The Experts below are selected from a list of 127986 Experts worldwide ranked by ideXlab platform
Jeanette S. Brown - One of the best experts on this subject based on the ideXlab platform.
-
Urinary incontinence in women: Direct costs of Routine Care
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, David H. Thom, Jennifer M. Creasman, Jeanette S. BrownAbstract:Objective The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. Study Design In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Results Mean age was 55 ± 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity ( P P P P Conclusion Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
-
Urinary incontinence in women: Direct costs of Routine Care.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, Jennifer M. Creasman, David Thom, Jeanette S. BrownAbstract:The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Mean age was 55 +/- 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity (P < .001) and body mass index (P < .001) were 2.2-fold higher for African American versus white women (P < .0001) and 42% higher for women with mixed versus stress incontinence (P < .05). Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
Leslee L. Subak - One of the best experts on this subject based on the ideXlab platform.
-
Urinary incontinence in women: Direct costs of Routine Care
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, David H. Thom, Jennifer M. Creasman, Jeanette S. BrownAbstract:Objective The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. Study Design In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Results Mean age was 55 ± 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity ( P P P P Conclusion Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
-
Urinary incontinence in women: Direct costs of Routine Care.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, Jennifer M. Creasman, David Thom, Jeanette S. BrownAbstract:The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Mean age was 55 +/- 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity (P < .001) and body mass index (P < .001) were 2.2-fold higher for African American versus white women (P < .0001) and 42% higher for women with mixed versus stress incontinence (P < .05). Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
Sebastian Schneeweiss - One of the best experts on this subject based on the ideXlab platform.
-
Safety and effectiveness of dabigatran and warfarin in Routine Care of patients with atrial fibrillation
Thrombosis and Haemostasis, 2015Co-Authors: Katsiaryna Bykov, Sebastian Schneeweiss, Dorothee B. Bartels, Krista F. Huybrechts, Kristina Zint, John D. SeegerAbstract:SummaryThe RE-LY study demonstrated the safety and efficacy of dabigatran relative to warfarin for stroke prevention in non-valvular atrial fibrillation. It is important to further evaluate safety and effectiveness of drugs in Routine Care. This study used a sequential cohort design with propensity score matching to compare dabigatran with warfarin among patients in two commercial health insurance databases. New users of these anticoagulants were followed from initiation until discontinuation, the end of the study, or the occurrence of a study outcome (primary study outcomes were stroke and major bleeding). Proportional hazards regression was conducted separately within each data source and results were pooled. Among 19,189 matched dabigatran and warfarin initiators (mean age: 68 years, 36 % female), as-treated follow-up (average of 5 months for dabigatran, 4 months for warfarin) identified 62 and 69 strokes, respectively (pooled HR = 0.77; 95 % CI = 0.54 to 1.09), and 354 and 395 major haemorrhages, respectively (HR = 0.75; 0.65 to 0.87). No meaningful heterogeneity was identified across subgroups, but numeric trends suggest more pronounced stroke prevention by dabigatran relative to warfarin among patients age 75+ (HR = 0.57; 0.33 to 0.97) or with < 6 months of use (HR = 0.51; 0.19 to 1.42). Major bleeds were reduced more by dabigatran among patients aged < 55 (HR = 0.51; 0.30 to 0.87) and with CHADS2 < 2 (HR = 0.58; 0.44 to 0.77). In conclusion, in Routine Care of patients with non-valvular atrial fibrillation, dabigatran treatment resulted in improved health outcomes compared with warfarin.
