“[Introduction] Hepatocellular carcinoma (HCC) is the fastest rising cause of cancer-related mortality in the US. The incidence of HCC has increased over the last 2 decades owing to the hepatitis C virus (HCV) epidemic. Most HCC cases are diagnosed in advanced stages, with a median survival less than 1 year. Regular surveillance for HCC may help improve early cancer detection rates when curative treatment can be applied and is recommended in patients with HCV-associated cirrhosis. The availability of direct-acting antiviral agents (DAAs) for HCV treatment has substantially altered the landscape of HCV. Though new DAA regimens can result in a … Read More
All posts in Epidemiology
Summary of findings: U.S. hospitals charge on average $417 for every $100 of their total costs, in statistical terms a 417 percent charge-to-cost ratio. Over the last 20 years, hospital expenditures have grown faster than overall health care expenditures. Hospital expenditures as a percentage of national health expenditures have increased from 30.8 percent in 1999 to 32.7 percent in 2018. In 2018 hospital expenditures alone comprised close to 6 percent of the national GDP. Of the 100 hospitals with the highest charges relative to their costs, for-profit corporations own or operate 95 of them. All of the top 100 hospitals … Read More
“[Introduction] [..] In one study of a large Accountable Care Organization, PCP relocation, retirement, or death was the dominant factor associated with the reassignment of approximately one-third of Medicare beneficiaries to a new Accountable Care Organization every year. [Methods] This cohort study used Medicare administrative claims data for a 20% random sample of continuously enrolled, fee-for-service beneficiaries. For the main study sample as well as subgroup analyses, we included beneficiaries visiting a PCP for at least 1 evaluation and management visit from January 1, 2008, to December 31, 2017. We then limited the study sample to PCPs who treated 30 … Read More
“In 2017, approximately 47,600 individuals in the US died from an opioid overdose, and morbidity and mortality from the opioid epidemic continues to accrue. [..] To fully estimate the epidemic’s scope and the impact of interventions to address it, it is essential to consider differences in individuals using prescription opioids vs heroin or illicit fentanyl, the increased risk of second overdose in people who have experienced an initial overdose, and the evolving time-dependent nature of the epidemic. Despite the contributions of prior models of the epidemic, most have not incorporated these elements, nor have they accounted for the more than … Read More
“[Abstract methods] we searched PubMed and Web of Science from inception to March 12, 2020, and included interventions that: successfully targeted any of nine prespecified potentially modifiable risk factors (hypertension, diabetes, hearing loss, obesity, physical inactivity, social isolation, depression, cigarette smoking, and less childhood education); had robust evidence that the intervention improved risk or risk behaviour; and are feasible to enact in an adult population. We established when in the life course each intervention would be delivered. We calculated dementia incidence reduction from annual incidence of dementia in people with each risk factor, and population attributable fraction for each risk, … Read More
“[Abstract] Objectives: To evaluate the effectiveness of conventional treatments for localised prostate cancer (active monitoring, radical prostatectomy and radical radiotherapy) in men aged 50–69 years. Design: A prospective, multicentre prostate-specific antigen testing programme followed by a randomised trial of treatment, with a comprehensive cohort follow-up. Setting: Prostate-specific antigen testing in primary care and treatment in nine urology departments in the UK. Participants: Between 2001 and 2009, 228,966 men aged 50–69 years received an invitation to attend an appointment for information about the Prostate testing for cancer and Treatment (ProtecT) study and a prostate-specific antigen test; 82,429 men were tested, 2664 … Read More
“In the United States, Medicare beneficiaries represent 70% to 80% of all patients hospitalized with heart failure (HF) each year. The Medicare population has also experienced substantial changes in the epidemiology of HF, with progressively fewer Medicare beneficiaries being diagnosed as having HF each year over the last decade after several decades of increasing incidence. However, the epidemiological mechanisms underlying the observed decline in the incidence of HF are not well understood. [..] We used a national 5% sample of all fee-for-service Medicare beneficiaries with no prior HF followed up from 2011 to 2016, accessing data on all of the … Read More
“On February 4, 2020, the U.S. secretary of health and human services declared that emergency use of diagnostics for SARS-CoV-2 was justified, triggering emergency authority for the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for a device if it reasonably believes that it may be effective, rather than waiting to grant full approval when it has reasonable assurance that the device is safe and effective. This mechanism expedites access to accurate diagnostic tests during emergencies, when information gaps and false results may adversely affect patient care and public health decision making. The EUA process enabled … Read More
“An estimated 19,416 individuals died of a drug overdose in the United States in the first 3 months of 2020 compared with 16,682 in the same 3-month period in 2019, according to preliminary data released last week by the US Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics. The agency also estimates that 75,500 overdose deaths occurred in the 12-month period between March 2019 and March 2020, an increase of approximately 10%. If this increased rate for drug overdose deaths holds, the United States is on track to reach a new all-time record for overdose fatalities … Read More
“The US Centers for Disease Control and Prevention has recognised public health programmes that reduced deaths from coronary heart disease and stroke and prevented deaths from smoking as two of the greatest public health achievements of the 20th century, both championed by robust evidence connecting these risks to reductions in healthy life expectancy. [..] To our knowledge, no study links a comprehensive set of modifiable risk factors to health-care spending by condition. [..] To address this research gap, we estimated US health-care spending attributable to 84 modifiable risk factors in 2016, with the latest data available. We included behavioural risks, … Read More