Publications by authors named "Jennifer R Frytak"
Article Synopsis
- The article addresses the challenge of applying treatment effect estimates from randomized trials to real-world clinical settings, due to effect measure modification.* -
- It presents a practical roadmap and four visual tools to aid researchers in selecting variables for models that extend trial effects, specifically using adjuvant chemotherapy for colon cancer as an example.* -
- The visualizations help identify modifiers, assess overlap between populations, and guide model specification, ultimately enhancing the validity of treatment effect extensions to clinical practice.*
Importance: Delivery of adjuvant chemotherapy can differ substantially between trial and real-world populations. Adherence metrics like relative dose intensity (RDI) cannot capture the timing of modifications and mask differences in the total amount of chemotherapy received.
Objective: To compare oxaliplatin delivery between MOSAIC trial participants and patients treated in the US Oncology Network with stage III colon cancer using a longitudinal cumulative dose (LCD).
The programmed death-1 inhibitor pembrolizumab has demonstrated efficacy and safety in clinical trials for treating advanced (unresectable/metastatic) melanoma. We investigated the real-world utilization of pembrolizumab and associated patient outcomes for advanced melanoma in US community oncology practices. This retrospective, observational study used deidentified data from electronic health records for adult patients with advanced melanoma who received pembrolizumab at The US Oncology Network sites from September 2014 through December 2015, with follow-up through September 2016.
View Article and Find Full Text PDFBackground: Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1) to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2) to assess the increased cost associated with this potential misdiagnosis.
View Article and Find Full Text PDFObjective: To determine whether racial and ethnic effects on bounce-back risk (ie, movement to settings of higher care intensity within 30 d of hospital discharge) in acute stroke patients vary depending on initial posthospital discharge destination.
Design: Retrospective analysis of administrative data.
Setting: Four hundred twenty-two hospitals, southern/eastern United States.
Objective: The aim of the study was to compare early symptom resolution with a single 2-g dose of azithromycin extended release or 10 days of amoxicillin/clavulanate 875 mg/125 mg every 12 hours in patients with acute sinusitis.
Materials And Methods: This was a prospective, randomized, open-label, observational study to mimic "real-world" conditions, including patients with symptoms of acute bacterial sinusitis lasting between 7 and 30 days. Key symptoms were assessed twice daily by patient diary, and patients were interviewed by telephone at 12 and 28 days.
Objective: To examine the economic burden of myelodysplastic syndromes (MDS) and the incremental cost of transfusion dependence.
Research Design And Methods: Adults with evidence of MDS were identified between 05/01/2000 and 09/30/2003 from a longitudinal, retrospective claims database for a large, geographically diverse US health plan and their medical histories were followed for at least 6 months. Patients were classified as transfusion-dependent (MDS-TD) or transfusion-independent (MDS-TI).
Background: Follow-up is critically important for stroke survivors with diabetes, yet there is limited research about the quality of diabetes care that these patients receive. We investigated performance on diabetes quality of care indicators for stroke survivors overall and by race.
Methods: Claims data was extracted for 1,460 Medicare beneficiaries with preexisting diabetes who survived hospitalization for acute ischemic stroke in 2000.
Background: Hospice is considered to be underutilized, particularly among patients with noncancer diagnoses such as stroke. The highest mortality among stroke patients occurs within the first 30 days; however, we know little about the hospice enrollment decision for this population during this critical time frame.
Objectives: To determine hospice enrollment rates and to describe sociodemographic and clinical predictors of hospice utilization among patients who die within 30 days of their stroke.
Background: The objective of this study was to assess the disease burden of Alzheimer's disease (AD) in a commercial managed care setting by comparing direct health care costs and adverse event outcomes between patients with AD and without AD.
Methods: The study design used eligibility, medical, and pharmacy claims data from a large, national, geographically diverse, fee-for-service U.S.
Objectives: To examine 1-year mortality and healthcare payments of stroke patients experiencing zero, one and two or more bounce-backs within 30 days of discharge.
Design: Retrospective analysis of administrative data.
Setting: Four hundred twenty-two hospitals in the southern and eastern United States.
Background: Bipolar disorder is challenging to diagnose in medical practice.
Objectives: Our objectives were (1) to determine the rate of depression misdiagnosis in patients previously diagnosed with bipolar disorder in administrative claims, (2) to determine the resulting increased treatment costs, and (3) to verify the misdiagnoses in the medical charts for a subset of patients.
Method: We employed cohort analysis using claims from a large, commercial, U.
Background: "Bounce-backs" (movements from a less intensive to a more intensive care setting) soon after hospital discharge are common, but reasons for bouncing-back remain unknown.
Objective: To examine how the primary diagnosis for first rehospitalization relates to thirty-day bounce-back number and initial discharge destination in acute stroke.
Population: Administrative data from 5,250 Medicare beneficiaries > or = 65 years discharged with acute ischemic stroke in 1998-2000 to a rehabilitation center, skilled nursing facility or home with home health care and with at least one thirty day rehospitalization.
Objective: To explore the relationship between persistence with alendronate therapy and fracture rates in women with postmenopausal osteoporosis.
Research Design And Methods: Claims data from a large US health plan database were used to examine persistence with therapy in postmenopausal women followed for 24 months. Persistence was defined as the time (in days) from the date of first fill to the run-out date of the last prescription with no lapses > 30 days after completion of the previous refill.
Objectives: To identify predictors of complicated transitions within 30 days after discharge from hospitalization for acute stroke.
Design: Retrospective analysis of administrative data.
Setting: Four hundred twenty-two hospitals in the southern and eastern United States.
Background And Purpose: Stroke patients appear to have improved outcomes when cared for by neurologists, but the mechanism by which improved outcome is achieved is unclear. This study compares 30-day cause-specific rehospitalization, 30-day mortality, and specific processes of care for patients treated by a neurologist only, a generalist only, a neurologist and a generalist (i.e.
View Article and Find Full Text PDFObjectives: To compare posttreatment medical costs for patients with overactive bladder (OAB) initiating treatment with oxybutynin chloride immediate release (oxybutynin IR), oxybutynin chloride extended release (oxybutynin ER), or tolterodine extended-release tartrate capsules (tolterodine ER).
Methods: Data were drawn from administrative claims of enrollees aged 18 years and older of a large US health plan. OAB patients were identified if at least 1 claim with an International Statistical Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for OAB appeared in medical claims from January 1, 2001, to December 31, 2002.
Background: Stroke affects more than 500,000 older persons each year in the United States, but no studies have compared older stroke patients in Medicare health maintenance organizations (HMOs) and fee-for-service (FFS) after recent changes in FFS reimbursement.
Objectives: We sought to compare utilization and outcomes after stroke in Medicare HMO and FFS.
Design: We reviewed administrative data in 11 regions from Medicare and a large national health plan.
Objective: To examine treatment compliance and dosage administration associated with infliximab, etanercept, and methotrexate therapy for rheumatoid arthritis (RA).
Study Design: Retrospective analysis using administrative and claims data from a large US health plan.
Patients And Methods: Patients were Medicare or commercial enrollees in a health plan with a pharmacy benefit and had a diagnosis of RA.