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[PMID]:28468784
[Au] Autor:Kalbaugh CA; Kucharska-Newton A; Wruck L; Lund JL; Selvin E; Matsushita K; Bengtson LGS; Heiss G; Loehr L
[Ad] Endereço:Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, NC corey_kalbaugh@med.unc.edu.
[Ti] Título:Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study.
[So] Source:J Am Heart Assoc;6(5), 2017 May 03.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Outpatient ascertainment of peripheral artery disease (PAD) is rarely considered in the measurement of PAD clinical burden; therefore, the clinical burden of PAD likely has been underestimated while contributing to a decreased awareness of PAD in comparison to other circulatory system disorders. METHODS AND RESULTS: The purpose of this study was to estimate the age-standardized annual period prevalence and incidence of PAD in the outpatient and inpatient settings using data from the Atherosclerosis Risk in Communities (ARIC) study linked with Centers for Medicare and Medicaid Services claims. The majority (>70%) of all PAD encounters occurred in the outpatient setting. The weighted mean age-standardized prevalence and incidence of outpatient PAD was 11.8% (95% CI 11.5-12.1) and 22.4 per 1000 person-years (95% CI 20.8-24.0), respectively. Black patients had higher weighted mean age-standardized prevalence (15.6%; 95% CI 14.6-16.4) compared with white patients (11.4%; 95% CI 11.1-11.7). Black women had the highest weighted mean age-standardized prevalence (16.9%; 95% CI 16.0-17.8). Black patients also had a higher incidence rate of PAD (31.3 per 1000 person-years; 95% CI 27.3-35.4) compared with white patients (25.4 per 1000 person-years; 95% CI 23.5-27.3). PAD prevalence and incidence did not differ by sex alone. CONCLUSIONS: This study provides comprehensive estimates of PAD in the inpatient and outpatient settings where the majority of PAD burden was found. PAD is an important circulatory system disorder similar in prevalence to stroke and coronary heart disease.
[Mh] Termos MeSH primário: Assistência Ambulatorial
Planos de Pagamento por Serviço Prestado
Medicare
Admissão do Paciente
Doença Arterial Periférica/epidemiologia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Afroamericanos
Distribuição por Idade
Idoso
Assistência Ambulatorial/economia
Comorbidade
Grupo com Ancestrais do Continente Europeu
Planos de Pagamento por Serviço Prestado/economia
Feminino
Custos Hospitalares
Seres Humanos
Incidência
Masculino
Medicare/economia
Admissão do Paciente/economia
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/economia
Doença Arterial Periférica/etnologia
Prevalência
Fatores de Risco
Distribuição por Sexo
Fatores de Tempo
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:28462763
[Au] Autor:Buck PO; Meyers JL; Gordon LD; Parikh R; Kurosky SK; Davis KL
[Ad] Endereço:GSK,5 Crescent Drive,Philadelphia,PA, 19112,USA.
[Ti] Título:Economic burden of diagnosed pertussis among individuals with asthma or chronic obstructive pulmonary disease in the USA: an analysis of administrative claims.
[So] Source:Epidemiol Infect;145(10):2109-2121, 2017 07.
[Is] ISSN:1469-4409
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Individuals with chronic respiratory conditions may be at increased risk for pertussis. We conducted a retrospective administrative claims analysis to examine the incidence and economic burden of diagnosed pertussis among adolescents and adults in the USA with chronic obstructive pulmonary disease (COPD) or asthma. Patients aged ⩾11 years with diagnosed pertussis and pre-existing COPD (n = 343) or asthma (n = 1041) were matched 1:1 to patients with diagnosed pertussis but without COPD or asthma. Differences in all-cause costs ('excess' costs) during the 45-day and 3-month and 6-month periods before and after the pertussis index date were calculated; adjusted excess costs were estimated via multivariate regressions. The incidence of diagnosed pertussis was higher among patients with COPD or asthma than among matched patients. Compared with matched patients, patients with pertussis and pre-existing COPD or asthma accrued greater all-cause adjusted costs across study periods ($3694 and $1193 more, respectively, in the 45-day period; $4173 and $1301 more in the 3-month period; and $6154 and $1639 more in the 6-month period; all P < 0·0001). Patients with pre-existing COPD or asthma experience an increased economic burden after diagnosed pertussis and may especially benefit from targeted tetanus, diphtheria, and acellular pertussis vaccination strategies.
