Scholars@Duke
Gillian Denise Sanders Schmidler

Gillian Denise Sanders Schmidler

Professor in Population Health Sciences
Population Health Sciences
gillian.schmidler@duke.edu
Duke Box 3485, Durham, NC 27710
200 Morris Street, Durham, NC 27710
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Selected Publications

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.

Journal Article Ann Intern Med · December 4, 2018 BACKGROUND: The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. PURPOSE: To compare the effectiveness of medical and procedural therapies in preventing thromboembolic ... Full text Link to item Cite

Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.

Journal Article Thromb Haemost · December 2018 BACKGROUND:  Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Medical therapy for decreasing stroke risk involves anticoagulation, which may increase bleeding risk for certain patients. In determining the optimal t ... Full text Link to item Cite

Single vs. dual chamber implantable cardioverter-defibrillators or programming of implantable cardioverter-defibrillators in patients without a bradycardia pacing indication: systematic review and meta-analysis.

Journal Article Europace · October 1, 2018 AIMS: Implantable cardioverter-defibrillators (ICDs) are key in the prevention of sudden cardiac death, but outcomes may vary by type of device or programming [single chamber (SC) vs. dual chamber (DC)] in patients without a bradycardia pacing indication. ... Full text Link to item Cite

Future Directions for Cost-effectiveness Analyses in Health and Medicine.

Journal Article Med Decis Making · October 2018 OBJECTIVES: In 2016, the Second Panel on Cost-effectiveness in Health and Medicine updated the seminal work of the original panel from 2 decades earlier. The Second Panel had an opportunity to reflect on the evolution of cost-effectiveness analysis (CEA) a ... Full text Link to item Cite

Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.

Journal Article Eur J Heart Fail · June 2018 AIM: There is limited information on the outcomes after primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with heart failure (HF) and diabetes. This analysis evaluates the effectiveness of a strategy of ICD plus medic ... Full text Link to item Cite

Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Journal Article Pediatrics · June 2018 CONTEXT: Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines. OBJECTIVES: To assess the comparative effectiveness of nonpha ... Full text Link to item Cite

When Is It Safe Not to Reimplant an Implantable Cardioverter Defibrillator at the Time of Battery Depletion?

Journal Article Card Electrophysiol Clin · March 2018 The implantable cardioverter defibrillator (ICD) is a life-saving therapy in various patient populations. Although data on the outcomes of initial ICD implants are abundant, data on ICD replacements, especially in patients with improved left ventricular (L ... Full text Link to item Cite

How well does early-career investigators' cardiovascular outcomes research training align with funded outcomes research?

Journal Article Am Heart J · February 2018 BACKGROUND: Outcomes research training programs should prepare trainees to successfully compete for research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) outcomes research. ... Full text Link to item Cite

Training cardiovascular outcomes researchers: A survey of mentees and mentors to identify critical training gaps and needs.

Journal Article Am Heart J · February 2018 BACKGROUND: Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS: From April to November 2014, we surveyed mentees a ... Full text Link to item Cite

Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins.

Journal Article Am Heart J · February 2018 BACKGROUND: Chronic lower extremity venous disease (LECVD) is twice as prevalent as coronary heart disease, and invasive therapies to treat LECVD accounted for an estimated $290 million in Medicare expenditures in 2015. Despite increasing use of these inva ... Full text Link to item Cite

Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review.

Journal Article Ann Intern Med · November 21, 2017 BACKGROUND: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. PURPOSE: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatment ... Full text Link to item Cite

Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II.

Conference J Cardiovasc Electrophysiol · November 2017 BACKGROUND: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator ... Full text Link to item Cite

New York Heart Association class and the survival benefit from primary prevention implantable cardioverter defibrillators: A pooled analysis of 4 randomized controlled trials.

Conference Am Heart J · September 2017 BACKGROUND: Primary prevention implantable cardioverter defibrillator (ICD) reduce all-cause mortality by reducing sudden cardiac death. There are conflicting data regarding whether patients with more advanced heart failure derive ICD benefit owing to the ... Full text Link to item Cite

Do Implantable Cardioverter-Defibrillators Lower the Risk of Sudden Death and Total Mortality in Patients with End-Stage Renal Disease?

Journal Article Current Cardiovascular Risk Reports · September 1, 2017 Purpose of Review: Although the risk of sudden cardiac death is high in patients with end-stage renal disease (ESRD), it is not clear if such patients benefit from the implantable cardioverter defibrillator (ICD). This paper reviews data on the risk of sud ... Full text Cite

Primary Prevention Implantable Cardioverter Defibrillators in Patients With Nonischemic Cardiomyopathy: A Meta-analysis.

Journal Article JAMA Cardiol · June 1, 2017 IMPORTANCE: Conflicting data have emerged on the efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death (primary prevention ICDs) in patients with nonischemic cardiomyopathy. OBJECTIVE: To investigate the ... Full text Link to item Cite

Prescription of Guideline-Recommended Implantable Cardioverter Defibrillator and Cardiac Resynchronization Therapy Among Patients Hospitalized With Heart Failure and Varying Degrees of Renal Function.

Journal Article Am J Cardiol · March 15, 2017 Implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) reduce mortality in many patients with heart failure (HF), but the current use and effectiveness of ICD/CRT in patients with chronic kidney disease (CKD) are uncertai ... Full text Link to item Cite

Advancing Value Assessment in the United States: A Multistakeholder Perspective.

Journal Article Value Health · February 2017 Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introd ... Full text Link to item Cite

Cost-Effectiveness Analysis 2.0.

Journal Article N Engl J Med · January 19, 2017 Full text Link to item Cite

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.

Journal Article Ann Intern Med · December 4, 2018 BACKGROUND: The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. PURPOSE: To compare the effectiveness of medical and procedural therapies in preventing thromboembolic ... Full text Link to item Cite

Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.

Journal Article Thromb Haemost · December 2018 BACKGROUND:  Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Medical therapy for decreasing stroke risk involves anticoagulation, which may increase bleeding risk for certain patients. In determining the optimal t ... Full text Link to item Cite

Single vs. dual chamber implantable cardioverter-defibrillators or programming of implantable cardioverter-defibrillators in patients without a bradycardia pacing indication: systematic review and meta-analysis.

Journal Article Europace · October 1, 2018 AIMS: Implantable cardioverter-defibrillators (ICDs) are key in the prevention of sudden cardiac death, but outcomes may vary by type of device or programming [single chamber (SC) vs. dual chamber (DC)] in patients without a bradycardia pacing indication. ... Full text Link to item Cite

Future Directions for Cost-effectiveness Analyses in Health and Medicine.

