Brennan M R Spiegel

Summary

Affiliation: University of California
Country: USA

Publications

  1. ncbi request reprint Dyspepsia management in primary care: a decision analysis of competing strategies
    Brennan M R Spiegel
    Department of Medicine and Health Services Research, Cedars Sinai Medical Center, Los Angeles, California, USA
    Gastroenterology 122:1270-85. 2002
  2. ncbi request reprint Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Building 115, Room 215B, Los Angeles, CA 90073, USA
    Gastroenterology 126:1721-32. 2004
  3. ncbi request reprint Clinical determinants of health-related quality of life in patients with irritable bowel syndrome
    Brennan M R Spiegel
    Division of Gastroenterology, the VA Greater Los Angeles Healthcare System, CA 90073, USA
    Arch Intern Med 164:1773-80. 2004
  4. ncbi request reprint The quality of published health economic analyses in digestive diseases: a systematic review and quantitative appraisal
    Brennan M R Spiegel
    Division of Gastroenterology, Veteran s Affairs Greater Los Angeles Healthcare System, California, USA
    Gastroenterology 127:403-11. 2004
  5. pmc Is there "cherry picking" in the ESRD Program? Perceptions from a Dialysis Provider Survey
    Amar A Desai
    Department of Medicine, StanfordUniversity School of Medicine, Stanford, California, USA
    Clin J Am Soc Nephrol 4:772-7. 2009
  6. doi request reprint Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights
    Lisa L Strate
    Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington Medical School, Seattle, Washington, USA
    Am J Gastroenterol 107:1486-93. 2012
  7. ncbi request reprint Treatment alternatives for hepatitis B cirrhosis: a cost-effectiveness analysis
    Fasiha Kanwal
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 101:2076-89. 2006
  8. ncbi request reprint Comparing rates of dyspepsia with Coxibs vs NSAID+PPI: a meta-analysis
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, Calif 90073, USA
    Am J Med 119:448.e27-36. 2006
  9. doi request reprint Understanding gastrointestinal distress: a framework for clinical practice
    Brennan M R Spiegel
    Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
    Am J Gastroenterol 106:380-5. 2011
  10. doi request reprint Dialysis practices that distinguish top- versus bottom-performing facilities by hemoglobin outcomes
    Brennan M R Spiegel
    Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
    Am J Kidney Dis 56:86-94. 2010

Detail Information

Publications48

  1. ncbi request reprint Dyspepsia management in primary care: a decision analysis of competing strategies
    Brennan M R Spiegel
    Department of Medicine and Health Services Research, Cedars Sinai Medical Center, Los Angeles, California, USA
    Gastroenterology 122:1270-85. 2002
  2. ncbi request reprint Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Building 115, Room 215B, Los Angeles, CA 90073, USA
    Gastroenterology 126:1721-32. 2004
    ..Because the symptoms of CS respond to a gluten-free diet, testing for CS in IBS may prevent years of morbidity and attendant expense. We sought to determine whether this might be a cost-effective diagnostic strategy in IBS-D...
  3. ncbi request reprint Clinical determinants of health-related quality of life in patients with irritable bowel syndrome
    Brennan M R Spiegel
    Division of Gastroenterology, the VA Greater Los Angeles Healthcare System, CA 90073, USA
    Arch Intern Med 164:1773-80. 2004
    ..The identification of predictive factors could allow physicians to better assess HRQOL without using misleading clinical clues. We, therefore, sought to identify determinants of HRQOL in patients with IBS...
  4. ncbi request reprint The quality of published health economic analyses in digestive diseases: a systematic review and quantitative appraisal
    Brennan M R Spiegel
    Division of Gastroenterology, Veteran s Affairs Greater Los Angeles Healthcare System, California, USA
    Gastroenterology 127:403-11. 2004
    ..We sought to appraise the quality of health economic analyses in digestive diseases, and to identify predictors of study quality...
  5. pmc Is there "cherry picking" in the ESRD Program? Perceptions from a Dialysis Provider Survey
    Amar A Desai
    Department of Medicine, StanfordUniversity School of Medicine, Stanford, California, USA
    Clin J Am Soc Nephrol 4:772-7. 2009
    ..Changes in ESRD reimbursement policy, including proposed bundled payment, have raised concern that dialysis facilities may use "cherry picking" practices to attract a healthier, better insured, or more adherent patient population...