[Mh] Termos MeSH primário: Demandas Administrativas em Assistência à Saúde/estatística & dados numéricos
Asma/economia
Asma/epidemiologia
Custos de Cuidados de Saúde/estatística & dados numéricos
Doença Pulmonar Obstrutiva Crônica/economia
Doença Pulmonar Obstrutiva Crônica/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Asma/etiologia
Criança
Estudos de Coortes
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/etiologia
Estudos Retrospectivos
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171125
[Lr] Data última revisão:
171125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1017/S0950268817000887


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[PMID]:28982884
[Au] Autor:Desserud KF; Bukholm I; Søreide JA
[Ad] Endereço:Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
[Ti] Título:Compensation Claims for Sub-substandard Care of Patients with Gastroentero-pancreatic Neuroendocrine Tumors: A Nationwide Descriptive Study of Cases Between 2005-2016 in Norway.
[So] Source:Anticancer Res;37(10):5667-5671, 2017 10.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Management of patients with neuroendocrine tumors of the gastrointestinal tract or pancreas (GEP-NENs) poses diagnostic and therapeutic challenges. This study described the medico-legal claims reported to a national governmental system that oversees compensation to patients with GEP-NENs Materials and Methods: An electronic search of the Norwegian System of Compensation to Patients database was performed to identify claims evaluated between 2005-2016. The clinical information and the medico-legal evaluation were reviewed. RESULTS: We identified seven patients, five women and two men, with a median age of 57 (range=47-73) years. Delayed diagnosis (median diagnostic delay of 18 (range=6-48) months) was the main cause for claims in six out of the seven patients). Four patients received financial compensation based on the claim judgement. CONCLUSION: This review of claims that were evaluated by the Norwegian System of Compensation to Patients showed that a timely diagnosis of GEP-NENs remains a clinical challenge.
[Mh] Termos MeSH primário: Carcinoma Neuroendócrino/economia
Carcinoma Neuroendócrino/terapia
Compensação e Reparação
Neoplasias Gastrointestinais/economia
Neoplasias Gastrointestinais/terapia
Erros Médicos/economia
Oncologia/economia
Neoplasias Pancreáticas/economia
Neoplasias Pancreáticas/terapia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Idoso
Carcinoma Neuroendócrino/patologia
Compensação e Reparação/legislação & jurisprudência
Bases de Dados Factuais
Diagnóstico Tardio/economia
Erros de Diagnóstico/economia
Feminino
Neoplasias Gastrointestinais/patologia
Seres Humanos
Responsabilidade Legal/economia
Masculino
Erros Médicos/legislação & jurisprudência
Oncologia/legislação & jurisprudência
Erros de Medicação
Meia-Idade
Estadiamento de Neoplasias
Noruega
Neoplasias Pancreáticas/patologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE


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[PMID]:28954922
[Au] Autor:Schwartz J; Wang Y; Qin L; Schwamm LH; Fonarow GC; Cormier N; Dorsey K; McNamara RL; Suter LG; Krumholz HM; Bernheim SM
[Ad] Endereço:From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (J.S., Y.W., L.Q., N.C., K.D., R.L.M., L.G.S., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (J.S., Y.W., R.L.M., H.M.K.), Section of Rheumatology, Department of Medicine (L.G.
[Ti] Título:Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization.
[So] Source:Stroke;48(11):3101-3107, 2017 Nov.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The Centers for Medicare & Medicaid Services publicly reports a hospital-level stroke mortality measure that lacks stroke severity risk adjustment. Our objective was to describe novel measures of stroke mortality suitable for public reporting that incorporate stroke severity into risk adjustment. METHODS: We linked data from the American Heart Association/American Stroke Association Get With The Guidelines-Stroke registry with Medicare fee-for-service claims data to develop the measures. We used logistic regression for variable selection in risk model development. We developed 3 risk-standardized mortality models for patients with acute ischemic stroke, all of which include the National Institutes of Health Stroke Scale score: one that includes other risk variables derived only from claims data (claims model); one that includes other risk variables derived from claims and clinical variables that could be obtained from electronic health record data (hybrid model); and one that includes other risk variables that could be derived only from electronic health record data (electronic health record model). RESULTS: The cohort used to develop and validate the risk models consisted of 188 975 hospital admissions at 1511 hospitals. The claims, hybrid, and electronic health record risk models included 20, 21, and 9 risk-adjustment variables, respectively; the C statistics were 0.81, 0.82, and 0.79, respectively (as compared with the current publicly reported model C statistic of 0.75); the risk-standardized mortality rates ranged from 10.7% to 19.0%, 10.7% to 19.1%, and 10.8% to 20.3%, respectively; the median risk-standardized mortality rate was 14.5% for all measures; and the odds of mortality for a high-mortality hospital (+1 SD) were 1.51, 1.52, and 1.52 times those for a low-mortality hospital (-1 SD), respectively. CONCLUSIONS: We developed 3 quality measures that demonstrate better discrimination than the Centers for Medicare & Medicaid Services' existing stroke mortality measure, adjust for stroke severity, and could be implemented in a variety of settings.
