Download or read book Comparative Effectiveness in Surgical Oncology written by Karl Y. Bilimoria and published by Springer. This book was released on 2015-02-12 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite tremendous recent advances in the treatment of most malignancies, there remain several critical questions for each cancer. This particularly true for the surgical management of solid-organ malignancies. Comparative effectiveness is a relatively new term which encompasses the age-old concepts of how best to treat cancer patients. Comparative effectiveness is defined as the direct comparison of healthcare interventions to determine which work best for which patients when considering the benefits and risks. The Institute of Medicine has defined comparative effectiveness research(CER) as the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. CER is certainly best done with well-conducted randomized controlled trials. Unfortunately, clinical trials are not always feasible owing to the impracticality of conducting the trial, the considerable cost, and the time required to complete the trial. These challenges are even more pronounced with respect to surgical treatment. Thus alternative approaches may need to be considered in order to address pressing questions in the care of the oncology patient. These approaches may include well-conducted retrospective cohort studies from cancer registries and other data sources, decision and cost-effectiveness analyses, and other novel methodologies. This book lays out the current critical questions for each major malignancy and proposes approaches to gain answers to these pressing questions.
Download or read book Initial National Priorities for Comparative Effectiveness Research written by Institute of Medicine and published by National Academies Press. This book was released on 2009-11-14 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.
Download or read book Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-04-16 with total page 111 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop.
Download or read book Comparative Effectiveness Research written by Carol M. Ashton and published by . This book was released on 2013-07-11 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Comparative Effectiveness Research: Evidence, Medicine, and Policy provides the first complete account of how — and why — the federal government decided to make comparative effectiveness research (CER) an important feature of health reform and the Affordable Care Act of 2010.
Download or read book Learning What Works written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-09 with total page 610 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is essential for patients and clinicians to have the resources needed to make informed, collaborative care decisions. Despite this need, only a small fraction of health-related expenditures in the United States have been devoted to comparative effectiveness research (CER). To improve the effectiveness and value of the care delivered, the nation needs to build its capacity for ongoing study and monitoring of the relative effectiveness of clinical interventions and care processes through expanded trials and studies, systematic reviews, innovative research strategies, and clinical registries, as well as improving its ability to apply what is learned from such study through the translation and provision of information and decision support. As part of its Learning Health System series of workshops, the Institute of Medicine's (IOM's) Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss capacity priorities to build the evidence base necessary for care that is more effective and delivers higher value for patients. Learning What Works summarizes the proceedings of the seventh workshop in the Learning Health System series. This workshop focused on the infrastructure needs-including methods, coordination capacities, data resources and linkages, and workforce-for developing an expanded and efficient national capacity for CER. Learning What Works also assesses the current and needed capacity to expand and improve this work, and identifies priority next steps. Learning What Works is a valuable resource for health care professionals, as well as health care policy makers.
Download or read book Comparative Effectiveness Research in Oncology written by and published by . This book was released on 2014 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Developing a Protocol for Observational Comparative Effectiveness Research A User s Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
Download or read book Disease Control Priorities Third Edition Volume 1 written by Haile T. Debas and published by World Bank Publications. This book was released on 2015-03-23 with total page 445 pages. Available in PDF, EPUB and Kindle. Book excerpt: Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
Download or read book Initial National Priorities for Comparative Effectiveness Research written by Institute of Medicine and published by National Academies Press. This book was released on 2009-11-14 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.
Download or read book Prophylactic Surgery written by Osman Nuri Dilek and published by Springer. This book was released on 2021-05-01 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume introduces the reader to the most important standards and principles of prophylactic surgery. After discussing the comparative effectiveness of screening in the treatment of hereditary cancer syndromes and evaluating genetic predisposition, the book moves on to address ethical, legal, social and cost-effectiveness dimensions of prophylactic surgery. With the aim of preventing hereditary predisposition syndromes, it also includes a chapter on the application of preventive surgery to all specific fields of surgery. Given its scope, the book will appeal to a broad readership, from experienced surgeons to students.
