Publications

@article{pmid40082770,

title = {One in three adenomas could be missed by white-light colonoscopy - findings from a systematic review and meta-analysis},

author = {Beate Jahn and Marvin Bundo and Marjan Arvandi and Monika Schaffner and Jovan Todorovic and Gaby Sroczynski and Amy Knudsen and Timo Fischer and Irmgard Schiller-Fruehwirth and Dietmar \"{O}fner and Friedrich Renner and Michael Jonas and Igor Kuchin and Julia Kruse and J\'{u}lia Santamaria and Monika Ferlitsch and Uwe Siebert},

doi = {10.1186/s12876-025-03679-4},

issn = {1471-230X},

year  = {2025},

date = {2025-03-01},

journal = {BMC Gastroenterol},

volume = {25},

number = {1},

pages = {170},

abstract = {BACKGROUND: White light (conventional) colonoscopy (WLC) is widely used for colorectal cancer screening, diagnosis and surveillance but endoscopists may fail to detect adenomas. Our goal was to assess and synthesize overall and subgroup-specific adenoma miss rates (AMR) of WLC in daily practice.nnMETHODS: We conducted a systematic review in MEDLINE, EMBASE, Cochrane Library, and grey literature on studies evaluating diagnostic WLC accuracy in tandem studies with novel-colonoscopic technologies (NCT) in subjects undergoing screening, diagnostic or surveillance colonoscopy. Information on study design, AMR overall and specific for adenoma size, histology, location, morphology and further outcomes were extracted and reported in standardized evidence tables. Study quality was assessed using the QUADAS-2 tool. Random-effects meta-analyses and meta-regression were performed to estimate pooled estimates for AMR with 95% confidence intervals (95% CI) and to explain heterogeneity.nnRESULTS: Out of 5,963 identified studies, we included sixteen studies with 4,101 individuals in our meta-analysis. One in three adenomas (34%; 95% CI: 30-38%) was missed by WLC in daily practice individuals. Subgroup analyses showed significant AMR differences by size (36%, adenomas 1-5 mm; 27%, adenomas 6-9 mm; 12%, adenomas ≥ 10 mm), histology (non-advanced: 42%, advanced: 21%), morphology (flat: 50%, polypoid: 27%), but not by location (distal: 36%, proximal: 36%).nnCONCLUSIONS: Based on our meta-analysis, one in three adenomas could be missed by WLC. This may significantly contribute to interval cancers. Our results should be considered in health technology assessment when interpreting sensitivity of fecal occult blood or other screening tests derived from studies using WLC as "gold standard".},

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pubstate = {published},

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@article{pmid40068831,

title = {Sex-Specific Fall Trajectories and Associated Self-Reported Risk Factors: A Prospective Analysis of the 3-Year 5-Country DO-HEALTH Trial},

author = {Maud Wieczorek and Gregor Freystaetter and Robert Theiler and Uwe Siebert and Andreas Egli and Tahir Masud and John A Kanis and Heike A Bischoff-Ferrari and },

doi = {10.1016/j.jamda.2025.105542},

issn = {1538-9375},

year  = {2025},

date = {2025-03-01},

journal = {J Am Med Dir Assoc},

pages = {105542},

abstract = {OBJECTIVE: Few studies have explored specific trajectories or patterns of falls over time in older adults, and the role of sex and self-reported risk factors for these trajectories were overlooked. This study aimed to identify sex-specific fall trajectories over 3 years and the self-reported risk factors associated with each trajectory in European older adults.nnDESIGN: Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial.nnSETTING AND PARTICIPANTS: Multicenter trial conducted in 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin (Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including 2157 community-dwelling adults aged 70 years and older without major health events in the 5 years prior to enrollment, with sufficient mobility and good cognitive status.nnMETHODS: Falls were recorded prospectively via phone calls and in-person assessments every 3 months over 3 years of follow-up. Group-based trajectory modeling was used to identify sex-specific trajectories based on the number of falls experienced over the follow-up, and penalized logistic regression models identified the self-reported risk factors most associated with each trajectory.nnRESULTS: A total of 1958 participants were included in this analysis (mean age: 74.9 years, 61.7% women). We identified a "lower fall trajectory" and a "higher fall trajectory" among women and a "lower fall trajectory" and an "increasing fall trajectory" among men. In women, living alone was the only self-reported risk factor associated with the higher fall trajectory. In men, living alone (marginal), as well as reporting fatigue, pain or discomfort, mobility issues, and higher self-rated health, were significantly associated with experiencing the increasing fall trajectory.nnCONCLUSIONS AND IMPLICATIONS: This study provides a comprehensive assessment of falls over 3 years, highlighting differences in fall patterns and associated self-reported risk factors between men and women. These findings may offer valuable insights for developing sex-specific fall risk prediction models and targeted fall prevention strategies.},

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@article{pmid39832766,

title = {Patient-Reported Outcome Measures in Patients with Diabetes Mellitus: Findings from the Diabetes Landeck Cohort},

author = {Veronika Haslwanter and L\'{a}ra R Hallson and Ursula Rochau and Uwe Siebert and Hans Robert Sch\"{o}nherr and Wilhelm Oberaigner},

doi = {10.1055/a-2496-2062},

issn = {1439-3646},

year  = {2025},

date = {2025-03-01},

urldate = {2025-01-01},

journal = {Exp Clin Endocrinol Diabetes},

volume = {133},

number = {3},

pages = {139-145},

abstract = {INTRODUCTION: Maintaining and optimizing quality of life (QoL) is a central issue and one of the most important goals in therapy for patients with chronic diseases, such as diabetes mellitus (DM). Despite its importance, there is little data on the QoL of patients with DM in Austria. The objective of this study was to extend an established population-based cohort, the Diabetes-Landeck cohort, by including patient-reported outcomes.nnMETHODS: We performed a survey on quality of life (QoL) and treatment satisfaction in patients from the Diabetes-Landeck cohort using the EQ-5D-5L, the problem areas in diabetes survey (PAID), and the diabetes treatment satisfaction questionnaire (DTSQ). Mean sum scores were calculated and compared between patient characteristic subgroups.nnRESULTS: In total 58 patients were recruited, with a mean age of 63 years and a mean hemoglobin A1c (HbA1c) of 7.1%. The mean sum score of EQ-5D-5L was 92 (SD=10.6), and that of DTSQ and PAID were 32.2 (SD=6.6) and 10.8 (SD=11.6), respectively. Patients with obesity (body mass index ≥ 30 kg/m) showed a statistically significant decreased mean sum score of EQ-5D-5L and a statistically significant increased mean sum score of DTSQ. Patients with HbA1c ≥7.5% showed a statistically significant decreased mean sum score of DTSQ.nnCONCLUSION: We observed patient-reported outcomes significantly associated with obesity and HbA1c, which could be used for targeted patient monitoring. Limited by small sample size and questions in generalizability, we strongly suggest the rollout of a larger study.},

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@article{pmid39994821,

title = {The association between buprenorphine doses above 16 milligrams and treatment retention in a multi-payer national sample in the United States, 2014 to 2021},

author = {Erin J Stringfellow and Huiru Dong and Seyedeh Nazanin Khatami and Hannah Lee and Mohammad S Jalali},

doi = {10.1111/add.70002},

issn = {1360-0443},

year  = {2025},

date = {2025-02-01},

journal = {Addiction},

abstract = {BACKGROUND AND AIMS: Buprenorphine-naloxone reduces overdose deaths in people with opioid use disorder (OUD). Treatment retention increases with higher daily doses. No national studies exist on retention's association with 24, 32 and 40 mg. This study aimed to: (1) estimate the effect on treatment retention of buprenorphine-naloxone doses between 4 and 40 mg compared with 16; and (2) compare the effect on treatment retention of 24, 32 and 40 mg doses.nnDESIGN: Observational cohort study in a national, multi-payer sample of prescription claims (IQVIA) of episodes involving buprenorphine-naloxone for OUD. Incident episodes started between 1 January 2014 and 31 March 2020, with a washout of 180 days. New episodes started with a 14+ day gap between prescriptions.nnSETTING: United States of America.nnPARTICIPANTS: The sample involved 620 229 episodes across 498 879 patients [42.3% female; mean age 37.9 (standard deviaion: 11.9)] who were dispensed prescriptions of buprenorphine-naloxone for OUD.nnMEASUREMENTS: The exposure was the maximum daily dose of buprenorphine-naloxone reached in the first 30 days of an episode, ranging from 4 to 40 mg. The outcome, treatment retention, was defined as having an active prescription at 1, 3, 6, 12, or 18 months. Covariates were age, sex, race and ethnicity, primary payer, and year of episode initiation.nnFINDINGS: Daily doses of 24, 32 and 40 mg increased retention compared with 16 mg at 1-18 months [adjusted odds ratio (aOR) range = 1.17; 95% confidence interval (CI) = 1.14, 1.20 at 18 months to 1.52 (CI = 1.49, 1.54) at 1 month, both for 24 mg]. In pairwise comparisons, 32 mg was favorable to 24 mg at 6, 12 and 18 months [aOR = 1.06 (95% CI = 1.02, 1.10) at 6 months; aOR = 1.09 (95% CI = 1.04, 1.14) at 12 months; aOR = 1.12 (95% CI = 1.06, 1.19) at 18 months], and 40 mg was favorable to 24 mg at 12 and 18 months [aOR = 1.10 (95% CI = 1.01, 1.21) at 12 months; aOR = 1.18 (95% CI = 1.06, 1.30) at 18 months].nnCONCLUSIONS: Daily buprenorphine-naloxone doses of 24 mg appear to be associated with increased treatment retention compared with 16 mg and, for 6+ month episodes, 32 and 40 mg appear to be associated with increased retention compared with 24 mg.},

