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https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#1
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530038/hiv-treatment-and-care-services-for-adolescents-a-situational-analysis-of-218-facilities-in-23-sub-saharan-african-countries
#2
Daniella Mark, Alice Armstrong, Catarina Andrade, Martina Penazzato, Luann Hatane, Lina Taing, Toby Runciman, Jane Ferguson
INTRODUCTION: In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28526087/a-multimodal-day-treatment-program-for-multi-problem-young-adults-study-protocol-for-a-randomized-controlled-trial
#3
Marie-Jolette A Luijks, Floor Bevaart, Josjan Zijlmans, Laura van Duin, Reshmi Marhe, Theo A H Doreleijers, Henning Tiemeier, Jessica J Asscher, Arne Popma
BACKGROUND: Effective interventions for young adults with severe, multiple problems - such as psychosocial and psychiatric problems, delinquency, unemployment and substance use - are scarce but urgently needed in order to support an adequate transition to adulthood. A multimodal day treatment program called "New Opportunities" (in Dutch: "De Nieuwe Kans"; DNK) was specifically developed to target multi-problem young adults in The Netherlands. The aim of this study protocol is to describe the design of a randomized controlled trial (RCT) in clinical practice to examine the effectiveness of DNK in comparison with care as usual (CAU)...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#4
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28521207/strategies-to-support-transitions-from-hospital-to-home-for-children-with-medical-complexity-a-scoping-review
#5
REVIEW
Sydney Breneol, Julia Belliveau, Christine Cassidy, Janet A Curran
BACKGROUND: Children with medical complexity constitute a small but resource-intensive subgroup of children with special health care needs. Their medical fragility and resource-intensive needs put them at greater risk for inadequate transitions from hospital to home-based care, and subsequent adverse outcomes and hospital re-admissions. OBJECTIVE: This scoping literature review was conducted to map empirically researched interventions, frameworks, programs or models that could inform or support the transition from hospital to home for children with medical complexity...
May 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28517943/implications-of-parent-child-relationships-for-emerging-adults-subjective-feelings-about-adulthood
#6
Anna K Lindell, Nicole Campione-Barr, Sarah E Killoren
Little is known about the role of parents in promoting their children's successful transition to adulthood, particularly for college students who may maintain stronger ties to parents than other emerging adults. The present study therefore investigated longitudinal implications of parent-child relationship qualities during emerging adults' first year of college for their feelings about the upcoming transition to adulthood 3 years later, as well as implications of 3 types of parental control (behavioral control, psychological control, helicopter parenting) for these associations...
May 18, 2017: Journal of Family Psychology: JFP
https://www.readbyqxmd.com/read/28515812/cost-effectiveness-of-mirabegron-compared-to-tolterodine-er-4-mg-for-overactive-bladder-in-canada
#7
Sender Herschorn, Jameel Nazir, Barbara Ramos, Zalmai Hakimi
INTRODUCTION: This analysis compared the cost-effectiveness of once-daily regimens of mirabegron 50 mg and generic tolterodine ER 4 mg in a hypothetical cohort of previously treated patients with overactive bladder (OAB) in Canada. METHODS: A Markov model was developed to represent different health states according to OAB symptoms (frequency, incontinence), presence/absence of adverse events (AEs; dry mouth, constipation, blurred vision), and treatment status (on-treatment, discontinue treatment, restart previous treatment)...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28508877/an-overview-of-female-to-male-gender-confirming-surgery
#8
REVIEW
Shane D Morrison, Mang L Chen, Curtis N Crane
Gender dysphoria is estimated to occur in approximately 25 million people worldwide, and can have severe psychosocial sequelae. Medical and surgical gender transition can substantially improve quality-of-life outcomes for individuals with gender dysphoria. Individuals seeking to undergo female-to-male (FtM) transition have various surgical options available for gender confirmation, including facial and chest masculinization, body contouring, and genital surgery. The World Professional Association for Transgender Health guidelines should be met before the patient undergoes surgery, to ensure that gender-confirming surgery is appropriate and indicated...
