ReportWire

Tag: Medical Meetings

  • New palliative care screening tool for surgical ICU patients may facilitate decision-making processes, reduce burden on families, medical staff

    New palliative care screening tool for surgical ICU patients may facilitate decision-making processes, reduce burden on families, medical staff

    Key takeaways 

    • Critically ill patients in the Surgical Intensive Care Unit (SICU) may benefit from palliative care, focusing on quality of life, when aggressive medical interventions will not improve outcomes or extend life. 
    • Across hospital systems, models and access to palliative care vary; identifying patients can be difficult, often occurring late in SICU stays.  
    • Using three key questions, a new screening tool, developed using a quality improvement process, helped the medical team identify which SICU patients may benefit from palliative care or goals of care consultations within seconds; all patients in the SICU could be screened in about 30 seconds. 

    Newswise — SAN DIEGO: To aid in decision-making processes and increase awareness around palliative care in the Surgical Intensive Care Unit (SICU), a research team at the University of North Carolina at Chapel Hill (UNC-Chapel Hill) has developed a screening tool to identify—within seconds—patients who may benefit from palliative care consultations or goals of care discussions. Their research findings, presented at the Scientific Forum during the American College of Surgeons (ACS) Clinical Congress 2022, show that the screening tool successfully identified SICU patients who were later deemed candidates for palliative care by their medical team.  

    As a general and trauma surgeon, Trista Day Snyder Reid, MD, MPH, FACS, an assistant professor of surgery at UNC Health, and the study’s medical advisor, explained that she often witnesses medical teams and families make agonizing decisions for patients in the SICU. When aggressive medical interventions will not improve outcomes or extend life, palliative care treatment, which focuses on symptom management and supportive communication, may improve a patient’s quality of life. Unfortunately, a medical team may hesitate to collectively identify appropriate patients or may refer patients to palliative care late in their SICU stay, increasing the burden and stress on the patient and their families.  

    “One of the things that we found at our institution was sometimes we would involve palliative care, but it would happen way down the line when the patient had been in the SICU for a long time already,” Dr. Reid said. “We want palliative care discussions to be happening sooner. And even if we’re not involving palliative care, we want goals of care discussions to happen early so the family has a rapport with the medical team and understands that their family member is really sick.” 

    Across hospital systems, screening criteria and access to palliative care vary. Research has shown that offering palliative care consultations early in an ICU stay can improve quality of life and even reduce the lengths of stay in the ICU.1 However, integrating palliative care into hospital systems remains challenging due to a lack of resources and insufficient training, among other factors.2 

    Study details  

    The UNC researchers initially developed a screening tool with 12 “yes/no” questions with input from SICU and palliative care physicians, nurses, and advanced practice providers. Fourth-year medical students at UNC-Chapel Hill completed the questionnaire after receiving feedback from the SICU medical team. Any question where the team answered “yes” was deemed a positive indicator that the patient would benefit from a palliative care consultation with a specialist or a goals of care discussion with the surgical team.  

    Three iterations of the screening tool were developed using the Plan-Do-Study-Act (PDSA) method before selecting three questions that the researchers found best correlated with a positive indicator: 

    1. Any team member (nursing, physician, pharmacist, etc.) expresses concern the patient may need palliative care. 
    2. ICU or surgical team answers ‘no’ to the question: “Would you be surprised if this patient died?” 
    3. Comorbidities: irreversible, progressive, or untreatable, severely impairing function. 

    If yes was answered to any of the three checklist questions, the researchers believed the patient would likely benefit from a palliative care consultation or goals of care discussion. 

    Key findings 

    • Screening tools from 282 patients in the SICU were recorded.  
    • Of those 282 patients, the screening tool successfully identified 22 patients, all of whom eventually received referrals for palliative care. 
    • Each patient could be screened in about three seconds; all patients in the SICU could be screened in about 30 seconds. 
    • The tool did not increase the burden on the palliative care team at UNC Health. 

    “The hope is that by using this screening tool, decisions traditionally made very late in the patient’s SICU stay, could be made much earlier,” said lead author Victoria Herdman, MD. Dr. Herdman was a fourth-year UNC-Chapel Hill medical student at the time of the study and is now completing her residency in cardiothoracic surgery at the University of Kentucky College of Medicine. “Physicians, physician assistants, nurse practitioners and nurses know early on who needs palliative care but sometimes that’s hard to jump into early in the stay. This screening tool is a way to guide everyone into it easier.” 

    The research was performed at a single site, but the team hopes to evaluate the tool within other ICU populations at UNC Health using a Quality Improvement process, possibly using an electronic medical record system or implementing it during daily rounds discussions with only one question. The study team also plans future research to analyze patient demographics to determine which marginalized populations are often left out of palliative care discussions. Simply discussing palliative care more often and educating team members and families, they said, can make a difference. 

    “I think as surgeons we tend to have a lot of ownership of our patients because they’re trusting us with their bodies. But I think that may also bias us a little bit in terms of palliative care. We hear the words ‘palliative care’ and may say, ‘Oh, no, no, no! We don’t want that. That’s like giving up on our patient,’” Dr. Reid said. “But the truth is, I think a lot of surgeons don’t truly understand the definition of palliative care—that the goal is to align what the patient wants with your treatments. Our long-term hope is to make discussions of palliative care more commonplace and to change the culture so that people feel comfortable involving palliative care, or at a minimum having a goals of care discussion, so that patients and their families understand all the possible treatment options.” 

    The study was supported by the UNC Institute for Healthcare Quality Improvement.  

    Study coauthors are Casey Olm-Shipman, MD, MS; Winnie Lau, MD; Kyle Lavin, MD; Marshall W. Fritz, BS; and Geoffrey Orme-Evans, JD, MPH. 

    Dr. Herdman and Dr. Reid have no disclosures to report.    

    Citation: Herdman V, et al. Surgical Intensive Care Unit (SICU) Palliative Care Screening-Tool: A Quality Improvement (QI) Project, Scientific Forum, American College of Surgeons Clinical Congress 2022. 

    ________________________  

    1Rotundo E, Braunreuther E, Dale M, et al. Retrospective Review of Trauma ICU Patients With and Without Palliative Care Intervention. J Am Coll Surg 2022; 235(2): 278-284. 

