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https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#1
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27906243/magnetically-controllable-silicon-microring-with-ferrofluid-cladding
#2
A El Amili, M C M M Souza, F Vallini, N C Frateschi, Y Fainman
We experimentally investigate the application of magnetic fluids (MFs) on integrated silicon photonics. Using a ferrofluid-clad silicon microring resonator, we demonstrate active control of resonances by applying an external magnetic field. Relatively high loaded quality factors on the order of 6000 are achieved, despite the optical losses introduced by the magnetic nanoparticles. We demonstrate resonance shifts of 185 pm in response to a 110 Oe strong magnetic field, corresponding to an overall refractive index change of -3...
December 1, 2016: Optics Letters
https://www.readbyqxmd.com/read/27905970/a-feasibility-study-on-using-smartphones-to-conduct-short-version-verbal-autopsies-in-rural-china
#3
Jing Zhang, Rohina Joshi, Jixin Sun, Samantha R Rosenthal, Miao Tong, Cong Li, Rasika Rampatige, Meghan Mooney, Alan Lopez, Lijing L Yan
BACKGROUND: Currently there are two main sources of mortality data with cause of death assignments in China. Both sources-the Ministry of Health-Vital Registration system and the Chinese Disease Surveillance Point system-present their own challenges. A new approach to cause of death assignment is a smartphone-based shortened version of a verbal autopsy survey. This study evaluates the feasibility and acceptability of this new method conducted by township health care providers (THP) and village doctors (VD) in rural China, where a large proportion of deaths occur in homes and cause of death data are inaccurate or lacking...
August 20, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905967/alzheimer-s-and-other-dementias-in-canada-2011-to-2031-a-microsimulation-population-health-modeling-pohem-study-of-projected-prevalence-health-burden-health-services-and-caregiving-use
#4
Douglas G Manuel, Rochelle Garner, Philippe Finès, Christina Bancej, William Flanagan, Karen Tu, Kim Reimer, Larry W Chambers, Julie Bernier
BACKGROUND: Worldwide, there is concern that increases in the prevalence of dementia will result in large demands for caregivers and supportive services that will be challenging to address. Previous dementia projections have either been simple extrapolations of prevalence or macrosimulations based on dementia incidence. METHODS: A population-based microsimulation model of Alzheimer's and related dementias (POHEM:Neurological) was created using Canadian demographic data, estimates of dementia incidence, health status (health-related quality of life and mortality risk), health care costs and informal caregiving use...
November 3, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905815/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm-incentive-under-the-physician-fee-schedule-and-criteria-for-physician-focused-payment-models-final-rule-with-comment-period
#5
(no author information available yet)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs)...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#6
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27905693/revisiting-the-cost-effectiveness-of-screening-65-year-old-men-for-abdominal-aortic-aneurysm-based-on-data-from-an-implemented-screening-programme
#7
Jakob Hager, Martin Henriksson, Per Carlsson, Toste Länne, Fredrik Lundgren
BACKGROUND: Health economic analyses based on randomized trials have shown that screening for abdominal aortic aneurysm (AAA) cost-effectively decreases AAA-related, as well as all- cause mortality. However, follow-up from implemented screening programmes now reveal substantially changed conditions in terms of prevalence, attendance rate, costs and mortality after intervention. Our aim was to evaluate whether screening for AAA among 65-year-old men is cost-effective based on contemporary data on prevalence and attendance rates from an ongoing AAA screening programme...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27905673/single-versus-multiple-visits-for-endodontic-treatment-of-permanent-teeth
#8
REVIEW
Maddalena Manfredi, Lara Figini, Massimo Gagliani, Giovanni Lodi
BACKGROUND: Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures...
December 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27905196/from-scratch-developing-a-hepatic-resection-service-for-metastatic-colorectal-cancer
#9
Neil Wylie, Phillip Hider, Delwyn Armstrong, Kheman Rajkomar, Sanket Srinivasa, Michael Rodgers, Anna Brown, Jonathan Koea
BACKGROUND: Waitemata District Health Board has New Zealand's largest catchment and busiest colorectal unit. The upper gastrointestinal unit was established in 2005, in part to provide a hepatic resection service for patients with colorectal carcinoma metastatic to the liver. The aim of this investigation was to report on quality indicators for the hepatic resection of colorectal carcinoma in the development of a regional resection service. METHODS: Prospectively collected data on patients undergoing hepatic resection for colorectal carcinoma between 2005 and 2014 was reviewed and correlated with costing data and national hepatic resection rates...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27905020/laparoscopic-versus-open-cholecystectomy-a-cost-effectiveness-analysis-at-rwanda-military-hospital
#10
Allison Silverstein, Ainhoa Costas-Chavarri, Mussa R Gakwaya, Joseph Lule, Swagoto Mukhopadhyay, John G Meara, Mark G Shrime
BACKGROUND: Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake in low- and middle-income countries. Thus, there is a need to evaluate laparoscopic cholecystectomy in comparison with an open approach in these settings. METHODS: A cost-effectiveness analysis was performed to evaluate laparoscopic and open cholecystectomies at Rwanda Military Hospital (RMH), a tertiary care referral hospital in Rwanda...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904656/the-berlin-treatment-algorithm-recommendations-for-tailored-innovative-therapeutic-strategies-for-multiple-sclerosis-related-fatigue
#11
REVIEW
Christian Veauthier, Helge Hasselmann, Stefan M Gold, Friedemann Paul
More than 80% of multiple sclerosis (MS) patients suffer from fatigue. Despite this, there are few therapeutic options and evidence-based pharmacological treatments are lacking. The associated societal burden is substantial (MS fatigue is a major reason for part-time employment or early retirement), and at least one out of four MS patients view fatigue as the most burdensome symptom of their disease. The mechanisms underlying MS-related fatigue are poorly understood, and objective criteria for distinguishing and evaluating levels of fatigue and tiredness have not yet been developed...