[Mh] Termos MeSH primário: Isquemia Encefálica/mortalidade
Modelos Biológicos
Índice de Gravidade de Doença
Acidente Vascular Cerebral/mortalidade
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/parasitologia
Isquemia Encefálica/patologia
Registros Eletrônicos de Saúde
Feminino
Seres Humanos
Masculino
Medicare
Estudos Retrospectivos
Fatores de Risco
Acidente Vascular Cerebral/patologia
Acidente Vascular Cerebral/fisiopatologia
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017960


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[PMID]:28899989
[Au] Autor:Kim YG; Yoon D; Park S; Han SJ; Kim DJ; Lee KW; Park RW; Kim HJ
[Ad] Endereço:From the Department of Biomedical Informatics (Y.-G.K., D.Y., S.P., R.W.P.), Department of Endocrinology and Metabolism (S.J.H., D.J.K., K.-W. L., H.J.K.), and Department of Biomedical Sciences (R.W.P.), Ajou University School of Medicine, Suwon, South Korea; and Department of Statistics, Ewha Woman
[Ti] Título:Dipeptidyl Peptidase-4 Inhibitors and Risk of Heart Failure in Patients With Type 2 Diabetes Mellitus: A Population-Based Cohort Study.
[So] Source:Circ Heart Fail;10(9), 2017 Sep.
[Is] ISSN:1941-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The association between dipeptidyl-peptidase IV inhibitors (DPP-4i) and heart failure (HF) remains unclear. In 1 randomized controlled trial and some observational studies, DPP-4i reportedly increased the risk of HF, but 2 other randomized controlled trials and observational studies have shown no such risk. Here, we evaluated the risk of HF and cardiovascular outcomes of DPP-4i compared with sulfonylureas. METHODS AND RESULTS: A population-based retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment Service database from January 1, 2009, to December 31, 2015. Incident users of sulfonylurea and DPP-4i who were not prescribed the comparator drug in the year before treatment initiation were included. DPP-4i-treated and sulfonylurea-treated patients were matched on propensity score, calculated with >40 variables. The risk of hospitalization for HF was evaluated with a Cox proportional hazards model in 255 691 matched pairs. Analyses were conducted in the total patient population and in both strata divided by the presence of cardiovascular disease during the baseline period. The hazard ratios (HRs) of hospitalization for HF for DPP-4i-treated patients were 0.78 (95% confidence interval [CI], 0.67-0.86) in all of the patients, 0.77 (95% CI, 0.68-0.79) in patients with baseline cardiovascular disease, and 0.71 (95% CI, 0.56-0.90) in patients without baseline cardiovascular disease compared with HRs for sulfonylurea-treated patients. Sitagliptin and linagliptin showed statistically lower risk for hospitalization for HF (HR, 0.76; 95% CI, 0.67-0.86 for sitagliptin-prescribed patients; HR, 0.74; 95% CI, 0.59-0.92 for linagliptin-prescribed patients) than for sulfonylurea. The HRs for hospitalization for myocardial infarction and stroke with the use of a DPP-4i versus sulfonylurea were HR, 0.76 (95% CI, 0.67-0.87) and HR, 0.63 (95% CI, 0.60-0.67), respectively. CONCLUSIONS: Our findings suggest that DPP-4i use did not increase the risk of HF compared with sulfonylurea. In addition, the risks for cardiovascular outcomes were not elevated in DPP-4i-treated patients compared with sulfonylurea-treated patients.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/tratamento farmacológico
Dipeptidil Peptidase 4/metabolismo
Inibidores da Dipeptidil Peptidase IV/efeitos adversos
Insuficiência Cardíaca/induzido quimicamente
Hipoglicemiantes/efeitos adversos
Compostos de Sulfonilureia/efeitos adversos
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Idoso
Bases de Dados Factuais
Diabetes Mellitus Tipo 2/diagnóstico
Diabetes Mellitus Tipo 2/enzimologia
Diabetes Mellitus Tipo 2/epidemiologia
Feminino
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/epidemiologia
Hospitalização
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Pontuação de Propensão
Modelos de Riscos Proporcionais
República da Coreia/epidemiologia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (Hypoglycemic Agents); 0 (Sulfonylurea Compounds); EC 3.4.14.5 (DPP4 protein, human); EC 3.4.14.5 (Dipeptidyl Peptidase 4)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE


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[PMID]:28802187
[Au] Autor:Lievens Y; De Schutter H; Stellamans K; Rosskamp M; Van Eycken L; Belgian College for Physicians in Radiation Oncology
[Ad] Endereço:Radiation Oncology Department, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: yolande.lievens@uzgent.be.
