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https://www.readbyqxmd.com/read/29036315/probabilistic-modeling-approach-to-reducing-healthcare-costs-with-reflex-testing
#1
Sameer Prakash, Tyler Hamby, Van Leung-Pineda, Don P Wilson
Objective: Statistical methods can be utilized to optimize the order for reflex diagnostic testing to attenuate patient and hospital costs without affecting quality of care. Our objective is to demonstrate the method of developing an order for testing and to apply this method to an illustrative example. Methods: An algorithm was developed for minimizing costs for any given number of diagnostic tests, and it was retrospectively applied to a sample. Results: The actual scenario of using both tests on all patients was compared to 2 other hypothetical reflex testing approaches: all patients are given 1 test, and those patients who tested negative were then given the second test...
September 23, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29036278/perceptions-of-risk-and-therapy-among-patients-with-barrett-s-esophagus-a-patient-survey-study
#2
M W Stier, N Lodhia, J Jacobs, D Nozicka, R Kavitt, U Siddiqui, I Waxman, V J Konda
Nondysplastic Barrett's esophagus has a risk of progression to esophageal adenocarcinoma as low as 0.18-0.3% per person per year, and low-grade dysplasia as low as 0.5%. While adherence to guidelines and selection of management options varies, little is known about what modifies patient decision-making. This study aims to evaluate and identify factors that influence patient perceptions of risk and decisions about management. An independently developed and piloted survey was administered to patients at an academic hospital...
September 21, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29034308/cost-effectiveness-analysis-study-of-hpv-testing-as-a-primary-cervical-cancer-screening-in-thailand
#3
Wichai Termrungruanglert, Nipon Khemapech, Tanitra Tantitamit, Suleeporn Sangrajrang, Piyalamporn Havanond, Piyawat Laowahutanont
OBJECTIVES: The aim of this study is to compare the cost and benefit of four different cervical cancer screening strategies involving primary HPV 16/18 genotyping, hrHPV testing alone and cytology for detecting CIN2 +. METHODS: Economical analysis using Markov modeling approach to combine the epidemiological data from current population-based study of The National Cancer Institute of Thailand. A cohort of 100,000 hypothetical female population age 30-65 years was simulated in each strategy...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/29033206/pediatric-environmental-health-using-data-on-toxic-chemical-emissions-in-practice
#4
Kara Koehrn, Jocelyn Hospital, Alan Woolf, Jennifer Lowry
Children's unique behavioral and physiological characteristics can increase their exposure and susceptibility to environmental chemicals. The link between exposure to environmental chemicals and specific health outcomes, however, is often uncertain. This article introduces several resources to help health practitioners identify potential environmental exposures and risks related to toxic chemicals. It focuses on the U.S. Environmental Protection Agency's (EPA's) free and public environmental data, including the Toxics Release Inventory (TRI) data that contain information about toxicants released to the environment...
October 12, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29032277/marine-ecological-risk-assessment-methods-for-radiation-accidents
#5
Sufen Ye, Luoping Zhang, Huan Feng
Ecological risk assessment (ERA) is a powerful technical tool that can be used to analyze potential and extreme adverse environmental impacts. With the rapid development of nuclear power plants in coastal areas around the world, the establishment of approaches and methodologies for marine ERA with a focus on radiation accidents is an urgent requirement for marine environmental management. In this study, the approaches and methodologies for ERA pertaining to marine radiation accidents (MRA) are discussed and summarized with applications in case studies, such as the nuclear accident in Fukushima, Japan, and a hypothetical accident in Daya Bay, China...
October 12, 2017: Journal of Environmental Radioactivity
https://www.readbyqxmd.com/read/29032111/paranormal-belief-and-errors-of-probabilistic-reasoning-the-role-of-constituent-conditional-relatedness-in-believers-susceptibility-to-the-conjunction-fallacy
#6
Paul Rogers, John E Fisk, Emma Lowrie
The present study examines the extent to which stronger belief in either extrasensory perception, psychokinesis or life-after-death is associated with a proneness to making conjunction errors (CEs). One hundred and sixty members of the UK public read eight hypothetical scenarios and for each estimated the likelihood that two constituent events alone plus their conjunction would occur. The impact of paranormal belief plus constituents' conditional relatedness type, estimates of the subjectively less likely and more likely constituents plus relevant interaction terms tested via three Generalized Linear Mixed Models...
October 12, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/29030805/an-explicit-structural-model-of-root-hair-and-soil-interactions-parameterised-by-synchrotron-x-ray-computed-tomography
#7
Samuel David Keyes, Konstantinos C Zygalakis, Tiina Roose
The rhizosphere is a zone of fundamental importance for understanding the dynamics of nutrient acquisition by plant roots. The canonical difficulty of experimentally investigating the rhizosphere led long ago to the adoption of mathematical models, the most sophisticated of which now incorporate explicit representations of root hairs and rhizosphere soil. Mathematical upscaling regimes, such as homogenisation, offer the possibility of incorporating into larger-scale models the important mechanistic processes occurring at the rhizosphere scale...
