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https://www.readbyqxmd.com/read/29045808/kaplan-meier-survival-analysis-overestimates-cumulative-incidence-of-health-related-events-in-the-presence-of-competing-risks-a-meta-analysis
#1
REVIEW
Sarah Lacny, Todd Wilson, Fiona Clement, Derek J Roberts, Peter Faris, William A Ghali, Deborah A Marshall
OBJECTIVE: Kaplan-Meier survival analysis may overestimate cumulative incidence in competing risks (CR) settings. The clinical significance of this overestimation has been questioned and CR methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CR method. STUDY DESIGN AND SETTING: We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF...
October 15, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29045797/public-health-detailing-to-increase-routine-hiv-screening-in-baltimore-maryland-satisfaction-feasibility-and-effectiveness
#2
Amelia Greiner Safi, Jamie Perin, Andrea Mantsios, Christina Schumacher, C Patrick Chaulk, Jacky M Jennings
The objective of this study was to evaluate the satisfaction with, and the feasibility and effectiveness of, a public health detailing project focused on increasing routine human immunodeficiency virus (HIV) screening of people aged 13-64 by primary care providers working in areas of Baltimore City, Maryland, with high rates of HIV transmission (defined as a mean geometric viral load of ≥1500 copies/mL per census tract). In public health detailing, trained public health professionals (ie, detailers) visit medical practice sites to meet with providers and site staff members, with the intention of influencing changes in clinical practice policy and/or behavior...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/29045582/strategies-to-reduce-injuries-and-develop-confidence-in-elders-stride-a-cluster-randomized-pragmatic-trial-of-a-multifactorial-fall-injury-prevention-strategy-design-and-methods
#3
Shalender Bhasin, Thomas M Gill, David B Reuben, Nancy K Latham, Jerry H Gurwitz, Patricia Dykes, Siobhan McMahon, Thomas W Storer, Pamela W Duncan, David A Ganz, Shehzad Basaria, Michael E Miller, Thomas G Travison, Erich J Greene, James Dziura, Denise Esserman, Heather Allore, Martha B Carnie, Maureen Fagan, Catherine Hanson, Dorothy Baker, Susan L Greenspan, Neil Alexander, Fred Ko, Albert L Siu, Elena Volpi, Albert W Wu, Jeremy Rich, Stephen C Waring, Robert Wallace, Carri Casteel, Jay Magaziner, Peter Charpentier, Charles Lu, Katy Araujo, Haseena Rajeevan, Scott Margolis, Richard Eder, Joanne M McGloin, Eleni Skokos, Jocelyn Wiggins, Lawrence Garber, Steven B Clauser, Rosaly Correa-De-Araujo, Peter Peduzzi
Background: Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. Methods: Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA...
October 14, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29045504/molecular-tumor-boards-current-practice-and-future-needs
#4
D L van der Velden, C M L van Herpen, H W M van Laarhoven, E F Smit, H J M Groen, S M Willems, P M Nederlof, M H G Langenberg, E Cuppen, S Sleijfer, N Steeghs, E E Voest
Background: due to rapid technical advances, steeply declining sequencing costs, and the ever-increasing number of targeted therapies, it can be expected that extensive tumor sequencing such as Whole Exome- and -Genome Sequencing will soon be applied in standard care. Clinicians will thus be confronted with increasingly complex genetic information and multiple test-platforms to choose from. General medical training, meanwhile, can hardly keep up with the pace of innovation. Consequently, there is a rapidly growing gap between clinical knowledge and genetic potential in cancer care...
September 27, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29045244/respectful-disposition-after-miscarriage-clinical-practice-recommendations
#5
Elizabeth Levang, Rana Limbo, Tammara Ruiz Ziegler
Compassionate clinical practice guidelines for healthcare providers for respectful disposition after miscarriage are presented. When woven into the whole of a clinician's practice, these guidelines provide the framework for giving women and their families the care they want and deserve when experiencing miscarriage. Relying on theoretical concepts of personhood, place, and protection, care providers can assess the unique meaning a woman assigns to her early pregnancy loss and offer interventions that embrace the concept of respectful disposition...
