Publications

@article{pmid37722825b,

title = {Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis},

author = {Josef Fritz and Katrin Belovari and Hanno Ulmer and Marc-Michael Zaruba and Moritz Messner and Maria Ungericht and Uwe Siebert and Frank Ruschitzka and Axel Bauer and Gerhard Poelzl},

doi = {10.1136/heartjnl-2023-322803},

issn = {1468-201X},

year  = {2024},

date = {2024-01-01},

journal = {Heart},

volume = {110},

number = {4},

pages = {290--298},

abstract = {OBJECTIVE: Clinical decision making in chronic heart failure (CHF) is based primarily on left ventricular ejection fraction (LVEF), and only secondarily on aetiology of the underlying disease. Our aim was to investigate the mediating role of LVEF in the relationship between aetiology and mortality.nnMETHODS: Using data of 2056 Austrian patients with CHF (mean age 57.2 years; mean follow-up 8.8 years), effects of aetiology on LVEF and overall mortality were estimated using multivariable-adjusted linear and Cox regression models. In causal mediation analyses, we decomposed the total effect of aetiology on mortality into direct and indirect (mediated through LVEF) effects.nnRESULTS: For the analysed aetiologies (dilated (DCM, n=1009) and hypertrophic (HCM, n=89) cardiomyopathy; ischaemic (IHD, n=529) and hypertensive (HHD, n=320) heart disease; cardiac amyloidosis (CA, n=109)), the effect of LVEF on mortality was similar (HR=1.07, 95% CI 1.04 to 1.10; p=0.718). HCM and CA were associated with significantly higher, and IHD and DCM with significantly lower LVEF compared with other aetiologies. Compared with respective other aetiologies, the corresponding total effect HRs for mortality were 0.77 (95% CI 0.67 to 0.89), 0.47 (95% CI 0.25 to 0.88), 1.40 (95% CI 1.21 to 1.62), 0.79 (95% CI 0.67 to 0.95) and 2.36 (95% CI 1.81 to 3.08) for DCM, HCM, IHD, HHD and CA, respectively. CA had the highest mortality despite a HR of 0.74 (95% CI 0.65 to 0.83). For all other aetiologies, <20% of the total mortality effects were mediated through LVEF.nnCONCLUSIONS: The direct effect of aetiology on mortality dominates the indirect effect through LVEF. Therefore, clarification of aetiology is as important as measurement of LVEF.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38218784,

title = {Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project},

author = {Laura Coll-Planas and Aina Carb\'{o}-Carde\~{n}a and Anu Jansson and Vladimira Dost\'{a}lov\'{a} and Alzbeta Bartova and Laura Rautiainen and Annika Kolster and Montse Mas\'{o}-Aguado and Laia Briones-Buixassa and Sergi Blancafort-Alias and Marta Roqu\'{e}-Figuls and Ashby Lavelle Sachs and Cristina Casajuana and Uwe Siebert and Ursula Rochau and Sibylle Puntscher and Iva Holmerov\'{a} and Kaisu H Pitkala and Jill S Litt},

doi = {10.1186/s12889-023-17547-x},

issn = {1471-2458},

year  = {2024},

date = {2024-01-01},

journal = {BMC Public Health},

volume = {24},

number = {1},

pages = {172},

abstract = {BACKGROUND: The negative effects of loneliness on population health and wellbeing requires interventions that transcend the medical system and leverage social, cultural, and public health system resources. Group-based social interventions are a potential method to alleviate loneliness. Moreover, nature, as part of our social and health infrastructure, may be an important part of the solutions that are needed to address loneliness. The RECETAS European project H2020 (Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an international research project aiming to develop and test the effectiveness of nature-based social interventions to reduce loneliness and increase health-related quality of life.nnMETHODS: This article describes the three related randomized controlled trials (RCTs) that will be implemented: the RECETAS-BCN Trial in Barcelona (Spain) is targeting people 18+ from low socio-economic urban areas; the RECETAS-PRG Trial in Prague (Czech Republic) is addressing community-dwelling older adults over 60 years of age, and the RECETAS-HLSNK trial is reaching older people in assisted living facilities. Each trial will recruit 316 adults suffering from loneliness at least sometimes and randomize them to nature-based social interventions called "Friends in Nature" or to the control group. "Friends in Nature" uses modifications of the "Circle of Friends" methodology based on group processes of peer support and empowerment but including activities in nature. Participants will be assessed at baseline, at post-intervention (3 months), and at 6- and 12-month follow-up after baseline. Primary outcomes are the health-related quality-of-life according to 15D measure and The De Jong Gierveld 11-item loneliness scale. Secondary outcomes are health and psychosocial variables tailored to the specific target population. Nature exposure will be collected throughout the intervention period. Process evaluation will explore context, implementation, and mechanism of impact. Additionally, health economic evaluations will be performed.nnDISCUSSION: The three RECETAS trials will explore the effectiveness of nature-based social interventions among lonely people from various ages, social, economic, and cultural backgrounds. RECETAS meets the growing need of solid evidence for programs addressing loneliness by harnessing the beneficial impact of nature on enhancing wellbeing and social connections.nnTRIAL REGISTRATION: Barcelona (Spain) trial: ClinicalTrials.gov, ID: NCT05488496. Registered 29 July 2022. Prague (Czech Republic) trial: ClinicalTrials.gov, ID: NCT05522140. Registered August 25, 2022. Helsinki (Finland) trial: ClinicalTrials.gov, ID: NCT05507684. Registered August 12, 2022.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38199940,

title = {Implementation of a comprehensive clinical risk management system in a university hospital},

author = {Wolfgang Buchberger and Marten Schmied and Michael Schomaker and Anca Del Rio and Uwe Siebert},

doi = {10.1016/j.zefq.2023.11.008},

issn = {2212-0289},

year  = {2024},

date = {2024-01-01},

journal = {Z Evid Fortbild Qual Gesundhwes},

abstract = {BACKGROUND: Adverse events during hospital treatment are common and can lead to serious harm. This study reports the implementation of a comprehensive clinical risk management system in a university hospital and assesses the impact of clinical risk management on patient harms.nnMETHODS: The clinical risk management system was rolled out over a period of eight years and consisted of a training of interdisciplinary risk management teams, external and internal risk audits, and the implementation of a critical incident reporting system (CIRS). The risks identified during the audits were analyzed according to the type, severity, and implementation of preventive measures. Other key figures of the risk management system were obtained from the annual risk reports. The number of liability cases was used as primary outcome measurement.nnRESULTS: Of the 1,104 risks identified during the risk audits, 56.2% were related to organization, 21.3% to documentation, 15.3% to treatment, and 7.2% to patient information and consent. The highest proportion of serious risks was found in the category organization (22.7%), the lowest in the category documentation (13.6%). Critical incident reporting identified between 241 and 370 critical incidents per year, for which in 79.5% to 83% preventive measures were implemented within twelve months. The frequency of incident reports per department correlated with the number of active risk managers and risk team meetings. Compared with the years prior to the introduction of the clinical risk management system, an average annual reduction of harms by 60.1% (95% CI: 57.1; 63.1) was observed two years after the implementation was completed. On average, the rate of harms dropped by 5% per year for each 10% increase in roll-out of the clinical risk management system (incidence rate ratio: 0.95; 95% CI: 0.93; 0.97) .nnCONCLUSION: The results of this project demonstrate the effectiveness of clinical risk management in detecting treatment-related risks and in reducing harm to patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37925258,

title = {Association of patient-practitioner sex concordance with specialist referral in primary hyperparathyroidism},

author = {Jordan M Broekhuis and Maria P Cote and Reagan A Collins and Jorge L Gomez-Mayorga and Natalia Chaves and Benjamin C James},

doi = {10.1016/j.surg.2023.08.048},

issn = {1532-7361},

year  = {2024},

date = {2024-01-01},

urldate = {2023-11-01},

journal = {Surgery},

volume = {175},

issue = {1},

pages = {19-24},

abstract = {BACKGROUND: Prior research has demonstrated barriers to the workup and management of primary hyperparathyroidism. As recent data have suggested that patient and practitioner sex concordance is associated with lower surgical complications, we sought to evaluate the effect of sex concordance on referral for primary hyperparathyroidism.nnMETHODS: We queried an institutional database for patients with first-incident hypercalcemia and subsequent biochemical evidence of primary hyperparathyroidism between 2010 and 2018. Primary care practitioner and endocrinologist sex, laboratory values, and complications of primary hyperparathyroidism were collected. Sex concordance (male patient/male practitioner or female patient/female practitioner) was evaluated as a binary predictor of specialist evaluation using logistic regression and Cox proportional hazards modeling.nnRESULTS: Among 1,100 patients, mean age was 62.5 (standard deviation 13.6), and 74% were female sex. Primary care practitioner sex was 52% female, and 63% of patients had sex concordance with their primary care practitioner. Endocrinologist sex was 59% female, and 45% of patients had sex concordance with their endocrinologist. Patients with sex concordance with their primary care practitioner (70 vs 80%, P = .001) and endocrinologist (71 vs 82%, P \< .001) were less likely to be female sex compared to those with discordance. After adjusting for demographics and clinical covariates, those patients with primary care practitioner sex concordance had 32% higher odds of endocrinologist evaluation (odds ratio 1.32, 95% confidence interval 1.003-1.734, P = .047). Similarly, those patients with endocrinologist sex concordance had a 48% higher rate of surgeon evaluation (hazard ratio 1.48, confidence interval 1.1-2.0, P = .009). Stratified analysis revealed that sex discordance reduced the rate of surgeon referral for female patients (hazard ratio 0.63, confidence interval 0.44-0.89, P = .008) but not male patients (hazard ratio 1.06, CI 0.58-1.93, P = .861).nnCONCLUSION: Sex discordance between patients and their health care professionals may contribute to under-referral in primary hyperparathyroidism. Further evaluation of the effect of patient and practitioner identities on communication and decision-making in surgery are needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37872045,

