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Seattle-Denver Center of Innovation (COIN)


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COIN Investigators & Staff

COIN Affiliate Investigator


Lauren A. Beste, MD, MSc, FACP
Title: Associate Professor Medicine, University of Washington
Director, VA National Liver Disease Database
Location: Seattle
University of Washington webpage
See Dr. Beste's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
Dr. Beste is an Affiliate Investigator with HSR&D. Her research interests include improving care for patients with chronic liver disease, particularly viral hepatitis, with emphasis on the role University of Washington of primary care providers. She is the Director of the Data and Analysis Group for the VA's national HIV, Hepatitis, and Related Conditions Programs Office and Associate Program Director for VISN 20's Extension for Community Healthcare Outcomes (VA-ECHO) hepatology telemedicine program. Dr. Beste practices internal medicine and hepatology at the VA Puget Sound. She is an Associate Professor in the University of Washington School of Medicine, Division of General Internal Medicine. Dr. Beste received her MD from Johns Hopkins University School of Medicine and her MSc in Health Services at the University of Washington. She is a proud 2009 graduate of VA Puget Sound's HSR&D Post-Doctoral Fellowship in Primary Care.

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Recent Publications




Keddem S, Maier M, Gardella C, Borgerding J, Lowy E, Chartier M, Haskell S, Hauser RG, Beste LA. Gonorrhea and Chlamydia Testing and Case Rates Among Women Veterans in the Veterans Health Administration. J Gen Intern Med. 2022 Aug 30. doi: 10.1007/s11606-022-07578-2. Epub ahead of print. PMID: 36042092
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Chen A, Beste LA, Strack K, Geyer J, Wheat C, Nelson K, Reddy A. COVID-19 Vaccinations Among US Veterans with Mental Illness: a Retrospective Cohort Study. J Gen Intern Med. 2022 Aug 15. doi: 10.1007/s11606-022-07763-3. Epub ahead of print. PMID: 35970960
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Rozenberg-Ben-Dror K, Maier MM, Beste L, Lowy E, Chartier M, Ross D, Morgan TR. Improving quality of hepatitis B care in the Veteran's Health Administration. Clin Liver Dis (Hoboken). 2022 Jul 1;19(6):213-218. doi: 10.1002/cld.1237. PMCID: PMC9248930. PMID: 35795619
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Bae JC, Beste LA, Utzschneider KM. The Impact of Insulin Resistance on Hepatic Fibrosis among United States Adults with Non-Alcoholic Fatty Liver Disease: NHANES 2017 to 2018. Endocrinol Metab (Seoul). 2022 Jun 21. doi: 10.3803/EnM.2022.1434. Epub ahead of print. PMID: 35726152
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Moon AM, Borgerding JA, Hauser RG, Lowy E, Chartier M, Maier MM, Morgan T, Ruege A, Weber J, Beste LA. Robust Hepatitis A Vaccination Response Within the United States Veterans Health Administration in the Wake of State Outbreaks. Am J Public Health. 2022 May 26:e1-e5. doi: 10.2105/AJPH.2022.306845. Epub ahead of print. PMID: 35617651
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Lee TH, Hunt CM, Maier MM, Lowy E, Beste LA. Hepatitis B Virus-Related Care Quality In Patients With Hepatitis B/Hiv Coinfection Versus Hepatitis B Monoinfection: A National Cohort Study. Clin Infect Dis. 2022 Mar 29:ciac227. doi: 10.1093/cid/ciac227. Epub ahead of print. PMID: 35349635
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Mattox EA, Yantsides KE, Borgerding J, Beste LA, Parsons EC, Fleet M, Palen BN, O'Hearn D, Germani MW, Chang MF. Participant Characteristics and Attendance Patterns for a Multispecialty Veterans Affairs ECHO Program 2012-2018. Telemed J E Health. 2022 Mar 22. doi: 10.1089/tmj.2021.0626. Epub ahead of print. PMID: 35325561.
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Wander PL, Lowy E, Beste LA, Tulloch-Palomino L, Korpak A, Peterson AC, Kahn SE, Danaei G, Boyko EJ. Associations of statin use with 30-day adverse outcomes among 4 801 406 US Veterans with and without SARS-CoV-2: an observational cohort study. BMJ Open. 2022 Mar 18;12(3):e058363. doi: 10.1136/bmjopen-2021-058363. PMCID: PMC8889446. PMID: 35304400
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Yakovchenko V, Morgan TR, Miech EJ, Neely B, Lamorte C, Gibson S, Beste LA, McCurdy H, Scott D, Gonzalez R, Park A, Powell BJ, Bajaj JS, Dominitz JA, Chartier M, Ross D, Chinman MJ, Rogal SS. Core implementation strategies for improving cirrhosis care in the Veterans Health Administration. Hepatology. 2022 Feb 6. doi: 10.1002/hep.32395. Epub ahead of print. PMID: 35124820.
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Wander PL, Lowy E, Beste LA, Tulloch-Palomino L, Korpak A, Peterson AC, Kahn SE, Boyko EJ. The Incidence of Diabetes Among 2,777,768 Veterans With and Without Recent SARS-CoV-2 Infection. Diabetes Care. 2022 Jan 27:dc211686. doi: 10.2337/dc21-1686. Epub ahead of print. PMID: 35085391.
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Johnson KM, Newman KL, Berry K, Itani K, Wu P, Kamath PS, Harris AHS, Cornia PB, Green PK, Beste LA, Ioannou GN. Risk factors for adverse outcomes in emergency versus nonemergency open umbilical hernia repair and opportunities for elective repair in a national cohort of patients with cirrhosis. Surgery. 2022 Jan 17:S0039-6060(21)01191-0. doi: 10.1016/j.surg.2021.12.004. Epub ahead of print. PMID: 35058058.
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Beste LA, Zhang X, Su GL, Van T, Ioannou GN, Oselio B, Tincopa M, Liu B, Singal AG, Zhu J, Waljee AK. Adapted time-varying covariates Cox model for predicting future cirrhosis development performs well in a large hepatitis C cohort. BMC Med Inform Decis Mak. 2021 Dec 14;21(1):347. doi: 10.1186/s12911-021-01711-7. PMID: 34903225.

