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https://www.readbyqxmd.com/read/29767472/the-impact-of-real-world-cardiovascular-related-pharmacogenetic-testing-in-an-insured-population
#1
Jennifer Billings, Patrick N Racsa, Kristine Bordenave, Charron L Long, Jeffrey J Ellis
BACKGROUND: Pharmacogenomics is intended to help clinicians provide the right drug to the right patient at an appropriate dose. However, limited evidence of clinical utility has slowed uptake of pharmacogenomic testing (PGT). OBJECTIVE: To evaluate the impact of real-world cardiovascular (CV)-related PGT on clinical outcomes, healthcare resource utilisation (HCRU) and cost in a large, heterogeneous population. METHODS: Individuals with Medicare Advantage Prescription Drug, Medicaid, or commercial coverage between 1/1/2011 and 9/30/2015 and ≥1 atherosclerotic CV-related diagnosis were identified...
May 16, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29761372/outcomes-of-takotsubo-cardiomyopathy-in-hospitalized-cancer-patients
#2
Parijat Saurav Joy, Achuta Kumar Guddati, Iuliana Shapira
BACKGROUND: Chemotherapy-induced cardiomyopathy is a critical complication of treatment for cancer. The emotional stress of a cancer diagnosis, ongoing chemotherapy, abnormal cancer-related wasting syndrome may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCM) in cancer patients is unknown. The incidence of TCM and related outcomes in cancer patients was investigated in this study. METHODS: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCM with and without malignancy...
May 14, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29741126/cost-effectiveness-of-mechanical-thrombectomy-for-acute-ischemic-stroke-an-australian-payer-perspective
#3
Nimita Arora, Koji Makino, Dominic Tilden, Kyriakos Lobotesis, Peter Mitchell, John Gillespie
AIMS: The goal of this study was to assess the cost-effectiveness of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) from an Australian payer perspective. METHODS: We used a Markov model that employed a life-time time horizon, modelling patients from symptom onset of stroke until end of life. Clinical efficacy and safety data were taken from an individual patient level data (IPD) meta-analysis of clinical studies. The treatment effect of MT compared to usual care was measured by changes in modified Rankin Score (mRS)...
May 9, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29736894/smoking-cessation-a-comparison-of-two-model-structures
#4
Becky Pennington, Alex Filby, Lesley Owen, Matthew Taylor
BACKGROUND: Most economic evaluations of smoking cessation interventions have used cohort state-transition models. Discrete event simulations (DESs) have been proposed as a superior approach. OBJECTIVE: We developed a state-transition model and a DES using the discretely integrated condition event (DICE) framework and compared the cost-effectiveness results. We performed scenario analysis using the DES to explore the impact of alternative assumptions. METHODS: The models estimated the costs and quality-adjusted life years (QALYs) for the intervention and comparator from the perspective of the UK National Health Service and Personal Social Services over a lifetime horizon...
May 8, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#5
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29712519/systematic-review-of-health-economic-studies-in-cranial-neurosurgery
#6
Won Hyung A Ryu, Michael M H Yang, Sandeep Muram, W Bradley Jacobs, Steven Casha, Jay Riva-Cambrin
OBJECTIVE As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures. METHODS The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29687022/influenza-like-illness-as-a-trigger-for-ischemic-stroke
#7
Amelia K Boehme, Jorge Luna, Erin R Kulick, Hooman Kamel, Mitchell S V Elkind
Objective: We hypothesized that ILI is associated with risk of incident stroke, and that the risk would be highest closest in time to the event. Methods: This case-crossover analysis utilized data obtained from the California State Inpatient Database of the Healthcare Cost and Utilization Project (HCUP). The outcome of interest was ischemic stroke. Exposure was defined as a visit to the emergency department or hospitalization for influenza-like illness (ILI) 365, 180, 90, 30, or 15 days before stroke (risk period) or similar time intervals exactly 1 or 2 years before stroke (control period)...
April 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29683095/azilsartan-and-chlorthalidone-new-powerful-fixed-dose-antihypertensive-combination
#8
Vasiliki Katsi, Eleni Athanasiadi, Costas Tsioufis, Dimitris Tousoulis
Arterial hypertension is a disease that still affects a major part of the population worldwide, and leads to fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. From the CDC statistical analysis, as regarding to United States, 1 of every 3 adults has high blood pressure, and οnly about half (54%) of them have it under control. Furthermore, all that leads to a nation cost about $46 billion each year. Efforts to find new ways to regulate arterial hypertension are therefore imperative...
