Publications

@article{Kongnakorn2004,

title = {Empirical {T}est and Validation of the Waiting {T}radeoff Method},

author = {T. Kongnakorn and J. Shannon Swan and F. Sainfort},

year  = {2004},

date = {2004-01-01},

journal = {Medical Decision Making (26th Annual Meeting SMDM Abstracts)},

volume = {25},

number = {1},

pages = {E34},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Walensky2004,

title = {A therapeutic HIV vaccine: how good is good enough?},

author = {R. P. Walensky and A. D. Paltiel and S. J. Goldie and R. T. Gandhi and M. C. Weinstein and G. R. Seage and H. E. Smith and H. Zhang and K. A. Freedberg},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15364455},

year  = {2004},

date = {2004-01-01},

urldate = {2004-01-01},

journal = {Vaccine},

volume = {22},

pages = {4044-53},

abstract = {The goal of a therapeutic HIV vaccine is to attenuate HIV disease 

	progression in those already infected. Our objective was to establish 

	comparative efficacy and cost-effectiveness thresholds at which a 

	therapeutic vaccine would make a valuable contribution to HIV care. 

	Using an HIV computer simulation model, we compared therapeutic vaccination 

	with HIV standard of care without vaccination. Input data were obtained 

	from the literature. Base case and sensitivity analyses related to 

	vaccine magnitude, penetrance, durability, and cost. In the base 

	case (0.5 log magnitude, 25% penetrance, 3-year durability, and US 

	4000 per series), vaccination increased quality-adjusted life expectancy 

	(QALE) by 0.50 months compared to no vaccination (cost-effectiveness 

	ratio US 89,900 per quality-adjusted life year (QALY)). Increasing 

	vaccine penetrance to 50% increased the projected QALE benefit to 

	0.91 months (cost-effectiveness ratio US 45,500/QALY). Even modestly 

	effective therapeutic HIV vaccines may produce small but meaningful 

	increases in life expectancy and compare favorably to alternative 

	uses of scarce HIV care resources.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wittram2004,

title = {Trends in thoracic radiology over a decade at a large academic medical center},

author = {C. Wittram and M. J. Meehan and Elkan F. Halpern and J. A. Shepard and T. C. McLoud and J. H. Thrall},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15273612},

year  = {2004},

date = {2004-01-01},

urldate = {2004-01-01},

journal = {J Thorac Imaging},

volume = {19},

pages = {164-70},

abstract = {OBJECTIVE: To investigate thoracic radiology usage over and above 

	the secular trends associated with hospital-wide changes in the number 

	of patients over a decade. MATERIALS AND METHODS: We retrospectively 

	reviewed administrative data from our 905-bed tertiary-care hospital 

	between January 1, 1992, to December 31, 2001. Three points of entry 

	to the radiology department were identified: inpatient (IP), outpatient 

	(OP), and the emergency room (ER). The total numbers of patients, 

	imaging studies, chest radiographs, chest CTs, CTs for pulmonary 

	embolism, pulmonary angiograms, ventilation/perfusion scintigrams 

	(V/Qs), lung biopsies, cardiac and chest MRIs, and FDG-PET scans 

	for lung nodules and masses were collected. The significance of trends 

	using linear regression analysis was evaluated. RESULTS: IP and OP numbers have significantly increased over a decade (P = 0.04 and P = 0.01 respectively); ER patient numbers have not. There has been 

	an increase in the ratio of chest radiographs per patient arising from the ER area (P = 0.0002). All 3 areas demonstrated an increase in the ratio of chest CTs per patient: IP (P = 0.0002), OP (P = textless0.0001), and ER (P = textless0.0001). IP and ER areas demonstrated an increase in the ratio of CTs for pulmonary embolism per patient (P = 0.00},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Neeser2004,

title = {Cost effectiveness of combination therapy with pioglitazone for type 

	2 diabetes mellitus from a german statutory healthcare perspective},

author = {K. Neeser and G. Lubben and Uwe Siebert and W. Schramm},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15061682},

issn = {1170-7690 (Print) 1170-7690 (Lin},

year  = {2004},

date = {2004-01-01},

journal = {PharmacoEconomics},

volume = {22},

number = {5},

pages = {321-41},

abstract = {BACKGROUND: Pioglitazone has been approved in Europe for oral combination 

	therapy for type 2 diabetes mellitus. Along with other agents of 

	the thiazolidinedione class, it has a novel intracellular mechanism 

	of action. Clinical trials with pioglitazone have confirmed a strong 

	product profile in terms of control of blood glucose and lipids. 

	However, the drug acquisition cost for pioglitazone is greater than 

	standard medications for type 2 diabetes. Long-term data regarding 

	the cost effectiveness of pioglitazone-based combination therapy 

	are not available. OBJECTIVE: To evaluate, using a decision analysis 

	model, the cost effectiveness of pioglitazone-based combination therapy 

	compared with relevant alternative medications for the treatment 

	of type 2 diabetes in Germany. METHODS: This study compared the clinical 

	effects and costs of pioglitazone 30 mg added to metformin in patients 

	who failed metformin monotherapy and pioglitazone added to a sulphonylurea 

	in patients who failed sulphonylurea monotherapy, with the most relevant 

	treatment alternatives. A published and validated Markov model was 

	adapted to reflect the management of type 2 diabetes. This simulated 

	the number of severe complications occurring and the mean life expectancy 

	of a diabetic cohort, which was based on the overweight group of 

	the UK Prospective Diabetes Study at year 6 of follow-up. Drug treatment 

	costs, other costs for general management of type 2 diabetes and 

	the costs of complications were combined to compute overall lifetime 

	treatment costs from the perspective of the German statutory healthcare 

	system in 2002. RESULTS: Combination therapy with pioglitazone/metformin 

	was associated with a higher life expectancy (15.2 years) relative 

	to sulphonylurea/metformin (14.9 years) or acarbose/metformin (14.7 

	years). Likewise, pioglitazone/sulphonylurea (15.5 years) was superior 

	to metformin/sulphonylurea (14.9 years) and acarbose/sulphonylurea 

	(14.8 years). Undiscounted incremental cost-effectiveness ratios 

	in comparison to the next best strategy were euro20,002 per life-year 

	gained (LYG) for pioglitazone/metformin versus sulphonylurea/metformin, 

	and euro8707 per LYG for pioglitazone/sulphonylurea versus metformin/sulphonylurea. 

	After discounting costs and life expectancy at 5% per year, the incremental 

	cost-effectiveness ratio was euro47 636 per LYG for pioglitazone/metformin 

	versus sulphonylurea/metformin, and euro19 745 per LYG for pioglitazone/sulphonylurea 

	versus metformin/sulphonylurea. CONCLUSIONS: In this model, with 

	its underlying assumptions and data, combination therapy with pioglitazone 

	increased life expectancy in overweight type 2 diabetes patients 

	at acceptable cost compared with other well established medications 

	in Germany. These findings should be re-evaluated as soon as additional 

	evidence becomes available from the currently ongoing long-term clinical 

	and economic studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rieber2004,

title = {Comparison of pressure measurement, dobutamine contrast stress echocardiography 

	and SPECT for the evaluation of intermediate coronary stenoses. {T}he 

	COMPRESS trial},

author = {J. Rieber and P. Jung and I. Erhard and A. Koenig and M. Hacker and T. M. Schiele and T. Segmiller and H. U. Stempfle and K. Theisen and Uwe Siebert and V. Klauss},

url = {http://www.ncbi.nlm.nih.gov/pubmed/16146908},

issn = {1462-8848 (Print) 1462-8848 (Lin},

year  = {2004},

date = {2004-01-01},

journal = {Int J Cardiovasc Intervent},

volume = {6},

number = {3-4},

pages = {142-7},

abstract = {BACKGROUND: DSE and SPECT are two well-established methods to non-invasively 

	investigate the functional significance of coronary artery stenoses 

	in patients with coronary artery disease. The measurement of Fractional 

	Flow Reserve has emerged a new invasive reference standard for lesion 

	specific quantification of coronary artery stenoses. The objective 

	of our prospective study was to compare sensitivity and specificity 

	of Dobutamine Stress Echocardiography (DSE) and Single Photon Emission 

	Computer tomography (SPECT) with the pressure derived Fractional 

	Flow Reserve (FFR) for the identification of hemodynamic relevant 

	coronary lesions in patients with predominately coronary multivessel 

	disease and angiographically intermediate stenoses. METHODS: Inclusion 

	criteria were a coronary lesion of 50-75% diameter stenosis by visual 

	assessment in patients with known or suspected CAD. SPECT, DSE and 

	FFR testing was performed within one week of coronary angiography. 

	RESULTS: The study comprised 48 consecutive symptomatic patients. 