title = {The impact of social determinants of health on thyroid cancer mortality and time to treatment},

author = {Reagan A Collins and Catherine McManus and Eric J Kuo and Rachel Liou and James A Lee and Jennifer H Kuo},

doi = {10.1016/j.surg.2023.04.062},

issn = {1532-7361},

year  = {2024},

date = {2024-01-01},

urldate = {2023-10-01},

journal = {Surgery},

volume = {175},

issue = {1},

pages = {57-64},

abstract = {BACKGROUND: Whereas racial disparities in thyroid cancer care are well established, the role of social determinants of health is less clear. We aimed to assess the individual and cumulative impact of social determinants of health on mortality and time to treatment among patients with thyroid cancer.nnMETHODS: We collected social determinants of health data from thyroid cancer patients registered in the National Cancer Database from 2004 to 2017. We created a count variable for patients in the lowest quartile of each social determinant of health (ie, low income, low education, and no insurance). We assessed the association of social determinants of health with mortality and time to treatment and the association between cumulative social determinants of health count and time to treatment using Cox regression.nnRESULTS: Of the 142,024 patients we identified, patients with longer time to treatment had greater mortality compared to patients treated within 90 days (90-180 days, adjusted hazard ratio 1.21 (95% confidence interval 1.13-1.29, P \< .001); \>180 days, adjusted hazard ratio 1.57 (95% confidence interval 1.41-1.76, (P \< .001). Compared to patients with no adverse social determinants of health, patients with 1, 2, or 3 adverse social determinants of health had a 10%, 12%, and 34%, respectively, higher likelihood of longer time to treatment (1 social determinant of health, hazard ratio 0.90, 95% confidence interval 0.89-0.92, P \< .001; 2 social determinants of health, hazard ratio 0.88, 95% confidence interval 0.87-0.90, P \< .001; 3 social determinants of health, hazard ratio 0.66, 95% confidence interval 0.62-0.71, P \< .001 for all). On subgroup analysis by race, each adverse social determinant of health was associated with an increased likelihood of a longer time to treatment for Black and Hispanic patients (P \< .05).nnCONCLUSION: A greater number of adverse social determinants of health leads to a higher likelihood of a longer time to treatment for patients with thyroid cancer, which, in turn, is associated with an increased risk for mortality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37792380,

title = {Depression and Suicide Among American Surgeons-A Grave Threat to the Surgeon Workforce},

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

doi = {10.1001/jamasurg.2023.4658},

issn = {2168-6262},

year  = {2024},

date = {2024-01-01},

urldate = {2023-10-01},

journal = {JAMA Surg},

volume = {159},

issue = {1},

pages = {7-8},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37302445,

title = {Hepatocellular Carcinoma Incidence Threshold for Surveillance in Virologically Cured Hepatitis C Individuals},

author = {Jagpreet Chhatwal and Ali Hajjar and Peter P Mueller and Gizem Nemutlu and Neeti Kulkarni and Mary Linton B Peters and Fasiha Kanwal},

doi = {10.1016/j.cgh.2023.05.024},

issn = {1542-7714},

year  = {2024},

date = {2024-01-01},

urldate = {2024-01-01},

journal = {Clin Gastroenterol Hepatol},

volume = {22},

issue = {1},

pages = {91-101},

abstract = {BACKGROUND \& AIMS: Guidelines recommend biannual surveillance for hepatocellular carcinoma (HCC) in hepatitis C individuals with cirrhosis if the HCC incidence rate is above 1.5 per 100 person-years (PY). However, the incidence threshold for surveillance in individuals who achieve a virologic cure is unknown. We estimated the HCC incidence rate above which routine HCC surveillance is cost-effective in this growing population of virologically cured hepatitis C individuals with cirrhosis or advanced fibrosis.nnMETHODS: We developed a Markov-based microsimulation model of the natural history of HCC in individuals with hepatitis C who achieved virologic cure with oral direct-acting antivirals. We used published data on the natural history of hepatitis C, competing risk post virologic cure, HCC tumor progression, real-world HCC surveillance adherence, contemporary HCC treatment options and associated costs, and utilities of different health states. We estimated the HCC incidence above which biannual HCC surveillance using ultrasound and alpha-fetoprotein would be cost-effective.nnRESULTS: In virologically cured hepatitis C individuals with cirrhosis or advanced fibrosis, HCC surveillance is cost-effective if HCC incidence exceeds 0.7 per 100 PY using $100,000 per quality-adjusted life year willingness-to-pay. At this HCC incidence, routine HCC surveillance would result in 2650 and 5700 additional life years per 100,000 cirrhosis and advanced fibrosis persons, respectively, compared with no surveillance. At $150,000 willingness-to-pay, surveillance is cost-effective if HCC incidence exceeds 0.4 per 100 PY. Sensitivity analysis showed that the threshold mostly remained below 1.5 per 100 PY.nnCONCLUSIONS: The contemporary HCC incidence threshold is much lower than the previous 1.5% incidence value used to guide HCC surveillance decisions. Updating clinical guidelines could improve the early diagnosis of HCC.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35778898,

title = {Equitable Policies Need Equitable Practices: Alcohol- and Substance-Exposed Pregnancy as a Case Study},

author = {Arielle R Deutsch and Mohammad S Jalali and Sarah Stout and Leah Frerichs},

doi = {10.1177/15248399221107605},

issn = {1524-8399},

year  = {2024},

date = {2024-01-01},

urldate = {2022-07-01},

journal = {Health Promot Pract},

volume = {25},

issue = {1},

pages = {17-21},

abstract = {There is clear need for more effective public health policies. Coupled with calls for more effective policies, increasing demand to address public health disparities experienced by systemically marginalized and historically oppressed groups emphasizes the long-standing need for policies that improve public health equity. Such need is highlighted when examining public health issues such as alcohol- and substance-exposed pregnancy (ASEP): Current policies are ineffective at reducing ASEP, and marginalized groups experience disproportionately lower benefits and higher negative consequences as a result of such policies. Powerful strategies to develop more effective policies that can account for the complexity of such issues, such as systems science methods (SSMs), are becoming popular. However, current best practices for such methods often do not emphasize the additional efforts that will be required to develop equitable, not just effective policies. Using ASEP as an example of a crucial complex issue requiring new policy, we suggest additional steps to include in SSM projects for developing more effective policies that will also help stakeholders determine high-equity policies to reduce health disparities. These steps include modeling structural differences experienced by marginalized groups via systemic racism and oppression, incorporating existing cultural and community sources of strength and resilience as key areas for policy development, and evaluating the sustainability of policies as a dimension of efficacy. We also discuss using community-based participatory approaches as a framework for all SSM processes to ensure that policy development itself is grounded in equitable shared decision-making for marginalized individuals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38048504,

title = {Why Similar Policies Resulted In Different COVID-19 Outcomes: How Responsiveness And Culture Influenced Mortality Rates},

author = {Tse Yang Lim and Ran Xu and Nick Ruktanonchai and Omar Saucedo and Lauren M Childs and Mohammad S Jalali and Hazhir Rahmandad and Navid Ghaffarzadegan},

doi = {10.1377/hlthaff.2023.00713},

issn = {1544-5208},

year  = {2023},

date = {2023-12-01},

journal = {Health Aff (Millwood)},

volume = {42},

number = {12},

pages = {1637--1646},

abstract = {In the first two years of the COVID-19 pandemic, per capita mortality varied by more than a hundredfold across countries, despite most implementing similar nonpharmaceutical interventions. Factors such as policy stringency, gross domestic product, and age distribution explain only a small fraction of mortality variation. To address this puzzle, we built on a previously validated pandemic model in which perceived risk altered societal responses affecting SARS-CoV-2 transmission. Using data from more than 100 countries, we found that a key factor explaining heterogeneous death rates was not the policy responses themselves but rather variation in responsiveness. Responsiveness measures how sensitive communities are to evolving mortality risks and how readily they adopt nonpharmaceutical interventions in response, to curb transmission. We further found that responsiveness correlated with two cultural constructs across countries: uncertainty avoidance and power distance. Our findings show that more responsive adoption of similar policies saves many lives, with important implications for the design and implementation of responses to future outbreaks.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37500964,

title = {Consensus report from the 10th Global Forum for Liver Magnetic Resonance Imaging: developments in HCC management},

author = {Bachir Taouli and Ahmed Ba-Ssalamah and Julius Chapiro and Jagpreet Chhatwal and Kathryn Fowler and Tae Wook Kang and Gesine Knobloch and Dow-Mu Koh and Masatoshi Kudo and Jeong Min Lee and Takamichi Murakami and David J Pinato and Kristina I Ringe and Bin Song and Parissa Tabrizian and Jin Wang and Jeong Hee Yoon and Mengsu Zeng and Jian Zhou and Val\'{e}rie Vilgrain},