[Ti] Título:Radiotherapy access in Belgium: How far are we from evidence-based utilisation?
[So] Source:Eur J Cancer;84:102-113, 2017 Oct.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. MATERIALS AND METHODS: AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. RESULTS: The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. CONCLUSION: Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy.
[Mh] Termos MeSH primário: Braquiterapia/tendências
Medicina Baseada em Evidências/tendências
Acesso aos Serviços de Saúde/tendências
Mau Uso de Serviços de Saúde/tendências
Neoplasias/radioterapia
Padrões de Prática Médica/tendências
Avaliação de Processos (Cuidados de Saúde)/tendências
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Bélgica
Braquiterapia/economia
Braquiterapia/utilização
Tomada de Decisão Clínica
Bases de Dados Factuais
Medicina Baseada em Evidências/economia
Feminino
Fidelidade a Diretrizes/tendências
Custos de Cuidados de Saúde/tendências
Acesso aos Serviços de Saúde/economia
Mau Uso de Serviços de Saúde/economia
Seres Humanos
Reembolso de Seguro de Saúde/tendências
Masculino
Meia-Idade
Neoplasias/economia
Neoplasias/mortalidade
Neoplasias/patologia
Cuidados Paliativos/tendências
Equipe de Assistência ao Paciente/tendências
Seleção de Pacientes
Guias de Prática Clínica como Assunto
Padrões de Prática Médica/economia
Avaliação de Processos (Cuidados de Saúde)/economia
Análise de Sobrevida
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170813
[St] Status:MEDLINE


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[PMID]:28727517
[Au] Autor:Reeder-Hayes KE; Meyer AM; Hinton SP; Meng K; Carey LA; Dusetzina SB
[Ad] Endereço:Katherine E. Reeder-Hayes, Anne Marie Meyer, Sharon Peacock Hinton, Ke Meng, Lisa A. Carey, and Stacie B. Dusetzina, University of North Carolina at Chapel Hill (UNC) Lineberger Comprehensive Cancer Center; Katherine E. Reeder-Hayes and Ke Meng, UNC Lineberger Integrated Cancer Information and Surve
[Ti] Título:Comparative Toxicity and Effectiveness of Trastuzumab-Based Chemotherapy Regimens in Older Women With Early-Stage Breast Cancer.