Journal Article Med Decis Making · October 2018 OBJECTIVES: In 2016, the Second Panel on Cost-effectiveness in Health and Medicine updated the seminal work of the original panel from 2 decades earlier. The Second Panel had an opportunity to reflect on the evolution of cost-effectiveness analysis (CEA) a ... Full text Link to item Cite

Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.

Journal Article Eur J Heart Fail · June 2018 AIM: There is limited information on the outcomes after primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with heart failure (HF) and diabetes. This analysis evaluates the effectiveness of a strategy of ICD plus medic ... Full text Link to item Cite

Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Journal Article Pediatrics · June 2018 CONTEXT: Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines. OBJECTIVES: To assess the comparative effectiveness of nonpha ... Full text Link to item Cite

When Is It Safe Not to Reimplant an Implantable Cardioverter Defibrillator at the Time of Battery Depletion?

Journal Article Card Electrophysiol Clin · March 2018 The implantable cardioverter defibrillator (ICD) is a life-saving therapy in various patient populations. Although data on the outcomes of initial ICD implants are abundant, data on ICD replacements, especially in patients with improved left ventricular (L ... Full text Link to item Cite

How well does early-career investigators' cardiovascular outcomes research training align with funded outcomes research?

Journal Article Am Heart J · February 2018 BACKGROUND: Outcomes research training programs should prepare trainees to successfully compete for research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) outcomes research. ... Full text Link to item Cite

Training cardiovascular outcomes researchers: A survey of mentees and mentors to identify critical training gaps and needs.

Journal Article Am Heart J · February 2018 BACKGROUND: Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS: From April to November 2014, we surveyed mentees a ... Full text Link to item Cite

Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins.

Journal Article Am Heart J · February 2018 BACKGROUND: Chronic lower extremity venous disease (LECVD) is twice as prevalent as coronary heart disease, and invasive therapies to treat LECVD accounted for an estimated $290 million in Medicare expenditures in 2015. Despite increasing use of these inva ... Full text Link to item Cite

Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review.

Journal Article Ann Intern Med · November 21, 2017 BACKGROUND: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. PURPOSE: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatment ... Full text Link to item Cite

Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II.

Conference J Cardiovasc Electrophysiol · November 2017 BACKGROUND: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator ... Full text Link to item Cite

New York Heart Association class and the survival benefit from primary prevention implantable cardioverter defibrillators: A pooled analysis of 4 randomized controlled trials.

Conference Am Heart J · September 2017 BACKGROUND: Primary prevention implantable cardioverter defibrillator (ICD) reduce all-cause mortality by reducing sudden cardiac death. There are conflicting data regarding whether patients with more advanced heart failure derive ICD benefit owing to the ... Full text Link to item Cite

Do Implantable Cardioverter-Defibrillators Lower the Risk of Sudden Death and Total Mortality in Patients with End-Stage Renal Disease?

Journal Article Current Cardiovascular Risk Reports · September 1, 2017 Purpose of Review: Although the risk of sudden cardiac death is high in patients with end-stage renal disease (ESRD), it is not clear if such patients benefit from the implantable cardioverter defibrillator (ICD). This paper reviews data on the risk of sud ... Full text Cite

Primary Prevention Implantable Cardioverter Defibrillators in Patients With Nonischemic Cardiomyopathy: A Meta-analysis.

Journal Article JAMA Cardiol · June 1, 2017 IMPORTANCE: Conflicting data have emerged on the efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death (primary prevention ICDs) in patients with nonischemic cardiomyopathy. OBJECTIVE: To investigate the ... Full text Link to item Cite

Prescription of Guideline-Recommended Implantable Cardioverter Defibrillator and Cardiac Resynchronization Therapy Among Patients Hospitalized With Heart Failure and Varying Degrees of Renal Function.

Journal Article Am J Cardiol · March 15, 2017 Implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT) reduce mortality in many patients with heart failure (HF), but the current use and effectiveness of ICD/CRT in patients with chronic kidney disease (CKD) are uncertai ... Full text Link to item Cite

Advancing Value Assessment in the United States: A Multistakeholder Perspective.

Journal Article Value Health · February 2017 Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introd ... Full text Link to item Cite

Cost-Effectiveness Analysis 2.0.

Journal Article N Engl J Med · January 19, 2017 Full text Link to item Cite

In reply

Journal Article JAMA - Journal of the American Medical Association · January 1, 2017 Cite

Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

Journal Article JAMA · September 13, 2016 IMPORTANCE: Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliv ... Full text Link to item Cite

An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio.

Journal Article J Comp Eff Res · July 2016 Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient car ... Full text Link to item Cite

Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women.

Journal Article Circ Heart Fail · January 2016 BACKGROUND: Clinical trials of implantable cardioverter defibrillators (ICDs) for primary prevention enrolled a limited number of women. We sought to examine clinical practice data to compare survival rates among women with heart failure with or without a ... Full text Link to item Cite

Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients.

Journal Article J Gen Intern Med · December 2015 BACKGROUND: Although the implantable cardioverter-defibrillator (ICD) is highly effective therapy for preventing sudden cardiac death, there is considerable uncertainty about its benefits and harms in older patients, especially in the presence of factors, ... Full text Link to item Cite

Benefits and Harms of Breast Cancer Screening: A Systematic Review.

Journal Article JAMA · October 20, 2015 IMPORTANCE: Patients need to consider both benefits and harms of breast cancer screening. OBJECTIVE: To systematically synthesize available evidence on the association of mammographic screening and clinical breast examination (CBE) at different ages and in ... Full text Link to item Cite

Complications from prophylactic replacement of cardiac implantable electronic device generators in response to United States Food and Drug Administration recall: A systematic review and meta-analysis.

Journal Article Heart Rhythm · July 2015 BACKGROUND: The number of cardiac implantable electronic device (CIED) recalls and advisories has increased over the past 3 decades, yet no consensus exists on how to best manage patients with these CIEDs, partially because rates of complications from prop ... Full text Link to item Cite

Primary prevention implantable cardioverter defibrillators in end-stage kidney disease patients on dialysis: a matched cohort study.

Journal Article Nephrol Dial Transplant · May 2015 BACKGROUND: Sudden cardiac death is the leading cause of death among end-stage kidney disease patients (ESKD) on dialysis, but the benefit of primary prevention implantable cardioverter defibrillators (ICDs) in this population is uncertain. We conducted th ... Full text Link to item Cite

Survival benefit of the primary prevention implantable cardioverter-defibrillator among older patients: does age matter? An analysis of pooled data from 5 clinical trials.

