Publications by authors named "Panagiotou O"

Objectives: This manuscript presents a comprehensive framework for the assessment of the value of real-world evidence (RWE) in healthcare decision-making. While RWE has been proposed to overcome some limitations of traditional, one-off studies, no systematic framework exists to measure if RWE actually lowers the burden. This framework aims to fill that gap by providing conceptual approaches for evaluating the time and cost efficiencies of RWE, thus guiding strategic investments in RWE infrastructure.

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  • High-intensity end-of-life care is burdensome without meaningful clinical benefits, and this study aims to uncover predictors among older adults with common cancers like breast, prostate, lung, and colorectal cancer.
  • The analysis used SEER-Medicare data from 2011 to 2015, focusing on Medicare beneficiaries aged 65 and older who passed away from these cancers, assessing various clinical and demographic factors.
  • Key findings revealed that increased comorbidity, female sex, Black race, living in populous or poorer areas, and having state-subsidized Medicare premiums were associated with higher chances of receiving high-intensity EoL care, while older age and living in the Midwest were linked to lower likelihoods.
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Throughout the COVID-19 pandemic in the US, counties adopted numerous nonpharmaceutical interventions, such as mask mandates and stay-at-home orders, to slow COVID-19 transmission and prevent hospitals from reaching full capacity. Early evidence has been mixed about whether these interventions are effective. However, most studies only covered the early waves of COVID-19 and did not account for county-level variation in the adoption and repeal of such policies.

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  • This study investigates the impact of COVID-19 on female patients with breast cancer, particularly focusing on underrepresented racial/ethnic populations from March 2020 to June 2021 in the US.
  • The analysis included 1,383 patients, revealing that older age and certain racial/ethnic groups (such as Black and Asian American/Pacific Islanders) showed higher odds of severe COVID-19 outcomes.
  • Key findings noted that factors like worse performance status, pre-existing health conditions, and active cancer significantly contributed to increased severity, while variables like Hispanic ethnicity and anti-cancer therapy type did not impact outcomes as much.
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  • The study investigates the impact of COVID-19 on female breast cancer patients using a large U.S. registry during 2020-2021, focusing on underrepresented racial/ethnic populations.
  • Key findings show that older age, being Black, Asian American/Pacific Islander, and having worse overall health significantly increase the severity of COVID-19 in these patients.
  • The overall hospitalization rate was 37% and mortality rate 9%, but these rates varied depending on the active status of breast cancer in patients.
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Objectives: To characterize the prevalence of functional and cognitive impairments, and associations between impairments and treatment among older patients with diffuse large B cell lymphoma (DLBCL) receiving nursing home (NH) care.

Methods: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify beneficiaries diagnosed with DLBCL 2011-2015 who received care in a NH within -120 ~ +30 days of diagnosis. Multivariable logistic regression was used to compare receipt of chemoimmunotherapy (including multi-agent, anthracycline-containing regimens), 30-day mortality, and hospitalization between NH and community-dwelling patients, estimating odds ratios (OR) and 95% confidence interval (CI).

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  • Breakthrough SARS-CoV-2 infections post-vaccination are a major concern, particularly for cancer patients who are at higher risk of severe outcomes.
  • A study analyzed 2,486 cancer patients with confirmed infections, focusing on the impact of receiving 2 or 3 doses of mRNA vaccines, looking at mortality and hospitalization rates.
  • Results showed that vaccinated individuals had significantly lower 30-day mortality and hospitalization rates compared to unvaccinated patients, with those receiving 3 doses having the best outcomes.
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  • Therapeutic advancements have improved outcomes for pediatric cancer, leading to a greater focus on managing the psychological and treatment-related challenges faced by patients.
  • An umbrella review analyzed 34 publications, revealing that hypnosis effectively reduces pain and distress during procedures, while exercise enhances patient mobility.
  • Although some pharmacological interventions, like ondansetron for nausea and granulocyte colony-stimulating factors for infections, showed benefits, many studies were small and of moderate quality, indicating the need for more robust research to better support the quality of life for these patients and their families.
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Background: Low-value healthcare is costly and inefficient and may adversely affect patient outcomes. Despite increases in low-value service use, little is known about how the receipt of low-value care differs across payers.

Objective: To evaluate differences in the use of low-value care between patients with commercial versus Medicaid coverage.

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To compare survival by gender and race among transgender and cisgender people enrolled in private insurance in the United States between 2011 and 2019. We examined Optum's Clinformatics Data Mart Database. We identified transgender enrollees using claims related to gender-affirming care.

