Toward Relevant and Credible Cost-Effectiveness Analyses for Value Assessment in the Decentralized U.S. Health Care System.

In the United States, there is an increased interest to understand the value of health technologies. Cost-effectiveness analysis is arguably the most appropriate framework to quantify value and to inform reimbursement decision making regarding medical interventions; however, a thorough analysis is resource intensive and complex. In many countries, the cost-effectiveness of medical interventions is evaluated by expert agencies at the national level, but in the United States, reimbursement decision making occurs at the local level.

Evaluating the Impact of Treatment Care Planning on Quality Measures.

Purpose: The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients' engagement in their care plan.

Harm Reduction Strategies and Disinhibitors Among Women Who Use Heroin.

People who use illicit drugs face significant physical risks in the acquisition, use, and aftermath of their use. This is particularly the case among those who use heroin in view of recent spikes in heroin-associated overdoses, injuries, and deaths. Using a restrictive deterrence framework, we identify the risks that women associate with chronic heroin use and the ways they seek to manage those risks.

Trends in Utilization of Statin Therapy and Contraindicated Statin Use in HIV--Infected Adults Treated With Antiretroviral Therapy From 2007 Through 2015.

Background HIV is associated with an increased risk for atherosclerotic cardiovascular disease, which may result in many people living with HIV taking a statin. Some statins are contraindicated with certain antiretroviral therapies ( ART ) and other medications commonly used by HIV -infected patients. Methods and Results We analyzed trends in the use of statins, including contraindicated statins, between 2007 and 2015 among HIV -infected patients aged ≥19 years taking ART who had employer-sponsored or Medicare supplemental health insurance in the Marketscan database (n=186 420).

Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 2: Effect on White Matter Integrity.

Background: Constraint-induced movement therapy (CIMT) is a method of physical rehabilitation that has demonstrated clinical efficacy in patients with chronic stroke, cerebral palsy, and multiple sclerosis (MS).

Objective: This pilot randomized controlled trial tested whether CIMT can also induce increases in white matter integrity in patients with MS.

Methods: Twenty adults with chronic hemiparetic MS were randomized to receive either CIMT or complementary and alternative medicine (CAM) treatment (reported in the first article of this pair).

Effective Governance and Hospital Boards Revisited: Reflections on 25 Years of Research.

This study reviews and synthesizes empirical research literature focusing on the relationship between boards of directors and organizational effectiveness of U.S. hospitals.

"They Said on the Death Certificate…But Really What I Think Happened": Characterizing Cause of Death in VA Medical Centers.

Cause of death information is a vital resource for family and public health, yet significant issues persist regarding its determination, documentation and communication. In this study, we aim to characterize cause of death attribution process from the perspective of next-of-kin of Veterans who died in Veterans Affairs (VA) Medical Centers. Using a semi-structured guide, we explored next-of-kin's experiences of the Veteran's terminal hospitalization and conducted a content analysis of interview texts.

Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.

Objective: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care.

Bosentan-based, treat-to-target therapy in patients with pulmonary arterial hypertension: results from the COMPASS-3 study.

The phase 4 COMPASS-3 study evaluated whether a singular endpoint produces clinically meaningful outcomes in patients with pulmonary arterial hypertension (PAH). The relationship between cardiac magnetic resonance imaging (cMRI)-derived parameters and right heart catheterization (RHC) measurements was also examined. In COMPASS-3 (ClinicalTrials.

A Community Health Advisor Program to Reduce Cancer Screening Disparities in the Deep South and Appalachia: The American Cancer Society's CHA Collaborative.

Introduction: Cancer disparities continue to exist in the United States. Community health advisors (CHAs) can play a critical role in addressing cancer disparities. The American Cancer Society (ACS) implemented a 3-year pilot CHA program in the South based on an evidence-based program to increase breast cancer screening.

Recent Advances in Computed Tomography Imaging in Chronic Obstructive Pulmonary Disease.