    2Aslakson RA, Curtis JR, Nelson, JE, et al. The changing role of palliative care in the ICU. Crit Care Med 2014: 42(11):2418. 

    # # #  

    About the American College of Surgeons  

    The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons.   

    American College of Surgeons (ACS)

    Source link

  • Timely Surveillance with Chest Imaging May Benefit Colorectal Cancer Patients

    Timely Surveillance with Chest Imaging May Benefit Colorectal Cancer Patients

    Key takeaways: 

    • Up to 50% of colorectal patients may develop metastatic cancer that has spread to other areas of the body. 
    • One of the most frequent areas colorectal cancer spreads to is the lungs, affecting up to 18% of patients with colorectal cancer; these patients often face a poor prognosis, especially if caught at a late stage. 
    • New study investigated optimal timing intervals and key clinical factors, including genetic factors and tumor characteristics, that may reveal which patients are at risk for developing lung metastases. 

    Newswise — SAN DIEGO: Colorectal cancer patients with certain clinical characteristics may benefit from more frequent chest imaging to help identify and target cancer that has spread to the lungs, according to new research presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. These findings have the potential to improve long-term outcomes of patients with metastatic colorectal cancer. 

    Despite improved survival rates, colorectal cancer is the third leading cause of cancer-related deaths in the United States.1 Though rates of colorectal cancer have declined among people 65 and older, largely thanks to increased screening efforts, rates among younger adults are rising.2 When the cancer is caught early, many patients can remain disease-free for the rest of their lives after surgical treatment, but colorectal cancer can spread (metastasize) in up to 50% of patients.3 One of the most common areas colorectal cancer spreads to is the lungs, affecting up to 18% of patients with colorectal cancer.4 Detecting cancerous nodules in the lung early provides patients with the best outcomes, but there are no evidence-based standards for when and how often to screen colorectal cancer patients with chest CT or PET scans. 

    “After patients are diagnosed with colorectal cancer, many of them want to better understand what their cancer diagnosis entails in terms of their surveillance and survivorship for the rest of their life, but we currently lack data and uniform guidelines to support how often these patients should be screened with chest imaging,” said co-author Mara Antonoff, MD, FACS, associate professor, thoracic and cardiovascular surgery, UT MD Anderson Cancer Center, Houston, where she also serves as program director of education. “With this study, we sought to develop a strategy that is evidence-based to determine how frequently, at what intervals, and for how long patients at risk of developing lung metastases should undergo imaging of their chest.” 

    Dr. Antonoff specializes in thoracic surgical oncology and has a clinical interest in colorectal cancer that has spread to the lungs. She is leading a multi-institutional study, under the umbrella of the American Association for Thoracic Surgery (AATS) Thoracic Surgery Oncology Group (TSOG) (TSOG 103), on developing optimal treatment strategies for colorectal cancer patients whose cancer spread is limited to the lungs. 

    To identify which colorectal cancer patients may benefit from early chest imaging and at what time intervals, Dr. Antonoff and an interdisciplinary team of researchers at MD Anderson – including cardiothoracic surgeons, colorectal cancer surgeons, and gastrointestinal oncologists – collaborated on this research project to investigate evidence-based surveillance guidelines for colorectal patients who are at risk of developing lung metastases. 

    Study details 

    Using two MD Anderson cancer databases that included both colorectal cancer patients and thoracic cancer patients, the study team retrospectively reviewed data from patients with colorectal cancer who did and did not develop lung metastases. Patients were grouped according to the development of lung metastases and the timing of their diagnosis. The team used statistical methods to investigate which clinical characteristics, such as age or genetic factors, correlated most with the risk of developing lung metastases.  

    Key findings 

    • Of 1,600 patients with colorectal cancer, 233 (14.6%) developed pulmonary (lung) metastases, with a median time of 15.4 months following colorectal surgery.  
    • The team identified age, neoadjuvant or adjuvant systemic therapy (such as chemotherapy or immunotherapy), lymph node ratio, lymphovascular and perineural invasion (high-risk tumor characteristics observed under a microscope), and presence of KRAS genetic mutations as risk factors for developing lung metastases. 
    • Further data analysis revealed that patients who required systemic therapy around the time of their surgical operation for colorectal cancer, who had an elevated lymph node ratio, and a KRAS mutation, were at risk of developing lung metastases within three months of surgery. 
    • The authors concluded that these patients may benefit from more frequent surveillance with chest CT or PET scans. 

    Nathaniel Deboever, MD, general surgery resident, UTHealth Houston McGovern Medical School, and the lead author of the study, noted that while these risk factors are not necessarily surprising from a clinical perspective, they highlight the need to adequately screen certain colorectal cancer patients after surgical treatment. In some cases, removing cancerous lung nodules surgically early on can significantly improve outcomes. 

    “A concrete clinical application of this research, following validation, is to build evidence-based guidelines affecting chest surveillance in patients with resected colorectal cancer,” said Dr. Deboever, who completed this research as part of his research fellowship with the department of thoracic and cardiovascular surgery at MD Anderson. “These guidelines will hopefully allow high-risk patients to undergo radiographic screening in a timely manner, permitting the early diagnosis of pulmonary disease.” 

    Next steps 

    In future research, the team plans to validate findings in a separate group of patients, with the hope of formalizing chest surveillance protocols for widespread clinical adoption. Drs. Antonoff and Deboever noted that as colorectal cancer research evolves, sensitive blood tests to detect cancer or advanced radiographic screening methods using artificial intelligence may also play an important role in monitoring patients. 

    “There are many patients who receive cancer care outside of cancer hospitals, so having algorithms, pathways, and recommended protocols can be very helpful for providers who care for a lot of different diseases with rapidly changing recommendations,” Dr. Antonoff said. “I think this research is really just the tip of the iceberg.” 

    This study was funded by the Department of Thoracic and Cardiovascular Surgery at MD Anderson Cancer Center, which included financial support from the Mason Family Philanthropic Research Fund.  

    Study coauthors are Erin M. Bayley, MD, MS; Brian K. Bednarski, MD, FACS; and Van Morris, MD. 

    Dr. Deboever and Dr. Antonoff have no disclosures to report.    

    Citation: Deboever N, et al. Do Resected Colorectal Cancer Patients Need Early Chest Imaging? Impact of Clinicopathologic Characteristics on Time to Development of Pulmonary Metastases, Scientific Forum, American College of Surgeons Clinical Congress 2022.  

