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https://www.readbyqxmd.com/read/29554338/cost-effectiveness-of-a-model-consultation-to-support-self-management-in-patients-with-osteoarthritis
#1
Raymond Oppong, Sue Jowett, Martyn Lewis, Kris Clarkson, Zoe Paskins, Peter Croft, John J Edwards, Emma Healey, Kelvin P Jordan, Andrew Morden, Bie Nio Ong, Mark Porcheret, Andrew Finney, Elaine Hay, Krysia Dziedzic
Objectives: The aim of this study was to estimate the cost-effectiveness of a model OA consultation for OA to support self-management compared with usual care. Methods: An incremental cost-utility analysis using patient responses to the three-level EuroQoL-5D (EQ-5D) questionnaire was undertaken from a UK National Health Service perspective alongside a two-arm cluster-randomized controlled trial. Uncertainty was explored through the use of cost-effectiveness acceptability curves...
March 14, 2018: Rheumatology
https://www.readbyqxmd.com/read/29553277/overuse-and-insurance-plan-type-in-a-privately-insured-population
#2
Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen
OBJECTIVES: A substantial portion of healthcare spending is wasted on services that do not directly improve patient health and that cause harm in some cases. Features of health insurance coverage, including enrollment in high-deductible health plans (HDHPs) or health maintenance organizations (HMOs), may provide financial and nonfinancial mechanisms to potentially reduce overuse of low-value healthcare services. STUDY DESIGN: Using 2009 to 2013 administrative data from 3 large commercial insurers, we examined patient characteristics and health insurance plan types associated with overuse of 6 healthcare services identified by the Choosing Wisely campaign...
March 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29497091/early-circulating-tumor-dna-dynamics-and-clonal-selection-with-palbociclib-and-fulvestrant-for-breast-cancer
#3
Ben O'Leary, Sarah Hrebien, James P Morden, Matthew Beaney, Charlotte Fribbens, Xin Huang, Yuan Liu, Cynthia Huang Bartlett, Maria Koehler, Massimo Cristofanilli, Isaac Garcia-Murillas, Judith M Bliss, Nicholas C Turner
CDK4/6 inhibition substantially improves progression-free survival (PFS) for women with advanced estrogen receptor-positive breast cancer, although there are no predictive biomarkers. Early changes in circulating tumor DNA (ctDNA) level may provide early response prediction, but the impact of tumor heterogeneity is unknown. Here we use plasma samples from patients in the randomized phase III PALOMA-3 study of CDK4/6 inhibitor palbociclib and fulvestrant for women with advanced breast cancer and show that relative change in PIK3CA ctDNA level after 15 days treatment strongly predicts PFS on palbociclib and fulvestrant (hazard ratio 3...
March 1, 2018: Nature Communications
https://www.readbyqxmd.com/read/29485947/differences-in-medicaid-antipsychotic-medication-measures-among-children-with-ssi-foster-care-and-income-based-aid
#4
Emily Leckman-Westin, Molly Finnerty, Sarah Hudson Scholle, Riti Pritam, Deborah Layman, Edith Kealey, Sepheen Byron, Emily Morden, Scott Bilder, Sheree Neese-Todd, Sarah Horwitz, Kimberly Hoagwood, Stephen Crystal
BACKGROUND: Concerns about antipsychotic prescribing for children, particularly those enrolled in Medicaid and with Supplemental Security Income (SSI), continue despite recent calls for selective use within established guidelines. OBJECTIVES: To (a) examine the application of 6 quality measures for antipsychotic medication prescribing in children and adolescents receiving Medicaid and (b) understand distinctive patterns across eligibility categories in order to inform ongoing quality management efforts to support judicious antipsychotic use...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29396074/direct-oral-anticoagulant-and-antiplatelet-combination-therapy-hemorrhagic-events-in-coronary-artery-stent-recipients
#5
REVIEW
Kimon Bekelis, Chiang-Hua Chang, David Malenka, Nancy E Morden
Direct oral anticoagulant (DOAC) use is growing as monotherapy and combined with platelet inhibitors. The safety of such combination therapy, especially in comparison to regimens including warfarin, in real world populations remains uncertain. We investigated hemorrhage associated with DOAC and antiplatelet combination therapy in a cohort of elderly coronary artery stent recipients. We employed Medicare data 2010-2013 for a 40% random sample of beneficiaries enrolled in inpatient, outpatient and prescription benefits...
