All Publications

  • Reply. Ophthalmology Shah, S. A., Amarikwa, L., Sears, C. M., Clauss, K. D., Rajjoub, R. D., Kang, J. Y., Tamhankar, M. A., Briceño, C. A., Harrison, A. R., Cockerham, K. P., Wester, S. T., Douglas, R. S., Dosiou, C., Kossler, A. L. 2024

    View details for DOI 10.1016/j.ophtha.2024.01.003

    View details for PubMedID 38349298

  • Teprotumumab-Related Adverse Events in Thyroid Eye Disease: A Multi-Center Study. Ophthalmology Shah, S. A., Amarikwa, L., Sears, C. M., Clauss, K. D., Rajjoub, R. D., Kang, J. Y., Tamhankar, M. A., Briceño, C. A., Harrison, A. R., Dosiou, C. C., Cockerham, K. P., Wester, S. T., Douglas, R. S., Kossler, A. L. 2023


    To assess the duration, incidence, reversibility, and severity of adverse events (AEs) in patients with thyroid eye disease (TED) treated with teprotumumab.Multi-center retrospective observational cohort study.Patients with TED of all stages and activity levels treated with at least 4 infusions of teprotumumab.Patients were treated with teprotumumab between February 2020 and October 2022 at 6 tertiary centers. AE metrics were solicited and recorded at each visit. AEs were grouped according to the United States FDA Adverse Event Reporting System.Primary outcomes measure: AE incidence and onset.AE severity, reversibility, duration, proptosis response, clinical activity score (CAS) reduction, and Gorman diplopia score (GDS) improvement.The study evaluated 131 patients. Proptosis improved by 2mm or more in 77% (101/131) of patients with 3.0±2.1mm average proptosis improvement and 3.2 points average CAS reduction. GDS improved by at least one point for 50% (36/72) of patients with baseline diplopia. AEs occurred in 81.7% (107/131) of patients. Patients had a median of 4 AEs. Most patients' AEs were mild (74.0%, 97/131), 28.2% (37/131) moderate, and 8.4% (11/131) severe. Mean interval AE onset was 7.9 weeks after the first infusion. Resolved AEs had a mean duration of 17.6 weeks. Forty-six percent (60/131) of patients had at least 1 persistent AE at last follow-up. Patients had a mean follow-up of 70.2±38.5 weeks after the first infusion. The most common type of AEs was musculoskeletal (58.0%, 76/131), followed by gastrointestinal (38.2%, 50/131), skin (38.2%, 50/131), ear and labyrinth (30.5%, 40/131), nervous system (20.6%, 27/131), metabolic (15.3%, 20/131), and reproductive system (12.2%, 16/131). Sixteen patients (12.2%) discontinued therapy due to AEs, including hearing loss (n=4), inflammatory bowel disease flare (n=2), hyperglycemia (n=1), muscle spasms (n=1), and multiple AEs (n=8).AEs are commonly reported while receiving teprotumumab treatment. Most are mild and reversible; however, serious AEs can occur and may warrant treatment cessation. Treating physicians should inform patients about the AE risk, properly screen patients prior to treatment, monitor patients closely throughout therapy, and understand how to manage AEs should they develop.

    View details for DOI 10.1016/j.ophtha.2023.10.018

    View details for PubMedID 37852417

  • Changes in low-acuity patient volume in an emergency department after launching a walk-in clinic. Journal of the American College of Emergency Physicians open Kurian, D., Sundaram, V., Naidich, A. G., Shah, S. A., Ramberger, D., Khan, S., Ravi, S., Patel, S., Ribeira, R., Brown, I., Wagner, A., Gharahbhagian, L., Miller, K., Shen, S., Yiadom, M. Y. 2023; 4 (4): e13011


    Unscheduled low-acuity care options are on the rise and are often expected to reduce emergency department (ED) visits. We opened an ED-staffed walk-in clinic (WIC) as an alternative care location for low-acuity patients at a time when ED visits exceeded facility capacity and the impending flu season was anticipated to increase visits further, and we assessed whether low-acuity ED patient visits decreased after opening the WIC.In this retrospective cohort study, we compared patient and clinical visit characteristics of the ED and WIC patients and conducted interrupted time-series analyses to quantify the impact of the WIC on low-acuity ED patient visit volume and the trend.There were 27,211 low-acuity ED visits (22.7% of total ED visits), and 7,058 patients seen in the WIC from February 26, 2018, to November 17, 2019. Low-acuity patient visits in the ED reduced significantly immediately after the WIC opened (P = 0.01). In the subsequent months, however, patient volume trended back to pre-WIC volumes such that there was no significant impact at 6, 9, or 12 months (P = 0.07). Had WIC patients been seen in the main ED, low-acuity volume would have been 27% of the total volume rather than the 22.7% that was observed.The WIC did not result in a sustained reduction in low-acuity patients in the main ED. However, it enabled emergency staff to see low-acuity patients in a lower resource setting during times when ED capacity was limited.