Download or read book Holland Frei Cancer Medicine written by Robert C. Bast, Jr. and published by John Wiley & Sons. This book was released on 2017-03-10 with total page 2004 pages. Available in PDF, EPUB and Kindle. Book excerpt: Holland-Frei Cancer Medicine, Ninth Edition, offers a balanced view of the most current knowledge of cancer science and clinical oncology practice. This all-new edition is the consummate reference source for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. A translational perspective throughout, integrating cancer biology with cancer management providing an in depth understanding of the disease An emphasis on multidisciplinary, research-driven patient care to improve outcomes and optimal use of all appropriate therapies Cutting-edge coverage of personalized cancer care, including molecular diagnostics and therapeutics Concise, readable, clinically relevant text with algorithms, guidelines and insight into the use of both conventional and novel drugs Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates
Download or read book Use of Statistical Analysis Data Mining Decision Analysis and Cost Effectiveness Analysis to Analyze Medical Data written by Beatrice Ugiliweneza and published by . This book was released on 2011 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: Statistical models have been the first choice for comparative effectiveness in clinical research. Though effective, these models are limited when the data to be analyzed do not fit the assumed distributions; which is mostly the case when the study is not a clinical trial. In this project, data mining, decision analysis and cost effectiveness analysis methods were used to supplement statistical models in comparing lumpectomy to mastectomy for surgical treatment of breast cancer. Mastectomy has been the gold standard for breast cancer treatment for since the 1800s. In the 20th century, an equivalence of mastectomy and lumpectomy was established in terms of long-term survival and disease free survival. However, short term comparative effectiveness in post-operative outcomes has not been fully explored. Studies using administrative data are lacking and no study has used new technologies of self-expression, particularly the internet discussion board. In this study, data used were from the Nationwide Inpatient Sample (NIS) 2005, the Thomson Reuter's MarketScan 2000 - 2001, the medical literature on clinical trials and online individuals' posts in discussion boards on breastcancer.org. The NIS was used to compare lumpectomy to mastectomy in terms of hospital length of stay, total charges and in-hospital death at the time of surgery. MarketScan data was used to evaluate the comparative follow-up outcomes in terms of risk of repeat hospitalization, risk of repeat operation, number of outpatient services, number of prescribed medications, length of stay, and total charges per post-operative hospital admission on a period of eight months average. The MarketScan was also used to construct a simple post-operative hospital admission predictive model and to perform short-term cost-effectiveness analysis. The medical literature was used to analyze long term -10 years- mortality and recurrence for both treatments. The web postings were used to evaluate the comparative cost to improve quality of life in terms of patient satisfaction. In NIS and MarketScan data, International Classification of Disease, 9th revision, Clinical Modification (lCD-9-CM) diagnosis codes were used to extract cases of breast cancer; and ICD-9-CM procedure codes and Current Procedural Terminology, 4th edition procedure codes were used to form groups of treatment. Data were pre-processed and prepared for analysis using data mining techniques such as clustering, sampling and text mining. To clean the data for statistical models, some continuous variables were normalized using methods such as logarithmic transformation. Statistical models such as linear regression, generalized linear models, logistic and proportional hazard (Cox) regressions were used to compare post-operative outcomes of lumpectomy versus mastectomy. Neural networks, decision tree and logistic regression predictive modeling techniques were compared to create a simple predictive model predicting 90-day post-operative hospital re-admission. Cost and effectiveness were compared with the Incremental Cost Effectiveness Ratio (ICER). A simple method to process and analyze online po stings was created and used for patients' input in the comparison of lumpectomy to mastectomy. All statistical analyses were performed in SAS 9.2. Data Mining was performed in SAS Enterprise Miner (EM) 6.1 and SAS Text Miner. Decision analysis and Cost Effectiveness Analysis were performed in TreeAge Pro 2011. A simple comparison of the two procedures using the NIS 2005, a discharge-level data, showed that in general, a lumpectomy surgery is associated with a significantly longer stay and more charges on average. From the MarketScan data, a person-level data where a patient can be followed longitudinally, it was found that for the initial hospitalization, patients who underwent mastectomy had a non-significant longer hospital stay and significantly lower charges. The post-operative number of outpatient services, prescribed medications as well as length of stay and charges for post-operative hospital admissions were not statistically significant. Using the MarketScan data, it was also found that the best model to predict 90-day post-operative hospital admission was logistic regression. A logistic regression revealed that the risk of a hospital re-admission within 90 days after surgery was 65% for a patient who underwent lumpectomy and 48% for a patient who underwent mastectomy. A cost effectiveness analysis using Markov models for up to 100 days after surgery showed that having lumpectomy saved hospital related costs every day with a minimum saving of $33 on day 10. In terms of long-term outcomes, the use of decision analysis methods on the literature review data revealed that, 10-years after surgery, 739 recurrences and 84 deaths were prevented among 10,000 women who had mastectomy instead of lumpectomy. Factoring patients' preferences in the comparison of the two procedures, it was found that patients who undergo lumpectomy are non-significantly more satisfied than their peers who undergo mastectomy. In terms of cost, it was found that lumpectomy saves $517 for each satisfied individual in comparison to mastectomy. In conclusion, the current project showed how to use data mining, decision analysis and cost effectiveness methods to supplement statistical analysis when using real world nonclinical trial data for a more complete analysis. The application of this combination of methods on the comparative effectiveness of lumpectomy and mastectomy showed that in terms of cost and patients' quality of life measured as satisfaction, lumpectomy was found to be the better choice.
