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.  

Focused Cardiac Ultrasound in Place of Repeat Echocardiography: Reliability and Cost Implications

Oct. 1, 2015

Vinay Kini, Nidhi Mehta, Jeremy Mazurek, Victor Rerrari, Andrew Epstein, Peter Groeneveld, James Kirkpatrick

In the Journal of the American Society of Echocardiography, Vinay Kini and colleagues, including Andrew Epstein and Peter Groeneveld, assess the reliability and cost-effectiveness of using expert focused cardiac ultrasound (eFCU) in place of repeat transthoracic echocardiography (TTE). Rates of repeat TTE (two or more performed within 30 days) are high and can substantially increase the cost of providing cardiovascular care. The authors enrolled patients with prior TTE within 30 days who were ordered for another TTE. Participants underwent eFCU in addition to TTE and the study...

Comparison of HIV Outcomes for Patients Linked at Hospital Versus Community-Based Clinics

Mar. 1, 2015

Asher J. Schranz, Kathleen A. Brady, Florence Momplaisir, Joshua P. Metlay, Alisa J. Stephens-Shields, Baligh R. Yehia

In AIDS Patient Care and STDs, Asher Schranz (New York University) and colleagues, including Baligh Yehia, compare HIV treatment outcomes for patients in hospital-based clinics versus those accessing care in a community clinic. The authors studied 2008-2011 data on HIV-infected adults in Philadelphia, assessing treatment outcomes in terms of retention in care, use of antiretroviral therapy, and viral suppression. Controlling for differences in patient and clinic characteristics, the authors find no difference in treatment outcomes between patients in hospital-based and community-based...

Presentation of Prescription and Nonprescription Opioid Overdoses to U.S. Emergency Departments

Feb. 26, 2015

Michael A. Yokell, M. Kit Delgado, Nicholas D. Zaller, N. Ewen Wang, Samuel K. McGowan, Traci Craig Green

In JAMA Internal Medicine, Kit Delgado and colleagues investigate characteristics of opioid overdose presentations to emergency departments. Opioid overdose is a leading cause of injury-related mortality in the United States. They analyze data from 2010 on 135,971 patients with opioid overdoses who were treated in emergency departments. The authors evaluate opioid type, patient characteristics, care utilization and clinical outcomes. They find that: two thirds of overdose cases involved prescription opioids, mortality was higher for overdoses with multiple opioids, most...

Oculomotor and Neurocognitive Assessment of Youth Ice Hockey Players: Baseline Associations and Observations After Concussion

Feb. 3, 2015

Brian T. Vernau, Matthew F. Grady, Arlene Goodman, Douglas J. Wiebe, Luke Basta, Yong Park, Kristy B. Arbogast, Christina L. Master

In Developmental Neuropsychology, Brian Vernau and colleagues, including Douglas Wiebe, evaluate several cognitive assessment tools designed to evaluate patients pre- and post-concussion. The study enrolled 180 youth hockey players, all of whom underwent three neurocognitive assessments: the K-D test, ImPACT, and SCAT 3 or Child SCAT 3 depending on the participant’s age. Over the course of the season, several of the players sustained a concussion and underwent standard post-injury clinical assessment. Analyzing the data from the different assessment tools, the authors find...

The Use of Health Information Technology to Improve Care and Outcomes for Older Adults

Jan. 18, 2015

Kathryn H. Bowles, Patricia Dykes, George Demiris

In a commentary in Research in Gerontological Nursing, Kathryn Bowles and colleagues look at how nurse scientists are using health information technology, such as electronic health records (EHR) and decision support, to improve care. They highlight positive research findings, including that integrated EHR systems reduced hospital-acquired pressure ulcers by 13 percent. Or how the use of a discharge decision support system helped to identify whether older adults were likely to need post-acute services, such as skilled home care or skilled nursing facility care. Use of the system,...

Effectiveness of Androgen-Deprivation Therapy and Radiotherapy for Older Men With Locally Advanced Prostate Cancer

Jan. 5, 2015

Justin E. Bekelman, Nandita Mitra, Elizabeth A. Handorf, Robert G. Uzzo, Stephen A. Hahn, Daniel Polsky and Katrina Armstrong

In the Journal of Clinical Oncology, Justin Bekelman and colleagues analyze whether treating locally advanced prostate cancer in older men with hormone therapy plus radiation improves chances of survival relative to hormone therapy alone. Earlier trials have shown that the combined course of treatment improves chances of survival for younger men. Bekelman and colleagues’ study tests whether this holds true for the treatment of older men with advanced prostate cancer. The authors compared the treatment of 31,541 men with prostate cancer ranging in age from 65 years to 85 years....

The Value of Measuring Value

Dec. 20, 2014

(An edited version of this post appeared in Philly.com)

US health care spending has never grown as slowly as it did last year.

Dwight D. Eisenhower was in the Oval Office when the US government began recording health care spending in 1960.  Since that time, growth in health care spending has never been lower than the 3.6% annual rate reported by researchers from the Centers for Medicare and Medicaid Services a few weeks ago in the journal Health Affairs.

Comparison of Pediatric and Adult Hospice Patients Using Electronic Medical Record Data from Nine Hospices in the United States, 2008–2012

Nov. 4, 2014

Laura Dingfield, Laura Bender, Pamela Harris, Kristina Newport, Margo Hoover-Regan, Chris Feudtner, Sheila Clifford, and David Casarett

In the Journal of Palliative Medicine, David Casarett and colleagues from Penn Medicine look at pediatric and adult hospice patients and analyze differences in their characteristics and outcomes. In the study of over 126,000 hospice patients, children (18 years of age or younger) make up less than one percent of the hospice population. The authors posit that characteristics and needs of children in hospice are very different to that of adults. Despite this, pediatric patients are in general receiving services designed for adults, with only one third of hospice agencies running...

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