Research Topics
| Brennan M R SpiegelSummaryAffiliation: University of California Country: USA Publications
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Detail Information
Publications
Dyspepsia management in primary care: a decision analysis of competing strategiesBrennan M R Spiegel
Department of Medicine and Health Services Research, Cedars-Sinai Medical Center, Los Angeles, California, USA
Gastroenterology 122:1270-85. 2002- Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysisBrennan 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... - Clinical determinants of health-related quality of life in patients with irritable bowel syndromeBrennan 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... - The quality of published health economic analyses in digestive diseases: a systematic review and quantitative appraisalBrennan 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... 
Is there "cherry picking" in the ESRD Program? Perceptions from a Dialysis Provider SurveyAmar 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...
Diverticular disease as a chronic illness: evolving epidemiologic and clinical insightsLisa 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...- Understanding gastrointestinal distress: a framework for clinical practiceBrennan 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... - Comparing rates of dyspepsia with Coxibs vs NSAID+PPI: a meta-analysisBrennan 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.... - Treatment alternatives for hepatitis B cirrhosis: a cost-effectiveness analysisFasiha Kanwal
Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
Am J Gastroenterol 101:2076-89. 2006..In patients with HBV cirrhosis with previous lamivudine resistance, "adefovir salvage" appears more effective and less expensive than "entecavir salvage.".. - Erythropoietic growth factors for treatment-induced anemia in hepatitis C: a cost-effectiveness analysisBrennan 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... - Dialysis practices that distinguish top- versus bottom-performing facilities by hemoglobin outcomesBrennan 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... - Is irritable bowel syndrome a diagnosis of exclusion?: a survey of primary care providers, gastroenterologists, and IBS expertsBrennan 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... - 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... - Minimizing complications from nonsteroidal antiinflammatory drugs: cost-effectiveness of competing strategies in varying risk groupsBrennan 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... - The cost-effectiveness and budget impact of intravenous versus oral proton pump inhibitors in peptic ulcer hemorrhageBrennan M R Spiegel
Division of Gastroenterology, Veteran's Administration Greater Los Angeles Healthcare System, California, USA
Clin Gastroenterol Hepatol 4:988-997. 2006..CONCLUSIONS: The higher effectiveness of IV PPI therapy may not offset its increased costs vs PO PPI therapy in ulcer hemorrhage. The managed care budget impact of IV PPIs exceeds most benchmarks... - Biomarkers and health-related quality of life in end-stage renal disease: a systematic reviewBrennan 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.... - The impact of somatization on the use of gastrointestinal health-care resources in patients with irritable bowel syndromeBrennan M R Spiegel
Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
Am J Gastroenterol 100:2262-73. 2005..This suggests that somatization is positively associated with health-care costs in IBS, and that the association may be driven more by physicians than patients... - Development and validation of a novel patient educational booklet to enhance colonoscopy preparationBrennan 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... - The relationship between laboratory-based outcome measures and mortality in end-stage renal disease: a systematic reviewAmar 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... - Colonoscopy yields fewer polyps as the day progresses despite using social influence theory to reverse the trendMarc 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... - The budget impact of endoscopic screening for esophageal varices in cirrhosisBrennan 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... - Development and validation of a disease-targeted quality of life instrument in chronic hepatitis B: the hepatitis B quality of life instrument, version 1.0Brennan 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..The HBQOL v1.0 is a valid and reliable measure that captures this HRQOL decrement. This instrument may be useful in everyday clinical practice and in future clinical trials... - The effect of irritable bowel syndrome on health-related quality of life and health care expendituresNikhil 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... - Treatment alternatives for chronic hepatitis B virus infection: a cost-effectiveness analysisFasiha 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 therapy may still be preferred in health care systems with limited resources, especially in those serving populations with a high prevalence of HBeAg-negative HBV... - Combination endoscopic band ligation and sclerotherapy compared with endoscopic band ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage: a meta-analysisHetal 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... - The cost-effectiveness of cyclooxygenase-2 selective inhibitors in the management of chronic arthritisBrennan 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, coxibs may provide an acceptable incremental cost-effectiveness ratio in the subgroup of patients with a history of bleeding ulcers... - Controversies in ulcerative colitis: a survey comparing decision making of experts versus community gastroenterologistsBrennan 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... - Asymptomatic pancreatic cystic neoplasms: maximizing survival and quality of life using Markov-based clinical nomogramsBenjamin 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... - Management of acute nonvariceal upper gastrointestinal hemorrhage: comparison of an American and a Canadian medical centreLaura 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... - Impact of hepatitis C on health related quality of life: a systematic review and quantitative assessmentBrennan 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)... - 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.... - Identifying best practices in dialysis care: results of cognitive interviews and a national survey of dialysis providersAmar 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... - The burden of IBS: looking at metricsBrennan 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... - Fewer polyps detected by colonoscopy as the day progresses at a Veteran's Administration teaching hospitalMichael 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... - 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... - Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspectiveBrennan 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... - Dysplasia and risk of further neoplastic progression in a regional Veterans Administration Barrett's cohortGareth 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..The rate of progression to high-grade dysplasia or cancer was significantly higher in those with baseline low-grade dysplasia. These data may warrant reevaluation of current Barrett's surveillance strategies... - 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 - Clinical impact of adjuvant chemotherapy in glioblastoma multiforme : a meta-analysisBrennan 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... - Minimizing recurrent peptic ulcer hemorrhage after endoscopic hemostasis: the cost-effectiveness of competing strategiesBrennan 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..However, i.v. PPIs are likely to reduce the need for second look endoscopy and may be preferred overall if the rebleed rate and cost of i.v. PPIs remains low... - Esomeprazole versus other proton pump inhibitors in erosive esophagitis: a meta-analysis of randomized clinical trialsIan 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... - Comparison of health-related quality of life between populationsSerena Slavenburg
Liver Int 28:285-6; author reply 286-7. 2008 - Impact of chronic viral hepatitis on health-related quality of life in HIV: results from a nationally representative sampleFasiha 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..These data are relevant in counseling coinfected patients regarding the impact of coinfection on HRQOL, and are important in designing clinical trials and conducting cost-effectiveness analyses including this vulnerable cohort... - The cost-effectiveness of colonic stenting as a bridge to curative surgery in patients with acute left-sided malignant colonic obstruction: a Canadian perspectiveHarminder Singh
Department of Internal Medicine, University of Manitoba, Winnipeg
Can J Gastroenterol 20:779-85. 2006..Colonic stenting should be offered as the initial therapeutic modality for Canadian colorectal cancer patients presenting with acute obstruction as a bridge to definitive RS... - Budget impact of tegaserod on a managed care organization formularyMichael 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... - Predictors of treatment in patients with chronic hepatitis C infection - role of patient versus nonpatient factorsFasiha 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... - The cost-effectiveness of hepatic venous pressure gradient monitoring in the prevention of recurrent variceal hemorrhageLaura E Targownik
Section of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada
Am J Gastroenterol 99:1306-15. 2004..CONCLUSIONS: Compared to EBL for the secondary prophylaxis of variceal rebleeding, combination medical therapy guided by HVPG monitoring is more effective and only marginally more expensive...