April 20, 2018: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29681809/tactile-star-a-novel-tactile-stimulator-and-recorder-system-for-evaluating-and-improving-tactile-perception
#9
Giulia Ballardini, Giorgio Carlini, Psiche Giannoni, Robert A Scheidt, Ilana Nisky, Maura Casadio
Many neurological diseases impair the motor and somatosensory systems. While several different technologies are used in clinical practice to assess and improve motor functions, somatosensation is evaluated subjectively with qualitative clinical scales. Treatment of somatosensory deficits has received limited attention. To bridge the gap between the assessment and training of motor vs. somatosensory abilities, we designed, developed, and tested a novel, low-cost, two-component (bimanual) mechatronic system targeting tactile somatosensation: the Tactile-STAR -a tactile stimulator and recorder...
2018: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/29667208/the-use-of-cardiac-ct-alone-to-exclude-left-atrial-thrombus-before-atrial-fibrillation-ablation-efficiency-safety-and-cost-analysis
#10
Wassim Mosleh, Ali Sheikh, Zaid Said, Mohamed A Abdel-Aal, Siri Gadde, Tanvi Shah, Michael F Wilson, Hiroko Beck, Chee Kim, Umesh C Sharma
BACKGROUND: Atrial fibrillation (AF) is a growing financial burden on the healthcare system. Cardiac computed tomographic angiography (CCTA) is needed for pulmonary vein mapping before AF ablation (AFA). CCTA has shown to be an alternative to transesophageal echocardiogram (TEE) to rule-out left atrial appendage thrombus (LAAT) pre-AFA. We aim to examine the safety, cost-effectiveness, and time-efficiency of utilizing CCTA alone to rule out LAAT before AFA. METHODS: We prospectively screened patients with paroxysmal AF undergoing cryoablation...
April 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29661237/evaluating-the-effects-of-delivering-integrated-kinesthetic-and-tactile-cues-to-individuals-with-unilateral-hemiparetic-stroke-during-overground-walking
#11
Muhammad Raheel Afzal, Sanghun Pyo, Min-Kyun Oh, Young Sook Park, Jungwon Yoon
BACKGROUND: Integration of kinesthetic and tactile cues for application to post-stroke gait rehabilitation is a novel concept which needs to be explored. The combined provision of haptic cues may result in collective improvement of gait parameters such as symmetry, balance and muscle activation patterns. Our proposed integrated cue system can offer a cost-effective and voluntary gait training experience for rehabilitation of subjects with unilateral hemiparetic stroke. METHODS: Ten post-stroke ambulatory subjects participated in a 10 m walking trial while utilizing the haptic cues (either alone or integrated application), at their preferred and increased gait speeds...
April 16, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29651791/a-discrete-event-simulation-model-to-assess-the-economic-value-of-a-hypothetical-pharmacogenomics-test-for-statin-induced-myopathy-in-patients-initiating-a-statin-in-secondary-cardiovascular-prevention
#12
Dominic Mitchell, Jason R Guertin, Anick Dubois, Marie-Pierre Dubé, Jean-Claude Tardif, Ange Christelle Iliza, Fiorella Fanton-Aita, Alexis Matteau, Jacques LeLorier
BACKGROUND: Statin (HMG-CoA reductase inhibitor) therapy is the mainstay dyslipidemia treatment and reduces the risk of a cardiovascular (CV) event (CVE) by up to 35%. However, adherence to statin therapy is poor. One reason patients discontinue statin therapy is musculoskeletal pain and the associated risk of rhabdomyolysis. Research is ongoing to develop a pharmacogenomics (PGx) test for statin-induced myopathy as an alternative to the current diagnosis method, which relies on creatine kinase levels...
April 12, 2018: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/29649884/the-pharmacologic-role-and-clinical-utility-of-pcsk9-inhibitors-for-the-treatment-of-hypercholesterolemia
#13
C Michael White
In addition to monoclonal antibodies against proprotein convertase subtilisin-kexin type 9 (PCSK9), vaccines against PCSK9 and smaller molecule inhibitors as well as RNA inhibitors of PCSK9 production have been created. The monoclonal antibodies against PCSK9 and the PCSK9 RNA inhibitors can reduce low-density lipoproteins (LDLs) by over 50%, non-high-density lipoprotein (HDL) cholesterol and triglycerides, and increasing HDL. Although effective in several homozygous familial hypercholesterolemia patient types, PCSK9 inhibitors does not work in all patient types...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29626176/preventive-antibiotics-in-stroke-study-pass-a-cost-effectiveness-study
#14
Willeke F Westendorp, Elles Zock, Jan-Dirk Vermeij, Henk Kerkhoff, Paul J Nederkoorn, Marcel G W Dijkgraaf, Diederik van de Beek
OBJECTIVE: To evaluate the cost-effectiveness of preventive ceftriaxone vs standard stroke unit care without preventive antimicrobial therapy in acute stroke patients. METHODS: In this multicenter, randomized, open-label trial with masked endpoint assessment, 2,550 patients with acute stroke were included between 2010 and 2014. Economic evaluation was performed from a societal perspective with a time horizon of 3 months. Volumes and costs of direct, indirect, medical, and nonmedical care were assessed...