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@article{pmid39163561,

title = {Incidence of Medication-Related Osteonecrosis of the Jaw in Patients With Breast Cancer During a 20-Year Follow-Up: A Population-Based Multicenter Retrospective Study},

author = {Christine Brunner and Marjan Arvandi and Christian Marth and Daniel Egle and Florentina Baumgart and Miriam Emmelheinz and Benjamin Walch and Johanna Lercher and Claudia Iannetti and Ewald W\"{o}ll and Agnes Pechlaner and August Zabernigg and Birgit Volgger and Maria Castellan and Oliver Tibor Andraschofsky and Alice Markl and Michael Hubalek and Michael Schnallinger and Sibylle Puntscher and Uwe Siebert and Sebastian Sch\"{o}nherr and Lukas Forer and Emanuel Bruckmoser and Johannes Laimer},

doi = {10.1200/JCO.24.00171},

issn = {1527-7755},

year  = {2025},

date = {2025-01-10},

urldate = {2024-08-01},

journal = {J Clin Oncol},

volume = {43},

issue = {2},

pages = {180-188},

abstract = {PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is one of the most important toxicities of antiresorptive therapy, which is standard practice for patients with breast cancer and bone metastases. However, the population-based incidence of MRONJ is not well established. We therefore performed a retrospective multicenter study to assess the incidence for a whole Austrian federal state (Tyrol).nnMATERIALS AND METHODS: This retrospective multicenter study was conducted between 2000 and 2020 at all nine breast centers across Tyrol, Austria. Using the cancer registry, the total Tyrolean population was screened for all patients with breast cancer. All patients with breast cancer and bone metastases receiving antiresorptive therapy were finally included in the study.nnRESULTS: From 8,860 patients initially screened, 639 individuals were eligible and included in our study. Patients received antiresorptive therapy once per month without de-escalation of therapy. MRONJ was diagnosed in 56 (8.8%, 95% CI, 6.6 to 11.0) patients. The incidence of MRONJ was 11.6% (95% CI, 8.0 to 15.3) in individuals treated with denosumab only, 2.8% (95% CI, 0.7 to 4.8) in those treated with bisphosphonates only, and 16.3% (95% CI, 8.8 to 23.9) in the group receiving bisphosphonates followed by denosumab. Individuals developed MRONJ significantly earlier when treated with denosumab. Time to MRONJ after treatment initiation was 4.6 years for individuals treated with denosumab only, 5.1 years for individuals treated with bisphosphonates only, and 8.4 years for individuals treated with both consecutively.nnCONCLUSION: MRONJ incidence in breast cancer patients with bone metastases was found to be considerably higher, especially for patients receiving denosumab, when compared with available data in the literature. Additionally, patients treated with denosumab developed MRONJ significantly earlier.},

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@article{pmid39846352,

title = {Directed Acyclic Graphs in Decision-Analytic Modeling: Bridging Causal Inference and Effective Model Design in Medical Decision Making},

author = {Stijntje W Dijk and Maurice Korf and Jeremy A Labrecque and Ankur Pandya and Bart S Ferket and L\'{a}ra R Hallsson and John B Wong and Uwe Siebert and M G Myriam Hunink},

doi = {10.1177/0272989X241310898},

issn = {1552-681X},

year  = {2025},

date = {2025-01-01},

journal = {Med Decis Making},

pages = {272989X241310898},

abstract = {Our commentary proposes the application of directed acyclic graphs (DAGs) in the design of decision-analytic models, offering researchers a valuable and structured tool to enhance transparency and accuracy by bridging the gap between causal inference and model design in medical decision making.The practical examples in this article showcase the transformative effect DAGs can have on model structure, parameter selection, and the resulting conclusions on effectiveness and cost-effectiveness.This methodological article invites a broader conversation on decision-modeling choices grounded in causal assumptions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39827910b,

title = {Advancing Mental Health Economics: Insights from the Themed Section},

author = {Rachael L Fleurence and Jagpreet Chhatwal},

doi = {10.1016/j.jval.2024.12.007},

issn = {1524-4733},

year  = {2025},

date = {2025-01-01},

journal = {Value Health},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39827910,

title = {Advancing Mental Health Economics: Insights from the Themed Section},

author = {Rachael L Fleurence and Jagpreet Chhatwal},

doi = {10.1016/j.jval.2024.12.007},

issn = {1524-4733},

year  = {2025},

date = {2025-01-01},

journal = {Value Health},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39744922,

title = {Exclusion of people from oncology clinical trials based on functional status},

author = {Nicole D Agaronnik and Mary Linton B Peters and Lisa I Iezzoni},

doi = {10.1177/17407745241304114},

issn = {1740-7753},

year  = {2025},

date = {2025-01-01},

journal = {Clin Trials},

pages = {17407745241304114},

abstract = {BACKGROUND/AIMS: People with disability have higher rates of cancer, excluding skin cancer, compared with people without disability. Food and Drug Administration draft guidelines from 2024 address use of performance status criteria to determine eligibility for clinical trials, advocating for less restrictive thresholds. We examined the exclusion of people with disability from clinical trials based on performance status and other criteria.nnMETHODS: We reviewed eligibility criteria in approved interventional Phase III and Phase IV oncology clinical trials listed on ClinicalTrails.gov between 1 January 2019 and 31 December 2023. Functional status thresholds were assessed using the Eastern Cooperative Oncology Group Performance Status Scale and Karnofsky Performance Scale in clinical trial eligibility criteria. Qualitative analysis was used to review eligibility criteria relating to functional impairments or disability.nnRESULTS: Among 96 oncology clinical trials, approximately 40% had restrictive Eastern Cooperative Oncology Group and Karnofsky Performance Scale thresholds, explicitly including only patients with Eastern Cooperative Oncology Group 0 or 1, or equivalent Karnofsky Performance Scale 70 or greater. Only 20% of studies included patients with Eastern Cooperative Oncology Group 2 and Karnofsky Performance Scale 60. Multiple studies contained miscellaneous eligibility criteria that could potentially exclude people with disability. No studies described making accommodations for people with disability to participate in the clinical trial.nnCONCLUSION: Draft Food and Drug Administration guidelines recommend including patients with Eastern Cooperative Oncology Group scores of 2 and Karnofsky Performance Scale scores of 60 in oncology clinical trials. We found that oncology clinical trials often exclude people with more restrictive performance status scores than the draft Food and Drug Administration guidelines, as well as other criteria that relate to disability. These estimates provide baseline information for assessing how the 2024 Food and Drug Administration guidance, if finalized, might affect the inclusion of people with disability in future trials.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid39107678,

title = {State-level racial and ethnic disparities in buprenorphine treatment duration in the United States},

author = {Huiru Dong and Erin J Stringfellow and Mohammad S Jalali},

doi = {10.1111/ajad.13638},

issn = {1521-0391},

year  = {2025},

date = {2025-01-01},

urldate = {2024-08-01},

journal = {Am J Addict},

volume = {34},

number = {1},

pages = {69-74},

abstract = {BACKGROUND AND OBJECTIVES: National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. However, the extent of such disparities at the state level remains largely unexplored. This study aims to examine such disparities at the state level.nnMETHODS: We analyzed 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data. The primary outcome was the difference in median treatment duration between White people and racial and ethnic minorities. We also included a second outcome measurement to quantify the difference in median treatment duration among episodes lasting ≥180 days. Using quantile regressions, we examined racial and ethnic disparities in treatment duration, adjusting for the patient\'s age, sex, payment type, and calendar year of the treatment episode. All analyses were conducted at the state level.nnRESULTS: Our study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and eight states displayed similar trends among episodes lasting ≥180 days. Five states exhibited longer treatment durations for White people in both overall and long-term episodes. Fifteen states showed no racial and ethnic disparities.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: These results are among the first to indicate substantial statewide variations in racial and ethnic disparities in buprenorphine treatment episode duration, providing a critical foundation for targeted interventions to enhance buprenorphine treatment, especially in states confronting such pronounced racial and ethnic disparities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39690747,

title = {Evaluations of digital public health interventions in the WHO Southeast Asia Region: a systematic literature review},

author = {Nachiket Gudi and Elstin Anbu Raj and Beate Jahn and Uwe Siebert and Angela Brand},

