UCSF CatLab

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The CatLab is focused on identifying and reducing low-value care, especially instances of perioperative healthcare overutilization that may not be of benefit and can cause potential harm to surgical patients. We employ large datasets, such as Medicare claims and the OptumLabs Data Warehouse, as well as interdisciplinary and cross-institutional collaborations to conduct our research.
Dr. Catherine L. Chen, MD, MPH is the principal investigator (PI) of the CatLab. Dr. Chen is an Associate Professor in the UCSF Department of Anesthesia and a Core Faculty at the Philip R. Lee Institute for Health Policy Studies at UCSF. She has published first-author publications in the New England Journal of Medicine and JAMA Ophthalmology, and her studies have highlighted the increased risk of delayed surgery and falls associated with the overuse of routine preoperative testing in cataract surgery patients as well as the unintended consequences of inappropriate opioid prescription.
The CatLab is currently studying the use of monitored anesthesia for cataract surgery, with a focus on improving the perioperative care of older adults and the resource utilization of healthcare systems. Preliminary data has been published in JAMA Internal Medicine, informing current and future studies.

 

 

Projects
  • CataractMAC Studies​
    • Medicare​
      • We are using Medicare claims to understand health systems and patterns of healthcare utilization. Our current focus is on improving anesthesia resource allocation to optimize the quality and safety of cataract surgery care. This dataset can also be used to explore other areas of perioperative healthcare delivery.​
    • Multicenter Perioperative Outcomes Group (MPOG) registry​
      • We are using the MPOG registry, a proprietary collection of electronic health records representing over 22 million anesthesia cases from over 60 sites in the US and internationally, to explore the intraoperative approaches to anesthesia care during cataract surgery.​
    • Qualitative interviews and Survey Studies​
      • We are conducting survey studies to better understand ophthalmologist, anesthesiologist, and patient perspectives about cataract surgery sedation with plans to incorporate our findings into a prospective clinical trial in the future.​
  • Perioperative Opioid Stewardship​
    • We are using various datasets including the OptumLabs Data Warehouse, which represents commercial claims from over 200 million covered lives, and the MPOG registry, to study various aspects of perioperative care, including opioid prescribing patterns and its impact on surgical patients and their family members.​
  • Other areas of interest
    • Diversity in the Perioperative Workforce
    • Impact of COVID on Perioperative Outcomes
    • Perioperative Sustainability

     

Publications & Media

In the News:

Publications:

Perumal D, Lee SJ, Chen CL. Perioperative Risk Assessment and Avoiding Overuse of Anesthesia Care for Routine Cataract Surgery-Reply. JAMA Intern Med. 2023 05 01; 183(5):497-498.

Lazzareschi DV, Fong N, Mavrothalassitis O, Whitlock EL, Chen CL, Chiu C, Adelmann D, Bokoch MP, Chen LL, Liu KD, Pirracchio R, Mathis MR, Legrand M, MPOG Collaborators. Intraoperative Use of Albumin in Major non-cardiac surgery: Incidence, Variability, and Association with Outcomes. Ann Surg. 2022 Dec 14.

Phero A, Dutton RP, Chen CL, Whitlock EL. Contemporary anesthesia practice for cataract surgery: analysis of the National Anesthesia Clinical Outcomes Registry. J Cataract Refract Surg. 2022 12 01; 48(12):1472-1474.

Olmos AV, Robinowitz D, Feiner JR, Chen CL, Gandhi S. Reducing Volatile Anesthetic Waste Using a Commercial Electronic Health Record Clinical Decision Support Tool to Lower Fresh Gas Flows. Anesth Analg. 2023 02 01; 136(2):327-337.

Perumal D, Dudley RA, Gan S, Boscardin WJ, Gill A, Gelb AW, Lee SJ, Chen CL. Anesthesia Care for Cataract Surgery in Medicare Beneficiaries. JAMA Intern Med. 2022 Oct 03.

Langnas E, Bishara A, Croci R, Rodriguez-Monguio R, Wick EC, Chen CL, Guan Z. Opioid prescribing practices at hospital discharge for surgical patients before and after the Centers for Disease Control and Prevention's 2016 opioid prescribing guideline. BMC Anesthesiol. 2022 05 11; 22(1):141.

Rodriguez-Monguio R, Lun Z, Bongiovanni T, Chen CL, Seoane-Vazquez E. Postoperative Respiratory Events in Surgical Patients Exposed to Opioid Analgesic Shortages Compared to Fully Matched Patients Non-exposed to Shortages. Drug Saf. 2022 04; 45(4):359-367.

Choi BJJ, Chen CL. The Triple Bottom Line and Stabilization Wedges: A Framework for Perioperative Sustainability. Anesth Analg. 2022 03 01; 134(3):475-485.

Chen CL, Gold GJ, Cannesson M, Lucero JM. Calling Out Aversive Racism in Academic Medicine. N Engl J Med. 2021 Dec 30; 385(27):2499-2501.

Langnas E, Rodriguez-Monguio R, Luo Y, Croci R, Dudley RA, Chen CL. The association of multimodal analgesia and high-risk opioid discharge prescriptions in opioid-naive surgical patients. Perioper Med (Lond). 2021 Dec 15; 10(1):60.

