Evaluating risk of hospitalization with G-CSF use in real-world oncology practice

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6626-6626
Author(s):  
H. Tan ◽  
K. Tomic ◽  
G. Daniel ◽  
D. Hurley ◽  
R. Barron
Keyword(s):  
Real World ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Published Data ◽  
Administrative Claims ◽  
Health Plans ◽  
Cycle Basis ◽  
Prophylactic Use ◽  
Oncology Practice ◽  
Stimulating Factor

6626 Background: Limited published data exist on how granulocyte colony-stimulating factor (G-CSF) treatment patterns affect risk of neutropenia-related hospitalizations. This study examines prophylactic vs. delayed use of G-CSF and compares the effectiveness of prophylaxis with filgrastim (FIL) vs. pegfilgrastim (PEG). Methods: A retrospective analysis of administrative claims from U.S. commercial health plans identified adult patients with non-Hodgkin's lymphoma, breast, or lung cancer, treated with chemotherapy between July 2004 and January 2008. For these patients, the first course of chemotherapy and each unique cycle with use of G-CSF (FIL or PEG) was identified and designated ‘prophylaxis’ if used within the first 5 days of each cycle, or ‘delayed', if after day 5. The risk of neutropenia-related hospitalization was then evaluated on a cycle basis. A generalized estimating equation (GEE) was used to adjust for baseline demographics and clinical characteristics. Results: Among 5,571 patient-cycles identified: 87.4% were prophylactic and 12.6% were delayed G-CSF. PEG use was primarily prophylactic (93.6%) in contrast to use of FIL which was delayed in 62.5% of patient-cycles. The rate of neutropenic hospitalization was 1.2% for prophylaxis (n=59) and 3.7% for delayed G-CSF (n=26) (P < 0.001). Among prophylactic patient-cycles, the neutropenic hospitalization rate was lower with PEG than FIL (1.1% (n=51) vs. 3.5% (n=8), p = 0.001). Multivariate analyses using GEE model showed consistent trends (Table). Conclusions: Prophylactic G-CSF use was associated with lower neutropenic hospitalization risk than delayed use. Among prophylactic use in real-world oncology practice, PEG was associated with about a two-thirds lower risk of neutropenic hospitalization compared with FIL. [Table: see text] [Table: see text]

scholarly journals Relapses and disease-modifying drug treatment in pregnancy and live birth in US women with MS

Neurology ◽  
2018 ◽  
Vol 91 (17) ◽  
pp. e1570-e1578 ◽  
Author(s):  
Maria K. Houtchens ◽  
Natalie C. Edwards ◽  
Amy L. Phillips
Keyword(s):  
Live Birth ◽  
Odds Ratio ◽  
Emergency Room Visit ◽  
Outpatient Visit ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Administrative Claims ◽  
Second Trimester ◽  
Disease Modifying ◽  
Relapse Rates

ObjectiveTo evaluate relapse rates and disease-modifying drug (DMD) treatment in US women with multiple sclerosis (MS) and a live birth.MethodsThis retrospective administrative claims database study used US commercial health plan data from women with MS and a live birth from January 1, 2006, to June 30, 2015. Relapses and DMD treatment were evaluated 1-year prepregnancy, during pregnancy, during puerperium (6 weeks postpregnancy), and 1-year postpregnancy. Relapse was defined as MS-related hospitalization, emergency room visit, or outpatient visit with corticosteroid prescription within 7 days. Generalized estimating equation models for longitudinal data tested for differences between prepregnancy vs the other time periods.ResultsA total of 2,158 patients were eligible. The odds of relapse declined during pregnancy (odds ratio [OR] 0.623, 95% confidence interval [CI] 0.521–0.744; p < 0.0001), increased during puerperium (OR 1.710, 95% CI 1.358–2.152; p < 0.0001), and ended at a higher level during the last 3 postpartum quarters (OR 1.216, 95% CI 1.052–1.406; p = 0.0081). The proportion of women with DMD treatment was rather low overall: approximately 20% prepregnancy, bottoming to 1.9% during the second trimester, and peaking at 25.5% 9 to 12 months postpartum. DMD treatment declined significantly during pregnancy (OR 0.171, 95% CI 0.144–0.203; p < 0.0001), remained lower during puerperium (OR 0.361, 95% CI 0.312–0.418; p < 0.0001), and ended at a higher level during the last 3 postpartum quarters (OR 1.259, 95% CI 1.156–1.371; p < 0.0001).ConclusionsThe rate of MS relapse decreased during pregnancy, increased 6 months postpartum, and decreased 6 to 12 months postpartum. DMD treatment was uncommon in the year before pregnancy, further decreased immediately prepregnancy and during pregnancy, and increased postpartum.

