Research Topics
| E GuadagnoliSummaryAffiliation: Harvard University Country: USA Publications
Research Grants
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Detail Information
Publications
Improving discussion of surgical treatment options for patients with breast cancer: local medical opinion leaders versus audit and performance feedbackE Guadagnoli
Departmnent of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Breast Cancer Res Treat 61:171-5. 2000..001) from 33% to 17%, but a similar decrease was observed among control hospitals. Using medical opinion leaders to intervene in hospitals appeared as effective as performance feedback...- Potential organ-donor supply and efficiency of organ procurement organizationsEdward Guadagnoli
Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston MA 02115, USA
Health Care Financ Rev 24:101-10. 2003..Although there is room to improve donor efficiency in the U.S., even a substantial improvement will not meet the Nation's demand for organs... - Effects of treatment recommendations and specialist intervention on care provided by primary care physicians to patients with myocardial infarction or heart failureEdward Guadagnoli
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Am J Med 117:371-9. 2004..To assess the effects of an intervention involving dissemination of treatment recommendations to primary care physicians treating outpatients with acute myocardial infarction or heart failure... - Impact of underuse, overuse, and discretionary use on geographic variation in the use of coronary angiography after acute myocardial infarctionE Guadagnoli
Department of Health Care Policy, Harvard Medical School, Boston MA 02115 5899, USA
Med Care 39:446-58. 2001..Geographic variation in the use of medical procedures has been well documented. However, it is not known whether this variation is due to differences in use when procedures are indicated, discretionary, or contraindicated... - Appropriateness of coronary angiography after myocardial infarction among Medicare beneficiaries. Managed care versus fee for serviceE Guadagnoli
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115 5899, USA
N Engl J Med 343:1460-6. 2000..However, it is not known whether this difference is due to less frequent use of cardiac procedures when they are indicated or to less frequent use when they are not indicated... - Providing consumers with information about the quality of health plans: the Consumer Assessment of Health Plans demonstration in Washington StateE Guadagnoli
Department of Health Care Policy, Harvard Medical School, Boston, USA
Jt Comm J Qual Improv 26:410-20. 2000..Results were obtained from one of the first CAHPS demonstration sites, the Washington State Health Care Authority... - Use of breast-conserving surgery for treatment of stage I and stage II breast cancerE Guadagnoli
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
J Clin Oncol 16:101-6. 1998..To assess the use of breast-conserving surgery in two states reported to differ with respect to surgical treatment of breast cancer... - Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scoresS T Normand
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115 5899, USA
J Clin Epidemiol 54:387-98. 2001..Because of the magnitude of the benefit and of the number of patients involved, steps should be taken to replicate these findings... - Effect of local medical opinion leaders on quality of care for acute myocardial infarction: a randomized controlled trialS B Soumerai
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
JAMA 279:1358-63. 1998..The effectiveness of recruiting local medical opinion leaders to improve quality of care is poorly understood... - Discussion of treatment options for early-stage breast cancer: effect of provider specialty on type of surgery and satisfactionN L Keating
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Med Care 39:681-91. 2001..To describe the physicians with whom breast cancer patients discuss treatment options and assess whether discussing surgical options with a medical oncologist is associated with type of surgery and satisfaction... - Age-related patterns of care: evidence against ageism in the treatment of early-stage breast cancerE Guadagnoli
Health Care Policy, Department of Medicine, Harvard Medical School, Dana Farber Cancer Institute, Boston, MA 02115, USA
J Clin Oncol 15:2338-44. 1997..To assess whether the use of adjuvant systemic therapy in postmenopausal women with early-stage breast cancer is influenced by patient age... 
