Time to ADT and chemotherapy initiation for treatment of metastatic prostate cancer (mPC).

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 41-41 ◽  
Author(s):  
Daniella J. Perlroth ◽  
Stephen F. Thompson ◽  
Yesenia Luna ◽  
Dana P. Goldman ◽  
Essy Mozaffari ◽  
...  
Keyword(s):  
Regression Models ◽  
Clinical Information ◽  
Sociodemographic Factors ◽  
Summary Statistics ◽  
Community Practice ◽  
Substantial Impact ◽  
Medicare Claims ◽  
Time To Initiation ◽  
The Difference ◽  
Chemotherapy Initiation

41 Background: ADT and chemotherapy use in men with mPC may differ across regions in community practice. The extent of variation could indicate whether men with mPC have appropriate access to effective treatments. Methods: We identified 16,024 men diagnosed with mPC in the Surveillance, Epidemiology, and End Results (SEER) database from 2000-2005 linked to their Medicare claims. Patients were excluded if they had a second cancer or disenrolled from Medicare Parts A or B (n=6,155), or failed to initiate therapy with ADT (n=3,400). We identified demographic and clinical information from SEER and treatments and comorbidities from J-codes and ICD-9 codes in the Medicare claims. We used regression models to estimate the probability of advancement to chemotherapy, the time from diagnosis to first ADT use, and time from first ADT to chemotherapy. Then the patient-level predicted results from these models were used to generate summary statistics by hospital service area (HSA). Results: There were 6,469 patients remaining after exclusion who were treated with ADT, and 1,198 of those received chemotherapy (19%). The median age was 76 years old, most were white (77%), married (62%), and 50% had 1 other major comorbidity (most frequent was diabetes, 21%). Men who were younger, married, with fewer comorbidities, and higher Gleason scores were statistically more likely to both receive chemotherapy and use it earlier. After adjusting for clinical and sociodemographic factors, the average time to ADT by referral region was 2.7 months but varied from 1.3 to 5.6; probability of progression to chemotherapy averaged 19% but varied from 6% to 30%, and the time from first ADT to chemotherapy averaged 19.7 months but varied from 12.9 to 25.7 months. The difference in time to ADT between regions in the 10th and 90th percentiles of use was 2.6 months, whereas for chemotherapy initiation, it was 12.4 months. Conclusions: Our results suggest that living in different parts of the country has a substantial impact on how clinically similar patients are treated. There was substantial variation across regions in use of and time to initiation of chemotherapy for men with mPC, but not in ADT use.

scholarly journals Efficacy of loading dose colistin versus carbapenems for treatment of extended spectrum beta lactamase producing Enterobacteriaceae

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wasan Katip ◽  
Jukapun Yoodee ◽  
Suriyon Uitrakul ◽  
Peninnah Oberdorfer
Keyword(s):  
Clinical Response ◽  
Clinical Information ◽  
Resistant Bacteria ◽  
Loading Dose ◽  
Extended Spectrum Beta Lactamase ◽  
Clinical Utilization ◽  
The Difference ◽  
Infection Types ◽  
Intra Abdominal Infection

AbstractColistin provides in vitro activity against numerous ESBL-producing and carbapenem-resistant bacteria. However, clinical information with respect to its utilization in infection caused by ESBL producers is limited. The aim of this study was a comparison of mortality rates of loading dose (LD) colistin and carbapenems as definitive therapies in a cohort of patients with infections caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae. A retrospective cohort study in 396 patients with ESBL-producing E.coli and K.pneumoniae infection at a university-affiliated hospital was conducted between 1 January 2005 and 30 June 2015 to compare outcomes of infected patients who received LD colistin (95 patients) with carbapenems (301 patients). The three primary outcomes were 30-day mortality, clinical response and microbiological response. The most common infection types were urinary tract infection (49.49%), followed by pneumonia (40.66%), bacteremia (13.64%), skin and soft tissue infections (4.80%) and intra-abdominal infection (3.03%). LD colistin group provided higher 30-day mortality when compared with carbapenems group (HR 7.97; 95% CI 3.68 to 17.25; P = 0.001). LD colistin was also independently associated with clinical failure (HR 4.30; 95% CI 1.93 to 9.57; P = 0.001) and bacteriological failure (HR 9.49; 95% CI 3.76 to 23.96; P = 0.001) when compared with those who received carbapenems. LD colistin treatment was associated with poorer outcomes, i.e. mortality rate, clinical response and microbiological response. Moreover, when adjusted confounding factors, LD colistin was still less effective than carbapenems. It should be noted that, however, the use of Vitek-2 to assess colistin susceptibility could provide inaccurate results. Also, the difference in baseline characteristics could still remain in retrospective study although compensation by hazard ratio adjustment was performed. Therefore, clinical utilization of LD colistin should be recommended as an alternative for treatment ESBL-producing Enterobacteriaceae only in the circumstances where carbapenems cannot be utilized, but this recommendation must be considered carefully.