	In 41 cases, a coronary multivessel disease was present. Mean FFR 

	was 0.80 +/- 0.13 (0.41-1.0). Overall sensitivity of DSE and SPECT 

	was 67% and 69% whereas specificity reached 77% and 87%. However, 

	sensitivity was significantly reduced if the target lesion was located 

	distally. DSE showed poor results if the lesions were located in 

	the circumflex artery or if a history of prior myocardial infarctions 

	was present. CONCLUSION: DSE and SPECT are both useful methods for 

	the non-invasive assessment of coronary artery disease. DSE showed 

	reasonable combination of sensitivity and specificity even in patients 

	with multivessel disease. Although use of noninvasive stress tests 

	is only limited in patients with prior myocardial infarctions and 

	invasive stress testing should be preferred in these patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rosen2004,

title = {Expect the unexpected: thoughts, insights and musing about research in radiology},

author = {M. P. Rosen and J. G. Jarvik and J. Shannon Swan},

url = {http://www.ncbi.nlm.nih.gov/pubmed/14974595},

year  = {2004},

date = {2004-01-01},

journal = {Acad Radiol},

volume = {11},

pages = {206--12},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kong2004,

title = {Polymer translocation through a nanopore. II. Excluded volume effect},

author = {Chung Yin Kong and M. Muthukumar},

url = {http://scitation.aip.org/content/aip/journal/jcp/120/7/10.1063/1.1642588},

year  = {2004},

date = {2004-01-01},

journal = {J. Chem Phys},

volume = {120},

number = {7},

pages = {3460-3466},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lee2004a,

title = {MRI before reexcision surgery in patients with breast cancer},

author = {Janie Lee and S. G. Orel and B. J. Czerniecki and L. J. Solin and M. D. Schnall},

url = {http://www.ncbi.nlm.nih.gov/pubmed/14736685},

year  = {2004},

date = {2004-01-01},

journal = {AJR Am J Roentgenol},

volume = {182},

pages = {473-80},

abstract = {OBJECTIVE: The aims of this study were to assess the diagnostic accuracy 

	of MRI in evaluating patients for residual cancer, identify the prevalence 

	of multicentric or multifocal disease, and evaluate the impact of 

	MRI on surgical treatment planning. SUBJECTS AND METHODS. Of 101 

	potentially eligible patients, 80 candidates for breast conservation 

	therapy who had primary breast cancer in 82 breasts diagnosed by 

	excisional biopsy with close or positive margins were included in 

	the study group. All patients underwent contrast-enhanced MRI before 

	further surgery and subsequently underwent either reexcision lumpectomy 

	or mastectomy with histopathologic correlation. RESULTS: Residual 

	carcinoma, either invasive or in situ, was present in 59.8% of the 

	breasts. The sensitivity and specificity of MRI for detecting residual 

	disease were 61.2% and 69.7 respectively. Twenty-three additional 

	lesions distant from the biopsy site were identified in 19 breasts, 

	and 18 suspicious lesions underwent biopsy. Histology results indicated 

	that six lesions were malignant, so the overall prevalence was 7.3 

	The positive predictive value of identifying an additional suspicious 

	lesion was 33.3 In 24 breasts, MRI changed which procedure would be performed next from reexcision lumpectomy to mastectomy (n = 9), biopsy of an additional lesion in the ipsilateral (n = 12) or contralateral (n = 2) breast, or neoadjuvant chemotherapy (n = 1). Approximately 

	25% of the breasts underwent mastectomy as definitive surgical treatment. 

	CONCLUSION: Overlap in the appearances of benign and malignant lesions 

	limits MRI evaluation for residual disease. MRI can show additional 

	suspicious lesions that are likely to be multicentric or multifocal 

	disease. These findings changed the original treatment plan for approximately 

	30% of breasts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Esserman2004,

title = {Applying the neoadjuvant paradigm to ductal carcinoma in situ},

author = {L. Esserman and K. Sepucha and Elissa Ozanne and E. S. Hwang},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15015707},

issn = {1068-9265 (Print) 1068-9265 (Lin},

year  = {2004},

date = {2004-01-01},

urldate = {2004-01-01},

journal = {Ann Surg Oncol},

volume = {11},

number = {1 Suppl},

pages = {28S-36S},

abstract = {Local treatment options for ductal carcinoma in situ (DCIS) are virtually 

	identical to those for early invasive breast cancer, despite the 

	fact that the survival from this condition is much higher. Our ability 

	to more appropriately tailor therapy for DCIS is hampered by a lack 

	of understanding of the natural history of DCIS, our limited ability 

	to predict the rate of progression to invasive cancer and the response 

	to therapy, and the absence of tools to follow patients who have 

	not had invasive treatments. Neoadjuvant therapy, which has been 

	proven to be both safe and effective in tailoring treatments for 

	invasive cancer, could be ideally suited to DCIS. However, neoadjuvant 

	therapy requires that doctors and patients delay surgical treatment 

	that has known benefits. In order to successfully introduce this 

	approach into clinical practice, risk assessment and decision support 

	tools will be needed to help physicians and patients feel comfortable 

	that they are not being exposed to unnecessary or excessive risk. 

	In addition, we need better imaging to track extent and progression 

	of disease. Among the possible benefits of the neoadjuvant approach, 

	we may discover that many lesions are responsive and some even reversible, 

	leaving us with treatments that might be tailored to biology and 

	with important clues for breast cancer prevention in high-risk women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Gazelle2004,

title = {Metastatic colorectal carcinoma: cost-effectiveness of percutaneous 

	radiofrequency ablation versus that of hepatic resection},

author = {G. Scott Gazelle and Pamela M. McMahon and M. T. Beinfeld and Elkan F. Halpern and M. C. Weinstein},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15564408},

year  = {2004},

date = {2004-01-01},

journal = {Radiology},

volume = {233},

pages = {729-39},

abstract = {PURPOSE: To evaluate the relative cost-effectiveness of radiofrequency 

	(RF) ablation and hepatic resection in patients with metachronous 

	liver metastases from colorectal carcinoma (CRC) and compare the 

	outcomes, cost, and cost-effectiveness of a variety of treatment 

	and follow-up strategies. MATERIALS AND METHODS: A state-transition 

	decision model for evaluating the (societal) cost-effectiveness of 

	RF ablation and hepatic resection in patients with CRC liver metastases 

	was developed. The model tracks the presence, number, size, location, 

	growth, detection, and removal of up to 15 individual metastases 

	in each patient. Survival, quality of life, and cost are predicted 

	on the basis of disease extent. Imaging, ablation, and resection 

	affect outcomes through detection and elimination of individual metastases. 

	Several patient care strategies were developed and compared on the 

	basis of cost, effectiveness, and incremental cost-effectiveness 

	(expressed as dollars per quality-adjusted life-year [QALY]). Extensive 

	sensitivity analysis was performed to evaluate the impact of alternative 

	scenarios and assumptions on results. RESULTS: A strategy permitting 

	ablation of up to five metastases with computed tomographic (CT) 

	follow-up every 4 months resulted in a gain of 0.65 QALYs relative 

	to a no-treat strategy, at an incremental cost of 2400 per QALY. 

	Compared with this ablation strategy, a strategy permitting resection 

	of up to four metastases, one repeat resection, and CT follow-up 

	every 6 months resulted in an additional gain of 0.76 QALYs at an 

	incremental cost of 24 300 per QALY. Across a range of model assumptions, 

	more aggressive treatment strategies (ie, ablation or resection of 

	more metastases, treatment of recurrent metastases, more frequent 

	follow-up imaging) were superior to less aggressive strategies and 

	had incremental cost-effectiveness ratios of less than 35 000 per 

	QALY. Findings were insensitive to changes in most model parameters; 

	however, results were somewhat sensitive to changes in size thresholds 

	for RF ablation, the number of metastases present, and surgery and 

	treatment costs. CONCLUSION: RF ablation is a cost-effective treatment 

	option for patients with CRC liver metastases. However, in most scenarios, 

	hepatic resection is more effective (in terms of QALYs gained) than 

	RF ablation and has an incremental cost-effectiveness ratio of less 

	than 35 000 per QALY.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kalra2004,

title = {Radiation from "extra" images acquired with abdominal and/or pelvic 

	CT: effect of automatic tube current modulation},

author = {M. K. Kalra and M. M. Maher and T. L. Toth and R. S. Kamath and Elkan F. Halpern and S. Saini},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15286312},

year  = {2004},

date = {2004-01-01},

journal = {Radiology},

volume = {232},

pages = {409-14},

abstract = {PURPOSE: To retrospectively determine the number and usefulness of 

	images acquired beyond the intended anatomic area of interest with 

	abdominal and/or pelvic computed tomography (CT) and to assess the 

	effect of automatic tube current modulation (ATCM) on associated 

	radiation. MATERIALS AND METHODS: Superior and inferior levels at 

	routine abdominal and/or pelvic CT were defined as the dome of the 

	diaphragm and the inferior margin of the pubic symphysis, respectively. 

	Records of 106 consecutive examinations (male-to-female ratio, 45:61; 

	age range, 21-86 years) performed from June 1 to June 30, 2003, were 

	reviewed to determine the number of "extra" images. Sixty-two abdominal 

	and/or pelvic CT examinations performed concurrently with chest or 

	thigh CT or for trauma were not included in the 106. Abdominal and/or pelvic CT was performed with either ATCM (n = 44) or manual selection of tube current (n = 62). CT parameters recorded for each extra image 

	included tube current, peak kilovoltage, and gantry rotation time. 

	Mean and median tube current-time products were calculated for extra 

	images. Extra images were analyzed for pathologic findings. Statistical 

	analysis was performed with the Student t test. RESULTS: Extra images 

	were acquired above the dome of the diaphragm in 103 (97 of 106 examinations 

	and below the pubic symphysis in 100 (94 of 106. A total of 1,280 

	extra images were acquired in 106 examinations (mean, 12 images per 

	examination). Nineteen additional findings were observed on extra 

	images. With ATCM, mean tube current-time product was 74.5 and 120.6 

	mAs for extra images acquired above the diaphragm and below the pubic 

	symphysis, respectively; with manual selection, mean tube current-time 

	products were 167.5 and 168.3 mAs (P textless.05). CONCLUSION: Most 

	extra images acquired at abdominal and/or pelvic CT contributed no 

	additional information. With ATCM, the radiation dose was reduced 

	by a mean of 56% (median, 72 for extra images above the diaphragm 

	and 29% (median, 36 for images below the pubic symphysis, compared 

	with dose levels with manual selection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Angermann2004,

title = {Reduction of cyclosporine after introduction of mycophenolate mofetil 

	improves chronic renal dysfunction in heart transplant recipients--the 

	IMPROVED multi-centre study},

author = {C. E. Angermann and S. Stork and A. Costard-Jackle and T. J. Dengler and Uwe Siebert and G. Tenderich and A. Rahmel and E. R. Schwarz and H. Nagele and F. M. Wagner and B. Haaff and K. Pethig},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15351162},

year  = {2004},

date = {2004-01-01},

journal = {Eur Heart J},

volume = {25},

pages = {1626-34},

abstract = {AIMS: This comparative prospective multi-centre study evaluated efficacy 

	and safety of cyclosporine A downtitration in heart transplant recipients 

	with chronic renal dysfunction potentially attributable to cyclosporine (n=161). METHODS: In the intervention arm (n=109, recruited from 

	9 centres), mycophenolate mofetil was introduced de novo or substituting 

	azathioprine, followed by cyclosporine reduction (target trough levels 2-4 microg/ml and 50 ng/ml, respectively). In controls (n=52, recruited 

	from 1 centre), immunosuppression remained unchanged. Renal function 

	was recorded twelve, six, and three months before, and throughout 

	the eight-month study period. RESULTS: At study entry, cyclosporine 

	trough levels and renal function parameters were comparable. At study 

	end, mean+/-SD cyclosporine in the intervention arm was 57+/-24 vs. 