May 16, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28505039/patient-reported-outcome-measures-in-urology
#9
Gopal L Narang, Stephanie C Pannell, Aaron A Laviana, Kathy H Y Huen, Jason Izard, Angela B Smith, Jonathan Bergman
PURPOSE OF REVIEW: Many urologic treatments have similar clinical outcomes, necessitating alternative methods to discriminate between options. Patient-reported outcome measures (PROMs) have become the new standard for evaluating the patient experience, and their use has drastically increased over the past decade. The purpose of this review is to discuss the status of PROMs in urology, highlight commonly used tools and address their future direction. RECENT FINDINGS: An increasing number of urology-specific PROMs tools have been developed and validated...
May 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28502246/time-in-assertive-community-treatment-a-statewide-quality-improvement-initiative-to-reduce-length-of-participation
#10
Steven Huz, Helle Thorning, Candace N White, Lin Fang, Bikki Tran Smith, Marleen Radigan, Lisa B Dixon
The investigators describe a New York State initiative to increase flow through assertive community treatment (ACT) while encouraging transition to less intensive services. This initiative began as ACT approached full capacity and as evidence emerged that participants can sustain recovery post-ACT. Comparison of performance indicators over time showed that time in ACT decreased, turnover rate increased, and the percentage of ACT participants who met treatment objectives rose. Also, post-ACT rates of ambulatory behavioral health follow-up increased while rates of psychiatric inpatient hospitalization decreased...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28495818/application-of-minimal-important-differences-in-degenerative-knee-disease-outcomes-a-systematic-review-and-case-study-to-inform-bmj-rapid-recommendations
#11
Tahira Devji, Gordon H Guyatt, Lyubov Lytvyn, Romina Brignardello-Petersen, Farid Foroutan, Behnam Sadeghirad, Rachelle Buchbinder, Rudolf W Poolman, Ian A Harris, Alonso Carrasco-Labra, Reed A C Siemieniuk, Per O Vandvik
OBJECTIVES: To identify the most credible anchor-based minimal important differences (MIDs) for patient important outcomes in patients with degenerative knee disease, and to inform BMJ Rapid Recommendations for arthroscopic surgery versus conservative management DESIGN: Systematic review. OUTCOME MEASURES: Estimates of anchor-based MIDs, and their credibility, for knee symptoms and health-related quality of life (HRQoL). DATA SOURCES: MEDLINE, EMBASE and PsycINFO...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28493847/cost-utility-of-stereotactic-radiation-therapy-versus-proton-beam-therapy-for-inoperable-advanced-hepatocellular-carcinoma
#12
Henry W C Leung, Agnes L F Chan
The cost-utility of proton beam therapy was compared to stereotactic body radiation therapy for inoperable advanced hepatocellular carcinoma. A Markov decision-analytic model was performed following time to progression and survival using phase II trial data. Patients transitioned between three health states. Clinical outcomes were estimated for quality of life using utility estimates in the published literature and measured as incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMBs). Real direct medical costs were extracted from the Bureau of National Health Insurance database...
April 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#13
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28467104/the-effectiveness-of-standardized-handoff-tool-interventions-during-inter-and-intra-facility-care-transitions-on-patient-related-outcomes-a-systematic-review
#14
Jennifer L Rosenthal, Robert Doiron, Sarah C Haynes, Brock Daniels, Su-Ting T Li
Improving physician handoffs is a patient safety priority. The authors hypothesize that standardized handoff interventions during care transitions improve patient-related outcome measures. PubMed, Cochrane, PsycINFO, CINAHL, Embase, and Web of Science were searched for publications from 2000 to May 2016. Eligible studies compared standardized handoff intervention(s) with no standardized handoff intervention and measured patient-related outcomes. Studies were evaluated independently for eligibility for inclusion by at least 2 authors in a 2-stage process; 14 articles met inclusion criteria...