scholarly journals Matching loci surveyed to questions asked in phylogeography

2016 ◽  
Vol 283 (1826) ◽  
pp. 20152340 ◽  
Author(s):  
Chih-Ming Hung ◽  
Sergei V. Drovetski ◽  
Robert M. Zink
Keyword(s):  
Population Diversity ◽  
Single Locus ◽  
Population Divergence ◽  
Summary Statistics ◽  
Recent Past ◽  
Size Change ◽  
The Caucasus ◽  
Nuclear Loci ◽  
The Difference ◽  
Coalescent Time

Although mitochondrial DNA (mtDNA) has long been used for assessing genetic variation within and between populations, its workhorse role in phylogeography has been criticized owing to its single-locus nature. The only choice for testing mtDNA results is to survey nuclear loci, which brings into contrast the difference in locus effective size and coalescence times. Thus, it remains unclear how erroneous mtDNA-based estimates of species history might be, especially for evolutionary events in the recent past. To test the robustness of mtDNA and nuclear sequences in phylogeography, we provide one of the largest paired comparisons of summary statistics and demographic parameters estimated from mitochondrial, five Z-linked and 10 autosomal genes of 30 avian species co-distributed in the Caucasus and Europe. The results suggest that mtDNA is robust in estimating inter-population divergence but not in intra-population diversity, which is sensitive to population size change. Here, we provide empirical evidence showing that mtDNA was more likely to detect population divergence than any other single locus owing to its smaller N e and thus faster coalescent time. Therefore, at least in birds, numerous studies that have based their inferences of phylogeographic patterns solely on mtDNA should not be readily dismissed.

scholarly journals The Relationship Between Alcohol Beverage Types and Violence

2018 ◽  
Vol 49 (1) ◽  
pp. 183-200
Author(s):  
Aleksandra J. Snowden
Keyword(s):  
Regression Models ◽  
Neighborhood Characteristics ◽  
Substantial Evidence ◽  
Alcohol Outlets ◽  
Observation Instrument ◽  
Beverage Type ◽  
Social Observation ◽  
Ecological Association ◽  
The Difference ◽  
The Relationship

There is substantial evidence of an ecological association between off-premise alcohol outlets and violence. We know less, however, about how specific beverage types that are sold in the outlets might explain the difference in violence rates across different alcohol outlets. Data on alcohol beverage types were collected for all off-premise alcohol outlets in Milwaukee, Wisconsin, using a systematic social observation instrument. Spatially lagged regression models were estimated to determine whether the variation in alcohol beverage types is related to robbery density net of important neighborhood predictors of crime rates. Availability of all alcohol beverage types (beer, wine, spirits, premixed, single beer, single spirits, single premixed) was positively associated with the density of robberies, net of neighborhood characteristics. Reducing alcohol beverages, regardless of the beverage type, sold at off-premise alcohol outlets may reduce violence in communities.

scholarly journals Asymmetric Fixed Effects Models for Panel Data

2018 ◽  
Author(s):  
Paul D Allison
Keyword(s):  
Logistic Regression ◽  
Panel Data ◽  
Opposite Direction ◽  
Difference Method ◽  
Fixed Effects ◽  
Regression Models ◽  
Social Phenomena ◽  
Logistic Regression Models ◽  
Fixed Effects Models ◽  
The Difference

