Quality improvement initiatives to advance and standardize quality of care in patients living with liver disease
Dr. Mayur Brahmania is an Assistant Professor of Medicine at Western University practicing in Hepatology and Transplant Hepatology. He completed his undergraduate and medical degree at the University of Saskatchewan and completing his residency at the University of British Columbia in Internal Medicine and a Gastroenterology fellowship at the University of Manitoba. After moving to Toronto for training in general and transplant Hepatology at the Toronto General Hospital: Toronto Centre for Liver Disease he undertook a research fellowship and earned a Masters of Public Health (MPH) degree at the Harvard TH Chan School of Public Health in Boston, MA. He also holds advanced certification from the Centre for Quality Improvement and Patient Safety (CQUIPS) from the University of Toronto.
Dr. Brahmania has been involved with the Choosing Wisely Canada (CWC) campaign as the Canadian Association for the Study of Liver Quality Lead. In this leadership role, he led the development of the 'top 5' list recommendations for Hepatology and his group is currently working to develop strategies to benchmark quality indicators for liver disease across Canada. He also works with CWC on the “Diving into Overuse in Hospitals” campaign to promote Choosing Wisely principles in Canadian hospitals. Locally, he is the program lead at Western for the Royal College’s STARS (Students Advocating for Resource Stewardship) campaign to develop quality improvement learning and principles for Medical Schools in Canada.
Dr. Brahmania is the current chair of the Gastroenterology Quality Improvement and Innovation Committee at Western University and currently focuses his research interests around quality improvement initiatives to advance and standardize quality of care in patients living with liver disease; many of these leading to publications in peer reviewed journals and presentation. He is also active in promoting quality improvement and patient safety within an educational setting; instructing and supervising resident quality improvement projects, teaching to medical students, business students and students from other healthcare disciplines. He is currently Co-Director of the LHSC Healthcare Excellence Incubator, an innovative course where healthcare and IVEY business students learn together about quality improvement principles and implementation within business framework.
Liver Transplant Tourism Hindi Z, Congly S, Tang E, Skaro A, Brahmania M. Liver Transpl. 2019 Nov 25. doi: 10.1002/lt.25692. [Epub ahead of print].
Safety of Combination Biologic and Antirejection Therapy Post-Liver Transplantation in Patients With Inflammatory Bowel Disease. Al Draiweesh S, Ma C, Alkhattabi M, McDonald C, Nguyen TM, Beaton M, Chande N, Colquhoun P, Feagan BG, Gregor JC, Khanna R, Marotta P, Ponich T, Quan D, Qumosani K, Sandhu A, Sey M, Skaro A, Teriaky A, Wilson A, Yan B, Brahmania M, Jairath V. Inflamm Bowel Dis. 2019 Oct 28. pii: izz244. doi: 10.1093/ibd/izz244. [Epub ahead of print]
Standardising the interpretation of liver biopsies in non-alcoholic fatty liver disease clinical trials. Pai RK, Kleiner DE, Hart J, Adeyi OA, Clouston AD, Behling CA, Jain D, Kakar S, Brahmania M, Burgart L, Batts KP, Valasek MA, Torbenson MS, Guindi M, Wang HL, Ajmera V, Adams LA, Parker CE, Feagan BG, Loomba R, Jairath V. Aliment Pharmacol Ther. 2019 Nov;50(10):1100-1111. doi: 10.1111/apt.15503. Epub 2019 Oct 3.
Canadian liver transplant allocation for hepatocellular carcinoma. Brahmania M, Marquez V, Kneteman NM, Bhat M, Marleau D, Wong P, Peletekian KM, Burak KW, Congly SE. J Hepatol. 2019 Nov;71(5):1058-1060. doi: 10.1016/j.jhep.2019.07.016. Epub 2019 Sep 5.
Implications of Manganese in Chronic Acquired Hepatocerebral Degeneration. Rajoriya N, Brahmania M, J Feld J. Ann Hepatol. 2019 Jan - Feb;18(1):274-278. doi: 10.5604/01.3001.0012.7938.
Choosing Wisely Canada-Top Five List in Hepatology: Official Position Statement of the Canadian Association for the Study of the Liver (CASL) and Choosing Wisely Canada (CWC). Brahmania M, Renner EL, Coffin CS, Yoshida EM, Wong P, Zeman M, Shah H. Ann Hepatol. 2019 Jan - Feb;18(1):165-171. doi: 10.5604/01.3001.0012.7908.
Variable access to antiviral treatment of chronic hepatitis B in Canada: a descriptive study. Congly SE, Brahmania M. CMAJ Open. 2019 Mar 29;7(1):E182-E189. doi: 10.9778/cmajo.20180108. Print 2019 Jan-Mar.
Lower 90-day Hospital Readmission Rates for Esophageal Variceal Bleeding After TIPS: A Nationwide Linked Analysis. Rush B, Deol N, Teriyaki A, Sey M, Jairath V, Walley KR, Celi LA, Brahmania M. J Clin Gastroenterol. 2020 Jan;54(1):90-95. doi: 10.1097/MCG.0000000000001199.
Outcomes of in-hospital cardiopulmonary resuscitation for patients with end-stage liver disease. Ufere NN, Brahmania M, Sey M, Teriaky A, El-Jawahri A, Walley KR, Celi LA, Chung RT, Rush B. Liver Int. 2019 Jul;39(7):1256-1262. doi: 10.1111/liv.14079. Epub 2019 Mar 26.
