scholarly journals Pirfenidone: A novel hypothetical treatment for COVID-19

2020 ◽  
Vol 144 ◽  
pp. 110005 ◽  
Author(s):  
Soroush Seifirad
2021 ◽  
pp. 135910532110256
Author(s):  
Eric A Finkelstein ◽  
Yin Bun Cheung ◽  
Maurice E Schweitzer ◽  
Lai Heng Lee ◽  
Ravindran Kanesvaran ◽  
...  

Many patients with advanced illness have unrealistic survival expectations, largely due to cognitive biases. Studies suggests that when people are motivated to be accurate, they are less prone to succumb to these biases. Using a randomized survey design, we test whether offering advanced cancer patients ( n = 200) incentives to estimate their prognosis improves accuracy. We also test whether presenting treatment benefits in terms of a loss (mortality) rather than a gain (survival) reduces willingness to take up a hypothetical treatment. Results are not consistent with the proposed hypotheses for either accuracy incentives or framing effects.


2021 ◽  
pp. 1-5
Author(s):  
Nickolai J.P. Martonick ◽  
Ashley J. Reeves ◽  
James A. Whitlock ◽  
Taylor C. Stevenson ◽  
Scott W. Cheatham ◽  
...  

Context: Instrument-assisted Soft Tissue Mobilization (IASTM) is a therapeutic intervention used by clinicians to identify and treat myofascial dysfunction or pathology. However, little is known about the amount of force used by clinicians during an IASTM treatment and how it compares to reports of force in the current literature. Objective: To quantify the range of force applied by trained clinicians during a simulated IASTM treatment scenario. Design: Experimental. Setting: University research laboratory. Participants: Eleven licensed clinicians (physical therapist = 2, chiropractor = 2, and athletic trainer = 7) with professional IASTM training participated in the study. The participants reported a range of credentialed experience from 1 to 15 years (mean = 7 [4.7] y; median = 6 y). Intervention: Participants performed 15 one-handed unidirectional sweeping strokes with each of the 5 instruments for a total of 75 data points each. Force data were collected from a force plate with an attached skin simulant during a hypothetical treatment scenario. Main Outcome Measures: Peak force and average forces for individual strokes across all instruments were identified. Averages for these forces were calculated for all participants combined, as well as for individual participants. Results: The average of peak forces produced by our sample of trained clinicians was 6.7 N and the average mean forces was 4.5 N. Across individual clinicians, average peak forces ranged from 2.6 to 14.0 N, and average mean forces ranged from 1.6 to 10.0 N. Conclusions: The clinicians in our study produced a broad range of IASTM forces. The observed forces in our study were similar to those reported in prior research examining an IASTM treatment to the gastrocnemius of healthy individuals and greater than what has been reported as effective in treating delayed onset muscle soreness. Our data can be used by researchers examining clinically relevant IASTM treatment force on patient outcomes.


Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 61
Author(s):  
Iciar Martínez-López ◽  
Jorge Maurino ◽  
Patricia Sanmartín-Fenollera ◽  
Ana Ontañon-Nasarre ◽  
Alejandro Santiago-Pérez ◽  
...  

Introduction: Hospital pharmacists are increasingly playing a critical role in the care of patients with multiple sclerosis (MS). However, little is known about their preferences and perspectives towards different attributes of disease-modifying therapies (DMTs). The objective of this research was to assess pharmacists´ preferences for DMT efficacy attributes. Methods: A multicenter, non-interventional, cross-sectional, web-based study was conducted. Preventing relapses, delaying disease progression, controlling radiological activity, and preserving health-related quality of life (HRQoL) and cognition were the attributes selected based on a literature review and a focus group with six hospital pharmacists. Conjoint analysis was used to determine preferences in eight hypothetical treatment scenarios, combining different levels of each attribute and ranking them from most to least preferred. Results: Sixty-five hospital pharmacists completed the study (mean age: 43.5 ± 7.8 years, 63.1% female, mean years of professional experience: 16.1 ± 7.4 years). Participants placed the greatest preference on delaying disease progression (35.7%) and preserving HRQoL (21.6%) and cognition (21.6%). Importance was consistent in all groups of pharmacists stratified according to demographic characteristics, experience, research background, and volume of patients seen per year. Conclusions: Understanding which treatment characteristics are meaningful to hospital pharmacists may help to enhance their synergistic role in the multidisciplinary management of patients with MS.


2019 ◽  
Vol 40 (2) ◽  
pp. 308-318
Author(s):  
Zobair M. Younossi ◽  
Radhika P. Tampi ◽  
Fatema Nader ◽  
Issah M. Younossi ◽  
Rebecca Cable ◽  
...  

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6565-6565
Author(s):  
S. R. Berry ◽  
P. J. Neumann ◽  
C. Bell ◽  
E. Nadler ◽  
W. C. Evans ◽  
...  