Journal Article Circ Cardiovasc Qual Outcomes · March 2015 BACKGROUND: The impact of patient age on the risks of death or rehospitalization after primary prevention implantable cardioverter-defibrillator (ICD) placement is uncertain. METHODS AND RESULTS: Data from 5 major ICD trials were merged: the Multicenter Au ... Full text Link to item Cite

Primary prevention implantable cardioverter-defibrillators and survival in older women.

Journal Article JACC Heart Fail · February 2015 OBJECTIVES: The purpose of this study was to assess the benefit of primary prevention implantable cardioverter defibrillators (ICDs) in women. BACKGROUND: Clinical trials of primary prevention ICDs enrolled a limited number of women. METHODS: Using a prope ... Full text Link to item Cite

Incidence and predictors of appropriate therapies delivered by the implantable cardioverter defibrillator in patients with ischemic cardiomyopathy: a systematic review.

Journal Article Int J Cardiol · December 20, 2014 BACKGROUND: Although the implantable cardioverter defibrillator (ICD) improves the survival of patients at increased risk of sudden cardiac death due to systolic heart failure, ICD shocks have been associated with both worse survival and quality of life. W ... Full text Link to item Cite

Outcomes of implantable cardioverter-defibrillator use in patients with comorbidities: results from a combined analysis of 4 randomized clinical trials.

Journal Article JACC Heart Fail · December 2014 OBJECTIVES: The aim of this study was to determine if the benefit of implantable cardioverter-defibrillators (ICDs) is modulated by medical comorbidity. BACKGROUND: Primary prevention ICDs improve survival in patients at risk for sudden cardiac death. Thei ... Full text Link to item Cite

Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease.

Journal Article Circ Arrhythm Electrophysiol · October 2014 BACKGROUND: Guidelines recommend that implantable cardioverter-defibrillator (ICD) candidates have an estimated longevity of ≥1 year. Longevity can be affected by chronic kidney disease (CKD). METHODS AND RESULTS: Using the National Cardiovascular Data Reg ... Full text Link to item Cite

Implantable cardioverter-defibrillators for primary prevention of sudden cardiac death in CKD: a meta-analysis of patient-level data from 3 randomized trials.

Journal Article Am J Kidney Dis · July 2014 BACKGROUND: The benefit of a primary prevention implantable cardioverter-defibrillator (ICD) among patients with chronic kidney disease is uncertain. STUDY DESIGN: Meta-analysis of patient-level data from randomized controlled trials. SETTING & POPULATION: ... Full text Link to item Cite

Prioritization of patient-centered comparative effectiveness research for osteoarthritis.

Journal Article Ann Intern Med · June 17, 2014 Osteoarthritis is a leading cause of disability in the United States. This article describes a prioritized research agenda about osteoarthritis management developed for the Patient-Centered Outcomes Research Institute. Evidence gaps were identified by revi ... Full text Link to item Cite

Association between prophylactic implantable cardioverter-defibrillators and survival in patients with left ventricular ejection fraction between 30% and 35%.

Journal Article JAMA · June 4, 2014 IMPORTANCE: Clinical trials of prophylactic implantable cardioverter-defibrillators (ICDs) have included a minority of patients with a left ventricular ejection fraction (LVEF) between 30% and 35%. Because a large number of ICDs in the United States are im ... Full text Link to item Cite

Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review.

Journal Article Ann Intern Med · June 3, 2014 BACKGROUND: The comparative effectiveness of treatments for atrial fibrillation (AF) is uncertain. PURPOSE: To evaluate the comparative effectiveness of rate- and rhythm-control therapies. DATA SOURCES: English-language studies in PubMed, EMBASE, and the C ... Full text Link to item Cite

Prioritization of research addressing management strategies for ductal carcinoma in situ.

Journal Article Ann Intern Med · April 1, 2014 Ductal carcinoma in situ is a common finding in women having mammography screening, and there is considerable uncertainty about the balance of harms and benefits of different management options. This article outlines the process for developing a prioritize ... Full text Link to item Cite

Prioritization of research addressing antipsychotics for adolescents and young adults with bipolar disorder.

Journal Article Ann Intern Med · April 1, 2014 Despite a paucity of high-quality evidence about benefits and harms, antipsychotic medication use among adolescents and young adults with bipolar disorder is increasing. The Patient-Centered Outcomes Research Institute tasked the Duke Evidence Synthesis Gr ... Full text Link to item Cite

Use Of Rate And Rhythm Control Drugs In Patients Younger Than 65 Years With Atrial Fibrillation.

Journal Article J Atr Fibrillation · 2014 Little is known about the use of pharmacologic rhythm or rate control in younger atrial fibrillation (AF) patients in clinical practice. Using commercial health data from 2006 through 2010, patients aged <65 years with an initial AF encounter were categori ... Link to item Cite

Cost-effectiveness of newer antiretroviral drugs in treatment-experienced patients with multidrug-resistant HIV disease.

Journal Article J Acquir Immune Defic Syndr · December 1, 2013 OBJECTIVE: Newer antiretroviral drugs provide substantial benefits but are expensive. The cost-effectiveness of using antiretroviral drugs in combination for patients with multidrug-resistant HIV disease was determined. DESIGN: A cohort state-transition mo ... Full text Link to item Cite

Accuracy of clinicians and models for estimating the probability that a pulmonary nodule is malignant.

Journal Article Ann Am Thorac Soc · December 2013 RATIONALE: Management of pulmonary nodules depends critically on the probability of malignancy. Models to estimate probability have been developed and validated, but most clinicians rely on judgment. OBJECTIVES: The aim of this study was to compare the acc ... Full text Link to item Cite

Efficacy and tolerability of treatments for chronic cough: a systematic review and meta-analysis.

Journal Article Chest · December 2013 BACKGROUND: Understanding the comparative effectiveness of treatments for patients with unexplained or refractory cough is important to increase awareness of proven therapies and their potential adverse effects in this unique population. METHODS: We perfor ... Full text Link to item Cite

Evaluating cough assessment tools: a systematic review.

Journal Article Chest · December 2013 BACKGROUND: Little is known about the comparative validity, reliability, or responsiveness of instruments for assessing cough frequency or impact, where the term impact encompasses both cough severity and the impact of cough on health-related quality of li ... Full text Link to item Cite

Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis.

Journal Article J Clin Oncol · November 20, 2013 PURPOSE: To estimate the risks of ovarian cancer and breast cancer associated with oral contraceptive (OC) use among women at elevated risk owing to mutations in BRCA1/2 or a strong family history. METHODS: We searched PubMed, Embase, the Cochrane Database ... Full text Link to item Cite

Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review.