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The field of health services research studies the health care system by examining outcomes relevant to patients and clinicians but also health economists and policy makers. Such outcomes often include health care spending, and utilization of care services. Building accurate prediction models using reproducible research practices for health services research is important for evidence-based decision making.

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Few studies have analyzed mortality rates among transgender (trans) populations in the United States and compared them to the rates of non-trans populations. Using private insurance data from 2011 to 2019, we estimated age-specific all-cause mortality rates among a subset of trans people enrolled in private insurance and compared them to a 10% randomly selected non-trans cohort. Overall, we found that trans people were nearly twice as likely to die over the period as their non-trans counterparts.

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Background: With rising cost pressures on health care systems, machine-learning (ML)-based algorithms are increasingly used to predict health care costs. Despite their potential advantages, the successful implementation of these methods could be undermined by biases introduced in the design, conduct, or analysis of studies seeking to develop and/or validate ML models. The utility of such models may also be negatively affected by poor reporting of these studies.

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We sought to determine the comparative benefits and harms of rehabilitation interventions for patients who have undergone elective, unilateral THA surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

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We sought to systematically review the evidence on the benefits and harms of prehabilitation interventions for patients who are scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

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We sought to determine the comparative benefit and harm of rehabilitation interventions for patients who have undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

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  • The study investigates the frequency and outcomes of coinfections in cancer patients who also have COVID-19, a group at high risk for such infections.
  • Among 8,765 patients analyzed, 16.6% developed coinfections, predominantly bacterial, with specific risk factors identified such as age, sex, and existing health conditions.
  • Co-occurrence of bacterial and fungal infections significantly increased the 30-day mortality rates, highlighting the severe impact of these coinfections in this vulnerable population.
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  • The study aimed to explore how a new geriatric risk index, which considers factors like age and comorbidities, impacts COVID-19 severity and mortality among older adults with cancer.
  • It analyzed a cohort of 5,671 patients aged 60 and older who were part of a global cancer registry during the pandemic, focusing on outcomes based on the developed risk index.
  • Results showed that nearly 20% of patients were labeled as high risk, and these individuals faced significantly worse COVID-19 severity compared to those classified as standard risk, with a mortality rate of 16.2% among all participants.
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Chronic liver inflammation causes continuous liver damage with progressive liver fibrosis and cirrhosis, which may eventually lead to hepatocellular carcinoma (HCC). Whereas the 10-year incidence for HCC in patients with cirrhosis is approximately 20%, many of these patients remain tumor free for their entire lives. Clarifying the mechanisms that define the various outcomes of chronic liver inflammation is a key aspect in HCC research.

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Purpose: Many older patients with advanced lung cancer have functional limitations and require skilled nursing home care. Function, assessed using activities of daily living (ADL) scores, may help prognostication. We investigated the relationship between ADL impairment and overall survival among older patients with advanced non-small-cell lung cancer (NSCLC) receiving care in nursing homes.

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Background: Vaccination is an important preventive health measure to protect against symptomatic and severe COVID-19. Impaired immunity secondary to an underlying malignancy or recent receipt of antineoplastic systemic therapies can result in less robust antibody titers following vaccination and possible risk of breakthrough infection. As clinical trials evaluating COVID-19 vaccines largely excluded patients with a history of cancer and those on active immunosuppression (including chemotherapy), limited evidence is available to inform the clinical efficacy of COVID-19 vaccination across the spectrum of patients with cancer.

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This review has been withdrawn because it has been found to be in breach of the Cochrane Commercial Sponsorship policy clause 2:  'Individuals who are currently employed or where employed any time in the last three years by a company that has a real or potential financial interest in the outcome of the review (including but not limited to drug companies or medical device manufacturers); or who hold or have applied for a patent related to the review are prohibited from being Cochrane Review authors. In most cases, current or previous employment would be characterized by the affiliation statement made by the author at the title registration, protocol, or review stage of the review'.

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Purpose: To examine the impact of global risk, a measure comprising age, comorbidities, function, and cognitive statuses, on treatment selection and outcomes among older home care recipients with diffuse large B-cell lymphoma.

Methods: From SEER-Medicare, we selected home care recipients diagnosed with diffuse large B-cell lymphoma in 2011-2015, who had pretreatment Outcome and Assessment Information Set (OASIS) evaluations. We created a global risk indicator categorizing patients as low-, moderate-, or high-risk on the basis of OASIS assessments.

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Background: The COVID-19 pandemic has devastated the global community with nearly 4.9 million deaths as of October 2021. While organ transplant (OT) recipients (OTr) may be at increased risk for severe COVID-19 due to their chronic immunocompromised state, outcomes for OTr with COVID-19 remain disputed in the literature.

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