doi = {10.1017/S026646232400045X},

issn = {1471-6348},

year  = {2024},

date = {2024-12-01},

journal = {Int J Technol Assess Health Care},

volume = {40},

number = {1},

pages = {e78},

abstract = {INTRODUCTION: Digital health technologies have been enhancing the capacity of healthcare providers and, thereby, the delivery of targeted health services. The Southeast Asia Region (SEAR) has invested in strengthening digital public health. Many digital health interventions have been implemented in public health settings but are rarely assessed using the holistic health technology assessment (HTA) approach.nnMETHODS: A systematic literature review was performed to provide an overview of evaluations of digital public health interventions in the World Health Organization (WHO) SEAR. Searches were conducted on four electronic databases. Screening title abstracts and full texts was independently conducted by two reviewers, followed by data extraction. Dimensions of HTA were analyzed against the EUnetHTA Core Model 3.0. Quality assessment of included articles was conducted using the JBI Checklist for Economic Evaluation and Consolidated Health Economic Evaluation Reporting Standards 2022 checklist to assess the reporting quality. The findings are presented using systematic evidence tables and bar charts.nnRESULTS: Of the forty-three studies screened at the full-text stage, thirteen studies conducted across six countries were included in the analysis. Telemedicine and m-health interventions were assessed in ten studies. Nine studies conducted cost-effectiveness analysis, and five assessments were conducted from a societal perspective. Four studies utilized more than one perspective for the assessment. Health problem definition and current use of technology, description and technical characteristics of the technology, clinical effectiveness, costs, economic evaluation, and organizational aspects were assessed by all the studies, whereas legal aspects were least assessed.nnCONCLUSION: The lack of HTAs on digital public health interventions in the region highlights the need for capacity-building efforts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39636625,

title = {Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020},

author = {Katrina A B Goddard and Eric J Feuer and Jeanne S Mandelblatt and Rafael Meza and Theodore R Holford and Jihyoun Jeon and Iris Lansdorp-Vogelaar and Roman Gulati and Natasha K Stout and Nadia Howlader and Amy B Knudsen and Daniel Miller and Jennifer L Caswell-Jin and Clyde B Schechter and Ruth Etzioni and Amy Trentham-Dietz and Allison W Kurian and Sylvia K Plevritis and John M Hampton and Sarah Stein and Liyang P Sun and Asad Umar and Philip E Castle},

doi = {10.1001/jamaoncol.2024.5381},

issn = {2374-2445},

year  = {2024},

date = {2024-12-01},

journal = {JAMA Oncol},

abstract = {IMPORTANCE: Cancer mortality has decreased over time, but the contributions of different interventions across the cancer control continuum to averting cancer deaths have not been systematically evaluated across major cancer sites.nnOBJECTIVE: To quantify the contributions of prevention, screening (to remove precursors [interception] or early detection), and treatment to cumulative number of cancer deaths averted from 1975 to 2020 for breast, cervical, colorectal, lung, and prostate cancers.nnDESIGN, SETTING, AND PARTICIPANTS: In this model-based study using population-level cancer mortality data, outputs from published models developed by the Cancer Intervention and Surveillance Modeling Network were extended to quantify cancer deaths averted through 2020. Model inputs were based on national data on risk factors, cancer incidence, cancer survival, and mortality due to other causes, and dissemination and effects of prevention, screening (for interception and early detection), and treatment. Simulated or modeled data using parameters derived from multiple birth cohorts of the US population were used.nnINTERVENTIONS: Primary prevention via smoking reduction (lung), screening for interception (cervix and colorectal) or early detection (breast, cervix, colorectal, and prostate), and therapy (breast, colorectal, lung, and prostate).nnMAIN OUTCOMES AND MEASURES: The estimated cumulative number of cancer deaths averted with interventions vs no advances.nnRESULTS: An estimated 5.94 million cancer deaths were averted for breast, cervical, colorectal, lung, and prostate cancers combined. Cancer prevention and screening efforts averted 8 of 10 of these deaths (4.75 million averted deaths). The contribution of each intervention varied by cancer site. Screening accounted for 25% of breast cancer deaths averted. Averted cervical cancer deaths were nearly completely averted through screening and removal of cancer precursors as treatment advances were modest during the study period. Averted colorectal cancer deaths were averted because of screening and removal of precancerous polyps or early detection in 79% and treatment advances in 21%. Most lung cancer deaths were avoided by smoking reduction (98%) because screening uptake was low and treatment largely palliative before 2014. Screening contributed to 56% of averted prostate cancer deaths.nnCONCLUSIONS AND RELEVANCE: Over the past 45 years, cancer prevention and screening accounted for most cancer deaths averted for these causes; however, their contribution varied by cancer site according to these models using population-level cancer mortality data. Despite progress, efforts to reduce the US cancer burden will require increased dissemination of effective interventions and new technologies and discoveries.},

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pubstate = {published},

tppubtype = {article}

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@article{pmid39658579,

title = {A unified framework for diagnostic test development and evaluation during outbreaks of emerging infections},

author = {Madhav Chaturvedi and Denise K\"{o}ster and Patrick M Bossuyt and Oke Gerke and Annette Jurke and Mirjam E Kretzschmar and Marc L\"{u}tgehetmann and Rafael Mikolajczyk and Johannes B Reitsma and Nicole Schneiderhan-Marra and Uwe Siebert and Carina Stekly and Christoph Ehret and Nicole R\"{u}bsamen and Andr\'{e} Karch and Antonia Zapf},

doi = {10.1038/s43856-024-00691-9},

issn = {2730-664X},

year  = {2024},

date = {2024-12-01},

journal = {Commun Med (Lond)},

volume = {4},

number = {1},

pages = {263},

abstract = {Evaluating diagnostic test accuracy during epidemics is difficult due to an urgent need for test availability, changing disease prevalence and pathogen characteristics, and constantly evolving testing aims and applications. Based on lessons learned during the SARS-CoV-2 pandemic, we introduce a framework for rapid diagnostic test development, evaluation, and validation during outbreaks of emerging infections. The framework is based on the feedback loop between test accuracy evaluation, modelling studies for public health decision-making, and impact of public health interventions. We suggest that building on this feedback loop can help future diagnostic test evaluation platforms better address the requirements of both patient care and public health.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39717009,

title = {Uncovering Patterns in Overdose Deaths: An Analysis of Spike Identification in Fatal Drug Overdose Data in Massachusetts, 2017-2023},

author = {Hannah Lee and Daniel Otero-Leon and Huiru Dong and Erin J Stringfellow and Mohammad S Jalali},

doi = {10.1177/00333549241299613},

issn = {1468-2877},

year  = {2024},

date = {2024-12-01},

journal = {Public Health Rep},

pages = {333549241299613},

abstract = {OBJECTIVES: Yearly rolling aggregate trends or rates are commonly used to analyze trends in overdose deaths, but focusing on long-term trends can obscure short-term fluctuations (eg, daily spikes). We analyzed data on spikes in daily fatal overdoses and how various spike detection thresholds influence the identification of spikes.nnMATERIALS AND METHODS: We used a spike detection algorithm to identify spikes among 16 660 drug-related overdose deaths (from any drug) reported in Massachusetts' vital statistics from 2017 through 2023. We adjusted the parameters of the algorithm to define spikes in 3 distinct scenarios: deaths exceeding 2 adjusted moving SDs above the 7-, 30-, and 90-day adjusted moving average.nnRESULTS: Our results confirmed the on-the-ground observation that there are days when many more people die of overdoses than would be expected based on fluctuations due to differences among people alone. We identified spikes on 5.8% to 20.6% of the days across the 3 scenarios, annually, constituting 11.1% to 31.6% of all overdose deaths. The absolute difference in percentage points of days identified as spikes varied from 5.2 to 11.5 between 7- and 30-day lags and from 0 to 4.6 between 30- and 90-day lags across years. When compared with the adjusted moving average across the 3 scenarios, in 2017 an average of 3.9 to 5.5 additional deaths occurred on spike days, while in 2023 the range was 3.7 to 6.0.nnPRACTICE IMPLICATIONS: A substantial percentage of deaths occurred annually on spike days, highlighting the need for effectively monitoring short-term overdose trends. Moreover, our study serves as a foundational analysis for future research into exogenous events that may contribute to spikes in overdose deaths, aiming to prevent future deaths.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39687038,

title = {Cost-Effectiveness of a Biomarker-Based Screening Strategy for Hepatocellular Carcinoma in Patients with Cirrhosis},

author = {Amit G Singal and Jagpreet Chhatwal and Neehar Parikh and Elliot Tapper},

doi = {10.1159/000539895},

issn = {2235-1795},

year  = {2024},

date = {2024-12-01},

journal = {Liver Cancer},

volume = {13},

number = {6},

pages = {643--654},

abstract = {INTRODUCTION: Given suboptimal performance of ultrasound-based surveillance for early hepatocellular carcinoma (HCC) detection in patients with cirrhosis, there is interest in alternative surveillance strategies, including blood-based biomarkers. We aimed to evaluate the cost-effectiveness of biomarker-based surveillance in patients with cirrhosis.nnMETHODS: We constructed a decision-analytic model to compare ultrasound/alpha-fetoprotein (AFP) and biomarker-based surveillance strategies in 1,000,000 simulated patients with compensated cirrhosis. Model inputs for adherence, benefits, and harms of each strategy were based on literature review, and costs were derived from the Medicare fee schedule. Primary outcomes were quality-adjusted life-years (QALY) and incremental cost-effectiveness ratio (ICER) of the surveillance strategies, with cost-effectiveness assessed at a threshold of USD 150,000 per QALY. We performed sensitivity analyses for HCC incidence, test performance characteristics, surveillance adherence, and biomarker costs.nnRESULTS: In the base case, both ultrasound/AFP and biomarker-based surveillance were cost-effective versus no surveillance, with ICERs of USD 105,620, and USD 101,295, per QALY, respectively. Biomarker-based surveillance was also cost-effective versus ultrasound/AFP, with an ICER of USD 14,800 per QALY. Biomarker sensitivity exceeding 80%, cost below USD 210, or adherence exceeding 58% were necessary for biomarker-based screening to be cost-effective versus ultrasound/AFP. In two-way sensitivity analyses, biomarker costs were directly related with test sensitivity and adherence, whereas sensitivity and adherence were inversely related. In a probabilistic sensitivity analysis, biomarker-based screening was the most cost-effective strategy in most (65%) simulations.nnCONCLUSION: Biomarker-based screening appears cost-effective for HCC screening, but results are sensitive to test sensitivity, adherence, and costs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{pmid39418046,

