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Cost utility analysis

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https://www.readbyqxmd.com/read/28718037/cost-effectiveness-of-surveillance-for-distant-recurrence-in-extremity-soft-tissue-sarcoma
#1
Trevor J Royce, Rinaa S Punglia, Aileen B Chen, Sagar A Patel, Katherine A Thornton, Chandrajit P Raut, Elizabeth H Baldini
BACKGROUND: Optimal distant recurrence (DR) surveillance strategies for extremity soft tissue sarcoma (STS) are unknown. We performed a cost-effectiveness analysis of different imaging modalities performed at guideline-specified intervals. METHODS: We developed a Markov model simulating lifetime outcomes for 54-year-old patients after definitive treatment for American Joint Committee on Cancer stage II-III extremity STS using four surveillance strategies: watchful waiting (WW), chest X-ray (CXR), chest computed tomography (CCT), and positron emission tomography-computed tomography (PET/CT)...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28717961/determining-the-optimal-forensic-dna-analysis-procedure-following-investigation-of-sample-quality
#2
Ronny Hedell, Johannes Hedman, Petter Mostad
Crime scene traces of various types are routinely sent to forensic laboratories for analysis, generally with the aim of addressing questions about the source of the trace. The laboratory may choose to analyse the samples in different ways depending on the type and quality of the sample, the importance of the case and the cost and performance of the available analysis methods. Theoretically well-founded guidelines for the choice of analysis method are, however, lacking in most situations. In this paper, it is shown how such guidelines can be created using Bayesian decision theory...
July 17, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#3
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28711902/risk-stratified-surveillance-and-cost-effectiveness-of-follow-up-after-radical-cystectomy-in-patients-with-muscle-invasive-bladder-cancer
#4
Ayumu Kusaka, Shingo Hatakeyama, Shogo Hosogoe, Itsuto Hamano, Hiromichi Iwamura, Naoki Fujita, Ken Fukushi, Takuma Narita, Kazuhisa Hagiwara, Hayato Yamamoto, Yuki Tobisawa, Tohru Yoneyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Hiroyuki Ito, Kazuaki Yoshikawa, Toshiaki Kawaguchi, Chikara Ohyama
BACKGROUND: The recurrence risk stratification and the cost effectiveness of oncological surveillance after radical cystectomy are not clear. We aimed to develop a risk stratification and a surveillance protocol with improved cost effectiveness after radical cystectomy. RESULTS: Of 581 enrolled patients, 175 experienced disease recurrences. The pathology-based protocol presented significant differences in recurrence-free survival between normal- and high-risk patients, but the medical expense was high, especially in normal-risk (≤pT2pN0) patients...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28711691/effects-of-the-2009-medical-cannabinoid-legalization-policy-on-hospital-use-for-cannabinoid-dependency-and-persistent-vomiting
#5
Mustafa Al-Shammari, Karina Herrera, Xibei Liu, Brandon Gisi, Takashi Yamashita, Kyu-Tae Han, Mohamed Azab, Harmeet Mashiana, Muthena Maklad, Muhammad Talha Farooqui, Ranjit Makar, Ji Won Yoo
BACKGROUND & AIMS: In year of 2009, the United States federal Department of Justice issued a memo stating that it would not prosecute users and sellers who complied with the state laws allowing for medical use of marijuana. There are growing concerns about legalization of marijuana use and its related public health effects. We performed an interrupted time series analysis to evaluate these effects. METHODS: We collected a representative sample of hospital discharge data from the healthcare cost and utilization project, from January 1993 through December 2014...
July 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28710057/images-of-little-cigars-and-cigarillos-on-instagram-identified-by-the-hashtag-swisher-thematic-analysis
#6
Jon-Patrick Allem, Patricia Escobedo, Kar-Hai Chu, Tess Boley Cruz, Jennifer B Unger
BACKGROUND: Little cigar and cigarillo use is becoming more prevalent in the United States and elsewhere, with implications for public health. As little cigar and cigarillo use grows in popularity, big social media data (eg, Instagram, Google Web Search, Twitter) can be used to capture and document the context in which individuals use, and are marketed, these tobacco products. Big social media data may allow people to organically demonstrate how and why they use little cigars and cigarillos, unprimed by a researcher, without instrument bias and at low costs...
July 14, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28709782/contextualizing-oncologic-imaging-utilization-through-end-of-life-spending%C3%A2-patterns
#7
Timothy P Copeland, John M Hillman, Benjamin L Franc
PURPOSE: The aim of this study was to assess the effect of spending patterns during the final year of life on high-cost imaging utilization in the final 3 months of life. METHODS: An academic comprehensive cancer center's radiology, cancer registry, and claims records were matched to identify decedents with dates of death from April 2013 through June 2014. Spending patterns in the final year of life were identified using group-based trajectory modeling. Descriptive analysis of CT, MRI, and PET utilization across trajectories was conducted...
