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https://www.readbyqxmd.com/read/28152956/implementing-value-based-cancer-care-a-multidisciplinary-approach-to-defining-breast-cancer-outcomes
#1
Tinisha L Mayo, Tracy E Spinks, Seohyun Lee, Carlos Hernando Barcenas, Benjamin D Smith, Sharon Hermes Giordano, Rosa F Hwang, Richard A Ehlers, Jesse C Selber, Ronald Stewart Walters, Debu Tripathy, Kelly Hunt, Thomas A Buchholz, Thomas W Feeley, Henry Mark Kuerer
16 Background: Value in healthcare (patient-centered outcomes achieved per dollar spent) unifies performance improvement goals with health outcomes of importance to patients. We describe the process through which value-based measures for breast cancer patients and dynamic capture of these metrics via our new electronic health record (EHR) were developed at our institution. METHODS: A review of the breast cancer literature was conducted on treatment options as well as expected outcomes and potential treatment complications...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28147547/structures-and-spectroscopy-of-medium-size-protonated-ammonia-clusters-at-different-temperatures-h-nh3-10-16
#2
Alhadji Malloum, Jean Jules Fifen, Zoubeida Dhaouadi, Serge Guy Nana Engo, Nejm-Eddine Jaidane
Structures of protonated ammonia clusters (H(+)(NH3)n) are very important for the determination of pKa's and solvation energies of the proton in ammonia. In this work, their structures were investigated at M06-2X/6-31++g(d,p) level of theory, for n=10-16 and for temperatures ranging from 0 to 400 K. In the cluster community, this is the first theoretical study on the protonated ammonia clusters larger than the nonamer. We noted that the population of the investigated clusters is reproduced by branched cage or cage like structures at low temperatures, while branched linear and branched cyclic or branched double cyclic isomers are the only isomers responsible for the population at higher temperatures...
January 28, 2017: Journal of Chemical Physics
https://www.readbyqxmd.com/read/28126598/reporting-of-data-monitoring-boards-in-publications-of-randomized-clinical-trials-is-often-deficient-acttion-systematic-review
#3
Jennifer S Gewandter, Rachel A Kitt, Matthew R Hunsinger, Joseph Poku, Jacqueline Lozano, Jenna Chaudari, Scott Evans, Robert A Gross, Michael P McDermott, Michael C Rowbotham, Dennis C Turk, Robert H Dworkin
OBJECTIVE: To examine whether primary reports of randomized clinical trials (RCTs) in six high-impact, general medical journals reported (1) whether or not a Data Monitoring Committee/Data and Safety Monitoring Board (DMC/DSMB) was used and (2) the composition of the responsibilities of the reported DSMB/DMCs. STUDY DESIGN AND SETTING: Systematic review of RCTs published in 2014 in Annals of Internal Medicine, BMJ, NEJM, JAMA, JAMA Internal Medicine, and Lancet...
January 23, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28125559/o-011-low-dose-il-2-administration-expands-human-regulatory-t-cells-in-patients-with-uc-and-humanized-mice-and-protects-against-experimental-colitis
#4
Jeremy Goettel, Daniel Kotlarz, David Illig, James Canavan, Jessica Allegretti, Matthew Hamilton, Ryan Kelly, Alexandra Griffith, Madeline Carellas, Anastasia Nelina, Athos Bousvaros, Joshua Korzenik, Scott Snapper
BACKGROUND: Treg dysfunction or deficiency results in unopposed immune activation and autoimmunity. Interleukin-2 (IL-2) is critical for the expansion, suppressive function, and maintenance of Tregs. Although conventional T cells and NK cells respond to IL-2, Tregs are more sensitive to lower concentrations of IL-2 due to constitutive expression of CD25, the high affinity IL-2 receptor. Low-dose IL-2 therapies have shown to preferentially expand Tregs and ameliorate manifestations of graft versus host disease (Koreth et al...