doi = {10.1007/s00330-023-09928-y},

issn = {1432-1084},

year  = {2023},

date = {2023-12-01},

urldate = {2023-07-01},

journal = {Eur Radiol},

volume = {33},

number = {12},

pages = {9152-9166},

abstract = {The 10th Global Forum for Liver Magnetic Resonance Imaging (MRI) was held as a virtual 2-day meeting in October 2021, attended by delegates from North and South America, Asia, Australia, and Europe. Most delegates were radiologists with experience in liver MRI, with representation also from specialists in liver surgery, oncology, and hepatology. Presentations, discussions, and working groups at the Forum focused on the following themes: • Gadoxetic acid in clinical practice: Eastern and Western perspectives on current uses and challenges in hepatocellular carcinoma (HCC) screening/surveillance, diagnosis, and management • Economics and outcomes of HCC imaging • Radiomics, artificial intelligence (AI) and deep learning (DL) applications of MRI in HCC. These themes are the subject of the current manuscript. A second manuscript discusses multidisciplinary tumor board perspectives: how to approach early-, mid-, and late-stage HCC management from the perspectives of a liver surgeon, interventional radiologist, and oncologist (Taouli et al, 2023). Delegates voted on consensus statements that were developed by working groups on these meeting themes. A consensus was considered to be reached if at least 80% of the voting delegates agreed on the statements. CLINICAL RELEVANCE STATEMENT: This review highlights the clinical applications of gadoxetic acid-enhanced MRI for liver cancer screening and diagnosis, as well as its cost-effectiveness and the applications of radiomics and AI in patients with liver cancer. KEY POINTS: • Interpretation of gadoxetic acid-enhanced MRI differs slightly between Eastern and Western guidelines, reflecting different regional requirements for sensitivity vs specificity. • Emerging data are encouraging for the cost-effectiveness of gadoxetic acid-enhanced MRI in HCC screening and diagnosis, but more studies are required. • Radiomics and artificial intelligence are likely, in the future, to contribute to the detection, staging, assessment of treatment response and prediction of prognosis of HCC-reducing the burden on radiologists and other specialists and supporting timely and targeted treatment for patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37439935,

title = {Consensus report from the 10th global forum for liver magnetic resonance imaging: multidisciplinary team discussion},

author = {Bachir Taouli and Ahmed Ba-Ssalamah and Julius Chapiro and Jagpreet Chhatwal and Kathryn Fowler and Tae Wook Kang and Gesine Knobloch and Dow-Mu Koh and Masatoshi Kudo and Jeong Min Lee and Takamichi Murakami and David J Pinato and Kristina I Ringe and Bin Song and Parissa Tabrizian and Jin Wang and Jeong Hee Yoon and Mengsu Zeng and Jian Zhou and Val\'{e}rie Vilgrain},

doi = {10.1007/s00330-023-09919-z},

issn = {1432-1084},

year  = {2023},

date = {2023-12-01},

urldate = {2023-07-01},

journal = {Eur Radiol},

volume = {33},

number = {12},

pages = {9167-9181},

abstract = {The 10th Global Forum for Liver Magnetic Resonance Imaging was held in October 2021. The themes of the presentations and discussions at this Forum are described in detail in the review by Taouli et al (2023). The focus of this second manuscript developed from the Forum is on multidisciplinary tumor board perspectives in hepatocellular carcinoma (HCC) management: how to approach early-, mid-, and late-stage management from the perspectives of a liver surgeon, an interventional radiologist, and an oncologist. The manuscript also includes a panel discussion by multidisciplinary experts on three selected cases that explore challenging aspects of HCC management. CLINICAL RELEVANCE STATEMENT: This review highlights the importance of a multidisciplinary team approach in liver cancer patients and includes the perspectives of a liver surgeon, an interventional radiologist, and an oncologist, including illustrative case studies. KEY POINTS: • A liver surgeon, interventional radiologist, and oncologist presented their perspectives on the treatment of early-, mid-, and late-stage HCC. • Different perspectives on HCC management between specialties emphasize the importance of multidisciplinary tumor boards. • A multidisciplinary faculty discussed challenging aspects of HCC management, as highlighted by three case studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36959868,

title = {Effective contact tracing for COVID-19: A systematic review},

author = {Carl-Etienne Juneau and Anne-Sara Briand and Pablo Collazzo and Uwe Siebert and Tomas Pueyo},

doi = {10.1016/j.gloepi.2023.100103},

issn = {2590-1133},

year  = {2023},

date = {2023-12-01},

journal = {Glob Epidemiol},

volume = {5},

pages = {100103},

abstract = {Contact tracing is commonly recommended to control outbreaks of COVID-19, but its effectiveness is unclear. Following PRISMA guidelines, we searched four databases using a range of terms related to contact tracing effectiveness for COVID-19. We found 343 papers; 32 were included. All were observational or modelling studies. Observational studies ( = 14) provided consistent, very-low certainty evidence that contact tracing (alone or in combination with other interventions) was associated with better control of COVID-19 (e.g. in Hong Kong, only 1084 cases and four deaths were recorded in the first 4.5 months of the pandemic). Modelling studies ( = 18) provided consistent, high-certainty evidence that under assumptions of prompt and thorough tracing with effective quarantines, contact tracing could stop the spread of COVID-19 (e.g. by reducing the reproduction number from 2.2 to 0.57). A cautious interpretation indicates that to stop the spread of COVID-19, public health practitioners have 2-3 days from the time a new case develops symptoms to isolate the case and quarantine at least 80% of its contacts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37991759,

title = {Estimated US Cancer Deaths Prevented With Increased Use of Lung, Colorectal, Breast, and Cervical Cancer Screening},

author = {Amy B Knudsen and Amy Trentham-Dietz and Jane J Kim and Jeanne S Mandelblatt and Rafael Meza and Ann G Zauber and Philip E Castle and Eric J Feuer},

doi = {10.1001/jamanetworkopen.2023.44698},

issn = {2574-3805},

year  = {2023},

date = {2023-11-01},

journal = {JAMA Netw Open},

volume = {6},

number = {11},

pages = {e2344698},

abstract = {IMPORTANCE: Increased use of recommended screening could help achieve the Cancer Moonshot goal of reducing US cancer deaths.nnOBJECTIVE: To estimate the number of cancer deaths that could be prevented with a 10-percentage point increase in the use of US Preventive Services Task Force (USPSTF)-recommended screening.nnDESIGN, SETTING, AND PARTICIPANTS: This decision analytical model study is an extension of previous studies conducted for the USPSTF from 2018 to 2023. This study simulated contemporary cohorts of US adults eligible for lung, colorectal, breast, and cervical cancer screening.nnEXPOSURES: Annual low-dose computed lung tomography among eligible adults aged 50 to 80 years; colonoscopy every 10 years among adults aged 45 to 75 years; biennial mammography among female adults aged 40 to 74 years; and triennial cervical cytology screening among female adults aged 21 to 29 years, followed by human papillomavirus testing every 5 years from ages 30 to 65 years.nnMAIN OUTCOMES AND MEASURES: Estimated number of cancer deaths prevented with a 10-percentage point increase in screening use, assuming screening commences at the USPSTF-recommended starting age and continues throughout the lifetime. Outcomes were presented 2 ways: (1) per 100 000 and (2) among US adults in 2021; and they were expressed among the target population at the age of screening initiation. For lung cancer, estimates were among those who will also meet the smoking eligibility criteria during their lifetime. Harms from increased uptake were also reported.nnRESULTS: A 10-percentage point increase in screening use at the age that USPSTF recommended screening commences was estimated to prevent 226 lung cancer deaths (range across models within the cancer site, 133-332 deaths), 283 (range, 263-313) colorectal cancer deaths, 82 (range, 61-106) breast cancer deaths, and 81 (1 model; no range available) cervical cancer deaths over the lifetimes of 100 000 persons eligible for screening. These rates corresponded with an estimated 1010 (range, 590-1480) lung cancer deaths prevented, 11 070 (range, 10 280-12 250) colorectal cancer deaths prevented, 1790 (range, 1330-2310) breast cancer deaths prevented, and 1710 (no range available) cervical cancer deaths prevented over the lifetimes of eligible US residents at the recommended age to initiate screening in 2021. Increased uptake was also estimated to generate harms, including 100 000 (range, 45 000-159 000) false-positive lung scans, 6000 (range, 6000-7000) colonoscopy complications, 300 000 (range, 295 000-302 000) false-positive mammograms, and 348 000 (no range available) colposcopies over the lifetime.nnCONCLUSIONS AND RELEVANCE: In this decision analytical model study, a 10-percentage point increase in uptake of USPSTF-recommended lung, colorectal, breast, and cervical cancer screening at the recommended starting age was estimated to yield important reductions in cancer deaths. Achieving these reductions is predicated on ensuring equitable access to screening.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37925262,

title = {Social vulnerability and time to surgeon evaluation for primary hyperparathyroidism in a Massachusetts cohort},

author = {Reagan A Collins and Jordan M Broekhuis and Maria P Cote and Jorge L Gomez-Mayorga and Natalia Chaves and Benjamin C James},

