Kristin Berry

Kristin Berry
University of Washington Seattle | UW

PhD

About

71
Publications
1,881
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3,256
Citations
Introduction

Publications

Publications (71)
Article
Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Particulate matter air pollution <2.5 μm in diameter (PM2.5) is a ubiquitous exposure primarily produced from fossil fuel combustion. Previous epidemiologic studies have been mixed. The objective of this study was to examine the association betwee...
Article
Full-text available
Background mRNA COVID-19 vaccines manufactured by Pfizer-BioNTech (BNT162b2) and Moderna (mRNA-1273) have been shown to be efficacious but have not been compared in head-to-head clinical trials. Methods We designed this observational study to emulate a target trial of COVID-19 vaccination by BNT162b2 versus mRNA-1273 among persons who underwent va...
Article
Background Whether to perform umbilical hernia repair in patients with cirrhosis is a common dilemma for surgeons. We aimed to determine the incidence, morbidity, and mortality associated with emergency and nonemergency umbilical hernia repair in patients with and without cirrhosis, and to explore opportunities for nonemergency repair. Methods Vet...
Article
Introduction: We evaluated the COVID-19 pandemic’s impact on HCC screening and diagnosis among patients with cirrhosis in the Veterans Health Administration. Methods: Rates and predictors of screening and diagnosis were reviewed 9/1/2019-2/29/2020 (“pre-COVID-19”,N=94,612) and 4/1/2020-9/30/2020 (“post-COVID-19”,N=88,073). Results: Screenin...
Article
Background: Little is known about real-world COVID-19 vaccine effectiveness (VE) in racially and ethnically diverse, elderly populations with high comorbidity burden. Objective: To determine the effectiveness of messenger RNA COVID-19 vaccines. Design: Target trial emulation study comparing newly vaccinated persons with matched unvaccinated co...
Article
Full-text available
Background We aimed to determine factors independently associated with early COVID-19 vaccination and adherence to two-dose regimens. Methods Among persons receiving care in the Veterans Affairs (VA) healthcare system (n = 5,766,638), we identified those who received at least one dose of COVID-19 vaccination through the VA, during the first ~3mont...
Article
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Background: We examined whether key sociodemographic and clinical risk factors for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality changed over time in a population-based cohort study. Methods and findings: In a cohort of 9,127,673 persons enrolled in the United States Veterans Affairs (VA) healthcare system,...
Article
Full-text available
Alcohol use can cause hepatic necroinflammation and worsening portal hypertension in patients with cirrhosis. We aimed to evaluate the associations between degree of alcohol use and clinical liver-related outcomes according to etiol- ogy of cirrhosis. In this retrospective cohort analysis, 44,349 U.S. veterans with cirrhosis from alcohol-associated...
Article
Full-text available
Background: We aimed to describe trends in adverse outcomes among patients who tested positive for SARS-CoV-2 between February and September 2020 within a national healthcare system. Methods: We identified enrollees in the national U.S. Veterans Affairs healthcare system who tested positive for SARS-CoV-2 between 2/28/2020 and 9/30/2020 (n=55,95...
Article
Full-text available
Importance A strategy that prioritizes individuals for SARS-CoV-2 vaccination according to their risk of SARS-CoV-2–related mortality would help minimize deaths during vaccine rollout. Objective To develop a model that estimates the risk of SARS-CoV-2–related mortality among all enrollees of the US Department of Veterans Affairs (VA) health care s...
Preprint
Full-text available
Objectives: We aimed to describe trends in the incidence of adverse outcomes among patients who tested positive for SARS-CoV-2 between February and September 2020 within a national healthcare system. Setting: US Veterans Affairs national healthcare system. Participants: Enrollees in the VA healthcare system who tested positive for SARS-CoV-2 betwee...
Article
Objective Examine the associations of BMI with testing positive for SARS‐CoV‐2 and risk of adverse outcomes in a cohort of Veterans Affairs enrollees. Method Adjusted relative risks/hazard ratios were calculated for the associations between BMI category (underweight, normal‐weight, overweight, class 1 obesity, class 2 obesity, and class 3 obesity)...
Article
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Background: Fibroscan-derived liver stiffness decreases after anti-viral treatment for hepatitis C virus (HCV) infection, which may affect the associations and interpretation of liver stiffness. Aims: To assess whether liver stiffness pre- or post-anti-viral therapy is associated with the development of decompensated cirrhosis, hepatocellular ca...
Article
Background and aims: Whether patients with cirrhosis have increased risk of SARS-CoV-2 infection and the extent to which infection and cirrhosis increase the risk of adverse patient outcomes remain unclear. Approach and results: We identified 88,747 patients tested for SARS-CoV-2 between 3/1/20-5/14/20 in the Veterans Affairs (VA) national healt...
Article
Background and Aims Patients with chronic hepatitis B (CHB) infection routinely undergo screening for hepatocellular carcinoma (HCC), but the efficacy of screening remains unclear. We aimed to evaluate the impact of screening with ultrasound (USS) and/or serum alpha-fetoprotein (AFP) on HCC-related mortality in patients with CHB. Methods We perfor...