October 17, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29042916/the-proposal-of-paediatric-virology-and-its-perspectives-an-interview-with-professor-of-paediatrics-maria-theodoridou
#6
Ioannis N Mammas, Demetrios A Spandidos
Professor Maria Theodoridou, Emeritus Professor of Paediatrics at the University of Athens, is one of the few paediatricians in Greece, who have experienced almost all the infectious diseases of the second half of the 20th century and their severe consequences, prior to the widespread adoption of immunisations. A milestone during her career was the establishment of a specialised National Reference Unit for the care of paediatric patients with acquired immune deficiency syndrome (AIDS) at the 'Aghia Sophia' Children's Hospital in Athens, Greece...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29041794/the-views-of-key-stakeholders-in-zimbabwe-on-the-introduction-of-postgraduate-family-medicine-training-a-qualitative-study
#7
Cherifa Sururu, Robert Mash
BACKGROUND: Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened. AIM: To explore the views of key stakeholders on the introduction of postgraduate family medicine training...
September 12, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29040895/economic-analysis-of-prenatal-screening-strategies-for-down-syndrome-in-singleton-pregnancies-in-turkey
#8
Zeynep Güldem Ökem, Gökçen Örgül, Berna Tari Kasnakoglu, Mehmet Çakar, M Sinan Beksaç
OBJECTIVES: To examine the costs and outcomes of different screening strategies for Down Syndrome (DS) in singleton pregnancies. STUDY DESIGN: A decision-analytic model was developed to compare the costs and the outcomes of different prenatal screening strategies. Five strategies were compared for women under 35-year of age: 1A) triple test (TT), 2A); combined test (CT), 3A) Non-invasive Prenatal Screening Test by using cell free fetal DNA (NIPT), 4A) and 5A) NIPT as a second-step screening for high-risk patients detected by either TT, or CT respectively...
October 5, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#9
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29040271/improving-tuberculosis-diagnosis-better-tests-or-better-healthcare
#10
Sumona Datta, Matthew J Saunders, Marco A Tovar, Carlton A Evans
In a Perspective accompanying Sylvia and colleagues, Carlton Evans and colleagues discuss the challenge of squaring policies around tuberculosis diagnosis with the realities of clinical practice in small villages and low-resource settings.
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29040263/tuberculosis-detection-and-the-challenges-of-integrated-care-in-rural-china-a-cross-sectional-standardized-patient-study
#11
Sean Sylvia, Hao Xue, Chengchao Zhou, Yaojiang Shi, Hongmei Yi, Huan Zhou, Scott Rozelle, Madhukar Pai, Jishnu Das
BACKGROUND: Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China's health system-characterized by a movement toward "integrated care" and promotion of initial contact with grassroots providers-will affect the care of TB patients...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29039984/financial-barriers-and-lapses-in-treatment-and-care-of-hiv-infected-adults-in-a-southern-state-in-the-united-states
#12
David A Wohl, Rita K Kuwahara, Kamran Javadi, Christine Kirby, David L Rosen, Sonia Napravnik, Claire Farel
Antiretroviral (ARV) adherence has largely been considered from the perspective of an individual's behavior with less attention given to potential structural causes for lapses in treatment, such as the cost of medications and care. HIV medication expense is typically covered by third party payers. However, private insurance premiums and deductibles may rise, or policies terminated such as with a change in employment. Likewise, a patient's eligibility for publicly funded coverage like state AIDS Drug Assistance Programs (ADAP) or Medicaid can also be lost...
October 17, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29039054/treatment-persistence-and-healthcare-costs-among-patients-with-rheumatoid-arthritis-changing-biologics-in-the-usa
#13
Benjamin Chastek, Chieh-I Chen, Clare Proudfoot, Shraddha Shinde, Andreas Kuznik, Wenhui Wei
INTRODUCTION: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibitor (TNFi) treatment, clinical guidelines support either cycling to another TNFi or switching to a different mechanism of action (MOA), but payers often require TNFi cycling before they reimburse switching MOA. This study examined treatment persistence, cost, and cost per persistent patient among MOA switchers versus TNFi cyclers. METHODS: This study of Commercial and Medicare Advantage claims data from the Optum Research Database included patients with RA and at least one claim for a TNFi (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between January 2012 and September 2015 who changed to another TNFi or a different MOA therapy (abatacept, tocilizumab, or tofacitinib) within 1 year...