-
Abstract 16227: Safety and Effectiveness of Dabigatran Relative to Warfarin in Routine Care
Circulation, 2014Co-Authors: John D. Seeger, Dorothee B. Bartels, Krista F. Huybrechts, Katsiaryna Bykov, Dalia Shash, Kristina Zint, Sebastian SchneeweissAbstract:Introduction: It is important to quantify the comparative safety and effectiveness of new drugs in Routine Care. Hypothesis: To assess the safety and effectiveness of dabigatran compared to warfarin in a sequential long-term study program in patients in Routine Care. Methods: This program uses 2 large commercial US health insurance databases and propensity score matching to compare new users of dabigatran and warfarin with respect to ischemic and bleeding events, with planned interim analyses. Results: From Oct 2010 through Dec 2012 patients with non-valvular atrial fibrillation and CHA 2 DS 2 -VASc scores ≥1 who initiated dabigatran, were matched (1:1) to warfarin initiators using a propensity score that balanced known risk factors for ischemic and bleeding events (Table). Follow-up until discontinuation of the anticoagulant, outcome event, or disenrollment was an average of 5 months (dabigatran) and 4 months (warfarin). Interim results indicate a 23% stroke rate reduction by dabigatran in a pooled analysis: HR=0.77, 95% CI=0.55-1.09. In the larger MarketScan database alone the stroke reduction was 36% (HR=0.64, 95% CI=0.44-0.95). There were only 26 strokes in the smaller Optum database leading to wide confidence intervals: HR=1.62, 95% CI=0.72-3.66. There was a 25% reduction in the rate of major hemorrhage: pooled HR=0.75, 95% CI=0.65-0.87 (MarketScan: HR=0.78 (95% CI=0.67-0.91), Optum: HR=0.56 (95% CI = 0.36-0.86)). Conclusions: Interim results from this sequential long-term study program of patients in Routine Care suggest that dabigatran has improved effectiveness and safety relative to warfarin. Results highlight the limitations of small event numbers, e.g. stroke in anticoagulated patients, in early stages of post-marketing monitoring programs making chance a likely explanation for variations in point estimates between databases. Assessments of effectiveness beyond the first six months of therapy are limited by the short average follow-up.
-
Risk of Ischemic Cerebrovascular and Coronary Events in Adult Users of Anticonvulsant Medications in Routine Care Settings
Journal of the American Heart Association, 2013Co-Authors: Elisabetta Patorno, Robert J. Glynn, Sonia Hernandez-diaz, Jerry Avorn, Peter M. Wahl, Rhonda L. Bohn, Daniel Mines, Jun Liu, Sebastian SchneeweissAbstract:Background Older-generation anticonvulsants that highly induce cytochrome P450 enzyme system activity produce metabolic abnormalities that may increase cardiovascular risk. The objective of this study was to evaluate the risk of ischemic cerebrovascular and coronary events in adult new users of anticonvulsants that highly induce cytochrome P450 activity compared with other anticonvulsant agents, as observed in a Routine Care setting. Methods and Results This was a cohort study of patients 40 to 64 years old from the HealthCore Integrated Research Database who had initiated an anticonvulsant medication between 2001 and 2006 and had no recorded major coronary or cerebrovascular condition in the 6 months before treatment initiation. Propensity score (PS) matching was used to evaluate ischemic cerebrovascular and coronary risk among anticonvulsant new users. High-dimensional propensity score (hdPS)–matched analyses were used to confirm adjusted findings. The study identified 913 events in 166 031 unmatched new treatment episodes with anticonvulsant drugs. In a PS-matched population of 22 864 treatment episodes, the rate ratio (RR) for ischemic coronary or cerebrovascular events associated with highly inducing agents versus other agents was 1.22 (95% CI, 0.90-1.65). The RR moved to 0.99 (95% CI, 0.73-1.33) with adjustment for hdPS matching (RR, 1.47; 95% CI, 0.95-2.28 for cerebrovascular events; RR, 0.70; 95% CI, 0.47-1.05 for coronary events). Conclusions In this exploratory analysis, there was no evidence of a consistent and statistically significant effect of initiating anticonvulsants that highly induce cytochrome P450 activity on ischemic coronary or cerebrovascular outcomes compared with other agents, given Routine Care utilization patterns.
