Publications by authors named "A D Sharan"
Background And Objectives: A few studies have compared the value (outcomes per dollar spent) provided by transforaminal endoscopic discectomy (TED) vs microdiscectomy (MD) for lumbar disc herniations. Here, we attempt to address this gap using a novel Operative Value Index (OVI), which combines a procedure-specific patient-reported outcome with intraoperative cost data based on time-driven activity-based costing.
Methods: MD (n = 95) and TED (n = 23) performed by neurosurgeons at our institution from 2017 to 2022 were retrospectively identified.
Article Synopsis
- Total disc replacement (TDR) is an alternative to anterior cervical discectomy and fusion (ACDF), and this study compares their costs as we shift towards value-based healthcare.
- Using time-driven activity-based costing (TDABC), researchers reviewed the costs of both procedures, analyzing direct and indirect costs through observation and data collection from various departments.
- The results showed that TDRs had significantly higher total intraoperative costs ($12,026) compared to ACDFs ($6,776), with the majority of the cost difference attributed to more expensive supply items, particularly implants.
We present a dataset of six metagenomes and 323 metagenome assembled genomes (MAGs) describing the microbial community of anaerobic digesters at three Canadian pulp and paper mills. Our objective was to assess the coding potential of the microbial community and obtain draft genomes of key organisms in the digesters.
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- Neuropathic pain (NP) is a challenging condition that can occur after spinal cord injury (SCI), and this study investigates the brain area called the periaqueductal gray (PAG) and how it relates to NP development using resting-state functional MRI (rsfMRI).
- The research involved 20 participants: 10 SCI patients (with and without NP) and 10 healthy controls, examining differences in functional connectivity (FC) between the PAG and other brain regions.
- Findings revealed decreased FC in SCI patients with NP compared to healthy controls and increased FC in other areas when compared to SCI patients without NP, suggesting significant brain connectivity alterations linked to neuropathic pain after spinal cord injury.
Article Synopsis
- Elective lumbar fusions are often criticized for being used improperly, prompting a study using a new Operative Value Index (OVI) to evaluate the cost-effectiveness of evidence-based lumbar fusions.
- A retrospective analysis of 294 patients found that a majority (92.9%) underwent evidence-based surgeries, with OVI measuring patient improvement per dollar spent showing significantly better outcomes for these procedures compared to non-evidence-based ones.
- The results indicate that adhering to evidence-based guidelines leads to greater patient improvement (2% per $1000 spent) and highlights the potential for systematic improvements in lumbar fusion practices.