Managed care market share and primary treatment for cancerNancy L Keating
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Health Serv Res 41:9-22. 2006..30). CONCLUSIONS: Increases in the market share of managed care do not appear to influence the receipt of equally effective primary treatments for cancer in the fee-for-service sector...- The effect of less than definitive care on breast carcinoma recurrence and mortalityT L Lash
Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
Cancer 89:1739-47. 2000..The objective of this study was to measure the effects of less than definitive care for patients with breast carcinoma on disease recurrence and mortality... - Access to specialty care and medical services in community health centersNakela L Cook
Health Care Policy Department, Harvard Medical School, Boston, USA
Health Aff (Millwood) 26:1459-68. 2007..Respondents reported that uninsured patients had greater difficulty obtaining access to off-site specialty services, including referrals and diagnostic testing, than did patients with Medicaid, Medicare, or private insurance... - Patient beliefs and tamoxifen discontinuance in older women with estrogen receptor--positive breast cancerAliza K Fink
Boston Medical Center, 88 E Newton St, Robinson 2, Boston, MA 02118, USA
J Clin Oncol 22:3309-15. 2004..Interventions designed to educate women about the benefits and risks of tamoxifen therapy may help to reduce discontinuance... - Measuring the quality of diabetes care using administrative data: is there bias?Nancy L Keating
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Health Serv Res 38:1529-45. 2003..We assessed whether measuring processes of diabetes care using administrative data without medical record data is likely to underdetect compliance with accepted standards for certain groups of patients... - Understanding individual and small area variation in the underuse of coronary angiography following acute myocardial infarctionPushkal P Garg
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115-5899, USA
Med Care 40:614-26. 2002..The causes of regional variation in underuse do not appear to be related to regional differences in patient or hospital characteristics, and therefore, require further study... - Pitfalls in assessing the quality of care for patients with cardiovascular diseaseT G DiSalvo
Heart Failure Center, Bigelow 630, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA
Am J Med 111:297-303. 2001..Lack of standardized data captured at the point of clinical care and low rates of eligibility for key measures hamper measurement of quality of care... - The effect of managed care market share on appropriate use of coronary angiography among traditional Medicare beneficiariesEllen Meara
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115 5899, USA
Inquiry 41:144-58. 2004..Within all ACC-AHA classes, coronary angiography fell slightly as managed care market share increased... - Treatment of early stage breast cancer: do surgeons and patients agree regarding whether treatment alternatives were discussed?Nancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
Breast Cancer Res Treat 79:225-31. 2003..Informing patients of available treatment alternatives is an important element of informed consent. We examined and compared patients' and their surgeons' reports of discussing treatment alternatives for early stage breast cancer... - Care in the months before death and hospice enrollment among older women with advanced breast cancerNancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
J Gen Intern Med 23:11-8. 2008..Variations in hospice use are not well understood... 
Is spending more always wasteful? The appropriateness of care and outcomes among colorectal cancer patientsMary Beth Landrum
Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 27:159-68. 2008..Our results show that instead of cutting spending, policies designed to target services to patients most likely to benefit could increase the value of medical spending...- Consultation with a medical oncologist before surgery and type of surgery among elderly women with early-stage breast cancerNancy L Keating
Department of Medicine, Brigham and Women s Hospital, and Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
J Clin Oncol 21:4532-9. 2003..We assessed whether consultation with a medical oncologist before surgery was associated with use of definitive surgery, axillary node dissection, and type of surgery... - Practice, clinical management, and financial arrangements of practicing generalistsNancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02115, USA
J Gen Intern Med 19:410-8. 2004.... - The influence of physicians' practice management strategies and financial arrangements on quality of care among patients with diabetesNancy L Keating
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115, USA
Med Care 42:829-39. 2004..Health care organizations use many strategies to influence physician behavior and the care delivered, but the effect of such strategies on quality is not known... - The association of ambulatory care with breast cancer stage at diagnosis among Medicare beneficiariesNancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
J Gen Intern Med 20:38-44. 2005..We examined outpatient care in the 2 years before breast cancer diagnosis to identify women at high risk for limited care and assess the relationship of the physicians seen and number of visits with stage at diagnosis... - Use of adjuvant chemotherapy and radiation therapy for colorectal cancer in a population-based cohortJohn Z Ayanian
Division of General Medicine and Channing Laboratory, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02115, USA
