Tyler Gallo

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Journals/Publications

• Gallo, T., Curry, S. C., & Raschke, R. A. (2021). Computerised risk scores to guide recognition and diagnosis in patients with possible heparin-induced thrombocytopenia. British journal of haematology, 192(1), 146-150.
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  The heparin-induced thrombocytopenia computerised risk (HIT-CR) score is designed to aid in the diagnosis of HIT. We sought to evaluate its potential clinical utility. In this retrospective cohort study, we collected HIT-CR scores on all inpatients receiving heparin over a 4-month period and performed chart reviews on the subset who independently underwent clinical diagnostic testing for HIT to identify patients with HIT. In all, 34 342 patients received heparin, 1744 had high-risk HIT-CR scores of ≥3 and 220 had the maximal risk score of 4. Only 6% of high-risk and 10% of maximal-risk patients underwent testing for HIT. Conversely, among all 317 patients who underwent independent testing for HIT, 67% had low-risk HIT-CR scores (
• Raschke, R. A., Stoffer, B., Assar, S., Fountain, S., Olsen, K., Heise, C. W., Gallo, T., Padilla-Jones, A., Gerkin, R., Parthasarathy, S., & Curry, S. C. (2021). The relationship of tidal volume and driving pressure with mortality in hypoxic patients receiving mechanical ventilation. PloS one, 16(8), e0255812.
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  To determine whether tidal volume/predicted body weight (TV/PBW) or driving pressure (DP) are associated with mortality in a heterogeneous population of hypoxic mechanically ventilated patients.
• Gress, K. L., Gallo, T., Urits, I., Geng, X., Viswanath, O., Kaye, A. D., & Woosley, R. L. (2020). Investigating the Impact of Gadolinium-Based Contrast Agents on the Corrected QT Interval. Cureus, 12(8), e9668.
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  Introduction The manufacturing labels for all currently marketed gadolinium-based MRI contrast agents describe adverse cardiac events reported during post-market use. The goal of this study was to determine prolongation of the rate-corrected QT interval occurs in the immediate setting after gadolinium-based MRI contrast agent injection. Methods This study enrolled adults scheduled to have a gadolinium-based MRI contrast agent injection as part of a diagnostic MRI. A single-lead electrocardiogram was recorded using the AliveCor Kardia® ECG (Mountain View, CA) device before and after injection. The rate-corrected QT interval was subsequently measured by two independent investigators. The QT interval was corrected for rate using the two most common formulas, originally cited by Bazett and Fridericia. These rate-corrected QT intervals from before and after gadolinium-based MRI contrast agent injection were compared using the Wilcoxon signed-rank test paired analysis. Results A total of 24 consenting adults had electrocardiogram that were free of motion artifact. The mean age of the final patient cohort was 59.4 years. There was an equal split of 12 men and 12 women. The mean pre-injection, rate-corrected QT interval, corrected using Bazett's formula, was 395 msec. The mean post-injection, rate-corrected QT interval, corrected using Bazett's formula, was 396 msec. The corrections using Fridericia's formula were 384 and 381 msec, respectively. There was no statistically significant change in Bazett-corrected QT interval (QTc-B) when pre-injection and post-injection values were directly compared. Discussion The results of the present investigation support the conclusion that gadolinium-based MRI contrast agents do not commonly affect rate-corrected QT interval in routine clinical use. While the frequency of rate-corrected QT interval prolongation might be overstated, the severity of adverse events is definitively not. A role for concomitant rate-corrected QT interval-prolonging drugs or unidentified rare factors such as genetic predisposition cannot be ruled out. The limitations of this study include its relatively small size and the implementation of a single-lead electrocardiogram to measure rate-corrected QT interval. Conclusion The present investigation revealed that significant rate-corrected QT interval prolongation, while previously reported in as many as 55% of patients after gadolinium-based MRI contrast agent injection, is not a common occurrence in the routine clinical setting.
• Heise, C. W., Gallo, T., Curry, S. C., & Woosley, R. L. (2020). Identification of populations likely to benefit from pharmacogenomic testing. Pharmacogenetics and genomics, 30(5), 91-95.
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  Pharmacogenomic testing (PGX) implementation is rapidly expanding, including pre-emptive testing funded by health systems. PGX continues to develop an evidence base that it saves money and improves clinical outcomes. Identifying the potential impact of pre-emptive testing in specific populations may aid in the development of a business case.
• Martin, L. G., Warholak, T. L., Hincapie, A. L., Gallo, T., Kjos, A. L., & Task Force On Informatics, A. J. (2019). Health Informatics Competencies for Pharmacists in Training. American journal of pharmaceutical education, 83(2), 6512.
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  To gather feedback from focus groups regarding health informatics competencies that should be taught in a Doctor of Pharmacy (PharmD) curricula and to revise the competencies based on this feedback. The pharmacy informatics task force of the American Association of Colleges of Pharmacy (AACP) used 11 sources to create a list of pharmacy informatics competencies. Subsequently, faculty feedback about the competency list was obtained via two synchronous online focus groups in August 2015. The list was then revised based on the feedback. Eight people (a department chair, six faculty members and a graduate student) participated in the focus groups (six were from private and two were from public institutions). Participants felt the list had too many competencies to be covered in a timely manner and some indicated that basic computer and Internet competencies should be considered pre-requisites. Participants also recommended that competencies be split by proposed curricular placement (eg, prerequisite, required, elective, didactic, experiential) for each objective. The competency list was revised in response to focus group feedback. The proposed curriculum aligns with the new Accreditation Council for Pharmacy Education (ACPE) standards requiring that professional pharmacy curricula cover multiple aspects of health informatics. The proposed competencies list can serve as a reference to assist in the development of the curriculum and ensure compliance with the new standards.
• Woosley, R. D., Romero, K., Heise, C. W., Gallo, T., Tate, J., & Woosley, R. L. (2019). Summary of Torsades de Pointes (TdP) Reports Associated with Intravenous Drug Formulations Containing the Preservative Chlorobutanol. Drug safety, 42(7), 907-913.
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  Drug-induced torsades de pointes (TdP) is a potentially lethal ventricular arrhythmia that is associated with drugs that prolong the QT interval on the electrocardiogram (ECG) due to their interference with the cardiac potassium current, I. Intravenous (IV) formulations of methadone have been associated with TdP and contain the preservative chlorobutanol, which, like methadone, blocks I. The combinations of chlorobutanol with methadone or terfenadine, another I blocker, produce synergistic I block.
• Woosley, R., Heise, C., Tate, J., Gallo, T., Woosley, D., & Romero, K. (2019). Drug labels, QT prolongation and ECG recommendations. Cardiology Today.
• Gallo, T., Curry, S. C., Padilla-Jones, A., Heise, C. W., Ramos, K. S., Woosley, R. L., & Raschke, R. A. (2018). A Computerized Scoring System to Improve Assessment of Heparin-induced Thrombocytopenia Risk. Journal of thrombosis and haemostasis : JTH.
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  Heparin induced thrombocytopenia (HIT) is an immune-mediated adverse drug event associated with life-threatening thrombotic complications. The four T's (4Ts) score is widely used to estimate the risk for HIT and guide diagnostic testing, but it is not easily amenable to computerized clinical decision support (CDS) implementation.

