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Medical research policy in the united states

Bik-Wai Bilvick Tai, Yuna H Bae, Quang A Le
BACKGROUND: Patient-centered care has become increasingly important and relevant for informed health care decision making. OBJECTIVE: Our study aimed to perform a systematic review of health economic evaluation studies from the patient's perspective. METHODS: PubMed, EMBASE, and Cochrane Central databases were searched through May 2014 for cost-effectiveness, cost-utility, and cost-benefit studies using the patient's perspective in their analysis...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Lusine Poghosyan, Robert J Lucero, Ashley R Knutson, Mark W Friedberg, Hermine Poghosyan
Purpose The purpose of this paper is to synthesize existing evidence regarding health care team networks, including their formation and association with outcomes in various health care settings. Design/methodology/approach Network theory informed this review. A literature search was conducted in major databases for studies that used social network analysis methods to study health care teams in the USA between 2000 and 2014. Retrieved studies were reviewed against inclusion and exclusion criteria. Findings Overall, 25 studies were included in this review...
October 10, 2016: Journal of Health Organization and Management
Zhu Zhang, Xiaolong Zheng, Daniel Dajun Zeng, Scott J Leischow
BACKGROUND: Dabbing is an emerging method of marijuana ingestion. However, little is known about dabbing owing to limited surveillance data on dabbing. OBJECTIVE: The aim of the study was to analyze Google search data to assess the scope and breadth of information seeking on dabbing. METHODS: Google Trends data about dabbing and related topics (eg, electronic nicotine delivery system [ENDS], also known as e-cigarettes) in the United States between January 2004 and December 2015 were collected by using relevant search terms such as "dab rig...
2016: Journal of Medical Internet Research
Erica Eggers Carroll
Good laboratory practice standards are US federal regulations enacted as part of the Federal Insecticide, Fungicide, and Rodenticide Act (40 CFR Part 160), the Toxic Substance Control Act (40 CFR Part 792), and the Good Laboratory Practice for Nonclinical Laboratory Studies (21 CFR Part 58) to support protection of public health in the areas of pesticides, chemicals, and drug investigations in response to allegations of inaccurate data acquisition. Essentially, good laboratory practices (GLPs) are a system of management controls for nonclinical research studies involving animals to ensure the uniformity, consistency, reliability, reproducibility, quality, and integrity of data collected as part of chemical (including pharmaceuticals) tests, from in vitro through acute to chronic toxicity tests...
October 2016: U.S. Army Medical Department Journal
Nefi D Acosta, Sidney H Golub
Stem cell policy in the United States is an amalgam of federal and state policies. The scientific development of human pluripotent embryonic stem cells (ESCs) triggered a contentious national stem cell policy debate during the administration of President George W. Bush. The Bush "compromise" that allowed federal funding to study only a very limited number of ESC derived cell lines did not satisfy either the researchers or the patient advocates who saw great medical potential being stifled. Neither more restrictive legislation nor expansion of federal funding proved politically possible and the federal impasse opened the door for a variety of state-based experiments...
September 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Charles Anthony Hughes, Patrick McMenamin, Vikas Mehta, Harold Pillsbury, David Kennedy
OBJECTIVES/HYPOTHESIS: The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. STUDY DESIGN: Retrospective analysis of research databases, public use files, and claims data...
August 31, 2016: Laryngoscope
David D Kim, Anirban Basu
BACKGROUND: The prevalence of adult obesity exceeds 30% in the United States, posing a significant public health concern as well as a substantial financial burden. Although the impact of obesity on medical spending is undeniably significant, the estimated magnitude of the cost of obesity has varied considerably, perhaps driven by different study methodologies. OBJECTIVES: To document variations in study design and methodology in existing literature and to understand the impact of those variations on the estimated costs of obesity...
July 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Aaron S Kesselheim, Jerry Avorn, Ameet Sarpatwari
IMPORTANCE: The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers. OBJECTIVES: To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs. EVIDENCE: We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United States, the justifications and consequences of high prices, and possible solutions...
August 23, 2016: JAMA: the Journal of the American Medical Association
Wendy Macias-Konstantopoulos
Human trafficking, a form of modern slavery, is an egregious violation of human rights with profound personal and public health implications. It includes forced labor and sexual exploitation of both U.S. and non-U.S. citizens and has been reported in all 50 states. Victims of human trafficking are currently among the most abused and disenfranchised persons in society, and they face a wide range of negative health outcomes resulting from their subjugation and exploitation. Medicine has an important role to play in mitigating the devastating effects of human trafficking on individuals and society...
October 18, 2016: Annals of Internal Medicine
Khaled Nashar, Kalathil K Sureshkumar
Improved survival of human immunodeficiency virus (HIV) infected patients with chronic kidney disease following the introduction of antiretroviral therapy resulted in the need to revisit the topic of kidney transplantation in these patients. Large cohort studies have demonstrated favorable outcomes and proved that transplantation is a viable therapeutic option. However, HIV-infected recipients had higher rates of rejection. Immunosuppressive therapy did not negatively impact the course of HIV infection. Some of the immunosuppressive drugs used following transplantation exhibit antiretroviral effects...