J Clin Oncol 21:1293-300. 2003..This population-based study was designed to assess use of these treatments in clinical practice... - Do increases in the market share of managed care influence quality of cancer care in the fee-for-service sector?Nancy L Keating
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
J Natl Cancer Inst 97:257-64. 2005.... - Surveillance testing among survivors of early-stage breast cancerNancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02115, USA
J Clin Oncol 25:1074-81. 2007..We described follow-up care for breast cancer survivors, examined how surveillance testing varies by the types of physicians seen, and assessed changes in testing rates over time... - Treatment decision making in early-stage breast cancer: should surgeons match patients' desired level of involvement?Nancy L Keating
Division of General Internal Medicine, Section on Health Services and Policy Research, Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
J Clin Oncol 20:1473-9. 2002.... - The influence of cost containment strategies and physicians' financial arrangements on patients' trust and satisfactionNancy L Keating
Division of General Internal Medicine, Brigham and Women s Hospital, MA, USA
J Ambul Care Manage 30:92-104. 2007..These results suggest that physicians may have managed potential conflicts to avoid compromising the patient-physician relationship... - Improving the management of chronic disease at community health centersBruce E Landon
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
N Engl J Med 356:921-34. 2007.... - Specialty of ambulatory care physicians and mortality among elderly patients after myocardial infarctionJohn Z Ayanian
Department of Medicine, Division of General Medicine and Primary Care, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02115, USA
N Engl J Med 347:1678-86. 2002..The outcome after myocardial infarction may be influenced by the type of physician providing ambulatory care... - The quality of chronic disease care in U.S. community health centersLeRoi S Hicks
Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 25:1712-23. 2006..Although the quality of chronic disease care in CHCs compares favorably with that of care received in other settings, gaps in quality were observed for the uninsured... - Factors related to underuse of surveillance mammography among breast cancer survivorsNancy L Keating
Division of General Internal Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
J Clin Oncol 24:85-94. 2006..We identified factors associated with underuse of surveillance mammography and examined whether variation was explained by differences in follow-up care... - Patients' perceptions of quality of care for colorectal cancer by race, ethnicity, and languageJohn Z Ayanian
Division of General Medicine and Channing Laboratory, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02115, USA
J Clin Oncol 23:6576-86. 2005..To identify opportunities for improving care, we evaluated patients' perceptions of the quality of their cancer care by race, ethnicity, and language... - Analyzing multiple informant data from an evaluation of the health disparities collaborativesBruce E Landon
Department of Health Care Policy, 180 Longwood Ave, Boston, MA 02115 5899, USA
Health Serv Res 42:146-64. 2007..To use multivariate regression methods to analyze simultaneously data obtained from multiple respondents or data sources (informants) at health centers... - Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare populationJ N Katz
Robert B Brigham Multipurpose Arthritis and Musculoskeletal Diseases Center, Brigham and Women s Hospital, Bostn, MA 02115, USA
J Bone Joint Surg Am 83:1622-9. 2001..The objective of this study was to determine whether the volumes of primary and revision total hip replacements performed at hospitals and by surgeons are associated with rates of mortality and complications... - Care following acute myocardial infarction in the Veterans Administration Medical Centers: a comparison with MedicareMary Beth Landrum
Department of Health Care Policy, Harvard Medical School, Boston, MA 02110, USA
Health Serv Res 39:1773-92. 2004..Further study of these differences both between and within the systems of care may help identify cost-effective strategies to improve care in both sectors... - The National Emergency Department Safety Study: study rationale and designAshley F Sullivan
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Acad Emerg Med 14:1182-9. 2007..NEDSS is the first comprehensive national study of the frequency and types of medical errors in EDs. This article describes the methods used to develop and implement the study... - Health and economic impact of surgical site infections diagnosed after hospital dischargeEli N Perencevich
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Emerg Infect Dis 9:196-203. 2003..Average total costs during the 8 weeks after discharge were US dollars 5,155 for patients with SSI and US dollars 1,773 for controls (p<0.001)... - Impact of health disparities collaboratives on racial/ethnic and insurance disparities in US community health centersLeRoi S Hicks
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Arch Intern Med 170:279-86. 2010..The Health Resources and Services Administration Health Disparities Collaboratives (HDCs) were developed to improve care for chronic medical conditions in community health centers (CHCs)... - Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgeryJeffrey N Katz
Division of Rheumatology, Immunology and Allergy, Brigham and Women s Hospital, 75 Francis Street, B 3, Boston, MA 02115, USA
Arthritis Rheum 48:560-8. 2003..To evaluate whether hospital volume and surgeon volume of total hip replacements (THRs) are associated with patient-reported functional status and satisfaction with surgery 3 years postoperatively... - Triage decisions for emergency department patients with chest pain: do physicians' risk attitudes make the difference?S D Pearson
