Age-specific protective effects of statins against cirrhosis in patients with chronic liver enzyme elevation associated with metabolic dysfunction: a retrospective cohort study of electronic health records.

Background: The hepatoprotective effects of statins in chronic liver diseases are well-documented; however, variation by age, sex, and formulation remains unclear. The optimal regimen for cirrhosis prevention has yet to be defined. We aimed to address this knowledge gap.

Transtheoretical Model Technology-based Interventions to Improve Health Behaviors in Veterans.

The Transtheoretical Model of Health Behavior Change (TTM) is a leading theoretical framework of motivation for healthful lifestyle modification and has been employed nationally and internationally within the civilian sector for decades. The TTM has demonstrated effectiveness in reducing the public health burden related to various chronic diseases that are largely preventable through successful health behavior change intervention. Because the VA healthcare system (VA) is committed to providing quality care to Veterans who, all too often, suffer from complex physical and psychological comorbidities, it is critical to reduce Veterans' unhealthy behaviors while also helping them adopt and sustain adaptive health behaviors.

Medication Adherence in the Real World: Lessons from the Diuretic Comparison Project.

: Antihypertensive treatment is crucial for preventing major adverse cardiovascular events, but suboptimal adherence remains a challenge. : This is a secondary analysis of routine care data from a large pragmatic trial comparing two thiazide diuretics: chlorthalidone (CTD) and hydrochlorothiazide (HCTZ). In the trial, 13,523 older hypertensive patients were randomized from 72 Veterans Affairs medical centers.

Real-world persistence of urate-lowering therapy following a treat-to-target intervention: A two-year follow-up analysis of the STOP gout trial.

Objective: Though gout guidelines endorse treat-to-target urate-lowering therapy (ULT), its long-term durability following treat-to-target implementation has not been extensively studied. Examining follow-up data from a trial implementing treat-to-target management, we evaluated the frequency and determinants of ULT persistence.

Methods: This analysis examined participants completing the 72-week STOP Gout trial with available follow-up data extending 2-years post-study.

Improvements in Health-Related Quality of Life with Treat-to-Target Urate-Lowering Therapy in Gout: A Post-hoc Analysis of a Randomized Multicenter Trial.

Background: While treat-to-target urate-lowering therapy (ULT) is endorsed as best practice in gout management, limited data exist on its impact on health-related quality of life (HRQoL). We assessed the impact of treat-to-target ULT on HRQoL among participants receiving protocolized gout care, identifying factors associated with HRQoL and HRQoL change.

Methods: This was a post-hoc analysis of a 72-week randomized trial, pooling data from allopurinol and febuxostat treatment arms.

How Does Positive Mental Health Affect Next-Step Treatment Outcomes in Treatment-Resistant Depression? A VAST-D Report.

Background: Many patients view the return of "positive mental health" (PMH) to be their most important goal of treatment for major depressive disorder (MDD). However, few studies have systematically measured PMH or prospectively examined the added value of considering PMH as a treatment predictor of outcome. This report aims to fill those gaps by determining features associated with PMH and their contributions to outcomes in outpatients with treatment-resistant depression.

Optimism and Cognitive Functioning Trajectories in a Cohort of Aging Men.

Objectives: Robust evidence supports optimism as an asset for good physical and emotional health in aging populations, but its role in cognitive aging remains understudied. This study evaluated whether higher optimism levels would be prospectively associated with higher initial levels and slower decline in cognitive functioning over 26 years in a community-dwelling cohort of aging men.

Methods: Participants included 847 men from the Veterans Affairs Normative Aging Study who completed the Revised Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory-2 in 1986 and ≥1 cognitive assessment repeated triennially in 1993-2019.

ProMix: Enhancing Protein Quantification through Experimental Design and Statistical Normalization.

Isobaric labeling of biospecimens followed by mass spectrometry (MS) has become the method of choice for large-scale, untargeted, quantitative proteomic profiling. However, subtle variation in experimental conditions can amplify sample variability and introduce systematic biases. Motivated by the challenges and opportunities arose in a recent proteogenomic study, we developed ProMix, a flexible analytical framework designed to improve protein normalization by leveraging two key experimental design features: (1) the inclusion of an additional reference sample to serve as an internal standard, and (2) the incorporation of replicates of each specimen.