Journal Article Cancer Epidemiol Biomarkers Prev · November 2013 Oral contraceptives may influence the risk of certain cancers. As part of the AHRQ Evidence Report, Oral Contraceptive Use for the Primary Prevention of Ovarian Cancer, we conducted a systematic review to estimate associations between oral contraceptive us ... Full text Link to item Cite

Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation.

Journal Article Am Heart J · November 2013 BACKGROUND: Atrial fibrillation (AF) guideline recommendations for antiarrhythmic drugs (AADs) are based on the effectiveness and safety of the AAD in patients with selected, concomitant heart disease. It is unknown to what extent these recommendations are ... Full text Link to item Cite

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

Journal Article Obstet Gynecol · August 2013 OBJECTIVE: To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. DATA SOURCES: We searched PubMed, Embas ... Full text Link to item Cite

Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis.

Journal Article Obstet Gynecol · July 2013 OBJECTIVE: To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES: We searc ... Full text Link to item Cite

Oral contraceptive use for the primary prevention of ovarian cancer.

Journal Article Evid Rep Technol Assess (Full Rep) · June 2013 OBJECTIVE: To estimate the overall balance of harms and benefits from the potential use of oral contraceptives (OCs) for the primary prevention of ovarian cancer DATA SOURCES: We searched PubMed®, Embase®, the Cochrane Database of Systematic Reviews, and C ... Link to item Cite

Survival benefit of primary prevention implantable cardioverter-defibrillator therapy after myocardial infarction: does time to implant matter? A meta-analysis using patient-level data from 4 clinical trials.

Journal Article Heart Rhythm · June 2013 BACKGROUND: Whether there is an optimal time to place an implantable cardioverter-defibrillator (ICD) more than 40 days after myocardial infarction (MI) in guideline-eligible patients is unknown. OBJECTIVE: To evaluate the effect of time from MI to randomi ... Full text Link to item Cite

Performance measures to promote quality improvement in sudden cardiac arrest prevention and treatment.

Journal Article Am Heart J · June 2013 Sudden cardiac arrest (SCA) is one of the most impactful public health problems in the United States. Despite the progress made in reducing the number of cardiac deaths, the incidence of sudden cardiac death remains high. Studies of life-saving interventio ... Full text Link to item Cite

Priorities for comparative effectiveness reviews in cardiovascular disease.

Journal Article Circ Cardiovasc Qual Outcomes · March 1, 2013 BACKGROUND: Comparative effectiveness reviews offer a systematic method to critically appraise existing research and to identify unaddressed clinical areas in cardiovascular disease where significant morbidity, mortality, and variation in the use of resour ... Full text Link to item Cite

Survival of patients receiving a primary prevention implantable cardioverter-defibrillator in clinical practice vs clinical trials.

Journal Article JAMA · January 2, 2013 IMPORTANCE: Randomized clinical trials have shown that implantable cardioverter-defibrillator (ICD) therapy saves lives. Whether the survival of patients who received an ICD in primary prevention clinical trials differs from that of trial-eligible patients ... Full text Link to item Cite

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

Journal Article Obstetrics and gynecology · January 1, 2013 To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. We searched PubMed, Embase, the Cochrane Database ... Cite

ECG-based signal analysis technologies for evaluating patients with acute coronary syndrome: a systematic review.

Journal Article J Electrocardiol · 2013 BACKGROUND/OBJECTIVES: Timely identification of cardiac ischemia is critical in patients with acute coronary syndrome (ACS). The first test is often the standard, resting 12-lead ECG. Given its limitations, signal analysis enhancements have been proposed. ... Full text Link to item Cite

Assessment of the quality of existing patient educational tools focused on sudden cardiac arrest: a systematic evaluation by the Sudden Cardiac Arrest Thought Leadership Alliance.

Journal Article Patient Prefer Adherence · 2013 BACKGROUND: Conveying contemporary treatment options for those at risk of sudden cardiac arrest (SCA) is challenging. The purpose of the present research was to evaluate the quality and usability of available patient educational tools relevant to SCA and i ... Full text Open Access Link to item Cite

Is heart failure guideline adherence being underestimated? The impact of therapeutic contraindications.

Journal Article Am Heart J · November 2012 BACKGROUND: Several studies based on claims data have reported underutilization of evidence-based heart failure (HF) therapies. The degree to which these estimates fail to account for therapeutic contraindications is unclear. METHODS: We identified patient ... Full text Link to item Cite

Identifying research needs for improving health care.

Journal Article Ann Intern Med · September 18, 2012 Insights from systematic reviews can help new studies better meet the priorities and needs of patients and communities. However, systematic reviews unfortunately have not yet achieved this position to direct and guide new research studies. The Agency for H ... Full text Link to item Cite

Effect of clinical decision-support systems: a systematic review.

Journal Article Ann Intern Med · July 3, 2012 BACKGROUND: Despite increasing emphasis on the role of clinical decision-support systems (CDSSs) for improving care and reducing costs, evidence to support widespread use is lacking. PURPOSE: To evaluate the effect of CDSSs on clinical outcomes, health car ... Full text Link to item Cite

Updated report on comparative effectiveness of ACE inhibitors, ARBs, and direct renin inhibitors for patients with essential hypertension: much more data, little new information.

Journal Article J Gen Intern Med · June 2012 OBJECTIVES: A 2007 systematic review compared angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in patients with hypertension. Direct renin inhibitors (DRIs) have since been introduced, and significant new research ... Full text Link to item Cite

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers for treatment of ischemic heart disease: Future research needs prioritization.

Journal Article Am Heart J · May 2012 BACKGROUND: A recent review evaluated the comparative effectiveness of angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) in patients with or at high risk for stable ischemic heart disease (IHD). The prioritizatio ... Full text Link to item Cite

Psychometric characteristics of outcome measures in juvenile idiopathic arthritis: a systematic review.

Journal Article Arthritis Care Res (Hoboken) · April 2012 OBJECTIVE: To review the performance characteristics of the instruments most commonly used to measure clinical outcomes in juvenile idiopathic arthritis (JIA), including global assessments, articular indices, functional/disability assessments, and quality ... Full text Link to item Cite

Enabling health care decisionmaking through clinical decision support and knowledge management.

Journal Article Evid Rep Technol Assess (Full Rep) · April 2012 OBJECTIVES: To catalogue study designs used to assess the clinical effectiveness of CDSSs and KMSs, to identify features that impact the success of CDSSs/KMSs, to document the impact of CDSSs/KMSs on outcomes, and to identify knowledge types that can be in ... Link to item Cite

Systematic review of disease-modifying antirheumatic drugs for juvenile idiopathic arthritis.