doi = {10.1016/j.surg.2023.04.067},

issn = {1532-7361},

year  = {2023},

date = {2023-11-01},

urldate = {2023-11-01},

journal = {Surgery},

volume = {175},

issue = {1},

pages = {25-31},

abstract = {BACKGROUND: Identifying patients at risk for under-evaluation of primary hyperparathyroidism is essential to minimizing long-term sequelae, including osteoporosis, nephrolithiasis, and cardiovascular disease. This study assessed the impact of social vulnerability on time-to-surgery evaluation among patients with primary hyperparathyroidism in a Massachusetts cohort.nnMETHODS: This is a retrospective review of patients from an institutional database with the first incident of hypercalcemia between 2010 and 2018 and subsequent biochemical diagnosis of primary hyperparathyroidism. The overall social vulnerability index and social vulnerability index subthemes were merged with the institutional data via patient ZIP code. Patients were stratified into social vulnerability index quartiles, where quartile 4 represented the highest vulnerability. Baseline sociodemographic and clinical characteristics were compared, and Cox regression was used to assess the association between social vulnerability index and time to surgeon evaluation.nnRESULTS: Of 1,082 patients included, those with a higher social vulnerability index were less likely to be evaluated by a surgeon (quartile 1 social vulnerability index: 31.1% vs. quartile 2 social vulnerability index: 31.41% vs. quartile 3 social vulnerability index: 25.93% vs. quartile 4 social vulnerability index: 21.92%, P = .03). On adjusted analysis, patients with the highest vulnerability had a 33% lower estimated rate of surgeon evaluation and were seen 67 days later compared with patients with the lowest vulnerability (hazard ratio: 0.67, confidence interval 0.47-0.97, P = .032). Differential rates of surgical evaluation by vulnerability persisted for the social vulnerability index subthemes for socioeconomic status, minority status and language, and housing type and transportation.nnCONCLUSION: Among a Massachusetts cohort, highly vulnerable populations with primary hyperparathyroidism are at greater risk for under-evaluation by a surgeon, which may contribute to the development of long-term sequelae of their disease.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37921772,

title = {Factors Associated With Abrupt Discontinuation of Long-Term High-Dose Opioid Treatment},

author = {Carolina Vivas-Valencia and Huiru Dong and Erin J Stringfellow and W Alton Russell and Jake R Morgan and Mina Tadrous and Mohammad S Jalali},

doi = {10.1001/jamanetworkopen.2023.41416},

issn = {2574-3805},

year  = {2023},

date = {2023-11-01},

journal = {JAMA Netw Open},

volume = {6},

number = {11},

pages = {e2341416},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37434347b,

title = {The association between longitudinal trends in receipt of buprenorphine for opioid use disorder and buprenorphine-waivered providers in the United States},

author = {Erin J Stringfellow and Tse Yang Lim and Huiru Dong and Ziyuan Zhang and Mohammad S Jalali},

doi = {10.1111/add.16291},

issn = {1360-0443},

year  = {2023},

date = {2023-11-01},

urldate = {2023-07-01},

journal = {Addiction},

volume = {118},

number = {11},

pages = {2215-2219},

abstract = {AIMS, DESIGN AND SETTING: We sought to describe longitudinal trends in buprenorphine receipt and buprenorphine-waivered providers in the United States from 2003 to 2021 and measure whether the relationship between the two differed after capacity-building strategies were enacted nationally in 2017. This was a retrospective study of two separate cohorts covering the years 2003-21, testing whether the association between two trends in these cohorts changed comparing 2003 to 2016 and from 2017 to 2021, among buprenorphine providers in the United States, regardless of treatment setting. Patients receiving dispensed buprenorphine at retail pharmacies.nnPARTICIPANTS: All providers who have obtained a waiver to prescribe buprenorphine in the United States, and an estimate of the annual number of patients who had buprenorphine for opioid use disorder (OUD) dispensed to them at a retail pharmacy.nnMEASUREMENTS: We synthesized and summarized data from multiple sources to assess the cumulative number of buprenorphine-waivered providers over time. We used national-level prescription data from IQVIA to estimate annual buprenorphine receipt for OUD.nnFINDINGS: From 2003 to 2021, the number of buprenorphine-waivered providers in the United States increased from fewer than 5000 in the first 2 years of Food and Drug Administration (FDA) approval to more than 114 000 in 2021, while patients receiving buprenorphine products for OUD increased from approximately 19 000 to more than 1.4 million. The strength of association between waivered providers and patients is significantly different before and after 2017 (P \< 0.001). From 2003 to 2016, for each additional provider, there was an average increase of 32.1 [95% confidence interval (CI) = 28.7-35.6] patients, but an increase of only 4.6 (95% CI= 3.5-5.7) patients for each additional provider, beginning in 2017.nnCONCLUSIONS: In the United States, the relationship between the rates of growth in buprenorphine providers and patients became weaker after 2017. While efforts to increase buprenorphine-waivered providers were successful, there was less success in translating that into significant increases in buprenorphine receipt.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37437883,

title = {Early Detection of Lung Cancer using small RNAs},

author = {Tobias Sikosek and Rastislav Horos and Franziska Trudzinski and Julia Jehn and Maurice Frank and Timothy Rajakumar and Laura V Klotz and Nathaniel Mercaldo and Mustafa Kahraman and Marco Heuvelman and Yasser Taha and Jennifer Gerwing and Jasmin Skottke and Alberto Daniel-Moreno and Marta Sanchez-Delgado and Sophie Bender and Christina Rudolf and Franziska Hinkfoth and Kaja Tikk and Judith Schenz and Markus A Weigand and Peter Feindt and Christian Schumann and Petros Christopoulos and Hauke Winter and Michael Kreuter and Marc A Schneider and Thomas Muley and Stephan Walterspacher and Martin Schuler and Kaid Darwiche and Christian Taube and Balazs Hegedus and Klaus F Rabe and Kimberly Rieger-Christ and Francine L Jacobsen and Clemens Aigner and Martin Reck and Alexander A Bankier and Amita Sharma and Bruno R Steinkraus},

doi = {10.1016/j.jtho.2023.07.005},

issn = {1556-1380},

year  = {2023},

date = {2023-11-01},

urldate = {2023-07-01},

journal = {J Thorac Oncol},

volume = {18},

number = {11},

pages = {1504-1523},

abstract = {BACKGROUND: Lung cancer remains the deadliest cancer in the world and survival is heavily dependent on tumor stage at the time of detection. Low-dose computed tomography (LDCT) screening can significantly reduce mortality, however, annual screening is limited by low adherence in the USA and still not broadly implemented in Europe. As a result, \<10% of lung cancers are detected through existing programs. Thus, there is great need for additional screening tests, such as a blood test that could be deployed in the primary care setting.nnMETHODS: We prospectively recruited 1,384 individuals meeting the NLST demographic eligibility criteria for lung cancer and collected stabilized whole blood to enable the pipetting-free collection of material, thus minimizing pre-analytical noise. Ultra-deep small RNA sequencing (20 million reads/sample) was performed with the addition of a method to remove highly abundant erythroid RNAs, and thus open bandwidth for the detection of less abundant species originating from plasma or the immune cellular compartment. We utilized 100 random data splits to train and evaluate an ensemble of logistic regression classifiers using small RNA expression of 943 individuals, discovered an 18-small RNA feature consensus signature (miLung), and validated this signature in an independent cohort (441 individuals). Blood cell sorting and tumor tissue sequencing were performed to deconvolve small RNAs into their source of origin.nnRESULTS: We generated diagnostic models and report a median ROC AUC of 0.86 (95% CI 0.84-0.86) in the discovery cohort, and generalized performance of 0.83 in the validation cohort. Diagnostic performance increased in a stage-dependent manner ranging from 0.73 (95% CI 0.71-0.76) for Stage I to 0.90 (95% CI 0.89-0.90) for Stage IV in the discovery cohort, and from 0.76 to 0.86 in the validation cohort. We identified a tumor-shed, plasma-bound ribosomal RNA fragment of the L1 stalk as a dominant predictor of lung cancer. The fragment is decreased following surgery with curative intent. In additional experiments, dried blood spot collection and sequencing demonstrated that small RNA analysis could potentially be conducted via home-sampling.nnCONCLUSION: These data suggest the potential of a small RNA-based blood test as a viable alternative to LDCT screening for early detection of smoking-associated lung cancer.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37344967,

title = {Social vulnerability predictors of drug poisoning mortality: A machine learning analysis in the United States},

author = {Moosa Tatar and Mohammad R Faraji and Katherine Keyes and Fernando A Wilson and Mohammad S Jalali},

