Journal ArticleAnn 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 ...
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Journal ArticleThromb 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 ...
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Journal ArticleEuropace · 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. ...
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Journal ArticleMed 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 ...
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Journal ArticleEur 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 ...
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Journal ArticlePediatrics · 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 ...
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Journal ArticleCard 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 ...
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Journal ArticleAm 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. ...
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Journal ArticleAm 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAnn 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 ...
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ConferenceJ 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 ...
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ConferenceAm 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 ...
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Journal ArticleCurrent 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 ...
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Journal ArticleJAMA 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleValue 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 ...
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Journal ArticleJAMA · 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleCirc 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 ...
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Journal ArticleJ 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, ...
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Journal ArticleJAMA · 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 ...
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Journal ArticleHeart 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 ...
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Journal ArticleNephrol 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 ...
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Journal ArticleCirc 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 ...
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Journal ArticleJACC 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 ...
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Journal ArticleInt 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 ...
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Journal ArticleJACC 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 ...
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Journal ArticleCirc 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 ...
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Journal ArticleAm 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: ...
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Journal ArticleAnn 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 ...
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Journal ArticleJAMA · 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleChest · 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 ...
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Journal ArticleChest · 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleCancer 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleObstet 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 ...
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Journal ArticleObstet 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 ...
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Journal ArticleEvid 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 ...
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Journal ArticleHeart 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleCirc 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 ...
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Journal ArticleJAMA · 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 ...
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Journal ArticleObstetrics 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 ...
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Journal ArticleJ 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. ...
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Journal ArticlePatient 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleArthritis 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 ...
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Journal ArticleEvid 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 ...
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Journal ArticleBMC 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 ...
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Journal ArticlePLoS 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleCirc 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleCancer · 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 ...
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Journal ArticleJAMA · 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 ...
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Journal ArticlePLoS 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 ...
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Journal ArticleCardiol 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleInt 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleInt 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 ...
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Journal ArticleGynecol 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleArch 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleEur 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 ...
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Journal ArticleThorax · 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleCrit 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleArch 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 ...
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Journal ArticleAIDS · 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 ...
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Journal ArticleEvid 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 ...
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Journal ArticleClin 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 ...
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Journal ArticleN 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleN 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 ...
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Journal ArticleHealth 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 ...
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Journal ArticleGastrointest 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 ...
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Journal ArticleEmerg 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleAliment 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 ...
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Journal ArticleCard 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 ...
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Journal ArticleCancer · 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleEmerg 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 ...
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Journal ArticlePediatrics · 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 ...
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Journal ArticleAm 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleJAMA · 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleEmerg 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 ...
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Journal ArticleCardiology 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleMed 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleGenet 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 ...
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Journal ArticleMed 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 ...
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Journal ArticleProc 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 ...
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Journal ArticleCardiology 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleAnn 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 ...
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Journal ArticleProc 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 ...
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Journal ArticleProc 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 ...
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Journal ArticleProc 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 ...
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Journal ArticleCan 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 ...
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Journal ArticleJ 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 ...
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