    ________________________ 

    1Key Statistics for Colorectal Cancer. American Cancer Society, January 12, 2022. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html 

    2Colorectal Cancer Rates Rise in Younger Adults. American Cancer Society, March 5, 2020. https://www.cancer.org/latest-news/colorectal-cancer-rates-rise-in-younger-adults.html  

    3Leporrier J, Maurel J, Chiche L, et al. A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. British Journal of Surgery 2006: 93(4), 465-474. 

    4Gonzalez M, Gervaz P. Risk factors for survival after lung metastasectomy in colorectal cancer patients: systematic review and meta-analysis. Future oncol. 2015: 11(2s):31-3. 

    # # #  

    About the American College of Surgeons  

    The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons.   

    American College of Surgeons (ACS)

    Source link

  • Fewer patients sent to hospital rehabilitation facilities for recovery after colorectal operations early in the COVID pandemic

    Fewer patients sent to hospital rehabilitation facilities for recovery after colorectal operations early in the COVID pandemic

    Key takeaways 

    • The first months of the COVID pandemic in 2020 caused a discernible change in post-surgery practice; colorectal surgeons discharged more patients direct to home for recovery, thus, bypassing a stay at a rehabilitation facility.   
    • The rate of patients discharged to rehabilitation facilities dropped 3% but the number of patients who were readmitted to the hospital with complications remained stable, even though patients underwent fewer minimally invasive procedures.  
    • Telemedicine visits rose among patients discharged home so care providers could check in on their patients. Study findings showing stable hospital readmission rates in pandemic year 2020 highlight the potential for lowering rehabilitation utilization for colorectal patients.  

    Newswise — SAN DIEGO: The first months of the COVID pandemic had a profound effect on hospital discharge practices and use patterns for patients with colorectal disease, according to findings presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. A study of more than 100,000 surgical patients who underwent procedures for colorectal cancer found that they had 40% lower odds of being discharged to post-hospital rehabilitation during the pandemic than before.  

    Despite this significantly lower rate, the hospital readmission rate did not change from pre-pandemic levels, said Marc Mankarious, MD, a surgical resident at Penn State Hershey Medical Center, Hershey, Pennsylvania. 

    “We found that discharge to a rehabilitation facility pre-pandemic was 10%, which agreed with previous literature, but once the pandemic hit, the discharge-to-rehabilitation rate dropped to about 7%,” Dr. Mankarious said. “We saw a drop of three percentage points, even though we were doing more emergent operations and more open operations, which are typical risk factors for requiring rehabilitation after surgery.” 

    The authors hypothesized that anecdotally, fear of going into confined spaces, staff and supply shortages, and disease outbreaks contributed to changes in discharge practices. 

    About the Study 

    The retrospective cohort study used two databases from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®): the Participant Use File and Target Colectomy databases. Researchers analyzed data on 116,677 patients: 90,250 from 2017 through 2019, and 26,427 from 2020. For comparison, the first quarter was excluded from all years because the first COVID restrictions did not go into effect until March 2020. ACS NSQIP is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care in hospitals. It was created by surgeons to help hospitals gauge the quality of their surgical programs and improve surgical outcomes by collecting robust, accurate, and precise clinical patient information. 

    Key findings  

    • In comparing the pre- and post-COVID-19 periods, the proportion of emergent cases and open operations—as opposed to minimally invasive procedures—increased in 2020, from 13 to 15% (p<0.001) and 31 to 32% (p<0.001), respectively.  
    • A multivariable analysis found that patients in 2020 had 40% lower odds of going to a post-discharge facility (odds ratio 0.62, p<0.001), even after the analysis adjusted for reasons for having the operations and other medical conditions the patients had. 
    • The rates of patients going back to the hospital within 30 days of discharge was 10% in both periods (p=0.4). 

    Surgeons’ observations  

    The stability in hospital readmission rates was telling because that may be “one of the factors that goes into deciding whether to offer a rehabilitation stay to a patient,” Dr. Mankarious said. 

    The study data did not include reasons why patients did or did not choose to go to post-discharge rehabilitation to recover; the authors hypothesized that factors included limited availability of beds and patient concerns about visitor restrictions and contracting COVID-19 Dr. Mankarious said. But the pandemic saw a 63-fold increase in telehealth use in 2020 over 2019.* “This situation may have made patients and physicians more comfortable with the patient going home and following up with each other electronically,” he said.  

    The data included some information on medical reasons for going to rehabilitation. “We did find that patients that went to rehabilitation in 2020 were more functionally dependent or functionally impaired than patients that went to rehabilitation in previous years, so those factors may also play a part in it.” Dr. Mankarious said. 

    The study grew out of what surgeons at Penn State Hershey were observing in the early days of the pandemic, said senior author Audrey Kulayat, MD, assistant professor of colorectal surgery. “We wondered if those observations had an impact on a bigger scale other than just at our institution,” she said. “But then we wanted to know, what’s the downside? Was there a downside? Are patients getting readmitted more frequently as a result of going back to their home or whatever institution versus going to a place with a higher level of nursing care? We didn’t find that they were readmitted more often.”  

    Potential change in discharge practice  

    The study findings raise questions about the potential overuse of posthospital rehabilitation for colorectal patients, Dr. Mankarious said. “Medicare spends about $60 billion per year on patients going to post-acute care facilities or rehab in general and any small reductions, even our 3%  reduction, which was significant, could result in considerable cost savings for the healthcare system.  

    “And it really helps us rethink who should go to post-surgery rehab, maybe raise our thresholds as we become more comfortable sending patients home and have better utilization of the new available modalities to help us follow up with them without having to send them to rehab,” Dr. Mankarious added. 

    Dr. Mankarious and Dr. Kulayat have no disclosures. 

    Study co-authors are Austin C. Portolese, MD; Jeffrey S. Scow, MD, FACS; Michael Deutsch, MD, FACS; and Nimalan A. Jeganathan, MD, FACS, all of Penn State Hershey Medical Center.  

    Citation: Mankarious MM, et al. Changing Disposition Patterns of Colorectal Surgery Patients in the Era of COVID-19. Scientific Forum Presentation, American College of Surgeons Clinical Congress 2022.  

    ________________________ 

    * Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristic and Location. (Issue Brief No. HP-2021-27) Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services; Washington, D.C.; December 2021. Available online.

