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Evaluating Surgeon-influenced Factors for Total Knee Arthroplasty Value-based Reimbursement.
J Am Acad Orthop Surg
January 2025
From the Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, USA (Sutton, Lizcano, Krueger, Courtney, and Purtill), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA (Austin).
Introduction: Clinical outcome measures used under value-based reimbursement models require risk stratification of patient demographics and medical history. Only certain perioperative patient factors may be influenced by the surgeon. The study evaluated surgeon-influenced modifiable factors associated with achieving literature-defined KOOS score thresholds to serve as the foundation of the newly established alternative payment models for total knee arthroplasties (TKA).
View Article and Find Full Text PDFAssessing Prevalence of Nonmedically Used Prescription Drug Involvement in Overdose Deaths Through Linkage of State Unintentional Drug Overdose Reporting System and Controlled Substances Monitoring Program Data.
Subst Use Misuse
January 2025
Tennessee Department of Health, Office of Informatics and Analytics, Nashville, TN, USA.
Background: While illicit substances are commonly involved in the overdose crisis, prescription substances still play a role. Oftentimes, decedents do not have prescriptions for these substances at the time of death. As such, we sought to examine the prevalence of nonmedical drug use in Tennessee through linkage of fatal drug overdose and prescription data.
View Article and Find Full Text PDFToward Developing Alternative Opioid Antagonists for Treating Community Overdose: A Model-Based Evaluation of Important Pharmacological Attributes.
Clin Pharmacol Ther
January 2025
Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, Food & Drug Administration, Silver Spring, Maryland, USA.
In response to increased illicit use of synthetic opioids, various μ-receptor antagonist formulations, with varied pharmacological characteristics, have been and are being developed. To understand how pharmacologic characteristics such as absorption rate and clearance rate affect reversal in treating community opioid overdose, we used our previously published translational opioid model. We adapted this model with in vitro receptor binding data and clinical pharmacokinetic data of three intranasal nalmefene formulations along with an intranasal naloxone formulation to study the reversal of fentanyl and carfentanil-induced respiratory depression in chronic opioid users.
View Article and Find Full Text PDFUnderstanding the opioid syndemic in North Carolina: A novel approach to modeling and identifying factors.
Biostatistics
December 2024
Department of Statistical Sciences, College of Arts and Sciences, Wake Forest University, 127 Manchester Hall, Winston-Salem, NC, 27109, United States.
The opioid epidemic is a significant public health challenge in North Carolina, but limited data restrict our understanding of its complexity. Examining trends and relationships among different outcomes believed to reflect opioid misuse provides an alternative perspective to understand the opioid epidemic. We use a Bayesian dynamic spatial factor model to capture the interrelated dynamics within six different county-level outcomes, such as illicit opioid overdose deaths, emergency department visits related to drug overdose, treatment counts for opioid use disorder, patients receiving prescriptions for buprenorphine, and newly diagnosed cases of acute and chronic hepatitis C virus and human immunodeficiency virus.
View Article and Find Full Text PDFPre-injury narcotic drug use in isolated severe traumatic brain injury: effect on outcomes.
Eur J Trauma Emerg Surg
January 2025
Division of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Los Angeles, CA, 90033, USA.
Purpose: The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients.
Methods: ACS TQIP study included adult trauma patients (≥ 16 years) with complete drug and alcohol screening. Isolated severe TBI was defined as head trauma with AIS 3-5 and without significant extracranial trauma.
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