July 6, 2016: World Journal of Nephrology
Jessica Olds, Rachel Reilly, Paul Yerrell, Janet Stajic, Jasmine Micklem, Kim Morey, Alex Brown
BACKGROUND: International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address...
2016: Health & Justice
Susan A Chapman, Joanne Spetz, Jessica Lin, Krista Chan, Laura A Schmidt
BACKGROUND: There is considerable movement in the U.S. to legalize use of cannabis for medicinal purposes. Twenty-three U.S. states and the District of Columbia have laws that decriminalize use of marijuana for medicinal purposes. Most prior studies of state medical marijuana laws and their association with overall marijuana use, adolescent use, crime rates, and alcohol traffic fatalities have used a binary coding of whether the state had a medical marijuana law or not. Mixed results from these studies raise the question of whether this method for measuring policy characteristics is adequate...
July 28, 2016: Substance Use & Misuse
Craig D Newgard, Zhuo Yang, Daniel Nishijima, K John McConnell, Stacy A Trent, James F Holmes, Mohamud Daya, N Clay Mann, Renee Y Hsia, Tom D Rea, N Ewen Wang, Kristan Staudenmayer, M Kit Delgado
BACKGROUND: The American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥95% sensitivity and ≥65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared with triage strategies consistent with the national targets. STUDY DESIGN: This was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services agencies to 105 trauma and nontrauma hospitals in 6 regions of the western United States from 2006 through 2008...
June 2016: Journal of the American College of Surgeons
Haijing Hao, Kunpeng Zhang
BACKGROUND: Many Web-based health care platforms allow patients to evaluate physicians by posting open-end textual reviews based on their experiences. These reviews are helpful resources for other patients to choose high-quality doctors, especially in countries like China where no doctor referral systems exist. Analyzing such a large amount of user-generated content to understand the voice of health consumers has attracted much attention from health care providers and health care researchers...
2016: Journal of Medical Internet Research
Cyrus Ahalt, Brie Williams
In January 2016, President Barack Obama addressed the overuse of solitary confinement in U.S. jails and prisons. Calling the practice "an affront to our common humanity," he described a young man’s suicide, cited medical research on isolation’s "lasting psychological consequences," and noted..
May 5, 2016: New England Journal of Medicine
Jalpa A Doshi, Franklin B Hendrick, Jennifer S Graff, Bruce C Stuart
INTRODUCTION: High quality research regarding treatment effectiveness, quality, and value is critical for improving the U.S. health care system. Recognition of this has led federal and state officials to better leverage existing data sources such as medical claims and survey data, but access must be balanced with privacy concerns. METHODS: We reviewed and catalogued data access policies for a selection of publicly-funded federal and state datasets to investigate how such policies may be promoting or limiting research activities...
2016: EGEMS
Suzanne Carlberg-Racich
Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction-which removes judgment and operates at the patient's stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system...
2016: PeerJ
Elise Andaya, Joanna Mishtal
Women's right to legal abortion in the U.S. is now facing its greatest social and legislative challenges since its 1973 legalization. Legislation restricting rights and access to abortion care has been passed at state and federal levels at an unprecedented rate. Given the renewed vigor of anti-abortion movements, we call on anthropologists to engage with this shifting landscape of reproductive politics. This article examines recent legislation that has severely limited abortion access and maps possible directions for future anthropological analysis...
April 26, 2016: Medical Anthropology Quarterly
Marguerite E Burns, Barbara L Wolfe
BACKGROUND: In September 2010, the Affordable Care Act increased the availability of private health insurance for young adult dependents in the United States and prohibited coverage exclusions for their pre-existing conditions. The coverage expansion improved young adults' financial protection from medical expenses and increased their mental health care use. These short-term effects signal the possibility of accompanying changes in mental health through one or more mechanisms: treatment-induced symptom relief or improved function; improved well-being and/or reduced anxiety as financial security increases; or declines in self-reported mental health if treatment results in the discovery of illnesses...
March 2016: Journal of Mental Health Policy and Economics
Jennifer C Goldsack, Barret Michalec, Mark Cipolle, Seema S Sonnad
BACKGROUND: Surgical knowledge production has changed dramatically in the last 30 y, moving away from investigations by individual surgeon researchers and toward remote and interdisciplinary research. We investigated how surgeons make decisions about engaging in research and identify motivators, facilitators, and barriers to conducting research in an increasingly challenging environment. MATERIALS AND METHODS: We performed a qualitative analysis of semistructured interviews with surgeons from academic medical centers across the United States...
May 1, 2016: Journal of Surgical Research
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