    # # #  

    About the American College of Surgeons 
    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons. 

    American College of Surgeons (ACS)

    Source link

  • Study finds less expensive noninvasive test is an effective alternative to a more costly test for colorectal cancer screening

    Study finds less expensive noninvasive test is an effective alternative to a more costly test for colorectal cancer screening

    Key takeaways 

    • National guidelines suggest a fecal immunochemical test (FIT) can be used as the primary noninvasive screening modality for early-stage colorectal cancer, but a significant proportion of patients still receive a more expensive alternative test called Cologuard®. 
    • Data used for national screening guidelines has shown no difference between the two tests at detecting adenoma versus colorectal malignancy. 
    • These results align with previous studies out of Japan and the Netherlands examining FIT as an appropriate screening modality that is more cost effective than other types of noninvasive colorectal screening tests.  

    Newswise — SAN DIEGO: Commercially available noninvasive screening tests for colorectal cancer—a fecal immunochemical test (FIT) and the multi-target stool DNAtest (mt-sDNA; or Cologuard®)—are equally effective for screening patients with early-stage colorectal cancer. However, a FIT costs about one-fifth of the multi-target DNA test, according to new study results presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. 

    Pavan K. Rao, MD, a general surgery resident at Allegheny Health Network in Pittsburgh, Pennsylvania, presented study results looking at 117,519 people in the Highmark claims database who underwent colorectal screening in 2019. Highmark is a Blue Cross Blue Shield Association insurer in four Mid-Atlantic states.   

    From that group, the researchers identified 91,297 people who had noninvasive screening with either the fecal immunochemical test (FIT, n=45,487) or the DNA test (mt-sDNA, n=46,110) instead of having a routine colonoscopy.   

    Key findings  

    • Among the study population that underwent colorectal screening, 45,487 (38.7 percent) had one of two commercially available FIT tests and 46,110 (39.2 percent) had the mt-sDNA test.  
    • Patients who were screened with either test presented with early disease, staged from 0 to II, at similar rates: 59.5 percent for FIT and 63.2 percent for mt-sDNA test (p=0.77).  
    • Patients within the Allegheny Health Network Oncology Registry diagnosed with colorectal cancer were matched to their claims data to determine distribution of cancer stage.  If the noninvasive test indicated signs of early disease, patients were then referred for additional testing to confirm the findings.   
    • The total annual costs for the tests were $6.47 million—$1.1 million for a FIT, or about $24 per test, and $5.6 million for mt-sDNA, or about $121 per test. Costs were calculated using Medicare reimbursement rates. 

    Observations on study results  

    The study followed guidelines issued by the U.S. Preventive Services Task Force (USPSTF) in 2016 and updated in 2019. Since then, the guidelines were updated again in 2021.1 

    “Despite national guidelines suggesting that FIT be used as the primary noninvasive screening modality, we found that on review of our insurer’s claims data, a significant proportion of patients still receive a more expensive alternative test. There is substantial cost savings not only to our patients but to our health system with promoting appropriate use of noninvasive testing,” Dr. Rao said. 

    “There was no difference in the clinical stage at the time of diagnosis between the two tests, which again demonstrates the clinical equipoise maintained by switching to FIT,” Dr. Rao said of the variation between the two tests.  

    He added, “When you look at the national data for which the guidelines put forward, they found no difference between the two tests at detecting adenoma versus colorectal malignancy.”2 

    Cost savings without compromising care  

    The researchers determined that transitioning all noninvasive colorectal cancer screening to FIT would result in a $3.9 million savings annually in the study population.  

    “In the current state of healthcare, we are thinking ever more about efficiency and reduction in costs while maintaining patient outcomes, and not compromising the quality of care we provide,” Dr. Rao said. “I think a colorectal surgeon or any specialist who sees appropriate patients for colorectal cancer screening can use this data to provide recommendations of alternative screening tests to patients who primarily do not want to undergo colonoscopy. We cannot only say it is appropriate from a guideline standpoint, but we’re also reducing wasteful spending in health care by appropriately using the FIT.” 

     What makes this study unique is the methodology used to analyze the claims data, said study coauthor Casey J. Allen, MD, a surgical oncologist at Allegheny Health Network and an assistant professor at Drexel University College of Medicine, Pittsburgh. The researchers analyzed outcomes in the local health registry and then applied those outcomes to the claims database. “It’s not just the cost of the mt-sDNA test kit or the cost of the FIT kit multiplied by the number of members in the healthcare system,” Dr. Allen said. “It’s the full downstream costs depending on the rates of false-positive and false-negative tests and how much it costs to obtain a colonoscopy when that occurs. The cost of a screening colonoscopy in the database the researchers used was $635. 

    These results support previous studies out of Japan3 and the Netherlands4 that found FIT was more cost-effective than other types of noninvasive colorectal screening tests.  

    Study coauthors are Samantha Falls, DO, Stacey Shipley, BA, and Katie Farah, MD, of Allegheny Health Network, Wexford, Pennsylvania; and Patrick L. Wagner, MD, FACS, David L. Bartlett, MD, FACS, and Sricharan Chalikonda, MD, MHA, FACS, of Allegheny Health Network, Pittsburgh.  

    Dr. Rao and Dr. Allen have no disclosures to report. 

    Citation: Rao, PK et al. Comprehensive Cost Implications of Commercially Available Non-invasive Colorectal Cancer Screening Modalities: Results of A Large National Insurer Claims Database Analysis, Scientific Forum, American College of Surgeons Clinical Congress 2022.  

    ________________________ 

    1U.S. Preventive Services Taskforce. Final Recommendation Statement, Colorectal Cancer: Screening. Updated May 18, 2021. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening (.) 

    2Rex DK, Boland CR, Dominitz et al. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112(7):1016-1030. 

    3Sekiguchi M, Igarashi A, Sakamoto T, Saito Y, Esaki M, Matsuda T. Cost-effectiveness analysis of colorectal cancer screening using colonoscopy, fecal immunochemical test, and risk score. J Gastroenterol Hepatol. 2020 ;35(9):1555-1561.  

    4Lansdorp-Vogelaar I, Goede SL, Bosch LJW, et al. Cost-effectiveness of high-performance biomarker tests vs fecal immunochemical test for noninvasive colorectal cancer screening. Clin Gastroenterol Hepatol. 2018;16(4):504-512.e11.  