July 11, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28707698/cost-effectiveness-of-intraoperative-nerve-monitoring-in-avoidance-of-bilateral-recurrent-laryngeal-nerve-injury-in-patients-undergoing-total-thyroidectomy
#8
Z Al-Qurayshi, E Kandil, G W Randolph
BACKGROUND: Intraoperative nerve monitoring (IONM) provides dynamic neural information and is recommended for high-risk thyroid surgery. In this analysis, the cost-effectiveness of IONM in preventing bilateral recurrent laryngeal nerve (RLN) injury was investigated. METHODS: A Markov chain model was constructed based on IONM use. The base-case patient was defined as a 40-year-old woman presenting with a 4·1-cm left-sided papillary thyroid cancer who developed RLN injury with loss of monitoring signal during planned bilateral thyroidectomy...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28707285/burden-of-atopic-dermatitis-in-the-united-states-analysis-of-healthcare-claims-data-in-the-commercial-medicare-and-medi-cal-databases
#9
Sulena Shrestha, Raymond Miao, Li Wang, Jingdong Chao, Huseyin Yuce, Wenhui Wei
INTRODUCTION: Comparative data on the burden of atopic dermatitis (AD) in adults relative to the general population are limited. We performed a large-scale evaluation of the burden of disease among US adults with AD relative to matched non-AD controls, encompassing comorbidities, healthcare resource utilization (HCRU), and costs, using healthcare claims data. The impact of AD disease severity on these outcomes was also evaluated. METHODS: Adult AD patients in the Commercial (n = 83,106), Medicare (n = 31,060), and Medi-Cal (n = 5550) databases were matched (1:1) to non-AD controls by demographic characteristics...
July 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28706985/clinical-utility-of-epstein-barr-virus-viral-load-monitoring-and-risk-factors-for-posttransplant-lymphoproliferative-disorders-after-kidney-transplantation-a-single-center-10-year-observational-cohort-study
#10
Erica Franceschini, Jessica Plessi, Stefano Zona, Antonella Santoro, Margherita Digaetano, Francesco Fontana, Gaetano Alfano, Giovanni Guaraldi, Patrizia Comoli, Francesca Facchini, Leonardo Potenza, William Gennari, Mauro Codeluppi, Mario Luppi, Gianni Cappelli, Inge C Gyssens, Cristina Mussini
BACKGROUND: Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. METHODS: Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706426/healthcare-utilization-and-costs-associated-with-gastroparesis
#11
Vaibhav Wadhwa, Dhruv Mehta, Yash Jobanputra, Rocio Lopez, Prashanthi N Thota, Madhusudhan R Sanaka
AIM: To use a national database of United States hospitals to evaluate the incidence and costs of hospital admissions associated with gastroparesis. METHODS: We analyzed the National Inpatient Sample Database (NIS) for all patients in whom gastroparesis (ICD-9 code: 536.3) was the principal discharge diagnosis during the period, 1997-2013. The NIS is the largest publicly available all-payer inpatient care database in the United States. It contains data from approximately eight million hospital stays each year...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28704722/arsanilic-acid-modified-superparamagnetic-iron-oxide-nanoparticles-for-purification-of-alkaline-phosphatase-from-hen-s-egg-yolk
#12
Hamed Farzi-Khajeh, Kazem D Safa, Siavoush Dastmalchi
Recent studies of magnetic carrier technology have focused on its applications in separation and purification technologies, due to easy separation of the target from the reaction medium by applying an external magnetic field. In the present study, Fe3O4 superparamagnetic nanoparticles were prepared to utilize a chemical co-precipitation method, then the surfaces of the nanoparticles were modified with arsanilic acid derivatives which were used as the specific nanocarriers for the affinity purification of alkaline phosphatase from the hen's egg yolk...
June 29, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28702174/costs-of-implementing-integrated-community-case-management-iccm-in-six-african-countries-implications-for-sustainability
#13
Emmanuelle Daviaud, Donnela Besada, Natalie Leon, Sarah Rohde, David Sanders, Nicholas Oliphant, Tanya Doherty
BACKGROUND: Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduced to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level scale-up implications...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28702109/bolstering-skin-grafts-with-a-surgical-scrub-brush-a-cost-effective-solution
#14
Mitchell Buller, Thomas J Lee, Jared Davis, Bradon J Wilhelmi
Objective: The objective of this article is to review the methods currently used for the bolstering of skin grafts and compare their advantages and disadvantages with those of the dry, sterile surgical scrub brush. We report a series of cases performed at a single institution and compare the cost-effectiveness, application, and limitations of this method with other options for skin graft bolstering. Methods: A PubMed search using the parameters "(bolster) AND skin graft" was conducted, yielding 85 results. A total of 40 publications met the criteria for our literature review...
2017: Eplasty
https://www.readbyqxmd.com/read/28700457/discontinuity-of-medicaid-coverage-impact-on-cost-and-utilization-among-adult-medicaid-beneficiaries-with-major-depression
#15
Xu Ji, Adam S Wilk, Benjamin G Druss, Cathy Lally, Janet R Cummings
BACKGROUND: Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. OBJECTIVE: Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression...
