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(Beth A. Virnig)

Eva A Enns, Cavan S Reilly, Beth A Virnig, Karen Baker, Nicholas Vogenthaler, Keith Henry
Retention in care is essential to the health of people living with HIV and also for their communities. We sought to quantify the value of integrating HIV surveillance data with clinical records for improving the accuracy of retention-in-care estimates and the efficiency of efforts to re-engage out-of-care patients. Electronic medical records (EMRs) of HIV+ patients ≥18 years old from a public, hospital-based clinic in Minneapolis, MN between 2008 and 2014 were merged with state surveillance data on HIV-related laboratory tests, out-of-state relocation, and mortality...
September 2016: AIDS Patient Care and STDs
Donna Z Bliss, Olga V Gurvich, Michelle A Mathiason, Lynn E Eberly, Kay Savik, Susan Harms, Christine Mueller, Jean F Wyman, Beth Virnig
Racial/ethnic disparities in preventing health problems have been reported in nursing homes. Incontinence is common among nursing home residents and can result in inflammatory-type skin damage, referred to as incontinence-associated skin damage (IASD). Little is known about the prevention of IASD and whether there are racial/ethnic disparities in its prevention. This study assessed the proportion of older nursing home residents receiving IASD prevention after developing incontinence after admission (n = 10,713) and whether there were racial/ethnic disparities in IASD prevention...
September 1, 2016: Western Journal of Nursing Research
Stephanie L Jarosek, Tetyana P Shippee, Beth A Virnig
OBJECTIVES: To use place-of-service (POS) codes in the Medicare hospice claims files to document where elderly hospice users with cancer die. DESIGN: Retrospective cohort study. SETTING: Surveillance, Epidemiology, and End Results (SEER) cancer registry areas. PARTICIPANTS: Elderly Medicare beneficiaries who died of lung, breast, colorectal, or pancreatic cancer in 2007 and 2008 (N = 46,037). MEASUREMENT: Use of hospice, place of service at death (home, nursing home, hospital, inpatient hospice, other), length of stay in hospice...
September 2016: Journal of the American Geriatrics Society
Elissa M Ozanne, Julie E Weiss, Tracy Onega, Wendy DeMartini, Karla Kerlikowske, Diana S M Buist, Louise Henderson, Rebecca A Hubbard, Martha Goodrich, Anna N A Tosteson, Beth A Virnig, Cristina O'Donoghue
BACKGROUND: Preoperative magnetic resonance imaging (MRI) use has increased among older women diagnosed with breast cancer. MRI detects additional malignancy, but its impact on locoregional surgery and radiation treatment remains unclear. METHODS: We examined the associations of preoperative MRI with initial locoregional treatment type (mastectomy, breast conserving surgery [BCS] with radiation therapy [RT], and BCS without RT) and BCS reoperation rates for Surveillance, Epidemiology, and End Results Medicare women diagnosed with stages 0 to III breast cancer from 2005 to 2009 (n = 55,997)...
June 12, 2016: American Journal of Surgery
Schelomo Marmor, Erin E Burke, Beth A Virnig, Eric H Jensen, Todd M Tuttle
BACKGROUND: The survival rates after pancreatectomy for elderly patients with adenocarcinoma of the pancreas remain poor. Elderly patients have increased perioperative mortality rates, higher morbidity rates, and higher rates of continued inpatient nursing care after pancreatectomy. The objective of the current study was to evaluate the outcomes of surgical resection versus chemotherapy (with or without radiotherapy) for elderly patients with potentially resectable adenocarcinoma of the pancreas...
July 15, 2016: Cancer
Donna Z Bliss, Olga V Gurvich, Lynn E Eberly, Kay Savik, Susan Harms, Jean F Wyman, Christine Mueller, Beth Virnig, Kjerstie Wiltzen
AIMS: Maintaining continence of nursing home (NH) residents promotes dignity and well-being and may reduce morbidity and healthcare treatment costs. To determine the prevalence of older continent adults who received primary prevention of incontinence at NH admission, assess whether there were racial or ethnic disparities in incontinence prevention, and describe factors associated with any disparities. METHODS: The design was an observational cross-sectional study of a nation-wide cohort of older adults free of incontinence at NH admission (n = 42,693)...
July 4, 2016: Neurourology and Urodynamics
Tracy Onega, Julia E Weiss, Diana S M Buist, Anna N A Tosteson, Louise M Henderson, Karla Kerlikowske, Martha E Goodrich, Cristina O'Donoghue, Karen J Wernli, Wendy B DeMartini, Beth A Virnig, Caroline S Bennette, Rebecca A Hubbard
PURPOSE: We compared the frequency and sequence of breast imaging and biopsy use for the diagnostic and preoperative workup of breast cancer according to breast magnetic resonance imaging (MRI) use among older women. MATERIALS AND METHODS: Using SEER-Medicare data from 2004 to 2010, we identified women with and without breast MRI as part of their diagnostic and preoperative breast cancer workup and measured the number and sequence of breast imaging and biopsy events per woman...
