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Outcome analysis

P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
Sapan H Shah, Brian E Schwartz, Aaron R Schwartz, Benjamin A Goldberg, Samuel J Chmell
The rate of total knee arthroplasty (TKA) utilization in younger patients (< 65 years old) is increasing. Little is known regarding demographics and in-hospital outcomes in this population. The National Hospital Discharge Survey (NHDS) database was searched using International Classification of Diseases, Ninth Revision (ICD-9) procedure codes for patients admitted to U.S. hospitals for unilateral primary TKA between 2001 and 2010. Patients were separated into young (< 65 years of age) and senior cohorts (≥ 65 years of age)...
October 24, 2016: Journal of Knee Surgery
Mei Chung, Alice M Tang, Zhuxuan Fu, Ding Ding Wang, Sydne Jennifer Newberry
Background: Conflicting evidence exists regarding potential cardiovascular risks associated with high levels of calcium intake. Purpose: To update and reanalyze 2 systematic reviews to examine the effects of calcium intake on cardiovascular disease (CVD) among generally healthy adults. Data Sources: MEDLINE; Cochrane Central Register of Controlled Trials; Scopus, including EMBASE; and previous evidence reports from English-language publications from 1966 to July 2016...
October 25, 2016: Annals of Internal Medicine
Sterling L Karakula, Roger D Weiss, Margaret L Griffin, Allison M Borges, Allen J Bailey, R Kathryn McHugh
BACKGROUND: Among those with opioid use disorder, heroin use is associated with poorer prognosis relative to use of prescription opioids alone. However, relatively little is known about distinguishing features between those who use heroin relative to those who use prescription opioids. In the present study we evaluated differences in delay discounting in those with opioid use disorder based on primary opioid of use. Delay discounting is associated with a range of negative outcomes and is an important therapeutic target in this population...
October 17, 2016: Drug and Alcohol Dependence
Dong-Hyun Choi, Seong-Ho Kang, Heesang Song
Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombosis. They secrete and express many substances that are crucial mediators of coagulation, inflammation, and atherosclerosis. Mean platelet volume (MPV) is a precise measure of platelet size, and is routinely reported during complete blood count analysis. Emerging evidence supports the use of MPV as a biomarker predicting the risk of ischemic stroke in patients with atrial fibrillation, and as a guide for prescription of anticoagulation and rhythm-control therapy...
October 24, 2016: Korean Journal of Internal Medicine
Amy E Barth, Amy Elleman
Purpose: We examined the effectiveness of a multistrategy inference intervention designed to increase inference making and reading comprehension for middle-grade struggling readers. Method: A total of 66 middle-grade struggling readers were randomized to treatment (n = 33) and comparison (n = 33) conditions. Students in the treatment group received explicit instruction in 4 inference strategies (i.e., clarification using text clues; activating and using prior knowledge; understanding character perspectives and author's purpose; answering inferential questions)...
October 24, 2016: Language, Speech, and Hearing Services in Schools
Julio Vargas, Vincenzo Landi, Amparo Martínez, Mayra Gómez, María Esperanza Camacho, Luz Ángela Álvarez, Lenin Aguirre, Juan Vicente Delgado
Macabea cattle are the only Bos taurus breed that have adapted to the wet tropical conditions of the Amazon. This breed has integrated into the culture of the indigenous Shuar-Asuar nations probably since its origins, being one of the few European zoogenetic resources assimilated by the deep-jungle Amazon communities. Despite its potential for local endogenous sustainable development, this breed is currently endangered. The present study used molecular genetics tools to investigate the within- and between-breeds diversity, in order to characterize the breed population, define its associations with other breeds, and infer its origin and evolution...
2016: PloS One
Adrian D Vickers, Claire Ainsworth, Reema Mody, Annika Bergman, Caroline S Ling, Jasmina Medjedovic, Michael Smyth
BACKGROUND: Biological therapies are increasingly used to treat ulcerative colitis (UC). AIM: To compare the efficacy of biologics in adults with moderately-to-severely active UC, stratified by prior exposure to anti-tumour necrosis factor (anti-TNF) therapy. METHODS: A systematic literature review was undertaken to identify studies of biologics approved for UC. Network meta-analysis was conducted for endpoints at induction and maintenance...