Journal Article BMC Pediatr · March 15, 2012 BACKGROUND: Treatment of juvenile idiopathic arthritis (JIA) with disease-modifying antirheumatic drugs (DMARDs) may improve outcomes compared to conventional therapy (e.g., non-steroidal anti-inflammatory drugs, intra-articular corticosteroids). The purpo ... Full text Link to item Cite

Strategies for treating latent multiple-drug resistant tuberculosis: a decision analysis.

Journal Article PLoS One · 2012 BACKGROUND: The optimal treatment for latent multiple-drug resistant tuberculosis infection remains unclear. In anticipation of future clinical trials, we modeled the expected performance of six potential regimens for treatment of latent multiple-drug resi ... Full text Open Access Link to item Cite

Quality of care for sudden cardiac arrest: Proposed steps to improve the translation of evidence into practice.

Journal Article Am Heart J · August 2011 Sudden cardiac arrest (SCA) is the most common cause of death in the United States. Despite national guidelines, patients at risk for SCA often fail to receive evidence-based therapies. Racial and ethnic minorities and women are at particularly high risk f ... Full text Link to item Cite

Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators.

Journal Article J Card Fail · April 2011 INTRODUCTION: This study was designed to determine if physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators (ICDs) are regionally associated with ICD use. METHODS AND RESULTS: A national sample of 9969 members of the ... Full text Link to item Cite

Extent of and reasons for nonuse of implantable cardioverter defibrillator devices in clinical practice among eligible patients with left ventricular systolic dysfunction.

Journal Article Circ Cardiovasc Qual Outcomes · March 2011 BACKGROUND: Several studies that used claims and registry data have reported that 40% to 80% of patients eligible for an implantable cardioverter defibrillator (ICD) fail to receive one in clinical practice, and the rates are especially high among women an ... Full text Link to item Cite

Systematic review of the incidence of sudden cardiac death in the United States.

Journal Article J Am Coll Cardiol · February 15, 2011 The need for consistent and current data describing the true incidence of sudden cardiac arrest (SCA) and/or sudden cardiac death (SCD) was highlighted during the most recent Sudden Cardiac Arrest Thought Leadership Alliance's (SCATLA) Think Tank meeting o ... Full text Link to item Cite

Development of an ovarian cancer screening decision model that incorporates disease heterogeneity: implications for potential mortality reduction.

Journal Article Cancer · February 1, 2011 BACKGROUND: Pathologic and genetic data suggest that epithelial ovarian cancer may consist of indolent and aggressive phenotypes. The objective of the current study was to estimate the impact of a 2-phenotype paradigm of epithelial ovarian cancer on the mo ... Full text Link to item Cite

Non-evidence-based ICD implantations in the United States.

Journal Article JAMA · January 5, 2011 CONTEXT: Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symp ... Full text Link to item Cite

Potential economic viability of two proposed rifapentine-based regimens for treatment of latent tuberculosis infection.

Journal Article PLoS One · 2011 RATIONALE: Rifapentine-based regimens for treating latent tuberculosis infection (LTBI) are being considered for future clinical trials, but even if they prove effective, high drug costs may limit their economic viability. OBJECTIVES: To inform clinical tr ... Full text Open Access Link to item Cite

Use of implantable cardioverter-defibrillators for primary prevention in older patients: a systematic literature review and meta-analysis.

Journal Article Cardiol J · 2011 BACKGROUND: Randomized clinical trials (RCTs) have demonstrated the efficacy of implantable cardioverter-defibrillators (ICDs) in reducing sudden cardiac death (SCD) in specific patient populations. However, patients ≥ 65 years were under-represented in th ... Full text Link to item Cite

Do physicians' attitudes toward implantable cardioverter defibrillator therapy vary by patient age, gender, or race?

Journal Article Ann Noninvasive Electrocardiol · January 2011 BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy improves survival of patients with systolic heart failure. We assessed whether physicians' recommendation for ICD therapy varies as a function of patient age, gender, race, and physician's sp ... Full text Link to item Cite

Addressing disparities in sudden cardiac arrest care and the underutilization of effective therapies.

Journal Article Am Heart J · October 2010 Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its major impact on public health, significant challenges exist at the patient, provider, public, and policy levels with respect to raising more widespread awarenes ... Full text Link to item Cite

Cost-effectiveness of implantable cardioverter defibrillators in patients >or=65 years of age.

Journal Article Am Heart J · July 2010 BACKGROUND: More than 80% of sudden cardiac deaths (SCDs) occur in patients >or=65 years old; the cost-effectiveness of implantable cardioverter defibrillator (ICD) therapy in older patients remains unclear. We sought to examine the cost-effectiveness of I ... Full text Link to item Cite

Optimal timing of implantable cardioverter-defibrillator implantation after myocardial infarction: a decision analysis.

Journal Article J Cardiovasc Electrophysiol · July 2010 BACKGROUND: The optimal timing of implantable cardioverter defibrillator (ICD) placement for the primary prevention of sudden cardiac death after myocardial infarction (MI) remains unknown. METHODS AND RESULTS: We developed a Markov model to investigate th ... Full text Link to item Cite

Cost-effectiveness of strategies to improve HIV testing and receipt of results: economic analysis of a randomized controlled trial.

Journal Article J Gen Intern Med · June 2010 BACKGROUND: The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results. OBJECTI ... Full text Link to item Cite

Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial.

Journal Article J Cardiovasc Electrophysiol · May 2010 INTRODUCTION: Remote monitoring is increasingly becoming the new standard of care for implantable cardioverter defibrillator (ICD) follow-up. We sought to determine whether remote monitoring of ICDs improves patient outcomes compared with quarterly device ... Full text Link to item Cite

A randomized trial of computer-based reminders and audit and feedback to improve HIV screening in a primary care setting.

Journal Article Int J STD AIDS · August 2009 Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV ... Full text Link to item Cite

Costs and cost-effectiveness of four treatment regimens for latent tuberculosis infection.

Journal Article Am J Respir Crit Care Med · June 1, 2009 RATIONALE: Isoniazid given daily for 9 months is the standard treatment for latent tuberculosis infection (LTBI), but its effectiveness is limited by poor completion rates. Shorter course regimens and regimens using directly observed therapy result in impr ... Full text Link to item Cite

Cost-effectiveness of voluntary HIV screening in Russia.

Journal Article Int J STD AIDS · January 2009 Russia has one of the world's fastest growing HIV epidemics, and HIV screening has been widespread. Whether such screening is an effective use of resources is unclear. We used epidemiologic and economic data from Russia to develop a Markov model to estimat ... Full text Link to item Cite

Reducing ovarian cancer mortality through screening: Is it possible, and can we afford it?