Wander PL, Lowy E, Beste LA, Tulloch-Palomino L, Korpak A, Peterson AC, Kahn SE, Boyko EJ. Prior Glucose-Lowering Medication Use and 30-Day Outcomes Among 64,892 Veterans With Diabetes and COVID-19. Diabetes Care. 2021 Oct 6:dc211351. doi: 10.2337/dc21-1351. Epub ahead of print. PMID: 34615690.

Palen BN, Mattox EA, He K, Beste LA, Borgerding J, Patel S, Au DH, Chang MF, Parsons EC. Impact of Sleep Telementorship in Primary Care: Sleep VA-ECHO (Veterans Affairs-Extension for Community Healthcare Outcomes). Int J Environ Res Public Health. 2021 Sep 21;18(18):9914. doi: 10.3390/ijerph18189914. PMID: 34574837.

Beste LA, Chen A, Geyer J, Wilson M, Schuttner L, Wheat C, Rojas J, Nelson K, Reddy A. Best Practices for an Equitable Covid-19 Vaccination Program. NEJM Catal Innov Care Deliv. 2021 Sep 15;2(10):10.1056/CAT.21.0238. doi: 10.1056/CAT.21.0238. PMCID: PMC8443122.

Kobayashi T, Van Epps P, Maier MM, Beste LA, Beck BF, Alexander B, Ohl ME. Discussion and Initiation of HIV Pre-exposure Prophylaxis Were Rare Following Diagnoses of Sexually Transmitted Infections Among Veterans. J Gen Intern Med. 2021 Aug 2. doi: 10.1007/s11606-021-07034-7. Epub ahead of print. PMID: 34341917

Hauser RG, Esserman D, Beste LA, Ong SY, Colomb DG, Bhargava A, Wadia R, Rose MG. A Machine Learning Model to Successfully Predict Future Diagnosis of Chronic Myelogenous Leukemia With Retrospective Electronic Health Records Data. Am J Clin Pathol. 2021 Jun 29:aqab086. doi: 10.1093/ajcp/aqab086. Epub ahead of print. PMID: 34184028

Rogal SS, Yakovchenko V, Gonzalez R, Park A, Beste LA, Rozenberg-Ben-Dror K, Bajaj JS, Scott D, McCurdy H, Comstock E, Sidorovic M, Gibson S, Lamorte C, Nobbe A, Chartier M, Ross D, Dominitz JA, Morgan TR. The Hepatic Innovation Team Collaborative: A Successful Population-Based Approach to Hepatocellular Carcinoma Surveillance. Cancers (Basel). 2021 May 7;13(9):2251. doi: 10.3390/cancers13092251. PMCID: PMC8125814. PMID: 34067177