scholarly journals Promoting Social Competence in Preschool with an Executive Functions Program Conducted by Teachers

2020 ◽  
Vol 12 (11) ◽  
pp. 4408
Author(s):  
Miriam Romero-López ◽  
M. Carmen Pichardo ◽  
Judit Bembibre-Serrano ◽  
Trinidad García-Berbén
Keyword(s):  
Social Competence ◽  
Executive Functions ◽  
Real World ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Control Group ◽  
Post Intervention ◽  
The Social ◽  
Executive Function Training ◽  
Experimental Group

The objective of this research is to examine the effectiveness of the “Executive Function Training Program in Preschool” (EFE-P) that includes real-world activities and applies different required methodologies for a sustainable education. In addition, it is evaluated whether the improvement of executive functions is transferred to the social competence domain. The study involved 100 students aged 5–6 years, of which 50 were randomly assigned to the active control group and 50 to the experimental group. Executive functions (BRIEF-P) and social competence (BASC and PKBS-2) were measured at two time points (pre-intervention and post-intervention). Data were analyzed using the Generalized Estimating Equation (GEE) for repeated data and results showed that children in the experimental group obtained better scores on executive functions and social competence compared to their peers in the control group. It is discussed if the executive functions training can be effective in improving social competence as long as the programs include real-world activities that encourage such transfer, as the EFE-P does.

Models for Longitudinal Data: A Generalized Estimating Equation Approach

Biometrics ◽  
1988 ◽  
Vol 44 (4) ◽  
pp. 1049 ◽  
Author(s):  
Scott L. Zeger ◽  
Kung-Yee Liang ◽  
Paul S. Albert
Keyword(s):  
Longitudinal Data ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Equation Approach ◽  
Generalized Estimating

Remittances and the Financing of Terrorism In Sub-Saharan Africa: 1974 - 2006

2012 ◽  
Vol 18 (1) ◽  
Author(s):  
Juliet U. Elu ◽  
Gregory N. Price
Keyword(s):  
Economic Growth ◽  
Count Data ◽  
Important Determinant ◽  
Estimating Equation ◽  
Sub Saharan Africa ◽  
Generalized Estimating Equation ◽  
Parameter Estimates ◽  
Consumption Expenditures ◽  
Sub Saharan ◽  
Financing Of Terrorism

AbstractRemittances have been recognized as an important determinant of economic growth for Sub-Saharan African economies as they can finance other determinants that constitute drivers of growth. To the extent that remittances finance terrorism, they can also inhibit economic growth as terrorism can constrain important drivers of growth such as investment and consumption expenditures. In this paper, we appeal to a theory of rational terrorism and consider whether remittances to Sub-Saharan Africa finance terrorism. We estimate the parameters of a static and dynamic terrorism incident supply function with maximum likelihood and Generalized Estimating Equation count data estimators for Sub-Saharan Africa between 1974 and 2006. Our parameter estimates suggest that for Sub-Saharan Africa, remittances are a source of finance for terrorism. We find that approximately one terrorism incident is financed in Sub-Saharan Africa for remittance inflows that range between approximately one quarter of a million dollars and one million dollars.

scholarly journals Institutionalization-Free Survival and Health Care Costs among Quebec Community-Dwelling Elderly Patients with Dementia

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Sarah-Gabrielle Beland ◽  
Antoine Pariente ◽  
Yola Moride
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Health Care Costs ◽  
Reference Population ◽  
Community Dwelling ◽  
Third Party ◽  
Published Data ◽  
Administrative Claims ◽  
Free Survival ◽  
Care Costs

Background. Published data on burden of dementia mainly include patients of third-care facilities. Economic consequences in an outpatient setting remain poorly examined. Objectives. To evaluate institutionalization-free survival and direct health care costs of dementia in the Quebec community-dwelling elderly population. Methods. A retrospective cohort study was conducted using the Quebec administrative claims databases. The cohort included a random sample of patients with treated dementia between January 1, 2000, and December 31, 2009 (n=37,138). The reference population included elderly patients without dementia matched in age group, gender, and index date. Using a third-party payer perspective, direct costs over 5 years were assessed. Results. Institutionalization-free survival at 5 years was lower in patients with dementia than in elderly without dementia (38.9% and 72.2%, resp.). Over 5 years, difference in mean total direct health care costs per patient was CAD$19,159, distributed into institutionalizations (CAD$13,598), hospitalizations (CAD$3,312), and prescribed medications (CAD$2,320). Costs of medical services were similar (−CAD$96). In the first year of followup, cost differentials were mainly attributable to hospitalizations, while in the last year (year 5) they were due to institutionalizations. Conclusion. This study confirms that dementia is an important socioeconomic burden in the community, the nature of which depends on disease progression.