Journal Article Gynecol Oncol · November 2008 OBJECTIVE: Ovarian cancer is a leading cause of cancer-related deaths among women. Given the low prevalence of this disease, the effectiveness of screening strategies has not been established. We wished to estimate the clinical impact and cost-effectivenes ... Full text Link to item Cite

Preventing tomorrow's sudden cardiac death today: dissemination of effective therapies for sudden cardiac death prevention.

Journal Article Am Heart J · October 2008 Because the burden of sudden cardiac death (SCD) is substantial, it is important to use all guideline-driven therapies to prevent SCD. Among those therapies is the implantable cardioverter defibrillator (ICD). When indicated, ICD use is beneficial and cost ... Full text Link to item Cite

Cost-effectiveness of HIV monitoring strategies in resource-limited settings: a southern African analysis.

Journal Article Arch Intern Med · September 22, 2008 BACKGROUND: Although the number of infected persons receiving highly active antiretroviral therapy (HAART) in low- and middle-income countries has increased dramatically, optimal disease management is not well defined. METHODS: We developed a model to comp ... Full text Link to item Cite

Cost-effectiveness of HIV screening in patients older than 55 years of age.

Journal Article Ann Intern Med · June 17, 2008 BACKGROUND: Although HIV infection is more prevalent in people younger than age 45 years, a substantial number of infections occur in older persons. Recent guidelines recommend HIV screening in patients age 13 to 64 years. The cost-effectiveness of HIV scr ... Full text Link to item Cite

Improving HIV screening and receipt of results by nurse-initiated streamlined counseling and rapid testing.

Journal Article J Gen Intern Med · June 2008 BACKGROUND: HIV testing is cost-effective in unselected general medical populations, yet testing rates among those at risk remain low, even among those with regular primary care. HIV rapid testing is effective in many healthcare settings, but scant researc ... Full text Link to item Cite

Screening pregnant women for autoimmune thyroid disease: a cost-effectiveness analysis.

Journal Article Eur J Endocrinol · June 2008 OBJECTIVE: Untreated maternal hypothyroidism during pregnancy can have adverse consequences on maternal health and child intelligence quotient (IQ). Our objective was to examine the cost-effectiveness of screening pregnant women for autoimmune thyroid dise ... Full text Link to item Cite

Validation of two models to estimate the probability of malignancy in patients with solitary pulmonary nodules.

Journal Article Thorax · April 2008 BACKGROUND: Effective strategies for managing patients with solitary pulmonary nodules (SPN) depend critically on the pre-test probability of malignancy. OBJECTIVE: To validate two previously developed models that estimate the probability that an indetermi ... Full text Link to item Cite

Prevalence of HIV infection among inpatients and outpatients in Department of Veterans Affairs health care systems: implications for screening programs for HIV.

Journal Article Am J Public Health · December 2007 OBJECTIVES: We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites. METHODS: We collected demographic data and data on comorbid conditions and then conducted blinded ... Full text Link to item Cite

An economic evaluation of prolonged mechanical ventilation.

Journal Article Crit Care Med · August 2007 OBJECTIVE: Patients who receive prolonged mechanical ventilation have high resource utilization and relatively poor outcomes, especially the elderly, and are increasing in number. The economic implications of prolonged mechanical ventilation provision, how ... Full text Link to item Cite

Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death.

Journal Article Am Heart J · June 2007 Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are o ... Full text Link to item Cite

Preventing tomorrow's sudden cardiac death today: part II: Translating sudden cardiac death risk assessment strategies into practice and policy.

Journal Article Am Heart J · June 2007 Although current evidence supporting a more precise strategy for identifying patients at highest risk for sudden cardiac death (SCD) is sparse, strategies for translating existing and future evidence into clinical practice and policy are needed today. A gr ... Full text Link to item Cite

HIV testing of at risk patients in a large integrated health care system.

Journal Article J Gen Intern Med · March 2007 OBJECTIVE: Early identification of HIV infection is critical for patients to receive life-prolonging treatment and risk-reduction counseling. Understanding HIV screening practices and barriers to HIV testing is an important prelude to designing successful ... Full text Link to item Cite

Noninvasive imaging for coronary artery disease: a technology assessment for the Medicare Coverage Advisory Commission.

Journal Article Am Heart J · February 2007 This report describes a review of the available scientific evidence through 2005 on direct noninvasive imaging tests (NITs) for coronary artery disease. In particular, the report addresses 6 key questions provided by the Agency for Healthcare Research and ... Full text Link to item Cite

Effectiveness and cost-effectiveness of thrombolysis in submassive pulmonary embolism.

Journal Article Arch Intern Med · January 8, 2007 BACKGROUND: Thrombolytic therapy is controversial in patients with submassive pulmonary embolism. METHODS: We performed a cost-effectiveness analysis to compare health effects and costs of treatment with alteplase plus heparin sodium vs heparin alone in he ... Full text Link to item Cite

Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia.

Journal Article AIDS · November 14, 2006 OBJECTIVE: To assess the effectiveness and cost-effectiveness of treating HIV-infected injection drug users (IDUs) and non-IDUs in Russia with highly active antiretroviral therapy HAART. DESIGN AND METHODS: A dynamic HIV epidemic model was developed for a ... Full text Link to item Cite

Genomic tests for ovarian cancer detection and management.

Journal Article Evid Rep Technol Assess (Full Rep) · October 2006 OBJECTIVES: To assess the evidence that the use of genomic tests for ovarian cancer screening, diagnosis, and treatment leads to improved outcomes. DATA SOURCES: PubMed and reference lists of recent reviews. REVIEW METHODS: We evaluated tests for: (a) sing ... Link to item Cite

Multislice computed tomography detected coronary artery disease. Commentary

Journal Article Evidence-Based Medicine · February 1, 2006 Full text Cite

The authors reply [11]

Journal Article New England Journal of Medicine · January 12, 2006 Cite

Cost-effectiveness as an outcome in randomized clinical trials.

Journal Article Clin Trials · 2006 BACKGROUND: Economic outcomes are now included in many contemporary randomized trials and provide an additional dimension to the assessment of interventions. Economic data collection and analysis pose several methodologic challenges, however. PURPOSE: This ... Full text Link to item Cite

Cost-effectiveness of implantable cardioverter-defibrillators.

Journal Article N Engl J Med · October 6, 2005 BACKGROUND: Eight randomized trials have evaluated whether the prophylactic use of an implantable cardioverter-defibrillator (ICD) improves survival among patients who are at risk for sudden death due to left ventricular systolic dysfunction but who have n ... Full text Link to item Cite

Implantable cardioverter defibrillators and cardiac resynchronization therapy in patients with left ventricular dysfunction: randomized trial evidence through 2004.

