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Journal of Comparative Effectiveness Research

David Thayer, Christopher Noda, Resmi Charalel, Abigail Mills, Randy Chang, Yu Tao, Olaguoke Akinwande
AIM: To compare the overall survival (OS) and liver cancer-specific survival of advanced-stage hepatocellular carcinoma (HCC) patients who received transarterial radioembolization (TARE) with those who received nonoperative/interventional treatment (NOT). MATERIALS & METHODS:  A total of 12,520 HCC patients from the Surveillance, Epidemiology and End Results database were categorized by treatment with either radioembolization or NOT. Kaplan-Meier and multivariate Cox regression were conducted...
March 19, 2018: Journal of Comparative Effectiveness Research
Carole Therasse, Isabelle Fusier, Anne-Laure Cordonnier, Florence Bérard, Olivier Parent de Curzon, François Bocquet, Pascal Paubel
AIM: Erythropoiesis-stimulating agents (ESAs) are particularly used to treat dialysis patients suffering from anemia due to renal failure. Since March 2014, ESAs have no longer been funded on top-of-diagnosis-related groups (DRGs) in French hospitals and are funded via DRGs. There are two ways to fund dialysis in French hospitals: the 'DRG for dialysis in session' and the 'off-dialysis DRG', which is not a DRG and consists in a supplement tariff specific to dialysis for patients hospitalized for another main reason than dialysis...
March 14, 2018: Journal of Comparative Effectiveness Research
Kristin M Sheffield, Lee Bowman, David M Smith, Li Li, Lisa M Hess, Leslie B Montejano, Tina M Willson, Amy J Davidoff
AIM: To develop a claims-based prediction model of poor performance status (PS) in commercially insured and Medicare supplemental beneficiaries with cancer. PATIENTS & METHODS: Retrospective analysis was conducted of electronic medical records (EMR) from community oncology practices linked to MarketScan claims. Multivariable logistic regression predicted PS scores from the EMR using claims-based diagnostic and procedure codes. RESULTS: The study included 8442 patients diagnosed with cancer from 2007 to 2015...
March 13, 2018: Journal of Comparative Effectiveness Research
C Daniel Mullins, La'Marcus T Wingate, Hillary A Edwards, Toyin Tofade, Anthony Wutoh
The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care...
February 26, 2018: Journal of Comparative Effectiveness Research
Jose María Mostaza, Carmen Suárez Fernández, Luis Castilla Guerra, Josep Maria Suriñach, Juan José Tamarit, José Luis Diaz Diaz, Iluminada García Polo, Esther Francia Santamaria, María Angeles Fidalgo Fernández, Carla de la Guerra Acebal, Meliton Francisco Dávila Ramos, Carles Ràfols
AIM: To analyze the use of oral anticoagulants in elderly patients with atrial fibrillation in clinical practice. PATIENTS & METHODS: Cross-sectional and multicenter study performed in atrial fibrillation patients ≥75 years treated with oral anticoagulants ≥3 months. RESULTS: 837 patients (83.0 ± 5.0 years; CHA2 DS2 -VASc 5.0 ± 1.4; HAS-BLED 2.1 ± 0.9; 70.8% vitamin K antagonists; 29.2% direct oral anticoagulants [DOACs]) were included...
February 21, 2018: Journal of Comparative Effectiveness Research
Ernest Law, Rachel Harrington, G Caleb Alexander, Soumi Saha, Elisabeth Oehrlein, Eleanor M Perfetto
The goal of comparative effectiveness research (CER) and patient-centered outcomes research (PCOR) is to improve health outcomes by providing stakeholders with evidence directly relevant to decision making. In January 2017, the Pharmaceutical Research and Manufacturers Association Foundation, alongside the Academy for Managed Care Pharmacy, organized a conference aimed at engaging experts and opinion leaders representing clinicians, patients and payers to identify and discuss barriers and strategies to enhancing uptake and use of CER/PCOR...
February 21, 2018: Journal of Comparative Effectiveness Research
Darcy A Thompson, Deborah A Federspiel
Darcy A Thompson is an Associate Professor of pediatrics at the University of Colorado School of Medicine. Her main research seeks to address early childhood obesity in low-income children. She works in the Lifestyle Medicine clinic at Children's Hospital Colorado, a clinic focused on caring for children with obesity and related comorbidities. She is also an Associate Medical Director for the Research Institute at Children's Hospital Colorado. Her training includes a Master of Public Health degree, a medical degree (Yale University) and the Robert Wood Johnson Clinical Scholars Fellowship (University of Washington)...
