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https://www.readbyqxmd.com/read/28324029/vital-directions-for-health-and-health-care-priorities-from-a-national-academy-of-medicine-initiative
#1
Victor J Dzau, Mark B McClellan, J Michael McGinnis, Sheila P Burke, Molly J Coye, Angela Diaz, Thomas A Daschle, William H Frist, Martha Gaines, Margaret A Hamburg, Jane E Henney, Shiriki Kumanyika, Michael O Leavitt, Ruth M Parker, Lewis G Sandy, Leonard D Schaeffer, Glenn D Steele, Pamela Thompson, Elias Zerhouni
Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28323449/the-relative-importance-of-real-time-in-cab-and-external-feedback-in-managing-fatigue-in-real-world-commercial-transport-operations
#2
Michael Fitzharris, Sara Liu, Amanda N Stephens, Michael G Lenné
OBJECTIVE: Real-time driver monitoring systems represent a solution to address key behavioral risks as they occur, particularly distraction and fatigue. The efficacy of these systems in real-world settings is largely unknown. This paper has three objectives: 1) to document the incidence and duration of fatigue in real-world commercial truck driving operations, 2) to determine the reduction, if any, in the incidence of fatigue episodes associated with providing feedback, and 3) to tease apart the relative contribution of in-cab warnings from 24 monitoring and feedback to employers...
March 21, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28317649/clinical-validity-of-cerebrospinal-fluid-a%C3%AE-42-tau-and-phospho-tau-as-biomarkers-for-alzheimer-s-disease-in-the-context-of-a-structured-5-phase-development-framework
#3
REVIEW
Niklas Mattsson, Anders Lönneborg, Marina Boccardi, Kaj Blennow, Oskar Hansson
Novel diagnostic criteria for Alzheimer's disease (AD) incorporate biomarkers, but their maturity for implementation in clinical practice at the prodromal stage (mild cognitive impairment [MCI]) is unclear. Here, we evaluate cerebrospinal fluid (CSF) β-amyloid42 (Aβ42), total tau, and phosphorylated tau in the light of a 5-phase framework for biomarker development. Ample evidence is available for phase 1 (identifying useful leads) and phase 2 (assessing the accuracy for AD dementia versus controls) for CSF biomarkers...
April 2017: Neurobiology of Aging
https://www.readbyqxmd.com/read/28317646/clinical-validity-of-delayed-recall-tests-as-a-gateway-biomarker-for-alzheimer-s-disease-in-the-context-of-a-structured-5-phase-development-framework
#4
REVIEW
Chiara Cerami, Bruno Dubois, Marina Boccardi, Andreas U Monsch, Jean Francois Demonet, Stefano F Cappa
Although Alzheimer's disease criteria promote the use of biomarkers, their maturity in clinical routine still needs to be assessed. In the light of the oncology framework, we conducted a literature review on measures used to assess delayed recall impairment due to medial temporal lobe dysfunction (i.e., free and cued word list recall tests). Ample evidence is available for phases 1 (rationale for use), 2 (discriminative ability), and 3 (early detection ability) for many of the tests in routine use. Evidence about phase 4 (performance in real world) and phase 5 (quantify impact and costs) is yet to come...
April 2017: Neurobiology of Aging
https://www.readbyqxmd.com/read/28306596/biosimilars-implications-for-rheumatoid-arthritis-therapy
#5
Stanley Cohen, Jonathan Kay
PURPOSE OF REVIEW: Abbreviated pathways for the approval of biosimilars have been established in the European Union (EU), the United States, and other countries. Biosimilar TNF inhibitors have been available in South Korea and the EU since 2012 and 2013, respectively, and the first biosimilar infliximab was introduced to the clinic in the United States in November 2016. Five TNF inhibitor biosimilars have now been approved, and many other biosimilars to treat rheumatoid arthritis and other inflammatory diseases are in development...
March 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#6
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303741/weight-of-the-evidence-evaluation-of-2-4-d-potential-for-interactions-with-the-estrogen-androgen-and-thyroid-pathways-and-steroidogenesis
#7
B H Neal, J Bus, M S Marty, K Coady, A Williams, J Staveley, J C Lamb
A comprehensive weight-of-the-evidence evaluation of 2,4-dichlorophenoxyacetic acid (2,4-D) was conducted for potential interactions with the estrogen, androgen and thyroid pathways and with steroidogenesis. This assessment was based on an extensive database of high quality in vitro, in vivo ecotoxicological and in vivo mammalian toxicological studies. Epidemiological studies were also considered. Toxicokinetic data provided the basis for determining rational cutoffs above which exposures were considered irrelevant to humans based on exceeding thresholds for saturation of renal clearance (TSRC); extensive human exposure and biomonitoring data support that these boundaries far exceed human exposures and provide ample margins of exposure...
