Digital Commons Network^™

What Is The Cost To Employers Of Direct Medical Care For Chronic Obstructive Pulmonary Disease?, Tursynbek Nurmagambetov, Adam Atherly, Seymour Williams, Fernando Holguin, David M. Mannino, Stephen C. Redd

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the United States. In 2000, an estimated 10.5 million people had COPD, of which more than 7.2 million were from the under-age 65 employed population. The prevalence of COPD in the workforce population was substantial with 46.5% of current employment among adults having the disease. However, the cost burden in the employed population is unknown. We examined COPD prevalence and costs in a large employment-based population. Using claims data from 1999 to 2003, we estimated the cost associated with COPD-related hospitalizations, emergency department visits, outpatient services, …

Assessing The Effectiveness Of Antiretroviral Adherence Interventions: Using Marginal Structural Models To Replicate The Findings Of Randomized Controlled Trials., Maya L. Petersen, Yue Wang, Mark J. Van Der Laan, David R. Bangsberg

Maya Petersen

Randomized controlled trials of interventions to improve adherence to antiretroviral medications are not always feasible. Marginal Structural Models (MSM) are a statistical methodology that aims to replicate the findings of randomized controlled trials using observational data. Under the assumption of no unmeasured confounders, three MSM estimators are available to estimate the causal effect of an intervention. Two of these estimators, G-computation and Inverse Probability of Treatment Weighted, can be implemented using standard software. G-computation relies on fitting a multivariable regression of adherence on the intervention and confounders. Thus, it is related to the standard multivariable regression approach to estimating causal …

Changing The Burden Of Copd Mortality, David M. Mannino, Victor A. Kiri

David M. Mannino

COPD is a major cause of mortality and morbidity worldwide with an estimated 2.75 million deaths in 2000 (fourth leading cause of death). In addition to the considerable morbidity and mortality associated with COPD, this disease incurs significant healthcare and societal costs. Current COPD guidelines acknowledge that the following can improve COPD mortality: smoking cessation; long-term oxygen therapy; and lung volume reduction surgery in small subsets of COPD patients. To date, no randomized controlled trials have demonstrated an effect of pharmacological treatment on mortality, although several observational studies suggest that both long-acting bronchodilators and inhaled corticosteroids may provide a survival …

Hospitalization For Patients With Sarcoidosis: 1979-2000, M. G. Foreman, David M. Mannino, L. Kamugisha, G. E. Westney

David M. Mannino

BACKGROUND AND AIM:

Sarcoidosis is a multi-system granulomatous disease of unknown etiology with significant racial and gender differences in disease severity, incidence, and prevalence. Primarily treated in outpatients, limited information is available on hospital outcomes in patients with sarcoidosis. The National Hospital Discharge Survey (NHDS) was analyzed over a 22-year period to determine trends in hospitalization and the impact of concurrent comorbidities.

METHODS:

Secondary analysis was done of the NHDS, a national survey of inpatient medical care for short stays in nonfederal facilities.

RESULTS:

There were a total of 750 million hospitalizations over this 22-year period, with 593,455 (0.08%) hospitalizations …

Estimation Of Direct Causal Effects., Maya L. Petersen, Sandra E. Sinisi, Mark J. Van Der Laan

Maya Petersen

Many common problems in epidemiologic and clinical research involve estimating the effect of an exposure on an outcome while blocking the exposure's effect on an intermediate variable. Effects of this kind are termed direct effects. Estimation of direct effects arises frequently in research aimed at understanding mechanistic pathways by which an exposure acts to cause or prevent disease, as well as in many other settings. Although multivariable regression is commonly used to estimate direct effects, this approach requires assumptions beyond those required for the estimation of total causal effects. In addition, when the exposure and intermediate interact to cause disease, …

Access To Death Certificates: What Should Research Ethics Committees Require For Approval?, Tore Nilstun, Colleen Cartwright, Rurik Lofmark, L Deliens, Susanne Fischer, Guido Miccinesi, Michael Norup, Agnes Van Der Heide

Professor Colleen M Cartwright

Purpose: To present and discuss the reactions of research ethics committees (RECs) in a number of countries when asked for approval of a study requiring access to death certificates to identify the physicians signing the certificates and to send them a four-page questionnaire about medical decisions made at the patient's end-of-life that could possibly have hastened death. Methods: A simple questionnaire were sent to the responsible national investigator in an international study (Australia, Belgium, Denmark, Italy, the Netherlands, Sweden, Switzerland) asking about the interactions between the national research group and the national/regional REC(s). Results: Different laws or guidelines were used …

The Prevalence And Characteristics Of Intimate Partner Violence In A Community Study Of Chinese American Women., Madelyn Hicks

Madelyn Hsiao-Rei Hicks

No abstract provided.