  6. doi request reprint Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights
    Lisa L Strate
    Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington Medical School, Seattle, Washington, USA
    Am J Gastroenterol 107:1486-93. 2012
    ..This review addresses the emerging literature regarding epidemiology, pathophysiology, and management of chronic, symptomatic diverticular disease, and provides current answers to common clinical questions...
  7. ncbi request reprint Treatment alternatives for hepatitis B cirrhosis: a cost-effectiveness analysis
    Fasiha Kanwal
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 101:2076-89. 2006
    ..Lamivudine is effective but is limited by viral resistance. In contrast, adefovir and entecavir have lower viral resistance, but are more expensive. The most cost-effective approach is uncertain...
  8. ncbi request reprint Comparing rates of dyspepsia with Coxibs vs NSAID+PPI: a meta-analysis
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, Calif 90073, USA
    Am J Med 119:448.e27-36. 2006
    ....
  9. doi request reprint Understanding gastrointestinal distress: a framework for clinical practice
    Brennan M R Spiegel
    Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
    Am J Gastroenterol 106:380-5. 2011
    ..When appropriate, screen for suicidal ideations. Finally, we provide a list of high-yield questions to screen for these maladaptive cognitions and emotions, and explain how the GI distress framework can be used in clinical practice...
  10. doi request reprint Dialysis practices that distinguish top- versus bottom-performing facilities by hemoglobin outcomes
    Brennan M R Spiegel
    Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
    Am J Kidney Dis 56:86-94. 2010
    ..The Identifying Best Practices in Dialysis (IBPiD) Study seeks to identify practices that distinguish top- from bottom-performing facilities by key outcomes, including achievement of recommended hemoglobin targets...
  11. ncbi request reprint Erythropoietic growth factors for treatment-induced anemia in hepatitis C: a cost-effectiveness analysis
    Brennan M R Spiegel
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, and Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California 90073, USA
    Clin Gastroenterol Hepatol 3:1034-42. 2005
    ..We sought to determine the cost effectiveness of adjunctive treatment with an EGF vs standard care in the treatment of hepatitis C...
  12. ncbi request reprint Is a negative colonoscopy associated with reassurance or improved health-related quality of life in irritable bowel syndrome?
    Brennan M R Spiegel
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, CA 90073, USA
    Gastrointest Endosc 62:892-9. 2005
    ..However, no previous data have measured these effects. We sought to measure the association of a normal colonoscopy with reassurance and HRQOL in patients with IBS aged <50 years...
  13. pmc Is irritable bowel syndrome a diagnosis of exclusion?: a survey of primary care providers, gastroenterologists, and IBS experts
    Brennan M R Spiegel
    Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 105:848-58. 2010
    ..Yet many clinicians are concerned about overlooking alternative diagnoses. We measured beliefs about whether IBS is a diagnosis of exclusion, and measured testing proclivity between IBS experts and community providers...
  14. ncbi request reprint Minimizing complications from nonsteroidal antiinflammatory drugs: cost-effectiveness of competing strategies in varying risk groups
    Brennan M R Spiegel
    Veteran s Affairs Greater Los Angeles Healthcare System, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California 90073, USA
    Arthritis Rheum 53:185-97. 2005
    ..To appraise the cost-effectiveness of competing therapeutic strategies in patient cohorts eligible for aspirin prophylaxis with varying degrees of gastrointestinal (GI) and cardiovascular risk...
  15. pmc Biomarkers and health-related quality of life in end-stage renal disease: a systematic review
    Brennan M R Spiegel
    Department of Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, CA 90073, USA
    Clin J Am Soc Nephrol 3:1759-68. 2008
    ....
  16. doi request reprint Development and validation of a novel patient educational booklet to enhance colonoscopy preparation
    Brennan M R Spiegel
    Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 106:875-83. 2011
    ..The success of colonoscopy depends on high-quality bowel preparation by patients; yet inadequate preparation is common. We developed and tested an educational booklet to improve bowel preparation quality...
  17. ncbi request reprint The impact of somatization on the use of gastrointestinal health-care resources in patients with irritable bowel syndrome
    Brennan M R Spiegel
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 100:2262-73. 2005
    ..We sought to determine whether higher levels of somatization are associated with higher levels of gastrointestinal (GI) resource utilization in IBS...