March 2, 2017: Critical Reviews in Toxicology
https://www.readbyqxmd.com/read/28294642/cost-effectiveness-of-sequenced-treatment-of-rheumatoid-arthritis-with-targeted-immune-modulators
#8
Jeroen P Jansen, Devin Incerti, Alex Mutebi, Desi Peneva, Joanna MacEwan, Bradley Stolshek, Primal Kaur, Mahdi Gharaibeh, Vibeke Strand
AIMS: To determine the cost-effectiveness of treatment sequences of biologic disease-modifying antirheumatic drugs or Janus kinase/STAT pathway inhibitors (collectively referred to as bDMARDs) versus conventional DMARDs (cDMARDs) from the US societal perspective for treatment of patients with moderately to severely active rheumatoid arthritis (RA) with inadequate responses to cDMARDs. MATERIALS AND METHODS: We developed an individual patient simulation model that assesses the impact of treatments on disease based on clinical trial data and real-world evidence...
March 15, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28294551/the-ignite-pharmacogenetics-working-group-an-opportunity-for-building-evidence-with-pharmacogenetic-implementation-in-a-real-world-setting
#9
REVIEW
L H Cavallari, A L Beitelshees, K V Blake, L G Dressler, J D Duarte, A Elsey, J N Eichmeyer, P E Empey, J P Franciosi, J K Hicks, A M Holmes, Ljb Jeng, C R Lee, J J Lima, N A Limdi, J Modlin, A O Obeng, N Petry, V M Pratt, T C Skaar, S Tuteja, D Voora, M Wagner, K W Weitzel, R A Wilke, J F Peterson, J A Johnson
No abstract text is available yet for this article.
March 14, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28293933/unmet-primary-physicians-needs-for-allergic-rhinitis-care-in-korea
#10
Hyeon Jong Yang, Young Hyo Kim, Bora Lee, Do Youn Kong, Dong Kyu Kim, Mi Ae Kim, Bong Seong Kim, Won Young Kim, Jeong Hee Kim, Yang Park, So Yeon Park, Woo Yong Bae, Keejae Song, Min Suk Yang, Sang Min Lee, Young Mok Lee, Hyun Jong Lee, Jae Hong Cho, Hye Mi Jee, Jeong Hee Choi, Young Yoo, Young Il Koh
Allergic rhinitis (AR) is one of the most common chronic allergic respiratory diseases worldwide. Various practical guidelines for AR have been developed and updated to improve the care of AR patients; however, up to 40% patients remain symptomatic. The unmet need for AR care is one of the greatest public health problems in the world. The gaps between guideline and real-world practice, and differences according to the region, culture, and medical environments may be the causes of unmet needs for AR care. Because there is no evidence-based AR practical guideline reflecting the Korean particularity, various needs are increasing...
May 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28293911/delta-9-tetrahydrocannabinol-cannabidiol-oromucosal-spray-sativex-%C3%A2-a-review-in-multiple-sclerosis-related-spasticity
#11
Gillian M Keating
Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (THC/CBD, Sativex(®), nabiximols) is available in numerous countries worldwide for the treatment of multiple sclerosis (MS)-related moderate to severe spasticity in patients who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. Twelve weeks' therapy with THC/CBD improved MS-related spasticity in patients with an inadequate response to other anti-spasticity agents who had undergone a successful initial trial of THC/CBD therapy, according to the results of a pivotal phase 3 trial...
March 14, 2017: Drugs
https://www.readbyqxmd.com/read/28293101/new-developments-in-the-management-of-partial-onset-epilepsy-role-of-brivaracetam
#12
REVIEW
Giangennaro Coppola, Giulia Iapadre, Francesca Felicia Operto, Alberto Verrotti
Currently, a number of novel anticonvulsant drugs, the so-called third generation, are in various stages of development. Several of them are already available or in ongoing clinical trials. These new compounds should take advantage of new insights into the basic pathophysiology of epileptogenesis, drug metabolism and drug interactions. Many of them still need to be further evaluated mainly in real-world observational trials and registries. Among newer anticonvulsant drugs for partial-onset seizures (POSs), rufinamide, lacosamide, eslicarbazepine and perampanel are those new treatment options for which more substantial clinical evidence is currently available, both in adults and, to some extent, in children...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28292291/traditional-arabic-islamic-medicine-validation-and-empirical-assessment-of-a-conceptual-model-in-qatar
#13
Sara N AlRawi, Amal Khidir, Maha S Elnashar, Huda A Abdelrahim, Amal K Killawi, Maya M Hammoud, Michael D Fetters
BACKGROUND: Evidence indicates traditional medicine is no longer only used for the healthcare of the poor, its prevalence is also increasing in countries where allopathic medicine is predominant in the healthcare system. While these healing practices have been utilized for thousands of years in the Arabian Gulf, only recently has a theoretical model been developed illustrating the linkages and components of such practices articulated as Traditional Arabic & Islamic Medicine (TAIM). Despite previous theoretical work presenting development of the TAIM model, empirical support has been lacking...