IDENTIFYING INADEQUATE RESPONSE AMONG ULCERATIVE COLITIS PATIENTS ON AN ADVANCED THERAPY IN A REAL-WORLD ADMINISTRATIVE CLAIMS DATABASE

2021 ◽  
Vol 160 (3) ◽  
pp. S26-S27
Author(s):  
April Naegeli ◽  
Theresa Hunter ◽  
Michael Grabner ◽  
Keith Isenberg ◽  
Mingyang Shan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Real World ◽  
Administrative Claims ◽  
Inadequate Response ◽  
Claims Database ◽  
Advanced Therapy

Evolution of standard of care therapies used for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC): A real-world analysis of patient health records from 2016 to 2019.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18728-e18728
Author(s):  
Nabil F. Saba ◽  
Soham Shukla ◽  
Kathleen M. Aguilar ◽  
Marc S. Ballas ◽  
Kelly Bell ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Real World ◽  
Data Extraction ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Treatment Discontinuation ◽  
Health Records ◽  
Treatment Regimens ◽  
Community Oncology ◽  
Oncology Practice

e18728 Background: The R/M HNSCC treatment landscape has evolved significantly in recent years, notably with the approval of 2 immuno-oncology agents (IO), pembrolizumab (second-line [2L] approval, 2016; first-line [1L] approval, 2019) and nivolumab (2L approval, 2016). Review of the literature suggests there is limited real-world (rw) data on clinical outcomes and safety associated with chemotherapy (chemo) and IO in R/M HNSCC. These analyses present a review of patient charts to assess rw clinical outcomes and safety in R/M HNSCC, stratified by patient factors. Methods: Data were derived via structured data extraction and manual review of electronic health records (EHRs; January 1, 2016–December 31, 2019) for patients with R/M HNSCC and who initiated systemic treatment at a community oncology practice in The US Oncology Network. Time-to-event endpoints were assessed by unadjusted Kaplan–Meier analyses and included death (rw overall survival [OS]), provider-assessed progression (rw progression-free survival [PFS]), rw duration of response (DoR), and treatment discontinuation (rw time-to-discontinuation [TTD]). Treatment sequences were evaluated following R/M HNSCC diagnosis. Provider-assessed response rates and adverse events (AEs) as captured in the EHRs were reported. Results: Overall, 257 patients who received 1L treatment were included in these analyses; median age was 64 years (range: 21, 90+); the majority of patients were male (77.4%) and white (74.7%), and 17.5% had evaluable PD-L1 status. The most common 1L treatment regimens were nivolumab (18.3%), carboplatin + paclitaxel (16.0%), and pembrolizumab (14.8%). Median follow-up time from treatment initiation was 7.9 months (range: 0.2, 45.9). Of the 174 patients with evaluable response to 1L treatment, overall response rate was 48.5% (95% CI: 38.3, 58.8) for chemo and 40.0% (95% CI: 28.9, 52.0) for IO. Median rwDoR was 7.6 months (95% CI: 5.8, 11.2). Median rwOS was 12.1 months (95% CI: 10.5, 16.6), and median rwPFS was 5.9 months (95% CI: 4.7, 6.8). Median rwTTD was 2.3 months (95% CI: 2.0, 3.2). The top reason for treatment discontinuation was treatment completion (38.5%) for chemo and progression (46.6.%) for IO. The most commonly reported AEs were rash (17.5%), fatigue (14.4%), and nausea (14.4%) for chemo and fatigue (12.4%), rash (7.2%), and anemia (5.2%) for IO. The percentage of AEs that did not require any intervention was 34.4% for chemo and 20.6% for IO. Conclusions: These analyses present rw clinical outcomes for patients with R/M HNSCC in community oncology practices. The proven role of IO continues to evolve, and continued work is needed to best demarcate the use of these agents, in addition to exploration of additional therapeutics for use in R/M HNSCC. Study funding: GlaxoSmithKline (GSK Study 207139).

Hip and Trunk Muscle Activity and Mechanics During Walking With and Without Unilateral Weight

2021 ◽  
pp. 1-8
Author(s):  
Kerri A. Graber ◽  
Kari L. Loverro ◽  
Mark Baldwin ◽  
Erika Nelson-Wong ◽  
Joshua Tanor ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Therapeutic Option ◽  
Frontal Plane ◽  
Estimating Equation ◽  
Trunk Muscle ◽  
Lower Extremity Injury ◽  
Generalized Estimating Equation ◽  
Functional Activities ◽  
Strengthening Exercises ◽  
Hip Abductor