title = {Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder},

author = {Bohdan Nosyk and Jeong Eun Min and Fahmida Homayra and Megan Kurz and Brenda Carolina Guerra-Alejos and Ruyu Yan and Micah Piske and Shaun R Seaman and Paxton Bach and Sander Greenland and Mohammad Ehsanul Karim and Uwe Siebert and Julie Bruneau and Paul Gustafson and Kyle Kampman and P Todd Korthuis and Thomas Loughin and Lawrence C McCandless and Robert W Platt and Kevin T Schnepel and M Eugenia Soc\'{i}as},

doi = {10.1001/jama.2024.16954},

issn = {1538-3598},

year  = {2024},

date = {2024-12-01},

journal = {JAMA},

volume = {332},

number = {21},

pages = {1822--1831},

abstract = {IMPORTANCE: Previous studies on the comparative effectiveness between buprenorphine and methadone provided limited evidence on differences in treatment effects across key subgroups and were drawn from populations who use primarily heroin or prescription opioids, although fentanyl use is increasing across North America.nnOBJECTIVE: To assess the risk of treatment discontinuation and mortality among individuals receiving buprenorphine/naloxone vs methadone for the treatment of opioid use disorder.nnDESIGN, SETTING, AND PARTICIPANTS: Population-based retrospective cohort study using linked health administrative databases in British Columbia, Canada. The study included treatment recipients between January 1, 2010, and March 17, 2020, who were 18 years or older and not incarcerated, pregnant, or receiving palliative cancer care at initiation.nnEXPOSURES: Receipt of buprenorphine/naloxone or methadone among incident (first-time) users and prevalent new users (including first and subsequent treatment attempts).nnMAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) with 95% compatibility (confidence) intervals were estimated for treatment discontinuation (lasting ≥5 days for methadone and ≥6 days for buprenorphine/naloxone) and all-cause mortality within 24 months using discrete-time survival models for comparisons of medications as assigned at initiation regardless of treatment adherence ("initiator") and received according to dosing guidelines (approximating per-protocol analysis).nnRESULTS: A total of 30 891 incident users (39% receiving buprenorphine/naloxone; 66% male; median age, 33 [25th-75th, 26-43] years) were included in the initiator analysis and 25 614 in the per-protocol analysis. Incident users of buprenorphine/naloxone had a higher risk of treatment discontinuation compared with methadone in initiator analyses (88.8% vs 81.5% discontinued at 24 months; adjusted HR, 1.58 [95% CI, 1.53-1.63]), with limited change in estimates when evaluated at optimal dose in per-protocol analysis (42.1% vs 30.7%; adjusted HR, 1.67 [95% CI, 1.58-1.76]). Per-protocol analyses of mortality while receiving treatment exhibited ambiguous results among incident users (0.08% vs 0.13% mortality at 24 months; adjusted HR, 0.57 [95% CI, 0.24-1.35]) and among prevalent users (0.08% vs 0.09%; adjusted HR, 0.97 [95% CI, 0.54-1.73]). Results were consistent after the introduction of fentanyl and across patient subgroups and sensitivity analyses.nnCONCLUSIONS AND RELEVANCE: Receipt of methadone was associated with a lower risk of treatment discontinuation compared with buprenorphine/naloxone. The risk of mortality while receiving treatment was similar for buprenorphine/naloxone and methadone, although the CI estimate for the hazard ratio was wide.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39652379,

title = {Serum levels of total bile acids are associated with an increased risk of HCC in patients with cirrhosis},

author = {Hashem B El-Serag and Aaron P Thrift and Hao Duong and Jing Ning and Saira Khaderi and Amit G Singal and Sumeet K Asrani and Jorge A Marrero and Hannah Powell and Kinza Rizwan and Omar Najjar and Christopher I Amos and Michelle Luster and Abeer Al-Sarraj and Emad Salem and Michael E Scheurer and Jagpreet Chhatwal and Salma Kaochar and Fasiha Kanwal},

doi = {10.1097/HC9.0000000000000545},

issn = {2471-254X},

year  = {2024},

date = {2024-11-01},

journal = {Hepatol Commun},

volume = {8},

number = {11},

abstract = {BACKGROUND: Previous studies have reported higher circulating bile acid levels in patients with HCC compared to healthy controls. However, the association between prediagnostic bile acid levels and HCC risk among patients with cirrhosis is unclear.nnMETHODS: We measured total BA (TBA) concentration in serum samples collected from a prospective cohort of patients with cirrhosis who were followed until the development of HCC, death, or last study date. Competing risk proportional hazard-adjusted models were used to estimate the association between tertiles of serum TBA levels and the risk of developing HCC. We quantified the incremental predictive value of serum bile acid when added to a previously validated clinical model.nnRESULTS: We analyzed data from 940 patients with cirrhosis, of whom 68 patients progressed to HCC during 3406 person-years of follow-up. Higher baseline serum TBA level was significantly associated with an increased risk of developing HCC with an adjusted HR of 3.69 (95% CI = 1.85-7.37) for the highest versus lowest tertile. TBA levels significantly increased predictive ability for progression to HCC at 2 years of follow-up; the c statistic increased from 0.74 to 0.80 (p < 0.001). There was evidence for a significant interaction between TBA level and hepatitis C (p = 0.04).nnCONCLUSIONS: In a large prospective cohort study, the prediagnostic serum level of TBAs was associated with a significant increase in the risk of developing HCC among patients with multi-etiology cirrhosis. The TBA-associated risk was additive to that of established demographic and clinical predictors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39561478,

title = {Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals},

author = {Samuel J Enumah and David C Chang and Nancy L Cho and Carrie E Cunningham and Gerard M Doherty and Matthew A Nehs and Gregory W Randolph and Jason B Liu},

doi = {10.1016/j.amjsurg.2024.116072},

issn = {1879-1883},

year  = {2024},

date = {2024-11-01},

journal = {Am J Surg},

volume = {241},

pages = {116072},

abstract = {BACKGROUND: The 2021 Hospital Price Transparency Rule mandated hospitals to publicly disclose their service prices to improve competition and lower healthcare costs. Our aim was to characterize commercial price variation for thyroidectomy and parathyroidectomy.nnMETHODS: We performed a national cross-sectional study of hospital price variation in 2022 and 2023 using the Turquoise Health dataset. Our main outcomes were within- and across-hospital 90th-to-10th percentile commercial price ratios and a high commercial-to-Medicare (1.5) price ratio. We performed logistic regressions to identify hospital factors associated with a high commercial-to-Medicare price ratio.nnRESULTS: For 16,794 unique commercial rates across 564 facilities, within-hospital price ratios ranged from 2.0 to 2.4, and across-hospital price ratios ranged from 2.7 to 4.1. High market concentration and five-star hospital rating were associated with high commercial-to-Medicare price ratios compared to low market concentration and three-star hospital rating, respectively.nnCONCLUSIONS: Notable variation exists within and across hospitals signaling facilities have negotiated different payments from insurance companies for the same service. Quality may be a modifiable factor to increase hospital revenue and improve care for patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39536966,

title = {Generative AI for Health Technology Assessment: Opportunities, Challenges, and Policy Considerations - an ISPOR Working Group Report},

author = {Rachael L Fleurence and Jiang Bian and Xiaoyan Wang and Hua Xu and Dalia Dawoud and Mitch Higashi and Jagpreet Chhatwal and },

doi = {10.1016/j.jval.2024.10.3846},

issn = {1524-4733},

year  = {2024},

date = {2024-11-01},

journal = {Value Health},

abstract = {OBJECTIVE: To provide an introduction to the uses of generative Artificial Intelligence (AI) and foundation models, including large language models (LLMs), in the field of health technology assessment (HTA).nnMETHODS: We reviewed applications of generative AI in three areas: systematic literature reviews, real world evidence (RWE) and health economic modeling.nnRESULTS: (1) Literature reviews: generative AI has the potential to assist in automating aspects of systematic literature reviews by proposing search terms, screening abstracts, extracting data and generating code for meta-analyses; (2) Real World Evidence (RWE): generative AI can facilitate automating processes and analyze large collections of real-world data (RWD) including unstructured clinical notes and imaging; (3) Health economic modeling: generative AI can aid in the development of health economic models, from conceptualization to validation. Limitations in the use of foundation models and LLMs include challenges surrounding their scientific rigor and reliability, the potential for bias, implications for equity, as well as nontrivial concerns regarding adherence to regulatory and ethical standards, particularly in terms of data privacy and security. Additionally, we survey the current policy landscape and provide suggestions for HTA agencies on responsibly integrating generative AI into their workflows, emphasizing the importance of human oversight and the fast-evolving nature of these tools.nnCONCLUSIONS: While generative AI technology holds promise with respect to HTA applications, it is still undergoing rapid developments and improvements. Continued careful evaluation of their applications to HTA is required. Both developers and users of research incorporating these tools, should familiarize themselves with their current capabilities and limitations.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lim2024,

