Differentiation of Active Corneal Infections from Healed Scars Using Deep Learning.

Purpose: To develop and evaluate an automated, portable algorithm to differentiate active corneal ulcers from healed scars using only external photographs.

Design: A convolutional neural network was trained and tested using photographs of corneal ulcers and scars.

Participants: De-identified photographs of corneal ulcers were obtained from the Steroids for Corneal Ulcers Trial (SCUT), Mycotic Ulcer Treatment Trial (MUTT), and Byers Eye Institute at Stanford University.

The International Science and Evidence-based Education Assessment.

Education is indispensable for the flourishing of people from all backgrounds and stages of life. However, given the accelerating demographic, environmental, economical, socio-political, and technological changes—and their associated risks and opportunities—there is increasing consensus that our current educational systems are falling short and that we need to repurpose education and rethink the organization of learning to meet the challenges of the 21st century. The United Nations Educational Scientific and Cultural Organization (UNESCO) “Futures of Education” initiative was formally launched at the United Nations General Assembly in 2019 to provide such a vision of education for the future.

Impact of non-medical switching on clinical and economic outcomes, resource utilization and medication-taking behavior: a systematic literature review.

Objective: To evaluate current knowledge of the impact of non-medical switching on clinical and economic outcomes, resource utilization and medication-taking behavior.

Methods: The literature was searched (Medline and Web of Science, January 2000-November 2015) to identify United States' studies evaluating ≥25 patients and measuring the impact of non-medical switching of drugs (switching to a chemically distinct but similar medication for reasons other than lack of clinical efficacy/response, side effects or poor adherence) on ≥1 clinical, economic, resource utilization or medication-taking behavior outcome. The direction of association between non-medical switching and outcomes was classified as negative or positive if a statistically significant worsening or improvement was reported, or neutral if no significant difference was observed.

Hematologic outcomes and blood utilization in cancer patients with chemotherapy-induced anemia (CIA) pre- and post-national coverage determination (NCD): results from a multicenter chart review.

Purpose: In July 2007, the Centers for Medicare and Medicaid Services (CMS) limited coverage of erythropoiesis-stimulating agents (ESAs) in cancer patients with chemotherapy-induced anemia (CIA) through a National Coverage Determination (NCD). The primary objective of this study was to compare transfusion rates in patients with CIA with lung, breast, or colorectal cancer before and after the NCD.

Methods: Adult Medicare patients with CIA treated at 49 community oncology clinics were selected from two time periods based on clinics' NCD implementation date.

Outcomes of erythropoiesis-stimulating agents in cancer patients with chemotherapy-induced anemia.

Purpose: To assess the clinical and economic outcomes among patients with chemotherapy-induced anemia (CIA) treated with United States Food and Drug Administration-approved fixed dosing regimens of erythropoiesis-stimulating agents (ESA).

Methods: Data were employed from the Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies (DOSE) registry to evaluate CIA patients who were initiated on either epoetin alfa (EPO) 40,000 Units (U) or darbepoetin alfa (DARB) 500 micrograms (mcg) between January 1, 2006 and May 8, 2009. Study measurements included ESA treatment dose and dose ratio, changes in hemoglobin (Hb) levels from baseline, and cumulative ESA costs.

Disease and treatment burden of psoriasis: examining the impact of biologics.

Plaque psoriasis is a chronic, inflammatory skin disease that can be difficult to treat. Traditional systemic agents, topical agents, phototherapy and biologic therapies can be used for patients with psoriasis. The authors reviewed published results from a variety of sources in order to better understand the effects of psoriasis treatments on patient satisfaction, patient adherence, healthcare resource utilization and productivity.

Healthcare costs associated with nephrology care in pre-dialysis chronic kidney disease patients.

Objective: To compare the healthcare costs of pre-dialysis chronic kidney disease (CKD) patients cared for in a nephrology clinic setting versus other care settings.

Methods: An analysis of health claims between 01/2002 and 09/2007 from the Ingenix Impact Database was conducted. Inclusion criteria were ≥ 18 years of age, ≥ 1 ICD-9 claim for CKD, and ≥ 1 estimated glomerular filtration rate (eGFR) value of < 60 mL/min/1.

Drug utilization and cost for erythropoiesis-stimulating agents in a long-term care resident population with chronic kidney disease.

