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Uri ladabaum

Uri Ladabaum, Ajitha Mannalithara
BACKGROUND & AIMS: We developed a model to determine whether a multitarget stool DNA (MT-sDNA) test that detects colorectal cancer (CRC) and polyps with higher sensitivity and lower specificity, but at a higher cost, than the fecal immunochemical test (FIT) can be used in screening. METHODS: We used a Markov model of average-risk CRC screening to compare the effectiveness and cost effectiveness of screening with the MT-sDNA test vs FIT or colonoscopy. We accounted for the complex longitudinal participation patterns observed in organized programs vs opportunistic screening, as well as organized programs' patient support costs and differential payment rates by commercial insurers vs Medicare...
September 2016: Gastroenterology
Jan T Lowery, Dennis J Ahnen, Paul C Schroy, Heather Hampel, Nancy Baxter, C Richard Boland, Randall W Burt, Lynn Butterly, Megan Doerr, Mary Doroshenk, W Gregory Feero, Nora Henrikson, Uri Ladabaum, David Lieberman, Elizabeth G McFarland, Susan K Peterson, Martha Raymond, N Jewel Samadder, Sapna Syngal, Thomas K Weber, Ann G Zauber, Robert Smith
Persons with a family history (FH) of colorectal cancer (CRC) or adenomas that are not due to known hereditary syndromes have an increased risk for CRC. An understanding of these risks, screening recommendations, and screening behaviors can inform strategies for reducing the CRC burden in these families. A comprehensive review of the literature published within the past 10 years has been performed to assess what is known about cancer risk, screening guidelines, adherence and barriers to screening, and effective interventions in persons with an FH of CRC and to identify FH tools used to identify these individuals and inform care...
September 1, 2016: Cancer
Uri Ladabaum, Ashley Patel, Ajitha Mannalithara, Vandana Sundaram, Aya Mitani, Manisha Desai
BACKGROUND: Tailoring screening to colorectal cancer (CRC) risk could improve screening effectiveness. Most CRCs arise from advanced neoplasia (AN) that dwells for years. To date, no available colorectal neoplasia risk score has been validated externally in a diverse population. The authors explored whether the National Cancer Institute (NCI) CRC risk-assessment tool, which was developed to predict future CRC risk, could predict current AN prevalence in a diverse population, thereby allowing its use in risk stratification for screening...
September 1, 2016: Cancer
Dan Li, Marita C Bautista, Sheng-Fang Jiang, Paras Daryani, Marilyn Brackett, Mary Anne Armstrong, Yun-Yi Hung, Debbie Postlethwaite, Uri Ladabaum
OBJECTIVES: Gastric intestinal metaplasia and dysplasia are precursor lesions for adenocarcinoma. The risks of progression to malignancy from these lesions are not well characterized, particularly in the US populations. METHODS: We identified 4,331 Kaiser Permanente Northern California members who were diagnosed with gastric intestinal metaplasia or dysplasia between 1997 and 2006 and followed them through December 2013. The incident rates of gastric adenocarcinoma, relative risks in comparison with the Kaiser Permanente general population, and predictors of progression to malignancy were investigated...
August 2016: American Journal of Gastroenterology
Naresh T Gunaratnam, Mehmet Akce, Riad Al Natour, Angela N Bartley, Ann F Fioritto, Kristen Hanson, Uri Ladabaum
No abstract text is available yet for this article.
May 2016: American Journal of Gastroenterology
Jasmine Zia, Jessica Schroeder, Sean Munson, James Fogarty, Linda Nguyen, Pamela Barney, Margaret Heitkemper, Uri Ladabaum
OBJECTIVES: Seventy percent of patients with irritable bowel syndrome (IBS) identify certain foods as triggers for their symptom flare-ups. To help identify potential trigger foods, practitioners often rely on patient food and gastrointestinal (GI) symptom journaling. The aim of the study was to evaluate the feasibility and usability of a novel food and symptom journal app, specifically designed for patients with IBS. Secondary aims were to explore the effect of using the app on GI symptoms and to describe associations between diet and GI symptoms suggested by individual patient data...
2016: Clinical and Translational Gastroenterology
Uri Ladabaum, Robert E Schoen
No abstract text is available yet for this article.
April 2016: Gastroenterology
Samir Gupta, Elizabeth T Jacobs, John A Baron, David A Lieberman, Gwen Murphy, Uri Ladabaum, Amanda J Cross, Rodrigo Jover, Lin Liu, Maria Elena Martinez
OBJECTIVE: For individuals with 1-2 small (<1 cm) low-risk colorectal adenomas, international guidelines range from no surveillance to offering surveillance colonoscopy in 5-10 years. We hypothesised that the risks for metachronous advanced neoplasia (AN) among patients with low-risk adenomas differ based on clinical factors distinct from those currently used. DESIGN: We pooled data from seven prospective studies to assess the risk of metachronous AN. Two groups with 1-2 small adenomas were defined based on guidelines from the UK (n=4516) or the European Union (EU)/US (n=2477)...
December 11, 2015: Gut
Andrew T Chan, Uri Ladabaum
No abstract text is available yet for this article.
January 2016: Gastroenterology
Uri Ladabaum, James M Ford, Myriam Martel, Alan N Barkun
No abstract text is available yet for this article.
