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https://www.readbyqxmd.com/read/28350948/bending-the-cost-curve-establishing-value-in-spine-surgery
#1
Scott L Parker, Silky Chotai, Clinton J Devin, Lindsay Tetreault, Thomas E Mroz, Darrel S Brodke, Michael G Fehlings, Matthew J McGirt
BACKGROUND: As publically promoted by all stakeholders in health care reform, prospective outcomes registry platforms lie at the center of all current evidence-driven value-based models. OBJECTIVE: To demonstrate the variability in outcomes and cost at population level and individual patient level for patients undergoing spine surgery for degenerative diseases. METHODS: Retrospective analysis of prospective longitudinal spine registry data was conducted...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28345481/cost-effectiveness-analysis-of-implementing-an-antimicrobial-stewardship-programme-in-critical-care-units
#2
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Catellanos, Paula Ramirez
AIMS: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) programme implementation focused on critical care units based on assumptions for the Spanish setting. MATERIAL AND METHODS: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed...
March 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28345434/effect-of-diabetes-treatment-related-attributes-on-costs-to-type-2-diabetes-patients-in-a-real-world-population
#3
Jie Meng, Roman Casciano, Yi-Chien Lee, Lee Stern, Dmitry Gultyaev, Liyue Tong, Brice Kitio-Dschassi
BACKGROUND: Type 2 diabetes mellitus (T2DM) results in a substantial economic burden on patients, health care systems, and society. Most literature assessing the cost of T2DM focuses on the long-term complications of the disease, the association between glucose control and cost, and patient characteristics resulting in poor and costly outcomes. However, it is likely that attributes specific to diabetes therapy can affect the use of costly resources. OBJECTIVE: To estimate the effect of diabetes treatment-related attributes, such as improved efficacy, adherence, and reduced risk for hypoglycemia, on costs to T2DM patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28343045/cervical-disc-arthroplasty-do-conflicts-of-interest-influence-the-outcome-of-clinical-studies
#4
REVIEW
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Kern Singh
BACKGROUND CONTEXT: Cervical disc arthroplasty (CDA) is an emerging technique for the treatment of cervical degenerative disease. Multiple studies have investigated the outcomes of CDA, particularly in comparison to cervical arthrodesis techniques such as anterior cervical discectomy and fusion (ACDF). As many entities have financial interests in CDA implants, it is imperative to consider the influence of conflicts of interest on the results of studies investigating the efficacy of CDA...
March 22, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28340317/opportunities-for-crash-and-injury-reduction-a-multi-harm-approach-for-crash-data-analysis
#5
Ann Mallory, Allison Kender, Kevin Moorhouse
OBJECTIVE: A multi-harm approach for analyzing crash and injury data was developed for the ultimate purpose of getting a richer picture of motor vehicle crash outcomes identifying research opportunities in crash safety. METHODS: Methods were illustrated using a retrospective analysis of 69,597 occupant cases from NASS CDS (National Automotive Sampling System Crashworthiness Data System) from 2005 to 2015. Occupant cases were analyzed by frequency and severity of outcome: fatality, injury by AIS (Abbreviated Injury Scale), number of cases, attributable fatality, disability, and injury costs...
March 24, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28338036/to-cord-or-not-to-cord-that-is-still-a-question
#6
Analia Veitz-Keenan, James R Keenan
Data sourcesA broad computerised search with similar key terms was performed in different databases that included: Ovid Medline, Thomson's ISI Web of Science, PubMed, Science Direct, EMBASE and the Cochrane Library. Grey literature, dissertations, abstracts and theses were searched too. Reference lists of the selected articles were hand-searched.Study selectionThe inclusion criteria included in vivo randomised clinical trials and quasi-randomised clinical trials using gingival retraction techniques with and without cord...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28334460/social-costs-of-illegal-drugs-alcohol-and-tobacco-in-the-european-union-a-systematic-review
#7
REVIEW
Pablo Barrio, Jillian Reynolds, Anna García-Altés, Antoni Gual, Peter Anderson
ISSUES: Drug use accounts for one of the main disease groups in Europe, with relevant consequences to society. There is an increasing need to evaluate the economic consequences of drug use in order to develop appropriate policies. Here, we review the social costs of illegal drugs, alcohol and tobacco in the European Union. APPROACH: A systematic search of relevant databases was conducted. Grey literature and previous systematic reviews were also searched. Studies reporting on social costs of illegal drugs, alcohol and tobacco were included...