title = {Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis},

author = {Tse Yang Lim and Huiru Dong and Erin Stringfellow and Zeynep Hasgul and Ju Park and Lukas Glos and Reza Kazemi and Mohammad S. Jalali},

doi = {10.1016/j.lana.2024.100898},

issn = {2667-193X},

year  = {2024},

date = {2024-11-00},

journal = {The Lancet Regional Health - Americas},

volume = {39},

publisher = {Elsevier BV},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39476201,

title = {Health-related quality of life dynamics: modeling insights from immunotherapy},

author = {Zeynep Hasgul and Anne Spanjaart and Sumreen Javed and Ali Akhavan and Marie Jos\'{e} Kersten and Mohammad S Jalali},

doi = {10.1007/s11136-024-03810-0},

issn = {1573-2649},

year  = {2024},

date = {2024-10-01},

journal = {Qual Life Res},

abstract = {BACKGROUND: Understanding health-related quality of life (HRQoL) dynamics is essential for assessing and improving treatment experiences; however, clinical and observational studies struggle to capture their full complexity. We use simulation modeling and the case of Chimeric Antigen Receptor T-cell therapy-a type of cancer immunotherapy that can prolong survival, but carries life-threatening risks-to study HRQoL dynamics.nnMETHODS: We developed an exploratory system dynamics model with mathematical equations and parameter values informed by literature and expert insights. We refined its feedback structure and evaluated its dynamic behavior through iterative interviews. Model simulated HRQoL from treatment approval through six months post-infusion. Two strategies-reducing the delay to infusion and enhancing social support-were incorporated into the model. To dynamically evaluate the effect of these strategies, we developed four metrics: post-treatment HRQoL decline, recovery time to pre-treatment HRQoL, post-treatment HRQoL peak, and durability of the peak.nnRESULTS: Model captures key interactions within HRQoL, providing a nuanced analysis of its continuous temporal dynamics, particularly physical well-being, psychological well-being, tumor burden, receipt and efficacy of treatment, side effects, and their management. Model analysis shows reducing infusion delays enhanced HRQoL across all four metrics. While enhanced social support improved the first three metrics for patients who received treatment, it did not change durability of the peak.nnCONCLUSIONS: Simulation modeling can help explore the effects of strategies on HRQoL while also demonstrating the dynamic interactions between its key components, offering a powerful tool to investigate aspects of HRQoL that are difficult to assess in real-world settings.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39310342,

title = {Characteristics Associated with Successful Residency Match in General Surgery},

author = {Reagan A Collins and Kaitlyn Nimmer and Salma A Sheriff and Tania K Arora and Anai N Kothari and Carrie Cunningham and Callisia N Clarke},

doi = {10.1097/AS9.0000000000000469},

issn = {2691-3593},

year  = {2024},

date = {2024-09-01},

journal = {Ann Surg Open},

volume = {5},

number = {3},

pages = {e469},

abstract = {OBJECTIVE: To evaluate characteristics of matched and unmatched general surgery residency (GSR) applicants.nnBACKGROUND: Given the recent change of the United States Medical Licensing Exam Step 1 grading to pass/fail, understanding the factors that influence GSR match success is integral to identifying potential interventions to improve match rates for diverse medical students.nnMETHODS: Retrospective review of GSR National Residency Matching Program (NRMP) applicant and Accreditation Council for Graduate Medical Education (ACGME) active resident data between 2011 and 2022. Data included application characteristics for United States ("US") and "independent" applicants, factors cited by program directors in the interview and ranking process, paths pursued if applicants went unmatched, and racial/ethnic representation.nnRESULTS: A total of 9149 US and 3985 independent applicants applied to GSR between 2011 and 2021. Matched  unmatched applicants had higher step 1 scores (US: 236  218,  0.005; independent: 237  228,  0.001), higher step 2 scores (US: 248  232,  0.006; independent: 245  234,  0.001), more likely to belong to alpha omega alpha (US: 17.1%  1.6%,  0.002) or to attend a top 40 National Institutes of Health-funded school (US: 31.0%  19.4%,  0.002) compared to unmatched applicants. Program directors heavily factored step 1 and step 2 scores, letters of recommendation, interactions with faculty and trainees, and interpersonal skills when interviewing and ranking applicants. The proportion of active general surgery residents  applicants was lower for Asians (12.3%  20.9%,  0.001), Black/African American (5.0%  8.8%,  0.001), Hispanic/Latino (5.0%  9.4%,  0.001), and underrepresented in medicine students (10.3%  19.1%,  0.001).nnCONCLUSIONS: In the pass/fail step 1 era, factors including step 2 score and other subjective metrics may be more heavily weighted in the GSR match process.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39221814,

title = {Improving Estimates of the Prevalence of Opioid Use Disorder in the United States: Revising Keyes et al},

author = {Tse Yang Lim and Katherine M Keyes and Jonathan P Caulkins and Erin J Stringfellow and Magdalena Cerd\'{a} and Mohammad S Jalali},

doi = {10.1097/ADM.0000000000001375},

issn = {1935-3227},

year  = {2024},

date = {2024-09-01},

urldate = {2024-09-01},

journal = {J Addict Med},

volume = {18},

number = {6},

pages = {705-710},

abstract = {OBJECTIVES: The United States faces an ongoing drug overdose crisis, but accurate information on the prevalence of opioid use disorder (OUD) remains limited. A recent analysis by Keyes et al used a multiplier approach with drug poisoning mortality data to estimate OUD prevalence. Although insightful, this approach made stringent and partly inconsistent assumptions in interpreting mortality data, particularly synthetic opioid (SO)-involved and non-opioid-involved mortality. We revise that approach and resulting estimates to resolve inconsistencies and examine several alternative assumptions.nnMETHODS: We examine 4 adjustments to Keyes and colleagues\' estimation approach: (A) revising how the equations account for SO effects on mortality, (B) incorporating fentanyl prevalence data to inform estimates of SO lethality, (C) using opioid-involved drug poisoning data to estimate a plausible range for OUD prevalence, and (D) adjusting mortality data to account for underreporting of opioid involvement.nnRESULTS: Revising the estimation equation and SO lethality effect (adj. A and B) while using Keyes and colleagues\' original assumption that people with OUD account for all fatal drug poisonings yields slightly higher estimates, with OUD population reaching 9.3 million in 2016 before declining to 7.6 million by 2019. Using only opioid-involved drug poisoning data (adj. C and D) provides a lower range, peaking at 6.4 million in 2014-2015 and declining to 3.8 million in 2019.nnCONCLUSIONS: The revised estimation equation presented is feasible and addresses limitations of the earlier method and hence should be used in future estimations. Alternative assumptions around drug poisoning data can also provide a plausible range of estimates for OUD population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39226505,

title = {State Mandates On Naloxone Coprescribing Associated With Short-Term Increase In Naloxone Codispensing},

author = {Huiru Dong and Erin J Stringfellow and Alton Russell and Mohammad S Jalali},

doi = {10.1377/hlthaff.2023.01667},

issn = {2694-233X},

year  = {2024},

date = {2024-09-01},

journal = {Health Aff (Millwood)},

volume = {43},

number = {9},

pages = {1319--1328},

abstract = {In the midst of the opioid crisis in the US, efforts to mitigate overdose risks have become paramount, leading some states to introduce mandates for coprescribing the life-saving overdose reversal drug naloxone. These mandates were designed to specifically address people receiving opioid analgesics who had an elevated risk for overdose. This included people receiving high opioid dosages, those concurrently using benzodiazepines, or those with a history of substance use disorder or overdose. Using a nationally representative, multipayer cohort of patients receiving prescription opioids, we investigated how naloxone codispensing rates changed at the state level from 2016 to 2021 among patients with an elevated risk for overdose. Then we used controlled interrupted time series analyses to assess mandates' longitudinal impact on naloxone codispensing in ten states that implemented mandates. We observed an immediate and significant increase in the naloxone codispensing rates in eight states after the implementation of mandates. Nevertheless, in five of these states, the codispensing rates exhibited a subsequent downward trend after the initial increase. State mandates show potential for improving naloxone codispensing; however, mandates alone might not be adequate for sustained change. Further research is needed to identify strategies complementing and enhancing the impact of mandates in combating the overdose crisis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39225720,

title = {Valuation of the EQ-5D-3L in Jordan},

author = {Abeer Al Rabayah and Bram Roudijk and Fredrick Dermawan Purba and Fanni Rencz and Saad Jaddoua and Uwe Siebert},