February 21, 2018: Journal of Comparative Effectiveness Research
David H Howard, John D Roback, David J Murphy
AIM: We estimate the impact of the FOCUS trial, which concluded that hip surgery patients with hemoglobin values above 8 g/dl do not benefit from routine transfusions, on transfusion rates. METHODS: We evaluated trends in transfusion rates using inpatient discharge data from four states. RESULTS: The transfusion rate was 5.2 percentage points lower in the fourth quarter of 2013 than it would have been had pre-FOCUS trends continued. Transfusion rates declined more in hospitals with a low end-of-life treatment intensity index, a general measure of treatment intensity...
February 21, 2018: Journal of Comparative Effectiveness Research
Glen T Schumock, A Simon Pickard
Evidence from comparative effectiveness research (CER) and patient-centered outcomes research (PCOR) studies are increasingly available in the literature. However, there remain opportunities to better integrate that evidence into decision-making. An invitation-only conference held in January 2017, titled "Comparative Effectiveness and Patient-Centered Outcomes Research: Enhancing Uptake and Use by Patients, Clinicians and Payers", sought to identify and discuss both gaps in the uptake and use of CER/PCOR, and approaches to enhance the uptake and use of CER/PCOR evidence by patients, clinicians and payers...
February 21, 2018: Journal of Comparative Effectiveness Research
Emily Beth Devine, Eleanor Perfetto, A Simon Pickard, Glen T Schumock, Jodi B Segal, Eileen Cannon, Jean Paul Gagnon, Diana I Brixner, Louis P Garrison, Michael D Murray
The term comparative effectiveness research (CER) took center stage with passage of the American Recovery and Reinvestment Act (2009). The companion US$1.1 billion in funding prompted the launch of initiatives to train the scientific workforce capable of conducting and using CER. Passage of the Patient Protection and Affordable Care Act (2010) focused these initiatives on patients, coining the term 'patient-centered outcomes research' (PCOR). Educational and training initiatives were soon launched. This report describes the initiative of the Pharmaceutical Research and Manufacturers Association of America (PhRMA) Foundation...
February 21, 2018: Journal of Comparative Effectiveness Research
Debra A Schaumberg, Laura McDonald, Surbhi Shah, Michael Stokes, Beth L Nordstrom, Sreeram V Ramagopalan
Comparative effectiveness research (CER) guidelines have been developed to direct the field toward the most rigorous study methodologies. A challenge, however, is how to ensure the best evidence is generated, and how to translate methodologically complex or nuanced CER findings into usable medical evidence. To reach that goal, it is important that both researchers and end users of CER output become knowledgeable about the elements that impact the quality and interpretability of CER. This paper distilled guidance on CER into a practical tool to assist both researchers and nonexperts with the critical review and interpretation of CER, with a focus on issues particularly relevant to CER in oncology...
February 21, 2018: Journal of Comparative Effectiveness Research
Tiffany P Quock, Tingjian Yan, Eunice Chang, Spencer Guthrie, Michael S Broder
AIM: To estimate healthcare utilization and costs in amyloid light-chain (AL) amyloidosis. PATIENTS & METHODS: AL amyloidosis patients were identified in 2007-2015 claims databases if they had ≥1 inpatient/≥2 outpatient claims consistent with AL amyloidosis and received ≥1 AL-specific treatment. Descriptive statistics were reported. RESULTS: 50.1% (n = 3670) were admitted ≥1 time during the year, 11.3% (n = 827) ≥3 times. From 2007 to 2015, bortezomib use increased from 4...
February 2, 2018: Journal of Comparative Effectiveness Research
Katarzyna Pigoń, Edyta Nowak-Radzik, Tomasz Młyńczak, Grzegorz Banasik, Ewa Nowalany-Kozielska, Andrzej Tomasik
AIM: Study was aimed to assess the real-world costs of manual thrombectomy (MT) in selected ST segment-elevation myocardial infarction patients with intracoronary thrombus (IT). METHODS: Study group (IT+) comprised 51 patients with MT applied and control group (IT-) comprised 56 patients without IT who underwent angioplasty alone. Costs comprised hospital care and cost of disposable materials used during primary angioplasty. RESULTS: Complex management of patients with IT is more expensive, though allows to achieve clinical outcomes comparable to low-risk ST segment-elevation myocardial infarction patients without IT...