  18. ncbi request reprint The cost-effectiveness and budget impact of intravenous versus oral proton pump inhibitors in peptic ulcer hemorrhage
    Brennan M R Spiegel
    Division of Gastroenterology, Veteran s Administration Greater Los Angeles Healthcare System, California, USA
    Clin Gastroenterol Hepatol 4:988-997. 2006
    ....
  19. ncbi request reprint The budget impact of endoscopic screening for esophageal varices in cirrhosis
    Brennan M R Spiegel
    Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, UCLA VA Center for Outcomes Research and Education CORE, 11301 Wilshire Blvd, Bldg 115 Rm 215, Los Angeles, CA 90073, USA
    Gastrointest Endosc 66:679-92. 2007
    ..However, these models were conducted before advances in variceal screening, including capsule endoscopy (CE), and they did not measure the budget impact (vs cost-effectiveness) of variceal screening...
  20. doi request reprint The relationship between laboratory-based outcome measures and mortality in end-stage renal disease: a systematic review
    Amar A Desai
    VA Greater Los Angeles Healthcare System, Department of Medicine, Los Angeles, California, USA
    Hemodial Int 13:347-59. 2009
    ..Renewed consideration of cardiovascular, inflammatory, and nutritional markers that are especially strong predictors of mortality may have important implications for risk stratification and targeted therapeutic interventions...
  21. doi request reprint Colonoscopy yields fewer polyps as the day progresses despite using social influence theory to reverse the trend
    Marc Kaneshiro
    Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
    Gastrointest Endosc 72:1233-40. 2010
    ..We previously reported that fewer polyps are detected by colonoscopy as the day progresses, a phenomenon that could be modified with "social influence theory" by using auditing and feedback...
  22. ncbi request reprint Development and validation of a disease-targeted quality of life instrument in chronic hepatitis B: the hepatitis B quality of life instrument, version 1.0
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
    Hepatology 46:113-21. 2007
    ..Internal consistency and test-retest reliability were excellent. The HBQOL v1.0 discriminated between viral responders versus nonresponders and correlated highly with SF-36 scores and global health...
  23. ncbi request reprint Treatment alternatives for chronic hepatitis B virus infection: a cost-effectiveness analysis
    Fasiha Kanwal
    Veterans Affairs Greater Los Angeles Healthcare System, David Geffen School of Medicine at University of California, Los Angeles, and Center for the Study of Digestive Healthcare Quality and Outcomes, Los Angeles, California 90073, USA
    Ann Intern Med 142:821-31. 2005
    ..Interferon has clinically significant side effects, and lamivudine is associated with viral resistance. In contrast, adefovir is safe and has lower viral resistance but is more expensive. The most cost-effective approach is uncertain...
  24. ncbi request reprint Combination endoscopic band ligation and sclerotherapy compared with endoscopic band ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage: a meta-analysis
    Hetal A Karsan
    VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Center for the Health Sciences, Division of Digestive Diseases, Los Angeles, California 90073, USA
    Dig Dis Sci 50:399-406. 2005
    ..Moreover, combination EBL and sclerotherapy had more esophageal stricture formation than EBL alone...
  25. doi request reprint The effect of irritable bowel syndrome on health-related quality of life and health care expenditures
    Nikhil Agarwal
    Department of Gastroenterology, Veterans Affairs Greater Los Angeles Healthcare System, David Geffen School of Medicine at University of California Los Angeles, 11301 Wilshire Boulevard, Building 115, Room 215, Los Angeles, CA 90073, USA
    Gastroenterol Clin North Am 40:11-9. 2011
    ..Clinicians should routinely screen for diminished HRQOL by performing a balanced biopsychosocial history rather than focusing just on bowel symptoms. HRQOL decrements should be acknowledged and addressed when making treatment decisions...
  26. doi request reprint Adenoma detection rate is necessary but insufficient for distinguishing high versus low endoscopist performance
    Hank S Wang
    Department of Medicine, Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
    Gastrointest Endosc 77:71-8. 2013
    ..Endoscopist quality is benchmarked by the adenoma detection rate (ADR)-the proportion of cases with 1 or more adenomas removed. However, the ADR rewards the same credit for 1 versus more than 1 adenoma...
  27. ncbi request reprint The cost-effectiveness of cyclooxygenase-2 selective inhibitors in the management of chronic arthritis
    Brennan M R Spiegel
    Veterans Administration Greater Los Angeles Healthcare System, David Geffen School of Medicine at University of California, CURE Digestive Diseases Research Center, Los Angeles, CA 90073, USA
    Ann Intern Med 138:795-806. 2003
    ..However, their absolute risk reduction is small and the cost-effectiveness of treatment is uncertain...