January 22, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29357369/relationship-between-qtl-for-grain-shape-grain-weight-test-weight-milling-yield-and-plant-height-in-the-spring-wheat-cross-rl4452-ac-domain
#6
Adrian L Cabral, Mark C Jordan, Gary Larson, Daryl J Somers, D Gavin Humphreys, Curt A McCartney
Kernel morphology characteristics of wheat are complex and quantitatively inherited. A doubled haploid (DH) population of the cross RL4452/'AC Domain' was used to study the genetic basis of seed shape. Quantitative trait loci (QTL) analyses were conducted on a total of 18 traits: 14 grain shape traits, flour yield (Fyd), and three agronomic traits (Plant height [Plht], 1000 Grain weight [Gwt], Test weight [Twt]), using data from trial locations at Glenlea, Brandon, and Morden in Manitoba, Canada, between 1999 and 2004...
2018: PloS One
https://www.readbyqxmd.com/read/29350509/measuring-overuse-with-electronic-health-records-data
#7
Thomas Isaac, Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen, Elizabeth A Kinsella, Thomas D Sequist
OBJECTIVES: To measure overuse of low-value care using electronic health record (EHR) data and manual chart review and to evaluate whether certain low-value services are better captured using EHR data. STUDY DESIGN: We implemented algorithms to extract performance on 13 Choosing Wisely-identified healthcare services using EHR data at a large physician practice group between 2011 and 2013. METHODS: We calculated rates of overuse using automated EHR extracts...
January 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29177605/evaluation-of-applying-ihc4-as-a-prognostic-model-in-the-translational-study-of-intergroup-exemestane-study-ies-pathies
#8
M C U Cheang, J M Bliss, G Viale, V Speirs, C Palmieri, A Shaaban, P E Lønning, J Morden, N Porta, J Jassem, C J van De Velde, B B Rasmussen, D Verhoeven, J M S Bartlett, R C Coombes
BACKGROUND: Intergroup Exemestane Study (IES) was a randomised study that showed a survival benefit of switching adjuvant endocrine therapy after 2-3 years from tamoxifen to exemestane. This PathIES aimed to assess the role of immunohistochemical (IHC)4 score in determining the relative sensitivity to either tamoxifen or sequential treatment with tamoxifen and exemestane. PATIENTS AND METHODS: Primary tumour samples were available for 1274 patients (27% of IES population)...
February 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29107391/the-application-and-feasibility-of-using-routine-data-sources-for-long-term-cancer-clinical-trial-follow-up
#9
EDITORIAL
I S Bhattacharya, J P Morden, C Griffin, C Snowdon, R Brannan, J M Bliss, L Kilburn
No abstract text is available yet for this article.
October 26, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29037845/implementing-core-nice-guidelines-for-osteoarthritis-in-primary-care-with-a-model-consultation-mosaics-a-cluster-randomised-controlled-trial
#10
K S Dziedzic, E L Healey, M Porcheret, E K Afolabi, M Lewis, A Morden, C Jinks, G A McHugh, S Ryan, A Finney, C Main, J J Edwards, Z Paskins, A Pushpa-Rajah, E M Hay
OBJECTIVE: To determine the effectiveness of a model osteoarthritis consultation, compared with usual care, on physical function and uptake of National Institute for Health and Care Excellence (NICE) osteoarthritis recommendations, in adults ≥45 years consulting with peripheral joint pain in UK general practice. METHOD: Two-arm cluster-randomised controlled trial with baseline health survey. Eight general practices in England. PARTICIPANTS: 525 adults ≥45 years consulting for peripheral joint pain, amongst 28,443 population survey recipients...
January 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28929187/modern-synthetic-material-is-a-safe-and-effective-alternative-for-medial-patellofemoral-ligament-reconstruction
#11
Paul Y F Lee, David Golding, Sam Rozewicz, Amit Chandratreya
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is often performed using gracilis autografts, which may be associated with donor site morbidity and complications. The use of a synthetic material can circumvent a harvest operation and has previously been demonstrated to be effective in other types of reconstructive procedures and may be effective in MPFL reconstruction. This study reports the clinical result with the use of a modern ultra-high molecular weight polyethylene with a braided jacket of polyester tape (FT) in MPFL reconstruction compared to using standard autografts...