Article
Full-text available
Objectives To determine how self-reported level of exposure to patients with novel coronavirus 2019 (COVID-19) affected the perceived safety, training and well-being of residents and fellows. Methods We administered an anonymous, voluntary, web-based survey to a convenience sample of trainees worldwide. The survey was distributed by email and so...
Article
Chronic hepatitis C virus (HCV) infection is an important cause of hepatocellular carcinoma (HCC) in the US. HCV eradication has been associated with a reduced risk of HCC.¹ Despite effective direct-acting antiviral therapies that have been available since 2013, only 14% of patients with HCV in the US were cured as of 2016.² In contrast, the Vetera...
Article
Full-text available
Importance: Identifying independent risk factors for adverse outcomes in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can support prognostication, resource utilization, and treatment. Objective: To identify excess risk and risk factors associated with hospitalization, mechanical ventilation, and mortality i...
Article
Objective Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are first-line agents for the treatment of chronic hepatitis B (CHB). Recent studies have challenged the assumption that these agents are equally effective at preventing hepatocellular carcinoma (HCC). We aimed to determine whether the risk of HCC and mortality differ in patients wit...
Article
Full-text available
Background: The real-world, long-term benefits of sustained virologic response (SVR) on the risk of variceal bleeding remain unclear. Aim: To assess the association between DAA-induced SVR and post-treatment variceal bleeding METHODS: We identified patients who initiated DAA-only anti-viral treatments in the United States Veterans Affairs health...
Article
Full-text available
Outcomes related to alcohol use after hepatitis C virus (HCV) treatment are unknown in the direct‐acting antiviral (DAA) era. We assessed levels of alcohol use before and after HCV treatment and their association with long‐term outcomes in a cohort of U.S. veterans. In this retrospective cohort analysis, 29,037 patients who initiated DAA regimens b...
Article
Background & aims: It is unclear whether a sustained virologic response (SVR) to direct-acting antiviral (DAA) therapy reduces the risk of incident hepatic encephalopathy (HE) in patients with hepatitis C virus (HCV) infection or whether it leads to resolution of pre-existent HE. Methods: We identified 71,457 patients who initiated antiviral tre...
Article
Objective: To describe the incidence and risk factors for mortality and morbidity in patients with cirrhosis undergoing elective or emergent abdominal surgeries. Background: Postoperative morbidity and mortality are higher in patients with cirrhosis; variation by surgical procedure type and cirrhosis severity remain unclear. Methods: We analyz...
Article
Background & aims: It is unclear if hepatocellular carcinoma (HCC) risk declines over time after hepatitis C virus (HCV) eradication. We analyzed changes in HCC annual incidence over time following HCV eradication and identified dynamic markers of HCC risk. Methods: We identified 48,135 patients who initiated HCV antiviral treatment from 2000 th...
Article
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It is unclear whether eradication of hepatitis C virus (HCV) leads to a reduction in the risk of hematologic malignancies. We aimed to determine the impact of sustained virologic response (SVR) induced by either direct‐acting antivirals (DAAs) or interferon (IFN) on the risk of hematologic malignancies. We identified 69,581 patients who initiated a...
Article
Background & aims: Hepatocellular carcinoma (HCC) risk varies dramatically in patients with cirrhosis according to well-described, readily available predictors. We aimed to develop simple models estimating HCC risk in patients with alcohol-related liver disease (ALD)-cirrhosis or non-alcoholic fatty liver disease (NAFLD)-cirrhosis and calculate th...
Article
Full-text available
Background and aims Hepatocellular carcinoma (HCC) risk is high in cirrhosis. We sought to describe differences in HCC risk, predictors and trends over time according to etiology of cirrhosis. Methods We identified 116,404 patients with cirrhosis diagnosed between 2001–2014 in the VA healthcare system and determined incident HCC cases occurring fr...
Data
Definition of patient characteristics based on diagnostic ICD9 codes recorded at least twice in inpatient or outpatient records. (DOCX)
Article
Background and aims: Most patients with hepatitis C virus (HCV) infection will undergo antiviral treatment with direct-acting antivirals (DAA) and achieve sustained virologic response (SVR). We aimed to develop models estimating HCC risk after antiviral treatment. Methods: We identified 45,810 patients who initiated antiviral treatment in the Ve...
Article
Background and aims: It is unclear whether there are differences between direct-acting antivirals (DAAs) for hepatitis C virus in risk of hepatocellular carcinoma (HCC) after antiviral therapy. We aimed to compare different DAA regimens with respect to risk of de novo HCC following antiviral therapy. Patients and methods: We identified 33 137 pa...
Article
Background & aims: Screening patients with cirrhosis for hepatocellular carcinoma (HCC) has been recommended. We conducted a matched case-control study within the US Veterans Affairs (VA) healthcare system to determine whether screening by abdominal ultrasonography (USS) and/or by measuring serum level of alpha fetoprotein (AFP) is associated with...