October 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29037552/the-impact-of-prenatal-group-b-streptococcus-screening-as-a-national-health-policy-in-taiwan
#14
Fung-Wei Chang, Chun-I Lee, Hueng-Chuen Fan, Her-Young Su, Yung-Liang Liu, Cheng-Yu Chen
OBJECTIVE: There was no national data on group B streptococcus (GBS) infections in Taiwan. Until 2012, when prenatal GBS screening was introduced to obstetric practices as a national health policy aimed at reducing neonatal GBS infections. The purpose of this study was to examine the impact of this national health policy on the incidence of maternal GBS colonization and neonatal GBS infection rate. Relatedly, the clinical characteristics of neonatal GBS infection were investigated to determine the correlations between the incidence of maternal GBS colonization and the neonatal GBS infection rate...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29037237/the-role-of-national-registries-in-improving-patient-safety-for-hip-and-knee-replacements
#15
Anne Lübbeke, Alan J Silman, Daniel Prieto-Alhambra, Amanda I Adler, Christophe Barea, Andrew J Carr
BACKGROUND: The serious adverse events associated with metal on metal hip replacements have highlighted the importance of improving methods for monitoring surgical implants. The new European Union (EU) device regulation will enforce post-marketing surveillance based on registries among other surveillance tools. Europe has a common regulatory environment, a common market for medical devices, and extensive experience with joint replacement registries. In this context, we elaborate how joint replacement registries, while building on existing structure and data, can better ensure safety and balance risks and benefits...
October 16, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29036894/how-can-data-drive-policy-and-practice-in-child-welfare-making-the-link-in-canada
#16
Barbara Fallon, Joanne Filippelli, Tara Black, Nico Trocmé, Tonino Esposito
Formal university-child welfare partnerships offer a unique opportunity to begin to fill the gaps in the child welfare knowledge base and link child welfare services to the realities of practice. With resources from a knowledge mobilization grant, a formal partnership was developed between the University of Toronto, clinicians, policy analysts, and researchers from child welfare agencies across Ontario. The key objectives of the grant included: (1) enhancing the capacity of service providers to access and analyze child welfare data to inform service and policy decisions; (2) integrating clinical expertise in service and policy decisions; and (3) developing a joint research agenda addressing high-priority knowledge gaps...
October 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29036540/tackling-anti-microbial-resistance-ethical-framework-for-rational-antibiotic-use
#17
Jasper Littmann, Annette Rid, Alena Buyx
Background: To reduce the effect of antimicrobial resistance and to preserve antibiotic effectiveness, clinical guidelines and health policy documents call for the rational use of antibiotics, which aims to reduce unnecessary or minimally effective antibiotic use. Methods: Through ethical analysis, we show that rational use programmes can lead to ethical conflicts, because they sometimes place patients at risk of harm-for example, a delayed switch to second-line antibiotics for community-acquired pneumonia can lead to substantial increases in mortality...
October 5, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/29036512/job-resignation-after-cancer-diagnosis-among-working-survivors-in-japan-timing-reasons-and-change-of-information-needs-over-time
#18
Miyako Takahashi, Miyako Tsuchiya, Yoshitsugu Horio, Hatsumi Funazaki, Kenjiro Aogi, Kazue Miyauchi, Yasuaki Arai
Objective: Despite advances in work-related policies for cancer survivors, support systems for working survivors in healthcare settings in Japan remain underdeveloped. We aimed to reveal (i) the present situation of cancer survivors' job resignation, the timing of resignation, and reasons for resignation; (ii) healthcare providers' screening behaviors of cancer survivors' work-related difficulties and (iii) changes to cancer survivors' information/support needs over time since diagnosis...
September 28, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29036228/factors-associated-to-acceptable-treatment-adherence-among-children-with-chronic-kidney-disease-in-guatemala
#19
Brooke M Ramay, Alejandro Cerón, Luis Pablo Méndez-Alburez, Randall Lou-Meda
Pediatric patients with Chronic Kidney Disease face several barriers to medication adherence that, if addressed, may improve clinical care outcomes. A cross sectional questionnaire was administered in the Foundation for Children with Kidney Disease (FUNDANIER, Guatemala City) from September of 2015 to April of 2016 to identify the predisposing factors, enabling factors and need factors related to medication adherence. Sample size was calculated using simple random sampling with a confidence level of 95%, confidence interval of 0...
2017: PloS One
https://www.readbyqxmd.com/read/29035630/a-population-health-measurement-framework-evidence-based-metrics-for-assessing-community-level-population-health-in-the-global-budget-context
#20
Elham Hatef, Elyse C Lasser, Hadi H K Kharrazi, Chad Perman, Russ Montgomery, Jonathan P Weiner
Population health is one of the pillars of the Triple Aim to improve US health care. The authors developed a framework for population health measurement and a proposed set of measures for further exploration to guide the population health efforts in Maryland. The authors searched peer-reviewed, expert-authored literature and current public health measures. Using a semi-structured analysis, a framework was proposed, which consisted of a conceptual model of several domains and identified population health measures addressing them...
October 16, 2017: Population Health Management
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