[So] Source:J Clin Oncol;35(29):3298-3305, 2017 Oct 10.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose The combination of chemotherapy and trastuzumab is the standard of care for adjuvant treatment of human epidermal growth factor receptor 2-positive breast cancer. Two regimens have been widely adopted in the United States: doxorubicin, cyclophosphamide, paclitaxel, and trastuzumab (ACTH) and docetaxel, carboplatin, and trastuzumab (TCH). No head-to-head comparison of these regimens has been conducted in a clinical trial, and existing trial data have limited generalizability to older patients. Methods We used SEER-Medicare data from 2005 to 2013 to compare outcomes of ACTH versus TCH among patients age older than 65 years. Propensity score matching was used to balance cohort characteristics between treatment arms. Outcomes included toxicity-related hospitalization, survival, and trastuzumab completion. Data from 1,077 patients receiving ACTH or TCH were analyzed, and the propensity-matched subsample included 416 women. Results There was a significant shift toward TCH over time, with 88% of patients receiving ACTH in 2005 compared with 15% by 2011. Among propensity score-matched patients, we found no difference between regimens in health care use overall or for chemotherapy-related adverse events (ACTH, 34% v TCH, 36.5%; P = .46). Patients receiving TCH were significantly more likely to complete trastuzumab (89% v 77%; P = .001). There was no difference in 5-year breast cancer-specific survival (ACTH, 92% v TCH, 96%; hazard ratio, 2.08; 95% CI, 0.90 to 4.82) or overall survival. Conclusion Among a matched sample of older patients, ACTH compared with TCH was not associated with a higher rate of serious adverse events or hospitalizations, but it was associated with less completion of adjuvant trastuzumab. We did not detect a difference in 5-year survival outcomes for ACTH compared with TCH. In the context of limited evidence in older patients, selection between these two regimens on the basis of concerns about differential toxicity or efficacy may not be appropriate.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Trastuzumab/administração & dosagem
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias da Mama/mortalidade
Neoplasias da Mama/patologia
Carboplatina/administração & dosagem
Pesquisa Comparativa da Efetividade
Ciclofosfamida/administração & dosagem
Bases de Dados Factuais
Intervalo Livre de Doença
Doxorrubicina/administração & dosagem
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Medicare
Análise Multivariada
Estadiamento de Neoplasias
Paclitaxel/administração & dosagem
Pontuação de Propensão
Estudos Retrospectivos
Programa de SEER
Taxoides/administração & dosagem
Fatores de Tempo
Trastuzumab/efeitos adversos
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Taxoids); 15H5577CQD (docetaxel); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); BG3F62OND5 (Carboplatin); P188ANX8CK (Trastuzumab); P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2016.71.4345


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[PMID]:28623046
[Au] Autor:Shah K; Mellars L; Changolkar A; Feldman SR
[Ad] Endereço:EMD Serono, Inc, Billerica, Massachusetts. Electronic address: dr.kamal.s.shah@gmail.com.
[Ti] Título:Real-world burden of comorbidities in US patients with psoriasis.
[So] Source:J Am Acad Dermatol;77(2):287-292.e4, 2017 Aug.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Understanding background comorbidity rates in psoriasis can provide perspective for adverse events associated with new therapies. OBJECTIVE: We sought to assess the extent of comorbidities in psoriasis patients by use of the Truven Health Analytics MarketScan database. METHODS: MarketScan, comprising commercial claims representative of a large US-insured population, had 1.22 million patients with ≥1 claim with a psoriasis diagnosis between January 1, 2008, and December 31, 2014. Patients ≥18 years of age who had ≥2 health claims in any diagnosis field for psoriasis (International Classification of Diseases, 9th Revision, Clinical Modification 696.1) with a psoriasis diagnosis (index) date between July 1, 2008, and June 30, 2014, were included to allow follow-up observation time. RESULTS: Prevalence and incidence of 24 comorbidities were assessed in 469,097 psoriasis patients; the most common comorbidities were hyperlipidemia (45.64% and 30.83%, respectively), hypertension (42.19% and 24.19%), depression (17.91% and 12.68%), type 2 diabetes mellitus (17.45% and 8.44%), and obesity (14.38% and 11.57%). LIMITATIONS: A limitation of the study was that only a certain insured population was represented. CONCLUSIONS: Comorbidity rates align with those described in the literature and support the concept that psoriasis patients have high rates of cardiometabolic comorbidities. This analysis highlights the potential utility of very large insurance databases for determining comorbidity prevalence in psoriasis, which may aid health care providers in managing psoriasis.
[Mh] Termos MeSH primário: Depressão/epidemiologia
Diabetes Mellitus Tipo 2/epidemiologia
Hiperlipidemias/epidemiologia
Hipertensão/epidemiologia
Obesidade/epidemiologia
Psoríase/epidemiologia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde/estatística & dados numéricos
Adolescente
Adulto
Idoso
Comorbidade
Bases de Dados Factuais
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Prevalência
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170618
[St] Status:MEDLINE


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[PMID]:28623045
[Au] Autor:Gu Y; Nordstrom BL
[Ad] Endereço:Pfizer Inc, Collegeville, Pennsylvania; Evidera, Waltham, Massachusetts. Electronic address: Yun.Gu@pfizer.com.
[Ti] Título:The risk of malignancy among biologic-naïve pediatric psoriasis patients: A retrospective cohort study in a US claims database.