    # # # 

    About the American College of Surgeons  

    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons. 

    American College of Surgeons (ACS)

    Source link

  • Operations for diverticulitis decreased in 2020, but the degree of disease severity increased

    Operations for diverticulitis decreased in 2020, but the degree of disease severity increased

    Key takeaways 

    • Overutilization of intubation respirators early in the pandemic may have masked signs and symptoms of diverticulitis in COVID-19 patients. 
    • Restricted access to computed tomography scanning and a preference for antibiotics may have been factors in postponing surgery until patients were sicker. 
    • Future research will look at 2021 data to see if care patterns returned to pre-pandemic levels. 

    Newswise — SAN DIEGO: The first year of the COVID pandemic significantly altered how patients and providers treated diverticulitis, causing a significant drop in operations to manage the disease but a corresponding increase in the proportion of more severe cases and the need for emergency surgery, according to results of a nationwide study presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. 

    Rolando H. Rolandelli, MD, FACS, chair of surgery at Morristown Medical Center in Morristown, New Jersey, and professor of surgery at Rutgers New Jersey Medical School, presented a study of 12,514 patients who had a colectomy for diverticulitis in 2018 and 10,869 who had the same procedure in 2020 using the ACS National Surgical Quality Improvement (ACS NSQIP®) database. That decline in 2020 represents a 13.14% decrease in operations for diverticulitis, which is an outpouching of the digestive tract causing painful inflammation or infection. ACS NSQIP is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care in hospitals. It was created by surgeons to help hospitals gauge the quality of their surgical programs and improve surgical outcomes by collecting robust, accurate, and precise clinical patient information. 

     “In the first year of the pandemic, 2020, we saw that patients were accessing the healthcare system less frequently for diverticulitis, but those who did were sicker on presentation. As a result, their postoperative outcomes were not as good,” Dr. Rolandelli said. 

    Key findings 

    • Patients were more likely to have emergency surgery for diverticulitis in 2020, with the proportion increasing to 20% of operations from 17.3% (p<0.001). 
    • The proportion of patients with a known abscess or perforation of the gastrointestinal tract also increased, from 50.1 to 54.55% (p<0.001). 
    • The proportion of Black patients increased in 2020, from 7 to 7.7% (p=0.032), which was offset by a decline in the proportion of white patients, from 82.4 to 77.7% (p<0.001). 

    Dr. Rolandelli said the study findings provide two lessons learned.  

    “One, when we limit access to health care, we do it by setting a priority for patients that are potentially at higher risk of progression of their disease, and in the early phase of the COVID pandemic, the priority was cancer patients,” he said. “This situation may have led to physicians  prescribing antibiotics as an alternative to surgery for diverticulitis, which may have caused patients’ disease to progress. By the time of surgery, they were much sicker.”  

    The second lesson learned: A possible overuse of intubation respirators early in the pandemic. “We had patients who basically had been in a coma for weeks and could not express their symptoms of diverticulitis,” he said, which typically include pain in the lower left quadrant of the abdomen and, less frequently, fever and constipation. “We probably saw patients who were developing diverticulitis and we were not realizing it.” 

    Surgeons’ observations  

    Precautions put into place early in the pandemic may have also contributed to the greater severity of diverticulitis cases at that time, Dr. Rolandelli said. Surgeons were informed that the COVID-19 virus could concentrate in the wall of the gastrointestinal tract, including the colon, and that they should exercise caution when using electrocautery to operate on patients with diverticulitis because it could vaporize the virus and cause it to spread. Also, restricted access to computed tomography scans—an important imaging technique for monitoring the growth of diverticular lesions—may have delayed medical treatment or even surgery.  

    Study coauthor Zoltan H. Nemeth, MD, PhD, a research scientist at the department of surgery at Morristown Medical Center and an adjunct assistant professor at Columbia University, New York, explained that a strength of the study was its size and the large population in the ACS NSQIP database. The limitation of such databases is that they do not provide granular data on how individual patients were treated.  

    Next steps 

    Future research will include analyzing 2021 data to see how they compare to 2018 and 2020, according to Dr. Nemeth. 

    “I think it’s clear that, at the beginning of the pandemic in 2020, we were not sure how to approach these patients; it was a learning experience,” Dr. Rolandelli said. “So, when we compare it with 2021, when we had a year of experience and we did not place patients on the respirator as often, we’re going to be able to sort out the differences in terms of how we’re managing the patients and the actual severity of diverticulitis.” 

    Study coauthors are Sara Soliman, BS; Grace C. Chang, DO; and Amanda K. Nemecz, MD, all from Morristown Medical Center.  

    Dr. Rolandelli and Dr. Nemeth have no disclosures to report.   

    Citation: Rolandelli, RH et al. How the Covid-19 Pandemic Affected the Severity and Clinical Presentation of Diverticulitis, Scientific Forum, American College of Surgeons Clinical Congress 2022.  

    # # # 

    About the American College of Surgeons  

    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons. 

    American College of Surgeons (ACS)

    Source link

  • Marijuana-dependent patients at higher risk for infection after knee or shoulder arthroscopy procedures

    Marijuana-dependent patients at higher risk for infection after knee or shoulder arthroscopy procedures

    Key takeaways 

    • A higher infection rate found by new research should raise a “red flag” for patients and providers and should be discussed along with other risk factors before an arthroscopic procedure.  
    • Higher rates of deep vein thrombosis (DVT) were also found among these patients, but the study’s analysis determined they were not statistically significant. 
    • The study has identified the need for additional research to better understand the relationship between marijuana dependence and potential postoperative complications. 

    Newswise — SAN DIEGO: Patients who are dependent on marijuana may face higher infection rates following knee and shoulder arthroscopy—a minimally invasive surgery in which a small camera is inserted to diagnose and sometimes treat injury—according to a study presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. 

    Using PearlDiver, a national insurance claims database, researchers from the University of Chicago performed a retrospective study of patients with marijuana dependence who underwent knee or shoulder arthroscopy for the postoperative complications of deep vein thrombosis (DVT), pulmonary embolism (PE), and infection.  

