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Cost cardiovascular disease utilization

Ibhar Al Mheid, Heval Mohamed Kelli, Yi-An Ko, Muhammad Hammadah, Hina Ahmed, Salim Hayek, Viola Vaccarino, Thomas R Ziegler, Greg Gibson, Michelle Lampl, R Wayne Alexander, Ken Brigham, Greg S Martin, Arshed A Quyyumi
BACKGROUND: Lifestyle modifications are first-line measures for cardiovascular disease prevention. Whether lifestyle intervention also preserves cardiovascular health is less clear. Our study examined the role of a Health Partner-administered lifestyle intervention on metrics of ideal cardiovascular health. METHODS AND RESULTS: A total of 711 university employees (48±11 years; 66% women, 72% Caucasian/22.5% African Americans) enrolled in a program that promoted healthier lifestyles at Emory University (Atlanta, GA)...
October 11, 2016: Journal of the American Heart Association
Ella Zomer, Rachel Leach, Christine Trimmer, Tim Lobstein, Stephen Morris, William Philip James, Nick Finer
BACKGROUND: Overweight/obesity is associated with significant morbidity, mortality and costs. Weight loss has been shown to reverse some of these effects, reducing the risk of chronic diseases such as cardiovascular disease (CVD). We aimed to determine potential monies available, from an English National Health Service perspective, for weight loss interventions to be cost-effective in the prevention of CVD. METHODS: A Markov model was developed, populated with overweight/obese individuals from the Health Survey for England aged 30-74 years, free of pre-existing CVD, and with available risk factor information to calculate CVD risk...
September 20, 2016: Diabetes, Obesity & Metabolism
Giovanni Veronesi, Simona Giampaoli, Francesco Gianfagna, Luigi Palmieri, Diego Vanuzzo, Guido Grassi, Giancarlo Cesana, Marco M Ferrario
OBJECTIVE: To evaluate the clinical utility of the CAMUNI-MATISS 20-year risk score, recently validated for the Italian population, as additional screening tool for individuals at "low" (ESC-SCORE Project predicted 10-year risk ≤ 1%; no preventive action), "intermediate" (ESC-SCORE 1-4%; lifestyle modification/statin treatment) and "high" risk (ESC-SCORE≥ 4% or diabetes; statin treatment) according to the Italian regulation. DESIGN AND METHOD: 40-65 years old initially CVD-free participants to 7 population-based cohorts enrolled in Northern and Central Italy between 1986 and 1996 were followed-up (median 16 years, IQR: 12-20) to the first occurrence of coronary event or ischemic stroke (fatal or non-fatal), coronary or carotid revascularizations...
September 2016: Journal of Hypertension
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Hyeon Chang Kim
Disease risk prediction models have been developed to assess the impact of multiple risk factors and to estimate an individual's absolute disease risk. Accurate disease prediction is essential for personalized prevention, because the benefits, risks, and costs of alternative strategies must be weighed to choose the best preventive strategy for individual patients. Cardiovascular disease (CVD) prediction is the earliest example of individual risk predictions. Since the Framingham study reported a CVD risk prediction method in 1976, an increasing number of risk assessment tools have been developed to CVD risk in various settings...
September 2016: Journal of Hypertension
Javier Valero-Elizondo, Joseph A Salami, Chukwuemeka U Osondu, Oluseye Ogunmoroti, Alejandro Arrieta, Erica S Spatz, Adnan Younus, Jamal S Rana, Salim S Virani, Ron Blankstein, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: Physical activity (PA) has an established favorable impact on cardiovascular disease (CVD) outcomes and quality of life. In this study, we aimed to estimate the economic effect of moderate-vigorous PA on medical expenditures and utilization from a nationally representative cohort with and without CVD. METHODS AND RESULTS: The 2012 Medical Expenditure Panel Survey data were analyzed. Our study population was limited to noninstitutionalized US adults ≥18 years of age...