Functioning and disability consequences of comorbid posttraumatic stress disorder and diabetes in Vietnam era men and women veterans.

Objective: Diabetes mellitus (DM) negatively impacts functioning and disability, particularly when comorbid with mental health diagnoses. Posttraumatic stress disorder (PTSD) increases the risk of developing DM and may have a particularly deleterious impact on DM-related outcomes. This study aimed to determine the extent to which PTSD and DM comorbidity was associated with poorer functioning and greater disability relative to neither or single diagnoses in older adult veteran men and women.

An Epidemiologic Approach for Estimating Risk Reduction and Asymptotic Power on the Log-Difference Scale.

When comparing the efficacy or harmfulness of two groups (e.g., drugs, devices, assays, interventions, environmental toxins), it is important to minimize bias by making this comparison with respect to a common referent-control group, assuming random allocation.

Combining Rule-based NLP-lite with Rapid Iterative Chart Adjudication for Creation of a Large, Accurately Curated Cohort from EHR data: A Case Study in the Context of a Clinical Trial Emulation.

The aim of this work was to create a gold-standard curated cohort of 10,000+ cases from the Veteran Affairs (VA) corporate data warehouse (CDW) for virtual emulation of a randomized clinical trial (CSP#592). The trial had six inclusion/exclusion criteria lacking adequate structured data. We therefore used a hybrid computer/human approach to extract information from clinical notes.

Impact of High-Titer Convalescent Plasma on Clinical and Virologic Outcomes Among Veterans Hospitalized With SARS-CoV-2 Infection: VA CoronavirUs Research and Efficacy Studies-1 (VA CURES-1).

In the initial absence of proven therapies, empirical COVID-19 convalescent plasma (CCP) was rapidly introduced for individuals hospitalized for COVID-19. Seventy-five participants were randomized from November 2020 to June 2021 in a double-blind, multi-site, placebo-controlled, randomized trial (VA CURES-1) evaluating the impact of CCP vs. saline in Veterans hospitalized with COVID-19 with hypoxemia.

Efficacy of three lung cancer prediction models in diagnosing benign and malignant pulmonary nodules.

Background: The predictive models for malignant lung nodules have been developed, but need further validation and optimization for broader clinical use. This study aimed to compare the diagnostic efficacy of the Mayo model, Peking University People's Hospital (PKUPH) model, and the lung cancer biomarker panel (LCBP) model in distinguishing between benign and malignant pulmonary nodules, providing valuable clinical research data for the early diagnosis of lung cancer.

Methods: Clinical and imaging data of patients diagnosed with pulmonary nodules at Meizhou People's Hospital from March 2021 through January 2023 were collected.

Posttraumatic stress disorder and hypertension in older adult Vietnam Era male and female veterans.

Hypertension is a known risk factor for cardiovascular disease, a leading cause of death for older adults. Posttraumatic stress disorder (PTSD) may increase the likelihood of developing hypertension; however, little is known about this association in older adult male and female veterans. To better understand the ways in which aging and biological sex impact the link between PTSD and hypertension, the present study used data from two cohorts of older adult Vietnam Era veterans (women: N = 4,104, M = 67.

Provider experiences with and attitudes about an embedded pragmatic clinical trial.

Background/aims: The Diuretic Comparison Project (DCP) was a pragmatic clinical trial comparing rates of cardiovascular events between hydrochlorothiazide or chlorthalidone. VA primary care providers (PCPs) and their patients were participants in the study. Veterans ≥ 65 years taking hydrochlorothiazide were randomized to continue on hydrochlorothiazide or switch to chlorthalidone.

CoVimmune COVID-19 Immunity Calculator: Web Application Development and Validation Study.

