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https://www.readbyqxmd.com/read/28530524/is-real-world-evidence-used-in-p-t-monographs-and-therapeutic-class-reviews
#1
Jason T Hurwitz, Mary Brown, Jennifer S Graff, Loretta Peters, Daniel C Malone
BACKGROUND: Payers are faced with making coverage and reimbursement decisions based on the best available evidence. Often these decisions apply to patient populations, provider networks, and care settings not typically studied in clinical trials. Treatment effectiveness evidence is increasingly available from electronic health records, registries, and administrative claims. However, little is known about when and what types of real-world evidence (RWE) studies inform pharmacy and therapeutic (P&T) committee decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#2
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#3
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528347/discriminative-accuracy-of-physician-and-nurse-predictions-for-survival-and-functional-outcomes-6-months-after-an-icu-admission
#4
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
Importance: Predictions of long-term survival and functional outcomes influence decision making for critically ill patients, yet little is known regarding their accuracy. Objective: To determine the discriminative accuracy of intensive care unit (ICU) physicians and nurses in predicting 6-month patient mortality and morbidity, including ambulation, toileting, and cognition. Design, Setting, and Participants: Prospective cohort study conducted in 5 ICUs in 3 hospitals in Philadelphia, Pennsylvania, and enrolling patients who spent at least 3 days in the ICU from October 2013 until May 2014 and required mechanical ventilation, vasopressors, or both...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28525286/cancer-patient-experience-in-the-teenage-young-adult-population-key-issues-and-trends-over-time-an-analysis-of-the-united-kingdom-national-cancer-patient-experience-surveys-2010-2014
#5
Caroline L Furness, Lesley Smith, Eva Morris, Caroline Brocklehurst, Sasha Daly, Rachael E Hough
Improving outcomes for teenagers and young adults (TYA) with cancer is a key element of the national cancer strategy in England. Recognition of the unique needs of this group has led to the development of recommendations for specific models of care and delivery of this care through the provision of dedicated clinical units in principal treatment centers (PTCs) across the United Kingdom. The aim of this study was to understand the current cancer patient experience for this patient group. We aimed to determine whether treatment experience is influenced by place of treatment and whether it has changed over time using patient-reported data from national cancer patient experience surveys...
May 19, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28524258/cardiotocography-interpretation-skills-and-the-association-with-size-of-maternity-unit-years-of-obstetric-work-experience-and-healthcare-professional-background-a-national-cross-sectional-study
#6
Line Thellesen, Jette Led Sorensen, Morten Hedegaard, Susanne Rosthoej, Nina Palmgren Colov, Kristine Sylvan Andersen, Thomas Bergholt
INTRODUCTION: We aimed to examine whether cardiotocography (CTG) knowledge, interpretation skills and decision-making measured by a written assessment were associated with size of maternity unit, years of obstetric work experience and healthcare professional background. MATERIAL AND METHODS: A national cross-sectional study in the setting of a CTG teaching intervention involving all 24 maternity units in Denmark. Participants were midwives (n=1260) and specialists (n=269) and residents (n=142) in obstetrics and gynecology who attended a one-day CTG course and answered a 30-item multiple-choice question test...
May 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#7
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28522118/a-national-survey-of-hdr-source-knowledge-among-practicing-radiation-oncologists-and-residents-establishing-a-willingness-to-pay-threshold-for-cobalt-60-usage
#8
Raymond Mailhot Vega, Wesley Talcott, Omar Ishaq, Patrice Cohen, Christina J Small, Tamara Duckworth, Gustavo Sarria Bardales, Carmen A Perez, Peter B Schiff, William Small, Matthew M Harkenrider
PURPOSE: Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. METHODS AND MATERIALS: A nationwide survey of U...
May 15, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28521785/expect-with-me-development-and-evaluation-design-for-an-innovative-model-of-group-prenatal-care-to-improve-perinatal-outcomes
#9
Shayna D Cunningham, Jessica B Lewis, Jordan L Thomas, Stephanie A Grilo, Jeannette R Ickovics
BACKGROUND: Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally...
May 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28515963/eliminating-racial-ethnic-disparities-in-aids-clinical-trials-in-the-united-states-a-qualitative-exploration-of-an-efficacious-social-behavioral-intervention
#10
Amanda Ritchie, Marya Viorst Gwadz, David Perlman, Rebecca De Guzman, Noelle R Leonard, Charles M Cleland
BACKGROUND: African American/Black and Hispanic persons living with HIV (AABH-PLWH) are under-represented in AIDS clinical trials (ACTs) in the United States. Barriers AABH-PLWH experience to ACTs are multi-faceted, including distrust of medical research, low levels of knowledge, unsupportive social norms, lack of referral, and challenges navigating ACT systems. In past research we found a multi-component peer-driven intervention was efficacious in boosting rates of screening for/enrollment into ACTs...
January 2017: Journal of AIDS & Clinical Research
https://www.readbyqxmd.com/read/28512732/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-1-lumpectomy-mastectomy-and-contralateral-prophylactic-mastectomy
#11
REVIEW
Lisa A Newman
Several prospective randomized clinical trials conducted internationally have proven the safety and survival equivalence of breast-conserving surgery compared with mastectomy. Adjuvant radiation is routinely recommended following lumpectomy surgery to minimize the risk of local recurrence. Comprehensive breast imaging (including bilateral mammography with diagnostic views and ultrasound evaluation), in addition to clinical examination, is essential to rule out potential contralateral pathology and to optimally characterize the extent of disease...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28511791/-usefulness-of-the-budget-and-the-balanced-scorecard-in-managing-primary-care-centres-impact-on-staff-motivation
#12
Juan Manuel Ramón-Jerónimo, Raquel Flórez-López, Natalia Domínguez-Lario
OBJECTIVE: To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. DESIGN: Qualitative study (case study) based on grounded theory performed between January and June 2014. LOCATION: Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. PARTICIPANTS: UGCAP managers and Health Area (CEO) managers...
