OP410 Real-World Benefit Of Endovascular Repair Of Abdominal Aortic Aneurysms - Comparison Of GORE® Global Registry for Endovascular Aortic Treatment And National Institute for Clinical Excellence 2018 Guidance

IntroductionEndovascular aneurysm repair (EVAR) is routinely used for treatment of abdominal aortic aneurysm (AAA). In 2018, draft guidance from the National Institute for Clinical Excellence (NICE) suggested EVAR was not cost-effective compared to open surgical repair. The analysis was driven by clinical inputs from randomized control trials which may not reflect current clinical practice. Data from registries may inform more robust economic modelling. The Global Registry for Endovascular Aortic Treatment (GREAT) was initiated to collect contemporary real-world data on the performance of GORE® aortic endografts and includes long-term data on survival, re-interventions and resource use. This study compares the real-world values for mortality and resource use following elective EVAR as collected by GREAT with the 2018 NICE AAA draft guidance.MethodsA total of 1,348 patients (88.7% men; mean age 73.1 years) undergoing elective AAA repair with the GORE® EXCLUDER device. Mortality, re-intervention and resource use was compared with the economic inputs for 2018 NICE draft guidance cost-utility analysis.ResultsAll patients survived EVAR compared to the 0.4 percent mortality indicated in the NICE analysis. All-cause mortality was lower through 1, 3 and 5 years with values of 6.9, 14.8 and 16.2 percent respectively compared to the NICE base case. The average length of stay was 3.7 days in GREAT compared to 8.34 days in the NICE analysis. Short- and long-term re-interventions were also lower with real-world data (3.6% versus 7.3% and 5.5% versus 8.3%).ConclusionsGREAT provides conflicting data on survival and resource use associated with EVAR compared to inputs of the 2018 NICE draft guidance These differences are likely to significantly alter incremental cost-effectiveness ratios. Robust cost-effectiveness modelling in health technology assessments should consider contemporary data, as it is likely more reflective of current clinical practice and more informative for clinical and economic decision making for AAA.

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Impact of the affordability of novel agents in patients with multiple myeloma: Real-world data of current clinical practice in Mexico

Cancer ◽

10.1002/cncr.31305 ◽

2018 ◽

Vol 124 (9) ◽

pp. 1946-1953 ◽

Cited By ~ 9

Author(s):

Luz Tarín-Arzaga ◽

Daniela Arredondo-Campos ◽

Victor Martínez-Pacheco ◽

Odra Martínez-González ◽

Alba Ramírez-López ◽

...

Keyword(s):

Multiple Myeloma ◽

Clinical Practice ◽

Real World ◽

Novel Agents ◽

Current Clinical Practice ◽

Real World Data ◽

World Data

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E095 Long-term efficacy of secukinumab in the management of ankylosing spondylitis in clinical practice: real world data

Rheumatology ◽

10.1093/rheumatology/kez110.093 ◽

2019 ◽

Vol 58 (Supplement_3) ◽

Cited By ~ 1

Author(s):

Hoda Alkoky ◽

Zuha Khan ◽

Hasan Tahir

Keyword(s):

Clinical Practice ◽

Ankylosing Spondylitis ◽

Real World ◽

Real World Data ◽

World Data ◽

Term Efficacy

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878-P: Real-World Data from U.S. Patients Using a Long-Term Implantable Continuous Glucose Monitoring (CGM) System: Age Effect on Glycemic Control

Diabetes ◽

10.2337/db20-878-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 878-P

Author(s):

KATHERINE TWEDEN ◽

SAMANWOY GHOSH-DASTIDAR ◽

ANDREW D. DEHENNIS ◽

FRANCINE KAUFMAN

Keyword(s):

Glycemic Control ◽

Continuous Glucose Monitoring ◽

Real World ◽

Glucose Monitoring ◽

Age Effect ◽

Real World Data ◽

World Data

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Long-term persistence with denosumab: real-world data from the Austrian Osteoporosis Clinic (AOC). A retrospective data analysis

Osteoporosis International ◽

10.1007/s00198-021-06102-2 ◽

2021 ◽

Author(s):

Ewald Boschitsch ◽

Oliver Naegele ◽

Anita Klinger ◽

Harald Brix-Samoylenko

Keyword(s):

Data Analysis ◽

Real World ◽

Retrospective Data ◽

Real World Data ◽

World Data ◽

Retrospective Data Analysis ◽

Osteoporosis Clinic

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Long-term effectiveness in patients previously treated with cladribine tablets: a real-world analysis of the Italian multiple sclerosis registry (CLARINET-MS)

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756286420922685 ◽

2020 ◽

Vol 13 ◽

pp. 175628642092268 ◽

Cited By ~ 1

Author(s):

Francesco Patti ◽

Andrea Visconti ◽

Antonio Capacchione ◽

Sanjeev Roy ◽

Maria Trojano ◽

...