February 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28050393/metronomic-chemotherapy-seems-prowess-to-battle-against-cancer-in-current-scenario
#5
Prema Muthusamy, Krishnan Vengadaragava Chary, G K Nalini
INTRODUCTION: Metronomic chemotherapy is an emerging method of chemotherapy. Metronomic 'lowdose' chemotherapy regimen induces tumour dormancy and reduces cancer resistance against anticancer drugs. It tends to improve overall success rate of cancer chemotherapy than conventional cyclical regimen. AIM: The aim of this systemic review was to provide comprehensive data of metronomic chemotherapy trials, regimens used and it's outcome in cancer therapeutics. MATERIALS AND METHODS: Fifty chemotherapy trial data were searched sequentially from web...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048107/su-f-i-04-low-dose-ct-lung-cancer-screening-protocol-evaluation
#6
E Nett, Y Imai
PURPOSE: The purpose of this study was to evaluate protocols for low dose CT (LDCT) for lung cancer screening on a Revolution CT (GE Healthcare; Waukesha, WI). Lung cancer the leading cause of cancer death for men and women, and more deaths are attributable to lung cancer than breast, colon and prostate cancers combined. Recently, the National Lung Screening Trial (NLST) showed LDCT screening resulted in a 20% reduction in lung cancer mortality and 6.7% in mortality from all causes [NEJM, 2011]...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28027060/methodological-quality-of-surgical-mortality-studies-using-large-hospital-databases-a-systematic-review
#7
Cécile Payet, Jean-Christophe Lifante, Matthew J Carty, Muriel Rabilloud, Antoine Duclos
OBJECTIVE: To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND DATA: Nationwide hospital data are increasingly used to investigate surgical outcomes. However, poor data granularity and coding inaccuracies may lead to flawed findings. METHODS: We conducted a systematic review in accordance with the PRISMA statement in 6 major journals (NEJM, Lancet, BMJ, JAMA, Medical Care, Annals of Surgery) using PubMed from its inception until December 31, 2014...
December 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27979724/a-peer-reviewed-instructional-video-is-as-effective-as-a-standard-recorded-didactic-lecture-in-medical-trainees-performing-chest-tube-insertion-a-randomized-control-trial
#8
Tomas J Saun, Scott Odorizzi, Celine Yeung, Marjorie Johnson, Glen Bandiera, Shelly P Dev
OBJECTIVE: Online medical education resources are becoming an increasingly used modality and many studies have demonstrated their efficacy in procedural instruction. This study sought to determine whether a standardized online procedural video is as effective as a standard recorded didactic teaching session for chest tube insertion. DESIGN: A randomized control trial was conducted. Participants were taught how to insert a chest tube with either a recorded didactic teaching session, or a New England Journal of Medicine (NEJM) video...
December 12, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27852915/levels-of-influence-habituation-and-the-prevalence-of-declared-conflicts-of-interest
#9
REVIEW
Jillian R H Bernstein, George Maliha, Jaimo Ahn, Joseph Bernstein
BACKGROUND: The International Committee of Medical Journal Editors has devised a system of mandatory disclosure, under which authors are required to disclose all conflicts of interest and the sources of support for the submitted research. Because payments from industry to physicians generally are common, it is likely that many authors of medical manuscripts will have information to disclose. As a result, the signal-to-noise ratio of such declarations may be low, thereby undermining the effectiveness of disclosure...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27843677/commentary-on-laminectomy-plus-fusion-versus-laminectomy-alone-for-lumbar-spondylolisthesis-by-ghogawala-z-dziura-j-butler-we-dai-f-terrin-n-magge-sn-et-al-nejm-2016-374-15-1424-34
#10
Nancy E Epstein
BACKGROUND: How does an article involving only 66 patients randomized into two spinal surgical groups get into the New England Journal of Medicine? Nevertheless, this one did. The article by Ghogawala et al. entitled Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis, compared the efficacy/outcomes of pedicle/screw/rod instrumented posterolateral lumbar fusions vs. decompressions alone for treating lumbar stenosis with grade I degenerative spondylolisthesis (DS)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#11
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753830/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#12
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27722281/structures-and-spectroscopy-of-protonated-ammonia-clusters-at-different-temperatures
#13
Alhadji Malloum, Jean Jules Fifen, Zoubeida Dhaouadi, Serge Guy Nana Engo, Nejm-Eddine Jaidane
The accurate determination of the solvation energies of a proton in ammonia is based on the precise knowledge of the structures of neutral and protonated ammonia clusters. In this work, we have investigated all the possible and stable structures of protonated ammonia clusters H(+)(NH3)n=2-9, along with their isomeric distribution at a specific temperature. New significant isomers are reported here for the first time and show that the structures of protonated ammonia clusters are not only branched linear as assumed by all previous authors...
