND Acute Lymphoblastic Leukemia (ALL) in adults is a rare malignancy associated with high... more BACKGROUND Acute Lymphoblastic Leukemia (ALL) in adults is a rare malignancy associated with high rates of relapse and poor outcomes. Despite the availability of multi-agent chemotherapies and the recently-approved novel targeted therapy blinatumomab (BLINA), most adults with relapsed or refractory (R/R) ALL are unlikely to achieve remission, undergo hematopoietic cell transplant (HCT), and experience long-term survival. The objective of this study was to determine current real-world standard of care, patient characteristics, healthcare resource utilization, and outcomes for adult R/R ALL after first relapse. Here we report patient characteristics, treatment patterns, and outcomes for this population. METHODS We conducted a retrospective study using Symphony Health Solutions9 Integrated Dataverse, a longitudinal transactional database that includes prescription, medical and hospital claims across > 4,900 US payers. Eligible patients were >15 yr, and had at least 1 ICD-9 or ICD...

Research paper thumbnail of Hospitalization and mortality trends among patients with confirmed COVID-19 in the United States, April through August 2020

Journal of Public Health Research

Background: The United States has experienced high COVID-19 case counts, hospitalizations, and de... more Background: The United States has experienced high COVID-19 case counts, hospitalizations, and death rates. This retrospective analysis reports changing trends in the demographics and clinical outcomes of hospitalized US COVID-19 patients between April and August 2020.Design and Methods: The Premier Healthcare Database Special Release was used to examine patient demographics of hospitalized COVID-19 patients from all US Census Bureau divisions. Demographics included age, sex, race, and ethnicity. Clinical outcomes included in-hospital mortality, intensive care unit (ICU) admission, and receipt of invasive mechanical ventilation.Results: Overall, 146,491 hospitalized COVID-19 patients were included (mean [SD] age, 61.0 [18.4] years; 51.7% male; 29.6% White non-Hispanic). Monthly total hospitalizations decreased from 44,854 in April to 18,533 in August; ICU admissions increased from 19.8% to 23.6%, and ventilator use and inpatient mortality decreased from 18.6% to 14.5% and 21.0% to 1...

Research paper thumbnail of Clinical and Pregnancy Outcomes of COVID-19 Among Hospitalized Pregnant Women in the United States

Open Forum Infectious Diseases

Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor m... more Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clini...

Research paper thumbnail of Health outcomes and economic burden of hospitalized COVID-19 patients in the United States

Journal of Medical Economics

Objective: The aims of this study were to evaluate health outcomes and the economic burden of hos... more Objective: The aims of this study were to evaluate health outcomes and the economic burden of hospitalized COVID-19 patients in the United States. Methods: Hospitalized patients with a primary or secondary discharge diagnosis code for COVID-19 (ICD-10 code U07.1) from 1 April to 31 October 2020 were identified in the Premier Healthcare COVID-19 Database. Patient demographics, hospitalization characteristics, and concomitant medical conditions were assessed. Hospital length of stay (LOS), in-hospital mortality, hospital charges, and hospital costs were evaluated overall and stratified by age groups, insurance types, and 4 COVID-19 disease progression states based on intensive care unit (ICU) and invasive mechanical ventilation (IMV) usage. Results: Of the 173,942 hospitalized COVID-19 patients, the median age was 63 years, 51.0% were male, and 48.5% were covered by Medicare. The most prevalent concomitant medical conditions were cardiovascular disease (73.5%), hypertension (64.8%), diabetes (40.7%), obesity (27.0%), and chronic kidney disease (24.2%). Approximately one-fifth (21.9%) of the hospitalized COVID-19 patients were admitted to the ICU and 16.9% received IMV; most patients (73.6%) did not require ICU admission or IMV, and 12.4% required both. The median hospital LOS was 5 days, in-hospital mortality was 13.6%, median hospital charges were 43,986,andmedianhospitalcostswere43,986, and median hospital costs were 43,986,andmedianhospitalcostswere12,046. Hospital LOS and inhospital mortality increased with ICU and/or IMV usage and age; hospital charges and costs increased with ICU and/or IMV usage. Patients with both ICU and IMV usage had the longest median hospital LOS (15 days), highest in-hospital mortality (53.8%), and highest hospital charges ($198,394) and hospital costs ($54,402). Limitations: This retrospective administrative database analysis relied on coding accuracy and a subset of admissions with validated/reconciled hospital costs. Conclusions: This study summarizes the severe health outcomes and substantial hospital costs of hospitalized COVID-19 patients in the US. The findings support the urgent need for rapid implementation of effective interventions, including safe and efficacious vaccines.