March 23, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28325241/radiation-oncology-in-the-developing-economies-of-central-and-eastern-europe
#8
REVIEW
Natia Esiashvili
Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28324781/genesis-and-properties-of-wetland-soils-by-vis-nir-swir-as-a-technique-for-environmental-monitoring
#9
José Alexandre Melo Demattê, Ingrid Horák-Terra, Raphael Moreira Beirigo, Fabrício da Silva Terra, Karina Patrícia Prazeres Marques, Caio Troula Fongaro, Alexandre Christófaro Silva, Pablo Vidal-Torrado
Wetlands are important ecosystems characterized by redoximorphic environments producing typical soil forming processes and organic carbon accumulation. Assessments and management of these areas are dependent on knowledge about soil characteristics and variability. By reflectance spectroscopy, information about soils can be obtained since their spectral behaviors are directly related to their chemical, physical, and mineralogical properties reflecting the pedogenetic processes and environment conditions. Our aims were: (a) to characterize the main soil classes of wetlands regarding their spectral behaviors in VIS-NIR-SWIR (350-2500 nm) and relate them to pedogenesis and environmental conditions, (b) to determine spectral ranges (bands) with greater expression of the main soil properties, (c) to identify spectral variations and similarities between hydromorphic soils from wetlands and other soils under different moisture conditions, and (d) to propose spectral models to quantify some chemical and physical soil properties used as environmental quality indicators...
March 18, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28324616/optimization-of-diazinon-biodegradation-from-aqueous-solutions-by-saccharomyces-cerevisiae-using-response-surface-methodology
#10
Mohammad H Ehrampoush, Abbas Sadeghi, Mohammad T Ghaneian, Ziaeddin Bonyadi
Diazinon is an organophosphate compound that inhibits the activity of acetylcholinesterase. Standards of the World Health Organization and Environmental Protection Agency for diazinon concentration in water are 0.1 and 9 × 10(-6) mg/L, respectively. The aim of this study was the optimization of diazinon biodegradation from aqueous solutions by Saccharomyces cerevisiae using the response surface methodology (RSM). Harvested cells of S. cerevisiae were locally purchased from the Iranian Research Organization for Science and Technology...
December 2017: AMB Express
https://www.readbyqxmd.com/read/28320542/evaluation-of-fixed-and-variable-hospital-costs-due-to-clostridium-difficile-infection-institutional-incentives-and-directions-for-future-research
#11
P Ryan, M Skally, F Duffy, M Farrelly, L Gaughan, P Flood, E McFadden, F Fitzpatrick
BACKGROUND: Economic analysis of Clostridium difficile infection (CDI) should consider the incentives facing institutional decision-makers. To avoid overstating the financial benefits of infection prevention, fixed and variable costs should be distinguished. AIM: To quantify CDI fixed and variable costs in a tertiary referral hospital during August 2015. METHODS: A micro-costing analysis estimated CDI costs per patient, including the additional costs of a CDI outbreak...
February 2, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28317802/port-site-infections-by-nontuberculous-mycobacterium-a-retrospective-clinico-microbiological-study
#12
Roumi Ghosh, Soumen Das, Asmita De, Harish Kela, Makhan Lal Saha, Prasanta Kumar Maiti
BACKGROUND: Port-site infection (PSI) is a prevailing, chronic, nagging, treatment refractory complication of laparoscopic surgery (LS). It neutralizes the advantages of minimally invasive surgery and increases morbidity, treatment cost of patient, leading to loss of confidence on operating surgeon. PSIs are preventable with appropriate preoperative, intraoperative, and postoperative measures. Atypical mycobacterium is most commonly associated with nonhealing postlaparoscopic wound infections, causing outbreaks or sporadic cases worldwide...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28298221/post-operative-opioid-pain-management-patterns-for-patients-who-receive-hip-surgery
#13
Chad E Cook, Daniel I Rhon, Brian D Lewis, Steven Z George
BACKGROUND: Identifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-operative non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has any study investigated the influence of opioid prescription patterns on health care costs and utilization. We aimed to investigate a subgrouping scheme associated with post-operative opioid prescription strategies and measure the subgroups' direct and indirect health care utilization and costs in individuals undergoing non-arthroplasty orthopedic hip surgery...
March 16, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28296280/prevention-of-renal-failure-in-chinese-patients-with-newly-diagnosed-type-2-diabetes-a-cost-effectiveness-analysis
#14
REVIEW
Bin Wu, Suhua Zhang, Houwen Lin, Shan Mou
AIMS: Diabetic kidney disease (DKD) is the second leading cause (16.4%) of end-stage renal disease (ESRD) in China. The current study is to assess the cost effectiveness of preventing DKD in patients with newly diagnosed type 2 diabetes (T2DM) from the Chinese health care perspective. METHODS: A lifetime Markov decision model was developed according to the disease course of DKD. Patients with newly diagnosed T2DM might receive treatment according to one of the following three strategies: "do nothing" strategy (control strategy), treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) (universal strategy), or screening for microalbuminuria followed by ACEI/ARB treatment (screening strategy)...