July 2016: Medical Care
Tracy Onega, Anna N A Tosteson, Julie Weiss, Jennifer Alford-Teaster, Rebecca A Hubbard, Louise M Henderson, Karla Kerlikowske, Martha E Goodrich, Cristina O'Donoghue, Karen J Wernli, Wendy B DeMartini, Beth A Virnig
BACKGROUND: Breast cancer in the U.S. - estimated at 232,670 incident cases in 2014 - has the highest aggregate economic burden of care relative to other female cancers. Yet, the amount of cost attributed to diagnostic/preoperative work up has not been characterized. We examined the costs of imaging and biopsy among women enrolled in Medicare who did and did not receive diagnostic/preoperative Magnetic Resonance Imaging (MRI). METHODS: Using Surveillance, Epidemiology and End Results (SEER)- Medicare data, we compared the per capita costs (PCC) based on amount paid, between diagnosis date and primary surgical treatment for a breast cancer diagnosis (2005-2009) with and without diagnostic/preoperative MRI...
February 27, 2016: BMC Health Services Research
Daniel Liberman, Stephanie Jarosek, Beth A Virnig, Haitao Chu, Sean P Elliott
PURPOSE: Bladder outlet obstruction after prostate cancer therapy imposes a significant burden on health and quality of life in men. Our objective was to describe the burden of bladder outlet obstruction after prostate cancer therapy by detailing the type of procedures performed and how often those procedures were repeated in men with recurrent bladder outlet obstruction. MATERIALS AND METHODS: Using SEER (Surveillance, Epidemiology and End Results)-Medicare linked data from 1992 to 2007 with followup through 2009 we identified 12,676 men who underwent at least 1 bladder outlet obstruction procedure after prostate cancer therapy, including external beam radiotherapy in 3,994, brachytherapy in 1,485, brachytherapy plus external beam radiotherapy in 1,847, radical prostatectomy in 4,736, radical prostatectomy plus external beam radiotherapy in 369 and cryotherapy in 245...
May 2016: Journal of Urology
Schelomo Marmor, James W Begun, Jean Abraham, Beth A Virnig
OBJECTIVES: Allogeneic hematopoietic cell transplantation (HCT) is the transplantation of stem cells from a donor and an effective treatment for many hematologic malignancies. We sought to compare allogeneic HCT survival outcomes and hazard of death among US centers that treat higher-risk patients versus those in centers that do not perform lower-risk HCT procedures. STUDY DESIGN: We utilized 2008 to 2010 Center for International Blood and Marrow Transplant Research data...
September 2015: American Journal of Managed Care
Donna Bliss, Susan Harms, Lynn E Eberly, Kay Savik, Olga Gurvich, Christine Mueller, Jean F Wyman, Beth Virnig
Older adults admitted to nursing homes (NHs) are at risk for low social engagement, which has associations with medical, psychological, and social well-being. Minorities may be at a disadvantage for social engagement because of their racial or ethnic group identity. This study assessed whether there were racial/ethnic disparities in social engagement among older adults (N = 15,927) at 1 year after their NH admission using multi-level predictors. No racial or ethnic-based disparities in social engagement were found; hence, an analysis of risk factors at NH admission that predicted low social engagement at 1 year for all residents was conducted...
November 26, 2015: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Alexis D Leal, Carrie A Thompson, Alice H Wang, Robert A Vierkant, Thomas M Habermann, Julie A Ross, Ruben A Mesa, Beth A Virnig, James R Cerhan
BACKGROUND: Hormonal and reproductive history has been associated with risk of some hematologic malignancies, but their role in myeloproliferative neoplasms (MPN) is largely unknown. METHODS: Using a population-based cohort study, we evaluated the association of these factors with risk of MPN overall, and for essential thrombocythemia (ET) and polycythemia vera (PV) specifically. Incident MPN cases from 1993 to 2004 were identified via linkage to Medicare. RR and 95% confidence intervals (CI) were estimated utilizing Cox proportional hazard regression...
January 2016: Cancer Epidemiology, Biomarkers & Prevention
Louise M Henderson, Julie Weiss, Rebecca A Hubbard, Cristina O'Donoghue, Wendy B DeMartini, Diana S M Buist, Karla Kerlikowske, Martha Goodrich, Beth Virnig, Anna N A Tosteson, Constance D Lehman, Tracy Onega
Preoperative breast magnetic resonance imaging (MRI) use among Medicare beneficiaries with breast cancer has substantially increased from 2005 to 2009. We sought to identify factors associated with preoperative breast MRI use among women diagnosed with ductal carcinoma in situ (DCIS) or stage I-III invasive breast cancer (IBC). Using Surveillance, Epidemiology, and End Results and Medicare data from 2005 to 2009 we identified women ages 66 and older with DCIS or stage I-III IBC who underwent breast-conserving surgery or mastectomy...