Research paper thumbnail of A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States

Clinical, Cosmetic and Investigational Dermatology

Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-sc... more Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (≤50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (>50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.

Research paper thumbnail of 1710. Profiling Patients with Rare Mucormycosis Infections Using Real-world Data

Open Forum Infectious Diseases

Background Invasive mucormycosis (IM) is universally fatal if untreated and is a challenge to ass... more Background Invasive mucormycosis (IM) is universally fatal if untreated and is a challenge to assess due to its rarity. Diagnosis is difficult and can be missed due to a low index for suspicion. IM prevalence may be increasing with medical advances, especially in neutropenia management, leading to improved survival and expansion of the at-risk patient group. Large administrative databases contain patient-level chart information and may offer a way to describe IM patients in a representative sample of the population. Methods A retrospective observational study was conducted using US data from the deidentified Optum Electronic Health Record database between January 2007 and June 2018. Patients with any fungal infection and IM specifically were defined by ICD9 (110–119, 117.7) or ICD10 (B35-49, B46) codes. Descriptive statistics were used to assess demographics, comorbidities, and antifungal agents (AF) prescribed among IM patients with an underlying diagnosis of hematologic malignancy...

Research paper thumbnail of Ceftaroline Fosamil for the Treatment of Methicillin-Resistant Staphylococcus Aureus Bacteremia: A Real-World Comparative Clinical Outcomes Study

Drugs - real world outcomes, Apr 2, 2024

Background and Objective Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in... more Background and Objective Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in substantial morbidity and mortality. As current treatments often lead to unsatisfactory outcomes, evidence guiding alternative treatment options is needed. This study evaluated real-world clinical outcomes of ceftaroline fosamil for the treatment of MRSA bacteremia. Methods This retrospective study included adults hospitalized with MRSA bacteremia between 2011 and 2019. Patients were classified according to treatment with ceftaroline fosamil (ceftaroline), vancomycin, or daptomycin: Group 1, ceftaroline; Group 2, vancomycin or daptomycin (without ceftaroline); Group 3, combination therapy with ≥ 2 of these three agents. Clinical outcomes were compared using propensity-score-adjusted odds ratios (ORs) from logistic regression models.

Research paper thumbnail of Substantial health and economic burden of COVID-19 during the year after acute illness among US adults not at high risk of severe COVID-19

BMC medicine, Feb 2, 2024

Research paper thumbnail of 522. Real-World, Retrospective Descriptive Study of COVID-19 Outpatient Therapeutic Uptake in High-Risk Patients Subsequently Hospitalized for COVID-19 During the Omicron Period in the US

Open Forum Infectious Diseases, Nov 26, 2023

Research paper thumbnail of Substantial health and economic burden of COVID-19 during the year after acute illness among US adults at high risk of severe COVID-19

BMC medicine, Feb 1, 2024

Research paper thumbnail of Subphenotypes of Self-Reported Symptoms and Outcomes in Long COVID: a prospective cohort study with latent class analysis

Objective: To characterize subphenotypes of self-reported symptoms and outcomes(SRSOs) in Post-ac... more Objective: To characterize subphenotypes of self-reported symptoms and outcomes(SRSOs) in Post-acute sequelae of COVID-19(PASC). Design: Prospective, observational cohort study of PASC subjects. Setting: Academic tertiary center from five clinical referral sources. Participants: Adults with COVID-19 ≥ 20 days before enrollment and presence of any new self-reported symptoms following COVID-19. Exposures: We collected data on clinical variables and SRSOs via structured telephone interviews and performed standardized assessments with validated clinical numerical scales to capture psychological symptoms, neurocognitive functioning, and cardiopulmonary function. We collected saliva and stool samples for quantification of SARS-CoV-2 RNA via qPCR. Primary and Secondary outcomes of measure: Description of PASC SRSOs burden and duration, derivation of distinct PASC subphenotypes via latent class analysis (LCA), and relationship between viral load with SRSOs and PASC subphenotypes. Results: B...