Article
Background and aims: It is unclear whether direct-acting antiviral (DAA) treatment-induced sustained virologic response (SVR) reduces the risk of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) infection. We aimed to determine the impact of DAA-induced SVR on HCC risk. Methods: We identified 62,354 patients who initiated...
Article
Objective: Hepatitis C virus (HCV) infection is associated with diabetes and may worsen glycemic control in patients with diabetes. We aimed to investigate whether eradication of HCV infection with direct-acting antiviral (DAAs) agents is associated with improved glycemic control in patients with diabetes. Research design and methods: We identif...
Article
Background & aims: Hepatitis C virus (HCV) treatment for patients with hepatocellular carcinoma (HCC) was uncommon before direct acting antiviral (DAA) medications. Real-world effectiveness of DAAs for HCV in patients with HCC is unclear. We describe rates of sustained virologic response (SVR) with DAA regimens by HCV genotype in patients with his...
Article
Background: Highly effective direct antiviral agents (DAAs) for hepatitis C virus (HCV) were introduced recently. Their utilisation has been limited by high cost and low access to care. Aim: To describe the effect of DAAs on HCV treatment and cure rates in the United States Veterans Affairs (VA) national healthcare system. Methods: We identifi...
Article
Background: The mean age of patients with chronic hepatitis C virus (HCV) infection in the USA has been increasing. Despite the increasing proportion of HCV-infected elderly patients, this group is under-represented in clinical trials of HCV treatment. Aim: We aimed to describe the real-world effectiveness of direct-acting antivirals (DAAs) amon...
Article
Purpose: Because benign biopsies resulting from false-positive mammographic findings are a known harm of breast cancer screening, physicians and test manufacturers are searching for ways to reduce their frequency. The aim of this study was to estimate potential costs and consequences associated with using an adjunct diagnostic test for triaging wo...
Article
Conclusion: DAAs produce high SVR rates in white, black, Hispanic, and Asian/PI/AI/AN patients. However, after adjusting for baseline characteristics, black race and Hispanic ethnicity remain independent predictors of treatment failure. Short, 8-week LDV/SOF monotherapy regimens should perhaps be avoided in black patients with genotype 1 HCV. This...
Article
Background: It is unclear whether alcohol use negatively impacts HCV treatment outcomes in the era of direct antiviral agents (DAAs). We aimed to evaluate the associations between current levels of drinking and treatment response among persons treated for HCV with DAAs in the national Veterans Affairs (VA) healthcare system. Methods: We identifi...
Article
Full-text available
Background & aims: We investigated the real-world effectiveness of sofosbuvir, ledipasvir/sofosbuvir, and paritaprevir/ritonavir/ombitasvir and dasabuvir (PrOD) in treatment of different subgroups of patients infected with hepatitis C virus (HCV) genotypes 1, 2, 3, or 4. Methods: We performed a retrospective analysis of data from 17,487 patients...
Article
Background and aims: Epidemiological factors have generated increased demand for liver transplantation among older patients. We aimed to describe trends in age among liver transplant registrants and recipients and the effect of age on waitlist and post-transplant outcomes and on transplant-related survival benefit. Methods: We obtained data from...
Article
Transjugular intrahepatic portosystemic shunt (TIPS) is an effective treatment of refractory ascites and variceal bleeding. However, it is unclear whether TIPS affects long-term survival. We investigated whether TIPS is associated with survival in patients with cirrhosis awaiting liver transplantation. Using the United Network for Organ Sharing (UN...
Article
Patients with T2 hepatocellular carcinoma (HCC) can obtain an exception that allows them to undergo liver transplantation with much lower actual model for end-stage liver disease (MELD) scores than patients without HCC. We compared patients who received liver transplants, with and without HCC, with regard to transplantation-related survival benefit...
Article
Objectives: The aim of this study was to assess potential cost-effectiveness of using a prostate cancer specific functional imaging technology capable of identifying residual localized disease versus small volume metastatic disease for asymptomatic men with low but detectable prostate specific antigen (PSA) elevation following radical prostatectom...
Article
Portal vein thrombosis (PVT) is common in patients with cirrhosis and may have adverse clinical consequences. We investigated whether PVT is associated with survival in patients with cirrhosis. Using the United Network for Organ Sharing registries from 2002 through 2013, we followed a cohort of transplant-naive adults with cirrhosis without hepatoc...
Article
Full-text available
Background: For uninsured American Indians and Alaskan Natives (AIAN) diagnosed with cancer, prompt enrollment in Medicaid may speed access to treatment and improve survival. We hypothesized that AIANs who were eligible for the Indian Health Service Care System (IHSCS) at cancer diagnosis may be enrolled in Medicaid sooner than other AIANs. Metho...
Article
