Background: Hypoxia is a typical microenvironmental feature of most solid tumors, affecting a variety of physiological processes. We developed a hypoxia-related prognostic risk score (HPRS) model to reveal tumor microenvironment (TME) and predict prognosis of lung adenocarcinoma (LUAD).
Methods: LUAD sample expression data were from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases.
Background: We sought to measure the impact of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) findings on clinical practice by studying trends in carotid artery stenting (CAS) and carotid endarterectomy (CEA) utilization before and after publication of CREST in a large US multihospital database.
Methods: The Premier Perspective Database was used to identify inpatient CEA and CAS procedures performed from January 2006 to March 2013. Patients were subclassified by age (<70/≥70 years) and presentation (symptomatic/asymptomatic).
Background: The Patient Assessment of Chronic Illness Care (PACIC) survey is a widely used instrument to assess the patient experience with healthcare delivery.
Purpose: This study aims to evaluate the factorial structure of PACIC from the patient perspective.
Methods: A postal survey was mailed to 4,796 randomly selected adults with diabetes from 34 primary care clinics.
Background: The 2009 US Preventive Services Task Force breast cancer screening update recommended against routine screening mammography for women aged 40-49; confusion and release of conflicting guidelines followed. We examined the impact of the USPSTF update on population-level screening mammography rates in women ages 40-49.
Methods And Findings: We conducted a retrospective, interrupted time-series analysis using a nationally representative, privately-insured population from 1/1/2006-12/31/2011.
Background And Purpose: Endovascular therapy has increasingly become the most common treatment for unruptured cerebral aneurysms in the United States. We evaluated a national, multi-hospital database to examine recent utilization trends and compare periprocedural outcomes between clipping and coiling treatments of unruptured aneurysms.
Methods: The Premier Perspective database was used to identify patients hospitalized between 2006 to 2011 for unruptured cerebral aneurysm who underwent clipping or coiling therapy.
Surveys of physicians are an important tool to assess opinions and self-reported behaviors of this policy-relevant population. However, this population is notoriously difficult to survey and plagued with low and falling response rates. In order to evaluate the potential import of response rate, we examine the presence of nonresponse bias in a survey of physicians providing diabetes care that achieved a 36% response rate.
View Article and Find Full Text PDFState Medicaid programs use preferred drug lists to help limit prescribing of high-cost drugs and, at the same time, to free providers from having to obtain prior authorization for a given prescription. We examined the impact of the Food and Drug Administration's May 2007 safety warning regarding rosiglitazone (Avandia), a diabetes drug found to raise the risk of heart attacks, on the drug's availability on state Medicaid preferred drug lists and on the prescribing of diabetes medications more generally for Medicaid beneficiaries. Nearly all state Medicaid programs covered rosiglitazone as a preferred drug, requiring no prior authorization, with minimal change after the safety warning.
View Article and Find Full Text PDFSome health plans have experimented with increasing consumer cost sharing, on the theory that consumers will use less unnecessary health care if they are expected to bear some of the financial responsibility for it. However, it is unclear whether the resulting decrease in use is sustained beyond one or two years. In 2004 Mayo Clinic's self-funded health plan increased cost sharing for its employees and their dependents for specialty care visits (adding a $25 copayment to the high-premium option) and other services such as imaging, testing, and outpatient procedures (adding 10 or 20 percent coinsurance, depending on the option).
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