May 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28463921/the-cost-effectiveness-of-dual-mobility-implants-for-primary-total-hip-arthroplasty-a-computer-based-cost-utility-model
#15
Brian T Barlow, Alexander S McLawhorn, Geoffrey H Westrich
BACKGROUND: Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. METHODS: Markov model analysis was conducted from the societal perspective with use of direct and indirect costs...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28463547/economic-decision-model-for-first-time-traumatic-patellar-dislocations-in-adolescents
#16
Benedict U Nwachukwu, Conan So, William W Schairer, Beth E Shubin-Stein, Sabrina M Strickland, Daniel W Green, Emily R Dodwell
BACKGROUND: The surgical management of traumatic patellar dislocations in adolescents is associated with a lower rate of recurrent dislocations compared with nonoperative care. However, the attendant cost of surgery and the quality-of-life benefit of a surgical treatment strategy are unclear. PURPOSE: To compare the cost-utility of 3 management strategies for acute first-time patellar dislocations in adolescents: (1) nonoperative treatment only, (2) initial nonoperative treatment with surgery only for recurrent dislocations, and (3) immediate surgery...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28459058/comorbidity-pain-utilization-and-psychosocial-outcomes-in-older-versus-younger-sickle-cell-adults-the-pisces-project
#17
Donna K McClish, Wally R Smith, James L Levenson, Imoigele P Aisiku, John D Roberts, Susan D Roseff, Viktor E Bovbjerg
Background. Patients with SCD now usually live well into adulthood. Whereas transitions into adulthood are now often studied, little is published about aging beyond the transition period. We therefore studied age-associated SCD differences in utilization, pain, and psychosocial variables. Methods. Subjects were 232 adults in the Pain in Sickle Cell Epidemiology Study (PiSCES). Data included demographics, comorbidity, and psychosocial measures. SCD-related pain and health care utilization were recorded in diaries...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28457614/corneal-collagen-cross-linking-in-the-management-of-keratoconus-in-canada-a-cost-effectiveness-analysis
#18
Victoria C Leung, Petros Pechlivanoglou, Hall F Chew, Wendy Hatch
PURPOSE: To use patient-level microsimulation models to evaluate the comparative cost-effectiveness of early corneal cross-linking (CXL) and conventional management with penetrating keratoplasty (PKP) when indicated in managing keratoconus in Canada. DESIGN: Cost-utility analysis using individual-based, state-transition microsimulation models. PARTICIPANTS: Simulated cohorts of 100 000 individuals with keratoconus who entered each treatment arm at 25 years of age...
April 27, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28445474/cost-effectiveness-of-a-transitional-pharmaceutical-care-program-for-patients-discharged-from-the-hospital
#19
Fatma Karapinar-Çarkıt, Ronald van der Knaap, Fatiha Bouhannouch, Sander D Borgsteede, Marjo J A Janssen, Carl E H Siegert, Toine C G Egberts, Patricia M L A van den Bemt, Marieke F van Wier, Judith E Bosmans
BACKGROUND: To improve continuity of care at hospital admission and discharge and to decrease medication errors pharmaceutical care programs are developed. This study aims to determine the cost-effectiveness of the COACH program in comparison with usual care from a societal perspective. METHODS: A controlled clinical trial was performed at the Internal Medicine department of a general teaching hospital. All admitted patients using at least one prescription drug were included...
2017: PloS One
https://www.readbyqxmd.com/read/28443686/combined-clinician-parent-delivery-of-rapid-syllable-transition-rest-treatment-for-childhood-apraxia-of-speech
#20
Donna C Thomas, Patricia McCabe, Kirrie J Ballard
PURPOSE: Although speech-language pathologists use parent-delivered home-practice, little is known about the quality of this practice and its relation to treatment efficacy. This study reports both treatment outcomes and fidelity following combined clinician-parent delivery of Rapid Syllable Transition (ReST) treatment. METHOD: Five children aged 5:1-11:7 with childhood apraxia of speech received 12 treatment sessions; six clinic-based and six at home, using multiple baselines across participants design...
April 26, 2017: International Journal of Speech-language Pathology
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