2016: PloS One
Ding-Yu Yeh, Hsiao-Ching Kuo, Yi-Hsin Yang, Pei-Shan Ho
The objective of this study was to determine the responsiveness of oral health-related quality of life (OHRQoL) (oral health impact profile [OHIP] and oral impact on daily performance [OIDP]) and health-related quality of life (HRQoL) (World Health Organization quality of life scale, brief [WHOQOL-BREF]) in dental caries restoration treatment. The study also aimed to assess the influence of treatment on the responsiveness of patients' quality of life (QoL). A total of 126 patients (aged 16-40 years) received dental caries restoration treatment with a 2-week follow-up and pre- and posttreatment interviews by questionnaire...
2016: PloS One
Robert Froud, Shilpa Patel, Dévan Rajendran, Philip Bright, Tom Bjørkli, Rachelle Buchbinder, Sandra Eldridge, Martin Underwood
BACKGROUND: Increasing patient-reported outcome measures in the 1980s and 1990s led to the development of recommendations at the turn of the millennium for standardising outcome measures in non-specific low back pain (LBP) trials. Whether these recommendations impacted use is unclear. Previous work has examined citation counts, but actual use and change over time, has not been explored. Since 2011, there has been some consensus on the optimal methods for reporting back pain trial outcomes...
2016: PloS One
Jochen Meyburg, Mona-Lisa Dill, Chani Traube, Gabrielle Silver, Rebecca von Haken
OBJECTIVE: Intensive care delirium is a substantial problem in adults. Intensive care delirium is increasingly recognized in pediatrics in parallel with the development of specific scoring systems for children. However, little is known about the fluctuating course of intensive care delirium in children after surgery and possible implications on diagnostic and therapeutic strategies. DESIGN: Patients that needed treatment in the PICU following elective surgery were screened for intensive care delirium with the Cornell Assessment of Pediatric Delirium...
October 21, 2016: Pediatric Critical Care Medicine
Justin Ernat, Christine Ho, Robert L Wimberly, ChanHee Jo, Anthony I Riccio
BACKGROUND: Few studies have prospectively assessed functional outcomes after the surgical management of supracondylar humerus fractures (SCHFXs) and the relationship between fracture pattern and ultimate patient outcome has never been prospectively evaluated. The purpose of this study was to prospectively evaluate fracture classification and functional outcome in children with extension SCHFXs using validated outcome measures. METHODS: An Institutional Review Board-approved prospective enrollment of consecutive patients with operative SCHFX was performed over a 3-year period...
October 21, 2016: Journal of Pediatric Orthopedics
Hyung Nam Kim, Tami H Wyatt, Xueping Li, Mark Gaylord
Although parents of premature infants experience many challenges when transitioning home from the neonatal intensive care unit, healthcare providers and social support systems tend to focus on mothers and infants rather than fathers. Unfortunately, very little is known about paternal concerns and needs as compared with maternal ones. The lack of understanding about paternal needs may lead to inadequate designs of neonatal intensive care unit family support programs with less involved fathers, all of which contribute to increased burdens on mothers and poor health outcomes for their infants...
October 2016: Journal of Perinatal & Neonatal Nursing
Pierre Russo, John C Magee, Robert A Anders, Kevin E Bove, Catherine Chung, Oscar W Cummings, Milton J Finegold, Laura S Finn, Grace E Kim, Mark A Lovell, Margret S Magid, Hector Melin-Aldana, Sarangarajan Ranganathan, Bahig M Shehata, Larry L Wang, Frances V White, Zhen Chen, Catherine Spino
The liver biopsy guides diagnostic investigation and therapy in infants with undiagnosed cholestasis. Histologic features in the liver may also have prognostic value in the patient with biliary atresia (BA). We assessed the relative value of histologic features in 227 liver needle biopsies in discriminating between BA and other cholestatic disorders in infants enrolled in a prospective Childhood Liver Disease Research Network (ChiLDReN) cohort study by correlating histology with clinical findings in infants with and without BA...
