Publications by authors named "Adam L Lessler"
Objectives: The mortality benefit for pulmonary embolism (PE) is the difference in mortality between treated and untreated patients. The mortality benefit threshold is the mortality benefit above which testing for a condition should be initiated and below which it should not. To illustrate this concept, the authors developed a decision model to estimate the mortality benefit threshold at several pretest probabilities for low-risk emergency department (ED) patients with possible PE and compare those thresholds with contemporary management of PE in the United States and what is known and not known about treatment benefits with anticoagulation.
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- The study aimed to improve the Pulmonary Embolism Rule-out Criteria (PERC) by identifying additional factors that could help determine when low-risk patients in the emergency department might not need testing for pulmonary embolism.
- Using decision models based on PERC criteria, researchers calculated a testing threshold of 1.4% for pulmonary embolism across different age and sex groups, analyzing various risks and benefits associated with evaluation and treatment.
- The findings revealed that factors like major bleeding risks from anticoagulation and mortality rates from untreated embolism significantly influenced the testing threshold, highlighting a lack of comprehensive literature on low-risk patients.
Background: Quality improvement collaboratives (QICs) based on the Chronic Care Model (CCM) are widely used models for improving medical care, but there has been little information to date about the specific projects undertaken by participants in these collaboratives and their outcomes.
Objectives: To describe initiatives undertaken by community health centers (CHCs) participating in QICs (the Health Disparities Collaboratives) for asthma, cardiovascular disease, or diabetes, and to determine whether particular features of these initiatives were associated with improvement in health care processes or outcomes.
Research Design: Observational cohort study.