    “Marijuana has been gaining so much popularity, but it’s a risk factor we aren’t really catching,” said lead study author Sarah Bhattacharjee, MD, who conducted the research while she was a medical student at the University of Chicago. Dr. Bhattacharjee is now a surgical resident in orthopaedic and sports medicine at the University of Washington. “The higher infection rate found by this new study should raise a ‘red flag’ for patients and providers and should be discussed along with other risk factors before an arthroscopic procedure.” 

    Although the effect of marijuana use has been studied in pain management and cardiovascular health, few studies have looked at the potential effects of marijuana use by patients who are undergoing surgery. More states are legalizing marijuana, and the size of the cannabis market is predicted to reach $91.5 billion by 2028.* Given that trend, the team of researchers from the University of Chicago set out to determine if marijuana-dependent users face an increased risk of complications following knee or shoulder arthroscopy.  

    “There’s so much information out there on smoking, alcohol, and other substances, but not on marijuana use,” said study coauthor Jason Strelzow, MD, assistant professor of orthopaedic surgery, University of Chicago. “As providers and surgeons, we should be discussing marijuana use with our patients, something that we have traditionally shied away from.” 

    Study details 

    All patients undergoing knee or shoulder arthroscopy were identified retrospectively in PearlDiver. Next, patients who had a diagnostic code for marijuana dependence were also identified within each surgery category; this is a rigid definition requiring patients to three or more criteria, such as using marijuana longer than intended, difficulty in cutting down use, spending a lot of time in obtaining or recovering from marijuana, and high tolerance.  

    The rates of DVT, PE, and infection within 90 days were assessed for all patients. Univariate analyses of marijuana dependence on all outcomes were performed, followed by a multivariate logistic regression analysis controlling for known patient comorbidities (other medical conditions). 

    Key findings 

    • The researchers identified 1,113,944 knee and 747,938 shoulder arthroscopy patients. Out of those 1,861,892 patients, 21,823 patients had a diagnostic code for marijuana dependence.  
    • Within both subgroups, the marijuana dependence cohort experienced increased rates of infection and DVT, while the PE rate stayed the same.  For the shoulder arthroscopy group, the rates of infection increased from 0.7%  to 1.7%, the DVT rate from 0.2% to 0.4%, while PE stayed at 0.2%. In the knee arthroscopy group, the rates of infection increased from 1.1% to 2.6%, the DVT rate rose from 0.2 to 0.3%, and PE stayed at 0.3%.   
    • In the multivariate analyses controlling for a variety of patient risk factors, including tobacco use or a history of diabetes, marijuana dependence was identified as an independent risk factor for infection within both cohorts. In this study, a statistical measure called a p-value (‘p’ stands for probability) was used to determine if the detected relationship was due to chance (p-values of 0.001 or below) or did, in fact, exist (p-values above 0.001). For the knee group, the p-value was 1.85, and for the shoulder group it was 1.65. 

    (Note: The presenting author reported on updated data from the podium during the conference reflecting stable PE rates.) 

    Dr. Strelzow hopes surgeons will use the study results to help inform marijuana-dependent patients about risks, benefits, and available alternatives, such as reducing or eliminating marijuana use six months prior to an arthroscopic procedure. 

    Although the study focused on minimally invasive surgery, Dr. Strelzow said that “we would expect similar or larger effects with more open or invasive procedures.” 

    Future research opportunities 

    The study has identified the need for additional research to better understand the relationship between marijuana dependence and postoperative complications. In addition, given that the study used very rigid criteria for marijuana dependence, there are opportunities for future clinical studies to investigate how various levels of marijuana use impact postoperative complications.  Dr. Strelzow said he plans to study the impact of marijuana dependence on fracture healing. 

    There are no author disclosures to report. 

    ________________________ 

    *Legal Cannabis Market Size Worth $91.5 Billion By 2028 | CAGR: 26.3%: Grand View Research, Inc. press release, July 27, 2021. Assessed at: https://www.grandviewresearch.com/industry-analysis/legal-cannabis-market?utm_source=prnewswire&utm_medium=referral&utm_campaign=HC_27-July-21&utm_term=legal-cannabis-market&utm_content=rd1 (.) 

    # # # 

    About the American College of Surgeons  

    The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates a surgeon is a Fellow of the American College of Surgeons.  

    American College of Surgeons (ACS)

    Source link

  • Aerobic Exercise May Help More than Balance Training to Hold Off Symptoms of Cerebellar Ataxia

    Aerobic Exercise May Help More than Balance Training to Hold Off Symptoms of Cerebellar Ataxia

    Currently, no medications exist to combat spinocerebellar ataxias, debilitating neurodegenerative diseases that cause loss of balance and coordination. Physicians recommend balance training to improve symptoms, but a new study suggests that rigorous aerobic exercise may provide greater benefit for adults with cerebellar ataxia. Patients were able to safely undergo six months of aerobic training five times a week. Their ataxia symptoms improved significantly, by an average of 1.9 points on the Scale for Assessment and Rating of Ataxia, compared with control patients who did balance training (who saw improvement of 0.6 SARA points). Although some balance-specific measures showed better results with balance training and studies of less-rigorous aerobic training showed little benefit, intense aerobic activity appears to be a promising therapeutic avenue for ataxia, and demonstrates important connections between nervous system health and aerobic activity.

    Full abstract, to be presented at the American Neurological Association 2022 Annual Meeting, October 22-25, 2022 in Chicago, and published in Annals of Neurology:

     

    Home Aerobic Versus Balance Training In Cerebellar Ataxias

    Scott Barbuto, MD, PhD, Columbia University Medical Center

    Coauthors: Sheng-Han Kuo, MD,  Lauren Winterbottom, OTR, Yaakov Stern, PhD, Joel Stein, MD