doi = {10.1111/ajad.13445},

issn = {1521-0391},

year  = {2023},

date = {2023-11-01},

urldate = {2023-06-21},

journal = {Am J Addict},

volume = {32},

number = {6},

pages = {539-546},

abstract = {BACKGROUND AND OBJECTIVES: Drug poisoning is a leading cause of unintentional deaths in the United States. Despite the growing literature, there are a few recent analyses of a wide range of community-level social vulnerability features contributing to drug poisoning mortality. Current studies on this topic face three limitations: often studying a limited subset of vulnerability features, focusing on small sample sizes, or solely including local data. To address this gap, we conducted a national-level analysis to study the impacts of several social vulnerability features in predicting drug mortality rates in the United States.nnMETHODS: We used machine learning to investigate the role of 16 social vulnerability features in predicting drug mortality rates for US counties in 2014, 2016, and 2018-the most recent available data. We estimated each vulnerability feature\'s gain relative contribution in predicting drug poisoning mortality.nnRESULTS: Among all social vulnerability features, the percentage of noninstitutionalized persons with a disability is the most influential predictor, with a gain relative contribution of 18.6%, followed by population density and the percentage of minority residents (13.3% and 13%, respectively). Percentages of households with no available vehicles, mobile homes, and persons without a high school diploma are the following features with gain relative contributions of 6.3%, 5.8%, and 5.1%, respectively.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: We identified social vulnerability features that are most predictive of drug poisoning mortality. Public health interventions and policies targeting vulnerable communities may increase the resilience of these communities and mitigate the overdose death and drug misuse crisis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37406750c,

title = {Ultrasound Surveillance of Small, Incidentally Detected Gallbladder Polyps: Projected Benefits by Sex, Age, and Comorbidity Level},

author = {Claudia L Seguin and Barak Davidi and Mary Linton B Peters and Andrew Eckel and Mukesh G Harisinghani and Reece J Goiffon and Amy B Knudsen and Pari V Pandharipande},

doi = {10.1016/j.jacr.2023.05.015},

issn = {1558-349X},

year  = {2023},

date = {2023-10-01},

urldate = {2023-10-01},

journal = {J Am Coll Radiol},

volume = {20},

number = {10},

pages = {1031-1041},

abstract = {OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6-7 to \<10 mm), incidentally detected gallbladder polyps, accounting for patient sex, age, and comorbidity level.nnMETHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to 5 years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis.nnRESULTS: Projected LE gains from surveillance were \<3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With 10 years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality.nnDISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37454978b,

title = {NordICC Trial Results in Line With Expected Colorectal Cancer Mortality Reduction After Colonoscopy: A Modeling Study},

author = {Danica M N van den Berg and Pedro Nascimento de Lima and Amy B Knudsen and Carolyn M Rutter and David Weinberg and Iris Lansdorp-Vogelaar and },

doi = {10.1053/j.gastro.2023.06.035},

issn = {1528-0012},

year  = {2023},

date = {2023-10-01},

journal = {Gastroenterology},

volume = {165},

number = {4},

pages = {1077--1079.e2},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37795630,

title = {Long-term benefits and harms of early colorectal cancer screening in German individuals with familial cancer risk},

author = {Gaby Sroczynski and L\'{a}ra R Hallsson and Nikolai M\"{u}hlberger and Beate Jahn and Raphael Rehms and Sabine Hoffmann and Alexander Crispin and Doris Lindoerfer and Ulrich Mansmann and Uwe Siebert},

doi = {10.1002/ijc.34747},

issn = {1097-0215},

year  = {2023},

date = {2023-10-01},

urldate = {2023-10-01},

journal = {Int J Cancer},

volume = {154},

issue = {3},

pages = {516-529},

abstract = {Individuals with a family history of colorectal cancer (CRC) may benefit from early screening with colonoscopy or immunologic fecal occult blood testing (iFOBT). We systematically evaluated the benefit-harm trade-offs of various screening strategies differing by screening test (colonoscopy or iFOBT), interval (iFOBT: annual/biennial; colonoscopy: 10-yearly) and age at start (30, 35, 40, 45, 50 and 55 years) and end of screening (65, 70 and 75 years) offered to individuals identified with familial CRC risk in Germany. A Markov-state-transition model was developed and used to estimate health benefits (CRC-related deaths avoided, life-years gained [LYG]), potential harms (eg, associated with additional colonoscopies) and incremental harm-benefit ratios (IHBR) for each strategy. Both benefits and harms increased with earlier start and shorter intervals of screening. When screening started before age 50, 32-36 CRC-related deaths per 1000 persons were avoided with colonoscopy and 29-34 with iFOBT screening, compared to 29-31 (colonoscopy) and 28-30 (iFOBT) CRC-related deaths per 1000 persons when starting age 50 or older, respectively. For iFOBT screening, the IHBRs expressed as additional colonoscopies per LYG were one (biennial, age 45-65 vs no screening), four (biennial, age 35-65), six (biennial, age 30-70) and 34 (annual, age 30-54; biennial, age 55-75). Corresponding IHBRs for 10-yearly colonoscopy were four (age 55-65), 10 (age 45-65), 15 (age 35-65) and 29 (age 30-70). Offering screening with colonoscopy or iFOBT to individuals with familial CRC risk before age 50 is expected to be beneficial. Depending on the accepted IHBR threshold, 10-yearly colonoscopy or alternatively biennial iFOBT from age 30 to 70 should be recommended for this target group.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37782860,

title = {How Funding Policy Maintains Structural Inequity Within Indigenous Community-Based Organizations},

author = {Arielle R Deutsch and Leah Frerichs and Zeynep Hasgul and Foster Murphey and Addie K Coleman and Annie Y Bachand and Arlana Bettelyoun and Paul Forney and Gene Tyon and Mohammad S Jalali},

doi = {10.1377/hlthaff.2023.00483},

issn = {1544-5208},

year  = {2023},

date = {2023-10-01},

journal = {Health Aff (Millwood)},

volume = {42},

number = {10},

pages = {1411--1419},

abstract = {Despite efforts to increase investment in Indigenous health and well-being in the United States, disparities remain. The way in which health-promoting organizations are funded is one key mechanism driving the systemic, long-term health disparities experienced by Indigenous people in the US. Using Indigenous-led community-based organizations (ICBOs) that provide psychosocial care as a case study, we highlight multiple ways in which policies that regulate the external funding that ICBOs depend on must change to promote equity and allow the organizations to flourish and address unmet psychosocial needs for Indigenous community members. We use a system dynamics approach to discuss how "capability traps" arise from a misfit between external funding regulations and organizations' needs for sustainability and effective care provision. We provide suggestions for reforming funding policies that focus on improving ICBO sustainability.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36987566,

title = {Delay in Surgery and Papillary Thyroid Cancer Survival in the United States: a SEER-Medicare Analysis},

author = {Natalia Chaves and Jordan M Broekhuis and Scott C Fligor and Reagan A Collins and Anna M Modest and Sumedh Kaul and Benjamin C James},

doi = {10.1210/clinem/dgad163},

issn = {1945-7197},

year  = {2023},

date = {2023-09-18},

urldate = {2023-03-01},

journal = {J Clin Endocrinol Metab},

volume = {108},

number = {10},

pages = {2589-2596},

abstract = {INTRODUCTION: Delays in surgery and their impact on survival in papillary thyroid cancer (PTC) is unclear. We sought to investigate the association between time to surgery and survival in patients with PTC.nnMETHODS: A total of 8,170 Medicare beneficiaries with PTC who underwent thyroidectomy were identified within the SEER-Medicare linked data files between 1999-2018. Disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meir analysis, and Cox proportional hazards models were specified to estimate the association between time to surgery and survival.nnRESULTS: Among 8,170 patients with PTC, mean age 69.3 (SD+/- 11.4), 89.8% had surgery within the first 90 days, 7.8% had surgery 91-180 days from diagnosis, and 2.4% had surgery after 180 days. Increasing time to surgery was associated with increased mortality for OS in the \>180-day group (aHR 1.24, 95% CI 1.01-1.53). Moreover, on stratification by summary stage, those with localized disease in the 91-180-day group increased risk by 25% (aHR 1.25 95%CI 1.05-1.51) and delaying over 180 days increased risk by 61% (aHR 1.61 95%CI 1.19-2.18) in OS. Those with localized disease in the \>180-day group had almost four times the estimated rate of DSS mortality (aHR3.51 95%CI 1.68-7.32). When stratified by T stage, those with T2 disease in the \>180 days group had double the estimated rate of all-cause mortality (aHR 2.0, 95% CI 1.1-3.3) and almost triple the estimated rate of disease-specific mortality (aHR 2.7, 95% CI 1.05-6.8).nnCONCLUSIONS: Delays in surgery for PTC may impact OS and DSS in localized disease, prior to nodal metastasis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37703336,

title = {Estimates of Hepatitis C Seroprevalence and Viremia in State Prison Populations in the United States},

author = {Anne C Spaulding and Shanika S Kennedy and Jeffery Osei and Ebrima Sidibeh and Isabella V Batina and Jagpreet Chhatwal and Matthew J Akiyama and Lara B Strick},

doi = {10.1093/infdis/jiad227},

issn = {1537-6613},

year  = {2023},

date = {2023-09-13},

urldate = {2023-09-01},

journal = {J Infect Dis},

volume = {228},

number = {Supplement_3},

pages = {S160--S167},

abstract = {BACKGROUND: Prior studies demonstrate that eliminating hepatitis C virus (HCV) in the United States (US) heavily depends on treating incarcerated persons. Knowing the scope of the carceral HCV epidemic by state will help guide national elimination efforts.nnMETHODS: Between 2019 and 2023, all state prison systems received surveys requesting data on hepatitis C antibody and viremic prevalence. We supplemented survey information with publicly available HCV data to corroborate responses and fill in data gaps.nnRESULTS: Weighting HCV prevalence by state prison population size, we estimate that 15.2% of the US prison population is HCV seropositive and 8.7% is viremic; 54.9% of seropositive persons have detectable RNA. Applying prevalence estimates to the total prison population at year-end 2021, 91 090 persons with HCV infection resided in a state prison.nnCONCLUSIONS: With updated and more complete HCV data from all 50 states, HCV prevalence in state prisons is nearly 9-fold higher than the US general population. The heterogeneity in HCV prevalence by state prison system may reflect variable exposure before arrest and/or differences in treatment availability during incarceration. Elimination of HCV in the country depends on addressing the carceral epidemic, and one of the first steps is understanding the size of the problem.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37703345,

