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https://www.readbyqxmd.com/read/28737102/comparative-effectiveness-of-rivaroxaban-in-the-treatment-of-nonvalvular-atrial-fibrillation
#1
Faye L Norby, Alvaro Alonso
Rivaroxaban is a direct oral anticoagulant (DOAC) approved for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, a common arrhythmia. In this review, we summarize the effectiveness of rivaroxaban versus warfarin and the DOACs dabigatran, apixaban and edoxaban. The primary focus is on primary evidence from clinical trials, indirect comparison studies and real-world studies. While there are gaps in the literature, the evidence thus far indicates that rivaroxaban is superior to warfarin and similar to dabigatran, apixaban and edoxaban for the prevention of stroke or systemic embolism in patients with nonvalvular atrial fibrillation, although rivaroxaban may be associated with an elevated bleeding risk compared with other DOACs...
July 24, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28735660/case-detection-and-diagnosis-of-primary-aldosteronism-the-consensus-of-taiwan-society-of-aldosteronism
#2
Vin-Cent Wu, Ya-Hui Hu, Leay Kiaw Er, Ruoh-Fang Yen, Chia-Hui Chang, Ya-Li Chang, Ching-Chu Lu, Chin-Chen Chang, Jui-Hsiang Lin, Yen-Hung Lin, Tzung-Dau Wang, Chih-Yuan Wang, Shih Te Tu, Shih-Chieh Jeff Chueh, Ching-Chung Chang, Fen-Yu Tseng, Kwan-Dun Wu
BACKGROUND/PURPOSE: Even though the increasing clinical recognition of primary aldosteronism (PA) as a public health issue, its heightened risk profiles and the availability of targeted surgical/medical treatment being more understood, consensus in its diagnosis and management based on medical evidence, while recognizing the constraints of our real-world clinical practice in Taiwan, has not been reached. METHODS: The Taiwan Society of Aldosteronism (TSA) Task Force acknowledges the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics into the management of PA...
July 20, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28735376/the-socio-economic-impact-of-bariatric-surgery
#3
Arendse Tange Larsen, Betina Højgaard, Rikke Ibsen, Jakob Kjellberg
INTRODUCTION: A recurring argument for bariatric surgery is cost savings due to sustained weight loss and reductions in comorbidities. However, studies prompting this argument tend to focus only on health care costs, and in some of them, cost changes after surgery have been modelled. The aim of this study was to generate real-world evidence on the socio-economic impact of bariatric surgery, by evaluating the effect on both direct and indirect costs. MATERIALS AND METHODS: Using real-world data from national registries, predictions of health care costs, social transfer payments and income were performed for a surgically treated individual and compared to those for a similar but non-surgically treated individual 3 years before and after surgery...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28734985/safety-of-catheter-ablation-for-atrial-fibrillation-using-fiber-optic-based-contact-force-sensing
#4
Moussa Mansour, Dhanunjaya Lakkireddy, Douglas Packer, John D Day, Srijoy Mahapatra, Kyle Brunner, Vivek Reddy, Andrea Natale
BACKGROUND: While the body of evidence showing the benefit of contact force (CF) sensing catheters in improving AF ablation success rate is growing, real-world safety data of this technology are limited. OBJECTIVE: The aim of this study is to report the complication rate in patients undergoing ablation using one specific CF sensing catheter (TactiCath™Quartz Contact Force Ablation Catheter (Abbott, St Paul, MN)) in a large worldwide database. METHODS: - User-reported adverse event data from January 2014 - December 2015 was reviewed for the ablation catheter...
July 19, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28730619/real-world-adherence-and-persistence-with-direct-oral-anticoagulants-in-adults-with-atrial-fibrillation
#5
Beenish S Manzoor, Todd A Lee, Lisa K Sharp, Surrey M Walton, William L Galanter, Edith A Nutescu
BACKGROUND: Evidence of adherence and persistence patterns in anticoagulation (AC) therapy comparing treatment-naïve and non-naïve patients is lacking. The objective of this study was to evaluate patterns of medication adherence and persistence in a real-world setting among AC-naïve and AC-experienced atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs). METHODS: AF patients newly initiating a DOAC with a minimum of 6 months of continuous health plan enrollment pre and post-index date (first DOAC prescription) were identified from the Truven Health MarketScan(®) Commercial and Medicare Supplemental databases (2009-2013)...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28729232/development-feasibility-and-small-scale-implementation-of-a-web-based-prognostic-tool-surveillance-epidemiology-and-end-results-cancer-survival-calculator
#6
Michelle Henton, Bridget Gaglio, Laurie Cynkin, Eric J Feuer, Borsika A Rabin
BACKGROUND: Population datasets and the Internet are playing an ever-growing role in the way cancer information is made available to providers, patients, and their caregivers. The Surveillance, Epidemiology, and End Results Cancer Survival Calculator (SEER*CSC) is a Web-based cancer prognostic tool that uses SEER data, a large population dataset, to provide physicians with highly valid, evidence-based prognostic estimates for increasing shared decision-making and improving patient-provider communication of complex health information...