March 14, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28290996/putting-polypills-into-practice-challenges-and-lessons-learned
#14
REVIEW
Ruth Webster, Jose M Castellano, Oyere K Onuma
Regulatory approvals for cardiovascular polypills are increasing rapidly across more than 30 countries. The evidence clearly shows polypills improve adherence and cardiovascular disease risk factors for patients with indications for use of polypill components-ie, those with established cardiovascular disease or at high risk. However, the implementation of polypills into clinical practice has many challenges. The clinical trials literature provides insights into the clinical impact of a polypill strategy, including cost-effectiveness, safety of use, substantial improvement in adherence, and better risk factor control than usual care...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290558/-real-world-data-on-novel-oral-anticoagulants-the-added-value-of-registries-and-observational-studies-focus-on-apixaban
#15
Francesco Pelliccia, Gaetano Tanzilli, Michele Schiariti, Nicola Viceconte, Cesare Greco, Carlo Gaudio
Anticoagulant therapy has been used with great effect for decades for the prevention of stroke among patients with atrial fibrillation. In recent years, the therapeutic armamentarium has been strengthened considerably, with the addition of anticoagulants acting through novel pathways. The currently available novel agents are apixaban, rivaroxaban and dabigatran. These novel oral anticoagulants (NOACs) were approved for use on the basis of major clinical trials clearly demonstrating improved risk reductions compared to warfarin for stroke and/or major bleeding events...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28290273/from-the-ebm-pyramid-to-the-greek-temple-a-new-conceptual-approach-to-guidelines-as-implementation-tools-in-mental-health
#16
L Salvador-Carulla, S Lukersmith, W Sullivan
Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development...
April 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28286993/clinical-and-economic-impact-of-mirabegron-compared-with-antimuscarinics-for-the-treatment-of-overactive-bladder-in-canada
#17
Zalmai Hakimi, Jameel Nazir, Charles McCrea, Malin Berling, Francis Fatoye, Barbara Ramos, Adrian Wagg
BACKGROUND: The β3-adrenoceptor agonist, mirabegron, and antimuscarinic agents provide similar efficacy for the treatment of overactive bladder (OAB), but mirabegron appears to be associated with better persistence, perhaps due to an absence of anticholinergic side-effects. This study estimated the expected costs associated with the management of OAB in Canada from a societal perspective by utilizing real-world evidence. METHODS: An economic model with monthly cycles and a 1-year time horizon was developed to depict a treatment pathway for a hypothetical cohort of 100 patients with OAB...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28282574/long-term-effectiveness-and-safety-of-natalizumab-in-a-portuguese-population
#18
I Correia, S Batista, O Galego, I B Marques, J Jesus-Ribeiro, A I Martins, C Nunes, M C Macário, L Cunha, L Sousa
OBJECTIVES: Natalizumab long-term effectiveness data in real-world relapsing-remitting multiple sclerosis (RRMS) is needed. Our objective is to report the long-term effectiveness and safety of natalizumab in a cohort of RRMS patients. METHODS: This is a retrospective study of natalizumab treatment for two years or longer in RRMS. Annualized relapse rate, Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging T2 lesion volume, JC virus antibody status, previous treatments and adverse events were analysed...
March 7, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28281244/effectiveness-of-liraglutide-and-lixisenatide-in-the-treatment-of-type-2-diabetes-real-world-evidence-from-the-health-improvement-network-thin-database-in-the-united-kingdom
#19
Michael Feher, Gabriela Vega-Hernandez, Emina Mocevic, Brian Buysse, Melissa Myland, Geraldine S Power, Lise L Nystrup Husemoen, Joseph Kim, Daniel R Witte
INTRODUCTION: The glucagon-like peptide-1 receptor agonists liraglutide and lixisenatide are effective at reducing glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM). Although liraglutide has demonstrated superior efficacy in head-to-head clinical trials, real-world evidence of comparative effectiveness is lacking. This observational study aimed to assess the effectiveness of liraglutide versus lixisenatide in UK clinical practice. METHODS: Electronic medical records from The Health Improvement Network (THIN) UK primary care database were analyzed...
March 9, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28279924/physicians-responses-to-financial-and-social-incentives-a-medically-framed-real-effort-experiment
#20
Mylène Lagarde, Duane Blaauw
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remuneration schemes in a multi-tasking context. We assess the impact of different incentives on the quantity (productivity) and quality of outputs of 132 participants...
March 2, 2017: Social Science & Medicine
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