Journal Article Am Heart J · June 2005 Although many studies have shown that implantable cardioverter defibrillator (ICD) therapy improves the survival of patients with significant left ventricular dysfunction, the magnitude of effectiveness of ICD therapy in clinically defined subgroups remain ... Full text Link to item Cite

Cost-effectiveness of screening for HIV.

Journal Article N Engl J Med · May 19, 2005 Full text Link to item Cite

Cost-effectiveness of defending against bioterrorism: a comparison of vaccination and antibiotic prophylaxis against anthrax.

Journal Article Ann Intern Med · April 19, 2005 BACKGROUND: Weaponized Bacillus anthracis is one of the few biological agents that can cause death and disease in sufficient numbers to devastate an urban setting. OBJECTIVE: To evaluate the cost-effectiveness of strategies for prophylaxis and treatment of ... Full text Link to item Cite

Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy.

Journal Article N Engl J Med · February 10, 2005 BACKGROUND: The costs, benefits, and cost-effectiveness of screening for human immunodeficiency virus (HIV) in health care settings during the era of highly active antiretroviral therapy (HAART) have not been determined. METHODS: We developed a Markov mode ... Full text Link to item Cite

Evidence-based medicine and policy: the case of the implantable cardioverter defibrillator.

Journal Article Health Aff (Millwood) · 2005 The implantable cardioverter defibrillator (ICD) is a costly new treatment for patients at high risk of sudden cardiac death. Randomized trials of the ICD showed it to be effective in some groups of patients but not in others. While new trials testing the ... Full text Link to item Cite

Cost-effectiveness of photodynamic therapy for high-grade dysplasia in Barrett's esophagus.

Journal Article Gastrointest Endosc · November 2004 BACKGROUND: Photodynamic therapy appears to be effective in ablating high-grade dysplasia in Barrett's esophagus. Our aim was to identify the most effective and cost-effective strategy for managing high-grade dysplasia in Barrett's esophagus without associ ... Full text Link to item Cite

Evaluating human papillomavirus vaccination programs.

Journal Article Emerg Infect Dis · November 2004 Human papillomavirus (HPV) has been implicated as the primary etiologic agent of cervical cancer. Potential vaccines against high-risk HPV types are in clinical trials. We evaluated vaccination programs with a vaccine against HPV-16 and HPV-18. We develope ... Full text Link to item Cite

Cost-effectiveness of testing for hypercoagulability and effects on treatment strategies in patients with deep vein thrombosis.

Journal Article Am J Med · June 15, 2004 PURPOSE: Among patients with deep vein thrombosis, hypercoagulable conditions impart a substantial risk of recurrent thrombosis. We sought to determine the cost-effectiveness of testing for these disorders, as well as which tests should be selected and how ... Full text Link to item Cite

Cost-effectiveness of screening for hepatocellular carcinoma in patients with cirrhosis due to chronic hepatitis C.

Journal Article Aliment Pharmacol Ther · June 1, 2004 BACKGROUND: Screening for hepatocellular carcinoma in cirrhotic patients using abdominal ultrasonography and alpha-foetoprotein levels is widely practiced. AIM: To evaluate its cost-effectiveness using a Markov decision model. METHODS: Several screening st ... Full text Link to item Cite

Cost-effectiveness of the implantable cardioverter defibrillator.

Journal Article Card Electrophysiol Rev · December 2003 Many clinicians and policymakers are concerned whether use of the implantable defibrillator (ICD) is justified in view of its high cost. Three randomized trials of the ICD have reported economic outcomes. Each trial found a large difference in cost between ... Full text Link to item Cite

Decision science and cervical cancer.

Journal Article Cancer · November 1, 2003 Mathematical modeling is an effective tool for guiding cervical cancer screening, diagnosis, and treatment decisions for patients and policymakers. This article describes the use of mathematical modeling as outlined in five presentations from the Decision ... Full text Link to item Cite

Cost-effectiveness of recombinant human activated protein C and the influence of severity of illness in the treatment of patients with severe sepsis.

Journal Article J Crit Care · September 2003 PURPOSE: To evaluate the cost-effectiveness of recombinant human activated protein C (rhAPC) compared with usual therapy for patients with severe sepsis, and also to determine the influence that severity of illness exerts on cost-effectiveness. MATERIALS A ... Full text Link to item Cite

Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules.

Journal Article Ann Intern Med · May 6, 2003 BACKGROUND: Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is a potentially useful but expensive test to diagnose solitary pulmonary nodules. OBJECTIVE: To evaluate the cost-effectiveness of strategies for pulmonary nodule diagnosis an ... Full text Link to item Cite

Cost-effectiveness of a potential vaccine for human papillomavirus.

Journal Article Emerg Infect Dis · January 2003 Human papillomavirus (HPV) infection, usually a sexually transmitted disease, is a risk factor for cervical cancer. Given the substantial disease and death associated with HPV and cervical cancer, development of a prophylactic HPV vaccine is a public healt ... Full text Link to item Cite

Perinatal screening for group B streptococci: cost-benefit analysis of rapid polymerase chain reaction.

Journal Article Pediatrics · September 2002 OBJECTIVE: To evaluate the costs and benefits of a group B streptococci screening strategy using a new, rapid polymerase chain reaction test in a hypothetical cohort of expectant mothers in the United States. DESIGN: Cost-benefit analysis using the human c ... Full text Link to item Cite

Effect of risk stratification on cost-effectiveness of the implantable cardioverter defibrillator.

Journal Article Am Heart J · September 2002 BACKGROUND: Implantable cardioverter defibrillators (ICDs) effectively prevent sudden cardiac death, but selection of appropriate patients for implantation is complex. We evaluated whether risk stratification based on risk of sudden cardiac death alone was ... Full text Link to item Cite

Evidence-based practice for mere mortals: the role of informatics and health services research.

Journal Article J Gen Intern Med · April 2002 The poor translation of evidence into practice is a well-known problem. Hopes are high that information technology can help make evidence-based practice feasible for mere mortal physicians. In this paper, we draw upon the methods and perspectives of clinic ... Full text Link to item Cite

Potential cost-effectiveness of prophylactic use of the implantable cardioverter defibrillator or amiodarone after myocardial infarction.

Journal Article Ann Intern Med · November 20, 2001 BACKGROUND: Clinical trials have shown that implantable cardioverter defibrillators (ICDs) improve survival in patients with sustained ventricular arrhythmias. OBJECTIVE: To determine the efficacy necessary to make prophylactic ICD or amiodarone therapy co ... Full text Link to item Cite

Cost-effectiveness of automated external defibrillators on airlines.