Wander PL, Lowy E, Beste LA, Tulloch-Palomino L, Korpak A, Peterson AC, Young BA, Boyko EJ. Risk factors for adverse outcomes among 35 879 veterans with and without diabetes after diagnosis with COVID-19. BMJ Open Diabetes Res Care. 2021 Jun;9(1):e002252. doi: 10.1136/bmjdrc-2021-002252. PMID: 34083248

Maier MM, Gylys-Colwell I, Lowy E, Borgerding J, Van Epps P, Ohl M, Hauser RG, Chartier M, Beste L. Differences in Syphilis Incidence Using a Laboratory Algorithm in People With and Without HIV in an 11-Year Nationwide Cohort Study. Open Forum Infect Dis. 2021 Jan 22;8(2):ofab030. doi: 10.1093/ofid/ofab030. PMCID: PMC7880267. PMID: 33604407

Beste LA, Icardi M, Hunt CM, Gylys-Colwell I, Lowy E, Taylor L, Morgan TR, Chang MF, Maier MM, Cheung R. In Reply. Arch Pathol Lab Med. 2021 Feb 1;145(2):129b-130. doi: 10.5858/arpa.2020-0643-LE. PMID: 33501499



Ioannou GN, Green PK, Beste LA, Mun EJ, Kerr KF, Berry K. Development of models estimating the risk of hepatocellular carcinoma after antiviral treatment for hepatitis C. J Hepatol. 2018 Nov;69(5):1088-1098. doi: 10.1016/j.jhep.2018.07.024. Epub 2018 Aug 21. PMCID: PMC6201746.
PMID: 30138686

Su F, Weiss NS, Beste LA, Moon AM, Jin GY, Green P, Berry K, Ioannou GN. Screening is associated with a lower risk of hepatocellular carcinoma-related mortality in patients with chronic hepatitis B. J Hepatol. 2020 Nov 24:S0168-8278(20)33807-1. doi: 10.1016/j.jhep.2020.11.023. Epub ahead of print.
PMID: 33245934

Rogal SS, Yakovchenko V, Morgan T, Bajaj JS, Gonzalez R, Park A, Beste L, Miech EJ, Lamorte C, Neely B, Gibson S, Malone PS, Chartier M, Taddei T, Garcia-Tsao G, Powell BJ, Dominitz JA, Ross D, Chinman MJ. Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans. Implement Sci. 2020 Oct 21;15(1):92. doi: 10.1186/s13012-020-01050-7. PMCID: PMC7579930.
PMID: 33087156

Beste LA, Maier MM, Borgerding J, Lowy E, Hauser RG, Van Epps P, Ohl M, Ross D, Chartier M. Testing practices and incidence of chlamydial and gonococcal infection in the Veterans Health Administration, 2009-2019. Clin Infect Dis. 2020 Sep 25:ciaa1454. doi: 10.1093/cid/ciaa1454. Epub ahead of print.
PMID: 32975293

Beste LA, Green P, Berry K, Belperio P, Ioannou GN. Hepatitis C-Related Hepatocellular Carcinoma Incidence in the Veterans Health Administration After Introduction of Direct-Acting Antivirals. JAMA. 2020 Sep 8;324(10):1003-1005. doi: 10.1001/jama.2020.10121. PMCID: PMC7489813.
PMID: 32897335

Ioannou GN, Tang W, Beste LA, Tincopa MA, Su GL, Van T, Tapper EB, Singal AG, Zhu J, Waljee AK. Assessment of a Deep Learning Model to Predict Hepatocellular Carcinoma in Patients With Hepatitis C Cirrhosis. JAMA Netw Open. 2020 Sep 1;3(9):e2015626. doi: 10.1001/jamanetworkopen.2020.15626. PMCID: PMC7489819.
PMID: 32870314

Waljee AK, Ryan KA, Krenz CD, Ioannou GN, Beste LA, Tincopa MA, Saini SD, Su GL, Arasim ME, Roman PT, Nallamothu BK, De Vries R. Eliciting patient views on the allocation of limited healthcare resources: a deliberation on hepatitis C treatment in the Veterans Health Administration. BMC Health Serv Res. 2020 May 1;20(1):369. doi: 10.1186/s12913-020-05211-8. PMCID: PMC7193376.
PMID: 32357873



Van Epps P, Wilson BM, Garner W, Beste LA, Maier MM, Ohl ME. Brief Report: Incidence of HIV in a Nationwide Cohort Receiving Pre-exposure Prophylaxis for HIV Prevention. J Acquir Immune Defic Syndr. 2019 Dec 15;82(5):427-430. doi: 10.1097/QAI.0000000000002186.
PMID: 31714421