Pelvic drop is caused by decreased hip abductor muscle activity and is associated with lower-extremity injury. Hip abductor strengthening exercises are well established; however, no standard method exists to increase hip abductor activity during functional activities. The purpose of this research was to study the effects of walking with a unilateral weight. A total of 26 healthy adults walked on an instrumented treadmill with and without handheld weight (15%–20% body weight). Muscle activity, kinematic, and kinetic data were collected using surface electromyography, motion capture, and force plates, respectively. Average hip and trunk muscle activity, hip, pelvic, and trunk angles, and peak internal hip moments during stance were compared for each side (contralateral/ipsilateral to the weight) between conditions (unweighted/weighted) using a generalized linear model with generalized estimating equation correction. Interactions between condition and side were observed for muscle activity, frontal plane pelvic and trunk angles, and frontal plane hip moments (P ≤ .003). Compared with the unweighted condition, the weighted condition had higher hip abductor activity contralateral to the weight (P < .001), while no change was found ipsilateral to the weight (P ≥ .790). Similar changes were found for kinematic and kinetic variables. Walking with a unilateral weight may be a therapeutic option to increase functional hip abductor activity.

The relationship between remission and health-related quality of life in a cohort of SLE patients

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 628-635 ◽  
Author(s):  
Michel W P Tsang-A-Sjoe ◽  
Irene E M Bultink ◽  
Maaike Heslinga ◽  
Lilian H van Tuyl ◽  
Ronald F van Vollenhoven ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Global Assessment ◽  
Short Form ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

Abstract Objective To investigate the relationship between remission and health-related quality of life (HRQoL) in patients with SLE in a longitudinal observational cohort. Methods HRQoL was measured at cohort visits using the physical and mental component score (PCS and MCS, respectively) of the Short Form 36 questionnaire. Definitions of Remission in SLE remission categories (no remission/remission on therapy/remission off therapy) were applied. Determinants of PCS and MCS were identified with simple linear regression analyses. Association between remission and HRQoL was assessed using generalized estimating equation models. Results Data from 154 patients with 2 years of follow-up were analysed. At baseline 60/154 (39.0%) patients were in either form of remission. Patients in remission had higher Short Form 36 scores in all subdomains compared with patients not in remission. PCS was positively associated with remission and employment, and negatively associated with SLICC damage index, ESR, medication, patient global assessment and BMI. MCS was positively associated with Caucasian ethnicity and negatively associated with patient global assessment. In generalized estimating equation analysis, a gradual and significant increase of PCS was observed from patients not in remission (mean PCS 36.0) to remission on therapy (41.8) to remission off therapy (44.8). No significant difference in MCS was found between remission states. Conclusion we show a strong and persistent association between remission and PCS, but not MCS. These results support the relevance (construct validity) of the Definition of Remission in SLE remission definitions and the further development of a treat-to-target approach in SLE.

scholarly journals Foreign Direct Investment, Economic Freedom and Economic Growth: Evidence from Developing Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 200 ◽  
Author(s):  
Md. Shakib Hossain
Keyword(s):  
Economic Growth ◽  
Developing Countries ◽  
Foreign Direct Investment ◽  
Standard Deviation ◽  
Poisson Regression ◽  
Direct Investment ◽  
Economic Freedom ◽  
Random Effect ◽  
Estimating Equation ◽  
Generalized Estimating Equation

<p class="Default">This paper has explores the interplay between economic freedom, foreign direct investment and economic growth using panel data analysis for a sample of 79 developing countries from 1998 to 2014 by considering the level of economic freedom, as provided by the “Heritage Foundation”. Panel unit root, pedroni residual co-integration test, generalized least square (GLS), feasible GLS (FGLS), pooled OLS, random effect, fixed effect, poisson regression, prais-winsten, generalized method of movement (GMM) and generalized estimating equation (GEE) methods have used to estimates the relationship. According to the OLS and generalized method of movement the coefficient implies that a one standard deviation improvement in business freedom, trade freedom, size, investment freedom, property rights, freedom from corruption, labor freedom, financial freedom, fiscal freedom, monetary freedom increases FDI by 21.4%, 15.6%, 21.6%, 17.5%, 11.55, 9.1%, 6.9%, 8.5%, 7.4%, 10.3% and 56.1%, 45.3%, 58.3%, 51.6%, 33.7%, 39.2%, 47.4%, 41.6%, 32.5%, 38.5% points respectively and  for the economic variable ,the coefficient implies that a one standard deviation improvement in GDPG and GDPPC increases FDI by 24.1%, 17.4% and 30.2%, 33.4% points respectively. By using the other method like random effect, fixed effect, poisson regression, prais-winsten and generalized estimating equation (GEE) method explores that economic freedom in the host country is a positive determinants of FDI inflows in developing countries and also the result suggests that foreign direct investment is positively correlated with the economic growth in the host countries.</p>

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