	116+/-36 ng/ml in controls. During the study, creatinine decreased 

	by 23.3+/-50.7 micromol/l (Ptextless0.0001) in the intervention arm but increased by 7.3+/-46.9 micromol/l (P=0.992) in controls (P=0.0001 

	for comparison between groups). A creatinine reduction of at least 

	20% was found in 35% of subjects of the intervention arm but only 

	in 4% in the control arm (Ptextless0.0001 for comparison between 

	groups). Improvement in renal function was not weakened after adjustment 

	for baseline characteristics in multiple regression analysis. Renal 

	function improved in strata of creatinine entry values from 150 to 

	310 micromol/l, regardless of the presence of diabetes. Myocardial 

	biopsies at target levels for cyclosporine and mycophenolate mofetil 

	showed three reversible subclinical rejection episodes. CONCLUSIONS: 

	Cyclosporine downtitration improved renal dysfunction in diabetic 

	and non-diabetic heart transplant recipients across a wide range 

	of creatinine levels. The long-term benefit of this strategy deserves 

	further study.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Beinfeld2004,

title = {Cost-effectiveness of uterine artery embolization and hysterectomy 

	for uterine fibroids},

author = {M. T. Beinfeld and Johanna Bosch and K. B. Isaacson and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/14695395},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2004},

date = {2004-01-01},

journal = {Radiology},

volume = {230},

number = {1},

pages = {207-13},

abstract = {PURPOSE: To compare the cost-effectiveness of uterine artery embolization 

	(UAE) with that of hysterectomy for women with symptomatic uterine 

	fibroids. MATERIALS AND METHODS: The authors developed a decision 

	model to compare the costs and effectiveness of UAE and hysterectomy. 

	In the model, a cohort of women aged 40 years with a diagnosis of 

	uterine fibroids and no desire for future pregnancy was followed 

	up until menopause. The analysis was performed from a societal perspective, 

	including all costs and effects, regardless of who incurs them. Transition 

	probability and quality-of-life estimates were obtained from the 

	literature and a gynecologist, whereas costs (in 1999 U.S. dollars) 

	were estimated by using rates of Medicare reimbursement for hospital 

	costs and physician fees. Sensitivity analyses of key estimates were 

	performed. Results were expressed in costs per quality-adjusted life-year 

	(QALY). RESULTS: UAE was more effective (8.29 vs 8.18 QALYs) and 

	less expensive (US dollars 6916 vs US dollars 7847) than hysterectomy. 

	Cost-effectiveness results, with the exception of quality-of-life 

	data, were robust to changes in most model assumptions. When the 

	quality-of-life adjustment was eliminated, the two procedures were 

	equally effective. CONCLUSION: UAE is a cost-effective alternative 

	to hysterectomy across a wide range of assumptions about the costs 

	and effectiveness of the two procedures. However, the study results 

	were sensitive to changes in quality-of-life values.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Blanchard2004,

title = {Mammographic screening: patterns of use and estimated impact on breast 

	carcinoma survival},

author = {K. Blanchard and J. A. Colbert and D. Puri and J. Weissman and B. Moy and D. B. Kopans and E. M. Kaine and R. H. Moore and Elkan F. Halpern and K. S. Hughes and K. K. Tanabe and B. L. Smith and J. S. Michaelson},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15274062},

year  = {2004},

date = {2004-01-01},

journal = {Cancer},

volume = {101},

pages = {495-507},

abstract = {BACKGROUND: Although many studies support the life-saving potential 

	of screening mammography, the actual utilization of screening and 

	the impact of the actual pattern of screening use on the breast carcinoma 

	death rate, remain incompletely understood. In the current report, 

	the authors describe patterns of screening use among women who were 

	examined at a large screening and diagnostic service and estimate 

	the added mortality associated with missed screening mammograms. 

	METHODS: Mammography use was assessed in a population of 72,417 women 

	who received a total of 254,818 screening mammograms at the Massachusetts 

	General Hospital (MGH) Avon Comprehensive Breast Center (Boston, 

	MA) between January 1, 1985, and February 19, 2002. A computer simulation 

	of breast carcinoma growth, spread, and detection of breast carcinoma 

	was used to estimate the likely health consequences of various types 

	of screening use. RESULTS: Both prompt return for annual screening 

	and full use of screening over extended periods of time were rare, 

	and comparison of the MGH population with other populations revealed 

	that the low level of use observed in the MGH population was not 

	atypical. Only 6% of women who received a mammogram in 1992 received 

	all annual mammograms that were available over the next 10 years; 

	the mean number of mammograms received during this period was 5.06, 

	or 51% of the number recommended by the American Cancer Society. 

	Computer simulation results indicate that this underutilization of 

	screening should result in higher mortality levels. Women from traditionally 

	underserved socioeconomic, racial, and ethnic groups, women without 

	insurance, and women who did not speak English had lower levels of 

	use compared with other women. Lower levels of use also were observed 

	among women receiving their first mammogram or who in the past had 

	not returned promptly. Women ages 55-65 years had higher levels of 

	use than did younger or older women. Women who previously had breast 

	carcinoma also had higher levels of screening use. Nonetheless, none 

	of the subpopulations of women stratified by age, race, ethnicity, 

	zip code, income,language, insurance, status, previous screening 

	use, or medical history exhibited a widespread propensity to promptly 

	return for annual screening over an extended period of time. CONCLUSIONS: 

	By many measures, the current analysis is one of the most detailed 

	descriptions of screening use to date. The authors observed a level 

	of screening use that was disappointingly low, with potentially negative 

	health-related consequences, among women across categories defined 

	by racial, ethnic, socioeconomic, and geographic characteristics; 

	insurance status; language; age; medical history; and previous screening 

	use. Improvements in the promptness with which women return to screening 

	appear to have the potential to lead to considerable reductions in 

	breast carcinoma death.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Dodel2004,

title = {Resource utilization and costs of stroke unit care in Germany},

author = {R. C. Dodel and C. Haacke and K. Zamzow and S. Paweilik and A. Spottke and M. Rethfeldt and Uwe Siebert and W. H. Oertel and O. Schoffski and T. Back},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15164804},

issn = {1098-3015 (Print) 1098-3015 (Lin},

year  = {2004},

date = {2004-00-01},

journal = {Value Health},

volume = {7},

number = {2},

pages = {144-52},

abstract = {OBJECTIVES: Stroke imposes a considerable economic burden on the individual 

	and society. Recently, the concept of an integrated stroke unit has 

	been established in several countries to improve the outcome of patients. 

	This study evaluates the costs of acute care of the different cerebrovascular 

	insults in a stroke unit. METHODS: The study population included 

	340 patients who were consecutively admitted to the Department of 

	Neurology, Philipps University Marburg, with the diagnosis of stroke 

	or transient ischemic attack (TIA) between January 1 and June 30, 

	2000. Clinical status and course were evaluated by using the Barthel 

	index and the modified Rankin scale. Employing a "bottom-up" approach, 

	we calculated the costs from the perspective of the hospital and 

	the third-party payer using data from provider departments and other 

	published sources. RESULTS: Inpatient costs were 3020 euros (3290 

	US dollars) for TIA, 3480 euros (3790 US dollars) for ischemic stroke 

	(IS), and 5080 euros (5540 US dollars) for intracerebral hemorrhage 

	(ICH) and differed significantly among these subgroups (P \< .05). 

	Patient subgroups ranked in the same order for average length of 

	stay at 9.4 days for TIA, 10.2 days for IS, and 11.9 days for ICH 

	(P \> .05). Approximately 30% of the hospital costs are due to physician 

	charges and care. Imaging amounted to 10% and lab investigations 

	to 14% of total costs, independent of the diagnosis. Postacute treatment, 

	including inpatient rehabilitation, cost 9880 euros per patient. 

	Across all diagnostic groups, a mean clinical improvement was observed 

	at time of discharge. CONCLUSIONS: Care of patients with cerebrovascular 

	events in a stroke unit causes a high demand of resources and has 

	a considerable impact on health-care expenditure. Therefore, investigations 

	comparing the stroke unit concept with other strategies in stroke 

	care are necessary to evaluate the stroke unit concept for a rational 

	use of available resources in patients with cerebrovascular events.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Murray2004,

title = {Direct-to-consumer advertising: public perceptions of its effects on health behaviors, health care, and the doctor-patient relationship},

author = {E. Murray and B. Lo and L. Pollack and Karen Donelan and K. Lee},

url = {http://www.ncbi.nlm.nih.gov/pubmed/15014047},

issn = {0893-8652 (Print) 0893-8652 (Lin},

year  = {2004},

date = {2004-00-01},

urldate = {2004-00-01},

journal = {J Am Board Fam Pract},

volume = {17},

number = {1},

pages = {6-18},

abstract = {Purpose: To determine public perceptions of the effect of direct-to-consumer 

	advertising (DTCA) of prescription medications on health behaviors, 

	health care utilization, the doctor-patient relationship, and the 

	association between socioeconomic status and these effects. METHODS: 

	Cross-sectional survey of randomly selected, nationally representative 

	sample of the US public using computer-assisted telephone interviewing. 