doi = {10.1007/s10198-024-01712-z},

issn = {1618-7601},

year  = {2024},

date = {2024-09-01},

journal = {Eur J Health Econ},

abstract = {BACKGROUND: In Jordan, no national value set is available for any preference-accompanied health utility measure.nnOBJECTIVE: This study aims to develop a value set for EQ-5D-3L based on the preferences of the Jordanian general population.nnMETHODS: A representative sample of the Jordanian general population was obtained through quota sampling involving age, gender, and region. Participants aged above 18 years were interviewed via videoconferencing using the EuroQol Valuation Technology 2.1 protocol. Participants completed ten composite time trade-offs (cTTO) and ten discrete choice experiments (DCE) tasks. cTTO and DCE data were analyzed using linear and logistic regression models, respectively, and hybrid models were applied to the combined DCE and cTTO data.nnRESULTS: A total of 301 participants with complete data were included in the analysis. The sample was representative of the general population regarding region, age, and gender. All model types applied, that is, random intercept model, random intercept Tobit, linear model with correction for heteroskedasticity, Tobit with correction for heteroskedasticity, and all hybrid models, were statistically significant. They showed logical consistency in terms of higher utility decrements with more severe levels. The hybrid model corrected for heteroskedasticity was selected to construct the Jordanian EQ-5D-3L value set as it showed the best fit and lowest mean absolute error. The predicted value for the most severe health state (33333) was - 0.563. Utility decrements due to mobility had the largest weight, followed by anxiety/depression, while usual activities had the smallest weight.nnCONCLUSION: This study provides the first EQ-5D-3L value set in the Middle East. The Jordanian EQ-5D-3L value set can now be used in health technology assessments for health policy planning by the Jordanian health sector's decision-makers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38935989b,

title = {Cost-Utility Analysis of Maintenance Pemetrexed Plus Best Supportive Care Compared With Best Supportive Care Alone in Treating Patients With Non-Small Cell Lung Cancer in Jordan},

author = {Abeer Al Rabayah and Rawan Al Froukh and Razan Sawalha and Maali Al Shnekat and Beate Jahn and Uwe Siebert and Saad M Jaddoua},

doi = {10.1016/j.vhri.2024.101004},

issn = {2212-1102},

year  = {2024},

date = {2024-09-01},

journal = {Value Health Reg Issues},

volume = {43},

pages = {101004},

abstract = {OBJECTIVES: To assess the cost-effectiveness of maintenance pemetrexed plus best supportive care (BSC) in non-small cell lung cancer patients from a Jordanian healthcare system perspective.nnMETHODS: A Markov model with 4 health states was developed to estimate life years, quality-adjusted life-years (QALY), costs, and the incremental cost-utility ratio of pemetrexed plus BSC versus BSC. A lifelong time horizon was used in the base-case analysis. The transition probabilities were estimated from the PARAMOUNT trial, the utility weights were taken from published literature, and costs were based on data and unit costs at King Hussein Cancer Center and the Jordan Food and Drug Administration. Both costs and outcomes were discounted using a 3%. The parameter uncertainty was tested using deterministic and probabilistic sensitivity analyses.nnRESULTS: The base-case analysis showed that pemetrexed plus BSC increased QALYs and cost compared with BSC. Pemetrexed plus BSC leads to incremental 0.255 QALYs and incremental costs of US $30 826, resulting in an incremental cost-utility ratio of US $120 886/QALY. The results were sensitive to changes in the utility estimates during the progression-free health state, the progression health state, and the cost of postprogression medications The probabilistic sensitivity analysis showed that the probability of pemetrexed plus BSC being a cost-effective option compared with BSC is 0 at a threshold of $56 000.nnCONCLUSIONS: Maintenance pemetrexed for non-small cell lung cancer is not a cost-effective option compared with BSC from a healthcare system perspective based on the listed price at a threshold of $56 000/QALY.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38848611,

title = {Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand},

author = {Peeradon Wongseree and Zeynep Hasgul and Mohammad S Jalali},

doi = {10.1016/j.vhri.2024.101010},

issn = {2212-1102},

year  = {2024},

date = {2024-09-01},

urldate = {2024-06-01},

journal = {Value Health Reg Issues},

volume = {43},

pages = {101010},

abstract = {OBJECTIVES: The purpose of this study is to evaluate the cost-effectiveness of increasing access to colorectal cancer (CRC) diagnosis, considering resource limitations in Thailand.nnMETHODS: We analyzed the cost-effectiveness of increasing access to fecal immunochemical test screening (strategy I), symptom evaluation (strategy II), and their combination through healthcare and societal perspectives using Colo-Sim, a simulation model of CRC care. We extended our analysis by adding a risk-stratification score (RS) to the strategies. We analyzed all strategies under the currently limited annual colonoscopy capacity and sufficient capacity. We estimated quality-adjusted life-years (QALYs) and costs over 2023 to 2047 and performed sensitivity analyses.nnRESULTS: Annual costs for CRC care will increase over 25 years in Thailand, resulting in a cumulative cost of 323B Thai baht (THB). Each strategy results in higher QALYs gained and additional costs. With the current colonoscopy capacity and willingness-to-pay threshold of 160 000 THB, strategy I with and without RS is not cost-effective. Strategy II + RS is the most cost-effective, resulting in 0.68 million QALYs gained with additional costs of 66B THB. Under sufficient colonoscopy capacity, all strategies are deemed cost-effective, with the combined approach (strategy I + II + RS) being the most favorable, achieving the highest QALYs (1.55 million) at an additional cost of 131 billion THB. This strategy also maintains the highest probability of being cost-effective at any willingness-to-pay threshold above 96 000 THB.nnCONCLUSIONS: In Thailand, fecal immunochemical test screening, symptom evaluation, and RS use can achieve the highest QALYs; however, boosting colonoscopy capacity is essential for cost-effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39629044b,

title = {Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder},

author = {Huiru Dong and Erin J Stringfellow and W Alton Russell and Benjamin Bearnot and Mohammad S Jalali},

doi = {10.1007/s11469-022-00985-w},

issn = {1557-1874},

year  = {2024},

date = {2024-08-01},

journal = {Int J Ment Health Addict},

volume = {22},

number = {4},

pages = {2285--2290},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39629044,

title = {Impact of Alternative Ways to Operationalize Buprenorphine Treatment Duration on Understanding Continuity of Care for Opioid Use Disorder},

author = {Huiru Dong and Erin J Stringfellow and W Alton Russell and Benjamin Bearnot and Mohammad S Jalali},

doi = {10.1007/s11469-022-00985-w},

issn = {1557-1874},

year  = {2024},

date = {2024-08-01},

journal = {Int J Ment Health Addict},

volume = {22},

number = {4},

pages = {2285--2290},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39123462,

title = {Somatic Mutation Profile as a Predictor of Treatment Response and Survival in Unresectable Pancreatic Ductal Adenocarcinoma Treated with FOLFIRINOX and Gemcitabine Nab-Paclitaxel},

author = {Rodrigo Paredes de la Fuente and Santiago Sucre and Cristina Ponce and Ahmed Anwer Ali Rattani and Mary Linton B Peters},

doi = {10.3390/cancers16152734},

issn = {2072-6694},

year  = {2024},

date = {2024-08-01},

journal = {Cancers (Basel)},

volume = {16},

number = {15},

abstract = {(1) Background: Pancreatic ductal adenocarcinoma (PDAC) has low survival rates despite treatment advancements. Aim: This study aims to show how molecular profiling could possibly guide personalized treatment strategies, which may help improve survival outcomes in patients with PDAC. (2) Materials and Methods: A retrospective analysis of 142 PDAC patients from a single academic center was conducted. Patients underwent chemotherapy and next-generation sequencing for molecular profiling. Key oncogenic pathways were identified using the Reactome pathway database. Survival analysis was performed using Kaplan-Meier curves and Cox Proportional Hazards Regression. (3) Results: Patients mainly received FOLFIRINOX (n = 62) or gemcitabine nab-paclitaxel (n = 62) as initial chemotherapy. The median OS was 13.6 months. Longer median OS was noted in patients with NOTCH (15 vs. 12.3 months,  = 0.007) and KIT pathway mutations (21.3 vs. 12.12 months,  = 0.04). Combinatorial pathway analysis indicated potential synergistic effects on survival. In the PFS, PI3K pathway (6.6 vs. 5.7 months,  = 0.03) and KIT pathway (10.3 vs. 6.2 months,  = 0.03) mutations correlated with improved PFS within the gemcitabine nab-paclitaxel subgroup. (4) Conclusions: Molecular profiling could play a role in PDAC for predicting outcomes and responses to therapies like FOLFIRINOX and gemcitabine nab-paclitaxel. Integrating genomic data into clinical decision-making can benefit PDAC treatment, though further validation is needed to fully utilize precision oncology in PDAC management.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39109430,

title = {The Impact of Low Workplace Support During Pregnancy on Surgeon Distress and Career Dissatisfaction},

author = {Thinzar M Lwin and Manuel Castillo-Angeles and Carrie E Cunningham and Rachel B Atkinson and Eugene Kim and Sarah Rae Easter and Ankush Gosain and Yue-Yung Hu and Erika L Rangel},