    Spinocerebellar ataxias are a group of disorders that result from cerebellar degeneration and cause balance and coordination loss. The diseases are devastatingly debilitating with many individuals requiring wheelchairs for mobility within ten years from initial diagnoses. With no disease modifying medications currently available, most guidelines recommend individuals with cerebellar ataxia to perform balance training to maintain functional abilities. Although conflicting results have been reported, most studies indicate that balance training can help improve symptoms of ataxia if the training is adequately challenging. The benefits of aerobic training for cerebellar ataxia have been less well-studied. After promising results in animals, the first study examining aerobic training in humans with cerebellar degeneration showed minimal benefits. However, participants were not provided a structured exercise program, and the training was limited to three, fifteen-minute sessions per week for one month. Hypothesizing that a larger dose of training could be beneficial, our research group conducted a pilot study having individuals with cerebellar degeneration perform one month of rigorous aerobic training, defined as thirty-minutes sessions, five times per week at 65–80% of their maximum heart rate. Our results indicated that individuals with cerebellar ataxias were able to safely perform rigorous aerobic exercise and that a phase II study comparing balance and aerobic training was feasible. After completion of the pilot study, we conducted a single center, assessor-blinded, randomized controlled phase II trial. Individuals with cerebellar ataxia were assigned (1:1) to either home aerobic or balance training for 6-months. The primary outcome was improvement in ataxia severity as measured by the Scale for the Assessment and Rating of Ataxia (SARA). Secondary outcomes included safety, training adherence, and balance improvements. Nineteen subjects were randomized to aerobic training and 17 subjects to balance training. There were no differences between groups at baseline. Thirty-one participants completed the trial, and there were no training-related serious adverse events. Compliance to training was over 70%. There was a mean improvement in ataxia severity of 1.9 SARA points (SD 1.62) in the aerobic group compared to an improvement of 0.6 points (SD 1.34) in the balance group. Although two other measures of balance were equivocal between groups, one measure of balance showed greater improvement with balance training compared to aerobic training.

    Overall, this 6-month trial comparing home aerobic versus balance training in individuals with cerebellar ataxia had excellent retention and adherence to training. There was a significant improvement in ataxia severity with aerobic training compared to balance training, and a phase III trial will be conducted.

     

    All abstracts from ANA2022 will be available in Annals of Neurology starting at 3:01 p.m. U.S. Eastern Time on October 14. This research is under embargo until that time. Contact Katherine Pflaumer ([email protected]) for additional highlighted abstracts, full meeting abstracts, and call-in information for the ANA2022 Media Roundtable (Oct. 25, 11 a.m. U.S. Central).

    American Neurological Association (ANA)

    Source link

  • MD Anderson hosts Leading Edge of Cancer Research Symposium

    MD Anderson hosts Leading Edge of Cancer Research Symposium

    Newswise — HOUSTON ― The University of Texas MD Anderson Cancer Center will host its virtual Leading Edge of Cancer Research Symposium from November 17-18, 2022, featuring presentations and discussions on important topics in discovery and translational research that will drive the next wave of cancer breakthroughs. The event also includes a virtual poster session; interested researchers are encouraged to submit abstracts by October 24, 2022.

    The Leading Edge of Cancer Research Symposium will include keynote presentations from Tyler Jacks, Ph.D., president of Break Through Cancer and the David H. Koch Professor of Biology at the Massachusetts Institute of Technology; Alan Ashworth, Ph.D., the E. Dixon Heise Distinguished Professor in Oncology at the University of California San Francisco; and Simona Colla, Ph.D., associate professor of Leukemia at MD Anderson.

    The event also will feature a panel discussion, “The Patient Is the Focus: Breakthroughs from Bench to Bedside, Clinical and Multiomics Integration and High Value Cancer Care.” Additional sessions will focus on the following topics:

    • Clonal Expansion in Normal and Pathological Tissues: It’s All a Matter of Fitness
    • Unleashing the Immune System to Develop Therapeutic Strategies
    • Integrated Immune-Microbiome Biomarker Discovery
    • Clinical Data Science

    “In the spirit of cooperation, MD Anderson is excited to host the Leading Edge of Cancer Research Symposium, and we welcome cancer researchers to participate in sharing cutting-edge discoveries that enable fruitful scientific discussions and innovations in the field,” said Giulio Draetta, M.D., Ph.D., chief scientific officer. “This collaborative environment is accessible to everyone, and we encourage our peers to join our collective mission to end cancer as we strive to bring the best science to our patients.”

    For more than 80 years, MD Anderson has advanced impactful research across the spectrum of cancer science. The institution has cultivated a unique environment that allows discoveries to be translated directly to the clinic and, simultaneously, insights from the clinic to inform studies in the lab. This seamless collaborative cycle enables significant breakthroughs at an unmatched pace.

    The Leading Edge of Cancer Research Symposium brings together the global research community to engage in beneficial discussions and to stimulate innovative research that will improve patients’ lives. More information on the symposium, including a full agenda and links to register or submit posters, can be found at MDAnderson.org/ResearchSymposium.

     

     

    – 30 –

    University of Texas M. D. Anderson Cancer Center

    Source link

  • Landmark Clinical Study Finds Aspirin as Effective as Commonly Used Blood Thinner to Prevent Life-Threatening Blood Clots and Death After Fracture Surgery

    Landmark Clinical Study Finds Aspirin as Effective as Commonly Used Blood Thinner to Prevent Life-Threatening Blood Clots and Death After Fracture Surgery

    Newswise — Patients who have surgery to repair bone fractures typically receive a type of injectable blood thinner, low-molecular-weight heparin, to prevent life-threatening blood clots, but a new clinical trial found that over-the-counter aspirin is just as effective. The findings, presented today at the Orthopaedic Trauma Association (OTA) annual meeting in Tampa, FL, could cause surgeons to change their practice and administer aspirin instead to these patients.

    The multi-center randomized clinical trial of more than 12,000 patients at 21 trauma centers in the U.S. and Canada, is the largest-ever trial in orthopedic trauma patients. The trial was co-led by the Department of Orthopaedics at the University of Maryland School of Medicine (UMSOM) and the Major Extremity Trauma Research Consortium (METRC) based at the Johns Hopkins Bloomberg School of Public Health.

    “We expect our findings from this large-scale trial to have an important impact on clinical practice, and potentially even change the standard of care,” said the study’s principal investigator Robert V. O’Toole, MD, the Hansjörg Wyss Medical Foundation Endowed Professor in Orthopaedic Trauma at UMSOM and head of the school’s Division of Orthopaedic Traumatology. “Orthopaedic trauma patients are commonly prescribed the blood thinner low-molecular-weight heparin to prevent blood clots for weeks following surgery. Not only does the medication need to be injected, it can also be quite expensive compared to aspirin.”