2016: Journal of the American Heart Association
Jonathan D Davis, Margaret A Olsen, Kerry Bommarito, Shane J LaRue, Mohammed Saeed, Michael W Rich, Justin M Vader
BACKGROUND: Thirty-day readmission following heart failure hospitalization impacts hospital performance measures and reimbursement. We investigated readmission characteristics and the magnitude of 30-day hospital readmissions after hospital discharge for heart failure using the Healthcare Cost and Utilization Project State Inpatient Databases (SID). METHODS: Adults aged ≥ 40 years hospitalized with a primary discharge diagnosis of heart failure from 2007-2011 were identified in the California, New York, and Florida SIDs...
August 31, 2016: American Journal of Medicine
Mark R Burge, R Philip Eaton, David S Schade
The coronary artery calcium (CAC) scan has recently emerged as a reproducible noninvasive test to detect asymptomatic atherosclerotic coronary artery disease. It has several advantages over the traditional cardiac stress testing modalities, including lower cost, greater sensitivity for nonobstructing coronary artery lesions, and excellent prognostic value when combined with the Framingham risk parameters. Its chief disadvantage is that it does not identify obstructing coronary artery lesions or noncalcified coronary artery plaque...
September 2016: Diabetes Technology & Therapeutics
Padraig Dixon, Sandra Hollinghurst, Louisa Edwards, Clare Thomas, Daisy Gaunt, Alexis Foster, Shirley Large, Alan A Montgomery, Chris Salisbury
OBJECTIVES: To investigate the cost-effectiveness of a telehealth intervention for primary care patients with raised cardiovascular disease (CVD) risk. DESIGN: A prospective within-trial patient-level economic evaluation conducted alongside a randomised controlled trial. SETTING: Patients recruited through primary care, and intervention delivered via telehealth service. PARTICIPANTS: Adults with a 10-year CVD risk ≥20%, as measured by the QRISK2 algorithm, with at least 1 modifiable risk factor...
2016: BMJ Open
Sarah S Casagrande, Andy Menke, Catherine C Cowie
BACKGROUND: The health of younger adults in the U.S. has important public health and economic-related implications. However, previous literature is insufficient to fully understand how the health of this group has changed over time. This study examined generational differences in cardiovascular risk factors of younger adults over the past 40 years. METHODS: Data were from 6 nationally representative cross-sectional National Health and Nutrition Examination Surveys (1971-2012; N = 44,670)...
2016: PloS One
R Brett McQueen, Vahram Ghushchyan, Temitope Olufade, John J Sheehan, Kavita V Nair, Joseph J Saseen
OBJECTIVE: Estimate the economic burden associated with incremental increases in the number of cardiometabolic risk factors (CMRFs) in the US. METHODS: We used the nationally representative Medical Expenditure Panel Survey from 2010 to 2012 to create a retrospective cohort of people based on the number of CMRFs (one, two, and three or four), and a comparison cohort of people with zero CMRFs. CMRFs included abdominal obesity, elevated blood pressure, elevated triglycerides, and elevated glucose and were defined using diagnostic codes, prescribed medications, and survey responses...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Nancy Helou, Andrew Dwyer, Maya Shaha, Anne Zanchi
BACKGROUND: The increasing prevalence of diabetes poses significant challenges to healthcare systems around the world. Diabetes is the leading cause of end-stage renal disease. Diabetic kidney disease (DKD) is becoming a global health concern because it is a progressive disease associated with major health complications and increased health costs. The treatment goals for DKD are to slow the progression of the renal disease and prevent cardiovascular events. Accordingly, patients are expected to adhere to prescribed treatments and manage a wide range of daily self-care activities...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
Fanni Rencz, László Gulácsi, Michael Drummond, Dominik Golicki, Valentina Prevolnik Rupel, Judit Simon, Elly A Stolk, Valentin Brodszky, Petra Baji, Jakub Závada, Guenka Petrova, Alexandru Rotar, Márta Péntek
OBJECTIVE: Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. METHODS: An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets...
November 2016: Quality of Life Research
Sucheta Gosavi, Aparna Bhagavat
: Cardiovascular disease remains a significant cause of mortality and morbidity despite relentless ongoing research all over the world. The different cardiovascular societies and research organizations are in a constant effort to improve overall cardiovascular (CV) outcome by conducting trials and establishment of guidelines. The ever growing health care costs have enforced governmental agencies to develop quality performance measures which are addressed towards increasing quality, safety, efficiency of patient care and to curtail the cost of health care...
