Publications by authors named "A D Epstein"

Importance: Hospital participation in the Bundled Payments for Care Improvement-Advanced (BPCI-A) initiative has been associated with modest savings and stable clinical outcomes overall, but it is unknown whether the program performs differently for medical and surgical or procedural (henceforth, surgical) episodes.

Objective: To assess the association of BPCI-A participation with Medicare spending and clinical outcomes for medical and surgical episodes.

Design, Setting, And Participants: This retrospective difference-in-differences cohort study utilized 100% Medicare fee-for-service inpatient claims for episodes initiated between January 1, 2017, and September 30, 2019, and included 90 days of follow-up.

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Background: Hematopoietic stem cell transplant (HSCT) has curative potential but also relatively high morbidity and mortality. Patients have multidimensional palliative care (PC) needs throughout the transplant process. However, PC is not routinely offered to patients with hematologic malignancies.

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Article Synopsis
  • This study examines the financial effects on healthcare payers of using 60-day peripheral nerve stimulation (60-Day PNS) compared to a conventional brief trial (PNS-BT) for chronic pain patients.
  • Analysis of Medicare data revealed that patients starting with 60-Day PNS had lower costs and fewer complications when progressing to permanent implants compared to those starting with PNS-BT.
  • Overall, the 60-Day PNS approach is more cost-effective, resulting in lower costs per successful treatment outcome for chronic pain management.
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Two major types of defective vectors have been derived from herpes simplex virus type 1 (HSV-1), non-replicative genomic vectors (nrHSV-1), and amplicon vectors. This review recapitulates the main features of both vector types and summarizes recent improvements in our understanding of virus/vector biology, particularly with regard to the critical role played by the overpowering of antiviral cellular defenses and the epigenetic control of viral gene expression. Over the past years, significant breakthroughs in vector design, genetic engineering, and HSV-1 biology have accelerated the development of nrHSV-1 vectors.

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