César Caraballo-Cordovez

César Caraballo-Cordovez
Yale University | YU · Center for Outcomes Research & Evaluation (CORE)

MD

About

101
Publications
5,361
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
584
Citations
Introduction
Cesar Caraballo currently works at the Center for Outcomes Research & Evaluation (CORE), Yale University. Cesar does research in public health, quality of care, and outcomes research in medicine.

Publications

Publications (101)
Article
Importance: Insufficient data exist about the clinical presentation, short-term, and long-term outcomes of patients with isolated distal deep vein thrombosis (IDDVT), that is, thrombosis in infrapopliteal veins without proximal extension or pulmonary embolism (PE). Objective: To determine the clinical characteristics, short-term, and 1-year outc...
Preprint
Importance Early morning blood draws disrupt patients’ sleep and adversely affect patient experience. Objective To describe the trends in non-urgent early morning blood draws in a large health care system. Design This cross-sectional study analyzed trends in non-urgent early morning (04:00–06:59) blood draws using the electronic medical records o...
Article
Full-text available
Background Whether there are sex differences in hemodynamic profiles among people with elevated blood pressure is not well understood and could guide personalization of treatment. Methods and results We described the clinical and hemodynamic characteristics of adults with elevated blood pressure in China using impedance cardiography. We included 4...
Article
Importance: Historically marginalized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed during recent years. Objective: To evaluate 15-year trends in racial and ethnic differences in self-reported sleep duration among adults in the US. Design, set...
Article
Background Disparities in multimorbidity prevalence indicate health inequalities, as the risk of morbidity does not intrinsically differ by race/ethnicity. This study aimed to determine if multimorbidity differences by race/ethnicity are decreasing over time. Methods Serial cross-sectional analysis of the National Health Interview Survey, 1999–201...
Preprint
Objective To evaluate medication guideline adherence among ambulatory patients with markedly elevated blood pressure (BP), overall and by patient characteristics. Design Population-based, retrospective cohort study. Setting Yale New Haven Health System. Participants Adult patients aged 18-85 years with markedly elevated BP (defined as two consec...
Preprint
Background Racial and ethnic disparities in delayed medical care due to reasons not related to cost of care remain understudied. We aimed to describe recent 20-year trends in such disparities. Methods The study used data from the National Health Interview Survey from 1999–2018 and included individuals ≥18 years of age. Respondents were categorized...
Article
Full-text available
OBJECTIVE Health-related expenditures resulting from diabetes are rising in the U.S. Medication nonadherence is associated with worse health outcomes among adults with diabetes. We sought to examine the extent of reported cost-related medication nonadherence (CRN) in individuals with diabetes in the U.S. RESEARCH DESIGN AND METHODS We studied adul...
Article
Background: Health-related expenditures due to diabetes mellitus (DM) are rising in the US. Medication nonadherence is associated with worse health outcomes, particularly among individuals with DM who require uninterrupted treatment. We sought to determine whether patients with DM in the US report cost-related nonadherence (CRN), a potential conseq...
Article
Poor hypertension awareness and underuse of guideline-recommended medications are critical factors contributing to poor hypertension control. Using data from 8095 hypertensive people aged ≥18 years from the National Health and Nutrition Examination Survey (2011–2018), we examined recent trends in racial and ethnic differences in awareness and antih...
Preprint
Full-text available
Importance: Minoritized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed over recent years. Objective: To determine 15–year trends in the racial and ethnic differences in self–reported sleep duration among adults in the US. Design: Serial cross–secti...
Article
Background New methods such as machine learning techniques have been increasingly used to enhance the performance of risk predictions for clinical decision-making. However, commonly reported performance metrics may not be sufficient to capture the advantages of these newly proposed models for their adoption by health care professionals to improve c...
Preprint
Full-text available
Background: Multimorbidity, an important health indicator, is a contributor to and result of health inequity. We sought to determine if gaps in multimorbidity by race and ethnicity are decreasing over time. Methods: Serial cross-sectional analysis of the National Health Interview Survey, 1999 to 2018. The study included individuals older than 18 ye...
Article
Full-text available
Background Racial and ethnic disparities contribute to differences in access and outcomes for patients undergoing heart transplantation. We evaluated contemporary outcomes for heart transplantation stratified by race and ethnicity as well as the new 2018 allocation system. Methods and Results Adult heart recipients from 2011 to 2020 were identifie...