-
Safety and effectiveness of bivalirudin in Routine Care of patients undergoing percutaneous coronary intervention
European Heart Journal, 2009Co-Authors: Jeremy A. Rassen, Murray A. Mittleman, Robert J. Glynn, M. Alan Brookhart, Sebastian SchneeweissAbstract:Aims To evaluate the effectiveness and safety of bivalirudin as used in Routine Care. Bivalirudin has been studied as an alternative to heparin plus glycoprotein IIb/IIIa inhibitor (GPI) during percutaneous coronary intervention (PCI). Trials have indicated that bivalirudin is non-inferior to heparin with respect to death and repeat revascularization and may decrease the risk of major bleeds. The use of bivalirudin in Routine Care has not been evaluated. Methods and results Using a representative database, we identified 127 185 individuals who underwent inpatient PCI between June 2003 and December 2006 and were administered either bivalirudin plus provisional GPI or the comparator, heparin plus GPI. We estimated relative risks of blood transfusion, repeated PCI, and in-hospital death. The adjusted hazard ratio (HR) for blood transfusion was 0.67 (0.61–0.73); instrumental variable analysis showed an HR of 0.72 (0.12–4.47). We observed a risk of in-hospital death of 0.80% in the bivalirudin group and 2.1% in the heparin group; the adjusted HR was 0.51 (0.44–0.60). Conclusion In our non-randomized study of Routine Care, we observed a reduction in blood transfusions and in short-term mortality for patients treated with bivalirudin compared with heparin plus GPI. The mortality benefit was more pronounced in our study than in randomized trials.
Jennifer M. Creasman - One of the best experts on this subject based on the ideXlab platform.
-
Urinary incontinence in women: Direct costs of Routine Care
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, David H. Thom, Jennifer M. Creasman, Jeanette S. BrownAbstract:Objective The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. Study Design In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Results Mean age was 55 ± 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity ( P P P P Conclusion Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
-
Urinary incontinence in women: Direct costs of Routine Care.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, Jennifer M. Creasman, David Thom, Jeanette S. BrownAbstract:The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Mean age was 55 +/- 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity (P < .001) and body mass index (P < .001) were 2.2-fold higher for African American versus white women (P < .0001) and 42% higher for women with mixed versus stress incontinence (P < .05). Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
Stephen K. Van Den Eeden - One of the best experts on this subject based on the ideXlab platform.
-
Urinary incontinence in women: Direct costs of Routine Care
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, David H. Thom, Jennifer M. Creasman, Jeanette S. BrownAbstract:Objective The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. Study Design In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Results Mean age was 55 ± 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity ( P P P P Conclusion Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
-
Urinary incontinence in women: Direct costs of Routine Care.
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Leslee L. Subak, Stephen K. Van Den Eeden, Jennifer M. Creasman, David Thom, Jeanette S. BrownAbstract:The purpose of this study was to estimate the direct costs of Routine Care for urinary incontinence (UI) in community-dwelling, racially diverse women. In the Reproductive Risks for Incontinence Study at Kaiser population-based study, 528 women with UI weekly or more quantified resources that were used for UI. Routine Care costs were calculated with the use of national resource costs ($2005). Potential predictors of these outcomes were examined by multivariable linear regression. Mean age was 55 +/- 9 (SD) years. Among women with weekly UI, 69% reported incontinence-related costs. Median weekly cost was $1.83 (25%-75% interquartile range [IQR], $0.50, $5.23), increasing from $0.93 (IQR, $0, $3) for moderate to $7.82 (IQR, $5, $37) for very severe incontinence. Costs that increased with incontinence severity (P < .001) and body mass index (P < .001) were 2.2-fold higher for African American versus white women (P < .0001) and 42% higher for women with mixed versus stress incontinence (P < .05). Women pay a mean of >$250 per year out-of-pocket for UI Routine Care. Effective incontinence treatment may decrease costs.