March 10, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#15
Christina H Shin, Dustin R Long, Duncan McLean, Stephanie D Grabitz, Karim Ladha, Fanny P Timm, Tharusan Thevathasan, Alberto Pieretti, Cristina Ferrone, Andreas Hoeft, Thomas W L Scheeren, Boyd Taylor Thompson, Tobias Kurth, Matthias Eikermann
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols driven by such measures are limited in their ability to define the optimal fluid state during surgery. METHODS: This analysis of data on file included 92,094 adult patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014 at an academic tertiary care hospital and two affiliated community hospitals...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28275074/same-day-diagnostic-and-surveillance-data-for-tuberculosis-via-whole-genome-sequencing-of-direct-respiratory-samples
#16
Antonina A Votintseva, Phelim Bradley, Louise Pankhurst, Carlos Del Ojo Elias, Matthew Loose, Kayzad Nilgiriwala, Anirvan Chatterjee, E Grace Smith, Nicolas Sanderson, Timothy M Walker, Marcus R Morgan, David H Wyllie, A Sarah Walker, Tim E A Peto, Derrick W Crook, Zamin Iqbal
Routine full characterization of Mycobacterium tuberculosis (TB) is culture-based, taking many weeks. Whole-genome sequencing (WGS) can generate antibiotic susceptibility profiles to inform treatment, augmented with strain information for global surveillance; such data could be transformative if provided at or near point of care.We demonstrate a low-cost DNA extraction method for TB WGS direct from patient samples. We initially evaluated the method using the Illumina MiSeq sequencer (40 smear-positive respiratory samples, obtained after routine clinical testing, and 27 matched liquid cultures)...
March 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28269447/using-bioimpedance-spectroscopy-parameters-as-real-time-feedback-during-tdcs
#17
Isar Nejadgholi, Herschel Caytak, Miodrag Bolic
An exploratory analysis is carried out to investigate the feasibility of using BioImpedance Spectroscopy (BIS) parameters, measured on scalp, as real-time feedback during Transcranial Direct Current Stimulation (tDCS). TDCS is shown to be a potential treatment for neurological disorders. However, this technique is not considered as a reliable clinical treatment, due to the lack of a measurable indicator of treatment efficacy. Although the voltage that is applied on the head is very simple to measure during a tDCS session, changes of voltage are difficult to interpret in terms of variables that affect clinical outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28266146/variable-competitive-effects-of-fungicide-resistance-in-field-experiments-with-a-plant-pathogenic-fungus
#18
Christina H Hagerty, Ryan C Graebner, Kathryn E Sackett, Christopher C Mundt
Classic evolutionary theory suggests that mutations associated with antimicrobial and pesticide resistance result in a fitness cost in the absence of the selective antimicrobial agent or pesticide. There is experimental evidence to support fitness costs associated with resistance to anti-microbial compounds and pesticides across many biological disciplines, including human pathology, entomology, plant sciences, and plant pathology. However, researchers have also found examples of neutral and increased fitness associated with resistance, where the effect of a given resistance mutation depends on environmental and biological factors...
March 7, 2017: Ecological Applications: a Publication of the Ecological Society of America
https://www.readbyqxmd.com/read/28260874/copd-symptom-burden-impact-on-health-care-resource-utilization-and-work-and-activity-impairment
#19
Bo Ding, Mark Small, Gina Bergström, Ulf Holmgren
BACKGROUND: Chronic obstructive pulmonary disease (COPD) can greatly impact the quality of life by limiting patients' activities. However, data on impact of symptomatic burden on the health care resource utilization (HCRU) and employment in COPD are lacking. We examined the association between COPD Assessment Test (CAT) score and direct/indirect costs associated with HCRU and work productivity. METHODS: Data from >2,100 patients with COPD consulting for routine care were derived from respiratory disease-specific programs in Europe, the USA and China...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28257551/video-assisted-thoracoscopic-versus-open-lobectomy-costs-and-outcomes
#20
Peter M Rodgers-Fischl, Jeremiah T Martin, Sibu P Saha
OBJECTIVES: Video-assisted thoracoscopic (VATS) lobectomy is considered a promising surgical therapy for the diagnosis and treatment of non-small-cell lung carcinoma. The issue of whether VATS is superior to open thoracotomy remains controversial, however. We sought to determine whether the use of VATS lobectomy for diagnosing and treating non-small-cell lung carcinoma would improve patient outcomes at our institution. METHODS: A retrospective review of electronic and paper medical charts identified 109 consecutive operations for all patients undergoing thoracotomy or VATS lobectomy performed at the University of Kentucky Chandler Medical Center for fiscal years 2013 and 2014...
March 2017: Southern Medical Journal
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