July 22, 2016: Current Vascular Pharmacology
Sushil K Sharma
Recent advances in the self-shielded cyclotrons, improved targets, video-monitored hot cells design, and automated PET radiopharmaceutical (RPs) synthesis modules, utilizing computer-controlled graphic user interphase (GUI) has revolutionized PET molecular imaging technology for basic biomedical research and theranostics to accomplish the ultimate goal of evidence-based personalized medicine. Particularly, [18F]HX4: (3-[18F]fluoro-2-(4-((2-nitro-1Himidazol-1-yl)methyl)-1H-1,2,3,-triazol-1-yl)-propan-1-ol), 18F-FAZA: 1-(5-[18F]Fluoro-5-deoxy-α-D-arabinofuranosyl)-2-nitroimidazole, and 18F-FMSIO: 18F-Ffluoromisonidazole to assess tumor hypoxia, [18F]FB-VAD-FMK: [18F]4-fluorobenzylcarbonyl-Val-Ala-Asp(OMe)-fluoromethylketone to determine in vivo apoptosis, 64Cu-PTSM: 64Cu-Pyrualdehyde Bis-N-Methylthiosemicarbazone for brain and myocardial perfusion imaging, and 68Ga-DOTATOC: 68Ga-DOTAD-Phy1-Tyr3-octreotide and 68Ga-DOTANOC: 68Ga-(1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid)-1-NaI3-octreotide for neuroendocrine and neural crest tumors have demonstrated great promise in personalized theranostics...
July 19, 2016: Current Drug Targets
Jeffrey M C Lau, Jie Zheng
The hybrid positron emission tomography/magnetic resonance (PET/MR) is a new imaging tool that has garnered immense research interest for its potentials to assist clinical investigations. PET/MR combines the quantitative measurement of PET with dynamic functional and anatomic assessment of MR and can deliver a robust clinical examination. Currently, simultaneous cardiovascular PET/MR imaging remains in the pre-clinical research stage, and most institutions have not adopted a clinical PET/MR clinical imaging service...
June 2016: Quantitative Imaging in Medicine and Surgery
Tomi Akinyemiju, Qingrui Meng, Neomi Vin-Raviv
IMPORTANCE: Over one-third of American adults (36%) are obese and more than two-thirds (69%) are overweight. The impact of obesity on hospitalization outcomes is not well understood. OBJECTIVE: To examine the association between body mass index (BMI) and overall, cancer, chronic obstructive pulmonary disease (COPD), asthma, and cardiovascular disease (CVD)-specific in-hospital mortality; postsurgical complications; and hospital length of stay (LOS). DESIGN: Cross-sectional study...
July 2016: Medicine (Baltimore)
Michael P McRae, Glennon Simmons, Jorge Wong, John T McDevitt
The combination of point-of-care (POC) medical microdevices and machine learning has the potential transform the practice of medicine. In this area, scalable lab-on-a-chip (LOC) devices have many advantages over standard laboratory methods, including faster analysis, reduced cost, lower power consumption, and higher levels of integration and automation. Despite significant advances in LOC technologies over the years, several remaining obstacles are preventing clinical implementation and market penetration of these novel medical microdevices...
July 19, 2016: Accounts of Chemical Research
Ranjit Manchanda, Rosa Legood, Antonis C Antoniou, Vladimir S Gordeev, Usha Menon
BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. OBJECTIVE: To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. METHODS: The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model...
September 2016: Journal of Medical Genetics
Sephy Philip, Sumita Chowdhury, John R Nelson, P Benjamin Everett, Carolyn K Hulme-Lowe, Jordana K Schmier
OBJECTIVE: Given the substantial economic and health burden of cardiovascular disease and the residual cardiovascular risk that remains despite statin therapy, adjunctive therapies are needed. The purpose of this model was to estimate the cost-effectiveness of high-purity prescription eicosapentaenoic acid (EPA) omega-3 fatty acid intervention in secondary prevention of cardiovascular diseases in statin-treated patient populations extrapolated to the US. METHODS: The deterministic model utilized inputs for cardiovascular events, costs, and utilities from published sources...
October 2016: Journal of Medical Economics
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