May 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28507921/sofosbuvir-based-regimens-with-task-shifting-is-cost-effective-in-expanding-hepatitis-c-treatment-access-in-the-united-states
#13
Channa R Jayasekera, Rachel Beckerman, Nathaniel Smith, Ryan B Perumpail, Robert J Wong, Zobair M Younossi, Aijaz Ahmed
Background and Aims: The current paradigm of specialist physician-managed treatment of chronic hepatitis C virus infection (HCV) is inefficient in absorbing the approximately 3 million patients awaiting treatment in the United States. Task shifting-whereby specialist physicians screen patients for treatment eligibility but on-treatment monitoring is devolved to more abundant non-physician clinicians-achieves non-inferior treatment outcomes with second generation direct-acting antivirals (2(nd) Gen DAAs), may increase treatment capacity, and may facilitate greater treatment access...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28505632/missed-opportunities-for-measles-mumps-rubella-vaccination-among-departing-u-s-adult-travelers-receiving-pretravel-health-consultations
#14
Emily P Hyle, Sowmya R Rao, Emily S Jentes, Amy Parker Fiebelkorn, Stefan H F Hagmann, Allison Taylor Walker, Rochelle P Walensky, Edward T Ryan, Regina C LaRocque
Background: Measles outbreaks continue to occur in the United States and are mostly due to infections in returning travelers. Objective: To describe how providers assessed the measles immunity status of departing U.S. adult travelers seeking pretravel consultation and to assess reasons given for nonvaccination among those considered eligible to receive the measles, mumps, rubella (MMR) vaccine. Design: Observational study in U.S. pretravel clinics...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#15
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504327/preferences-for-prenatal-diagnosis-of-sickle-cell-disorder-a%C3%A2-discrete-choice-experiment-comparing-potential-service-users%C3%A2-and-health-care-providers
#16
Melissa Hill, Eugene Oteng-Ntim, Frida Forya, Mary Petrou, Stephen Morris, Lyn S Chitty
BACKGROUND: Non-invasive prenatal diagnosis (NIPD) for sickle-cell disorder (SCD) is moving closer to implementation and studies considering stakeholder preferences are required to underpin strategies for offering NIPD in clinical practice. OBJECTIVE: Determine service user and provider preferences for key attributes of prenatal diagnostic tests for SCD and examine views on NIPD. METHOD: A questionnaire that includes a discrete choice experiment was used to determine the preferences of service users and providers for prenatal tests that varied across three attributes: accuracy, time of test and risk of miscarriage...
May 15, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28502379/external-validation-of-the-clinical-indications-of-computed-tomography-ct-of-the-head-in-patients-with-low-energy-geriatric-hip-fractures
#17
Amrut Borade, Harish Kempegowda, Hemil H Maniar, Anthony De Giacomo, Paul Tornetta, Kasey Bramlett, Andrew J Marcantonio, Lucas S Marchand, Erik N Kubiak, William H Ip, James F Kellam, Jay S Bender, Eric G Meinberg, James Kee, Regis Renard, Michael Suk, Daniel S Horwitz
INTRODUCTION: On evaluation of the clinical indications of computed tomography (CT) scan of head in the patients with low-energy geriatric hip fractures, Maniar et al. identified physical evidence of head injury, new onset confusion, and Glasgow Coma Scale (GCS)<15 as predictive risk factors for acute findings on CT scan. The goal of the present study was to validate these three criteria as predictive risk factors for a larger population in a wider geographical distribution. PATIENTS AND METHODS: Patients ≥65 years of age with low-energy hip fractures from 6 trauma centers in a wide geographical distribution in the United States were included in this study...
April 26, 2017: Injury
https://www.readbyqxmd.com/read/28502278/a-new-health-technology-assessment-system-for-devices-the-first-five-years
#18
Bruce Campbell, Lee Dobson, Joanne Higgins, Bernice Dillon, Mirella Marlow, Chris Pomfrett
OBJECTIVES: The aim of this study was to review 5 years of activity from a new system devised by the National Institute for Health and Care Excellence (NICE), for assessing medical devices and diagnostics aimed at identifying and speeding adoption of technologies with clinical and cost advantages, compared with current practice in the United Kingdom healthcare system. METHODS: All eligible notified technologies were classified using the Food and Drug Administration and Global Medical Device Nomenclature nomenclatures...
May 15, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#19
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28498844/windowed-persistent-homology-a-topological-signal-processing-algorithm-applied-to-clinical-obesity-data
#20
Craig Biwer, Amy Rothberg, Heidi IglayReger, Harm Derksen, Charles F Burant, Kayvan Najarian
Overweight and obesity are highly prevalent in the population of the United States, affecting roughly 2/3 of Americans. These diseases, along with their associated conditions, are a major burden on the healthcare industry in terms of both dollars spent and effort expended. Volitional weight loss is attempted by many, but weight regain is common. The ability to predict which patients will lose weight and successfully maintain the loss versus those prone to regain weight would help ease this burden by allowing clinicians the ability to skip treatments likely to be ineffective...
2017: PloS One
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