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Tag: Regenstrief Institute

  • Extensive Study Reveals Vaccination Numbers Required to Prevent COVID-19 Hospitalizations and ED Visits

    Extensive Study Reveals Vaccination Numbers Required to Prevent COVID-19 Hospitalizations and ED Visits

    Newswise — An analysis of real-world data from more than 1.2 million patients from health systems in four geographically dispersed states — Indiana, Oregon, Texas and Utah — conducted by the U.S. Centers for Disease Control and Prevention’s VISION Network, has determined both the number of adults needed to be vaccinated to prevent one COVID-19 associated hospitalization and the number needed to be vaccinated to prevent one COVID-19 associated emergency department (ED) visit.

    This study is one of the first, largest and most comprehensive studies to present clear measurement, by age groups, of how widespread vaccination needs to be to provide protection against serious and moderate disease in adults.

    Preventing a hospitalization indicates that vaccination provided protection against severe disease. Preventing an ED visit indicates that vaccination provided protection against moderate disease.

    “The number needed to be vaccinated or more technically, ‘number needed to vaccinate,’ comes from the related concept of ‘number needed to treat’ — how many must be treated to avoid one bad outcome. One can think of number needed to treat or vaccinate as similar to how much gas you need, or how hard you need to push on the gas pedal to accelerate,” said study co-author Shaun Grannis, M.D., M.S., Regenstrief Institute Vice President for Data and Analytics and the Regenstrief Professor of Medical Informatics at Indiana University of School of Medicine. “Knowing the number of patients who need to be vaccinated is a way of measuring how effective the vaccine is. The lower the number of patients needed to be vaccinated, the more effective the vaccine. If we can prevent more hospitalizations with fewer vaccinations, that’s important to know.  

    “Knowing the number of patients needed to be vaccinated helps us plan on the volume of vaccine needed and the type of awareness and education that we want to provide. This number informs decision-making processes by public health officials, vaccine producers, health systems and others.”

    The study found that the number of patients needed to be vaccinated to prevent one COVID-19-associated hospitalization was higher than the number needed to vaccinate to prevent one COVID-19 associated ED visit, reflecting differences in outcome severity. These numbers were dependent on patient risk factors as well as local disease incidence.

    The number needed to be vaccinated to prevent one COVID-19-associated hospitalization ranged from 44 to 615 (median was 205) individuals and was lower for adults aged 65 years or older and for those with underlying medical conditions. The number needed to be vaccinated decreased as the population became older because older individuals are more susceptible to the adverse effects of the virus and, therefore, the vaccine provides greater protection.

    The number of patients needed to be vaccinated to prevent COVID-19-associated ED visits showed a different pattern because vaccines were more effective at preventing ED visits among younger adults than older ones. The median number needed to be vaccinated to prevent one ED visit ranged from 75 to 592 (median was 156) individuals.

    Information from patients who had received either two or three mRNA vaccine doses was analyzed. None were immunocompromised. Data was from December 2021- February 2022, a period of Omicron BA.1 variant predominance.

    “The reason why the number of patients needed to be vaccinated to prevent a COVID-19 related hospitalization is different from the number needed to prevent an ED (Emergency Department) visit is not fully understood, but it is likely because of how people seek healthcare. Many people, especially younger ones who lack health insurance or Medicare, are more likely to use the ED for primary healthcare. On the other hand, older people usually go to their regular doctor instead of going to the ED,” Dr. Grannis observed.

    “Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021-February 2022, VISION Network: a retrospective cohort study” is published in The Lancet Regional Health–Americas.

    Regenstrief Institute co-authors, in addition to Dr. Grannis, are Interim Director of the Center for Biomedical Informatics Brian Dixon, PhD, MPA; William F. Fadel, PhD and Nimish R. Valvi, DrPH. Peter Embí, M.D., former president of the Regenstrief Institute and current affiliated scientist, is also a co-author.

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  • Racial disparities discovered in insomnia treatment study

    Racial disparities discovered in insomnia treatment study

    INDIANAPOLIS — In one of the first studies to investigate racial disparities in the pharmacologic treatment of insomnia, researchers from Regenstrief Institute and Indiana University report that patients belonging to racial minority groups were significantly less likely to be prescribed medication following diagnosis of insomnia than White patients.

    The study found that Black patients were much less likely to have been prescribed an FDA-approved insomnia medication at any time post diagnosis than White patients. Other non-White individuals were significantly less likely to be prescribed an FDA-approved medication two, three, and four years after insomnia diagnosis but not in year one.

    “We looked at comorbidities — anxiety disorders and depression — and we looked at where individuals lived and other factors that might account for the disparity in prescriptions for medications following a diagnosis of insomnia,” noted co-author and Regenstrief Research Scientist Malaz Boustani, M.D., MPH. “We found that race was the only variable that accounted for the differences in treatment.”

    The researchers reported that despite older patients and those with comorbidities being less likely to be prescribed insomnia medications regardless of race, White patients overall still had a shorter period between diagnosis and prescription than other races.

    Insomnia is a common sleep disorder involving difficulty falling asleep, staying asleep or getting good-quality sleep. According to the U.S. Centers for Disease Control and Prevention, not getting enough sleep is linked with many chronic diseases and conditions including type 2 diabetes, heart disease, obesity and depression.

    “We did this study to simply identify treatment trends,” said Regenstrief Institute Research Scientist Noll Campbell, PharmD, M.S., a study co-author. “Are the trends we found caused by individual patient preferences, group-based preferences, or are they the result of different approaches to nonpharmacologic options for the treatment of insomnia? Future research will be needed to discern why these trends are occurring.”

    In this study, Indiana Network for Patient Care (INPC) data from about 10,000 individuals who were prescribed FDA-approved medications for insomnia was analyzed. The INPC is managed by the Indiana Health Information Exchange. Regenstrief created the INPC and provides access to data for research purposes.

    “The Indiana Network for Patient Care proved once again to be an invaluable resource for understanding clinical practice. It was only through the INPC that we obtained the demographic, diagnostic, medication, and clinical notes data necessary for analyzing racial disparities in insomnia medication prescribing,” said Regenstrief Institute Research Scientist Paul Dexter, M.D., a study co-author and clinician-informatician.

    “The systematic analysis of electronic health records data can play an important role in helping us uncover disparities that can be acted upon towards more equitable care, said Regenstrief Institute Research Scientist Arthur Owora, PhD, MPH, the study senior author. “This potential is highlighted by this study; however, given the inherent deficits of secondary data sources, a cautious interpretation is warranted, and further research is needed to better understand how and to what extent patient preferences and patient-clinician interactions may have contributed to the observed disparities in insomnia treatment.”

    The study population was 75 percent White, 69 percent female and 62 percent non-Hispanic. Average age at the time of insomnia diagnosis was 61.

    “In addition to revealing racial disparity in prescription of medications for insomnia, the data suggests that providers may be undertreating insomnia,” said study first author Emma Holler, MPH, a doctoral student and clinical epidemiologist with Indiana University School of Public Health — Bloomington.

    “Racial disparities in the pharmacological treatment of insomnia: A time-to-event analysis using real-world data” is published in the peer-reviewed journal Sleep Medicine.

    This work was supported in part by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

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