Publications by authors named "Joseph S Ross"

The Centers for Medicare and Medicaid Services (CMS) coverage with evidence development (CED) program provides coverage for items and services not meeting Medicare's "reasonable and necessary" standard while requiring participation in clinical studies. As additional evidence is available, CMS may reconsider CED decisions. Of twenty-six items and services in the CED program since its 2005 inception, CMS has reconsidered coverage for ten (38 percent).

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Under the 21st Century Cures Act of 2016, a summary of the evidence used to support local coverage determinations, which represent the vast majority of Medicare's coverage decisions for new technologies, must be made publicly accessible. Using reports from the Medicare Coverage Database on local coverage determinations and the medical literature, we examined the availability of these decisions and the quality of evidence cited for therapeutic drugs, biologics, and moderate- or high-risk devices during the period 2015-22 to understand whether evidence strength and generalizability differed for indications with favorable versus unfavorable coverage decisions. Evidence summaries were publicly available for 26 percent of coverage decisions originally effected during 2015-18 and 100 percent during 2019-22.

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Article Synopsis
  • * Evidence from court documents shows that the Celect IVC filter’s clinical study did not adhere to FDA guidelines and had inadequate methods for detecting serious complications.
  • * The misreporting of adverse events and patient deaths raises concerns about the accuracy of safety information provided to both clinicians and patients, underlining a need for reform in medical device regulations.
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Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.

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Background: Digital remote patient monitoring (RPM) enables longitudinal care outside traditional healthcare settings, especially in the vulnerable period after hospitalizations, with broad coverage of the service by payers. We sought to evaluate patterns of RPM service availability at US hospitals and the association of these services with 30-day readmissions for two key cardiovascular conditions, heart failure (HF) and acute myocardial infarction (AMI).

Methods: We used contemporary national data from the American Hospital Association (AHA) Annual Survey to ascertain US hospitals offering RPM services for post-discharge or chronic care and used census-based county-level data to define the characteristics of the communities they serve.

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In 2017, the National Library of Medicine (NLM) added a voluntary field for conflict of interest (COI) statements ("posted COI") on the abstract page of PubMed, but the extent to which it is used is unknown. This repeated cross-sectional study examined journals and articles indexed on PubMed from 2016 through 2021. We described the proportion of all journals with at least one article that included a posted COI and the percentage of all articles that included a posted COI over time.

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Objectives: To compare the premarket and postmarket evidence of safety and efficacy of direct oral anticoagulants approved for stroke prevention in atrial fibrillation patients across four major regulatory agencies.

Design: Cross-sectional.

Setting: European Medicines Association (EMA), US Food and Drug Administration (FDA), Health Canada and Australian Therapeutic Goods Administration (TGA).

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Industry payments to psychiatrists remain poorly characterized. Using data from the Centers for Medicare and Medicaid Services, the authors of this repeated cross-sectional study detail the extent and concentration of nonresearch industry payments to psychiatrists from 2015 to 2021. The proportion of psychiatrists receiving industry payments, payment distribution, and payment concentration among psychiatrists was assessed.

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Article Synopsis
  • Nearly all medical devices in the U.S. are authorized through the FDA's 510(k) clearance process, which compares new devices to existing ones without requiring extensive safety evidence.
  • Supporters argue this process fosters innovation and quick access to market, while critics raise concerns about patient safety.
  • In September 2023, the FDA released guidance documents aimed at reforming this process, focusing on improving predicate selection, clinical testing standards, and regulations for implantable devices to enhance transparency and safety.
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  • Improving the control of hypertension is crucial for public health, but accurately identifying uncontrolled hypertension using electronic health records (EHR) is challenging across different health systems.
  • A retrospective study analyzed EHR data from two health systems—Yale-New Haven Health System and OneFlorida Clinical Research Consortium—covering adult patients with hypertension from October 2015 to December 2018 to assess their blood pressure control status.
  • The study found that a significant percentage of patients had uncontrolled hypertension, with notably higher rates among Black patients compared to White patients, highlighting disparities in hypertension management.
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Background: Cardiovascular devices account for one third of all Class I recalls, the U.S. Food and Drug Administration's (FDA) most severe designation, indicating a reasonable probability of "serious adverse health consequences or death.

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Article Synopsis
  • Artificial intelligence (AI) is being increasingly integrated into cardiovascular care for various purposes like prevention and treatment, but faces ethical and trust issues from both patients and healthcare providers.
  • A comprehensive literature review was conducted to identify these ethical concerns and trust barriers, revealing that issues such as privacy, healthcare inequity, and accountability are significant obstacles to AI adoption.
  • Key findings show that major trust barriers stem from fears about data security, potential harm to patients, and the perceived lack of transparency and human touch in AI-driven healthcare.
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  • Real-world evidence is gaining interest for assessing the efficacy and safety of treatments for substance use disorders (SUDs), but its feasibility as a substitute for clinical trials remains unclear.
  • A study evaluated 272 clinical trials for SUDs registered on ClinicalTrials.gov to see if their data could be replicated using current insurance claims or electronic health records.
  • Findings showed that while many trials had identifiable criteria, no trial met all the requirements for effective emulation using real-world data, highlighting limitations in available data sources.
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  • This study compares the cardiovascular effectiveness of different second-line antihyperglycemic agents (SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, and sulfonylureas) in patients with type 2 diabetes and cardiovascular disease.
  • Using data from over 1.4 million patients across multiple databases, the researchers analyzed the risk of major adverse cardiovascular events (MACE) over a follow-up period of several years.
  • Results indicated that SGLT2 inhibitors and GLP-1 receptor agonists had significantly lower risks of MACE compared to DPP-4 inhibitors and sulfonylureas, pointing to their potential superiority as treatment options for
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  • A systematic review was conducted to summarize quantitative bias analysis (QBA) methods for observational studies, focusing on their characteristics and range based on peer-reviewed articles.
  • Out of over 10,000 records, 53 articles detailed 57 QBA methods, with a majority (93%) aimed at observational studies and relevant biases such as unmeasured confounding and misclassification.
  • This review provides a valuable resource for future researchers to identify appropriate QBA methods to adjust for biases in summary-level epidemiologic data.
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