doi = {10.1097/SLA.0000000000006484},

issn = {1528-1140},

year  = {2024},

date = {2024-08-01},

journal = {Ann Surg},

abstract = {OBJECTIVE: To describe the impact of lack of workplace support (LOWS) for obstetric health on surgeon distress and career satisfaction.nnBACKGROUND: Although most pregnant surgeons desire clinical duty reductions to mitigate obstetric risk, few modify their schedules due to low workplace support.nnMETHODS: US surgeons with at least one live birth completed an electronic survey. LOWS during pregnancy was defined as (1) disagreeing that colleagues/leadership were supportive of obstetric-mandated bedrest; (2) feeling unable to reduce clinical duties despite health concerns due to risk of financial penalties, requirement to make up missed call shifts, being perceived as "weak", burdening colleagues, or accommodations being denied by the workplace. Multivariate logistic regression determined the association between LOWS and burnout, low quality of life, plans to leave clinical practice or to reduce work hours, and likelihood of recommending a surgical career to one's child.nnRESULTS: Of 557 surgeons, the 360 (64.6%) who reported LOWS during pregnancy were more likely to report burnout (OR:2.57; 95%CI:1.60-4.13), low quality of life (OR:1.57; 95%CI:1.02-2.41), a desire to leave their practice (OR:2.74; 95%CI: 1.36-5.49), plans to reduce clinical hours in the next year (OR:4.25; 95%CI:1.82-9.90), and were less likely to recommend their career to their child (OR:0.44; 95%CI:0.28-0.70).nnCONCLUSIONS: LOWS for maternal-fetal health concerns is associated with burnout, low quality of life, and career dissatisfaction. The work environment is a modifiable factor requiring system-level interventions to limit clinical work during pregnancy and provide fair compensation for covering surgeons. Supporting surgeons during pregnancy is a short-term investment with long-term implications for improving longevity and diversity of the workforce.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38353683,

title = {Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients-economic evaluation along a one-year observation period},

author = {T Egelseer-Bruendl and B Jahn and M Arvandi and S Puntscher and J Santamaria and L Brunelli and K Weissenegger and B Pfeifer and S Neururer and C Rissbacher and A Huber and B Fetz and C Kleinheinz and R Modre-Osprian and K Kreiner and U Siebert and G Poelzl},

doi = {10.1007/s00392-024-02395-5},

issn = {1861-0692},

year  = {2024},

date = {2024-08-01},

urldate = {2024-02-14},

journal = {Clin Res Cardiol},

volume = {113},

number = {8},

pages = {1232-1241},

abstract = {OBJECTIVE: This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.nnMETHODS: We conducted a cost-effectiveness analysis along a retrospective cohort study (2016-2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.nnRESULTS: Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when "non-HF related costs" related to the DMP were replaced with average costs.nnCONCLUSIONS: The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for "non-HF related costs." These findings promote a widespread adoption of telemedicine-assisted DMP for HF.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38938049b,

title = {Assessment of Epidemiological Data and Surveillance in Korea Substance Use Research: Insights and Future Directions},

author = {Meekang Sung and Vaughan W Rees and Hannah Lee and Mohammad S Jalali},

doi = {10.3961/jpmph.24.171},

issn = {2233-4521},

year  = {2024},

date = {2024-07-01},

journal = {J Prev Med Public Health},

volume = {57},

number = {4},

pages = {307--318},

abstract = {OBJECTIVES: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea.nnMETHODS: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments.nnRESULTS: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets.nnCONCLUSIONS: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39041731,

title = {Supporting a diverse surgeon workforce: embracing personality and supporting psychological resilience to improve surgeon health and wellbeing},

author = {Tasha M Hughes and Carrie E Cunningham},

doi = {10.1093/bjsopen/zrae072},

issn = {2474-9842},

year  = {2024},

date = {2024-07-01},

journal = {BJS Open},

volume = {8},

number = {4},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39013385,

title = {Diagnostic Prediction Model for Tuberculous Meningitis: An Individual Participant Data Meta-Analysis},

author = {Anna M Stadelman-Behar and Nicki Tiffin and Jayne Ellis and Fiona V Creswell and Kenneth Ssebambulidde and Edwin Nuwagira and Lauren Richards and Vittoria Lutje and Adriana Hristea and Raluca Elena Jipa and Jos\'{e} E Vidal and Renata G S Azevedo and S\'{e}rgio Monteiro de Almeida and Gislene Bot\~{a}o Kussen and Keite Nogueira and Felipe Augusto Souza Gualberto and Tatiana Metcalf and Anna Dorothee Heemskerk and Tarek Dendane and Abidi Khalid and Amine Ali Zeggwagh and Kathleen Bateman and Uwe Siebert and Ursula Rochau and Arjan van Laarhoven and Reinout van Crevel and Ahmad Rizal Ganiem and Sofiati Dian and Joseph Jarvis and Joseph Donovan and Thuong Nguyen Thuy Thuong and Guy E Thwaites and Nathan C Bahr and David B Meya and David R Boulware and Tom H Boyles},

doi = {10.4269/ajtmh.23-0789},

issn = {1476-1645},

year  = {2024},

date = {2024-07-01},

journal = {Am J Trop Med Hyg},

abstract = {No accurate and rapid diagnostic test exists for tuberculous meningitis (TBM), leading to delayed diagnosis. We leveraged data from multiple studies to improve the predictive performance of diagnostic models across different populations, settings, and subgroups to develop a new predictive tool for TBM diagnosis. We conducted a systematic review to analyze eligible datasets with individual-level participant data (IPD). We imputed missing data and explored three approaches: stepwise logistic regression, classification and regression tree (CART), and random forest regression. We evaluated performance using calibration plots and C-statistics via internal-external cross-validation. We included 3,761 individual participants from 14 studies and nine countries. A total of 1,240 (33%) participants had "definite" (30%) or "probable" (3%) TBM by case definition. Important predictive variables included cerebrospinal fluid (CSF) glucose, blood glucose, CSF white cell count, CSF differential, cryptococcal antigen, HIV status, and fever presence. Internal validation showed that performance varied considerably between IPD datasets with C-statistic values between 0.60 and 0.89. In external validation, CART performed the worst (C = 0.82), and logistic regression and random forest had the same accuracy (C = 0.91). We developed a mobile app for TBM clinical prediction that accounted for heterogeneity and improved diagnostic performance (https://tbmcalc.github.io/tbmcalc). Further external validation is needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38552671b,

title = {Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening With a Blood Test That Meets the Centers for Medicare \& Medicaid Services Coverage Decision},

author = {Rosita van den Puttelaar and Pedro Nascimento de Lima and Amy B Knudsen and Carolyn M Rutter and Karen M Kuntz and Lucie de Jonge and Fernando Alarid Escudero and David Lieberman and Ann G Zauber and Anne I Hahn and John M Inadomi and Iris Lansdorp-Vogelaar},

doi = {10.1053/j.gastro.2024.02.012},

issn = {1528-0012},

year  = {2024},

date = {2024-07-01},

journal = {Gastroenterology},

volume = {167},

number = {2},

pages = {368--377},

abstract = {BACKGROUND \& AIMS: A blood-based colorectal cancer (CRC) screening test may increase screening participation. However, blood tests may be less effective than current guideline-endorsed options. The Centers for Medicare \& Medicaid Services (CMS) covers blood tests with sensitivity of at least 74% for detection of CRC and specificity of at least 90%. In this study, we investigate whether a blood test that meets these criteria is cost-effective.nnMETHODS: Three microsimulation models for CRC (MISCAN-Colon, CRC-SPIN, and SimCRC) were used to estimate the effectiveness and cost-effectiveness of triennial blood-based screening (from ages 45 to 75 years) compared to no screening, annual fecal immunochemical testing (FIT), triennial stool DNA testing combined with an FIT assay, and colonoscopy screening every 10 years. The CMS coverage criteria were used as performance characteristics of the hypothetical blood test. We varied screening ages, test performance characteristics, and screening uptake in a sensitivity analysis.nnRESULTS: Without screening, the models predicted 77-88 CRC cases and 32-36 CRC deaths per 1000 individuals, costing $5.3-$5.8 million. Compared to no screening, blood-based screening was cost-effective, with an additional cost of $25,600-$43,700 per quality-adjusted life-year gained (QALYG). However, compared to FIT, triennial stool DNA testing combined with FIT, and colonoscopy, blood-based screening was not cost-effective, with both a decrease in QALYG and an increase in costs. FIT remained more effective (+5-24 QALYG) and less costly (-$3.2 to -$3.5 million) than blood-based screening even when uptake of blood-based screening was 20 percentage points higher than uptake of FIT.nnCONCLUSION: Even with higher screening uptake, triennial blood-based screening, with the CMS-specified minimum performance sensitivity of 74% and specificity of 90%, was not projected to be cost-effective compared with established strategies for colorectal cancer screening.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38877668,

title = {Entorhinal vessel density correlates with phosphorylated tau and TDP-43 pathology},

author = {Josu\'{e} Llamas Rodr\'{i}guez and Andr\'{e} J W van der Kouwe and Jan Oltmer and Emma Rosenblum and Nathaniel Mercaldo and Bruce Fischl and Michael Marshall and Matthew P Frosch and Jean C Augustinack},