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts, USA
J Gen Intern Med 10:557-64. 1995..To determine whether physicians' risk attitudes correlate with their triage decisions for emergency department patients with acute chest pain... - Correlates of support for organ donation among three ethnic groupsP McNamara
Partnership for Organ Donation, Boston, MA 02109 4901, USA
Clin Transplant 13:45-50. 1999.... - The influence of age on clinical and patient-reported outcomes after cholecystectomyE A Mort
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
J Gen Intern Med 9:61-5. 1994..The decline in work performance in older patients may indicate the need for a longer recuperation period... - Multiple informants: a new method to assess breast cancer patients' comorbidityTimothy L Lash
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
Am J Epidemiol 157:249-57. 2003.... - Contribution of hospital characteristics to the volume-outcome relationship: dislocation and infection following total hip replacement surgeryDaniel H Solomon
Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Arthritis Rheum 46:2436-44. 2002..We evaluated the contribution of hospital structural characteristics to the volume-outcome relationship in THR by examining the rates and predictors of postoperative complications... - Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacementCharlotte B Phillips
Robert Breck Brigham Multipurpose Arthritis and Musculoskeletal Diseases Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA
J Bone Joint Surg Am 85:20-6. 2003..LEVEL OF EVIDENCE: Prognostic study, Level II-1 (retrospective study). See p. 2 for complete description of levels of evidence... - Reducing racial/ethnic disparities in female breast cancer: screening rates and stage at diagnosisFranco Sassi
Department of Social Policy, The London School of Economics and Political Science, London, United Kingdom
Am J Public Health 96:2165-72. 2006..We assessed whether population rates of mammography screening, and their changes over time, were associated with improvements in breast cancer stage at diagnosis and whether the strength of this association varied by race/ethnicity... - Inside the health disparities collaboratives: a detailed exploration of quality improvement at community health centersEllie Grossman
Division of General Internal Medicine, New York University School of Medicine, New York, New York, USA
Med Care 46:489-96. 2008.... - Medicare breast surgery fees and treatment received by older women with localized breast cancerJack Hadley
The Urban Institute, Washington, DC 20037, USA
Health Serv Res 38:553-73. 2003..This suggests that the earlier study was not severely affected by ecological bias or other data limitations inherent in Medicare claims data... - Examining the relationship of patients' attitudes and beliefs with their self-reported level of participation in medical decision-makingNeeraj K Arora
Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892 7344, USA
Med Care 43:865-72. 2005..We applied constructs from the transtheoretical model (TTM) of behavior change to identify modifiable determinants of patient participation in medical decision-making... - Relationship of diabetes-specific knowledge to self-management activities, ambulatory preventive care, and metabolic outcomesStephen D Persell
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Prev Med 39:746-52. 2004..Providing patient education about diabetes care processes should be tested as a means of increasing ambulatory care to prevent diabetes complications... - Understanding cancer patients' experience and outcomes: development and pilot study of the Cancer Care Outcomes Research and Surveillance patient surveyJennifer L Malin
Division of General Internal Medicine Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
Support Care Cancer 14:837-48. 2006..The keystone to this effort is the baseline patient survey administered approximately 4 months after diagnosis... - Adjuvant tamoxifen prescription in women 65 years and older with primary breast cancerRebecca A Silliman
Department of Medicine, Boston University School of Medicine, MA, USA
J Clin Oncol 20:2680-8. 2002..We examined patterns of adjuvant tamoxifen discussion and prescription among breast cancer patients age 65 years and older... - Breast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosisPatricia A Ganz
University of California, School of Medicine and Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, Los Angeles, 90095 6900, USA
J Clin Oncol 21:4027-33. 2003..We examined the health-related quality of life (QOL) of a cohort of older women with breast cancer after their diagnosis... - Patient demographic and socioeconomic characteristics in the SEER-Medicare database applications and limitationsPeter B Bach
Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA
Med Care 40:IV-19-25. 2002..Finally, they describe the available data on date of death, and explain why confidence in these measures is justified... - Rates and outcomes of primary and revision total hip replacement in the United States medicare populationNizar N Mahomed
Toronto Western Hospital, ON, Canada
J Bone Joint Surg Am 85:27-32. 2003..The objective of this study was to characterize the rates and immediate postoperative outcomes of primary and revision total hip replacement in persons sixty-five years of age and older residing in the United States...
Research Grants
- Managed Care Penetration and Cancer CareEdward Guadagnoli; Fiscal Year: 2002..If managed care penetration is negatively associated with the delivery of care, interventions targeted toward policy-makers, providers, and patients will be needed to counteract the effects of market forces. ..