Research paper thumbnail of Real-World Evidence of the Top 100 Prescribed Drugs in the USA and Their Potential for Drug Interactions with Nirmatrelvir; Ritonavir

The AAPS Journal

Nirmatrelvir (coadministered with ritonavir as PAXLOVIDTM) reduces the risk of COVID-19-related h... more Nirmatrelvir (coadministered with ritonavir as PAXLOVIDTM) reduces the risk of COVID-19-related hospitalizations and all-cause death in individuals with mild-to-moderate COVID-19 at high risk of progression to severe disease. Ritonavir is coadministered as a pharmacokinetic enhancer. However, ritonavir may cause drug-drug interactions (DDIs) due to its interactions with various drug-metabolizing enzymes and transporters, including cytochrome P450 (CYP) 3A, CYP2D6, and P-glycoprotein transporters. To better understand the extent of DDIs (or lack thereof) of nirmatrelvir; ritonavir in a clinical setting, this study used real-world evidence (RWE) from the Optum Clinformatics Data Mart database to identify the top 100 drugs most commonly prescribed to US patients at high risk of progression to severe COVID-19 disease. The top 100 drugs were identified based on total counts associated with drugs prescribed to high-risk patients (i.e., ≥ 1 medical condition associated with an increased r...

Research paper thumbnail of Risk factors in people with mold infections that have spread to different parts of the body: a plain language summary

Future Microbiology, Aug 31, 2022

Research paper thumbnail of Use of the Postacute Sequelae of COVID-19 Diagnosis Code in Routine Clinical Practice in the US

JAMA Network Open

ImportanceA new International Classification of Diseases, Tenth Revision, Clinical Modification (... more ImportanceA new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021.ObjectiveTo examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice.Design, Setting, and ParticipantsThis cohort study of US patients with an ICD-10-CM code for post–COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post–COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post–COVID-19 diagnosis date was required.Main Outcomes and MeasuresPresence of the ICD-10-CM U09.9 code.ResultsThere were 56 143 p...

Research paper thumbnail of Characterizing patients with rare mucormycosis infections using real-world data

BMC Infectious Diseases, 2022

Background Invasive mucormycosis (IM) is a rare and often life-threatening fungal infection, for ... more Background Invasive mucormycosis (IM) is a rare and often life-threatening fungal infection, for which clinical and epidemiological understanding is lacking. Electronic health record (EHR) data can be utilized to elucidate large populations of patients with IM to address this unmet need. This study aimed to descriptively assess data on patients with IM using the Optum® EHR dataset. Methods US patient data from the Optum® deidentified EHR dataset (2007–2019) were analyzed to identify patients with IM. Patients with hematologic malignancies (HM), at high risk of IM, were selected and sorted by IM diagnosis (ICD9 117.7; ICD10 B46). Demographics, comorbidities/other diagnoses, and treatments were analyzed in patients with IM. Results In total, 1133 patients with HM and IM were identified. Most were between 40 and 64 years of age, Caucasian, and from the Midwest. Essential primary hypertension (50.31%) was the most common comorbidity. Of the 1133 patients, only 33.72% were prescribed an ...

Research paper thumbnail of Curating and Integrating Data from Multiple Sources to Support Healthcare Analytics

Studies in Health Technology and Informatics, 2015

As the volume and variety of healthcare related data continues to grow, the analysis and use of t... more As the volume and variety of healthcare related data continues to grow, the analysis and use of this data will increasingly depend on the ability to appropriately collect, curate and integrate disparate data from many different sources. We describe our approach to and highlight our experiences with the development of a robust data collection, curation and integration infrastructure that supports healthcare analytics. This system has been successfully applied to the processing of a variety of data types including clinical data from electronic health records and observational studies, genomic data, microbiomic data, self-reported data from surveys and self-tracked data from wearable devices from over 600 subjects. The curated data is currently being used to support healthcare analytic applications such as data visualization, patient stratification and predictive modeling.

Research paper thumbnail of Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

PLOS ONE

Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavir... more Background The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years. Methods Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region. Results The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between Marc...