  28. ncbi request reprint Management of acute nonvariceal upper gastrointestinal hemorrhage: comparison of an American and a Canadian medical centre
    Laura E Targownik
    Veterans Affairs Greater Los Angeles Health Care System, California, USA
    Can J Gastroenterol 17:489-95. 2003
    ..The aim of the present study was to compare the structure, process and outcomes of care between a Canadian and an American tertiary care medical centre in the management of acute nonvariceal UGIH...
  29. pmc Controversies in ulcerative colitis: a survey comparing decision making of experts versus community gastroenterologists
    Brennan M R Spiegel
    Veteran s Administration Greater Los Angeles Healthcare System, Los Angeles, California, USA
    Clin Gastroenterol Hepatol 7:168-74, 174.e1. 2009
    ..We performed a national vignette survey to measure variations in decision-making in areas of controversy...
  30. pmc Asymptomatic pancreatic cystic neoplasms: maximizing survival and quality of life using Markov-based clinical nomograms
    Benjamin M Weinberg
    Department of Gastroenterology, VA Greater Los Angeles Healthcare System, USA
    Gastroenterology 138:531-40. 2010
    ..The natural history and management of pancreatic cysts, especially for branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), remain uncertain. We developed evidence-based nomograms to assist with clinical decision making...
  31. doi request reprint Fewer polyps detected by colonoscopy as the day progresses at a Veteran's Administration teaching hospital
    Michael Y Chan
    Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
    Clin Gastroenterol Hepatol 7:1217-23; quiz 1143. 2009
    ..Providers are predisposed to cognitive errors because the procedure is often performed repetitively throughout the day. We measured the adjusted relationship between colonoscopy start time and polyp yield...
  32. ncbi request reprint The burden of IBS: looking at metrics
    Brennan M R Spiegel
    VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, UCLA VA Center for Outcomes Research and Education, 11301 Wilshire Boulevard, Building 115, Room 215, Los Angeles, CA 90073, USA
    Curr Gastroenterol Rep 11:265-9. 2009
    ..Resource utilization is highest in patients with severe symptoms and poor HRQOL. Treatment decisions should be tailored to the severity of each patient's symptoms and HRQOL decrement...
  33. ncbi request reprint Endoscopic screening for esophageal varices in cirrhosis: Is it ever cost effective?
    Brennan M R Spiegel
    Division of Gastroenterology, Greater Los Angeles VA Healthcare System, CA 90073, USA
    Hepatology 37:366-77. 2003
    ....
  34. pmc Identifying best practices in dialysis care: results of cognitive interviews and a national survey of dialysis providers
    Amar A Desai
    Department of Medicine, University of California San Francisco, San Francisco, California, USA
    Clin J Am Soc Nephrol 3:1066-76. 2008
    ..We sought to catalogue "best practices" that may account for interfacility variations in outcomes...
  35. ncbi request reprint Impact of hepatitis C on health related quality of life: a systematic review and quantitative assessment
    Brennan M R Spiegel
    Division of Gastroenterology, VA Greater Los Angeles Healthcare System, USA
    Hepatology 41:790-800. 2005
    ..Supplementary material for this article can be found on the HEPATOLOGY website (http://www.interscience.wiley.com/jpages/0270-9139/suppmat/index.html)...
  36. ncbi request reprint Do physicians follow evidence-based guidelines in the diagnostic work-up of IBS?
    Brennan M R Spiegel
    Division of Gastroenterology and Hepatology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
    Nat Clin Pract Gastroenterol Hepatol 4:296-7. 2007
  37. pmc Bacterial overgrowth and irritable bowel syndrome: unifying hypothesis or a spurious consequence of proton pump inhibitors?
    Brennan M R Spiegel
    VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    Am J Gastroenterol 103:2972-6. 2008
    ..Our article explores these premises, lays out the argument supporting this "PPI hypothesis," discusses potential implications, and outlines next steps to further investigate this possibility...