6565 Background: New cancer drugs are increasingly expensive and raise difficult questions about the magnitude of therapeutic benefit needed to justify their incremental cost. In this context, it is unclear whether oncologists endorse standard thresholds of $50,000 to $100,000 per year of life. Methods: We surveyed 1,379 U.S. and 356 Canadian (Cdn) oncologists and asked how much longer a patient would need to survive metastatic cancer to justify the expense of a new treatment. To determine the stability of attitudes towards cost-effectiveness (CE) we randomized oncologists to receive two different versions of the scenario in which the price of the new treatment was varied (higher versus lower drug cost). In the U.S. survey, oncologists were also randomized to receive surveys in which we varied the provision of contextual information about the CE of several familiar interventions. Both U.S. and Cdn oncologists were asked to indicate what they “thought was ‘good value for money’ expressed as cost per life-year gained (LYG).” Results: Response rate was 57% in the U.S. and 48% in Canada. CE ratios implied by oncologists’ responses differed significantly between the groups randomized to the higher versus lower price of the hypothetical treatment (p < 0.001 U.S., p < 0.0001 Canada), but were independent of randomization to varying contextual information (p > 0.1). The median willingness to pay for a quality-adjusted year of life ranged from $150,000 (for oncologists considering the lower priced drug) to $250,000 (for those considering the more expensive drug) in both countries. Among those who considered the more expensive drug, 25% of respondents implicitly endorsed a CE ratio greater than $600,000 (U.S.) and $500,000 (Canada). In contrast, when asked directly to indicate CE ratios that were good value for the money outside of the clinical scenario, 70% (U.S.) and 64% (Canada) of respondents indicated values of less than $100,000 per LYG. Conclusions: Oncologists responding to our survey provided inconsistent views on how much benefit expensive new drugs should provide to be worthwhile. This suggests that means of eliciting input from physicians that reflect more stable attitudes need to be developed to appropriately inform decision-makers. No significant financial relationships to disclose.


2006 ◽  
Vol 61 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Lori Van Manen ◽  
Deb Feldman-Stewart ◽  
Michael D. Brundage

2021 ◽  
pp. 302-310
Author(s):  
Kazuhiro Suzuki ◽  
Vince Grillo ◽  
Yirong Chen ◽  
Shikha Singh ◽  
Dianne Athene Ledesma

PURPOSE Sixteen percent (16%) of patients with castration-resistant prostate cancer (CRPC) show no bone metastasis at diagnosis. However, 33% will become metastatic within 2 years. The goal of treatment in patients with nonmetastatic CRPC (nmCRPC), therefore, is to delay symptomatic metastases without undue toxicity. With novel antiandrogen treatments of different strengths and limitations available, physician preferences for nmCRPC treatment in Japan should be understood. METHODS A discrete choice experiment was conducted. Physicians chose between two hypothetical treatments in nmCRPC defined by six attributes: risk of fatigue, falls or fracture, cognitive impairment, hypertension, rashes as side effects of treatment, and extension of time until cancer-related pain occurs. Relative preference weights and relative importance were estimated by hierarchical Bayesian logistic regression. Physicians were also asked to make treatment decisions based on four hypothetical patient profiles to understand the most important factors driving decision making. RESULTS A total of 151 physicians completed the survey. Extension of time until cancer-related pain occurs was the most important attribute (relative importance, 32.3%; CI, 31.3% to 33.3%). Based on summed preference weights across all attributes, preferences for hypothetical treatment profiles I, II, and III were compared. A hypothetical treatment profile with better safety though shorter extension time was preferred (I: mean [standard deviation] = 1.7 [1.6 to 2.1]) over treatment profiles with lower safety but longer extension time (II: −2.7 [−2.8 to −2.6] and III: −0.2 [−0.3 to −0.1]). Treatment characteristics were more important factors for physicians' decision making than patient characteristics in prescribing treatment. CONCLUSION Physicians preferred a treatment with better safety profile, and treatment characteristics were the most important factors for decision making. This might have implications in physicians' decision making for nmCRPC treatment in the future in Japan.


2021 ◽  
Author(s):  
Bo Lan

The Fully Bayesian (FB) approach to road safety analysis has been available for some time, but it is largely unevaluated and untested. This study is trying to bridge the gap by conducting a thorough evaluation of FB method for black spots identification and treatment effect analysis. First, an evaluation is conducted on the univariate FB versus the empirical Bayesian (EB) method for single level severity data through the development of various models, and multivariate FB versus univariate FB for multilevel severity data, as well as the performance of various ranking and evaluation criteria for black spots identification. It is confirmed that the FB method is superior to the EB with respect to key ranking criteria (expected rank, mode rank and median rank of posterior PM, etc.). The multivariate FB method is better than univariate FB for the multilevel severity crashes. Then a teat of the FB before-after method for treatment effect analysis is performed. Two FB testing frameworks were employed. First the univariate before-after fully Bayesian (FB) method was examined using three simulated datasets. Then multivariate Poisson log normal (MVPLN), univariate Poisson log normal (PLN) and PB (Poisson gamma) models were evaluated using two groups of California unsignalized intersections. Hypothetical treatment sites were selected from these datasets such that a significant effect would be estimated by the naive before-after method that does not account for regression to the mean. This study confirmed that FB methods can indeed provide valid results, in that they correctly estimate a treatment effect of zero at these hypothetical treatment sites after accounting for regression to the mean. Finally the EB and the validated FB before after methods were applied to evaluation of two treatments: the conversion of rural intersections from unsignalized to signalized control; and the conversion of road segments from a four-lane to a three-lane cross-section with two-way left turn lanes (also known as road diets). The result indicates that both FB and EB method can provide comparable treatment effect estimates. This would suggest it is still appropriate to conduct treatment effect analysis using the EB method for univariate crash data, but that it is essential in so doing to account for temporal trends in crash frequency.


2011 ◽  
Vol 76 (2) ◽  
pp. 190-193 ◽  
Author(s):  
B. Ben-Zeev ◽  
R. Aharoni ◽  
A. Nissenkorn ◽  
R. Arnon

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