Palliative medicine and hospital readmissions in end-stage liver disease. Rush B, Fruhstofer C, Walley KR, Celi LA, Brahmania M. BMJ Support Palliat Care. 2019 Feb 13. pii: bmjspcare-2018-001635. doi: 10.1136/bmjspcare-2018-001635. [Epub ahead of print]
Association Between Severe Serum Alanine Aminotransferase Flares and Hepatitis B e Antigen Seroconversion and HBV DNA Decrease in Untreated Patients With Chronic HBV Infection. Brahmania M, Lombardero M, Hansen BE, Terrault NA, Lok AS, Perrillo RP, Belle SH, Di Bisceglie AM, Feld JJ, Lee WM, Fried MW, Janssen HLA; Hepatitis B Research Network. Clin Gastroenterol Hepatol. 2019 Nov;17(12):2541-2551.e2. doi: 10.1016/j.cgh.2019.02.005. Epub 2019 Feb 8.
Genome-wide Association Study Identifies Genetic Variants Associated With Early and Sustained Response to (Pegylated) Interferon in Chronic Hepatitis B Patients: The GIANT-B Study. Brouwer WP, Chan HLY, Lampertico P, Hou J, Tangkijvanich P, Reesink HW, Zhang W, Mangia A, Tanwandee T, Montalto G, Simon K, Ormeci N, Chen L, Tabak F, Gunsar F, Flisiak R, Ferenci P, Akdogan M, Akyuz F, Hirankarn N, Jansen L, Wong VW, Soffredini R, Liang X, Chen S, Groothuismink ZMA, Santoro R, Jaroszewicz J, Ozaras R, Kozbial K, Brahmania M. M, Xie Q, Chotiyaputta W, Xun Q, Pazgan-Simon M, Oztas E, Verhey E, Montanari NR, Sun J, Hansen BE, Boonstra A, Janssen HLA; GIANT-B Global Consortium . Clin Infect Dis. 2019 Nov 13;69(11):1969-1979. doi: 10.1093/cid/ciz084.
Comparative outcomes in patients with ulcer- vs non-ulcer-related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients. Sey MSL, Mohammed SB, Brahmania M, Singh S, Kahan BC, Jairath V. Aliment Pharmacol Ther. 2019 Mar;49(5):537-545. doi: 10.1111/apt.15092. Epub 2019 Jan 9.
Development, Validation, and Comparative Assessment of an International Scoring System to Determine Risk of Upper Gastrointestinal Bleeding. Oakland K, Kahan BC, Guizzetti L, Martel M, Bryant RV, Brahmania M, Singh S, Nguyen NQ, Sey MSL, Barkun A, Jairath V. Clin Gastroenterol Hepatol. 2019 May;17(6):1121-1129.e2. doi: 10.1016/j.cgh.2018.09.039. Epub 2018 Sep 27.
Publicly Funded Oral Chronic Hepatitis B Treatment Patterns in Ontario over 16 Years: An Ecologic Study. Tadrous M, Brahmania M, Martins D, Knowles S, Janssen HLA, Mamdani MM, Juurlink DN, Gomes T. J Manag Care Spec Pharm. 2018 May;24(5):464-468. doi: 10.18553/jmcp.2018.24.5.464.
Palliative care access for hospitalized patients with end-stage liver disease across the United States. Rush B, Walley KR, Celi LA, Rajoriya N, Brahmania M. Hepatology. 2017 Nov;66(5):1585-1591. doi: 10.1002/hep.29297. Epub 2017 Sep 26.
Concerns for the Methodology and Results Described in "Palliative Care and Health Care Utilization for Patients With End-Stage Liver Disease at the End of Life". Rush B, Brahmania M. Clin Gastroenterol Hepatol. 2017 Oct;15(10):1641-1642. doi: 10.1016/j.cgh.2017.04.003. Epub 2017 Apr 7.
Wait Time for Curative Intent Radio Frequency Ablation is Associated with Increased Mortality in Patients with Early Stage Hepatocellular Carcinoma. Brahmania M, Ahmed O, Kelley M, Kowgier M, Khalili K, Beecroft R, Renner EL, Wong D, Shah H, Feld J, Janssen HLA, Sherman M. Ann Hepatol. 2017 Sep - Oct;16(5):765-771. doi: 10.5604/01.3001.0010.2776.
A Curious Case of Iron-Deficiency Anemia. Shaffer S, Brahmania M, Shah H. Can J Gastroenterol Hepatol. 2016;2016:8954308. doi: 10.1155/2016/8954308. Epub 2016 Apr 3.
Quality Improvement Primer Series: Launching a Quality Improvement Initiative. Weizman AV, Mosko J, Bollegala N, Bernstein M, Brahmania M, Liu L, Steinhart AH, Silver SS, Bell CM, Nguyen GC. Clin Gastroenterol Hepatol. 2016 Aug;14(8):1067-71. doi: 10.1016/j.cgh.2016.04.041. Epub 2016 May 20.
Quality Improvement Primer Series: How to Sustain a Quality Improvement Effort. Bernstein M, Hou JK, Weizman AV, Mosko J, Bollegala N, Brahmania M, Liu L, Steinhart AH, Silver SS, Nguyen GC, Bell CM.Clin Gastroenterol Hepatol. 2016 Oct;14(10):1371-5. doi: 10.1016/j.cgh.2016.05.019. Epub 2016 May 20.
New therapeutic agents for chronic hepatitis B. Brahmania M, Feld J, Arif A, Janssen HL. Lancet Infect Dis. 2016 Feb;16(2):e10-21. doi: 10.1016/S1473-3099(15)00436-3. Epub 2016 Jan 13. Review.
A curious case of iron deficiency anemia. Shaffer S, Brahmania M, Shah H. Can J Gastroenterol Hepatol. 2015 Sep 1. pii: 17087. [Epub ahead of print]