	Main outcome measures: numbers and proportions of respondents in 

	the past 12 months who, as a result of DTCA, requested preventive 

	care or scheduled a physician visit; were diagnosed with condition 

	mentioned in advertisement; disclosed health concerns to a doctor; 

	felt enhanced confidence or sense of control; perceived an effect 

	on the doctor-patient relationship; requested a test, medication 

	change, or specialist referral; or manifested serious dissatisfaction 

	after a visit to a doctor. RESULTS: As a result of DTCA, 14% of respondents 

	disclosed health concerns to a physician, 6% requested preventive 

	care, 5% felt more in control during a physician visit; 5% made requests 

	for a test, medication change, or specialist referral, and 3% received 

	the requested intervention. One percent of patients reported negative 

	outcomes, including worsened treatment, serious dissatisfaction with 

	the visit, or that the physician acted challenged. Effects of DTCA 

	were greater for respondents with low socioeconomic status. CONCLUSIONS: 

	DTCA has positive and negative effects on health behaviors, health 

	service utilization, and the doctor-patient relationship that are 

	greatest on people of low socioeconomic status. The benefits of DTCA 

	in terms of encouraging hard-to-reach sections of the population 

	to seek preventive care must be balanced against increased health 

	care costs caused by clinically inappropriate requests generated 

	by DTCA.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wu2003,

title = {Proton high-resolution magic angle spinning NMR analysis of fresh 

	and previously frozen tissue of human prostate},

author = {C. L. Wu and J. L. Taylor and W. He and A. G. Zepeda and Elkan F. Halpern and A. Bielecki and R. G. Gonzalez and L. L. Cheng},

url = {http://www.ncbi.nlm.nih.gov/pubmed/14648580},

issn = {0740-3194 (Print) 0740-3194 (Lin},

year  = {2003},

date = {2003-12-01},

journal = {Magn Reson Med},

volume = {50},

number = {6},

pages = {1307-11},

abstract = {The previously observed improvement in spectral resolution of tissue 

	proton NMR with high-resolution magic angle spinning (HRMAS) was 

	speculated to be due largely to freeze-thawing artifacts resulting 

	from tissue storage. In this study, 12 human prostate samples were 

	analyzed on a 14.1T spectrometer at 3 degrees C, with HRMAS rates 

	of 600 and 700 Hz. These samples were measured fresh and after they 

	were frozen for 12-16 hr prior to thawing. The spectral linewidths 

	measured from fresh and previously frozen samples were identical 

	for all metabolites except citrate and acetate. The metabolite intensities 

	of fresh and freeze-thawed samples depend on the quantification procedures 

	used; however, in this experiment the differences of means were \<30%. 

	As expected, it was found that tissue storage impacts tissue quality 

	for pathological analysis, and HRMAS conditions alone are not sufficiently 

	destructive to impair pathological evaluation. Furthermore, although 

	storage conditions affect absolute metabolite concentrations in NMR 

	analysis, relative metabolite concentrations are less affected.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Dodel2003,

title = {Dopamine transporter imaging and SPECT in diagnostic work-up of Parkinson's disease: a decision-analytic approach},

author = {R. C. Dodel and H. Hoffken and J. C. Moller and B. Bornschein and T. Klockgether and T. Behr and W. H. Oertel and Uwe Siebert},

url = {http://www.ncbi.nlm.nih.gov/pubmed/14531047},

issn = {0885-3185 (Print) 0885-3185 (Lin},

year  = {2003},

date = {2003-10-01},

urldate = {2003-10-01},

journal = {Mov Disord},

volume = {18 Suppl 7},

pages = {S52-62},

abstract = {As a diagnostic test for patients with suspected Parkinson's disease 

	(PD), single photon emission computed tomography (SPECT) using [(123)I]FP-CIT 

	tracer has better sensitivity but is more expensive than regular 

	clinical examination (CE). Our objective was to evaluate the clinical 

	and economic impacts of different diagnostic strategies involving 

	[(123)I]FP-CIT SPECT. We developed a decision tree model to predict 

	adequate treatment-month equivalents (ATME), costs, and incremental 

	cost-effectiveness ratio (ICER) during a 12-month time horizon in 

	patients with suspected PD referred to a specialized movement disorder 

	outpatient clinic. In our cost- effectiveness analysis, we adopted 

	the perspective of the German health care system and used data from a German prospective health care utilization study (n = 142) and 

	published diagnostic studies. Compared strategies were CE only (EXAM+), 

	SPECT only (SPECT+), SPECT following negative CE (SINGLE+), and SPECT 

	following positive CE (DOUBLE+). Costs of SPECT amounted to euro;789 

	per investigation. Based on our model, expected costs (and ATME) 

	were euro;946 (52.85 ATME) for EXAM+, euro;1352 (53.40 ATME) for 

	DOUBLE+, euro;1731 (32.82 ATME) for SINGLE+, and euro;2003 (32.96 

	ATME) for SPECT+; performance of SPECT was induced in 0%, 54%, 56%, 

	and 100% of the patients, respectively. DOUBLE+ was more effective 

	and less expensive than SINGLE+ or SPECT+; thus these two do not 

	offer reasonable choices. The ICER of DOUBLE+ compared to EXAM+ was 

	euro;733 per ATME gained. In sensitivity analyses, the ICER of DOUBLE+ 

	versus EXAM+ ranged from euro;63 to euro;2411 per ATME gained. Whether 

	the diagnostic work-up of patients referred to a specialized movement 

	disorder clinic with a high prevalence of PD should include [(123)I]FP-CIT 

	SPECT depends on patient preferences and the decision maker's willingness 

	to pay for adequate early treatment. SPECT should be used as a confirmatory 

	test before treatment initiation and limited to patients with a positive 

	test result in the clinical examination. These results should be 

	adjusted to the specific setting and individual patient preferences.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Stahl2003a,

title = {Stroke: Effect of implementing an evaluation and treatment protocol 

	compliant with NINDS recommendations},

author = {James Stahl and K. L. Furie and S. Gleason and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12954888},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-09-01},

journal = {Radiology},

volume = {228},

number = {3},

pages = {659-68},

abstract = {PURPOSE: To evaluate--relative to routine clinical practice--the potential 

	cost-effectiveness of implementing a strategy compliant with National 

	Institute of Neurological Disorders and Stroke (NINDS) recommendations 

	for care of patients presenting with signs and symptoms of acute 

	ischemic stroke. MATERIALS AND METHODS: A discrete-event simulation 

	model of the process of stroke care from symptom onset through administration 

	of tissue plasminogen activator (tPA) was constructed. A literature 

	review was performed to determine process times, performance of computed 

	tomography (CT), health outcomes, and cost estimates. The following 

	were compared: (a) a "base-case" strategy determined on the basis 

	of findings in the literature and (b) a NINDS-compliant strategy 

	(ie, evaluation by emergency physician in less than 10 minutes, interpretation 

	of CT scans within 45 minutes, and administration of tPA within 1 

	hour after presentation). Strategies were compared with regard to 

	cost and effectiveness. Sensitivity analyses were performed for all 

	relevant cost, timing, and resource parameters. Outcomes of concern 

	were quality-adjusted life years and number of patients treated within 

	a 3-hour therapeutic window. RESULTS: The NINDS-compliant strategy 

	resulted in an average quality-adjusted life years value of 3.64, 

	versus 3.63 for the base case, at an approximate cost of 434 US dollars 

	per patient. The NINDS-compliant strategy increased the proportion 

	of treatable patients from 1.4% to 3.7% and remained cost-effective 

	for expenditures of up to 450 US dollars per patient. Assuming base-case 

	parameters are used, increasing the number of CT scanners from two 

	to eight raised the proportion of treatable patients to 1.5%. Increasing 

	the number of available neurologists from four to eight raised the 

	proportion to 1.44%. Reducing the time from stroke onset to emergency 

	department arrival by 30 minutes raised the proportion to up to 7.7%. 

	CONCLUSION: Applying NINDS recommendations is potentially cost-effective, 

	although reducing the time from stroke onset to emergency department 

	arrival may be even more so.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Smala2003,

title = {Cabergoline versus levodopa monotherapy: a decision analysis},

author = {A. M. Smala and E. A. Spottke and O. Machat and Uwe Siebert and D. Meyer and R. Kohne-Volland and M. Reuther and J. DuChane and W. H. Oertel and K. B. Berger and R. C. Dodel},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12889079},

issn = {0885-3185 (Print) 0885-3185 (Lin},

year  = {2003},

date = {2003-08-01},

journal = {Mov Disord},

volume = {18},

number = {8},

pages = {898-905},

abstract = {We evaluated the incremental cost-effectiveness of cabergoline compared 

	with levodopa monotherapy in patients with early Parkinson's disease 

	(PD) in the German healthcare system. The study design was based 

	on cost-effectiveness analysis using a Markov model with a 10-year 

	time horizon. Model input data was based on a clinical trial "Early 

	Treatment of PD with Cabergoline" as well as on cost data of a German 

	hospital/office-based PD network. Direct and indirect medical and 

	nonmedical costs were included. Outcomes were costs, disease stage, 

	cumulative complication incidence, and mortality. An annual discount 

	rate of 5% was applied and the societal perspective was chosen. The 

	target population included patients in Hoehn and Yahr Stages I to 

	III. It was found that the occurrence of motor complications was 

	significantly lower in patients on cabergoline monotherapy. For patients aged \>/=60 years of age, cabergoline monotherapy was cost effective 

	when considering costs per decreased UPDRS score. Each point decrease 

	in the UPDRS (I-IV) resulted in costs of euro;1,031. Incremental 

	costs per additional motor complication-free patient were euro;104,400 for patients \<60 years of age and euro;57,900 for patients \>/=60 

	years of age. In conclusion, this decision-analytic model calculation 

	for PD was based almost entirely on clinical and observed data with 

	a limited number of assumptions. Although costs were higher in patients 

	on cabergoline, the corresponding cost-effectiveness ratio for cabergoline 

	was at least as favourable as the ratios for many commonly accepted 

	therapies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lee2003,

title = {Celiac artery compression by the median arcuate ligament: a pitfall 

	of end-expiratory MR imaging},

author = {V. S. Lee and J. N. Morgan and A. G. Tan and Pari Pandharipande and G. A. Krinsky and J. A. Barker and C. Lo and J. C. Weinreb},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12893901},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-08-01},

journal = {Radiology},

volume = {228},

number = {2},

pages = {437-42},

abstract = {PURPOSE: To measure the prevalence and degree of celiac artery compression 

	during breath-hold imaging at end inspiration and end expiration 

	in patients referred to undergo magnetic resonance (MR) imaging of 

	the abdomen for reasons unrelated to intestinal ischemia. MATERIALS 

	AND METHODS: A series of 100 patients underwent routine MR imaging 

	of the upper abdomen at 1.5 T; imaging included multiple dynamic 

	contrast-enhanced fat-suppressed transverse three-dimensional spoiled 

	gradient-echo acquisitions (3.6-4.5/1.5-1.9 [repetition time msec/echo 

	time msec], 12 degrees flip angle). Arterial phase acquisitions were obtained during suspended respiration at end expiration (n = 50) or at end inspiration (n = 50), and venous phase acquisitions were 

	obtained at the opposite respiratory phase. Two radiologists, blinded 

	to patient identity and the phase of respiration, independently assessed 

	the degree of narrowing on reconstructed oblique sagittal images. 