title = {Hepatitis C Elimination in Moldova Is Feasible and Cost-Saving: A Modeling Study},

author = {Alec Aaron and Huaiyang Zhong and Lindsey Hiebert and Yueran Zhuo and Madeline Adee and Angela Paraschiv and Silvia Stratulat and John W Ward and Jagpreet Chhatwal},

doi = {10.1093/infdis/jiad138},

issn = {1537-6613},

year  = {2023},

date = {2023-09-13},

urldate = {2023-09-01},

journal = {J Infect Dis},

volume = {228},

number = {Supplement_3},

pages = {S189--S197},

abstract = {BACKGROUND: Moldova, an upper-middle-income country in Eastern Europe, is facing a high burden of hepatitis C virus (HCV). Our objective was to assist the National Agency of Public Health of Moldova in planning to achieve the World Health Organization's HCV elimination goals by 2030.nnMETHODS: This study adapted a previously developed microsimulation model to simulate the HCV epidemic in Moldova from 2004 to 2050. Model outcomes included temporal trends in HCV infection, prevalence, mortality, and total cost of care, including screening and treatment. We evaluated scenarios that could eliminate HCV by 2030.nnRESULTS: Multiple strategies could lead to HCV elimination in Moldova by 2030. A realistic scenario of a 20% annual screening and 80% treatment rate would require 2.75 million individuals to be screened and 65 000 treated by 2030. Compared to 2015, this program will reduce HCV incidence by 98% and HCV-related deaths by 72% in 2030. Between 2022 and 2030, this strategy would cost $17.5 million for HCV screening and treatment. However, by 2050, the health system would save \>$85 million compared to no investment in elimination efforts.nnCONCLUSIONS: HCV elimination in Moldova is feasible and can be cost saving, but requires resources to scale HCV screening and treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37753604,

title = {Understanding the dynamics emerging from the interplay among poor mental wellbeing, energy balance-related behaviors, and obesity prevalence in adolescents: A simulation-based study},

author = {Anaely Aguiar and Furkan \"{O}nal and Gaironeesa Hendricks and Laurence Blanchard and Eduard Romanenko and Anne-Siri Fismen and Emmanuel Nwosu and Sondre Herstad and Natalie Savona and Janetta Harbron and C\'{e}cile Knai and Oddrun Samdal and Harry Rutter and Nanna Lien and Mohammad S Jalali and Birgit Kopainsky},

doi = {10.1111/obr.13628},

issn = {1467-789X},

year  = {2023},

date = {2023-09-01},

journal = {Obes Rev},

volume = {24 Suppl 2},

pages = {e13628},

abstract = {Both obesity and poor mental wellbeing have a high prevalence in European youth. Adolescents in six countries identified mental wellbeing factors as main drivers of youth obesity through systems mapping. This study sought to (1) explore the dynamics of the interplay between poor mental wellbeing, energy balance-related behaviors, and adolescent overweight and obesity prevalence and (2) test the effect of intervention point scenarios to reduce adolescent obesity. Drawing on the youth-generated systems maps and a literature synthesis, we built a simulation model that represents the links from major feedback pathways for poor mental wellbeing to changes in dietary, physical activity, and sleep behaviors. The model was calibrated using survey data from Norway, expert input, and literature and shows a good fit between simulated behavior and available statistical data. The simulations indicate that adolescent mental wellbeing is harmed by socio-cultural pressures and stressors, which trigger reinforcing feedback mechanisms related to emotional/binge eating, lack of motivation to engage in physical activity, and sleep difficulty. Targeting a combination of intervention points that support a 25% reduction of pressure on body image and psychosocial stress showed potentially favorable effects on mental wellbeing-doubling on average for boys and girls and decreasing obesity prevalence by over 4%.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37722825,

title = {Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis},

author = {Josef Fritz and Katrin Belovari and Hanno Ulmer and Marc-Michael Zaruba and Moritz Messner and Maria Ungericht and Uwe Siebert and Frank Ruschitzka and Axel Bauer and Gerhard Poelzl},

doi = {10.1136/heartjnl-2023-322803},

issn = {1468-201X},

year  = {2023},

date = {2023-09-01},

journal = {Heart},

abstract = {OBJECTIVE: Clinical decision making in chronic heart failure (CHF) is based primarily on left ventricular ejection fraction (LVEF), and only secondarily on aetiology of the underlying disease. Our aim was to investigate the mediating role of LVEF in the relationship between aetiology and mortality.nnMETHODS: Using data of 2056 Austrian patients with CHF (mean age 57.2 years; mean follow-up 8.8 years), effects of aetiology on LVEF and overall mortality were estimated using multivariable-adjusted linear and Cox regression models. In causal mediation analyses, we decomposed the total effect of aetiology on mortality into direct and indirect (mediated through LVEF) effects.nnRESULTS: For the analysed aetiologies (dilated (DCM, n=1009) and hypertrophic (HCM, n=89) cardiomyopathy; ischaemic (IHD, n=529) and hypertensive (HHD, n=320) heart disease; cardiac amyloidosis (CA, n=109)), the effect of LVEF on mortality was similar (HR=1.07, 95% CI 1.04 to 1.10; p=0.718). HCM and CA were associated with significantly higher, and IHD and DCM with significantly lower LVEF compared with other aetiologies. Compared with respective other aetiologies, the corresponding total effect HRs for mortality were 0.77 (95% CI 0.67 to 0.89), 0.47 (95% CI 0.25 to 0.88), 1.40 (95% CI 1.21 to 1.62), 0.79 (95% CI 0.67 to 0.95) and 2.36 (95% CI 1.81 to 3.08) for DCM, HCM, IHD, HHD and CA, respectively. CA had the highest mortality despite a HR of 0.74 (95% CI 0.65 to 0.83). For all other aetiologies, <20% of the total mortality effects were mediated through LVEF.nnCONCLUSIONS: The direct effect of aetiology on mortality dominates the indirect effect through LVEF. Therefore, clarification of aetiology is as important as measurement of LVEF.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37660758,

title = {Dynamics of colorectal cancer screening in low and middle-income countries: A modeling analysis from Thailand},

author = {Peeradon Wongseree and Zeynep Hasgul and Borwornsom Leerapan and Cherdsak Iramaneerat and Pochamana Phisalprapa and Mohammad S Jalali},

doi = {10.1016/j.ypmed.2023.107694},

issn = {1096-0260},

year  = {2023},

date = {2023-09-01},

journal = {Prev Med},

pages = {107694},

abstract = {BACKGROUND: Low and middle-income countries face constraints for early colorectal cancer (CRC) detection, including restricted access to care and low colonoscopy capacity. Considering these constraints, we studied strategies for increasing access to early CRC detection and reducing CRC progression and mortality rates in Thailand.nnMETHODS: We developed a system dynamics model to simulate CRC death and progression trends. We analyzed the impacts of increased access to screening via fecal immunochemical test and colonoscopy, improving access to CRC diagnosis among symptomatic individuals, and their combination.nnRESULTS: Projecting the status quo (2023-2032), deaths per 100 K people increase from 87.5 to 115.4, and CRC progressions per 100 K people rise from 131.8 to 159.8. In 2032, improved screening access prevents 2.5 CRC deaths and 2.5 progressions per 100 K people, with cumulative prevented 7 K deaths and 9 K progressions, respectively. Improved symptom evaluation access prevents 7.5 CRC deaths per 100 K with no effect on progression, totaling 35 K saved lives. A combined approach prevents 9.3 deaths and 1.8 progressions per 100 K, or 41 K and 7 K cumulatively. The combined strategy prevents most deaths; however, there is a tradeoff: It prevents fewer CRC progressions than screening access improvement. Increasing the current annual colonoscopy capacity (200K) to sufficient capacity (681 K), the combined strategy achieves the best results, preventing 15.0 CRC deaths and 10.3 CRC progressions per 100 K people, or 54 K and 30 K cumulatively.nnCONCLUSION: Until colonoscopy capacity increases, enhanced screening and symptom evaluation are needed simultaneously to curb CRC deaths, albeit not the best strategy for CRC progression prevention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37256423,

title = {Screening for colorectal cancer : A recommendation statement of the Austrian National Committee for Cancer Screening},

author = {Gerald Gartlehner and Eva Schernhammer and Sigurd F Lax and Matthias Preusser and Herbert Bachler and Harald Tietzer and Maria Kletecka-Pulker and Helga Turnher and Uwe Siebert},

