Comparative Effectiveness Research / PCORI

The analysis of the relative effectiveness of different medical treatments. The Patient-Centered Outcomes Research Institute (PCORI) is a government-sponsored organization set up to fund this analysis.  

The Role Of Staffing And Classroom Characteristics On Preschool Teachers' Use Of One-To-One Intervention With Children With Autism

Jul. 6, 2020

Victor LushinSteven Marcus, Daphney Gaston, Rinad Beidas, Ashlee Lamson, Ilene Goy, Irina Godina, Joanne Rees, Rebecca Rivera, David Mandell

Abstract [from journal]

For preschool children with autism, individual (one-to-one) behavioral interventions are among the best-tested treatments. However, they are rarely used in special education preschools. We observed formally and informally delivered one-to-one behavioral interventions use by classroom staff (n = 51) in 12 classrooms across three special education preschools for children with autism, aged 3-6 years, in a major US city. We estimated the associations between one-to-one intervention use and classroom characteristics including staff-student

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Intravitreal Anti-Vascular Endothelial Growth Factor Cost Savings Achievable With Increased Bevacizumab Reimbursement and Utilization

Jun. 13, 2020

David B. Glasser, Ravi Parikh, Flora Lum, George A. Williams

Abstract [from journal]

Purpose: To model Medicare Part B and patient savings associated with increased bevacizumab payment and utilization for intravitreal anti-vascular endothelial growth factor (VEGF) therapy.

Design: Cost analysis.

Methods: Medicare claims and IRIS® Registry data were used to calculate Medicare Part B expenditures and patient co-pays for anti-VEGF agents with increasing reimbursement and utilization of bevacizumab relative to ranibizumab and aflibercept.

Main

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Comparative Effectiveness of Proton vs Photon Therapy as Part of Concurrent Chemoradiotherapy for Locally Advanced Cancer

Dec. 26, 2019

Brian C. Baumann, Nandita Mitra, Joanna G. Harton, Ying Xiao, Andrzej P. Wojcieszynski, Peter E. Gabriel, Haoyu Zhong, Huaizhi Geng, Abigail Doucette, Jenny Wei, Peter J. O’Dwyer, Justin E. Bekelman, James M. Metz

Abstract [from journal]

Importance: Concurrent chemoradiotherapy is the standard-of-care curative treatment for many cancers but is associated with substantial morbidity. Concurrent chemoradiotherapy administered with proton therapy might reduce toxicity and achieve comparable cancer control outcomes compared with conventional photon radiotherapy by reducing the radiation dose to normal tissues.

Objective: To assess whether proton therapy in the setting of concurrent chemoradiotherapy is associated with fewer 90-day unplanned...

Interfacility Transfer of Medicare Beneficiaries With Acute Type A Aortic Dissection and Regionalization of Care in the United States

Oct. 7, 2019

Andrew B. Goldstone, Peter Chiu, Michael Baiocchi, Bharathi Lingala, Justin Lee, Joseph Rigdon, Michael P. Fischbein, Y. Joseph Woo

Abstract

Background: The feasibility and effectiveness of delaying surgery to transfer patients with acute type A aortic dissection—a catastrophic disease that requires prompt intervention—to higher-volume aortic surgery hospitals is unknown. We investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. We further decomposed this hypothesis into subparts, investigating the isolated effect of transfer and the isolated effect of receiving care at a high-

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How to Pay for Proton Therapy in Cancer Clinical Trials

Jul. 20, 2018

It’s a classic Catch-22: many insurers will not cover expensive proton therapy for some cancers because there’s little proof that it’s more beneficial or less harmful than standard treatment; meanwhile, patients cannot enroll in the clinical trials to test its comparative effectiveness because their insurers won’t cover the therapy. In a commentary in the Journal of Clinical Oncology, LDI Senior Fellow Justin Bekelman and colleagues point out the dilemma and suggest a way forward.

The Value of Value Frameworks

Oct. 26, 2017

“Value” is more than a buzzword. In response to rising costs, payers, physicians, and patients have turned to value assessment frameworks to inform treatment plans and design sustainable budgets. However, the usefulness and potential of these tools remain murky. LDI’s 50th anniversary symposium convened a panel to elucidate key questions for the future of value frameworks—what does value mean to different stakeholders in the health care system? How should payers, doctors, and patients appraise the value of the care they receive?

Unicompartmental Knee Arthroplasty Vs. Total Knee Arthroplasty for Medial Compartment Arthritis in Patients Older Than 75 Years: Comparable Reoperation, Revision, and Complication Rates

Jul. 11, 2017

Homayoun Siman, Atul F. Kamath, Nazly Carrillo, William S. Harmsen, Mark W. Pagnano, Rafael J. Sierra

In The Journal of Arthroplasty, Homayoun Siman and colleagues, including Atul Kamath, assess the effectiveness of unicompartmental knee arthroplasty (UKA) vs. total knee arthroplasty (TKA) in similar patients. Prior studies have shown that UKA procedures have advantages over TKA, including preservation of bone stock, shorter and easier recovery, lower overall cost, lower morbidity, better functional outcome, and subjective feeling of a more natural knee. The authors conducted a retrospective review of patients 75 years and older who underwent UKA or TKA over a 10-year period in...

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