    View details for DOI 10.1002/emp2.13011

    View details for PubMedID 37484497

    View details for PubMedCentralID PMC10361543

  • Trends in Attendance and Participation Among Virtual, Hybrid and In-Person ASOPRS Conferences: A Quantitative Analysis American Academy of Ophthalmology Shah, S. A., Choi, S., Lu, L., Kossler, A., Fountain, T. American Academy of Ophthalmology. 2023
  • Teprotumumab-Related adverse events in thyroid eye disease: a multi-center real world study 45th Annual Meeting of the European Thyroid Association ETA 2023 Shah, S. A., Amarikwa, L., Sears, C., Ugradar, S., Clauss, K., Rajjoub, R., Kang, J., Tamhankar, M., Briceno, C., Harrison, A., Dosiou, C., Cockerham, K., Wester, S., Douglas, R., Kossler, A. L. Endocrine Abstracts. 2023
  • #CosmeticsTwitter: Predicting Public Interest in Nonsurgical Cosmetic Procedures Using Twitter Data. Aesthetic surgery journal Cohen, S. A., Tijerina, J. D., Shah, S. A., Amarikwa, L., Kossler, A. L. 2022


    The use of social media in plastic surgery is expanding. The Twitter Academic Research Product Tract (TARPT) database provides plastic surgeons the opportunity to monitor public interest in plastic surgery procedures. Previously, TARPT has been shown to be effective in tracking public interest in surgical cosmetic facial and body procedures.To determine the ability of the TARPT tool to track and predict public interest in nonsurgical cosmetic procedures and to examine temporal public interest trends in nonsurgical cosmetic procedures.We used the TARPT tool to calculate the total number of tweets containing keywords related to 15 nonsurgical cosmetic procedures from 2010 to 2020. We obtained annual case volumes for each of the 15 procedures from annual reports provided by the American Society of Plastic Surgeons (ASPS). We used univariate linear regression to compare tweet volumes and procedure volumes, using P < 0.05 as a threshold for significance.Univariate linear regression revealed significant positive correlations between tweet volumes and ASPS procedure volumes for 10 search terms representing six nonsurgical cosmetic procedures: "xeomin", "microdermabrasion", "facial filler", "fat filler", "fat injections", "fat transfer", "hyaluronic acid filler", "hyaluronic acid injection", "HA filler", and "PRP filler". Thirty-two search terms did not demonstrate a significant relationship, illustrating the importance of careful selection of search terms.Our analyses demonstrates that the TARPT tool is an informative data source for plastic surgeons, with the potential to (1) guide marketing and advertising strategies and (2) monitor real-time public interest in nonsurgical cosmetic procedures, helping surgeons respond to patients' evolving needs.

    View details for DOI 10.1093/asj/sjac147

    View details for PubMedID 35675468

  • Comparison of treatment cost and quality-of-life impact of thyroid eye disease therapies Shah, S., Lu, T., Yu, M., Hiniker, S., Dosiou, C., Kossler, A. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2022
  • Pulling Back the Curtain: How Many California Hospitals Are Complying with Federal Price Transparency Rules? Baker, L., Mulaney, B., Shah, S. A., Kim, C. California Health Care Foundation. 2021
  • Compliance with Price Transparency by California Hospitals Mulaney, B., Shah, S. A., Kim, C., Baker, L. Stanford Health Policy. 2021 48
  • A Common Outer Retinal Change in Retinal Degeneration by Optical Coherence Tomography Can Be Used to Assess Outcomes of Gene Therapy HUMAN GENE THERAPY Joe, M., Li, W., Hiriyanna, S., Yu, W., Shah, S. A., Abu-Asab, M., Qian, H., Wu, Z. 2019; 30 (12): 1520–30


    Identifying early disease hallmarks in animal models with slow disease progression may expedite disease detection and assessment of treatment outcomes. Using optical coherence tomography, a widely applied noninvasive method for monitoring retinal structure changes, we analyzed retinal optical sections from six mouse lines with retinal degeneration caused by mutations in different disease-causing genes. While images from wild-type mice revealed four well-separated hyper-reflective bands in the outer retina (designated as outer retina reflective bands, ORRBs) at all ages, the second band (ORRB2) and the third band (ORRB3) were merged in retinas of five mutant mouse lines at early ages, suggesting the pathological nature of this alteration. This ORRB change appeared to be degenerating photoreceptor related, and occurred before obvious morphological changes that can be identified on both hematoxylin and eosin-stained sections and electron microscopic sections. Importantly, the merging of ORRB2 and ORRB3 was reversed by treatment with adeno-associated viral vector-mediated gene replacement therapies, and this restoration occurred much earlier than measurable functional or structural improvement. Our data suggest that the ORRB change could be a common hallmark of early retinal degeneration and its restoration could be used for rapid and noninvasive assessment of therapeutic effects following gene therapy or other treatment interventions.

    View details for DOI 10.1089/hum.2019.162

    View details for Web of Science ID 000500758500001

    View details for PubMedID 31672061

    View details for PubMedCentralID PMC6919282