FACTORS INFLUENCING HEALTH INSURERS' DECISIONS TO COVER NEW GENETIC TECHNOLOGIES

2000 ◽  
Vol 16 (1) ◽  
pp. 178-189 ◽  
Author(s):  
Michele M. Schoonmaker ◽  
Barbara A. Bernhardt ◽  
Neil A. Holtzman
Keyword(s):  
Gene Therapy ◽  
Critical Role ◽  
Medical Costs ◽  
Outpatient Setting ◽  
Carrier Screening ◽  
Consensus Conference ◽  
Detection Rates ◽  
Factors Influencing ◽  
Genetic Technologies ◽  
Health Insurers

Objective: To examine the relative importance of factors influencing health insurers' coverage of new genetic technologies.Methods: A national survey in which the decision makers for private health insurers were asked whether they would cover cystic fibrosis (CF) carrier screening, testing for genetic susceptibility to breast cancer (BRCA test), and medical costs of a clinical trial of gene therapy for CF under a variety of conditions.Results: Respondents' coverage of the two tests and of medical costs of clinical trials was low at the time of the study (4%–15.5% of insurers.) Their coverage of CF carrier screening and BRCA testing would be increased significantly if the group tested was restricted to those at high risk, if detection rates were higher and costs lower, and if testing was endorsed by a national professional group or consensus conference. Coverage of the medical costs of a trial of CF gene therapy would be significantly more likely if the trial was restricted to children or adults with severe CF, safety and effectiveness was proven, and therapy could be administered in a regional hospital or an outpatient setting rather than in a research hospital.Conclusions: Health insurers play a critical role in the diffusion of new genetic technologies. The validity of genetic tests and the safety and effectiveness of new therapies are primary factors influencing health insurers' coverage. Lower costs and approval of professional groups are other factors associated with increased coverage.

Multivariate analysis of factors influencing medical costs of acute pancreatitis hospitalizations based on a national administrative database

2012 ◽  
Vol 44 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Atsuhiko Murata ◽  
Shinya Matsuda ◽  
Toshihiko Mayumi ◽  
Kohji Okamoto ◽  
Kazuaki Kuwabara ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Multivariate Analysis ◽  
Medical Costs ◽  
Administrative Database ◽  
Factors Influencing

EXTH-51. DEVELOPMENT OF A NOVEL GENE THERAPY APPROACH TARGETING GLIOBLASTOMA FOLLOWING ARTIFICIAL INTELLIGENCE (AI)-DIRECTED IDENTIFICATION OF THE GBM STATE

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi174-vi175
Author(s):  
David Tran ◽  
Son Le ◽  
Bo Ma ◽  
Darin Falk ◽  
Serge Zolotukhin
Keyword(s):  
Gene Therapy ◽  
Gene Network ◽  
Single Cell Analysis ◽  
Regulatory Gene ◽  
Critical Role ◽  
Tumor Control ◽  
Master Regulators ◽  
Gene Therapy Approach ◽  
Differentiated Cells ◽  
Neuronal Precursor Cell

Abstract BACKGROUND Profound heterogeneity has severely hampered therapeutic advancements in GBM. Remarkably, however, GBM exhibits broad clinical and histopathologic overlaps suggesting the presence of a common state. The GBM state embodies network restructuring forced by founding mutations and perpetuated in subclones of GBM stem-like cells (GSCs). Successful targeting of the GBM state promises to circumvent the heterogeneity. METHODS To decipher the GBM state, we applied NETZEN, an AI suite integrating a deep neural network with gene network-based ranking, to first generate the reference GBM gene network from TCGA’s entire GBM RNAseq collection, and then identify the altered master regulatory gene subnetwork in GBM using a dataset containing >30 diverse patient-derived GSC lines and their paired differentiated cells, 6 astrocyte and 3 neuronal precursor cell lines. To develop a gene therapy against the GBM state, we screened a rAAV capsid library through GBM patient-derived xenografts (PDX) to identify variants with specific tropism for GBM cells that can deliver targeting constructs intratumorally. RESULTS We discovered a putative GBM state anchored by developmentally restricted master regulators. To validate its critical role, we deconstructed it using shRNA in a panel of PDX and uniformly observed improved tumor control and survival compared to controls (p< 0.05 in all lines). More notably, when the core GBM state was forcibly reconstructed in astrocytes, transformation into GSC-like cells occurred, as measured by single-cell analysis, neurosphere formation, and most importantly, development of lethal infiltrating brain tumors in 15/15 mice. Finally, selected novel rAAV capsids with 10-40-fold higher specificity for GBM cells were utilized in a shRNA-based rAAV platform to target key master regulators of the validated GBM state. CONCLUSIONS The GBM state is established by a developmental master regulator subnetwork permitting the creation of a first-of-its-kind, heterogeneity-agnostic GBM therapy. This AI-directed R&D program can be expanded to target other tumors.

