Personalized Medicine and Genomics

An emerging model of health care delivery that uses genetic information to customize a patient’s treatment.

A Text Messaging Intervention With Financial Incentive For Adolescents With Type 1 Diabetes

Aug. 30, 2020

Tara Kaushal, Lorraine E. Levitt Katz, Janet Joseph, Michelle Marowitz, Knashawn H. Morales, Daniel Atkins, Dean Ritter, Reid Simon, Lori Laffel, Terri H. Lipman

Abstract [from journal]

Background: Adolescents with type 1 diabetes (T1D) have higher hemoglobin A1C (HbA1c) levels than others. In general, adolescents engage with text messaging (TM) and financial incentives, both associated with improved diabetes outcomes. This study aimed to assess the impact of a TM intervention with financial incentives on self-care behaviors and HbA1c.

Methods: A six-month randomized controlled trial compared MyDiaText™, a TM education and support application, with standard care. The sample

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Characteristics Of Twitter Use By State Medicaid Programs In The United States: Machine Learning Approach

Aug. 17, 2020

Jane M. Zhu, Abeed Sarker, Sarah Gollust, Raina MerchantDavid Grande

Abstract [from journal]

Background: Twitter is a potentially valuable tool for public health officials and state Medicaid programs in the United States, which provide public health insurance to 72 million Americans.

Objective: We aim to characterize how Medicaid agencies and managed care organization (MCO) health plans are using Twitter to communicate with the public.

Methods: Using Twitter's public application programming interface, we collected 158,714 public posts ("tweets") from active

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Effects Of Dual Antiplatelet Therapy On Graft Patency After Lower Extremity Bypass

Grace Wang, MD
Aug. 7, 2020

Nathan Belkin, Jordan B. Stoecker, Benjamin M. Jackson, Scott M. Damrauer, Julia Glaser, Venkat Kalapatapu, Michael A. Golden, Grace J. Wang

Abstract [from journal]

Objective: Current guidelines recommend single agent antiplatelet therapy for patients with symptomatic peripheral arterial disease and for consideration of dual antiplatelet therapy (DAPT) after surgical revascularization. The objective of this study was both to explore prescribing patterns of single versus dual antiplatelet therapy after lower extremity bypass surgery, and to investigate the effects of antiplatelet therapy on bypass graft patency.

Methods: A retrospective analysis of

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Reduction Of Postoperative Opioid Use After Elective Spine And Peripheral Nerve Surgery Using An Enhanced Recovery After Surgery Program

Aug. 6, 2020

Tracy M. Flanders, Joseph Ifrach, Saurabh Sinha, Disha S. Joshi, Ali K. Ozturk, Neil R. Malhotra, Rachel Pessoa, Michael J. Kallan, Lee A. FleisherMichael A. Ashburn, Eileen Maloney, William C. Welch, Zarina S. Ali

Abstract [from journal]

Objective: Enhanced recovery after surgery (ERAS) pathways have previously been shown to be feasible and safe in elective spinal procedures. As publications on ERAS pathways have recently emerged in elective neurosurgery, long-term outcomes are limited. We report on our 18-month experience with an ERAS pathway in elective spinal surgery.

Methods: A historical cohort of 149 consecutive patients was identified as the control group, and 1,141 patients were prospectively enrolled in an ERAS

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The Contemporary Landscape Of Genetic Testing And Breast Cancer: Emerging Issues

Jul. 20, 2020

Payal D. Shah, Susan M. Domchek

Abstract [from journal]

The landscape of genetic testing for breast cancer susceptibility has transformed dramatically over the last decade and a half. Traditionally, the process of genetic testing resided fully within a medical infrastructure, from identification of appropriate testing candidates to gene selection to risk mitigation recommendations. More recently, decreasing costs, advancing technology, and a growing understanding of therapeutic implications of certain genetic test results have led to more widespread uptake of testing that increasingly

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Views From Patients With Cancer In The Setting Of Unplanned Acute Care: Informing Approaches To Reduce Health Care Utilization

Jun. 23, 2020

Tara L. Kaufmann, Katharine A. Rendle, Erin Aakhus, Vivek Nimgaonkar, Arnav Shah, Andrea Bilger, Peter E. Gabriel, Rebecca Trotta, Jennifer Braun, Lawrence N. Shulman, Justin E. Bekelman, Frances K. Barg

Abstract [from journal]

Purpose: New oncology care delivery models that avoid preventable acute care are needed, yet it is unclear which interventions best meet the needs of patients and caregivers. Perspectives from patients who experienced unplanned acute care events may inform the successful development and implementation of care delivery models.

Methods: We performed a qualitative interview study of patients with solid tumors on active treatment who experienced the following 3 types of unplanned acute care events

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Text Messaging And Lottery Incentive To Improve Colorectal Cancer Screening Outreach At A Community Health Center: A Randomized Controlled Trial

Shivan J. Mehta, MD, MBA
May. 8, 2020

Shivan J. Mehta, Akinbowale Oyalowo, Catherine Reitz, Owen Dean, Timothy McAuliffe, David A. Asch, Chyke A. Doubeni

Abstract [from journal]

Efforts to boost colorectal cancer (CRC) screening rates in underserved populations have been limited by effectiveness and scalability. We evaluate the impact of adding a lottery-based financial incentive to a text messaging program that asks patients to opt-in to receive mailed fecal immunochemical testing (FIT). This is a two-arm pragmatic randomized controlled trial at a community health center in Southwest Philadelphia from April to July 2017. We included CRC screening-eligible patients between ages 50-74 years who had a mobile

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Can We Afford to Cure Cancer?

Oct. 26, 2018

Novel gene and cell therapies hold out the promise of a cure for previously incurable conditions, often at eye-popping prices. Last month, more than 75 health policy and biomedical researchers, federal and state regulators, and clinicians convened at the Cost of a Cure Conference at the University of Pennsylvania to discuss key political, economic, and clinical challenges to the future of gene and cell therapies.

Penn’s Gant Family Precision Medicine Consortium Takes on Sustainable Targeted Oncology

Sep. 20, 2018

Biomedical advances in genomics and oncology, combined with rising costs for targeted cancer therapies, challenge the way we currently deliver and pay for cancer care. To foster the economic sustainability of targeted therapies, the University of Pennsylvania convened the Gant Family Precision Cancer Medicine Consortium, a multidisciplinary work group of experts from health care economics, policy, law, regulation, biomedical research, patient advocacy, and the pharmaceutical and insurance industry.

Three Solutions to Maximize the Clinical Benefit and Affordability of Targeted Cancer Drugs

Apr. 18, 2018

Spending on cancer drugs in the United States has nearly doubled in the past five years and continues to grow, imposing substantial financial burden on patients with cancer. One of the biggest drivers of this growth is targeted cancer drugs – small molecules, monoclonal antibodies, and other therapies for cancer that target specific genomic aberrations. Now, a group led by the Abramson Cancer Center of the University of Pennsylvania has proposed three solutions to maximize the clinical benefit and affordability of targeted cancer drugs.

Orphan Drugs and Precision Cancer Medicine

Apr. 19, 2017

“Orphan drug” is a bit of misnomer, or at least verbal shorthand.  It’s not the drug that’s “orphan” or rare; rather, the disease is the orphan, meaning that it might not affect enough people, and provide enough of a market, to incentivize a drug company to look for therapies. That’s the premise behind the 1983 Orphan Drug Act (ODA), which offers incentives for companies to develop therapies for diseases that affect less than 200,000 people in the United States.

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