The Volume-Outcome Relationship in Robotic Proctectectomy: Does Center Volume Matter? Results of a National Cohort Study
Abstract [from journal]
Background: Utilization of robotic proctectomy (RP) for rectal cancer has steadily increased since the inception of robotic surgery in 2002. Randomized control trials evaluating the safety of RP are in process to better understand the role of robotic assistance in proctectomy. This study aimed to characterize the trends in the use of RP for rectal cancer, and to compare oncologic outcomes with center-level RP volume.
Materials and Methods: 8107 patients with rectal adenocarcinoma who underwent RP were...
Performance of a Clinical Decision Support Tool to Identify PICU Patients at High Risk for Clinical Deterioration
Abstract [from journal]
Objectives: To evaluate the translation of a paper high-risk checklist for PICU patients at risk of clinical deterioration to an automated clinical decision support tool.
Design: Retrospective, observational cohort study of an automated clinical decision support tool, the PICU Warning Tool, adapted from a paper checklist to predict clinical deterioration events in PICU patients within 24 hours.
Setting: Two quaternary care medical-surgical PICUs—The Children’s Hospital of Philadelphia and...
Effect of Prices, Distribution Strategies, and Marketing on Demand for HIV Self-testing in Zimbabwe: A Randomized Clinical Trial
Abstract [from journal]
Importance: HIV self-testing is a promising approach for increasing awareness of HIV status in sub-Saharan Africa, particularly in Zimbabwe, where HIV prevalence is 13%. Evidence is lacking, however, on the optimal pricing policies and delivery strategies for maximizing the effect of HIV self-testing.
Objective: To assess demand for HIV self-testing among adults and priority-population subgroups under alternative pricing and distribution strategies.
Design, Setting, and Participants:...
Public reporting of cardiovascular outcomes remains controversial, 20 years after New York became the first state to mandate reporting of mortality data for percutaneous coronary intervention (PCI). It has been associated with a lower likelihood of performing potentially lifesaving procedures, perhaps reflecting an avoidance of intervening in high-risk cases.
Contributions to Members of Congressional Committees Responding to the Opioid Crisis From PACs Connected to Opioid Firms
Amidst an unprecedented opioid epidemic, two Congressional committees have led the federal legislative response to the crisis.
Pharmaceutical company payments can significantly influence physician prescribing behavior, according to a recent National Bureau of Economics Research (NBER) Working Paper by LDI Senior Fellows Matthew Grennan, Ashley Swanson, and colleagues.
Financial conflicts of interest between the drug and device industry and physicians have long been recognized, but the frequency and scope of such conflicts between industry and patient advocacy organizations (PAOs) are less understood.
ABSTRACT [FROM JOURNAL]
Neuroimaging is advancing a new definition of Alzheimer's disease (AD). Using imaging biomarkers, clinicians may begin to diagnose the disease by identifying pathology and neurodegeneration in either cognitively impaired or unimpaired adults. This “biomarker-based” diagnosis may allow clinicians novel opportunities to use interventions that either delay the onset or slow the progression of cognitive decline, but it will also bring novel challenges. How will changing the definition of AD from a clinical to a biomarker construct change the experience of...
Engaging patients, families, and independent experts in policymaking is a laudable goal, but the process of doing so isn’t necessarily straightforward. If efforts to introduce patient and public perspectives also introduce bias, they may do more harm than good. A recent study raises concerns about bias in public engagement, finding that public engagement efforts by the Food and Drug Administration (FDA) may attract speakers with significant conflicts of interest (COI), which are frequently undisclosed.
In the New England Journal of Medicine, Matthew McCoy and colleagues, including Ezekiel Emanuel, examine conflicts of interest arising from the presence of industry executives on the boards of patient-advocacy organizations. Previous research has raised concern that the presence of industry leaders on the boards of these non-profit organizations may lead to advocacy for questionable reforms that do not always benefit the organizations’ constituents. The authors analyzed tax records, annual reports, and websites of 104 of the largest U.S patient-advocacy organizations to understand...