	Radiologists reached consensus in 97 patients, who formed the cohort 

	for this study. The percentage of stenosis of the celiac artery relative 

	to its origin and the angle formed by the proximal celiac artery 

	and the aorta were also measured in all patients. This angle and 

	the arcsine transformation of the percentage of stenosis were compared 

	for the two respiratory phases by using a paired Student t test. 

	chi2 analysis was used to evaluate whether the degree of narrowing 

	was independent of the breath-hold protocol that was used. RESULTS: 

	In total, 55 (57%) of 97 patients had at least mild artery narrowing 

	at end expiration, of whom 40 (73%) had less narrowing at end inspiration 

	and 11 (20%) had no change. The average percentage of stenosis at 

	end expiration (21% +/- 16) was significantly higher than that at 

	end inspiration (11% +/- 11; P \<.001). At end expiration, the average 

	celiac artery angle was significantly lower in patients with mild 

	to severe narrowing (41 degrees +/- 19) than in those without narrowing 

	(50 degrees +/- 19; P \<.03). CONCLUSION: Accentuation of celiac artery 

	compression at end expiration can give rise to a potential pitfall 

	of breath-hold abdominal imaging. When compression is suspected, 

	imaging should be performed during inspiration.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{McMahon2003,

title = {Cost-effectiveness of PET in the diagnosis of Alzheimer disease},

author = {Pamela M. McMahon and S. S. Araki and E. A. Sandberg and P. J. Neumann and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12802006},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-08-01},

journal = {Radiology},

volume = {228},

number = {2},

pages = {515-22},

abstract = {PURPOSE: To evaluate the cost-effectiveness of positron emission tomography 

	(PET) in the diagnosis of Alzheimer disease (AD) in community-dwelling 

	patients with mild or moderate dementia who present to specialized 

	AD centers. MATERIALS AND METHODS: A decision-analytic model was 

	used to compare costs and quality-adjusted life years (QALYs) associated 

	with strategies involving single photon emission computed tomography 

	(SPECT), dynamic susceptibility-weighted contrast material-enhanced 

	magnetic resonance (MR) imaging, and PET as functional imaging adjuncts 

	to the standard clinical work-up. Sensitivity analyses were performed 

	to examine changes in test characteristics, health-related quality-of-life 

	survey instruments, therapeutic effectiveness, and treatment rules. 

	RESULTS: The use of PET to confirm the results of the standard clinical 

	work-up cost more but yielded fewer benefits than a strategy in which 

	dynamic susceptibility-weighted contrast-enhanced MR imaging was 

	substituted for the typically performed structural computed tomography. 

	This relationship remained stable in scenarios in which standard 

	diagnostic work-up accuracy, drug treatment effectiveness, and version 

	of the Health Utilities Index were altered. Dynamic susceptibility-weighted 

	contrast-enhanced MR imaging cost US dollars 598800 per QALY gained 

	(range, US dollars 74400 to US dollars 1.9 million per QALY), compared 

	with the cost of the standard diagnostic work-up. Treating all patients 

	with dementia was the dominant imaging strategy, except when side 

	effects in patients with non-AD-related dementia were modeled. In 

	all scenarios, SPECT yielded fewer benefits than other strategies 

	at a higher cost. CONCLUSION: PET may have high diagnostic accuracy, 

	but adding it to the standard diagnostic regimen at AD clinics would 

	yield limited, if any, benefits at very high costs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Gazelle2003,

title = {Assessment and validation of imaging methods and technologies},

author = {G. Scott Gazelle and S. E. Seltzer and P. F. Judy},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12945926},

issn = {1076-6332 (Print) 1076-6332 (Lin},

year  = {2003},

date = {2003-08-01},

urldate = {2003-08-01},

journal = {Acad Radiol},

volume = {10},

number = {8},

pages = {894-6},

abstract = {In summary, the group identified many challenges and opportunities 

	facing those wishing to conduct rigorous assessment and validation 

	of imaging technologies. Specific needs and recommendations were 

	outlined by the group. Overall, it was felt that the field has made 

	great progress in the past several years, and that the future is 

	promising.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Casella2003,

title = {A randomized comparison of 4 doses of intracoronary adenosine in the assessment of fractional flow reserve},

author = {G. Casella and J. Rieber and T. M. Schiele and H. U. Stempfle and Uwe Siebert and M. Leibig and K. Theisen and U. Buchmeier and V. Klauss},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12955409},

issn = {0300-5860 (Print) 0300-5860 (Lin},

year  = {2003},

date = {2003-08-01},

urldate = {2003-08-01},

journal = {Z Kardiol},

volume = {92},

number = {8},

pages = {627-32},

abstract = {BACKGROUND: Fractional flow reserve (FFR) is a measure of coronary 

	stenosis severity that is based on pressure measurements obtained 

	at maximal hyperemia. Therefore, achievement of maximal vasodilatation 

	of the coronary microcirculation is a prerequisite for the measurement 

	of FFR. The study was designed to address the hypothesis that intracoronary 

	adenosine yields more complete vasodilatation of the coronary microcirculation 

	when high doses are used, resulting in a more accurate FFR measurement. 

	METHODS: Thirty-six patients with 43 moderate lesions underwent determination 

	of FFR during cardiac catheterization. FFR was calculated in all 

	lesions as the ratio of the distal coronary pressure to the aortic 

	pressure at hyperemia. Different incremental doses of intracoronary 

	adenosine (16, 24, 32 and 40 microg for both coronary arteries) were 

	administered in a randomized fashion. RESULTS: No adverse events 

	occurred with any intracoronary adenosine bolus. At baseline there 

	were no significant differences for mean aortic and distal coronary 

	pressure, heart rate as well as FFR values between the different 

	doses. FFR was not significantly altered from the different incremental 

	adenosine doses. However, in 27 (63%) out of 43 lesions there was 

	a further reduction of FFR up to 0.23 when a dose \>16 microg was 

	injected. CONCLUSIONS: This study suggests that doses of adenosine 

	up to 40 microg are safe and can be used to achieve a more pronounced 

	vasodilatation in individual patients compared to the standard doses. 

	This may have therapeutic impact with FFR values near cut-off points 

	in patients undergoing diagnostic coronary angiography as well as 

	in patients in whom FFR is used to assess the outcome of interventions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Carmen2003,

title = {Racial differences in mammographic breast density.},

author = {Marcela G. Carmen and Kevin S. Hughes and Elkan Halpern and Elizabeth Rafferty and Daniel Kopans and Yuri R. Parisky and Armando Sardi and Lisa Esserman and Steven Rust and James Michaelson},

url = {https://pubmed.ncbi.nlm.nih.gov/12879477/},

doi = {10.1002/cncr.11517},

issn = {0008-543X},

year  = {2003},

date = {2003-08-01},

journal = {Cancer},

volume = {98},

pages = {590--596},

abstract = {African American women have a lower incidence but a higher mortality from breast carcinoma than Caucasians. A proposed explanation for this discrepancy is the decreased efficacy of screening among African American women. Increased breast density in African American women may result in decreased sensitivity of mammography. The purpose of this article is to determine whether there is a difference in mammographic breast density between African American and Caucasian women. A series of 769 women were recruited from 5 sites. Mammograms were reviewed centrally by seven reviewers using Breast Imaging Reporting and Data System categories converted to numeric values. The mean mammographic densities for Caucasian, African American, and Latina patients were compared using a two-way analysis of covariance. The mean values for each race were estimated adjusting for the reader as well as for each patient's age and body mass index (BMI). African American women had the lowest mean breast density. The reported density in this group was 2.43, compared with 2.69 among Caucasians and 2.65 among Latina patients. After adjusting for age and BMI as well as the reader, there was still an independent racial effect on breast density (P = 0.0050). Mammographic breast density was lower in African American women than in Caucasians and Latinas. This discrepancy may be an intrinsic racial difference due to undetermined causes. Factors, such as the growth rate of tumors and the incidence of calcifications, must be studied to confirm that other forces do not have a negative impact on the efficacy of screening mammograms in African American women.},

keywords = {},

pubstate = {ppublish},

tppubtype = {article}

}

@article{Hoffmann2003,

title = {Response to highly active antiretroviral therapy strongly predicts 

	outcome in patients with AIDS-related lymphoma},

author = {C. Hoffmann and E. Wolf and G. Fatkenheuer and T. Buhk and A. Stoehr and A. Plettenberg and H. J. Stellbrink and H. Jaeger and Uwe Siebert and H. A. Horst},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12824790},

issn = {0269-9370 (Print) 0269-9370 (Lin},

year  = {2003},

date = {2003-07-01},

journal = {AIDS},

volume = {17},

number = {10},

pages = {1521-9},

abstract = {BACKGROUND: AIDS-related lymphoma (ARL) remains a frequent complication 

	of HIV infection. We analyzed the outcome of patients with ARL with 

	respect to the use and efficacy of highly active antiretroviral therapy 

	(HAART) and to potential prognostic factors. METHODS: This multicenter 

	cohort study included patients with systemic ARL diagnosed between 

	1990-2001. We evaluated overall survival and the effects of several 

	variables on overall survival using the Kaplan-Meier method and the 

	extended Cox proportional hazards model. Response to HAART was used 

	as a time-dependent variable and was defined as a CD4 cell count increase of \>/= 100 x 106 cells/l and/or at least one viral load 

	\< 500 copies/ml during the first 2 years following diagnosis of ARL. 