doi = {10.1007/s00508-023-02209-0},

issn = {1613-7671},

year  = {2023},

date = {2023-09-01},

urldate = {2023-05-01},

journal = {Wien Klin Wochenschr},

volume = {135},

issue = {17-18},

pages = {447-445},

abstract = {BACKGROUND: Colorectal cancer is the fourth most common cancer in Austria. To date, colorectal cancer screening in Austria remains opportunistic and includes colonoscopy or stool-based blood tests. The Austrian National Committee for Cancer Screening developed evidence-based recommendations for a nationwide organized colorectal cancer screening program.nnMETHODS: The methodological framework followed the approach of the United States Preventive Services Task Force. The evidence base underlying the newly developed recommendations comprised a review of the existing published evidence and a decision analytic model tailored to the Austrian context. Using a structured process, committee members considered 1) the magnitude of the net benefit of each screening strategy, 2) the certainty of evidence, and 3) the level of acceptance of the interventions among the target population.nnRECOMMENDATIONS: The Austrian National Committee for Cancer Screening recommends the implementation of a nationwide organized colorectal cancer screening program for all adults aged 45-75 years. For persons 65 years or older, screening decisions should occur on an individual basis in accordance with a person's overall health, prior screening history, and preferences. Specifically, the committee recommends either a 10-year screening colonoscopy or biennial fecal immunochemical tests with colonoscopy following a positive result, with both screening strategies considered equivalent. Each citizen should be able to make an informed decision about their preferred screening method. Switching between the two screening strategies should be possible. Following an unremarkable colonoscopy, screening by fecal immunochemical test (FIT) is only required after 10 years. Screening recommendations apply only to asymptomatic persons at average risk for colorectal cancer. The screening program must be pilot tested, and accompanied by a public information campaign, formative evaluation, quality assurance, and data collection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37196759,

title = {Increasing the initiation of antiretroviral therapy through optimal placement of diagnostic technologies for pediatric HIV in Zimbabwe: a modeling analysis},

author = {Melike Yildirim and Karen A Webb and Andrea L Ciaranello and Alyssa K Amick and Angela Mushavi and Anesu Chimwaza and Anneke Claypool and Tendayi Murape and Nicole C McCann and Clare F Flanagan and Mohammad S Jalali},

doi = {10.1016/j.ijid.2023.05.013},

issn = {1878-3511},

year  = {2023},

date = {2023-09-01},

urldate = {2023-09-01},

journal = {Int J Infect Dis},

volume = {134},

pages = {31-38},

abstract = {OBJECTIVES: Point-of-care (POC) devices for infant HIV testing provide timely result-return and increase ART initiation. We aimed to optimally locate POC devices to increase 30-day ART initiation in Matabeleland South, Zimbabwe.nnMETHODS: We developed an optimization model to identify locations for limited POC devices at health facilities, maximizing the number of infants who receive HIV test results and initiate ART within 30 days of testing. We compared location-optimization model results to non-model-based decision heuristics, which are more practical and less data intensive. Heuristics assign POC devices based on demand, test positivity, laboratory result-return probability, and POC machine functionality.nnRESULTS: With current placement of 11 existing POC machines, 37% of all tested infants with HIV were projected to receive results, 35% to initiate ART within 30 days of testing. With optimal placement of existing machines, 46% were projected to receive results and 44% to initiate ART within 30 days, retaining 3 machines in current locations, moving 8 to new facilities. Relocation based on the highest POC device functionality would be the best-performing heuristic decision (44% receiving results and 42% initiating ART withing 30 days), although it still would not perform as well as the optimization-based approach.nnCONCLUSION: Optimal and ad-hoc heuristic relocation of limited POC machines would increase timely result-return and ART initiation, without further, often costly, interventions. Location-optimization can enhance decision-making regarding placement of medical technologies for HIV care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Swan2023,

title = {Confirmatory Factor Analysis and Measurement Invariance of the Functional Assessment of Cancer Therapy Lung Cancer Utility Index (FACT-LUI)},

author = {J. Shannon Swan and Michelle M. Langer},

doi = {10.1177/23814683231186992},

issn = {2381-4683},

year  = {2023},

date = {2023-08-27},

urldate = {2023-07-00},

journal = {MDM Policy \& Practice},

volume = {8},

number = {2},

pages = {23814683231186992},

publisher = {SAGE Publications},

abstract = {\<jats:p\> Background. A portion of the Functional Assessment of Cancer Therapy-Lung (FACT-L) instrument contributed to a previously published utility index, the FACT Lung Utility Index or FACT-LUI. Six FACT items representing lung cancer quality of life covered fatigue, pain, dyspnea, cough, anxiety, and depression. Two FACT items had been previously combined by the index authors into one for nausea and/or appetite loss, resulting in 7 final domains. Methods. The objective was to perform measurement invariance testing within a confirmatory factor analysis (CFA) framework to support the feasibility of using the FACT-LUI for non\textendashpreference-based psychometric applications. The original index patients comprised group 1, and similar FACT patient data ( n = 249) from another published study comprised group 2. One 2-factor model and two 1-factor CFA models were evaluated to assess measurement invariance across groups, using varying degrees of item parceling and a small number of residual covariances, all justified by the literature. Results. The 1-factor models were most optimal. A 1-factor model with 1 pair of items parceled showed invariance to the partial scalar level using usual fit criteria across groups, requiring 2 unconstrained intercepts. A 1-factor model with 3 pairs of justified parcels showed full configural, metric, and scalar invariance across groups. Conclusions. The FACT-LUI items fit a partially to fully invariant 1-factor model, suggesting feasibility for non\textendashpreference-based applications. Implications. Results suggest useful incorporation of the FACT-LUI into clinical trials with no substantial increased respondent burden, allowing preference-based and other psychometric applications from the same index items. \</jats:p\>\<jats:sec\>\<jats:title\>Highlights\</jats:title\>\<jats:p\> This work suggests that in addition to being originally designed for use as a utility index, the 7 FACT-LUI items together also fit simple CFA and measurement invariance models. This less expected result indicates that these items as a group are also potentially useful in non\textendashpreference-based applications. Clinical trials can make for challenging decisions concerning which patient-reported outcome measures to include without being burdensome. However, the literature suggests a need for improved reporting of quality of life in lung cancer in particular as well as cancer in general. Inclusion of more disease-specific items such as the FACT-LUI may allow for information gathering of both preference-based and non\textendashpreference-based data with less demand on patients, similar to what has been done with some generic instruments. \</jats:p\>\</jats:sec\>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37561981,

title = {The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma},

author = {Leontios Pappas and Islam Baiev and Stephanie Reyes and Andrea Grace Bocobo and Apurva Jain and Kristen Spencer and Tri Minh Le and Osama E Rahma and Jordan Maurer and Jen Stanton and Karen Zhang and Anaemy Danner De Armas and Thomas T Deleon and Marc Roth and Mary Linton B Peters and Andrew X Zhu and Kylie Boyhen and Christine VanCott and Tushar Patel and Lewis R Roberts and Stacie Lindsey and Nora Horick and Jochen K Lennerz and A John Iafrate and Laura Williams Goff and Kabir Mody and Mitesh J Borad and Rachna T Shroff and Milind M Javle and R Katie Kelley and Lipika Goyal},

doi = {10.1200/PO.22.00594},

issn = {2473-4284},

year  = {2023},

date = {2023-08-01},

journal = {JCO Precis Oncol},

volume = {7},

pages = {e2200594},

abstract = {PURPOSE: Increased awareness of the distinct tumor biology for adolescents and young adults (AYAs) with cancer has led to improvement in outcomes for this population. However, in cholangiocarcinoma (CCA), a paucity of data exist on the AYA population. To our knowledge, we present the largest study to date on AYA disease biology, treatment patterns, and survival outcomes in CCA.nnMETHODS: A multi-institutional cohort of patients with CCA diagnosed with intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma (ECC) was used for analysis. Retrospective chart review was conducted on patients who were 50 years old and younger (young; n = 124) and older than 50 years (older; n = 723).nnRESULTS: Among 1,039 patients screened, 847 patients met eligibility (72% ICC, 28% ECC). Young patients had a larger median tumor size at resection compared with older patients (4.2  3.6 cm;  .048), more commonly had N1 disease (65%  43%;  .040), and were more likely to receive adjuvant therapy (odds ratio, 4.0; 95% CI, 1.64 to 9.74). Tumors of young patients were more likely to harbor an  fusion,  mutation, or  mutation ( .05 for each). Young patients were more likely to receive palliative systemic therapy (96%  69%;  .001), targeted therapy (23%  8%;  .001), and treatment on a clinical trial (31%  19%;  .004). Among patients who presented with advanced disease, young patients had a higher median overall survival compared with their older counterparts (17.7  13.5 months; 95% CI, 12.6 to 22.6  11.4 to 14.8;  .049).nnCONCLUSION: Young patients with CCA had more advanced disease at resection, more commonly received both adjuvant and palliative therapies, and demonstrated improved survival compared with older patients. Given the low clinical trial enrollment and poor outcomes among some AYA cancer populations, data to the contrary in CCA are highly encouraging.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37060168,

title = {Optimizing outcomes in heart failure: 2022 and beyond},

author = {Ewa A Jankowska and Tomas Andersson and Claudia Kaiser-Albers and Biykem Bozkurt and Ovidiu Chioncel and Andrew J S Coats and Loreena Hill and Friedrich Koehler and Lars H Lund and Theresa McDonagh and Marco Metra and Clemens Mittmann and Wilfried Mullens and Uwe Siebert and Scott D Solomon and Maurizio Volterrani and John J V McMurray},