Rodriguez Villalvazo Y, McDanel JS, Beste LA, Sanchez AJ, Vaughan-Sarrazin M, Katz DA. Effect of travel distance and rurality of residence on initial surveillance for hepatocellular carcinoma in VA primary care patient with cirrhosis. Health Serv Res. 2020 Feb;55(1):103-112. doi: 10.1111/1475-6773.13241. Epub 2019 Nov 25. PMCID: PMC6980959.
PMID: 31763691

Beste LA, Icardi M, Hunt CM, Gylys-Colwell I, Lowy E, Taylor L, Morgan TR, Chang MF, Maier MM, Cheung R. Alanine Aminotransferase Results Differ by Analyzer Manufacturer in a National Integrated Health Setting, 2012-2017. Arch Pathol Lab Med. 2020 Jun;144(6):748-754. doi: 10.5858/arpa.2018-0622-OA. Epub 2019 Nov 7.
PMID: 31697169

Johnson KM, Newman KL, Green PK, Berry K, Cornia PB, Wu P, Beste LA, Itani K, Harris AHS, Kamath PS, Ioannou GN. Incidence and Risk Factors of Postoperative Mortality and Morbidity After Elective Versus Emergent Abdominal Surgery in a National Sample of 8193 Patients With Cirrhosis. Ann Surg. 2019 Oct 23. doi: 10.1097/SLA.0000000000003674. Epub ahead of print.
PMID: 31714310

Dunn SH, Rogal SS, Maier MM, Chartier M, Morgan TR, Beste LA. Access to Comprehensive Services for Advanced Liver Disease in the Veterans Health Administration. Dig Dis Sci. 2019 Dec;64(12):3471-3479. doi: 10.1007/s10620-019-05785-2. Epub 2019 Aug 20.
PMID: 31432344

Beste LA, Ioannou GN, Chang MF, Forsberg CW, Korpak AM, Boyko EJ, Sporleder JL, Smith NL, Maynard C, Chartier M, Dominitz JA. Prevalence of Hepatitis B Virus Exposure in the Veterans Health Administration and Association With Military-Related Risk Factors. Clin Gastroenterol Hepatol. 2020 Apr;18(4):954-962.e6. doi: 10.1016/j.cgh.2019.07.056. Epub 2019 Aug 5.
PMID: 31394284

Ioannou GN, Beste LA, Green PK, Singal AG, Tapper EB, Waljee AK, Sterling RK, Feld JJ, Kaplan DE, Taddei TH, Berry K. Increased Risk for Hepatocellular Carcinoma Persists Up to 10 Years After HCV Eradication in Patients With Baseline Cirrhosis or High FIB-4 Scores. Gastroenterology. 2019 Nov;157(5):1264-1278.e4. doi: 10.1053/j.gastro.2019.07.033. Epub 2019 Jul 26. PMC6815714
PMID: 31356807

Maier MM, Gylys-Colwell I, Lowy E, Van Epps P, Ohl M, Chartier M, Beste LA. Health Care Facility Characteristics are Associated with Variation in Human Immunodeficiency Virus Pre-exposure Prophylaxis Initiation in Veteran's Health Administration. AIDS Behav. 2019 Jul;23(7):1803-1811. doi: 10.1007/s10461-018-2360-6.
PMID: 30547331

Serper M, Kaplan DE, Shults J, Reese PP, Beste LA, Taddei TH, Werner RM. Quality Measures, All-Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis. Hepatology. 2019 Dec;70(6):2062-2074. doi: 10.1002/hep.30779. Epub 2019 Jun 26. PMCID: PMC6864236.
PMID: 31107967

Beste LA. Concerns About Direct-Acting Antiviral Agents for Hepatitis C-Cause for Reassurance. JAMA Netw Open. 2019 Jun 5;2(6):e194757. doi: 10.1001/jamanetworkopen.2019.4757.
PMID: 31173111

Moon AM, Weiss NS, Beste LA, Su F, Ho SB, Jin GY, Lowy E, Berry K, Ioannou GN. Reply. Gastroenterology. 2019 Mar;156(4):1218-1220. doi: 10.1053/j.gastro.2019.02.024. Epub 2019 Feb 19.
PMID: 30794764

Konerman MA, Beste LA, Van T, Liu B, Zhang X, Zhu J, Saini SD, Su GL, Nallamothu BK, Ioannou GN, Waljee AK. Machine learning models to predict disease progression among veterans with hepatitis C virus. PLoS One. 2019 Jan 4;14(1):e0208141. doi: 10.1371/journal.pone.0208141. PMCID: PMC6319806.
PMID: 30608929