Preprint
Full-text available
Objective: To examine United States (US) trends in racial/ethnic differences in hypertension awareness and antihypertensive medication use, and whether these differences help explain racial/ethnic differences in hypertension control among adults from 2011 to 2018. Design: Population-based study. Setting: National Health and Nutrition Examination Su...
Article
Importance The elimination of racial and ethnic differences in health status and health care access is a US goal, but it is unclear whether the country has made progress over the last 2 decades. Objective To determine 20-year trends in the racial and ethnic differences in self-reported measures of health status and health care access and affordabi...
Article
Background: It remains unclear why depression is associated with adverse outcomes in heart failure (HF) patients. We examine the relationship between depression and clinical outcomes among patients with HF and reduced ejection fraction (HFrEF) managed with guideline directed medical therapy (GDMT). Methods: Using the GUIDE-IT trial, 894 patients wi...
Article
Full-text available
Aims Improved cancer survivorship has led to a higher number of anthracycline‐induced cardiomyopathy patients with end‐stage heart failure. We hypothesize that outcomes following continuous‐flow LVAD (CF‐LVAD) implantation in those with anthracycline‐induced cardiomyopathy are comparable with other aetiologies of cardiomyopathy. Methods and result...
Article
Full-text available
Objectives The aim of this study was to examine patterns of care and clinical outcomes among patients with heart failure with reduced ejection fraction (HFrEF) in the United States and Canada. Background In the GUIDE-IT (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment) trial, the use of N-terminal pro–B-type natriuretic peptid...
Preprint
BACKGROUND Harnessing health-related data posted on social media in real-time has the potential to offer insights into how the pandemic impacts the mental health and general well-being of individuals and populations over time. OBJECTIVE The aim of this study was to obtain information on symptoms and medical conditions self-reported by non-Twitter...
Article
Background: Harnessing health-related data posted on social media in real-time has the potential to offer insights into how the pandemic impacts the mental health and general well-being of individuals and populations over time. Objective: The aim of this study was to obtain information on symptoms and medical conditions self-reported by non-Twit...
Article
Full-text available
Objective To evaluate effects of atrial fibrillation (AF) on cardiac biomarkers and outcomes in a trial population of patients with heart failure (HF) with reduced ejection fraction treated with optimal guideline-directed medical therapy. Methods We performed a secondary analysis of 894 patients in the Guiding Evidence-Based Therapy Using Biomarke...
Preprint
Background: Whether there are sex differences in hemodynamic profiles among people with elevated blood pressure is not well understood and could guide personalization of treatment. Methods and results: We described the clinical and hemodynamic characteristics of adults with elevated blood pressure in China using impedance cardiography. We included...
Preprint
Full-text available
Hospitalizations for acute cardiac conditions have markedly declined during the coronavirus disease 2019 (COVID-19) pandemic, yet the cause of this decline is not clear. Using remote monitoring data of 4,029 patients with implantable cardiac defibrillators (ICDs) living in New York City and Minneapolis/Saint Paul, we assessed changes in markers of...
Preprint
Full-text available
Nationwide public health restrictions due to the coronavirus disease 2019 (COVID-19) pandemic have disrupted people’s routine physical activities, yet little objective information is available on the extent to which physical activity has changed among patients with pre-existing cardiac diseases. Using remote monitoring data of 9,924 patients with p...
Preprint
Full-text available
Background: The coronavirus disease 2019 (COVID-19) has continued to spread in the US and globally. Closely monitoring public engagement and perception of COVID-19 and preventive measures using social media data could provide important information for understanding the progress of current interventions and planning future programs. Objective: To me...
Article
Full-text available
Background Infection fatality rate and infection hospitalization rate, defined as the proportion of deaths and hospitalizations, respectively, of the total infected individuals, can estimate the actual toll of COVID-19 on a community as the denominator is ideally based on a representative sample of a population, which captures the full spectrum of...
Preprint
BACKGROUND The coronavirus disease 2019 (COVID-19) has continued to spread in the US and globally. Closely monitoring public engagement and perception of COVID-19 and preventive measures using social media data could provide important information for understanding the progress of current interventions and planning future programs. OBJECTIVE To mea...
Article
Background: The coronavirus disease 2019 (COVID-19) has continued to spread in the US and globally. Closely monitoring public engagement and perception of COVID-19 and preventive measures using social media data could provide important information for understanding the progress of current interventions and planning future programs. Objective: To...