2016: EPMA Journal
https://www.readbyqxmd.com/read/27903876/handicap-principle-implies-emergence-of-dimorphic-ornaments
#12
Sara M Clifton, Rosemary I Braun, Daniel M Abrams
Species spanning the animal kingdom have evolved extravagant and costly ornaments to attract mating partners. Zahavi's handicap principle offers an elegant explanation for this: ornaments signal individual quality, and must be costly to ensure honest signalling, making mate selection more efficient. Here, we incorporate the assumptions of the handicap principle into a mathematical model and show that they are sufficient to explain the heretofore puzzling observation of bimodally distributed ornament sizes in a variety of species...
November 30, 2016: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/27903558/cost-effectiveness-analysis-of-routine-pneumococcal-vaccination-in-the-uk-a-comparison-of-the-phid-cv-vaccine-and-the-pcv-13-vaccine-using-a-markov-model
#13
Emmanuelle Delgleize, Oscar Leeuwenkamp, Eleni Theodorou, Nicolas Van de Velde
OBJECTIVES: In 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the 7-valent vaccine (introduced in 2006) for vaccination against invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) in the UK. Using recent evidence on the impact of PCVs and epidemiological changes in the UK, we performed a cost-effectiveness analysis (CEA) to compare the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with PCV-13 in the ongoing national vaccination programme...
November 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27903191/cost-effectiveness-of-stereotactic-radiosurgery-versus-whole-brain-radiation-therapy-for-up-to-10-brain-metastases
#14
Nataniel H Lester-Coll, Arie P Dosoretz, William J Magnuson, Maxwell S Laurans, Veronica L Chiang, James B Yu
OBJECTIVE The JLGK0901 study found that stereotactic radiosurgery (SRS) is a safe and effective treatment option for treating up to 10 brain metastases. The purpose of this study is to determine the cost-effectiveness of treating up to 10 brain metastases with SRS, whole-brain radiation therapy (WBRT), or SRS and immediate WBRT (SRS+WBRT). METHODS A Markov model was developed to evaluate the cost effectiveness of SRS, WBRT, and SRS+WBRT in patients with 1 or 2-10 brain metastases. Transition probabilities were derived from the JLGK0901 study and modified according to the recurrence rates observed in the Radiation Therapy Oncology Group (RTOG) 9508 and European Organization for Research and Treatment of Cancer (EORTC) 22952-26001 studies to simulate the outcomes for patients who receive WBRT...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#15
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27903140/can-we-pay-for-performance-in-behavioral-health-care
#16
Rebecca E Stewart, Ishara Lareef, Trevor R Hadley, David S Mandell
Pay for performance (P4P) has become a popular strategy to reward quality and cost-efficiency in behavioral health care and other health care disciplines. This column presents the results of a literature review of P4P in behavioral health care. Fifteen empirical studies evaluating the outcomes of behavioral health services provided in a P4P system were identified. The limited data suggest that P4P can achieve its desired effect. More research is needed on outcomes, performance, and unintended consequences.
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#17
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27902655/organizational-perspectives-on-rapid-response-team-structure-function-and-cost-a-qualitative-study
#18
Patricia L Smith, Jean McSweeney
BACKGROUND: Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. OBJECTIVES: The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. METHODS: Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902586/neurological-psychological-and-cognitive-disorders-in-patients-with-chronic-kidney-disease-on-conservative-and-replacement-therapy
#19
Silvia Lai, Oriano Mecarelli, Patrizia Pulitano, Roberto Romanello, Leonardo Davi, Alessia Zarabla, Amalia Mariotti, Maria Carta, Giorgia Tasso, Luca Poli, Anna Paola Mitterhofer, Massimo Testorio, Nicla Frassetti, Paola Aceto, Alessandro Galani, Carlo Lai
Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy.Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27901312/female-white-footed-mice-peromyscus-leucopus-trade-off-offspring-skeletal-quality-for-self-maintenance-when-dietary-calcium-intake-is-low
#20
Christina M Schmidt, Wendy R Hood
During gestation and lactation in mammals, calcium and other minerals are transferred from female to offspring to support skeletal ossification. To meet mineral requirements, females commonly mobilize mineral from their own skeleton to augment dietary intake. Because the fitness costs of bone loss are expected to limit the amount of endogenous mineral that females transfer to their young, the amount of mineral allocated to offspring is predicted to be influenced by the availability of mineral in the female's diet...
November 30, 2016: Journal of Experimental Zoology. Part A, Ecological Genetics and Physiology
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