Presentations

• Gallo, T., Raschke, R. A., & Curry, S. (2019, May). Heparin-induced thrombocytopenia computerized risk score in laboratory-tested patients. ABRC Research Conference. Phoenix, AZ.

Poster Presentations

• Gallo, T. (2021). Clinician satisfaction with clinical decision support to reduce the risk of torsades de pointes. AMIA Clinical Informatics Conference.
• Gallo, T. (2021). Medications Evoking Torsade de Pointes Clinical Decision Support and Clinician Response to the Advisory. American College of Clinical Pharmacy Annual Meeting.
• Gallo, T. (2020, October). Initial characteristics of one site’s experience with implementation of the Pharmacogenomic Testing for Veterans (PHASER) program. Pharmacogenomics Research Network Annual Meeting.
• Gallo, T., Heise, C., & Curry, S. (2019, Nov). Identifying target populations for pharmacogenomic testing implementation using a benefit tool. Re-imagine Health: Is my fate in my genes. Phoenix, AZ.
• Bhattacharjee, S., Gallo, T., Patel, J. G., & Harrison, D. J. (2018, May). Caregiver Burden among Individuals Providing Informal Caregiving to Survivors of Major Adverse Cardiac Event (Mace): A Systematic Review. ISPOR 23rd Annual International Meeting. Baltimore, MD, USA: ISPOR.