Lung imaging is increasingly being used to diagnose, quantify, and phenotype chronic obstructive pulmonary disease (COPD). Although spirometry is the gold standard for the diagnosis of COPD and for severity staging, the role of computed tomography (CT) imaging has expanded in both clinical practice and research. COPD is a heterogeneous disease with considerable variability in clinical features, radiographic disease, progression, and outcomes.

A Pilot Study of Sleep, Work Practices, Visual Processing Speed, and 5-Year Motor Vehicle Crash Risk Among Truck Drivers.

The purpose of this pilot study was to explore the relationships between sleep, work practices, speed of processing, and 5-year motor vehicle crash risk among a group of older truck drivers. Anthropometric, demographic, and psychological data were recorded, along with health, sleep, and work histories from a sample of 23 truck drivers. Results from this pilot study suggest that physical fatigue may play a role in processing speed.

Ectopic Liver Within the Placental Parenchyma of a Stillborn Fetus.

Rarely, liver tissue can be seen in the umbilical cord, where it is thought to result from ectopic localization during embryogenesis. The placental parenchyma is also a rare site for this occurrence. The exact pathophysiology of ectopic liver in the placenta is unknown.

Comparison of Levetiracetam Dosing Regimens in End-Stage Renal Disease Patients Undergoing Intermittent Hemodialysis.

Background: Levetiracetam (LEV) is primarily renally eliminated. In end-stage renal disease (ESRD) patients on hemodialysis (HD), pharmacokinetic studies recommend daily dosing with 50% supplemental doses after 4-hour HD sessions. However, poor medication adherence after HD could result in fluctuating plasma drug levels.

Influence of Type II Diabetes and High Depressive Symptoms on the Likelihood for Developing Activities of Daily Living (ADL) Disability and Mortality in Older Puerto Ricans.

Objective: To examine the development of activities of daily living (ADL) disability and mortality according to diabetes and high depressive symptoms among Puerto Rican adults aged 60 and older.

Method: Data came from Wave I and Wave II of the Puerto Rican Elderly: Health Conditions Study ( n = 3,419). Logistic regression was used.

Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015).

Educating Families of Children Newly Diagnosed With Cancer.

Parents/caregivers require specialized education in order to care for their child with a newly diagnosed cancer. Currently, no evidence-based guidelines exist to identify content essential for inclusion in patient/family education prior to a child's initial discharge home; this study used Delphi methodology to obtain multidisciplinary consensus regarding essential content amongst pediatric oncology experts from the Children's Oncology Group. Three questionnaire rounds were employed to identify essential content, evaluate the importance of the educational topics identified, and gain expert consensus regarding the final ranking of topics identified and whether or not each topic was considered mandatory for inclusion in education for newly diagnosed patients.

Obesity, Prediabetes, and Perceived Stress in Municipal Workers.

The primary cause of death for men and women in the United States is heart disease. Obesity and diabetes are major contributors to heart disease, and the risk is worsened in the presence of stress. It is clinically useful to identify predictors of obesity and prediabetes in a working population.

THE LIMITED EFFECT OF COINCIDENT ORIENTATION ON THE CHOICE OF INTRINSIC AXIS (.).

The allocentric system computes and represents general object-to-object spatial relationships to provide a spatial frame of reference other than the egocentric system. The intrinsic frame-of-reference system theory, which suggests people learn the locations of objects based upon an intrinsic axis, is important in research about the allocentric system. The purpose of the current study was to determine whether the effect of coincident orientation on the choice of intrinsic axis was limited.

Alterations in gene expression and DNA methylation during murine and human lung alveolar septation.

DNA methylation, a major epigenetic mechanism, may regulate coordinated expression of multiple genes at specific time points during alveolar septation in lung development. The objective of this study was to identify genes regulated by methylation during normal septation in mice and during disordered septation in bronchopulmonary dysplasia. In mice, newborn lungs (preseptation) and adult lungs (postseptation) were evaluated by microarray analysis of gene expression and immunoprecipitation of methylated DNA followed by sequencing (MeDIP-Seq).