September 2015: Gastroenterology
Uri Ladabaum, Lourdes Alvarez-Osorio, Thomas Rösch, Bernd Brueggenjuergen
BACKGROUND AND STUDY AIMS: Colorectal cancer (CRC) screening strategies in Germany include guaiac-based fecal occult blood testing (gFOBT) starting at age 50 and a switch to colonoscopy at age 55 or continued gFOBT testing, but screening utilization is limited. Blood-based biomarkers, such as methylated Septin 9 DNA ( (m) SEPT9), may improve screening rates. We performed a cost-effectiveness analysis of current and emerging CRC screening strategies in Germany. METHODS: Using a validated Markov model, we compared annual gFOBT for ages 50 through 54 followed by biennial testing until age 75 (FOBT) or by colonoscopy at ages 55 and 65 (FOBT/COLO 55,65), substitution of fecal immunochemical testing (FIT) for gFOBT (FIT, FIT/COLO 55,65), and annual or biennial plasma (m) SEPT9 testing...
June 2014: Endoscopy International Open
Michael P Douglas, Uri Ladabaum, Mark J Pletcher, Deborah A Marshall, Kathryn A Phillips
The American College of Medical Genetics and Genomics (ACMG) recommends that mutations in 56 genes for 24 conditions are clinically actionable and should be reported as secondary findings after whole-genome sequencing (WGS). Our aim was to identify published economic evaluations of detecting mutations in these genes among the general population or among targeted/high-risk populations and conditions and identify gaps in knowledge. A targeted PubMed search from 1994 through November 2014 was performed, and we included original, English-language articles reporting cost-effectiveness or a cost-to-utility ratio or net benefits/benefit-cost focused on screening (not treatment) for conditions and genes listed by the ACMG...
February 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Kathryn A Phillips, Mark J Pletcher, Uri Ladabaum
No abstract text is available yet for this article.
2015: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Sara J Knight, Ateesha F Mohamed, Deborah A Marshall, Uri Ladabaum, Kathryn A Phillips, Judith M E Walsh
BACKGROUND: . While choices about genetic testing are increasingly common for patients and families, and public opinion surveys suggest public interest in genomics, it is not known how adults from the general population value genetic testing for heritable conditions. We sought to understand in a US sample the relative value of the characteristics of genetic tests to identify risk of hereditary colorectal cancer, among the first genomic applications with evidence to support its translation to clinical settings...
January 14, 2015: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Uri Ladabaum, Ajitha Mannalithara, Lina Jandorf, Steven H Itzkowitz
BACKGROUND: Colorectal cancer (CRC) screening is underused by minority populations, and patient navigation increases adherence with screening colonoscopy. In this study, the authors estimated the cost-effectiveness of navigation for screening colonoscopy from the perspective of a payer seeking to improve population health. METHODS: A validated model of CRC screening was informed with inputs from navigation studies in New York City (population: 43% African American, 49% Hispanic, 4% white, 4% other; base-case screening: 40% without navigation, 65% with navigation; navigation costs: $29 per colonoscopy completer, $21 per noncompleter, $3 per non-navigated individual)...
April 1, 2015: Cancer
Uri Ladabaum
No abstract text is available yet for this article.
December 2014: Digestive Diseases and Sciences
Li Tao, Uri Ladabaum, Scarlett Lin Gomez, Iona Cheng
BACKGROUND: Socioeconomic status (SES) plays an important role in colorectal cancer (CRC) mortality, although the independent and joint effects with nativity and neighborhood factors have yet to be evaluated. METHODS: With nearly one-third of all US Hispanics residing in California, the authors obtained information from the California Cancer Registry to examine the associations between neighborhood SES and mortality in all 33,146 Hispanic individuals diagnosed with CRC from 1988 through 2010, with a particular focus on associations among US-born and foreign-born Hispanics...
November 15, 2014: Cancer
Uri Ladabaum, Zachary Levin, Ajitha Mannalithara, Joel V Brill, M Kate Bundorf
OBJECTIVES: Screening decreases colorectal cancer (CRC) mortality. The national press has scrutinized colonoscopy charges. Little systematic evidence exists on colorectal testing and payments among commercially insured persons. Our aim was to characterize outpatient colorectal testing utilization and payments among commercially insured US adults. METHODS: We conducted an observational cohort study of outpatient colorectal test utilization rates, indications, and payments among 21 million 18-64-year-old employees and dependants with noncapitated group health insurance provided by 160 self-insured employers in the 2009 Truven MarketScan Databases...
October 2014: American Journal of Gastroenterology
Kristen Dilzell, Kerry Kingham, Kelly Ormond, Uri Ladabaum
Facilitating family communication about Lynch syndrome is a public health priority since following appropriate screening guidelines can decrease morbidity and mortality. The aims of this study were to (1) ascertain what educational materials individuals with Lynch syndrome provide to at-risk relatives, and (2) identify relationships between receiving educational materials and pursuing clinical follow-up. Seventy-four participants, recruited from the Stanford Cancer Institute and a support group, completed an online questionnaire; 50 were first to be diagnosed with a Lynch syndrome mutation in their family (probands) and 24 were first or second-degree relatives...
September 2014: Familial Cancer
Allison W Kurian, Emily E Hare, Meredith A Mills, Kerry E Kingham, Lisa McPherson, Alice S Whittemore, Valerie McGuire, Uri Ladabaum, Yuya Kobayashi, Stephen E Lincoln, Michele Cargill, James M Ford
PURPOSE: Multiple-gene sequencing is entering practice, but its clinical value is unknown. We evaluated the performance of a customized germline-DNA sequencing panel for cancer-risk assessment in a representative clinical sample. METHODS: Patients referred for clinical BRCA1/2 testing from 2002 to 2012 were invited to donate a research blood sample. Samples were frozen at -80° C, and DNA was extracted from them after 1 to 10 years. The entire coding region, exon-intron boundaries, and all known pathogenic variants in other regions were sequenced for 42 genes that had cancer risk associations...
July 1, 2014: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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