  38. ncbi request reprint Dysplasia and risk of further neoplastic progression in a regional Veterans Administration Barrett's cohort
    Gareth S Dulai
    Greater Los Angeles Veterans Administration Healthcare System, Department of Medicine, Division of Gastroenterology, UCLA School of Medicine, Los Angeles, CA 90073, USA
    Am J Gastroenterol 100:775-83. 2005
    ..Our aims were to estimate and compare the risk of progression to high-grade dysplasia or cancer in groups of Barrett's patients stratified by baseline dysplasia status...
  39. doi request reprint Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspective
    Brennan M R Spiegel
    Department of Gastroenterology, VA Greater Los Angeles Healthcare System, California, USA
    Clin Gastroenterol Hepatol 9:461-9; quiz e59. 2011
    ..The article concludes that bacteria may contribute to some IBS symptoms, but that bacteria cannot be the only explanation, and a causal link between SIBO and IBS is not secure...
  40. ncbi request reprint Clinical impact of adjuvant chemotherapy in glioblastoma multiforme : a meta-analysis
    Brennan M R Spiegel
    VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
    CNS Drugs 21:775-87. 2007
    ..We sought to update prior analyses by focusing exclusively on GBM, including new trials of novel treatments, assessing effectiveness of individual treatment categories and presenting data in a clinically useful format...
  41. ncbi request reprint Minimizing recurrent peptic ulcer hemorrhage after endoscopic hemostasis: the cost-effectiveness of competing strategies
    Brennan M R Spiegel
    Department of Digestive Diseases, University of California at Los Angeles School of Medicine, Los Angeles, California, USA
    Am J Gastroenterol 98:86-97. 2003
    ..Our objective was to evaluate the cost-effectiveness of competing strategies for the posthemostasis management of patients with high risk ulcer stigmata...
  42. ncbi request reprint Esomeprazole versus other proton pump inhibitors in erosive esophagitis: a meta-analysis of randomized clinical trials
    Ian M Gralnek
    Rambam Medical Center, Department of Gastroenterology, GI Outcomes Unit, Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
    Clin Gastroenterol Hepatol 4:1452-8. 2006
    ..We performed a meta-analysis to calculate the pooled effect of esomeprazole on healing rates, symptom relief, and adverse events versus competing PPIs in EE...
  43. doi request reprint Comparison of health-related quality of life between populations
    Serena Slavenburg
    Liver Int 28:285-6; author reply 286-7. 2008
  44. ncbi request reprint Impact of chronic viral hepatitis on health-related quality of life in HIV: results from a nationally representative sample
    Fasiha Kanwal
    VA Greater Los Angeles Health Care System, Division of Gastroenterology Hepatology, David Geffen School of Medicine at UCLA, 90073, USA
    Am J Gastroenterol 100:1984-94. 2005
    ..We compared health-related quality of life (HRQOL) of patients with HIV and hepatitis C virus (HCV) or HIV and hepatitis B virus (HBV) coinfection to those with HIV monoinfection...
  45. ncbi request reprint Budget impact of tegaserod on a managed care organization formulary
    Michael A Bloom
    Innovative Health Solutions, Brookline, Massachusetts, USA
    Am J Manag Care 11:S27-34. 2005
    ..When the associated budget impact of adding tegaserod to its formulary is absorbed across an entire MCO population, the PMPM impact of tegaserod is small...
  46. ncbi request reprint The cost-effectiveness of hepatic venous pressure gradient monitoring in the prevention of recurrent variceal hemorrhage
    Laura E Targownik
    Section of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada
    Am J Gastroenterol 99:1306-15. 2004
    ..Combination of beta-blocker and nitrate therapy, guided by hepatic venous pressure gradient (HVPG) monitoring, is a novel alternative strategy. We sought to determine the cost-effectiveness of these competing strategies...
  47. pmc The cost-effectiveness of colonic stenting as a bridge to curative surgery in patients with acute left-sided malignant colonic obstruction: a Canadian perspective
    Harminder Singh
    Department of Internal Medicine, University of Manitoba, Winnipeg
    Can J Gastroenterol 20:779-85. 2006
    ..The aim of the present study was to determine the most cost-effective strategy in a Canadian setting. patients and..
  48. ncbi request reprint Predictors of treatment in patients with chronic hepatitis C infection - role of patient versus nonpatient factors
    Fasiha Kanwal
    John Cochran VA Medical Center, St Louis, MO, USA
    Hepatology 46:1741-9. 2007
    ..These potentially modifiable provider-level factors may serve as high-yield targets for future quality improvement initiatives in HCV...