Lee SJ, Smith AK, Diaz-Ramirez LG, Covinsky KE, Gan S, Chen CL, Boscardin WJ. A Novel Metric for Developing Easy-to-Use and Accurate Clinical Prediction Models: The Time-cost Information Criterion. Med Care. 2021 05 01; 59(5):418-424.

Chen CL, Lucero JM. We Asked the Experts: Breaking the Cycle of Attrition in Perioperative Academic Medicine. World J Surg. 2021 01; 45(1):53-56.

Dixit AA, Elser H, Chen CL, Ferschl M, Manuel SP. Language-Related Disparities in Pain Management in the Post-Anesthesia Care Unit for Children Undergoing Laparoscopic Appendectomy. Children (Basel). 2020 Oct 04; 7(10).

Rodriguez-Monguio R, Naveed M, Croci R, Gross K, Langnas E, Chen CL, Seoane-Vazquez E. Perioperative Prescribing Practices of Extended-Release Opioids in Noncancer Surgical Patients, 2015-2018. Anesth Analg. 2020 10; 131(4):1249-1259.

Chen CL, McLeod SD, Lietman TM, Shen H, Boscardin WJ, Chang HP, Whooley MA, Gelb AW, Lee SJ, Dudley RA. Preoperative Medical Testing and Falls in Medicare Beneficiaries Awaiting Cataract Surgery. Ophthalmology. 2021 02; 128(2):208-215.

Liu C, Ahmed K, Chen CL, Dudley RA, Gonzales R, Orrico K, Yerneni K, Stienen MN, Veeravagu A, Desai A, Park J, Ratliff JK, Zygourakis CC. Association Between Physician Industry Payments and Cost of Anterior Cervical Discectomy and Fusion in Medicare Beneficiaries. World Neurosurg. 2020 11; 143:e574-e580.

Dixit AA, Chen CL, Inglis-Arkell C, Manuel SP. Assessment of Unused Opioids Following Ambulatory Surgery. Am Surg. 2020 Jun; 86(6):652-658.

Jeffery MM, Chaisson CE, Hane C, Rumanes L, Tucker J, Hang L, McCoy R, Chen CL, Bicket MC, Hooten WM, Larochelle M, Becker WC, Kornegay C, Racoosin JA, Sanghavi D. Assessment of Potentially Inappropriate Prescribing of Opioid Analgesics Requiring Prior Opioid Tolerance. JAMA Netw Open. 2020 04 01; 3(4):e202875.

Chen CL, Jeffery MM, Krebs EE, Thiels CA, Schumacher MA, Schwartz AJ, Thombley R, Finlayson E, Rodriguez-Monguio R, Ward D, Dudley RA. Long-Term Trends in Postoperative Opioid Prescribing, 1994 to 2014. J Am Acad Orthop Surg Glob Res Rev. 2020 01; 4(1).

Chen CL, Clay TH, McLeod S, Chang HP, Gelb AW, Dudley RA. A Revised Estimate of Costs Associated With Routine Preoperative Testing in Medicare Cataract Patients With a Procedure-Specific Indicator. JAMA Ophthalmol. 2018 03 01; 136(3):231-238.

Chen CL, Neuman MD. Do Anesthetic Choices Signal Quality? Anesthesiology. 2018 03; 128(3):429-430.

Chen CL, Gelb AW, Dudley RA. Preoperative Testing in Patients Undergoing Cataract Surgery. N Engl J Med. 2015 07 16; 373(3):285-6.

Chen CL, Lin GA, Bardach NS, Clay TH, Boscardin WJ, Gelb AW, Maze M, Gropper MA, Dudley RA. Preoperative medical testing in Medicare patients undergoing cataract surgery. N Engl J Med. 2015 Apr 16; 372(16):1530-8.

Chen CL, Shore AD, Johns R, Clark JM, Manahan M, Makary MA. The impact of obesity on breast surgery complications. Plast Reconstr Surg. 2011 Nov; 128(5):395e-402e.

Chen CL, Shapiro ML, Angood PB, Makary MA. Patient Safety.. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE, eds. Schwartz’s Principles of Surgery. 9th ed. New York, NY: McGraw-Hill. 2009.

Makary MA, Chen CL, Meguid R, Al-Attar A, eds. General Surgery Review. 2nd ed. Washington DC: Ladner-Drysdale. 2008.

Price LA, Thombs B, Chen CL, Milner SM. Liver disease in burn injury: evidence from a national sample of 31,338 adult patients. J Burns Wounds. 2007 Jun 12; 7:e1.

Honors and Awards: 

FAER Resident Scholar, Foundation for Anesthesia Education and Research, 2011

People


 Catherine Chen, MD, PhD 
 PI, Associate Professor 
 UCSF Profile

 

Jacob Flores, BS

 Clinical Research Coordinator

 Siqi Gan, NPH

 Statistician

 Yanting Luo, MS

 Statistician

 Alexandria Bao

 Visiting Scholar

 Liam Molina

 Medical Student

 

 

 

 

 

Lab Alumni

  • Millis Faust, MD
  • Yasmine Eichbaum, BS
  • Nora Lyang, BS

 

Contribute

If you would like to help support our research, the link to the UCSF Donate Page that will help fund future studies is below:

Donate Here

On the page, please select "Direct your gift to a specific area" at the top and specify "Catherine L. Chen – Department of Anesthesiology " in the "Other" box.

Your generosity is greatly appreciated.

 


2019 Foundation for Anesthesia Education and Research (FAER) MRTG Meeting Participants