Research paper thumbnail of Patient Characteristics and Risk Factors in Invasive Mold Infections: Comparison from a Systematic Review and Database Analysis

ClinicoEconomics and Outcomes Research: CEOR, 2021

Introduction Diagnosis and treatment of invasive mold infections (IMI) can be challenging and IMI... more Introduction Diagnosis and treatment of invasive mold infections (IMI) can be challenging and IMI is a significant source of morbidity and mortality. Invasive aspergillosis (IA) and invasive mucormycosis (IM) are two of the most common mold infections. A better understanding of patient comorbidities and risk factors that predispose IMI may help clinicians to refine the difficult diagnostic and treatment process. Methods A systematic literature review (SLR) was conducted (January 2008–October 2019) for studies reporting comorbidities/risk factors of patients with IA or IM (Phase I), followed by an analysis on the Optum® US EHR database of prominent risk factor cohorts based on SLR findings and expert opinion (Phase II). From the four identified patient cohorts: 1) patients undergoing solid organ transplant (SOT) and patients with 2) hematologic cancers, 3) diabetes, or 4) lung disease, rates of IA, IM, or concurrent IA and IM; patient comorbidities; and Charlson Comorbidity Index (CC...

Research paper thumbnail of Curating and integrating user-generated health data from multiple sources to support healthcare analytics

IBM Journal of Research and Development

As the volume and variety of healthcare-related data continue to grow, the analysis and use of th... more As the volume and variety of healthcare-related data continue to grow, the analysis and use of this data will increasingly depend on the ability to appropriately collect, curate, and integrate disparate data from many different sources including user-generated health data. We describe our approach to, and highlight our experiences with, the development of a robust data curation process that supports healthcare analytics. The process consists of the following steps: collection, understanding, validation, cleaning, integration, enrichment, and storage. It has been successfully applied to the processing of a variety of data types including clinical data from electronic health records and observational studies, genomic data, microbiome data, self-reported data from surveys, and self-tracked data from wearables from more than 600 subjects. The curated data have been used to support a number of healthcare analytic applications, including descriptive analytics, data visualization, patient stratification, and predictive modeling.

Research paper thumbnail of Prevention of Mother to Child Transmission (PMTCT) in Ethiopia

The Pfizer Global Health Fellows Program is an international corporate volunteer program. Through... more The Pfizer Global Health Fellows Program is an international corporate volunteer program. Through the GHF program, Pfizer colleagues are paired with leading international development organizations in short-term assignments in key emerging markets designed to transfer their professional expertise in ways that promote access, quality and

Research paper thumbnail of Treatment of Relapsed or Refractory Acute Lymphoblastic Leukemia in Real-World US Practices

Blood, 2017

BACKGROUND Acute Lymphoblastic Leukemia (ALL) in adults is a rare malignancy associated with high... more BACKGROUND Acute Lymphoblastic Leukemia (ALL) in adults is a rare malignancy associated with high rates of relapse and poor outcomes. Despite the availability of multi-agent chemotherapies and the recently-approved novel targeted therapy blinatumomab (BLINA), most adults with relapsed or refractory (R/R) ALL are unlikely to achieve remission, undergo hematopoietic cell transplant (HCT), and experience long-term survival. The objective of this study was to determine current real-world standard of care, patient characteristics, healthcare resource utilization, and outcomes for adult R/R ALL after first relapse. Here we report patient characteristics, treatment patterns, and outcomes for this population. METHODS We conducted a retrospective study using Symphony Health Solutions9 Integrated Dataverse, a longitudinal transactional database that includes prescription, medical and hospital claims across > 4,900 US payers. Eligible patients were >15 yr, and had at least 1 ICD-9 or ICD...

Research paper thumbnail of Hospitalization and mortality trends among patients with confirmed COVID-19 in the United States, April through August 2020

Journal of Public Health Research

Background: The United States has experienced high COVID-19 case counts, hospitalizations, and de... more Background: The United States has experienced high COVID-19 case counts, hospitalizations, and death rates. This retrospective analysis reports changing trends in the demographics and clinical outcomes of hospitalized US COVID-19 patients between April and August 2020.Design and Methods: The Premier Healthcare Database Special Release was used to examine patient demographics of hospitalized COVID-19 patients from all US Census Bureau divisions. Demographics included age, sex, race, and ethnicity. Clinical outcomes included in-hospital mortality, intensive care unit (ICU) admission, and receipt of invasive mechanical ventilation.Results: Overall, 146,491 hospitalized COVID-19 patients were included (mean [SD] age, 61.0 [18.4] years; 51.7% male; 29.6% White non-Hispanic). Monthly total hospitalizations decreased from 44,854 in April to 18,533 in August; ICU admissions increased from 19.8% to 23.6%, and ventilator use and inpatient mortality decreased from 18.6% to 14.5% and 21.0% to 1...