July 20, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28726478/the-association-of-positive-emotion-and-first-smoking-lapse-an-ecological-momentary-assessment-study
#7
Christine Vinci, Liang Li, Cai Wu, Cho Y Lam, Lin Guo, Virmarie Correa-Fernández, Claire A Spears, Diana S Hoover, Paul E Etcheverry, David W Wetter
OBJECTIVE: Individuals attempting to quit smoking typically have poor success rates, and the majority fail to maintain long-term abstinence. Although a large body of evidence documents the impact of negative affect on reducing abstinence, there is a much smaller body of research on positive emotions, which could be an important mechanism that is associated with successful cessation. As such, this study examined positive emotions in real-time via ecological momentary assessment (EMA) to determine whether discrete positive emotions were uniquely related to 2 cessation milestones: quit day lapse and first lapse...
July 20, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28724817/real-world-evidence-of-safety-profile-of-intravitreal-bevacizumab-avastin-in-an-indian-scenario
#8
Prashant Jain, Jay Sheth, Giridhar Anantharaman, Mahesh Gopalakrishnan
PURPOSE: The purpose of this study was to evaluate the safety profile of intravitreal bevacizumab (Avastin) as an off-label pharmacotherapeutic agent for various ocular conditions. METHODS: Retrospective analysis was carried out on 3806 injections of 1761 patients that were administered with intravitreal bevacizumab injection at a tertiary eye care center in India. The injections were administered on a pro re nata basis for various indications such as age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO)...
July 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28720799/reduced-ultrafine-particle-levels-in-s%C3%A3-o-paulo-s-atmosphere-during-shifts-from-gasoline-to-ethanol-use
#9
Alberto Salvo, Joel Brito, Paulo Artaxo, Franz M Geiger
Despite ethanol's penetration into urban transportation, observational evidence quantifying the consequence for the atmospheric particulate burden during actual, not hypothetical, fuel-fleet shifts, has been lacking. Here we analyze aerosol, meteorological, traffic, and consumer behavior data and find, empirically, that ambient number concentrations of 7-100-nm diameter particles rise by one-third during the morning commute when higher ethanol prices induce 2 million drivers in the real-world megacity of São Paulo to substitute to gasoline use (95% confidence intervals: +4,154 to +13,272 cm(-3))...
July 18, 2017: Nature Communications
https://www.readbyqxmd.com/read/28719901/patient-related-benefits-for-adults-with-cochlear-implantation-a-multicultural-longitudinal-observational-study
#10
Thomas Lenarz, Lida Muller, Hanna Czerniejewska-Wolska, Hector Vallés Varela, César Orús Dotú, Marcin Durko, Alicia Huarte Irujo, Bartosz Piszczatowski, Marek Zadrożniak, Colin Irwin, Petra L Graham, Josie Wyss
OBJECTIVES: To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. DESIGN: This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed...
July 19, 2017: Audiology & Neuro-otology
https://www.readbyqxmd.com/read/28716982/real-world-setting-comparison-of-nonvitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#11
George Ntaios, Vasileios Papavasileiou, Konstantinos Makaritsis, Konstantinos Vemmos, Patrik Michel, Gregory Y H Lip
BACKGROUND AND PURPOSE: Evidence from the real-world setting complements evidence coming from randomized controlled trials. We aimed to summarize all available evidence from high-quality real-world observational studies about efficacy and safety of nonvitamin-K oral anticoagulants compared with vitamin-K antagonists in patients with atrial fibrillation. METHODS: We searched PubMed and Web of Science until January 7, 2017 for observational nationwide or health insurance databases reporting matched or adjusted results comparing nonvitamin-K oral anticoagulants versus vitamin-K antagonists in patients with atrial fibrillation...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28716830/reality-and-truth-balancing-the-hope-and-the-hype-of-real-world-evidence
#12
EDITORIAL
Anushka Patel, Laurent Billot
No abstract text is available yet for this article.