April 6, 2018: Neurology
https://www.readbyqxmd.com/read/29578954/health-care-costs-and-utilization-of-dabigatran-compared-with-warfarin-for-secondary-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-a-retrospective-population-study
#15
Nai-Fang Chi, Ye Wang, Li-Nien Chien, Shu-Chen Chien, Yu Ko
BACKGROUND: It remains unclear whether the use of new oral anticoagulants, compared with warfarin, is economically beneficial in Asian countries. OBJECTIVE: The objective of this study is to compare the health care costs and utilization between dabigatran and warfarin in a real-world nonvalvular atrial fibrillation (NVAF) population. RESEARCH DESIGN: Data were obtained from the Taiwan National Health Insurance Database, and patients with an NVAF diagnosis between June 1, 2012, and May 31, 2014, were identified using the International Classification of Diseases, Ninth Revision code of 427...
March 23, 2018: Medical Care
https://www.readbyqxmd.com/read/29566843/the-importance-of-model-structure-in-the-cost-effectiveness-analysis-of-primary-care-interventions-for-the-management-of-hypertension
#16
Maria Cristina Peñaloza-Ramos, Sue Jowett, Andrew John Sutton, Richard J McManus, Pelham Barton
BACKGROUND: Management of hypertension can lead to significant reductions in blood pressure, thereby reducing the risk of cardiovascular disease. Modeling the course of cardiovascular disease is not without complications, and uncertainty surrounding the structure of a model will almost always arise once a choice of a model structure is defined. OBJECTIVES: To provide a practical illustration of the impact on the results of cost-effectiveness of changing or adapting model structures in a previously published cost-utility analysis of a primary care intervention for the management of hypertension Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups (TASMIN-SR)...
March 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29564942/cost-effectiveness-of-percutaneous-patent-foramen-ovale-closure-as-secondary-stroke-prevention
#17
David L Tirschwell, Mark Turner, David Thaler, James Choulerton, David Marks, John Carroll, Lee MacDonald, Richard W Smalling, Maria Koullick, Ning Yan Gu, Jeffrey L Saver
OBJECTIVE: Compared to medical therapy alone, percutaneous closure of patent foramen ovale (PFO) further reduces risk of recurrent ischemic strokes in carefully selected young to middle-aged patients with a recent cryptogenic ischemic stroke. The objective of this study was to evaluate the cost-effectiveness of this therapy in the context of the United Kingdom (UK) healthcare system. METHODS: A Markov cohort model consisting of 4 health states (Stable after index stroke, Post-Minor Recurrent Stroke, Post-Moderate Recurrent Stroke, and Death) was developed to simulate the economic outcomes of device-based PFO closure compared to medical therapy...
March 22, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29562884/rationale-and-design-of-a-statewide-cohort-to-examine-efficient-resource-utilization-for-patients-with-intracerebral-hemorrhage-enrich
#18
Farhaan S Vahidy, Ellie G Meyer, Arvind B Bambhroliya, Jennifer R Meeks, Charles E Begley, Tzu-Ching Wu, Jon E Tyson, Charles C Miller, Ritvij Bowry, Wamda O Ahmed, Gretchel A Gealogo, Louise D McCullough, Steven Warach, Sean I Savitz
BACKGROUND: Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for higher level of care. However, evidence of improvement in patient-centered outcomes for these patients treated at larger stroke treatment centers as compared to community hospitals is lacking. METHODS / DESIGN: "Efficient Resource Utilization for Patients with Intracerebral Hemorrhage (EnRICH)" is a prospective, multisite, state-wide, cohort study designed to assess the impact of level of care on long-term patient-centered outcomes for patients with primary / non-traumatic intracerebral hemorrhage...
March 21, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29557547/-mobile-applications-related-to-stroke-a-systematic-review
#19
L Rodriguez-Prunotto, R Cano-de-la-Cuerda
INTRODUCTION: The incidence of stroke has increased in recent years, highlighting the role of prevention and identification of risk factors, as well as the analysis of their costs. At present, new technologies, specifically mobile applications, are considered as tools with potential benefits in patients with stroke care. AIM: To carry out a systematic review about the information related to potential or specifically designed mobile applications in the field of stroke, in order to classify them and carry out a description of the main characteristics of them...
April 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29557218/prospective-utility-study-of-patients-with-multiple-cardiovascular-events
#20
Rhys D Pockett, Phil McEwan, Joshua Ray, Irwin Tran, Simon Shutler, Steven Martin, Zaheer Yousef, Ameet Bakhai
OBJECTIVES: The effects of acute coronary syndrome (ACS) events on health-related quality-of-life (HRQoL) and the time dependency of these effects are unknown. This study aimed to characterize health utilities in ACS patients to aid development of future economic models estimating the cost per quality-adjusted life-year impact of ACS events and potential treatments. METHODS: Multi-center, non-interventional, longitudinal evaluation of health utility in patients experiencing ACS or stroke events...
April 3, 2018: Journal of Medical Economics
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