doi = {10.1002/ehf2.14363},

issn = {2055-5822},

year  = {2023},

date = {2023-08-01},

journal = {ESC Heart Fail},

volume = {10},

number = {4},

pages = {2159--2169},

abstract = {Although the development of therapies and tools for the improved management of heart failure (HF) continues apace, day-to-day management in clinical practice is often far from ideal. A Cardiovascular Round Table workshop was convened by the European Society of Cardiology (ESC) to identify barriers to the optimal implementation of therapies and guidelines and to consider mitigation strategies to improve patient outcomes in the future. Key challenges identified included the complexity of HF itself and its treatment, financial constraints and the perception of HF treatments as costly, failure to meet the needs of patients, suboptimal outpatient management, and the fragmented nature of healthcare systems. It was discussed that ongoing initiatives may help to address some of these barriers, such as changes incorporated into the 2021 ESC HF guideline, ESC Heart Failure Association quality indicators, quality improvement registries (e.g. EuroHeart), new ESC guidelines for patients, and the universal definition of HF. Additional priority action points discussed to promote further improvements included revised definitions of HF 'phenotypes' based on trial data, the development of implementation strategies, improved affordability, greater regulator/payer involvement, increased patient education, further development of patient-reported outcomes, better incorporation of guidelines into primary care systems, and targeted education for primary care practitioners. Finally, it was concluded that overarching changes are needed to improve current HF care models, such as the development of a standardized pathway, with a common adaptable digital backbone, decision-making support, and data integration, to ensure that the model 'learns' as the management of HF continues to evolve.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37079205,

title = {Assessing the Complex General Surgical Oncology Pipeline: Trends in Race and Ethnicity Among US Medical Students, General Surgery Residents, and Complex General Surgical Oncology Trainees},

author = {Reagan A Collins and Salma A Sheriff and Christopher Yoon and Adrianne N Cobb and Anai N Kothari and Lisa A Newman and Lesly A Dossett and Alliric I Willis and Sandra L Wong and Callisia N Clarke},

doi = {10.1245/s10434-023-13499-z},

issn = {1534-4681},

year  = {2023},

date = {2023-08-01},

journal = {Ann Surg Oncol},

volume = {30},

number = {8},

pages = {4579--4586},

abstract = {BACKGROUND: Cancer incidence is expected to increase in coming decades, disproportionately so among minoritized communities. Racially and ethnically concordant care is essential to addressing disparities in cancer outcomes within at-risk groups. Here, we assess trends in racial and ethnic representation of medical students (MS), general surgery (GS) residents, and complex general surgical oncology (CGSO) fellows.nnMETHODS: This is a retrospective review of data from the American Association of Medical Colleges and the Accreditation Council of Medical Education (ACGME) from 2015 to 2020. Self-reported race and ethnicity was obtained for MS, GS, and CGSO trainees. Race and ethnicity proportions were compared with respective representation in the 2020 US Census. Mann-Kendall, Wilcoxon rank sum, and linear regression were used to assess trends, as appropriate.nnRESULTS: A total of 316,448 MS applicants, 128,729 MS matriculants, 27,574 GS applicants, 46,927 active GS residents, 710 CGSO applicants, and 659 active CGSO fellows were included. With every progressive stage in training, there was a smaller proportion of URM active trainees than applicants. Further, URM, Hispanic/Latino, and Black/African American trainees were significantly underrepresented compared with 2020 Census data. While the proportion of White CGSO fellows increased over time (54.5-69.2%, p = 0.009), the proportion of Black/African American and Hispanic/Latino (URM) CGSO fellows did not significantly change over the study period, though URM representation was lower in 2020 as compared with 2015.nnDISCUSSION: From 2015 to 2020, minority representation decreased at every advancing stage in surgical oncology training. Efforts to address barriers for URM applicants to CGSO fellowships are needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37191861,

title = {ASO Visual Abstract: Assessing the Complex General Surgical Oncology Pipeline-Trends in Race and Ethnicity Among US Medical Students, General Surgery Residents, and Complex General Surgical Oncology Trainees},

author = {Reagan A Collins and Salma A Sheriff and Christopher Yoon and Adrianne N Cobb and Anai N Kothari and Lisa A Newman and Lesly A Dossett and Alliric I Willis and Sandra L Wong and Callisia N Clarke},

doi = {10.1245/s10434-023-13609-x},

issn = {1534-4681},

year  = {2023},

date = {2023-08-01},

urldate = {2023-05-01},

journal = {Ann Surg Oncol},

volume = {30},

issue = {8},

pages = {4587-4588},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36799870,

title = {Long-Term Effects of Increasing Buprenorphine Treatment Seeking, Duration, and Capacity on Opioid Overdose Fatalities: A Model-Based Analysis},

author = {Erin J Stringfellow and Tse Yang Lim and Catherine DiGennaro and Ziyuan Zhang and Pritika Paramasivam and Benjamin Bearnot and Keith Humphreys and Mohammad S Jalali},

doi = {10.1097/ADM.0000000000001153},

issn = {1935-3227},

year  = {2023},

date = {2023-08-01},

urldate = {2023-02-01},

journal = {J Addict Med},

volume = {17},

issue = {4},

pages = {439-446},

abstract = {OBJECTIVES: Because buprenorphine treatment of opioid use disorder reduces opioid overdose deaths (OODs), expanding access to care is an important policy and clinical care goal. Policymakers must choose within capacity limitations whether to expand the number of people with opioid use disorder who are treated or extend duration for existing patients. This inherent tradeoff could be made less acute with expanded buprenorphine treatment capacity.



METHODS: To inform such decisions, we used a validated simulation model to project the effects of increasing buprenorphine treatment-seeking, average episode duration, and capacity (patients per provider) on OODs in the United States from 2023 to 2033, varying the start time to assess the effects of implementation delays.



RESULTS: Results show that increasing treatment duration alone could cost lives in the short term by reducing capacity for new admissions yet save more lives in the long term than accomplished by only increasing treatment seeking. Increasing provider capacity had negligible effects. The most effective 2-policy combination was increasing capacity and duration simultaneously, which would reduce OODs up to 18.6% over a decade. By 2033, the greatest reduction in OODs (≥20%) was achieved when capacity was doubled and average duration reached 2 years, but only if the policy changes started in 2023. Delaying even a year diminishes the benefits. Treatment-seeking increases were equally beneficial whether they began in 2023 or 2025 but of only marginal benefit beyond what capacity and duration achieved.



CONCLUSIONS: If policymakers only target 2 policies to reduce OODs, they should be to increase capacity and duration, enacted quickly and aggressively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37461007,

title = {A multimorbidity model for estimating health outcomes from the syndemic of injection drug use and associated infections in the United States},

author = {John J Chiosi and Peter P Mueller and Jagpreet Chhatwal and Andrea L Ciaranello},

doi = {10.1186/s12913-023-09773-1},

issn = {1472-6963},

year  = {2023},

date = {2023-07-17},

urldate = {2023-07-01},

journal = {BMC Health Serv Res},

volume = {23},

number = {1},

pages = {760},

abstract = {BACKGROUND: Fatal drug overdoses and serious injection-related infections are rising in the US. Multiple concurrent infections in people who inject drugs (PWID) exacerbate poor health outcomes, but little is known about how the synergy among infections compounds clinical outcomes and costs. Injection drug use (IDU) converges multiple epidemics into a syndemic in the US, including opioid use and HIV. Estimated rates of new injection-related infections in the US are limited due to widely varying estimates of the number of PWID in the US, and in the absence of clinical trials and nationally representative longitudinal observational studies of PWID, simulation models provide important insights to policymakers for informed decisions.nnMETHODS: We developed and validated a MultimorbiditY model to Reduce Infections Associated with Drug use (MYRIAD). This microsimulation model of drug use and associated infections (HIV, hepatitis C virus [HCV], and severe bacterial infections) uses inputs derived from published data to estimate national level trends in the US. We used Latin hypercube sampling to calibrate model output against published data from 2015 to 2019 for fatal opioid overdose rates. We internally validated the model for HIV and HCV incidence and bacterial infection hospitalization rates among PWID. We identified best fitting parameter sets that met pre-established goodness-of-fit targets using the Pearson's chi-square test. We externally validated the model by comparing model output to published fatal opioid overdose rates from 2020.nnRESULTS: Out of 100 sample parameter sets for opioid use, the model produced 3 sets with well-fitting results to key calibration targets for fatal opioid overdose rates with Pearson's chi-square test ranging from 1.56E-5 to 2.65E-5, and 2 sets that met validation targets. The model produced well-fitting results within validation targets for HIV and HCV incidence and serious bacterial infection hospitalization rates. From 2015 to 2019, the model estimated 120,000 injection-related overdose deaths, 17,000 new HIV infections, and 144,000 new HCV infections among PWID.nnCONCLUSIONS: This multimorbidity microsimulation model, populated with data from national surveillance data and published literature, accurately replicated fatal opioid overdose, incidence of HIV and HCV, and serious bacterial infections hospitalization rates. The MYRIAD model of IDU could be an important tool to assess clinical and economic outcomes related to IDU behavior and infections with serious morbidity and mortality for PWID.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}