Objective: To compare drug-utilization patterns and costs in patients with chronic kidney disease (CKD), not on dialysis, yet receiving epoetin alfa (EPO) or darbepoetin alfa (DARB) in a long-term care setting.

Design: A retrospective analysis of pharmacy dispensing from January 2007 through March 2009, was conducted using the AnalytiCareSM LTC database.

Setting: Long-term care.

Effectiveness of anti-tumor necrosis factor agents in the treatment of rheumatoid arthritis: observational study.

Objective: The efficacy of anti-tumor necrosis factor therapies in rheumatoid arthritis has been demonstrated in randomized clinical trials. The purpose of the present study was to evaluate the effectiveness of these agents for the treatment of rheumatoid arthritis in a real-world setting.

Method: This retrospective chart review included patients from 6 clinics in the United States.

Self-reported frequency and severity of disease flares, disease perception, and flare treatments in patients with ulcerative colitis: results of a national internet-based survey.

Objectives: The purpose of this study was to better understand the characteristics and patterns of treatment of flares of ulcerative colitis (UC) from the patient's perspective. A secondary objective was to determine the predictive value of disease characteristics, particularly disease flares, on current use of biologic therapy.

Methods: Study participants were recruited from an Internet panel of self-identified individuals with inflammatory bowel disease (UC or Crohn's disease).

Good research practices for measuring drug costs in cost-effectiveness analyses: a managed care perspective: the ISPOR Drug Cost Task Force report--Part III.

Objectives: The objective of this report is to provide guidance and recommendations on how drug costs should be measured for cost-effectiveness analyses conducted from the perspective of a managed care organization (MCO).

Methods: The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis (DCTF) was appointed by the ISPOR Board of Directors. Members were experienced developers or users of CEA models.

Health plan retention and pharmacy costs of newly diagnosed patients with chronic kidney disease in a managed care population.

Background: Chronic kidney disease is prevalent in the United States, and diabetes and hypertension cause up to two thirds of all new cases. Many health plans believe that these patients do not retain their health plans for a long duration, therefore plans do not focus on prevention for this disease.

Objective: To determine health plan retention rates and direct healthcare costs of adults with newly diagnosed chronic kidney disease with diabetes or hypertension.

Direct all-cause health care costs associated with chronic kidney disease in patients with diabetes and hypertension: a managed care perspective.

Background: Diabetes and hypertension are the 2 major causes of endstage renal disease. The rate of chronic kidney disease (CKD) secondary to diabetes and/or hypertension is on the rise, and the related health care costs represent a significant economic burden.

Objective: To quantify from a health system perspective the incremental direct all-cause health care costs associated with a diagnosis of CKD in patients with diabetes and/or hypertension.

Impact of limiting erythropoiesis-stimulating agent use for chemotherapy-induced anemia on the United States blood supply margin.

Background: Recently, the Centers for Medicare and Medicaid Services issued a national coverage determination that limited erythropoiesis-stimulating agents (ESAs) utilization in patients with chemotherapy-induced anemia (CIA). This study evaluated the impact of limiting the use of ESAs for CIA on the US blood supply margin.

Study Design And Methods: A modeling simulation was employed to compare the number of red blood cell (RBC) units transfused in CIA patients treated with ESAs to the number of RBC units that would be transfused if ESAs were limited or discontinued.

Current management of anemia in critically ill patients: analysis of a database of 139 hospitals.

Purpose: This analysis focused on three objectives: 1) to measure packed red blood cell (pRBC) use across different critical care settings; 2) to characterize transfused and nontransfused critically ill patients; and (3) to identify potential predictors of transfusion use.

Methods: A retrospective analysis of critically ill patients from 139 hospitals across the United States was conducted. Hospital administrative and laboratory data were collected for patients 18 years of age and older admitted to the intensive care unit (ICU) (including coronary care unit and intermediate care units) from January 1, 2004, to May 31, 2005.

An examination of productivity and resource utilization associated with epoetin alfa treatment in employees with predialysis chronic kidney disease.

Objective: This study assessed the employer cost burden of predialysis CKD-related anemia for a major US manufacturer, by examining indirect and direct costs before and after initiation of epoetin alfa (EPO).