doi = {10.1002/alz.13896},

issn = {1552-5279},

year  = {2024},

date = {2024-07-01},

urldate = {2024-06-01},

journal = {Alzheimers Dement},

volume = {20},

number = {7},

pages = {4649-4662},

abstract = {INTRODUCTION: The entorhinal cortex (EC) and perirhinal cortex (PC) are vulnerable to Alzheimer\'s disease. A triggering factor may be the interaction of vascular dysfunction and tau pathology.nnMETHODS: We imaged post mortem human tissue at 100 μm with 7 T magnetic resonance imaging and manually labeled individual blood vessels (mean = 270 slices/case). Vessel density was quantified and compared per EC subfield, between EC and PC, and in relation to tau and TAR DNA-binding protein 43 (TDP-43) semiquantitative scores.nnRESULTS: PC was more vascularized than EC and vessel densities were higher in posterior EC subfields. Tau and TDP-43 strongly correlated with vasculature density and subregions with severe tau at the preclinical stage had significantly greater vessel density than those with low tau burden.nnDISCUSSION: These data impact cerebrovascular maps, quantification of subfield vasculature, and correlation of vasculature and pathology at early stages. The ordered association of vessel density, and tau or TDP-43 pathology, may be exploited in a predictive context.nnHIGHLIGHTS: Vessel density correlates with phosphorylated tau (p-tau) burden in entorhinal and perirhinal cortices. Perirhinal area 35 and posterior entorhinal cortex showed greatest p-tau burden but also the highest vessel density in the preclinical phase of Alzheimer\'s disease. We combined an ex vivo magnetic resonance imaging model and histopathology to demonstrate the 3D reconstruction of intracortical vessels and its spatial relationship to the pathology.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38858832,

title = {Emulator-Based Bayesian Calibration of the CISNET Colorectal Cancer Models},

author = {Carlos Pineda-Antunez and Claudia Seguin and Luuk A van Duuren and Amy B Knudsen and Barak Davidi and Pedro Nascimento de Lima and Carolyn Rutter and Karen M Kuntz and Iris Lansdorp-Vogelaar and Nicholson Collier and Jonathan Ozik and Fernando Alarid-Escudero},

doi = {10.1177/0272989X241255618},

issn = {1552-681X},

year  = {2024},

date = {2024-07-01},

urldate = {2024-07-01},

journal = {Med Decis Making},

volume = {44},

number = {5},

pages = {543-553},

abstract = {PURPOSE: To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET)\'s SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate the model-predicted outcomes to calibration targets.nnMETHODS: We used Latin hypercube sampling to sample up to 50,000 parameter sets for each CISNET-CRC model and generated the corresponding outputs. We trained multilayer perceptron artificial neural networks (ANNs) as emulators using the input and output samples for each CISNET-CRC model. We selected ANN structures with corresponding hyperparameters (i.e., number of hidden layers, nodes, activation functions, epochs, and optimizer) that minimize the predicted mean square error on the validation sample. We implemented the ANN emulators in a probabilistic programming language and calibrated the input parameters with Hamiltonian Monte Carlo-based algorithms to obtain the joint posterior distributions of the CISNET-CRC models\' parameters. We internally validated each calibrated emulator by comparing the model-predicted posterior outputs against the calibration targets.nnRESULTS: The optimal ANN for SimCRC had 4 hidden layers and 360 hidden nodes, MISCAN-Colon had 4 hidden layers and 114 hidden nodes, and CRC-SPIN had 1 hidden layer and 140 hidden nodes. The total time for training and calibrating the emulators was 7.3, 4.0, and 0.66 h for SimCRC, MISCAN-Colon, and CRC-SPIN, respectively. The mean of the model-predicted outputs fell within the 95% confidence intervals of the calibration targets in 98 of 110 for SimCRC, 65 of 93 for MISCAN, and 31 of 41 targets for CRC-SPIN.nnCONCLUSIONS: Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis, such as the CISNET CRC models. In this work, we present a step-by-step guide to constructing emulators for calibrating 3 realistic CRC individual-level models using a Bayesian approach.nnHIGHLIGHTS: We use artificial neural networks (ANNs) to build emulators that surrogate complex individual-based models to reduce the computational burden in the Bayesian calibration process.ANNs showed good performance in emulating the CISNET-CRC microsimulation models, despite having many input parameters and outputs.Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis.This work aims to support health decision scientists who want to quantify the uncertainty of calibrated parameters of computationally intensive simulation models under a Bayesian framework.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38738534,

title = {The Impact of Model Assumptions on Personalized Lung Cancer Screening Recommendations},

author = {Kevin Ten Haaf and Koen de Nijs and Giulia Simoni and Andres Alban and Pianpian Cao and Zhuolu Sun and Jean Yong and Jihyoun Jeon and Iakovos Toumazis and Summer S Han and G Scott Gazelle and Chung Ying Kong and Sylvia K Plevritis and Rafael Meza and Harry J de Koning},

doi = {10.1177/0272989X241249182},

issn = {1552-681X},

year  = {2024},

date = {2024-07-01},

urldate = {2024-05-01},

journal = {Med Decis Making},

volume = {44},

number = {5},

pages = {497-511},

abstract = {BACKGROUND: Recommendations regarding personalized lung cancer screening are being informed by natural-history modeling. Therefore, understanding how differences in model assumptions affect model-based personalized screening recommendations is essential.nnDESIGN: Five Cancer Intervention and Surveillance Modeling Network (CISNET) models were evaluated. Lung cancer incidence, mortality, and stage distributions were compared across 4 theoretical scenarios to assess model assumptions regarding 1) sojourn times, 2) stage-specific sensitivities, and 3) screening-induced lung cancer mortality reductions. Analyses were stratified by sex and smoking behavior.nnRESULTS: Most cancers had sojourn times \<5 y (model range [MR]; lowest to highest value across models: 83.5%-98.7% of cancers). However, cancer aggressiveness still varied across models, as demonstrated by differences in proportions of cancers with sojourn times \<2 y (MR: 42.5%-64.6%) and 2 to 4 y (MR: 28.8%-43.6%). Stage-specific sensitivity varied, particularly for stage I (MR: 31.3%-91.5%). Screening reduced stage IV incidence in most models for 1 y postscreening; increased sensitivity prolonged this period to 2 to 5 y. Screening-induced lung cancer mortality reductions among lung cancers detected at screening ranged widely (MR: 14.6%-48.9%), demonstrating variations in modeled treatment effectiveness of screen-detected cases. All models assumed longer sojourn times and greater screening-induced lung cancer mortality reductions for women. Models assuming differences in cancer epidemiology by smoking behaviors assumed shorter sojourn times and lower screening-induced lung cancer mortality reductions for heavy smokers.nnCONCLUSIONS: Model-based personalized screening recommendations are primarily driven by assumptions regarding sojourn times (favoring longer intervals for groups more likely to develop less aggressive cancers), sensitivity (higher sensitivities favoring longer intervals), and screening-induced mortality reductions (greater reductions favoring shorter intervals).nnIMPLICATIONS: Models suggest longer screening intervals may be feasible and benefits may be greater for women and light smokers.nnHIGHLIGHTS: Natural-history models are increasingly used to inform lung cancer screening, but causes for variations between models are difficult to assess.This is the first evaluation of these causes and their impact on personalized screening recommendations through easily interpretable metrics.Models vary regarding sojourn times, stage-specific sensitivities, and screening-induced lung cancer mortality reductions.Model outcomes were similar in predicting greater screening benefits for women and potentially light smokers. Longer screening intervals may be feasible for women and light smokers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38935989,

title = {Cost-Utility Analysis of Maintenance Pemetrexed Plus Best Supportive Care Compared With Best Supportive Care Alone in Treating Patients With Non-Small Cell Lung Cancer in Jordan},

author = {Abeer Al Rabayah and Rawan Al Froukh and Razan Sawalha and Maali Al Shnekat and Beate Jahn and Uwe Siebert and Saad M Jaddoua},

doi = {10.1016/j.vhri.2024.101004},

issn = {2212-1102},

year  = {2024},

date = {2024-06-01},

journal = {Value Health Reg Issues},

volume = {43},

pages = {101004},

abstract = {OBJECTIVES: To assess the cost-effectiveness of maintenance pemetrexed plus best supportive care (BSC) in non-small cell lung cancer patients from a Jordanian healthcare system perspective.nnMETHODS: A Markov model with 4 health states was developed to estimate life years, quality-adjusted life-years (QALY), costs, and the incremental cost-utility ratio of pemetrexed plus BSC versus BSC. A lifelong time horizon was used in the base-case analysis. The transition probabilities were estimated from the PARAMOUNT trial, the utility weights were taken from published literature, and costs were based on data and unit costs at King Hussein Cancer Center and the Jordan Food and Drug Administration. Both costs and outcomes were discounted using a 3%. The parameter uncertainty was tested using deterministic and probabilistic sensitivity analyses.nnRESULTS: The base-case analysis showed that pemetrexed plus BSC increased QALYs and cost compared with BSC. Pemetrexed plus BSC leads to incremental 0.255 QALYs and incremental costs of US $30 826, resulting in an incremental cost-utility ratio of US $120 886/QALY. The results were sensitive to changes in the utility estimates during the progression-free health state, the progression health state, and the cost of postprogression medications The probabilistic sensitivity analysis showed that the probability of pemetrexed plus BSC being a cost-effective option compared with BSC is 0 at a threshold of $56 000.nnCONCLUSIONS: Maintenance pemetrexed for non-small cell lung cancer is not a cost-effective option compared with BSC from a healthcare system perspective based on the listed price at a threshold of $56 000/QALY.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}