September 29, 2016: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/27651214/commercial-conflict-of-interest-and-medical-publication-what-should-the-practising-physician-do-about-it
#14
Prem Pais
I read with interest the comment by Mark Wilson, which deals with possible conflict of interest (CoI) affecting publications in academic medical journals. This comment has specifically targeted the New England Journal of Medicine (NEJM) and its editor-in-chief Jeffrey Drazen on the "Vioxx scandal" which broke 15 years ago. Wilson's comment seems to be in response to a blog by Natarajan on CoI in medical publications. In the blog Natarajan writes of commercial CoI biasing publication of clinical trials and cites, among other examples, a publication in the NEJM on trials of voriconazole...
October 2016: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/27650288/reporting-and-dealing-with-missing-quality-of-life-data-in-rcts-has-the-picture-changed-in-the-last-decade
#15
REVIEW
S Fielding, A Ogbuagu, S Sivasubramaniam, G MacLennan, C R Ramsay
PURPOSE: Missing data are a major problem in the analysis of data from randomised trials affecting power and potentially producing biased treatment effects. Specifically focussing on quality of life outcomes, we aimed to report the amount of missing data, whether imputation was used and what methods and was the missing mechanism discussed from four leading medical journals and compare the picture to our previous review nearly a decade ago. METHODS: A random selection (50 %) of all RCTS published during 2013-2014 in BMJ, JAMA, Lancet and NEJM was obtained...
December 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27642926/br-04-1management-of-treatment-resistant-hypertension
#16
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642883/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#17
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27637413/reporting-on-data-monitoring-committees-in-neonatal-randomised-controlled-trials-is-inconsistent
#18
L M Perrem, S Gosling, I Ravikumar, A S Khashan, J Miletin, C A Ryan, E Dempsey
AIM: To evaluate the reported use of data monitoring committees (DMCs), the frequency of interim analysis, prespecified stopping rules and early trial termination in neonatal randomised controlled trials (RCTs). METHODS: We reviewed neonatal RCTs published in four high-impact general medical journals, specifically looking at safety issues including documented involvement of a DMC, stated interim analysis, stopping rules and early trial termination. We searched all journal issues over an 11-year period (2003-2013) and recorded predefined parameters on each item for RCTs meeting inclusion criteria...
January 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27608485/conflict-of-interest-and-bias-in-publication
#19
Ruth Macklin
In his excellent article about commercial conflict of interest, Mark Wilson quotes Dennis Thompson, a political scientist who provided a searching analysis of the concept of conflict of interest (Col). Using Thompson's analysis, Wilson writes: "Determining whether factors such as ambition, the pursuit of fame and financial gain had biased a judgment was challenging. Motives are not always clear to either the conflicted party or to an outside observer." In this commentary, I aim to broaden the discussion beyond the narrowly commercial aspects of Col...
October 2016: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/27604162/journal-bias-or-author-bias
#20
Ian Harris
I read with interest the comment by Mark Wilson in the Indian Journal of Medical Ethics regarding bias and conflicts of interest in medical journals. Wilson targets one journal (the New England Journal of Medicine: NEJM) and one particular "scandal" to make his point that journals' decisions on publication are biased by commercial conflicts of interest (CoIs). It is interesting that he chooses the NEJM which, by his own admission, had one of the strictest CoI policies and had published widely on this topic...
October 2016: Indian Journal of Medical Ethics
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