[So] Source:J Am Acad Dermatol;77(2):293-301.e1, 2017 Aug.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Little published literature exists regarding malignancy risk in pediatric psoriasis patients. OBJECTIVE: To compare malignancy risk in biologic-naïve pediatric psoriasis patients with a matched pediatric population without psoriasis. METHODS: This retrospective cohort study used IMS LifeLink Health Plan Claims data covering 1998-2008. Cancer incidence was compared with the US Surveillance, Epidemiology, and End Results (SEER) data using standardized incidence ratios (SIR), and between cohorts using Cox models. RESULTS: Among 9045 pediatric psoriasis patients and 77,206 comparators, 18 probable or highly probable cancers were identified. Pediatric psoriasis patients had a nonsignificantly lower incidence than comparators (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.05-3.54). The HR increased to 1.67 (95% CI 0.54-5.18) when cancer diagnosed during the first 90 days of follow-up was included. The pediatric psoriasis cohort had a significantly increased lymphoma rate compared with SEER (SIR 5.42, 95% CI 1.62-12.94), but no significant increase relative to the comparator cohort. LIMITATIONS: Misclassification of disease and outcome might have occurred with patients in the claims database. CONCLUSION: Patients with pediatric psoriasis showed no significant increase in overall cancer risk compared with those without psoriasis. A potential increased risk for lymphoma was observed when compared with the general population.
[Mh] Termos MeSH primário: Neoplasias/epidemiologia
Psoríase/epidemiologia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Adolescente
Produtos Biológicos/uso terapêutico
Estudos de Casos e Controles
Criança
Pré-Escolar
Feminino
Seres Humanos
Incidência
Lactente
Recém-Nascido
Linfoma/epidemiologia
Masculino
Modelos de Riscos Proporcionais
Psoríase/tratamento farmacológico
Estudos Retrospectivos
Programa de SEER
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biological Products)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170618
[St] Status:MEDLINE


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[PMID]:28605640
[Au] Autor:Stallmann C; Swart E; Robra BP; March S
[Ad] Endereço:Institute of Social Medicine and Health Economics, Faculty of Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. Electronic address: christoph.stallmann@med.ovgu.de.
[Ti] Título:Linking primary study data with administrative and claims data in a German cohort study on work, age, health and work participation: is there a consent bias?
[So] Source:Public Health;150:9-16, 2017 Sep.
[Is] ISSN:1476-5616
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We analysed the degree and impact of consent bias in the prospective study 'leben in der Arbeit (lidA)' after linking primary interview data with claims data from German statutory health insurance funds as well as with administrative data provided by the German Federal Employment Agency. STUDY DESIGN: Prospective cohort study. METHODS: Within two study waves (2011, 2014) primary data were collected based on computer-assisted personal interviews. During interview informed consent to data linkage was obtained. We used binary logistic regression analyses with participants' consent for record linkage as the dependent variable calculating odds ratios (ORs) and 95% confidence intervals (95% CIs) for independent variables. Several sociodemographic, socio-economic and work-related factors were modelled as potential determinants of consent. RESULTS: A total of 4244 participants took part in both waves. After excluding invalid consent, 4178 participants were included in the analysis. About 3918 (93.8%) of these participants gave their consent to link their primary data with data from at least one source. Within regression analyses only moderate bias was found due to region of residence, apprenticeship, professional affiliations, income and number of diseases. Participants from former West Germany were less likely to have their study data linked with both data sources (OR 0.63 [95% CI 0.42-0.96]) than those from the former East Germany. Participants with no information on income were more likely to refuse consent to both data sources compared to the reference group (net income: under EUR 1000; OR 0.15 [95% CI 0.08-0.30]). Respondents with two (OR 1.37 [95% CI 1.06-1.77]) or three and more diseases (OR 1.30 [95% CI 1.02-1.66]) diagnosed by a doctor agreed more frequently to linking both data sources than participants without disease. There is just a small proportion of variance in consenting explained by the models (R : 0.063-0.085). Also, only small changes of factors' prevalence were observed in consenters. CONCLUSIONS: For the first time in Germany, the lidA-study links primary survey data with health claims and administrative employment data. We conclude that there is only a minor relation between the analysed factors and consent behaviour of the participants. A linked data set may be used in further analyses without substantial biases.
[Mh] Termos MeSH primário: Demandas Administrativas em Assistência à Saúde
Viés
Armazenamento e Recuperação da Informação
Consentimento Livre e Esclarecido
[Mh] Termos MeSH secundário: Fatores Etários
Emprego/estatística & dados numéricos
Feminino
Alemanha
Nível de Saúde
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE



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