	RESULTS: Among 203 patients with ARL, median overall survival was 

	9.0 months [95% confidence interval (CI), 7.6-12.4 months]. In the 

	univariate analyses, age \< 60 years, no previous AIDS, CD4 cell counts \>/= 200 x 106 cells/l, hemoglobin \> 11 g/dl, Ann Arbor stages I-II 

	and A, no extranodal lesion, response to HAART, and complete remission 

	showed statistically significant association with prolonged overall 

	survival. In the multivariate Cox model, the only factors independently 

	associated with overall survival were response to HAART [relative 

	hazard (RH), 0.32; 95% CI, 0.16-0.62], complete remission (RH, 0.24; 

	95% CI, 0.15-0.36), previous AIDS (RH, 1.92; 95%CI, 1.23-3.01) and 

	extranodal involvement (RH, 2.85; 95% CI, 1.47-5.51). CONCLUSIONS: 

	Efficacy of HAART was independently associated with prolonged survival 

	in this large cohort of patients with ARL. Information on patient's 

	response to HAART is crucial for the evaluation of future treatment 

	strategies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hur2003,

title = {Cost-effectiveness of photodynamic therapy for treatment of Barrett's 

	esophagus with high grade dysplasia},

author = {Chin Hur and N. S. Nishioka and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12870783},

issn = {0163-2116 (Print) 0163-2116 (Lin},

year  = {2003},

date = {2003-07-01},

journal = {Dig Dis Sci},

volume = {48},

number = {7},

pages = {1273-83},

abstract = {The purpose of this study was to compare the effectiveness and cost-effectiveness 

	of photodynamic therapy (PDT) versus surgical esophagectomy and intensive 

	endoscopic surveillance for patients with Barrett's esophagus and 

	high-grade dysplasia (HGD) who are operative candidates. The results 

	of our Markov Monte Carlo model show that PDT increased life expectancy 

	by 1.8 years and quality-adjusted life expectancy (QALE) by 1.65 

	years when compared to the surveillance strategy. Relative to the 

	esophagectomy strategy, PDT resulted in a greater life expectancy 

	by 0.8 years and 2.17 additional quality-adjusted life years (QALYs). 

	Although PDT cost 20,400 dollars and 7,100 dollars more than surveillance 

	and esophagectomy respectively, the resulting incremental cost-effective 

	ratios (ICERs) of 12,400 dollars/QALY and 3,300 dollars/QALY are 

	within commonly accepted values. These findings were sensitive to 

	the value assigned to the quality of life after PDT, but only at 

	unrealistic values. In conclusion, PDT increases life expectancy 

	and is cost-effective when compared to endoscopic surveillance and 

	surgical esophagectomy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Casella2003a,

title = {Impact of intravascular ultrasound-guided stenting on long-term clinical outcome: a meta-analysis of available studies comparing intravascular ultrasound-guided and angiographically guided stenting},

author = {G. Casella and V. Klauss and F. Ottani and Uwe Siebert and P. Sangiorgio and D. Bracchetti},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12822148},

issn = {1522-1946 (Print) 1522-1946 (Lin},

year  = {2003},

date = {2003-07-01},

urldate = {2003-07-01},

journal = {Catheter Cardiovasc Interv},

volume = {59},

number = {3},

pages = {314-21},

abstract = {To date, only a few studies have compared the clinical efficacy of 

	intracoronary ultrasound (IVUS)-guided to angiographically guided 

	stenting. Furthermore, it is not yet known whether the lower restenosis 

	rate shown with the former strategy would translate into a substantial 

	clinical advantage. Therefore, the aim of the present investigation 

	was to improve the level of evidence of these studies by means of 

	a formal meta-analysis. Nine studies were considered suitable for 

	analysis. Odds ratios (ORs) were calculated for 6-month clinical 

	follow-up. Primary endpoint was a composite of death and nonfatal 

	myocardial infarction (MI), as considered in every single study. 

	Secondary endpoints were major adverse cardiac events (MACEs), according 

	to single study definition, the individual cardiac events, as well 

	as several pre- and postprocedure and follow-up angiographic parameters. 

	Overall, 2,972 patients were included. At 6 months, the OR for death and nonfatal MI was 1.13 (95% CI = 0.79-1.61; P = 0.5) for patients 

	with IVUS-guided stenting. However, patients with IVUS-guided stenting had less target vessel revascularizations (OR = 0.62; 95% CI = 0.49-0.78; P = 0.00003) and MACEs (OR = 0.79; 95% CI = 0.64-0.98; P = 0.03) 

	compared to angiographically guided stenting. In addition, subjects 

	treated with IVUS-guided stenting had significantly less binary restenosis (OR = 0.75; 95% CI = 0.60-0.94; P = 0.01). The present meta-analysis 

	demonstrates that IVUS-guided stenting implantation has a neutral 

	effect on long-term death and nonfatal MI compared to an angiographic 

	optimization. However, IVUS-guided stenting significantly lowers 

	6-month angiographic restenosis and target vessel revascularizations. 

	Whether these benefits could be very helpful when dealing with lesions 

	at high risk for restenosis is still an issue.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Delille2003,

title = {Invasive ductal breast carcinoma response to neoadjuvant chemotherapy: noninvasive monitoring with functional MR imaging pilot study},

author = {J. P. Delille and P. J. Slanetz and E. D. Yeh and Elkan F. Halpern and D. B. Kopans and L. Garrido},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12775851},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-07-01},

urldate = {2003-07-01},

journal = {Radiology},

volume = {228},

number = {1},

pages = {63-9},

abstract = {PURPOSE: To investigate if the extraction flow product (EFP), as determined 

	on dynamic contrast material-enhanced magnetic resonance (MR) images, 

	could be a potential marker of tumor response to neoadjuvant chemotherapy 

	in patients with locally advanced breast cancer. MATERIALS AND METHODS: 

	Fourteen women with proven breast cancer underwent MR imaging prior 

	to and following neoadjuvant chemotherapy. Dynamic gradient-echo 

	and echo-planar MR images were acquired before and after injection 

	of gadopentetate dimeglumine. Precontrast T1s were measured before 

	EFP maps were calculated by using a multicompartmental model. Mean 

	EFP (EFPmean) and distribution analysis of EFP (EFPcount) were measured 

	in tumors before and after neoadjuvant chemotherapy and were compared 

	with tumor response at MR imaging. The significance of the difference 

	in EFP values between the responders and nonresponders was calculated 

	with a two-tailed Student t test. RESULTS: EFPmean after neoadjuvant 

	chemotherapy in partial responders and nonresponders was 33 mL x 

	100 g-1 x min-1 +/- 9.8 and 54.2 mL x 100 g-1 x min-1 +/- 10.3, respectively 

	(P \<.005). EFPmean decreased after neoadjuvant chemotherapy in the 

	responders and nonresponders by 37% +/- 30 and -5% +/- 35, respectively 

	(P \>.05). An increase in EFPmean values was observed only in nonresponders 

	who received taxanes. For regimens without taxanes, EFPmean decreased 

	regardless of the morphologic response. EFPcount decreased for all 

	the responders by 77% +/- 33 and increased for all the nonresponders 

	by 45% +/- 68 (P \<.02). CONCLUSION: EFPcount appears to provide functional 

	information regarding changes in tumor angiogenesis due to neoadjuvant 

	chemotherapy. Functional MR imaging of the breast may be useful in 

	monitoring tumor response to neoadjuvant chemotherapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{DIppolito2003,

title = {Percutaneous tumor ablation: reduced tumor growth with combined radio-frequency ablation and liposomal doxorubicin in a rat breast tumor model.},

author = {Giuseppe D'Ippolito and Muneeb Ahmed and Geoffrey D. Girnun and Keith E. Stuart and Jonathan B. Kruskal and Elkan F. Halpern and S. Nahum Goldberg},

url = {https://pubmed.ncbi.nlm.nih.gov/12808127/},

doi = {10.1148/radiol.2281020358},

issn = {0033-8419},

year  = {2003},

date = {2003-07-01},

urldate = {2003-07-01},

journal = {Radiology},

volume = {228},

pages = {112--118},

abstract = {To determine whether combined intravenous liposomal doxorubicin and radio-frequency (RF) ablation decreases tumor growth and increases endpoint survival over those with RF or liposomal doxorubicin alone in an animal tumor model. Subcutaneous R3230 mammary adenocarcinoma (1.1-1.4 cm) was implanted in female Fischer rats. Initially, 35 tumors were randomized into four experimental groups: (a) conventional monopolar RF (70 degrees C for 5 minutes) alone, (b) liposomal doxorubicin (1 mg) alone, (c) RF ablation followed by liposomal doxorubicin, and (d) no treatment. Ten additional tumors were randomized into two groups that received a 90 degrees C RF dose either with or without liposomal doxorubicin. Tumor growth rates and the defined survival endpoint, the time at which the tumor reached 3.0 cm in diameter, were recorded. The effect of treatments on endpoint survival and tumor doubling time were analyzed by means of the Kaplan-Meier method and analysis of variance statistics. Differences in endpoint survival and tumor doubling time in the six groups were highly significant (P \<.001). Endpoint survivals were 9.1 days +/- 2.5 for the control group, 16 days +/- 3.7 for tumors treated with 70 degrees C RF alone, 16.5 days +/- 3.2 for tumors treated with liposomal doxorubicin alone, and 26.6 +/- 5.3 days with combined treatment. For 90 degrees C RF ablation, endpoint survivals were 16.6 days +/- 1.2 and 31.5 days +/- 3.0 without and with liposomal doxorubicin (P \<.01). Mean endpoint survival and tumor doubling times for the three RF levels (0, 70 degrees C, and 90 degrees C) were all significantly different (P =.01). Additionally, animals that received combined liposomal doxorubicin and 90 degrees C RF ablation survived longer than did animals that received combined liposomal doxorubicin and 70 degrees C RF ablation (P \<.01). Combined RF ablation and liposomal doxorubicin retards tumor growth and may increase animal survival compared with that with either therapy alone or no therapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Visser2003a,

title = {Cost-effectiveness targets for multi-detector row CT angiography 

	in the work-up of patients with intermittent claudication},

author = {K. Visser and M. C. Kock and K. M. Kuntz and M. C. Donaldson and G. Scott Gazelle and M. G. Hunink},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12773672},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-06-01},

journal = {Radiology},

volume = {227},

number = {3},

pages = {647-56},

abstract = {PURPOSE: To determine the costs, sensitivity for detection of significant 

	stenoses, and proportion of equivocal multi-detector row computed 

	tomographic (CT) angiography results in the work-up of patients with 

	intermittent claudication that would make this imaging examination 

	cost-effective compared with gadolinium-enhanced magnetic resonance 

	(MR) angiography. MATERIALS AND METHODS: A decision model was used 

	to compare the societal cost-effectiveness of a new imaging modality 

	with that of gadolinium-enhanced MR angiography. Main outcome measures 

	were quality-adjusted life years (QALYs) and lifetime costs. By using 

	threshold analysis of a given willingness to pay per QALY, target 

	values for costs, sensitivity for detection of significant stenoses, 

	and proportion of cases requiring additional work-up with intraarterial 

	digital subtraction angiography owing to equivocal results of the 

	new modality were determined. The base case evaluated was that of 

	60-year-old men with severe intermittent claudication and assumed 

	an incremental cost-effectiveness threshold of 100,000 US dollars 

	per QALY. RESULTS: If treatment were limited to angioplasty, a new 

	imaging modality would be cost-effective if the costs were 300 US 

	dollars and the sensitivity was 85%, even if up to 35% of patients 

	needed additional work-up. When both angioplasty and bypass surgery 

	were considered as treatment options, a new imaging modality was 

	cost-effective if the costs were 300 US dollars, the sensitivity 

	was higher than 94%, and 20% of patients required additional work-up. 