October 13, 2017: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/29029957/a-model-based-approach-for-estimation-of-changes-in-lumbar-segmental-kinematics-associated-with-alterations-in-trunk-muscle-forces
#8
Iman Shojaei, Navid Arjmand, Judith R Meakin, Babak Bazrgari
The kinematics information from imaging, if combined with optimization-based biomechanical models, may provide a unique platform for personalized assessment of trunk muscle forces (TMFs). Such a method, however, is feasible only if differences in lumbar spine kinematics due to differences in TMFs can be captured by the current imaging techniques. A finite element model of the spine within an optimization procedure was used to estimate segmental kinematics of lumbar spine associated with five different sets of TMFs...
October 6, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29029621/uncertainty-on-the-effectiveness-and-safety-of-rivaroxaban-in-premenopausal-women-with-atrial-fibrillation-empirical-evidence-needed
#9
Herbert J A Rolden, Angela H E M Maas, Gert Jan van der Wilt, Janneke P C Grutters
BACKGROUND: Novel anticoagulations (NOACs) are increasingly prescribed for the prevention of stroke in premenopausal women with atrial fibrillation. Small studies suggest NOACs are associated with a higher risk of abnormal uterine bleeds than vitamin K antagonists (VKAs). Because there is no direct empirical evidence on the benefit/risk profile of rivaroxaban compared to VKAs in this subgroup, we synthesize available indirect evidence, estimate decision uncertainty on the treatments, and assess whether further research in premenopausal women is warranted...
October 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29028922/methods-for-handling-longitudinal-outcome-processes-truncated-by-dropout-and-death
#10
Lan Wen, Graciela Muniz Terrera, Shaun R Seaman
Cohort data are often incomplete because some subjects drop out of the study, and inverse probability weighting (IPW), multiple imputation (MI), and linear increments (LI) are methods that deal with such missing data. In cohort studies of ageing, missing data can arise from dropout or death. Methods that do not distinguish between these reasons for missingness typically provide inference about a hypothetical cohort where no one can die (immortal cohort). It has been suggested that inference about the cohort composed of those who are still alive at any time point (partly conditional inference) may be more meaningful...
September 26, 2017: Biostatistics
https://www.readbyqxmd.com/read/29028461/antibiotic-impregnated-central-venous-catheters-do-not-change-antibiotic-resistance-patterns
#11
Isaiah R Turnbull, Sara A Buckman, Christopher B Horn, Grant V Bochicchio, John E Mazuski
BACKGROUND: Antibiotic-impregnated central venous catheters (CVCs) decrease the incidence of infection in high-risk patients. However, use of these catheters carries the hypothetical risk of inducing antibiotic resistance. We hypothesized that routine use of minocycline and rifampin-impregnated catheters (MR-CVC) in a single intensive care unit (ICU) would change the resistance profile for Staphylococcus aureus. METHODS: We reviewed antibiotic susceptibilities of S...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29027602/combining-risk-communication-strategies-to-simultaneously-convey-the-risks-of-four-diseases-associated-with-physical-inactivity-to-socio-demographically-diverse-populations
#12
Eva Janssen, Robert A C Ruiter, Erika A Waters
A single risk factor can increase the risk of developing multiple diseases, but most risk communication research has been conducted in the context of a single disease. We explored which combination of three recommended risk communication strategies is most effective in simultaneously conveying risk estimates of four diseases associated with physical inactivity: colon cancer, stroke, diabetes, and heart disease. Participants (N = 1161, 50% no college experience, 50% racial/ethnic minority) were shown hypothetical risk estimates for each of the four diseases...
October 13, 2017: Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/29025728/necessary-catheter-diameters-for-mechanical-thrombectomy-with-adapt
#13
O Nikoubashman, A Nikoubashman, M Büsen, M Wiesmann
BACKGROUND AND PURPOSE: Large-bore catheters allow mechanical thrombectomy in ischemic stroke by engaging and retrieving clots without additional devices (direct aspiration first-pass technique [ADAPT]). The purpose of this study was to establish a model for minimal catheter diameters needed for ADAPT. MATERIALS AND METHODS: We established a theoretic model for the calculation of minimal catheter diameters needed for ADAPT. We then verified its validity in 28 ADAPT maneuvers in a porcine in vivo model...
October 12, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29025143/cost-effectiveness-of-the-pharmacist-assisted-warfarin-monitoring-program-at-a-medical-center-in-taiwan
#14
Jen-Yu Chang, Chi-Chuan Wang, Hao-Cheng Kang, Li-Jiuan Shen, Chih-Fen Huang
Objective: To investigate the cost-effectiveness of the first patient self-paying pharmacist-assisted warfarin monitoring (PAWM) program in Taiwan. Design: A Markov model with a 1-month cycle length and a 20-year time horizon was employed in this study. The model is composed of the following eight states: three no-event states (i.e. 'subtherapeutic,' 'within therapeutic' and 'supratherapeutic' states), two serious adverse events (AEs) (i.e. bleeding and thromboembolism), two sequelae states and death...