January 29, 2018: Journal of Comparative Effectiveness Research
Laura Dormer
Welcome to the seventh volume of the Journal of Comparative Effectiveness Research. It is great to start the year with a look back at some of our successes from 2017, as well as a look forward to the content of this issue and beyond.
January 5, 2018: Journal of Comparative Effectiveness Research
Monika Parisi, Corey Pelletier, Dasha Cherepanov, Michael S Broder
AIM: With the aggregation of real-world data in healthcare, opportunities for outcomes research are growing. In this study, we summarize published literature examining comparative effectiveness research (CER), treatment patterns, quality of life (QoL) and costs in HER2-negative and triple-negative (TN) metastatic breast cancer (mBC). METHODS: PubMed (2010-January 2016) and four conferences (2013-January 2016) were searched using MeSH/keywords, including mBC, QoL, morbidity and therapeutics...
January 5, 2018: Journal of Comparative Effectiveness Research
Jack Zigler, Nicole Ferko, Chris Cameron, Leena Patel
AIM: To compare the efficacy and safety of total disc replacement, lumbar fusion, and conservative care in the treatment of single-level lumbar degenerative disc disease (DDD). MATERIALS & METHODS: A network meta-analysis was conducted to determine the relative impact of lumbar DDD therapies on Oswestry Disability Index (ODI) success, back pain score, patient satisfaction, employment status, and reoperation. Odds ratios or mean differences and 95% credible intervals were reported...
March 2018: Journal of Comparative Effectiveness Research
Patricia Guyot, Wei Cheng, Gabriel Tremblay, Ronda Copher, Heather Burnett, Xuan Li, Charles Makin
AIM: For dichotomous outcomes, odds ratio (OR) is one of the usual summary measures of indirect treatment comparison. A corresponding number needed to treat (NNT) estimate may facilitate understanding of the treatment effect. METHODS: We show how to estimate NNT based on OR results of a matching adjusted indirect comparison. We also have derived the explicit formula of its 95% CIs by applying the delta method, and as an alternative, a simulation-based method. RESULTS: The method was applied in a case study example in radioiodine-refractory differentiated thyroid cancer (RR-DTC) patients, comparing lenvatinib to sorafenib...
March 2018: Journal of Comparative Effectiveness Research
Marija Kalaba, Jovan Kosutic, Brian Godman, Vesela Radonjic, Ana Vujic, Slobodan Jankovic, Dragana Srebro, Zlatko Kalaba, Radan Stojanovic, Milica Prostran
AIM: Antimicrobial resistance and inappropriate use of antibiotics in children are important issues. Consequently, there is a need to develop comprehensive stewardship programs even in hospitals with limited resources starting with children's hospitals. METHODS: Retrospective observational analysis of antimicrobial utilization and resistance patterns over 5 years in a tertiary care children's hospital in Serbia. RESULTS: Cumulative antimicrobial resistance decreased but was still high, with high cumulative resistance rates among the most widely used antibiotics in the hospital...
March 2018: Journal of Comparative Effectiveness Research
Sonia Indacochea Caceda, Richard Rubio Ramos, Carlos Martín Saborido
Postpartum hemorrhage is one of the main causes of maternal death. Oxytocin has traditionally been used to prevent postpartum hemorrhage. AIM: To compare oxytocin with carbetocin, a long-acting analog of oxytocin, for prevention of uterine hemorrhage after cesarean delivery. MATERIALS & METHODS: Clinical data were retrieved from the 2012 Cochrane meta-analysis "Carbetocin for preventing postpartum hemorrhage". A decision tree was constructed. The direct costs were those of medications from the Peruvian official price list (DIGEMID)...
December 21, 2017: Journal of Comparative Effectiveness Research
Alexis A Krumme, Ajinkya Pawar, Sebastian Schneeweiss, Robert J Glynn, Niteesh K Choudhry, Martin Kulldorff, Adrian Santiago Ortiz, Jerome Avorn, Joshua J Gagne
Since 2010, four oral anticoagulants have been approved for marketing in addition to warfarin for treatment of thromboembolic disease. Limited head-to-head data exist comparing these treatments, leaving patients and clinicians with little guidance for selecting a strategy that balances recurrence reduction with bleeding risk. In the dabigatran, apixaban, rivaroxban, edoxaban and warfarin comparative effectiveness research study, we compare all five currently available oral anticoagulant agents for the extended treatment of deep venous thrombosis and pulmonary embolism, as well as no extended treatment, and evaluate whether results differ in specific sub-populations...
December 21, 2017: Journal of Comparative Effectiveness Research
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