Keyword(s):

Multiple Sclerosis ◽

Real World ◽

Event Analysis ◽

Treatment Change ◽

Real World Data ◽

Indirect Measure ◽

Disease Modifying Drugs ◽

Disease Modifying ◽

Using Data

Background: The CLARINET-MS study assessed the long-term effectiveness of cladribine tablets by following patients with multiple sclerosis (MS) in Italy, using data from the Italian MS Registry. Methods: Real-world data (RWD) from Italian MS patients who participated in cladribine tablets randomised clinical trials (RCTs; CLARITY, CLARITY Extension, ONWARD or ORACLE-MS) across 17 MS centres were obtained from the Italian MS Registry. RWD were collected during a set observation period, spanning from the last dose of cladribine tablets during the RCT (defined as baseline) to the last visit date in the registry, treatment switch to other disease-modifying drugs, date of last Expanded Disability Status Scale recording or date of the last relapse (whichever occurred last). Time-to-event analysis was completed using the Kaplan–Meier (KM) method. Median duration and associated 95% confidence intervals (CI) were estimated from the model. Results: Time span under observation in the Italian MS Registry was 1–137 (median 80.3) months. In the total Italian patient population ( n = 80), the KM estimates for the probability of being relapse-free at 12, 36 and 60 months after the last dose of cladribine tablets were 84.8%, 66.2% and 57.2%, respectively. The corresponding probability of being progression-free at 60 months after the last dose was 63.7%. The KM estimate for the probability of not initiating another disease-modifying treatment at 60 months after the last dose of cladribine tablets was 28.1%, and the median time-to-treatment change was 32.1 (95% CI 15.5–39.5) months. Conclusion: CLARINET-MS provides an indirect measure of the long-term effectiveness of cladribine tablets. Over half of MS patients analysed did not relapse or experience disability progression during 60 months of follow-up from the last dose, suggesting that cladribine tablets remain effective in years 3 and 4 after short courses at the beginning of years 1 and 2.

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Long-term outcome of minimally invasive mitral valve annuloplasty in disproportionate mitral regurgitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.0894 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Albano ◽

S Nagumo ◽

M Vanderheyden ◽

J Bartunek ◽

C Collet ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Real World ◽

Independent Predictor ◽

Real World Data ◽

Long Term Outcome ◽

World Data ◽

Mitral Valve Annuloplasty

Abstract Background Hypothetical concept of disproportionate secondary mitral regurgitation (SMR) has been recently introduced to facilitate patient's selection for mitral valve intervention. However, real world data validating this concept are unavailable. Purpose To investigate long-term effects of minimally invasive mitral valve annuloplasty (MVA) in patients with disproportionate (dSMR) versus proportionate SMR. Methods The study population consisted of 44 consecutive patients (age 67±9,5 years; 64% males) on guidelines-directed therapy with advanced heart failure (HF), reduced LV ejection fraction (EF) (32±9,7%) and SMR undergoing isolated mini-invasive MVA. Patients with organic mitral regurgitation or concomitant myocardial revascularization were excluded. To assess SMR disproportionality, the PISA-derived effective regurgitant orifice area (EROA) and regurgitant volume (RV) were compared to the estimated EROA and RV by using Gorlin formula and pooled real world data. Results According to EROA, a total of 20 (46%) and 24 (54%) patients, respectively, had dSMR and proportionate SMR (pSMR). According to RV, a total of 17 (39%) had dSMR and 27 (61%) had pSMR. Patients with dSMR showed significantly lower prevalence of male gender and higher prevalence of diabetes mellitus than patients with pSMR (p<0,001). Moreover, we observed smaller LV end-diastolic volume, larger EROA and RV (both p<0,01) and higher LV EF (p=0,02) in the dSMR versus the pSMR group. Other baseline characteristics were similar. During median follow up of 4.39 y (IQR 2,2–9,96y), a total of 25 (56%) patients died from any cause while 21 (47%) individuals were readmitted for worsening HF. Patients with dSMR versus pSMR according to both EROA and RV showed significantly lower rate of HF readmissions (both p<0.05) (Figure 1, 2). In Cox regression analysis combining clinical and imaging parameters, dSMR was the only independent predictor of HF readmissions (HR 0.20, 95% CI 0.07–0.60, p=0.004). In contrast, mortality was similar between dSMR and pSMR (NS) with age as the only independent predictor (HR 1,10; 95% CI 1,03–1,18, p=0,003). Conclusions Minimally invasive MVA is associated with significant reduction of HF readmissions in patients with dSMR versus pSMR while the mortality is similar. This suggests the importance of other parameters, i.e. age and degree of LV remodeling, to guide clinical management in SMR. Funding Acknowledgement Type of funding source: None

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Inferring Long-Term Demand of Newly Established Stations for Expansion Areas in Bike Sharing System

Applied Sciences ◽

10.3390/app11156748 ◽

2021 ◽

Vol 11 (15) ◽

pp. 6748

Author(s):

Hsun-Ping Hsieh ◽

Fandel Lin ◽

Jiawei Jiang ◽

Tzu-Ying Kuo ◽

Yu-En Chang

Keyword(s):

New York ◽

Feature Extraction ◽

Real World ◽

Extraction Methods ◽

Real World Data ◽

Urban Dynamics ◽

Bike Sharing ◽

The Government ◽

Short Time

Research on flourishing public bike-sharing systems has been widely discussed in recent years. In these studies, many existing works focus on accurately predicting individual stations in a short time. This work, therefore, aims to predict long-term bike rental/drop-off demands at given bike station locations in the expansion areas. The real-world bike stations are mainly built-in batches for expansion areas. To address the problem, we propose LDA (Long-Term Demand Advisor), a framework to estimate the long-term characteristics of newly established stations. In LDA, several engineering strategies are proposed to extract discriminative and representative features for long-term demands. Moreover, for original and newly established stations, we propose several feature extraction methods and an algorithm to model the correlations between urban dynamics and long-term demands. Our work is the first to address the long-term demand of new stations, providing the government with a tool to pre-evaluate the bike flow of new stations before deployment; this can avoid wasting resources such as personnel expense or budget. We evaluate real-world data from New York City’s bike-sharing system, and show that our LDA framework outperforms baseline approaches.

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