Background: This study illustrates the development of a simple web-based application, which demonstrates the relationship between serum anti-SARS-CoV-2 S1/receptor-binding domain immunoglobulin G (IgG) and anti-SARS-CoV-2 neutralizing antibody (nAb) half-maximal inhibitory concentration (IC50) titers in a vaccinated US adult population and compares them to prior data on nAb titers at different time points after vaccination.

Objective: The objective of this study is to create an easily accessible calculator that uses the results of commercially available anti-SARS-CoV-2 serum IgG to approximate the underlying ability to neutralize SARS-CoV-2.

Methods: Our web-based application leveraged two previously published datasets.

Twenty Year History of Cancer Informatics (CiX) - A Long and Established Legacy of Quality Research and Scientific Advances in the Field of Oncology.

Over a 20 year period, the journal Cancer Informatics has played an important role defining and forging a bridge between bioinformations and translational cancer research. The main focus of the journal has been to advance the prevention, diagnosis, and treatment of cancer. This involves the specialized intersection of genomics, molecular biology, data science, computer programing, statistics, communication theory, and the clinical sciences to answer important questions in the field of cancer research.

Predicting benefit from adjuvant therapy with corticosteroids in community-acquired pneumonia: a data-driven analysis of randomised trials.

Background: Despite several randomised controlled trials (RCTs) on the use of adjuvant treatment with corticosteroids in patients with community-acquired pneumonia (CAP), the effect of this intervention on mortality remains controversial. We aimed to evaluate heterogeneity of treatment effect (HTE) of adjuvant treatment with corticosteroids on 30-day mortality in patients with CAP.

Methods: In this individual patient data meta-analysis, we included RCTs published before July 1, 2024, comparing adjuvant treatment with corticosteroids versus placebo in patients hospitalised with CAP.

Use of a novel claw-suture technique for localization of solitary pulmonary nodules: retrospective study and experience from one center.

Background: Video-assisted thoracoscopic surgery (VATS) is more effective for diagnosing and treating solitary pulmonary nodules (SPNs). It is sometimes difficult to localize through use of minimally invasive techniques. We evaluated the feasibility, effectiveness, and safety of a novel localization method for SPNs.

Epidemiology of Rounding Error.

This work represents a significant contribution to understanding the importance of appropriately rounding numbers with minimal error. That is, to reduce inexact rounding and data truncation error and simultaneously eliminate unintentional misleading findings in epidemiological studies. The rounding of numbers represents a compromise solution that attempts to find a balance between the loss of information from reporting too few significant digits versus retaining more digits than necessary.

Comparing Single-Hospital and National Models to Predict 30-Day Inpatient Mortality.

Background: Advances in artificial intelligence and machine learning have facilitated the creation of mortality prediction models which are increasingly used to assess quality of care and inform clinical practice. One open question is whether a hospital should utilize a mortality model trained from a diverse nationwide dataset or use a model developed primarily from their local hospital data.

Objective: To compare performance of a single-hospital, 30-day all-cause mortality model against an established national benchmark on the task of mortality prediction.

Chlorthalidone vs Hydrochlorothiazide and Kidney Outcomes in Patients With Hypertension: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Hypertension is a risk factor for the development and progression of chronic kidney disease (CKD). It is unclear whether different thiazide diuretics have a differential impact on kidney outcomes.

Objective: To compare kidney outcomes in patients with hypertension taking chlorthalidone and hydrochlorothiazide.

Cohort Profile: Baseline Characteristics of Veterans from Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) - an Embedded Pragmatic, Cluster Randomized Trial in the United States.

Purpose: AIM-Back is an embedded pragmatic clinical trial (ePCT) with cluster randomization designed to increase access and compare the effectiveness of two different non-pharmacological care pathways for low back pain (LBP) delivered within the Veteran Administration Health Care System (VAHCS). This manuscript describes baseline characteristics of AIM-Back participants as well as the representativeness of those referred to the AIM-Back program by sex, age, race, and ethnicity, relative to Veterans with low back pain at participating clinics.

Participants: To be eligible for AIM-Back, Veterans were referred to the randomized pathway at their clinic by trained primary care providers (Referral cohort).