Culture in la clínica: Evaluating the utility of the Cultural Formulation Interview (CFI) in a Mexican outpatient setting

2017 ◽  
Vol 54 (4) ◽  
pp. 466-487 ◽  
Author(s):  
Alyssa M. Ramírez Stege ◽  
Kristin Elizabeth Yarris
Keyword(s):  
Mental Illness ◽  
Outpatient Setting ◽  
Cultural Factors ◽  
Clinical Settings ◽  
Cultural Formulation ◽  
Factors Influencing ◽  
Health And Illness ◽  
Promising Development ◽  
Cultural Formulation Interview

While the classification of psychiatric disorders has been critiqued for failing to adequately account for culture, the inclusion of the Cultural Formulation Interview (CFI) in the DSM-5 has been viewed as a promising development for the inclusion of cultural factors in diagnosis and treatment of mental illness. In this study, we assess the appropriateness, acceptability, and clinical utility of the CFI among outpatients in a Mexican psychiatric hospital. Our assessment included observations of psychiatric residents’ application of the CFI with 19 patients during routine outpatient visits, along with pre- and post-CFI interviews to determine providers’ and patients’ views of the CFI. The CFI was generally well received by providers and patients, viewed as a way of building trust and increasing providers’ understanding of contextual factors influencing mental illness, such as social support. However, the CFI questions specifically related to “culture” were of limited effect and both patients and providers did not view them as useful. We discuss implications for the clinical assessment of cultural factors influencing mental health and illness and for the incorporation of the CFI in Mexican clinical settings.

Factors influencing word of mouth behaviour in the restaurant industry

2017 ◽  
Vol 35 (1) ◽  
pp. 81-110 ◽  
Author(s):  
Mohammad Reza Jalilvand ◽  
Sirous Salimipour ◽  
Mehdi Elyasi ◽  
Mehdi Mohammadi
Keyword(s):  
Relationship Quality ◽  
Structural Equation ◽  
Word Of Mouth ◽  
Critical Role ◽  
Influential Factors ◽  
Restaurant Industry ◽  
Equation Modeling ◽  
Content Type ◽  
Factors Influencing

Purpose Restaurants with limited promotion budgets depend mainly on word of mouth (WOM) among customers. WOM seems particularly important to the marketing of services. This is because services are experiential in nature and difficult to assess before purchase. In the restaurants context there is little research on WOM. The purpose of this paper is to examine the factors that may influence tourists’ WOM about restaurants implying on the critical role of relationship quality. Design/methodology/approach A comprehensive literature review is conducted to identify the major factors influencing WOM in the context of restaurant industry. The study utilizes self-administered questionnaire survey and the target population are the customers who have referred to the restaurants of Tehran, Iran. A convenience sampling approach was utilized to collect a sample of 326 customers. A structural equation modeling procedure is applied to the examination of the antecedents of WOM. Findings The paper found that food quality, personal interaction quality, physical environment quality, and perceived value influence WOM behavior of customer in an indirect way through relationship quality. Practical implications This research conjectured that an understanding of factors that influence the tourist to talk each other about a given restaurant are worthy of additional research. Consequently, the study helps to understand how these factors can provide alternative sources of marketing to attract the long-term economic sustainability of restaurant industry in Iran. Originality/value To the authors’ knowledge, this research will be the first attempt to explore influential factors on WOM in restaurant industry focusing on the critical role of relationship quality. It is expected that researchers will find this research a contribution to the WOM literature, particularly in restaurant industry.

scholarly journals Factor Analysis Influencing Postoperative Hospital Stay and Medical Costs for Patients with Definite, Suspected, or Unmatched Diagnosis of Acute Cholecystitis according to the Tokyo Guidelines 2013

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Aoi Hayasaki ◽  
Koji Takahashi ◽  
Takehiro Fujii ◽  
Koji Kumamoto ◽  
Koji Fujii ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Performance Status ◽  
Medical Costs ◽  
Postoperative Hospital Stay ◽  
Imaging Findings ◽  
Tokyo Guidelines ◽  
Severity Grade ◽  
Factors Influencing ◽  
Preoperative Factors

Purpose. To identify significant independent preoperative factors influencing postoperative hospital stay (PHS) and medical costs (MC) in 171 patients who underwent cholecystectomy for benign gallbladder diseases and had definite, suspected, or unmatched acute cholecystitis (AC) diagnosis according to the Tokyo Guidelines 2013 (TG13).Methods.The 171 patients were classified according to the combination of diagnostic criteria including local signs of inflammation (A), systemic signs of inflammation (B), and imaging findings (C): A+ B+ C (definite diagnosis,n=84), A+ B (suspected diagnosis,n=25), (A or B) + C (n=10), A (n=41), and B (n=11).Results. The A+ B + C and (A or B) + C groups had equivalent PHS and MC, suggesting that imaging findings were essential for AC diagnosis. PHS and MC were significantly increased in the order of severity grades based on TG13. Performance status (PS), white blood cell count, and severity grade were identified as preoperative factors influencing PHS by multivariate analysis, and significant independent preoperative factors influencing MC were age, PS, preoperative biliary drainage, hospital stay before surgery, albumin, and severity grade.Conclusion. PS and severity grade significantly influenced prolonged PHS and increased MC.

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