September 19, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28888408/atrial-fibrillation-and-stent-selection-bare-metal-vs-drug-eluting-from-medicare-claims
#12
COMPARATIVE STUDY
Greg Dadekian, Aaron V Kaplan, Chiang-Hua Chang, Nancy E Morden
In treating coronary artery disease, many factors influence the choice of bare metal stent (BMS) or drug-eluting stent (DES), including bleed risk and suitability for prolonged dual antiplatelet therapy. Atrial fibrillation (AF) further complicates this choice, due to common use of anticoagulation. We examined stent selection in the United States by AF status and across academic medical centers (AMCs) to explore how cardiologists are managing this complex choice. Using a 100% Medicare denominator file and associated claims (2008 to 2012), we identified patients over age 65 receiving inpatient coronary artery stents...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28875077/uncovering-unseen-fungal-diversity-from-plant-dna-banks
#13
Erin M Datlof, Anthony S Amend, Kamala Earl, Jeremy Hayward, Clifford W Morden, Rachael Wade, Geoffrey Zahn, Nicole A Hynson
Throughout the world DNA banks are used as storage repositories for genetic diversity of organisms ranging from plants to insects to mammals. Designed to preserve the genetic information for organisms of interest, these banks also indirectly preserve organisms' associated microbiomes, including fungi associated with plant tissues. Studies of fungal biodiversity lag far behind those of macroorganisms, such as plants, and estimates of global fungal richness are still widely debated. Utilizing previously collected specimens to study patterns of fungal diversity could significantly increase our understanding of overall patterns of biodiversity from snapshots in time...
2017: PeerJ
https://www.readbyqxmd.com/read/28600210/accelerated-versus-standard-epirubicin-followed-by-cyclophosphamide-methotrexate-and-fluorouracil-or-capecitabine-as-adjuvant-therapy-for-breast-cancer-in-the-randomised-uk-tact2-trial-cruk-05-19-a-multicentre-phase-3-open-label-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
David Cameron, James P Morden, Peter Canney, Galina Velikova, Robert Coleman, John Bartlett, Rajiv Agrawal, Jane Banerji, Gianfilippo Bertelli, David Bloomfield, A Murray Brunt, Helena Earl, Paul Ellis, Claire Gaunt, Alexa Gillman, Nicholas Hearfield, Robert Laing, Nicholas Murray, Niki Couper, Robert C Stein, Mark Verrill, Andrew Wardley, Peter Barrett-Lee, Judith M Bliss
BACKGROUND: Adjuvant chemotherapy for early breast cancer has improved outcomes but causes toxicity. The UK TACT2 trial used a 2×2 factorial design to test two hypotheses: whether use of accelerated epirubicin would improve time to tumour recurrence (TTR); and whether use of oral capecitabine instead of cyclophosphamide would be non-inferior in terms of patients' outcomes and would improve toxicity, quality of life, or both. METHODS: In this multicentre, phase 3, randomised, controlled trial, we enrolled patients aged 18 years or older from 129 UK centres who had histologically confirmed node-positive or high-risk node-negative operable breast cancer, had undergone complete excision, and were due to receive adjuvant chemotherapy...
July 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28583965/for-selected-services-blacks-and-hispanics-more-likely-to-receive-low-value-care-than-whites
#15
William L Schpero, Nancy E Morden, Thomas D Sequist, Meredith B Rosenthal, Daniel J Gottlieb, Carrie H Colla
US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006-11, we found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied.
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28467729/long-term-follow-up-of-the-intergroup-exemestane-study
#16
RANDOMIZED CONTROLLED TRIAL
James P Morden, Isabel Alvarez, Gianfilippo Bertelli, Alan S Coates, Robert Coleman, Lesley Fallowfield, Jacek Jassem, Stephen Jones, Lucy Kilburn, Per E Lønning, Olaf Ortmann, Claire Snowdon, Cornelis van de Velde, Jørn Andersen, Lucia Del Mastro, David Dodwell, Stig Holmberg, Hanna Nicholas, Robert Paridaens, Judith M Bliss, R Charles Coombes
Purpose The Intergroup Exemestane Study, an investigator-led study of 4,724 postmenopausal patients with early breast cancer (clinical trial information: ISRCTN11883920), has previously demonstrated that a switch from adjuvant endocrine therapy after 2 to 3 years of tamoxifen to exemestane was associated with clinically relevant improvements in efficacy. Here, we report the final efficacy analyses of this cohort. Patients and Methods Patients who remained disease free after 2 to 3 years of adjuvant tamoxifen were randomly assigned to continue tamoxifen or switch to exemestane to complete a total of 5 years of adjuvant endocrine therapy...
August 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#17
REVIEW
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28292825/the-growing-problem-of-co-treatment-with-opioids-and-benzodiazepines
#18
EDITORIAL
Pinar Karaca-Mandic, Ellen Meara, Nancy E Morden
No abstract text is available yet for this article.
March 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#19
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28003026/a-nurse-led-clinic-for-patients-consulting-with-osteoarthritis-in-general-practice-development-and-impact-of-training-in-a-cluster-randomised-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Emma L Healey, Chris J Main, Sarah Ryan, Gretl A McHugh, Mark Porcheret, Andrew G Finney, Andrew Morden, Krysia S Dziedzic
BACKGROUND: Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery...
December 21, 2016: BMC Family Practice
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