	CONCLUSION: Multi-detector row CT angiography, as compared with currently 

	used imaging modalities such as MR angiography, has the potential 

	to be cost-effective in the evaluation of patients with intermittent 

	claudication.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hunink2003,

title = {CT screening: a trade-off of risks, benefits, and costs},

author = {M. G. Hunink and G. Scott Gazelle},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12782661},

issn = {0021-9738 (Print) 0021-9738 (Lin},

year  = {2003},

date = {2003-06-01},

journal = {J Clin Invest},

volume = {111},

number = {11},

pages = {1612-9},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Gazelle2003a,

title = {Cost-effectiveness of hepatic metastasectomy in patients with metastatic 

	colorectal carcinoma: a state-transition Monte Carlo decision analysis},

author = {G. Scott Gazelle and M. G. Hunink and K. M. Kuntz and Pamela M. McMahon and Elkan F. Halpern and M. Beinfeld and J. S. Lester and K. K. Tanabe and M. C. Weinstein},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12677152},

issn = {0003-4932 (Print) 0003-4932 (Lin},

year  = {2003},

date = {2003-04-01},

journal = {Ann Surg},

volume = {237},

number = {4},

pages = {544-55},

abstract = {OBJECTIVE: To evaluate the cost-effectiveness of hepatic resection 

	("metastasectomy") in patients with metachronous liver metastases 

	from colorectal carcinoma (CRC), and to investigate the impact of 

	operative and follow-up strategies on outcomes, cost, and cost-effectiveness. 

	SUMMARY BACKGROUND DATA: There is substantial evidence that resection 

	of CRC liver metastases can result in long-term survival in some 

	patients. However, several unresolved issues are difficult to address 

	using currently available clinical data. These include the appropriate 

	threshold for resection, whether to perform repeat resection, and 

	the relative cost-effectiveness of the procedure(s). METHODS: The 

	authors developed a state-transition Monte Carlo decision model to 

	evaluate the (societal) cost-effectiveness of hepatic metastasectomy 

	in patients with metachronous CRC liver metastases. The model tracks 

	the presence, number, size, location, growth, detection, and removal 

	of up to 15 individual metastases in each patient. Survival, quality 

	of life, and cost are predicted on the basis of disease extent. Imaging 

	and surgery affect outcomes via detection and removal of individual 

	metastases. Several patient management strategies were developed 

	and compared with respect to cost, effectiveness, and incremental 

	cost-effectiveness ($/quality-adjusted life year [QALY]). A reference 

	strategy in which metastasectomy is not offered and imaging is not 

	performed for the purpose of assessing resectability or operative 

	planning ("no-surgery" strategy) was included for comparison. Extensive 

	sensitivity analysis was performed to evaluate the impact of alternative 

	model assumptions on results. RESULTS: A strategy permitting resection 

	of up to six metastases and one repeat resection, with CT follow-up 

	every 6 months, resulted in a gain of 2.63 QALYs relative to the 

	no-test/no-treat strategy, at an incremental cost of 18,100 US dollars/QALY. 

	When additional surgical strategies were considered, the incremental 

	cost-effectiveness ratio (ICER; relative to the next least effective 

	strategy) of the six metastases, one repeat, 6-month strategy was 

	31,700 US dollars/QALY. Across a range of model assumptions, more 

	aggressive treatment strategies (i.e., resection of more metastases, 

	resection of recurrent metastases) were superior to less aggressive 

	strategies and had ICERs below 35,000 US dollars/QALY. Findings were 

	insensitive to changes in most model parameters but somewhat sensitive 

	to changes in surgery and treatment costs. CONCLUSIONS: Hepatic metastasectomy 

	is a cost-effective option for selected patients with metachronous 

	CRC metastases limited to the liver. When considering metastasectomy, 

	more aggressive approaches are generally preferred to less aggressive 

	approaches. Overall, surgeons should be encouraged to consider resection 

	for all patients whose metastases can technically be removed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Stahl2003,

title = {Optimizing management and financial performance of the teaching ambulatory care clinic.},

author = {James E. Stahl and Mark S. Roberts and Scott Gazelle},

url = {https://pubmed.ncbi.nlm.nih.gov/12709093/},

doi = {10.1046/j.1525-1497.2003.20726.x},

issn = {0884-8734},

year  = {2003},

date = {2003-04-01},

journal = {Journal of general internal medicine},

volume = {18},

pages = {266--274},

abstract = {To examine how to optimize teaching ambulatory care clinics performance with regard to access to care, access to teaching, and financial viability. Optimization analysis using computer simulation. A discrete-event simulation model of the teaching ambulatory clinic setting was developed. This method captures flow time, waiting time, competition for resources, and the interdependency of events, providing insight into system dynamics. Sensitivity analyses were performed on staffing levels, room availability, patient characteristics such as "new" versus "established" status, and clinical complexity and pertinent probabilities. In the base-case, 4 trainees:preceptor, patient flow time (registration to check out) was 148 minutes (SD 5), wait time was 20.6 minutes (SD 4.4), the wait for precepting was 6.2 minutes (SD 1.2), and average daily net clinic income was $1,413. Utilization rates were preceptors (59%), trainees (61%), medical assistants (64%), and room (68%). Flow time and the wait times remained relatively constant for strategies with trainee:preceptor ratios \<4:1 but increased with number of trainees steadily thereafter. Maximum revenue occurred with 3 preceptors and 5 trainees per preceptor. The model was relatively insensitive to the proportion of patients presenting who were new, and relatively sensitive to average evaluation and management (E/M) level. Flow and wait times rose on average by 0.05 minutes and 0.01 minutes per percent new patient, respectively. For each increase in average E/M level, flow time increased 8.4 minutes, wait time 1.2 minutes, wait for precepting 0.8 minutes, and net income increased by $490. Teaching ambulatory care clinics appear to operate optimally, minimizing flow time and waiting time while maximizing revenue, with trainee-to-preceptor ratios between 3 and 7 to 1.},

keywords = {},

pubstate = {ppublish},

tppubtype = {article}

}

@article{Siebert2003,

title = {Cost effectiveness of peginterferon alpha-2b plus ribavirin versus interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C},

author = {Uwe Siebert and G. Sroczynski and S. Rossol and J. Wasem and U. Ravens-Sieberer and B. M. Kurth and M. P. Manns and J. G. McHutchison and J. B. Wong and C. Model Group German Hepatitis and Group International Hepatitis Interventional Therapy},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12584228},

issn = {0017-5749 (Print) 0017-5749 (Lin},

year  = {2003},

date = {2003-03-01},

journal = {Gut},

volume = {52},

number = {3},

pages = {425-32},

abstract = {BACKGROUND: Peginterferon alpha-2b plus ribavirin therapy in previously 

	untreated patients with chronic hepatitis C yields the highest sustained 

	virological response rates of any treatment strategy but is expensive. 

	AIMS: To estimate the cost effectiveness of treatment with peginterferon 

	alpha-2b plus ribavirin compared with interferon alpha-2b plus ribavirin 

	for initial treatment of patients with chronic hepatitis C. METHODS: 

	Individual patient level data from a randomised clinical trial with 

	peginterferon plus ribavirin were applied to a previously published 

	and validated Markov model to project lifelong clinical outcomes. 

	Quality of life and economic estimates were based on German patient 

	data. We used a societal perspective and applied a 3% annual discount 

	rate. RESULTS: Compared with no antiviral therapy, peginterferon 

	plus fixed or weight based dosing of ribavirin increased life expectancy 

	by 4.2 and 4.7 years, respectively. Compared with standard interferon 

	alpha-2b plus ribavirin, peginterferon plus fixed or weight based 

	dosing of ribavirin increased life expectancy by 0.5 and by 1.0 years 

	with incremental cost effectiveness ratios of 11,800 euros and 6600 

	euros per quality adjusted life year (QALY), respectively. Subgroup 

	analyses by genotype, viral load, sex, and histology showed that 

	peginterferon plus weight based ribavirin remained cost effective 

	compared with other well accepted medical treatments. CONCLUSIONS: 