    Blood clots cause as many as 100,000 deaths in the U.S. each year, according to the U.S. Centers for Disease Control (CDC). Patients who experience fractures that require surgery – an estimated 1 million people in the U.S. annually – are at increased risk of developing blood clots in the veins, including a fatal pulmonary embolism, which is a clot in the lung. Current guidelines recommend prescribing low-molecular-weight heparin (enoxaparin), although research in total joint replacement surgery suggested a potential benefit of aspirin as a less-expensive, widely available option.

    Dr. O’Toole, who is also Chief of Orthopaedics at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center (UMMC), presented the results of the landmark clinical trial at the OTA annual meeting. The $12 million study was funded by the Patient-Centered Outcomes Research Institute (PCORI), (PCS-1511-32745), an independent, nonprofit organization that finances research to help patients and clinicians make better-informed healthcare decisions.

    The study enrolled 12,211 patients with leg or arm fractures that necessitated surgery or pelvic fractures regardless of the specific treatment. Half were randomly assigned to receive 30 mg of injectable low-molecular-weight heparin twice daily. The other half received 81 mg of aspirin twice daily. The follow-up period after surgery was 90 days.

    The main finding of the study was that aspirin was “noninferior,” or no worse, than low-molecular-weight heparin in preventing death from any cause – 47 patients in the aspirin group died compared with 45 patients in the heparin group. Secondary outcomes noted no differences in non-fatal pulmonary embolism. The incidence of bleeding complications and all other safety outcomes was similar in both groups.  Of all the outcomes studied, the one potential difference noted was fewer blood clots in the legs in the low-molecular-weight heparin group. This relatively small difference was driven by clots lower in the leg, which are of unclear clinical importance.

    “With data from more than 12,000 patients, this study provides clear evidence that aspirin is a viable option for preventing blood clots in the lung and death in patients who require surgery for orthopaedic trauma,” said Andrew Pollak, MD, the James Lawrence Kernan Professor and Chair of the Department of Orthopedics at UMSOM and Senior Vice President and Chief Clinical Officer for the 11-hospital University of Maryland Medical System (UMMS).

    The trial was called PREVENTion of CLots in Orthopaedic Trauma, or PREVENT CLOT. Patients enrolled in the trial were treated at the R Adams Cowley Shock Trauma Center at UMMC and 20 other trauma centers in 15 other states and two in Canada. Recruitment started in April 2017 and continued through 2021. Deborah Stein, MD, MPH, Professor of Surgery at UMSOM and Director of Adult Critical Care Services at UMMC, and Renan Castillo, PhD, an Associate Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, are co-principal investigators.

    “This exciting trial, the largest ever conducted in orthopedic trauma patients, provides important guidance to surgeons in helping to prevent potentially fatal blood clots after fracture surgery by using a medication that is both inexpensive and easy to administer,” said Mark T. Gladwin, MD, Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.

     

    About the University of Maryland School of Medicine

    Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world — with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile), is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9 among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192 public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

     

    University of Maryland School of Medicine

    Source link

  • ISPOR Europe 2022 Plenaries and Speakers Announced

    ISPOR Europe 2022 Plenaries and Speakers Announced

    Newswise — Lawrenceville, NJ, USA—October 4, 2022—ISPOR—The Professional Society for Health Economics and Outcomes Research announced today its plenary sessions and speakers for its ISPOR Europe 2022 conference. The conference will be held 6-9 November in Vienna, Austria and focused on the theme, “Collaborating Across Borders: Building and Using Evidence to Enable Access.” The conference theme is especially timely, as the new Health Technology Assessment (HTA) Regulation in the European Union has spurred conversations about how different countries, regions, or even cities, can work together in a variety of outcomes research methods. Conference registration options include in-person as well as virtual attendance.

    Plenary sessions and speakers for the conference are outlined below. Speakers listed are confirmed with additional speakers added to the online program as they are confirmed. 

    Plenary 1—Monday, 7 November:
    The Convergence of HTA and Regulation: A New HTA Reality and Collaboration with Regulatory Agencies
    The new HTA regulation in Europe is expected to have a more systematic and synergic collaboration with regulatory agencies. This session will explore how the different activities and remits of both regulatory and HTA assessment can be optimized. Confirmed speakers currently include:

    • Moderator: Rui Santos Ivo; INFARMED; Lisbon, Portugal
    • Marcus Guardian, MBA; EUnetHTA; Diemen, Netherlands 

    Plenary 2—Tuesday, 8 November:
    Patient-Centered Research in the Real World: Possible Across Borders?
    This session will discuss advances and lessons learned for reliably capturing patient-centric data and whether doing so across borders is realistic to aid in effectiveness evaluation of new medicines. Confirmed speakers currently include:

    • Moderator: Tara Symonds, PhD; Clinical Outcomes Solutions Ltd; Folkestone, England, UK
    • Nancy Devlin, PhD; University of Melbourne; Melbourne, Australia
    • Eleanor M. Perfetto, PhD, RPh, MS; University of Maryland; Baltimore, MD, USA

    Plenary 3—Wednesday, 9 November:
    Innovative Methods for Integrating Data Across Outcomes and Borders
    The volume, granularity, and heterogeneity of real-world evidence have been growing exponentially as technology platforms provided new opportunities to access, link, and integrate these data and use them for outcomes research and regulatory purposes. This session will examine innovative study designs to derive comparative effectiveness when randomized controlled trials cannot be performed. Confirmed speakers currently include:

    • Moderator: Uwe Siebert, MD, MPH, MSc, ScD; UMIT – University for Health Sciences; Hall in Tirol, Austria
    • Peter Arlett, MBBS (MD); European Medicines Agency; Amsterdam, Netherlands 

    The ISPOR Short Course Program for HEOR training and education will also be offered on 6 November at ISPOR Europe 2022.

    ISPOR is recognized globally as the leading professional society for health economics and outcomes research and for its role in improving healthcare decisions. ISPOR Europe 2022 draws healthcare stakeholders with an interest in HEOR, including researchers and academicians, assessors and regulators, payers and policymakers, the life sciences industry, healthcare providers, and patient engagement organizations.

    Additional information on the conference can be found at:
    Conference Information  |  Program  | Short Courses  |  Press  |  Exhibits & Sponsorship

    ###

     

    ABOUT ISPOR
    ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
    Website  | LinkedIn  | Twitter (@ispororg)  |  YouTube  |  Facebook  |  Instagram  

    ISPOR–The Professional Society for Health Economics and Outcomes Research

    Source link