Download or read book Delivering Affordable Cancer Care in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2013-06-20 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.
Download or read book A National Cancer Clinical Trials System for the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2010-07-08 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.
Download or read book Mindfulness Based Cancer Recovery written by Linda Carlson and published by New Harbinger Publications. This book was released on 2011-02-03 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Mind-Body Approach to Healing If you have received a cancer diagnosis, you know that the hundreds of questions and concerns you have about what's to come can be as stressful as the cancer treatment itself. But research shows that if you mentally prepare yourself to handle cancer treatment by getting stress and anxiety under control, you can improve your quality of life and become an active participant in your own recovery. Created by leading psychologists specializing in oncology, the Mindfulness-Based Cancer Recovery program is based on mindfulness-based stress reduction (MBSR), a therapeutic combination of mindfulness meditation and gentle yoga now offered to cancer survivors and their loved ones in hundreds of medical centers, hospitals, and clinics worldwide. Let this book be your guide as you let go of fear and focus on getting well. With this eight-week program, you'll learn to: • Use proven MBSR skills during your treatment and recovery • Boost your immune function through meditation and healing yoga • Calm feelings of fear, uncertainty, and lack of control • Mindfully manage difficult symptoms and side effects • Discover your own capacity for healing and thriving after adversity
Download or read book Dynamic Regression Models for Survival Data written by Torben Martinussen and published by Springer Science & Business Media. This book was released on 2007-11-24 with total page 471 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book studies and applies modern flexible regression models for survival data with a special focus on extensions of the Cox model and alternative models with the aim of describing time-varying effects of explanatory variables. Use of the suggested models and methods is illustrated on real data examples, using the R-package timereg developed by the authors, which is applied throughout the book with worked examples for the data sets.
Download or read book EBOOK Purchasing to Improve Health Systems Performance written by Josep Figueras and published by McGraw-Hill Education (UK). This book was released on 2005-03-16 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Purchasing is championed as key to improving health systems performance. However, despite the central role the purchasing function plays in many health system reforms, there is very little evidence about its development or its real impact on societal objectives. This book addresses this gap and provides: ·A comprehensive account of the theory and practice of purchasing for health services across Europe ·An up-to-date analysis of the evidence on different approaches to purchasing ·Support for policy-makers and practitioners as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context ·An assessment of the intersecting roles of citizens, the government and the providers Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as researchers and students in the field of health studies. Contributors: Toni Ashton, Philip Berman, Michael Borowitz, Helmut Brand, Reinhard Busse, Andrea Donatini, Martin Dlouhy, Antonio Duran, Tamás Evetovits, André P. van den Exter, Josep Figueras, Nick Freemantle, Julian Forder, Péter Gaál, Chris Ham, Brian Hardy, Petr Hava, David Hunter, Danguole Jankauskiene, Maris Jesse, Ninel Kadyrova, Joe Kutzin, John Langenbrunner, Donald W. Light, Hans Maarse, Nicholas Mays, Martin McKee, Eva Orosz, John Øvretveit, Dominique Polton, Alexander S. Preker, Thomas A. Rathwell, Sabine Richard, Ray Robinson, Andrei Rys, Constantino Sakellarides, Sergey Shishkin, Peter C. Smith, Markus Schneider, Francesco Taroni, Marcial Velasco-Garrido, Miriam Wiley