	Peginterferon alpha-2b plus ribavirin should reduce the incidence 

	of liver complications, prolong life, improve quality of life, and 

	be cost effective for the initial treatment of chronic hepatitis 

	C.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Holmes2003,

title = {Review of human immunodeficiency virus type 1-related opportunistic 

	infections in sub-Saharan Africa},

author = {C. B. Holmes and E. Losina and R. P. Walensky and Y. Yazdanpanah and K. A. Freedberg},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12594648},

issn = {1537-6591 (Electronic) 1058-4838},

year  = {2003},

date = {2003-03-01},

journal = {Clin Infect Dis},

volume = {36},

number = {5},

pages = {652-62},

abstract = {Understanding the natural history of human immunodeficiency virus 

	type 1 (HIV-1) and opportunistic infections in sub-Saharan Africa 

	is necessary to optimize strategies for the prophylaxis and treatment 

	of opportunistic infections and to understand the likely impact of 

	antiretroviral therapy. We undertook a systematic review of the literature 

	on HIV-1 infection in sub-Saharan Africa to assess data from recent 

	cohorts and selected cross-sectional studies to delineate rates of 

	opportunistic infections, associated CD4 cell counts, and associated 

	mortality. We searched the MEDLINE database and the Cochrane Database 

	of Systematic Reviews and Cochrane Clinical Trials Register for English-language 

	literature published from 1990 through April 2002. Tuberculosis, 

	bacterial infections, and malaria were identified as the leading 

	causes of HIV-related morbidity across sub-Saharan Africa. Of the 

	few studies that reported CD4 cell counts, the range of cell counts 

	at the time of diagnosis of opportunistic infections was wide. Policies 

	regarding the type and timing of opportunistic infection prophylaxis 

	may be region specific and urgently require further study.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bouma2003,

title = {Evaluation of intracoronary stenting by intravascular optical coherence tomography},

author = {B. E. Bouma and G. J. Tearney and H. Yabushita and M. Shishkov and C. R. Kauffman and D. DeJoseph Gauthier and B. D. MacNeill and S. L. Houser and H. T. Aretz and Elkan F. Halpern and I. K. Jang},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12591841},

issn = {1468-201X (Electronic) 1355-6037},

year  = {2003},

date = {2003-03-01},

urldate = {2003-03-01},

journal = {Heart},

volume = {89},

number = {3},

pages = {317-20},

abstract = {BACKGROUND: Conventional contrast cineangiography and intravascular 

	ultrasound (IVUS) provide a limited definition of vessel microstructure 

	and are unable to evaluate dissection, tissue prolapse, and stent 

	apposition on a size scale less than 100 micro m. OBJECTIVE: To evaluate 

	the use of intravascular optical coherence tomography (OCT) to assess 

	the coronary arteries in patients undergoing coronary stenting. METHODS: 

	OCT was employed in patients having percutaneous coronary interventions. 

	Images were obtained before initial balloon dilatation and following 

	stent deployment, and were evaluated for vessel dissection, tissue 

	prolapse, stent apposition, and stent asymmetry. IVUS images were 

	obtained before OCT, using an automatic pull back device. RESULTS: 

	42 stents were imaged in 39 patients without complications. Dissection, 

	prolapse, and incomplete stent apposition were observed more often 

	with OCT than with IVUS. Vessel dissection was identified in eight 

	stents by OCT and two by IVUS. Tissue prolapse was identified in 

	29 stents by OCT and 12 by IVUS; the extent of the prolapse (mean 

	(SD)) was 242 (156) microm by OCT and 400 (100) microm by IVUS. Incomplete 

	stent apposition was observed in seven stents by OCT and three by 

	IVUS. Irregular strut separation was identified in 18 stents by both 

	OCT and IVUS. CONCLUSIONS: Intracoronary OCT for monitoring stent 

	deployment is feasible and provides superior contrast and resolution 

	of arterial pathology than IVUS.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Stylopoulos2003,

title = {A cost--utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients},

author = {N. Stylopoulos and G. Scott Gazelle and D. W. Rattner},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12415334},

issn = {1432-2218 (Electronic) 0930-2794},

year  = {2003},

date = {2003-02-01},

urldate = {2003-02-01},

journal = {Surg Endosc},

volume = {17},

number = {2},

pages = {180-9},

abstract = {BACKGROUND: The controversial issue of the cost-effectiveness of laparoscopic 

	inguinal hernia repair is examined, employing a decision analytic 

	method. MATERIALS AND METHODS: The NSAS, NHDS (National Center for 

	Health Statistics), HCUP-NIS (Agency for Healthcare Research and 

	Quality) databases and 51 randomized controlled trials were analyzed. 

	The study group constituted of a total of 1,513,008 hernia repairs. 

	Projection of the clinical, economic, and quality-of-life outcomes 

	expected from the different treatment options was done by using a 

	Markov Monte Carlo decision model. Two logistic regression models 

	were used to predict the probability of hospital admission after 

	an ambulatory procedure and the probability of death after inguinal 

	hernia repair. Four treatment strategies were modeled: (1) laparoscopic 

	repair (LR), (2) open mesh (OM), (3) open non-mesh (ONM), and (4) 

	expectant management. Costs were expressed in US dollars and effectiveness 

	in quality-adjusted life years (QALYs). The main outcome measures 

	were the average and the incremental cost-effectiveness (ICER) ratios. 

	RESULTS: Compared to the expectant management, the incremental cost 

	per QALY gained was 605 dollars (4086 dollars, 9.04 QALYs) for LR, 

	697 dollars (4290 dollars, 8.975 QALYs) for OM, and 1711 dollars 

	(6200 dollars, 8.546 QALYs) for ONM. In sensitivity analysis the 

	two major components that affect the cost-effectiveness ratio of 

	the different types of repair were the ambulatory facility cost and 

	the recurrence rate. At a LR ambulatory facility cost of 5526 dollars 

	the ICER of LR compared to OM surpasses the threshold of 50,000 dollars/QALY. 

	CONCLUSIONS: On the basis of our assumptions this mathematical model 

	shows that from a societal perspective laparoscopic approach can 

	be a cost-effective treatment option for inguinal hernia repair.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Livraghi2003,

title = {Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study},

author = {T. Livraghi and L. Solbiati and M. F. Meloni and G. Scott Gazelle and Elkan F. Halpern and S. N. Goldberg},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12563138},

issn = {0033-8419 (Print) 0033-8419 (Lin},

year  = {2003},

date = {2003-02-01},

urldate = {2003-02-01},

journal = {Radiology},

volume = {226},

number = {2},

pages = {441-51},

abstract = {PURPOSE: To report complications encountered by members of a collaborative 

	group who performed radio-frequency (RF) ablation in patients with 

	focal liver cancer. MATERIALS AND METHODS: Members of 41 Italian 

	centers that were part of a collaborative group used a percutaneous 

	internally cooled RF ablation technique and a standardized protocol 

	for follow-up. They completed a questionnaire regarding number of 

	deaths, presumed cause of death, and likelihood of its relationship 

	to the RF procedure; number and types of major complications; and 

	types of minor complications and side effects. Enrollment included 

	2,320 patients with 3,554 lesions (size, 3.1 cm +/- 1.1 [SD] in diameter): 

	1,610 had hepatocellular carcinoma with chronic liver disease; 693 had metastases, predominantly from colorectal cancer (n = 501); and 

	17 had cholangiocellular carcinoma. Number and characteristics of 

	complications (ie, deaths and major and minor complications) attributed 

	to the procedure were reported. Data were subsequently analyzed with 

	analysis of variance to determine whether the major complication 

	rate was related to tumor size, number of ablation sessions, or electrode 

	type (single or cluster). RESULTS: In total, 3,554 lesions were treated. 

	Six deaths (0.3%) were noted, including two caused by multiorgan 

	failure following intestinal perforation; one case each of septic 

	shock following Staphylococcus aureus-caused peritonitis, massive 

	hemorrhage following tumor rupture, liver failure following stenosis 

	of right bile duct; and one case of sudden death of unknown cause 

	3 days after the procedure. Fifty (2.2%) patients had additional 

	major complications. The most frequent of these were peritoneal hemorrhage, 

	neoplastic seeding, intrahepatic abscesses, and intestinal perforation. 

	An increased number of RF sessions were related to a higher rate 

	of major complications (P \<.01), whereas the number of complications 

	was not significantly different when tumor size or electrode type 

	were compared. Minor complications were observed in less than 5% 

	of patients. CONCLUSION: Results of this study confirm that RF ablation 

	is a relatively low-risk procedure for the treatment of focal liver 

	tumors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Meissner2003,

title = {High-resolution MR imaging of human atherosclerotic femoral arteries in vivo: validation with intravascular ultrasound},

author = {O. A. Meissner and J. Rieger and J. Rieber and V. Klauss and Uwe Siebert and F. Tato and K. J. Pfeifer and M. Reiser and Udo Hoffmann},

url = {http://www.ncbi.nlm.nih.gov/pubmed/12582191},

issn = {1051-0443 (Print) 1051-0443 (Lin},

year  = {2003},

date = {2003-02-01},

urldate = {2003-02-01},

journal = {J Vasc Interv Radiol},

volume = {14},

number = {2 Pt 1},

pages = {227-31},

abstract = {PURPOSE: To establish a magnetic resonance (MR) imaging protocol for 

	noninvasive in-vivo analysis of atherosclerotic femoral artery segments 

	in humans and to compare the results to those of intravascular ultrasonography 

	(IVUS). MATERIALS AND METHODS: In seven patients with peripheral 

	arterial occlusive disease, 20 femoral arterial segments per person 

	were examined by high-resolution (HR) MR imaging and IVUS. Comparison 

	was possible in 123 of 140 segments. MR imaging was performed at 

	1.5 T with use of a three-dimensional (3D) time-of-flight sequence 

	with an in-plane resolution of 0.78 x 0.49 mm(2). 3D contrast-enhanced 

	MR angiography was used for exact positioning of the HR MR imaging 

	slices. IVUS (3.5 F, 40 MHz) was performed with use of a motorized 

	pullback system. Parameters analyzed included cross-sectional lumen 

	area (LA), vessel area (VA), and extent of vessel wall calcification. 

	RESULTS: Agreement between IVUS and HR MR imaging was analyzed with 

	use of the Bland-Altman method. The paired LA measurements were in 

	close agreement: the Bland-Altman mean bias in LA was -0.4 mm with a precision of +/-5.1 mm (P =.062). As a result of dorsal echo extinction 

	in IVUS, VA measurements were feasible in only 74 of 140 segments. VA measurements were moderately correlated (r = 0.74; P \<.0001), 

	and a 25% overestimation by HR MR imaging compared to IVUS was observed. 

	Intra- and interobserver comparisons for LA and VA measured with 

	HR MR imaging did not show significant differences. Vessel wall calcifications 

	were classified with a sensitivity of 91%, a specificity of 93%, 

	and an accuracy of 93%. CONCLUSIONS: The MR imaging protocol introduced 

	in the present study permits precise assessment of LA and extent 

	of calcification in peripheral arterial occlusive disease in vivo. 

	HR MR imaging shows high concordance with IVUS and may have the potential 

	for noninvasive therapy monitoring.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}