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28716504/series-pragmatic-trials-and-real-world-evidence-paper-8-data-collection-and-management-data-collection-in-pragmatic-trials
#13
Anna-Katharina Meinecke, Paco Welsing, George Kafatos, Des Burke, Sven Trelle, Maria Kubin, Gaelle Nachbaur, Matthias Egger, Mira Zuidgeest
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice...
July 14, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#14
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28715550/multidimensional-evidence-generation-and-fda-regulatory-decision-making-defining-and-using-real-world-data
#15
Jonathan P Jarow, Lisa LaVange, Janet Woodcock
No abstract text is available yet for this article.
July 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28712968/treatment-of-social-cognition-in-schizophrenia-current-status-and-future-directions
#16
William P Horan, Michael F Green
Efforts to develop psychosocial interventions that specifically target social cognition in schizophrenia spectrum disorders began nearly two decades ago. The field has matured considerably since then and has engendered a great deal of optimism about this treatment approach. Indeed, the efficacy of social cognitive interventions, especially those that address multiple domains of social cognition, has received substantial support. This article critically evaluates the current evidence for social cognitive interventions, identifies limitations and open questions, and suggests priorities and directions for further research...
July 13, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28712619/ethics-of-informed-consent-for-pragmatic-trials-with-new-interventions
#17
Shona Kalkman, Scott Y H Kim, Ghislaine J M W van Thiel, Diederick E Grobbee, Johannes J M van Delden
OBJECTIVES: Pragmatic trials evaluate the comparative benefits, risks, and burdens of health care interventions in real-world conditions. Such studies are now recognized as valuable to the perimarketing stage of drug development and evaluation, with early pragmatic trials (EPTs) being explored as a means to generate real-world evidence at the time of regulatory market approval. In this article, we present an analysis of the ethical issues involved in informed consent for EPTs, in light of the generally recognized concern that traditional ethical rules governing randomized clinical trials, such as lengthy informed consent procedures, could threaten the "real world" nature of such trials...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28712615/predicting-real-world-effectiveness-of-cancer-therapies-using-overall-survival-and-progression-free-survival-from-clinical-trials-empirical-evidence-for-the-asco-value-framework
#18
Darius N Lakdawalla, Jason Shafrin, Ningqi Hou, Desi Peneva, Seanna Vine, Jinhee Park, Jie Zhang, Ron Brookmeyer, Robert A Figlin
OBJECTIVES: To measure the relationship between randomized controlled trial (RCT) efficacy and real-world effectiveness for oncology treatments as well as how this relationship varies depending on an RCT's use of surrogate versus overall survival (OS) endpoints. METHODS: We abstracted treatment efficacy measures from 21 phase III RCTs reporting OS and either progression-free survival or time to progression endpoints in breast, colorectal, lung, ovarian, and pancreatic cancers...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28710065/the-limitations-of-using-randomised-controlled-trials-as-a-basis-for-developing-treatment-guidelines
#19
REVIEW
Roger Mulder, Ajeet B Singh, Amber Hamilton, Pritha Das, Tim Outhred, Grace Morris, Darryl Bassett, Bernhard T Baune, Michael Berk, Philip Boyce, Bill Lyndon, Gordon Parker, Gin S Malhi
Randomised controlled trials (RCTs) are considered the 'gold standard' by which novel psychotropic medications and psychological interventions are evaluated and consequently adopted into widespread clinical practice. However, there are some limitations to using RCTs as the basis for developing treatment guidelines. While RCTs allow researchers to determine whether a given medication or intervention is effective in a specific patient sample, for practicing clinicians it is more important to know whether it will work for their particular patient in their particular setting...
July 14, 2017: Evidence-based Mental Health
https://www.readbyqxmd.com/read/28709719/metformin-effects-on-the-heart-and-the-cardiovascular-system-a%C3%A2-review-of-experimental-and-clinical-data
#20
REVIEW
L Nesti, A Natali
BACKGROUND: Metformin, the eldest and most widely used glucose lowering drug, is likely to be effective also on cardiac and vascular disease prevention. Nonetheless, uncertainty still exists with regard to its effects on the cardiovascular system as a whole and specifically on the myocardium, both at the organ and cellular levels. METHODS: We reviewed the available data on the cardiac and vascular effects of metformin, encompassing both in vitro, either tissue or isolated organ, and in vivo studies in experimental animals and humans, as well as the evidence generated by major clinical trials...
May 10, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
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