Article
Full-text available
ImportancePatient outcomes in heart failure clinical trials are generally better than those observed in real-world settings. This may be related to stricter inclusion and exclusion criteria in clinical trials.Objective We study sought to characterize the clinical implications of differences between patients in clinical trials and those in a real-wo...
Article
Full-text available
Machine learning (ML) techniques have become ubiquitous and indispensable for solving intricate problems in most disciplines. To determine the extent of funding for clinical research projects applying ML techniques by the National Institutes of Health (NIH) in 2017, we searched the NIH Research Portfolio Online Reporting Tools Expenditures and Resu...
Article
Background Community engagement and rapid translation of findings for the benefit of patients has been noted as a major criterion for NIH decisions regarding allocation of funds for research priorities. We aimed to examine whether the presence of top NIH-funded institutions resulted in a benefit on the cardiovascular and cancer mortality of their l...
Article
Background Scaling SARS-CoV-2 testing to meet demands of safe reopenings continues to be plagued by assay costs and supply chain shortages. In response, we developed SalivaDirect, which received Emergency Use Authorization (EUA) from the U.S. FDA. Methods We simplified our saliva-based diagnostic test by (1) not requiring collection tubes with pre...
Article
Introduction: Anthracycline-induced cardiomyopathy (AC-CM) presenting as end-stage heart failure may require mechanical circulatory support. Hypothesis: We hypothesize that there is no difference in outcomes after LVAD placement in those with AC-CM compared to other forms of cardiomyopathy. Methods: Interagency Registry for Mechanically Assisted Ci...
Article
Background: Isolated distal deep vein thrombosis (IDDVT) is a common form of venous thromboembolism (VTE). Limited data exist about the clinical characteristics, initial treatment, and short-term outcomes of these patients. Methods: Using the data from the RIETE registry (05/2001-02/2019), we identified patients with IDDVT without pulmonary embolis...
Article
Introduction: Combination therapy with two or more antihypertensive agents is recommended for management of patients with markedly elevated blood pressure (systolic blood pressure [SBP] ≥160 mmHg or diastolic blood pressure [DBP] ≥100 mmHg) by the 2017 AHA/ACC hypertension guideline. Using electronic health records (EHR) data from a large health sy...
Preprint
Full-text available
Importance COVID-19 case fatality and hospitalization rates, calculated using the number of confirmed cases of COVID-19, have been described widely in the literature. However, the number of infections confirmed by testing underestimates the total infections as it is biased based on the availability of testing and because asymptomatic individuals ma...
Preprint
Full-text available
Importance Racial and ethnic disparities plague the US health care system despite efforts to eliminate them. To understand what has been achieved amid these efforts, a comprehensive study from the population perspective is needed. Objectives To determine trends in rates and racial/ethnic disparities of key access to care measures among adults in t...
Preprint
Full-text available
Importance Thirty-five years ago, the Heckler Report described health disparities among minority populations in the US. Since then, policies have been implemented to address these disparities. However, a recent evaluation of progress towards improving the health and health equity among US adults is lacking. Objectives To evaluate racial/ethnic dis...
Article
Introducción: las dermatosis infecciosas y no infecciosas tienen una alta prevalencia en pacientes con infección por el virus de la inmunodeficiencia humana (VIH) y son importantes para su diagnóstico y seguimiento clínico. A pesar de que hay extensa documentación de dichas dermatosis en otras poblaciones y especialmente en países desarrollados, la...
Article
Full-text available
Background Patients with comorbid conditions have a higher risk of mortality with SARS-CoV-2 (COVID-19) infection, but the impact on heart failure patients living near a disease hotspot is unknown. Therefore, we sought to characterize the prevalence and outcomes of COVID-19 in a live registry of heart failure patients across an integrated health ca...
Article
Background/aims Non-inferiority trials are increasing in cardiovascular medicine, with approval of many drugs and devices on the basis of such studies. Surrogate markers as primary endpoints have been also more frequently used for efficient assessment of cardiovascular interventions. However, there is uncertainty about their concordance with clinic...
Article
Objectives This study sought to use INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) results to evaluate sex differences in the use and clinical outcomes of left ventricular assist devices (LVAD). Background Despite a similar incidence of heart failure in men and women, prior studies have highlighted potential underus...
Article
Background Many clinical investigations depend on participant self-report as a principal method of identifying health care events. If self-report is used as the trigger to collect and adjudicate medical records, any event that is not reported by the patient will be missed by the investigators, reducing the power of the study and misrepresenting the...