August 22, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29023799/mir-214-activates-tp53-but-suppresses-the-expression-of-rela-ctnnb1-and-stat3-in-human-cervical-and-colorectal-cancer-cells
#15
Karthik Subramanian Chandrasekaran, Anusha Sathyanarayanan, Devarajan Karunagaran
High Mobility Group AT-hook 1 (HMGA1) was identified as a target of miR-214 in human cervical and colorectal cancers (CaCx and CRC) in a previous study. While the expression of miR-214 remains suppressed, HMGA1 behaves as a potent oncogene and plays crucial roles in several aberrant signalling pathways by interacting with intermediates like RELA, CTNNB1, STAT3, and TP53 in CaCx and CRC. Hypothetically, miR-214 should be able to regulate the stabilization of some of these intermediates through the regulation of HMGA1...
October 10, 2017: Cell Biochemistry and Function
https://www.readbyqxmd.com/read/29023225/-transformation-tuesday-temporal-context-and-post-valence-influence-the-provision-of-social-support-on-social-media
#16
Erin A Vogel, Jason Rose, Chantal Crane
Social network sites (SNSs) such as Facebook have become integral in the development and maintenance of interpersonal relationships. Users of SNSs seek social support and validation, often using posts that illustrate how they have changed over time. The purpose of the present research is to examine how the valence and temporal context of an SNS post affect the likelihood of other users providing social support. Participants viewed hypothetical SNS posts and reported their intentions to provide social support to the users...
October 12, 2017: Journal of Social Psychology
https://www.readbyqxmd.com/read/29022364/fast-wandering-takotsubo-syndrome-atypical-mixed-evolution-from-apical-to-mid-ventricular-ballooning
#17
Grazia Casavecchia, Stefano Zicchino, Matteo Gravina, Guglielmo Maulucci, Vincenzo Manuppelli, Nicola Tarantino, Antonio Ruggiero, Dolores Russo, Francesco Santoro, Luca Macarini, Matteo Di Biase, Natale Daniele Brunetti
We report the case of a 53-year-old woman admitted for typical chest pain and a diagnosis of Takotsubo syndrome (TTS). Initial echocardiographic presentation was characterized by apical and mid-ventricular akinesis and basal hyper-kinesis. Unexpectedly, later after admission, echocardiography showed recovered apical akinesis with an apparent 'migration' of systolic dysfunction to mid-ventricular segment and hyper-kinesis of apical and basal segments. One week after admission, left ventricular contractility completely recovered and cardiac magnetic resonance imaging did not show signs of subendocardial late-enhancement and myocardial edema...
October 12, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29022120/experience-based-utility-and-own-health-state-valuation-for-a-health-state-classification-system-why-and-how-to-do-it
#18
John Brazier, Donna Rowen, Milad Karimi, Tessa Peasgood, Aki Tsuchiya, Julie Ratcliffe
In the estimation of population value sets for health state classification systems such as the EuroQOL five dimensions questionnaire (EQ-5D), there is increasing interest in asking respondents to value their own health state, sometimes referred to as "experience-based utility values" or, more correctly, own rather than hypothetical health states. Own health state values differ to hypothetical health state values, and this may be attributable to many reasons. This paper critically examines whose values matter; why there is a difference between own and hypothetical values; how to measure own health state values; and why to use own health state values...
October 11, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29021933/a-survey-based-method-to-evaluate-optimal-treatment-selection-for-escape-maintained-problem-behavior
#19
Valdeep Saini, Alison M Betz, Meagan K Gregory, Yanerys Leon, Nathalie Fernandez
Geiger, Carr, and LeBlanc (2010) developed a decision-making model for escape-maintained problem behavior that could be used to guide the course of treatment selection. We used a digital survey to evaluate the model's potential usefulness. We presented novice and expert practitioners' written hypothetical scenarios and asked them to determine the optimal treatment in a given situation. Some participants were given the model, whereas others were instructed to use their best clinical judgment. Using logistic regression analyses, the general findings for our scenarios were the following: (a) experts without the aid of a decision model had better odds of selecting the optimal treatment than novices without the decision model, (b) experts with the decision model did not have greater odds of selecting optimal treatment than experts without the model, and...
September 2017: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/29021640/population-attributable-fractions-for-colorectal-cancer-and-red-and-processed-meats-in-colombia-a-macro-simulation-study
#20
Esther de Vries, Doris C Quintero, Giana Henríquez-Mendoza, Oscar Fernando Herrán
AIM: to estimate the population attributable risk of consumption of red and processed meat for colorectal cancer in Colombia. METHODS: to model the expected incidence of colorectal cancer in the hypothetical situation of no red and processed meat consumption in Colombia, for the year 2010. A dynamic macrosimulation model, PREVENT 3.01, was used to integrate available cancer incidence, meat consumption prevalence and associated risk data and to evaluate the impact of eliminating red and processed meat from the Colombian diet on national colorectal cancer incidence...
June 30, 2017: Colombia Médica: CM
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