October 21, 2016: American Journal of Surgical Pathology
Chip P Rowan, Michael C Riddell, Norman Gledhill, Veronica K Jamnik
PURPOSE: Prediabetes is linked to several modifiable risk factors, in particular, physical activity participation. The optimal prescription for physical activity remains uncertain. This pilot study aimed to investigate the effectiveness of continuous moderate intensity (CON) versus high intensity interval (HIIT) aerobic training in persons with prediabetes. Outcome measures included hemoglobin A1c (A1C), body composition, musculoskeletal and aerobic fitness. METHODS: Participants (n= 35) were recruited and screened using a questionnaire plus capillary blood point-of-care A1C analysis...
October 21, 2016: Medicine and Science in Sports and Exercise
Pavel S Roshanov, Bram Rochwerg, Ameen Patel, Omid Salehian, Emmanuelle Duceppe, Emilie P Belley-Côté, Gordon H Guyatt, Daniel I Sessler, Yannick Le Manach, Flavia K Borges, Vikas Tandon, Andrew Worster, Alexandra Thompson, Mithin Koshy, Breagh Devereaux, Frederick A Spencer, Robert D Sanders, Erin N Sloan, Erin E Morley, James Paul, Karen E Raymer, Zubin Punthakee, P J Devereaux
BACKGROUND: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. METHODS: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker users) at least 45 yr old who had in-patient noncardiac surgery from 2007 to 2011...
October 24, 2016: Anesthesiology
Bertel T Hansen, Kim M Sønderskov, Ida Hageman, Peter T Dinesen, Søren D Østergaard
BACKGROUND: Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes...
October 20, 2016: Epidemiology
Sergey V Malov, Alexey Antonik, Minzhong Tang, Alexandre Berred, Yi Zeng, Stephen J O'Brien
A new approach for statistical association signal identification is developed in this paper. We consider a strategy for nonprecise signal identification by extending the well-known signal detection and signal identification methods applicable to the multiple testing problem. Collection of statistical instruments under the presented approach is much broader than under the traditional signal identification methods, allowing more efficient signal discovery. Further assessments of maximal value and average statistics in signal discovery are improved...
October 24, 2016: Biometrical Journal. Biometrische Zeitschrift
Pavel Sumazin, Yidong Chen, Lisa R Treviño, Stephen F Sarabia, Oliver A Hampton, Kayuri Patel, Toni-Ann Mistretta, Barry Zorman, Patrick Thompson, Andras Heczey, Sarah Comerford, David A Wheeler, Murali Chintagumpala, Rebecka Meyers, Dinesh Rakheja, Milton J Finegold, Gail Tomlinson, D Williams Parsons, Dolores López-Terrada
Despite being the most common liver cancer in children, hepatoblastoma (HB) is a rare neoplasm. Consequently, few pre-treatment tumors have been molecularly profiled and there are no validated prognostic or therapeutic biomarkers for HB patients. We report on the first large-scale effort to profile pre-treatment HBs at diagnosis. Our analysis of 88 clinically-annotated HBs revealed three risk-stratifying molecular subtypes that are characterized by differential activation of hepatic progenitor cell markers and metabolic pathways: high-risk tumors were characterized by up-regulated NFE2L2 activity, high LIN28B, HMGA2, SALL4 and AFP expression, and high coordinated expression of oncofetal proteins and stem cell markers; while low-risk tumors had low LIN28B and let-7 expression, and high HNF1A activity...
October 24, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Jamie Perin, John S Preisser
Alternating logistic regressions is an estimating equations procedure used to model marginal means of correlated binary outcomes while simultaneously specifying a within-cluster association model for log odds ratios of outcome pairs. A recent generalization of alternating logistic regressions, known as orthogonalized residuals, is extended to incorporate finite sample adjustments in the estimation of the log odds ratio model parameters for when there is a moderately small number of clusters. Bias adjustments are made both in the sandwich variance estimators and in the estimating equations for the association parameters...
October 24, 2016: Biometrics
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