August 2017: Medical Care
https://www.readbyqxmd.com/read/28699797/candidemia-and-invasive-candidiasis-among-hospitalized-neonates-and-pediatric-patients
#16
Rachel Harrington, Sylvia L Kindermann, Qingjiang Hou, Robert J Taylor, Nkechi Azie, David L Horn
OBJECTIVE: To investigate the epidemiology, treatment, length of stay (LOS) and costs for neonatal and pediatric inpatients with invasive candidiasis (IC). METHODS: The Cerner Health Facts Database was used to assess inpatients (2005-2014) identified by positive blood or cerebrospinal fluid (CSF) Candida cultures. Log-transformed LOS and cost were examined in candidemia-only patients (n= 191) using multivariable linear regression. RESULTS: 202 patients had a positive culture (blood: n = 192; CSF: n = 10; both: n = 2)...
July 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28699357/adoption-of-robotic-assisted-partial-nephrectomies-a-population-based-analysis-of-u-s-surgeons-from-2004-2013
#17
Hoiwan Cheung, Ye Wang, Steven Chang, Yash S Khandwala, Francesco Del Giudice, Benjamin I Chung
INTRODUCTION: Urological surgeries have contributed to the increasing prevalence of minimally invasive robotic procedures. Although factors influencing the adoption of robotic-assisted radical prostatectomy have previously been identified, the explanation for the rapid rise in robotic partial nephrectomies remains unknown. Using a retrospective population-based sample, we attempt to determine hospital and surgeon-specific factors influencing a surgeon's decision to utilize robotic assistance for partial nephrectomies...
July 12, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28697684/what-is-the-accuracy-of-an-early-third-trimester-sonogram-for-identifying-lga-infants-born-to-gdm-patients-diagnosed-with-the-one-step-approach
#18
Kelsey J Simpson, Meredith Pavicic, Gene T Lee
PURPOSE: The one-step approach for screening of GDM will increase the incidence 2- to 3-fold. These larger cohorts may need to target high-morbidity subsets to be cost-effective. We asked whether ultrasound could stratify the GDM patients with the highest risk for a large for gestational age (LGA) infant. MATERIALS AND METHODS: A retrospective analysis was performed on 413 GDM patients diagnosed using the one-step approach. Ultrasound data from 28 weeks 0 day to 34 weeks 6 days was studied...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28697524/-health-science-research-with-primary-care-routine-data-from-electronic-patient-records-the-beonet-registry
#19
Heidrun Lingner, Ines Aumann, Margarethe Wacker, Michael Kreuter, Reiner Leidl, J-Matthias Graf von der Schulenburg, Tobias Welte
Reliable current information is needed for daily patient care and the health system, but comprehensive data, especially from primary care, are scarce and/or hard to access. The BeoNet Register-Database (BNR) aims to depict quality of medical care in Germany using routine data and with no additional documentation or costs for GPs. Registry design, data structure and database use will be demonstrated using chronic obstructive lung disease (COPD) as an example. The BNR is moving through pilot- and roll-out phases...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28697253/effect-of-antidepressant-switching-vs-augmentation-on-remission-among-patients-with-major-depressive-disorder-unresponsive-to-antidepressant-treatment-the-vast-d-randomized-clinical-trial
#20
Somaia Mohamed, Gary R Johnson, Peijun Chen, Paul B Hicks, Lori L Davis, Jean Yoon, Theresa C Gleason, Julia E Vertrees, Kimberly Weingart, Ilanit Tal, Alexandra Scrymgeour, David D Lawrence, Beata Planeta, Michael E Thase, Grant D Huang, Sidney Zisook, Sanjai D Rao, Patricia D Pilkinton, James A Wilcox, Ali Iranmanesh, Mamta Sapra, George Jurjus, James P Michalets, Muhammed Aslam, Thomas Beresford, Keith D Anderson, Ronald Fernando, Sriram Ramaswamy, John Kasckow, Joseph Westermeyer, Gihyun Yoon, D Cyril D'Souza, Gunnar Larson, William G Anderson, Mary Klatt, Ayman Fareed, Shabnam I Thompson, Carlos J Carrera, Solomon S Williams, Timothy M Juergens, Lawrence J Albers, Clifford S Nasdahl, Gerardo Villarreal, Julia L Winston, Cristobal A Nogues, K Ryan Connolly, Andre Tapp, Kari A Jones, Gauri Khatkhate, Sheetal Marri, Trisha Suppes, Joseph LaMotte, Robin Hurley, Aimee R Mayeda, Alexander B Niculescu, Bernard A Fischer, David J Loreck, Nicholas Rosenlicht, Steven Lieske, Mitchell S Finkel, John T Little
Importance: Less than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant. Objective: To determine the relative effectiveness and safety of 3 common alternate treatments for MDD. Design, Setting, and Participants: From December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study...
July 11, 2017: JAMA: the Journal of the American Medical Association
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