Because benign biopsies resulting from false-positive mammographic findings are a known harm of breast cancer screening, physicians and test manufacturers are searching for ways to reduce their frequency. The aim of this study was to estimate potential costs and consequences associated with using an adjunct diagnostic test for triaging women with s...
Article
We aimed to determine whether combining serum AFP level with HCC tumor burden allows better stratification of post-transplantation survival in patients with HCC undergoing liver transplantation. We calculated the risk of post-transplantation mortality associated with serum AFP level or HCC tumor burden, adjusting for donor and recipient characteris...
Article
229 Background: Asymptomatic men with low but detectable PSA elevation following radical prostatectomy, often receive costly, burdensome, and potentially damaging salvage radiation therapy with uncertain benefit. A new prostate cancer specific functional imaging technology capable of identifying residual localized disease vs. small volume metastati...
Article
6077 Background: When added to first-line chemotherapy for metastatic colorectal cancer, bevacizumab provides a moderate survival increase, but is associated with significant adverse events and high cost. As only a minority of patients respond to antiangiogenic therapy, a diagnostic that identifies potential responders ex ante could potentially cha...
Article
Because of the ongoing epidemics of obesity and diabetes, nonalcoholic steatohepatitis (NASH) may become a leading indication for liver transplantation. There are concerns about the posttransplant survival of patients with NASH because of associated cardiovascular and metabolic risk factors. We aimed to determine recent trends in the proportion of...
Article
We aimed to estimate the survival benefit derived from transplantation in patients with stage II hepatocellular carcinoma (HCC) and Child's A cirrhosis, defined as the mean lifetime with transplantation minus the mean lifetime with treatments other than transplantation. We calculated the posttransplantation survival of all adult, first-time, deceas...
Article
In many applications, the outcome of interest is a mark such that its observation is contingent upon occurrence of an event. With incomplete follow-up data, the marginal mark distribution is, however, nonparametrically nowhere identifiable in many practical situations. To address this problem, we suggest a semiparametric model that postulates a nor...
Article
Colorectal cancer screening is effective and cost-effective, but little data from health plan settings are available inform decision-makers regarding direct economic implications of colorectal cancer screening programs. The purpose of this study was to compare the prediagnosis evaluation and first-year treatment costs of persons diagnosed with colo...
Article
The National Emphysema Treatment Trial, a randomized clinical trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema, included a prospective economic analysis. After pulmonary rehabilitation, 1218 patients at 17 medical centers were randomly assigned to lung-volume-reduction surgery or continued medical treatment. C...
Article
We aimed to determine the quality of life (QOL) for long term survivors of colorectal cancer. Persons with colorectal cancer who had survived at least 5 yr from diagnosis were recruited from a local cancer registry to answer questions about general QOL and colon cancer-specific issues. Before the general survey, focus group interviews with long ter...
Article
We aimed to determine cancer-related medical care costs for long term survivors of colorectal cancer. The SEER-Medicare database was used to measure lifetime cancer-attributable costs of care for those with colorectal cancer surviving at least 5 yr versus age- and gender-matched controls. Costs were directly estimated, stratified by age at diagnosi...
Article
To describe the trends in prostate-specific antigen (PSA) use and associated cancer detection among black and white Medicare beneficiaries older than 65 years during the calendar period from January 1991 through December 1998. Medicare claims data were linked with cancer registry data from the Surveillance, Epidemiology and End Results program of t...
Article
The National Cancer Institute has published consensus guidelines for universal screening for hereditary nonpolyposis colorectal cancer (HNPCC) in patients with newly diagnosed colorectal cancer. To determine the cost-effectiveness of screening compared with standard care in eligible patients with colorectal cancer and their siblings and children. C...
Article
A source of controversy in the economic literature concerns whether to include or exclude future medical care costs when computing attributable costs for lifesaving interventions. Although it is hypothesized that including future medical care costs will offset the cost savings achieved through prevention, the magnitude of the effect is not known. T...
Article
When economic endpoints are included alongside clinical effectiveness measures in randomized clinical trials (RCT), they are summarized together by the incremental cost effectiveness ratio (ICER). Adding economic endpoints to an RCT complicates the planning of experiments because investigators must now solicit their beliefs about costs, but even mo...
Article
To determine from a large cohort of women eligible for screening mammography, the number who would meet criteria for genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC). Detailed personal and family cancer histories, obtained from 6,682 women aged 50-80 years randomly selected from communities in Washington State, were matched to...

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