Journal Article JAMA · September 26, 2001 CONTEXT: Installation of automated external defibrillators (AEDs) on passenger aircraft has been shown to improve survival of cardiac arrest in that setting, but the cost-effectiveness of such measures has not been proven. OBJECTIVE: To examine the costs a ... Full text Link to item Cite

Publishing web-based guidelines using interactive decision models.

Journal Article J Eval Clin Pract · May 2001 Commonly used methods for guideline development and dissemination do not enable developers to tailor guidelines systematically to specific patient populations and update guidelines easily. We developed a web-based system, ALCHEMIST, that uses decision mode ... Full text Link to item Cite

Cost-effectiveness of a potential vaccine for Coccidioides immitis.

Journal Article Emerg Infect Dis · 2001 Coccidioidomycosis, a systemic fungal infection, affects Americans living in the Southwest. We evaluated the cost- effectiveness of a potential vaccine against Coccidioides immitis. Using a decision model we developed, we estimate that among children, vacc ... Full text Link to item Cite

Radiofrequency ablation for supraventricular tachycardia

Journal Article Cardiology Review · January 1, 2001 We compared radiofrequency ablation with drug treatment for patients with symptomatic supraventricular reentrant tachycardia using a cost-effectiveness model. For patients with monthly episodes of arrhythmia, ablation was more effective and less expensive ... Cite

Cost-effectiveness of radiofrequency ablation for supraventricular tachycardia.

Journal Article Ann Intern Med · December 5, 2000 BACKGROUND: Radiofrequency ablation is an established but expensive treatment option for many forms of supraventricular tachycardia. Most cases of supraventricular tachycardia are not life-threatening; the goal of therapy is therefore to improve the patien ... Full text Link to item Cite

Design and pilot evaluation of a system to develop computer-based site-specific practice guidelines from decision models.

Journal Article Med Decis Making · 2000 BACKGROUND: Local tailoring of clinical practice guidelines (CPGs) requires experts in medicine and evidence synthesis unavailable in many practice settings. The authors' computer-based system enables developers and users to create, disseminate, and tailor ... Full text Link to item Cite

Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A cost-effectiveness analysis.

Journal Article Ann Intern Med · May 18, 1999 BACKGROUND: Low-molecular-weight heparins are effective for treating venous thrombosis, but their cost-effectiveness has not been rigorously assessed. OBJECTIVE: To evaluate the cost-effectiveness of low-molecular-weight heparins compared with unfractionat ... Full text Link to item Cite

Evaluation of genetic tests: APOE genotyping for the diagnosis of Alzheimer disease.

Journal Article Genet Test · 1999 Many studies have now confirmed the association between inheritance of the epsilon 4 allele of the apolipoprotein E (APOE) gene and Alzheimer disease (AD). However, although the medical community holds the near-unanimous opinion that APOE genotyping should ... Full text Link to item Cite

Distributed decision support using a web-based interface: prevention of sudden cardiac death.

Journal Article Med Decis Making · 1999 Although decision models can provide a formal foundation for guideline development and clinical decision support, their widespread use is often limited by the lack of platform-independent software that geographically dispersed users can access and use easi ... Full text Link to item Cite

Design of a modular, extensible decision support system for arrhythmia therapy.

Journal Article Proc AMIA Symp · 1998 We developed a decision-support system for evaluation of treatment alternatives for supraventricular and ventricular arrhythmias. The system uses independent decision models that evaluate the costs and benefits of treatment for recurrent atrioventricular-n ... Link to item Cite

Prophylaxis with isoniazid for low-risk tuberculin reactors

Journal Article Cardiology Review · January 1, 1998 We evaluated the effectiveness and costs by giving monitored prophylaxis to low-risk tuberculin reactors aged 35, 50, or 70 years. Compared with no prophylaxis, we found that isoniazid prophylaxis increased the probability of survival at 1 year and for all ... Cite

Monitored isoniazid prophylaxis for low-risk tuberculin reactors older than 35 years of age: a risk-benefit and cost-effectiveness analysis.

Journal Article Ann Intern Med · December 15, 1997 BACKGROUND: Isoniazid chemoprophylaxis effectively prevents the development of active infectious tuberculosis. Current guidelines recommend withholding this prophylaxis for low-risk tuberculin reactors older than 35 years of age because of the risk for fat ... Full text Link to item Cite

Cost-effectiveness of implantable cardioverter defibrillators relative to amiodarone for prevention of sudden cardiac death.

Journal Article Ann Intern Med · January 1, 1997 BACKGROUND: Implantable cardioverter defibrillators (ICDs) are remarkably effective in terminating ventricular arrhythmias, but they are expensive and the extent to which they extend life is unknown. The marginal cost-effectiveness of ICDs relative to amio ... Full text Link to item Cite

Presentation and explanation of medical decision models using the World Wide Web.

Journal Article Proc AMIA Annu Fall Symp · 1996 We demonstrated the use of the World Wide Web for the presentation and explanation of a medical decision model. We put on the web a treatment model developed as part of the Cardiac Arrhythmia and Risk of Death Patient Outcomes Research Team (CARD PORT). To ... Link to item Cite

Prevention of sudden cardiac death: a probabilistic model for decision support.

Journal Article Proc Annu Symp Comput Appl Med Care · 1995 As part of the Cardiac Arrhythmia and Risk of Death Patient Outcomes Research Team (CARD PORT) study we are developing a comprehensive decision model to help physicians identify preferred strategies for preventing sudden cardiac death. The model integrates ... Link to item Cite

A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states.

Journal Article Proc Annu Symp Comput Appl Med Care · 1994 We developed a computer-based utility assessment tool to assess the preferences of patients towards HIV-related health states and identify risk behaviors (both sexual and drug related) of the patient being interviewed. The reliability of the computer-based ... Link to item Cite

Computed tomography for nontraumatic headache: current utilization and cost-effectiveness.

Journal Article Can Assoc Radiol J · June 1993 A retrospective study was performed at two teaching hospitals--one in the United States and one in Canada--to determine the results of computed tomography (CT) examinations of the head in patients with nontraumatic headache. Of 1111 examinations performed ... Link to item Cite

The potential use of expert systems to enable physicians to order more cost-effective diagnostic imaging examinations.

Journal Article J Digit Imaging · May 1991 Educating physicians to order diagnostic imaging examinations more cost-effectively is a difficult and time consuming task, which may be assisted significantly by the use of an expert system. This report is based on a study undertaken at the Health Science ... Full text Link to item Cite