Methods: Hemoglobin (Hb) levels, direct costs, and indirect costs for employees with CKD-related anemia were collected for 15 months (9 months pre-EPO and 6 months concurrent/post-EPO treatment). Indirect costs (absenteeism and presenteeism) and direct costs (medical and pharmacy) were compared for the pre- and post-EPO treatment periods.

Anaemia and the risk of injurious falls in a community-dwelling elderly population.

Background: Anaemia in the elderly is associated with a number of health-related functional declines, such as frailty, disability and muscle weakness. These may contribute to falls which, in the elderly, result in serious injuries in perhaps 10% of cases.

Objective: To investigate whether anaemia increases the risk of injurious falls in an elderly population.

Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies (DOSE) : a registry for characterizing anaemia management and outcomes in oncology patients.

Background And Objective: To report the design, methodology, implementation and initial results of the Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies (DOSE) Registry, the first US patient registry to collect and report on practice patterns and outcomes associated with erythropoiesis-stimulating therapy (EST) for anaemia management in oncology patients.

Methods: DOSE is a prospective ongoing registry of oncology patients treated with epoetin-alpha or darbepoetin-alpha. Patients from either community or academic centres who meet prespecified entry criteria are eligible for inclusion in the registry.

Cost analytic model to determine the least costly inpatient erythropoiesis stimulating therapy regimen.

Background: Unlike in outpatient settings, the comparative costs of epoetin alpha (EPO) and darbepoetin alpha (DARB) have not been evaluated broadly from the inpatient hospital perspective.

Objective: To develop a cost analytic model comparing hospital inpatient costs for erythropoiesis stimulating therapies within the nephrology and oncology settings.

Methods: A cost analytic model incorporating erythropoietic drug, pharmacy, and nursing costs was developed from the inpatient hospital perspective to evaluate comparative costs of EPO and DARB.

Dose and cost comparison of erythropoietic agents in the inpatient hospital setting.

Purpose: The inpatient dosing patterns and treatment costs in cancer and predialysis chronic kidney disease (CKD) patients treated with erythropoietic agents from a hospital pharmacy perspective were studied.

Methods: An analysis of electronic inpatient records from the Premier Perspective comparative hospital database was conducted. Study participants were identified through hospitalizations recorded between July 2002 and March 2005 from over 500 hospitals nationwide.

Dosing patterns, hematologic outcomes, and costs of erythropoietic agents in anemic predialysis chronic kidney disease patients from an observational study.

Introduction: Epoetin alfa (EPO) and darbepoetin alfa (DARB) are two erythropoietic agents currently available in the United States for the treatment of anemia in patients with pre-dialysis chronic kidney disease (CKD). The goal of this study was to assess and compare EPO- and DARB-treated CKD patients with respect to dosing patterns, hematologic outcomes, and associated costs.

Materials And Methods: In this multicenter, retrospective chart review, 400 charts of anemic predialysis CKD patients (200 treated with EPO and 200 treated with DARB) were sequentially selected from a large self-insured employer health insurance database.

Dose conversion and cost effectiveness of erythropoietic therapies in chemotherapy-related anaemia : a meta-analysis.

Objective: To estimate a dose-conversion ratio (DCR) between epoetin alfa (EPO) and darbepoetin alfa (DARB) and compare the costs of both drugs at the estimated DCRs using average wholesale prices (AWPs).

Methods: A search of PUBMED, CANCERLIT and references for papers and abstracts reporting on clinical trials of DARB or EPO for chemotherapy-related anaemia (CRA) identified 56 publications. A meta-analysis was conducted on the 12 eligible papers to estimate a DCR at which the two drugs were equally effective as measured by the area under the curve of haemoglobin (Hb) change (Hb AUC) at weeks 4 and 13.

The economic impact of epoetin alfa therapy on delaying time to dialysis in elderly patients with chronic kidney disease.

The aim of this study was to evaluate the impact of epoetin alfa (EPO) therapy on delaying progression to renal dialysis and quantify the associated medical cost savings in elderly chronic kidney disease (CKD) patients. Elderly (>/=65 years) dialysis patients who had >/=1 hemoglobin (Hb) value and >/=1 glomerular filtration rate (GFR) value of <60 mL/min/1.73 m(2) were identified using health claims and laboratory data from the period January 1999 to February 2005.