January 2016: Breast Journal
Erin E Burke, Schelomo Marmor, Beth A Virnig, Todd M Tuttle, Eric H Jensen
BACKGROUND: Adequate lymph node evaluation (LNE) is recommended for surgically treated pancreatic adenocarcinoma because studies have shown an association between improved survival and adequate LNE. This study aimed to understand the mechanism of this association and determine whether LNE is a valuable quality metric. METHODS: Using the linked Surveillance Epidemiology End Results Medicare database, we identified patients with surgically treated pancreatic adenocarcinoma from 2000 to 2010...
December 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Donna Z Bliss, Olga V Gurvich, Kay Savik, Lynn E Eberly, Susan Harms, Jean F Wyman, Christine Mueller, Judith Garrard, Beth Virnig
Incontinence is a common health problem among nursing home (NH) residents. Differences between black and white NH residents in incontinence prevalence have been reported. Although reducing health disparities is a principal objective of the national health care agenda, little is known about disparities in incidence of new incontinence in NHs. The purpose of this study was to assess whether there were racial/ethnic disparities in the time to development of incontinence in adults over age 65 who had been continent on NH admission...
December 2015: Research in Nursing & Health
Schelomo Marmor, Erin E Burke, Pamela R Portschy, Beth A Virnig, Eric H Jensen, Todd M Tuttle
BACKGROUND: Increased lymph node evaluation has been associated with improved survival rates in patients with pancreatic cancer. We sought to evaluate the trends and factors associated with lymph node examination over time and the effects on survival. METHODS: Using the Surveillance, Epidemiology and End Results database, we conducted an analysis of adults with adenocarcinoma of the pancreas who underwent surgical resection. Using the Cochrane Armitage test for trend and logistic regression we identified factors associated with lymph node evaluation...
September 2015: Surgical Oncology
Jing Zhang, Haitao Chu, Hwanhee Hong, Beth A Virnig, Bradley P Carlin
Network meta-analysis expands the scope of a conventional pairwise meta-analysis to simultaneously compare multiple treatments, synthesizing both direct and indirect information and thus strengthening inference. Since most of trials only compare two treatments, a typical data set in a network meta-analysis managed as a trial-by-treatment matrix is extremely sparse, like an incomplete block structure with significant missing data. Zhang et al. proposed an arm-based method accounting for correlations among different treatments within the same trial and assuming that absent arms are missing at random...
July 28, 2015: Statistical Methods in Medical Research
John T Schousboe, Misti L Paudel, Brent C Taylor, Allyson M Kats, Beth A Virnig, Kristine E Ensrud, Bryan E Dowd
OBJECTIVE: To compare standardized estimates of the true resource costs of outpatient health care to the allowable and billed charges for that care among Medicare Fee for Service (FFS) beneficiaries. DATA SOURCES/STUDY SETTING: Medicare Carrier and Outpatient Standard Analytic (SAF) files linked to participant data in the Study of Osteoporotic Fractures from 2004 through 2010. Participants were 3,435 female Medicare Fee for Service enrollees age 80 and older recruited in one rural and three metropolitan areas of the United States...
February 2016: Health Services Research
Wendy Yi Xu, Jean Abraham, Schelomo Marmor, David Knutson, Beth A Virnig
This study examines the relationship between Healthcare Effectiveness Data and Information Set-based diabetes quality measures and resource use for evaluation and management (E&M), inpatient facility, and surgical procedure services for a national sample of Medicare fee-for-service beneficiaries in 1685 Hospital Service Areas. Using multivariate regression analyses, the study findings suggest that higher rates of beneficiaries' receipt of HbA1c, low-density lipoprotein cholesterol, and retinal eye exam tests ("composite quality") during the year is inversely related to average inpatient resource use...
February 2016: Population Health Management
Sean P Elliott, Yunhua Fan, Stephanie Jarosek, Haitao Chu, Levi Downs, Kathryn Dusenbery, Melissa A Geller, Beth A Virnig
PURPOSE: Cervical cancer treatment is associated with a risk of urinary adverse events (UAEs) such as ureteral stricture and vesicovaginal fistula. We sought to measure the long-term UAE risk after surgery and radiation therapy (RT), with confounding controlled through propensity-weighted models. METHODS AND MATERIALS: From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified women ≥66 years old with nonmetastatic cervical cancer treated with simple surgery (SS), radical hysterectomy (RH), external beam RT plus brachytherapy (EBRT+BT), or RT+surgery...
July 1, 2015: International Journal of Radiation Oncology, Biology, Physics
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