Article
Background Psychiatric comorbidities play a key role in patient selection for left ventricular assist devices (LVADs), but their impact on clinical outcomes is unknown. Objectives The goal of this study was to examine the clinical impact of psychiatric illness on outcomes in patients receiving LVADs for end-stage heart failure (HF). Methods The s...
Article
Full-text available
Background Atherosclerotic cardiovascular disease ( ASCVD ) has a strong association with diabetes mellitus ( DM ), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment‐related expenses. Therefore, we examined the burden of fin...
Preprint
Full-text available
Background: Patients with comorbid conditions have a higher risk of mortality with SARS-CoV-2 (COVID-19) infection, but the impact on heart failure patients living near a disease hotspot is unknown. Therefore, we sought to characterize the prevalence and outcomes of COVID-19 in a live registry of heart failure patients across an integrated health c...
Article
Background: Non-inferiority trials are increasing in cardiovascular medicine, with approval of many drugs and devices on the basis of such studies. Surrogate endpoints have been also increasingly used for efficient assessment of cardiovascular interventions, but there is uncertainty about their concordance with clinical outcomes. Non-inferiority de...
Article
Objectives Tricuspid regurgitation (TR) is common in end stage heart failure patients receiving left ventricular assist devices (LVADs), but the benefit of concomitant tricuspid valve procedures (TVP) remains uncertain. This study examined the impact of TVP at time of LVAD implantation on clinical outcomes and quality of life metrics. Methods We i...
Article
Purpose Aortic insufficiency (AI) is a common problem in advanced heart failure and progression after left ventricular assist device implantation is well described. Patterns of care for AVP at the time of LVAD implantation and the associated outcomes remain poorly described. Methods We included all patients in the INTERMACS (Interagency Registry f...
Article
Purpose The clinical impact of mitral valve procedures (MVP) at time of left ventricular assist device (LVAD) is not well understood. We examined the association of MVP, according to severity of MR, with long term survival and quality of life metrics. Methods Continuous-flow LVAD recipients with MR from the 2008-2017 INTERMACS registry were includ...
Article
Purpose Tricuspid regurgitation (TR) is common in end stage heart failure patients receiving left ventricular assist devices (LVADs), but the value of intervention is uncertain. This study examined the impact of tricuspid valve procedures (TVP) at time of LVAD implantation on clinical outcomes and quality of life metrics. Methods We included patie...
Preprint
We propose a novel reinforcement learning-based approach for adaptive and iterative feature selection. Given a masked vector of input features, a reinforcement learning agent iteratively selects certain features to be unmasked, and uses them to predict an outcome when it is sufficiently confident. The algorithm makes use of a novel environment sett...
Article
BACKGROUND Age is known to be associated with the prevalence and pathophysiology of hypertension. However, there is little information on whether age stands as a good proxy for the specific hemodynamic profile of an individual with elevated blood pressure (BP), which could be important in the selection of therapy. DESIGN This is a cross‐sectional...
Article
Background The trend of increasing total and out-of-pocket expenditure among patients with diabetes mellitus represents a risk of financial hardship for Americans and a threat to medical and nonmedical needs. We aimed to describe the national scope and associated tradeoffs of financial hardship from medical bills among nonelderly individuals with d...
Article
Staphylococcemia mortality: influence of methicillin resistance and site of infection acquisition in a patient's cohort from Medellin, Colombia Resumen introducción. La incidencia de bacteriemia por Staphylococcus aureus resistente a meticilina (sarm) parece estar en aumento en algunos países. Este fenómeno se ha detectado también en Colombia. obje...
Article
Sepsis is a highly complex and lethal syndrome with highly heterogeneous clinical manifestations that makes it difficult to detect and treat. It is also one of the major and most urgent global public health challenges. More than 30 million people are diagnosed with sepsis each year, with 5 million attributable deaths and long-term sequalae among su...
Article
Full-text available
Background The New York Heart Association (NYHA) classification has served as a fundamental tool for risk stratification of heart failure (HF) and determines clinical trial eligibility and candidacy for drugs and devices. However, its ability to adequately stratify risk is unclear. Methods and Results To compare NYHA class with objective assessment...
Article
Objectives: The purpose of this study was to examine outcomes after left ventricular assist device (LVAD) implantation in older adults (>75 years of age). Background: An aging heart failure population together with improvements in mechanical circulatory support (MCS) technology have led to increasing LVAD implantations in older adults. However,...