Research paper thumbnail of Clinical and Pregnancy Outcomes of COVID-19 Among Hospitalized Pregnant Women in the United States

Open Forum Infectious Diseases

Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor m... more Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clini...

Research paper thumbnail of Health outcomes and economic burden of hospitalized COVID-19 patients in the United States

Journal of Medical Economics

Objective: The aims of this study were to evaluate health outcomes and the economic burden of hos... more Objective: The aims of this study were to evaluate health outcomes and the economic burden of hospitalized COVID-19 patients in the United States. Methods: Hospitalized patients with a primary or secondary discharge diagnosis code for COVID-19 (ICD-10 code U07.1) from 1 April to 31 October 2020 were identified in the Premier Healthcare COVID-19 Database. Patient demographics, hospitalization characteristics, and concomitant medical conditions were assessed. Hospital length of stay (LOS), in-hospital mortality, hospital charges, and hospital costs were evaluated overall and stratified by age groups, insurance types, and 4 COVID-19 disease progression states based on intensive care unit (ICU) and invasive mechanical ventilation (IMV) usage. Results: Of the 173,942 hospitalized COVID-19 patients, the median age was 63 years, 51.0% were male, and 48.5% were covered by Medicare. The most prevalent concomitant medical conditions were cardiovascular disease (73.5%), hypertension (64.8%), diabetes (40.7%), obesity (27.0%), and chronic kidney disease (24.2%). Approximately one-fifth (21.9%) of the hospitalized COVID-19 patients were admitted to the ICU and 16.9% received IMV; most patients (73.6%) did not require ICU admission or IMV, and 12.4% required both. The median hospital LOS was 5 days, in-hospital mortality was 13.6%, median hospital charges were 43,986,andmedianhospitalcostswere43,986, and median hospital costs were 43,986,andmedianhospitalcostswere12,046. Hospital LOS and inhospital mortality increased with ICU and/or IMV usage and age; hospital charges and costs increased with ICU and/or IMV usage. Patients with both ICU and IMV usage had the longest median hospital LOS (15 days), highest in-hospital mortality (53.8%), and highest hospital charges ($198,394) and hospital costs ($54,402). Limitations: This retrospective administrative database analysis relied on coding accuracy and a subset of admissions with validated/reconciled hospital costs. Conclusions: This study summarizes the severe health outcomes and substantial hospital costs of hospitalized COVID-19 patients in the US. The findings support the urgent need for rapid implementation of effective interventions, including safe and efficacious vaccines.

Research paper thumbnail of A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States

Clinical, Cosmetic and Investigational Dermatology

Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-sc... more Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (≤50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (>50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.

Research paper thumbnail of 1710. Profiling Patients with Rare Mucormycosis Infections Using Real-world Data

Open Forum Infectious Diseases

Background Invasive mucormycosis (IM) is universally fatal if untreated and is a challenge to ass... more Background Invasive mucormycosis (IM) is universally fatal if untreated and is a challenge to assess due to its rarity. Diagnosis is difficult and can be missed due to a low index for suspicion. IM prevalence may be increasing with medical advances, especially in neutropenia management, leading to improved survival and expansion of the at-risk patient group. Large administrative databases contain patient-level chart information and may offer a way to describe IM patients in a representative sample of the population. Methods A retrospective observational study was conducted using US data from the deidentified Optum Electronic Health Record database between January 2007 and June 2018. Patients with any fungal infection and IM specifically were defined by ICD9 (110–119, 117.7) or ICD10 (B35-49, B46) codes. Descriptive statistics were used to assess demographics, comorbidities, and antifungal agents (AF) prescribed among IM patients with an underlying diagnosis of hematologic malignancy...