2022
Cancer tracking system improves timeliness of liver cancer care at a Veterans Hospital: A comparison of cohorts before and after implementation of an automated care coordination tool
Zhang Y, Mezzacappa C, Shen L, Ivatorov A, Petukhova-Greenstein A, Mehta R, Ciarleglio M, Deng Y, Levin W, Steinhardt S, Connery D, Pineau M, Onyiuke I, Taylor C, Rose M, Taddei T. Cancer tracking system improves timeliness of liver cancer care at a Veterans Hospital: A comparison of cohorts before and after implementation of an automated care coordination tool. PLOS Digital Health 2022, 1: e0000080. PMID: 36812575, PMCID: PMC9931271, DOI: 10.1371/journal.pdig.0000080.Peer-Reviewed Original Research
2021
SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation
Kaplan D, Mehta R, Garcia-Tsao G, Albrecht J, Aytaman A, Baffy G, Bajaj J, Hernaez R, Hunt K, Ioannou G, Johnson K, Kanwal F, Lee T, Monto A, Pandya P, Schaubel D, Taddei T. SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation. Contemporary Clinical Trials 2021, 104: 106367. PMID: 33771685, PMCID: PMC8422958, DOI: 10.1016/j.cct.2021.106367.Peer-Reviewed Original ResearchConceptsHepatic decompensationPortal hypertensionEvents of decompensationHepatic decompensation eventsLiver-related deathSignificant portal hypertensionAcceptable safety profileProspective human studiesRole of statinsChronic liver diseaseClasses of medicationsPatient-reported outcomesDevelopment of decompensationEffect of simvastatinVA Medical CenterCompensated cirrhosisDecompensation eventsStatin therapyVariceal hemorrhageCirrhotic patientsStandard therapyVascular reactivityExert pleiotropic effectsLiver diseaseRetrospective study
2019
351 – Cancer Tracking System Improves Timeliness of Liver Cancer Care At a Veterans Hospital
Zhang Y, Mehta R, Taddei T. 351 – Cancer Tracking System Improves Timeliness of Liver Cancer Care At a Veterans Hospital. Gastroenterology 2019, 156: s-1192. DOI: 10.1016/s0016-5085(19)39956-1.Peer-Reviewed Original Research
2018
Implementation of a Population-Based Cirrhosis Identification and Management System
Kanwal F, Mapaskhi S, Smith D, Taddei T, Hussain K, Madu S, Duong N, White D, Cao Y, Mehta R, El-Serag H, Asch S, Midboe A. Implementation of a Population-Based Cirrhosis Identification and Management System. Clinical Gastroenterology And Hepatology 2018, 16: 1182-1186.e2. PMID: 29803805, PMCID: PMC7185902, DOI: 10.1016/j.cgh.2018.01.041.Peer-Reviewed Original ResearchTransarterial Chemoembolization within First 3 Months of Sorafenib Initiation Improves Overall Survival in Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study with Propensity Matching
Kaplan DE, Mehta R, D'Addeo K, Gade TP, Taddei TH. Transarterial Chemoembolization within First 3 Months of Sorafenib Initiation Improves Overall Survival in Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study with Propensity Matching. Journal Of Vascular And Interventional Radiology 2018, 29: 540-549.e4. PMID: 29477619, PMCID: PMC6104514, DOI: 10.1016/j.jvir.2017.11.033.Peer-Reviewed Original ResearchConceptsUnresectable hepatocellular carcinomaTransarterial chemoembolizationHepatocellular carcinomaMacrovascular invasionPropensity matchingOverall survivalEnd-stage liver disease (MELD) scoreBarcelona Clinic Liver Cancer stageVeterans Health Administration hospitalsInitiation of sorafenibSignificant hepatic dysfunctionLiver Disease scoreRetrospective cohort studyAdjuvant transarterial chemoembolizationLiver Cancer stageMulti-institutional studySorafenib initiationHepatic dysfunctionCohort studyMost patientsSystemic therapyPrimary outcomeUnadjusted analysesMultimodal therapySubgroup analysisSorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma
Kaplan DE, Mehta R, D’Addeo K, Valderrama A, Taddei TH. Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma. Medicine 2018, 97: e9757. PMID: 29369224, PMCID: PMC5794408, DOI: 10.1097/md.0000000000009757.Peer-Reviewed Original ResearchConceptsAdvanced hepatocellular carcinomaHepatocellular carcinomaOverall survivalBarcelona Clinic Liver Cancer (BCLC) systemManagement of HCCVeterans Health Administration hospitalsRetrospective cohort studyFirst-line therapySimilar survival outcomesChild-TurcottePugh scoreComorbidity indexChart abstractionCohort studySurvival benefitSystemic therapyBCLC stagePrimary outcomePrescriber typeSurvival outcomesAdministration HospitalMultivariable modelProvider specialtyCancer stagingHCC diagnosis
2017
Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study
Reiss KA, Yu S, Mamtani R, Mehta R, D'Addeo K, Wileyto EP, Taddei TH, Kaplan DE. Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study. Journal Of Clinical Oncology 2017, 35: jco.2017.73.824. PMID: 28872925, PMCID: PMC5662845, DOI: 10.1200/jco.2017.73.8245.Peer-Reviewed Original ResearchConceptsSorafenib patientsHazard ratioOverall survivalHepatocellular carcinomaPotential confoundersNoninferiority marginEnd-stage liver disease-sodium (MELD-Na) scoreVeterans Health Administration hospitalsHigher Child-TurcottePotential treatment biasReduced pill burdenComorbidity Index scorePrimary end pointFirst-line therapyGastrointestinal adverse effectsDose of sorafenibSignificant OS differenceAdvanced hepatocellular carcinomaLower overall survivalMultivariate logistic regressionMulti-institutional studyChild-TurcotteOS relativePugh scorePurpose SorafenibHealthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States
Kaplan DE, Chapko MK, Mehta R, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Pocha C, Valderrama A, Taddei TH, Group V. Healthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States. Clinical Gastroenterology And Hepatology 2017, 16: 106-114.e5. PMID: 28756056, PMCID: PMC5735018, DOI: 10.1016/j.cgh.2017.07.024.Peer-Reviewed Original ResearchConceptsMultivariable generalized linear modelsMultidisciplinary tumor boardHepatocellular carcinomaIntegrated health systemCancer-related costsHealthcare costsLiver transplantationBCLC stageLiver diseaseTumor boardBarcelona Clinic Liver Cancer stageVeterans Affairs Corporate Data WarehouseHealth systemCases of HCCBasis of receiptLiver disease cohortReceipt of transplantationLiver disease etiologyChronic liver diseaseLiver Cancer stageLiver cancer surveillanceBasis of severityHospital academic affiliationCorporate Data WarehouseCirrhosis controlsRacial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.
Davis BA, Aminawung JA, Abu-Khalaf MM, Evans SB, Su K, Mehta R, Wang SY, Gross CP. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study. Journal Of The National Comprehensive Cancer Network 2017, 15: 346-354. PMID: 28275035, DOI: 10.6004/jnccn.2017.0034.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBiomarkers, TumorBreast NeoplasmsConnecticutFemaleGene Expression ProfilingGenetic TestingHealth Services AccessibilityHealthcare DisparitiesHumansLymphatic MetastasisMiddle AgedNeoplasm GradingNeoplasm StagingOdds RatioPatient Outcome AssessmentPopulation SurveillanceRegistriesRetrospective StudiesSocioeconomic FactorsYoung AdultConceptsPopulation-based studyOncotype DXODX testingBreast cancerHispanic womenHormone receptor-positive breast cancerReceptor-positive breast cancerRetrospective population-based studyWhite womenRacial disparitiesGEP test resultsBreast cancer careBreast cancer outcomesStudy inclusion criteriaGene expression profiling testsMore white womenClinical characteristicsTest receiptCancer outcomesCancer careInclusion criteriaLogistic analysisEthnic disparitiesStatewide populationWomenAssociation of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality
Serper M, Taddei TH, Mehta R, D’Addeo K, Dai F, Aytaman A, Baytarian M, Fox R, Hunt K, Goldberg DS, Valderrama A, Kaplan DE, Group V. Association of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality. Gastroenterology 2017, 152: 1954-1964. PMID: 28283421, PMCID: PMC5664153, DOI: 10.1053/j.gastro.2017.02.040.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, HepatocellularChi-Square DistributionDelivery of Health Care, IntegratedFemaleGastroenterologistsHumansKaplan-Meier EstimateLiver NeoplasmsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioOncologistsPatient Care TeamPractice Patterns, Physicians'Proportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsSpecializationSurgeonsTime FactorsTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsConceptsRetrospective cohort studyMultidisciplinary tumor boardHealth system factorsHepatocellular carcinomaHCC therapyCohort studyOverall survivalTumor boardTime-varying Cox proportional hazards modelsCox proportional hazards modelActive hepatocellular carcinomaOutcomes of patientsProportional hazards modelHepatocellular carcinoma treatmentVeterans Administration HospitalSystem factorsLiver transplantationActive therapyLiver resectionTransarterial therapiesMedical oncologistsMultidisciplinary careSubspecialist carePatient survivalAblative therapyIdentifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis
Goldberg DS, Taddei TH, Serper M, Mehta R, Dieperink E, Aytaman A, Baytarian M, Fox R, Hunt K, Pedrosa M, Pocha C, Valderrama A, Kaplan DE. Identifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis. Hepatology 2017, 65: 864-874. PMID: 27531119, DOI: 10.1002/hep.28765.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedCarcinoma, HepatocellularCohort StudiesEarly Detection of CancerFemaleHumansLinear ModelsLiver CirrhosisLiver NeoplasmsMagnetic Resonance ImagingMaleMiddle AgedMultimodal ImagingPopulation SurveillancePrevalenceProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSex FactorsTomography, X-Ray ComputedUltrasonography, DopplerUnited StatesUnited States Department of Veterans AffairsConceptsHCC surveillanceHepatocellular carcinomaPatients 75 yearsHepatocellular carcinoma surveillancePrimary care physiciansHigh-risk populationVeterans Health AdministrationOverall health care systemVeterans Administration CenterHealth care systemAbdominal ultrasoundCirrhosis patientsPrimary outcomeCare physiciansInverse associationCirrhosis diagnosisLeading causeOdds ratioPercentage of timeSurveillance ratesNumber of visitsHealth AdministrationPatientsCirrhosisCare systemUp-titration of sorafenib for hepatocellular carcinoma: Impact on duration of exposure and cost.
Kaplan D, Yu S, Taddei T, Reiss K, Mehta R, D'Addeo K, Aytaman A, Hunt K, Fox R, Baytarian M, Valdarrama A. Up-titration of sorafenib for hepatocellular carcinoma: Impact on duration of exposure and cost. Journal Of Clinical Oncology 2017, 35: 385-385. DOI: 10.1200/jco.2017.35.4_suppl.385.Peer-Reviewed Original ResearchDuration of exposureBCLC BICD9 codesBarcelona Clinic Liver Cancer stageInitiation of sorafenibMedian overall survivalLiver Cancer stageLonger exposure durationECOG PSExposure durationUp-titrationChild-TurcotteMELD scoreSorafenib therapyFirst doseOverall survivalPharmacy recordsMedian agePrescription fillsLiver diseaseTumor numberC-HCCEquivalent survivalHCC patientsCancer stageSorafenib for hepatocellular carcinoma managed by non-oncologists: Impact on drug exposure and survival.
Kaplan D, Taddei T, Mehta R, D'Addeo K, Aytaman A, Hunt K, Fox R, Baytarian M, Valdarrama A. Sorafenib for hepatocellular carcinoma managed by non-oncologists: Impact on drug exposure and survival. Journal Of Clinical Oncology 2017, 35: 404-404. DOI: 10.1200/jco.2017.35.4_suppl.404.Peer-Reviewed Original ResearchICD9 codesBarcelona Clinic Liver Cancer stageOverall median survival rateInitial dosing regimensLiver Cancer stageMedian survival rateSimilar treatment durationCTP AECOG PSExtrahepatic spreadChild-TurcotteMacrovascular invasionMELD scorePrescriber specialtyReal-world practiceMedian agePharmacy recordsSorafenib exposureBCLC 0Dosing regimensLiver diseaseTumor numberPrescribing practicesHCC patientsCancer stage
2016
Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis
Kaplan DE, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Knott A, Mehta R, Pedrosa M, Pocha C, Valderrama A, Taddei T, for the VOCAL Study Group. Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis. Digestive Diseases And Sciences 2016, 61: 3309-3320. PMID: 27405990, PMCID: PMC5067291, DOI: 10.1007/s10620-016-4239-6.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBilirubinCreatinineDisease ProgressionEnd Stage Liver DiseaseEvidence-Based MedicineFemaleHumansInternational Normalized RatioLiver CirrhosisLiver TransplantationMaleMiddle AgedOdds RatioPrognosisProportional Hazards ModelsRetrospective StudiesSerum AlbuminSeverity of Illness IndexUnited StatesVeteransConceptsTransplant-free survivalHarrell's C-statisticC-statisticPugh scoreChild-TurcotteCTP scoreHighest Harrell's C-statisticsCox proportional hazards modelEvidence-based cutpointProportional hazards modelLong-term survivalEtiology subgroupsSerum creatinineVeteran patientsLaboratory variablesRisk ratioTotal bilirubinHazards modelCirrhosisPatientsLower cutpointsDisease etiologySurvivalCutpointsScores
2015
Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database
Kaplan DE, Dai F, Aytaman A, Baytarian M, Fox R, Hunt K, Knott A, Pedrosa M, Pocha C, Mehta R, Duggal M, Skanderson M, Valderrama A, Taddei TH, Group V. Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database. Clinical Gastroenterology And Hepatology 2015, 13: 2333-2341.e6. PMID: 26188137, PMCID: PMC4655141, DOI: 10.1016/j.cgh.2015.07.010.Peer-Reviewed Original ResearchConceptsCTP scoreAdministrative databasesChild-TurcottePugh scoreVeterans Health Administration Corporate Data WarehouseLaboratory dataCox proportional hazards regressionSeverity of ascitesTransplant-free survivalSeverity IndexInternational normalized ratioClinical laboratory valuesHarrell's C-statisticProportional hazards regressionDiseases version 9U.S. Veterans Health AdministrationVeterans Health AdministrationMulticenter collaborative studyLarge administrative databaseLong-term survivalDisease severity scoreValidity of diagnosesCorporate Data WarehouseElectronic healthcare databasesCommon Procedural TerminologyInterim analysis of hepatocellular carcinoma (HCC) screening and survival in 4,087 veterans diagnosed with HCC from 2008 to 2010.
Kaplan D, Taddei T, Aytaman A, Hunt K, Knott A, Dieperink E, Baytarian M, Fox R, Pedrosa M, D'Addeo K, Dai F, Mehta R, Duggal M, Pocha C, Skanderson M, Valderrama A. Interim analysis of hepatocellular carcinoma (HCC) screening and survival in 4,087 veterans diagnosed with HCC from 2008 to 2010. Journal Of Clinical Oncology 2015, 33: 243-243. DOI: 10.1200/jco.2015.33.3_suppl.243.Peer-Reviewed Original ResearchVeterans Health AdministrationHepatocellular carcinomaTumor sizeICD9 codesInterim analysisVA Corporate Data WarehouseCharlson-Deyo indexLiver disease careEtiology of cirrhosisPresence of ascitesLarger tumor sizeIVA/IVBHepatocellular carcinoma screeningTotal tumor sizeNumber of tumorsCorporate Data WarehouseMultivariate survival modelsMajority of veteransMedian OSAdvanced diseaseHepatitis CMilan criteriaBCLC stagingChart abstractionHepatitis B
2014
Mo1036 Development and Validation of a Virtual Child-Turcotte-Pugh Score to Assess Liver Disease Severity in an Administrative Healthcare Database
Kaplan D, Taddei T, Skanderson M, Pocha C, Pedrosa M, Mehta R, Knott A, Hunt K, Fox R, Duggal M, Dai F, D K, Baytarian M, Valderrama A, Aytaman A. Mo1036 Development and Validation of a Virtual Child-Turcotte-Pugh Score to Assess Liver Disease Severity in an Administrative Healthcare Database. Gastroenterology 2014, 146: s-992. DOI: 10.1016/s0016-5085(14)63605-2.Peer-Reviewed Original ResearchMo1059 Interim Analysis of HCC Screening and Survival in 1131 Veterans Diagnosed With HCC From 2008-2010
Taddei T, Kaplan D, Aytaman A, Baytarian M, D K, Dai F, Duggal M, Fox R, Hunt K, Knott A, Mehta R, Pedrosa M, Pocha C, Valderrama A, Skanderson M. Mo1059 Interim Analysis of HCC Screening and Survival in 1131 Veterans Diagnosed With HCC From 2008-2010. Gastroenterology 2014, 146: s-998. DOI: 10.1016/s0016-5085(14)63627-1.Peer-Reviewed Original Research