Standard fixed effects methods presume that effects of variables are symmetric: the effect of increasing a variable is the same as the effect of decreasing that variable but in the opposite direction. This is implausible for many social phenomena. York and Light (2017) showed how to estimate asymmetric models by estimating first-difference regressions in which the difference scores for the predictors are decomposed into positive and negative changes. In this paper, I show that there are several aspects of their method that need improvement. I also develop a data generating model that justifies the first-difference method but can be applied in more general settings. In particular, it can be used to construct asymmetric logistic regression models.

scholarly journals Causal Interaction and Effect Modification: Same Model, Different Concepts

2017 ◽  
Author(s):  
Luke Keele ◽  
Randolph T. Stevenson
Keyword(s):  
Political Science ◽  
Regression Models ◽  
Interaction Analysis ◽  
Effect Modification ◽  
The Political ◽  
Science Literature ◽  
Causal Interaction ◽  
Single Treatment ◽  
Social Scientists ◽  
The Difference

Social scientists use the concept of interactions to study effect dependency. Such analyses can be conducted using standard regression models. However, an interaction analysis may represent either a causal interaction or effect modification. Under causal interaction, the analyst is interested in whether two treatments have differing effects when both are administered. Under effect modification, the analysts investigates whether the effect of a single treatment varies across levels of a baseline covariate. Importantly, the identification assumptions for these two types of analysis are very different. In this paper, we clarify the difference between these two types of interaction analysis. We demonstrate that this distinction is mostly ignored in the political science literature. We conclude with a review of several applications.

scholarly journals Electronic Ticketing System and Traveler Purchasing Intention

2013 ◽  
Vol 217 ◽  
pp. 129-146
Author(s):  
THẢO HOÀNG THỊ PHƯƠNG
Keyword(s):  
Regression Models ◽  
Online Shopping ◽  
Behavioral Control ◽  
Ease Of Use ◽  
Perceived Behavioral Control ◽  
Perceived Ease Of Use ◽  
Demographic Groups ◽  
Purchasing Intention ◽  
Shopping Experience ◽  
The Difference

This research aims to identify the importance of factors that influence customer intention of purchasing electronic air ticket (e-ticket). The research compares the difference in purchasing intentions based on e-ticketing between demographic groups of age, income, educational level, and online shopping experience. With the sample size of 295 travelers, the regression models and ANOVA tests are used to process and explain data. The research detects four components, namely, perceived system usefulness, perceived ease of use, perceived behavioral control, and security of transaction that influence the consumer intention to buy e-ticket. The paper then recommends managerial solutions to the development of an electronic ticketing system in particular and e-commerce in general.

scholarly journals Differences in Sickness Allowance Receipt between Swedish Speakers and Finnish Speakers in Finland

2017 ◽  
Vol 52 ◽  
pp. 43-58 ◽  
Author(s):  
Kaarina S. Reini ◽  
Jan Saarela
Keyword(s):  
Regression Models ◽  
Health Condition ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Objective Health ◽  
Language Groups ◽  
Health Measure ◽  
All Cause Mortality ◽  
The Difference ◽  
The Individual

Previous research has documented lower disability retirement and mortality rates of Swedish speakers as compared with Finnish speakers in Finland. This paper is the first to compare the two language groups with regard to the receipt of sickness allowance, which is an objective health measure that reflects a less severe poor health condition. Register-based data covering the years 1988-2011 are used. We estimate logistic regression models with generalized estimating equations to account for repeated observations at the individual level. We find that Swedish-speaking men have approximately 30 percent lower odds of receiving sickness allowance than Finnish-speaking men, whereas the difference in women is about 15 percent. In correspondence with previous research on all-cause mortality at working ages, we find no language-group difference in sickness allowance receipt in the socially most successful subgroup of the population.

scholarly journals Comparison of Rapid Hydration and Standard Hydration Prior to Ifosfamide Administration in Pediatric Patients: A Safety and Efficacy Study

2020 ◽  
Vol 25 (3) ◽  
pp. 246-250
Author(s):  
Aubrie Eaton ◽  
Tosha Egelund ◽  
John Ng
Keyword(s):  
Pediatric Patients ◽  
Hemorrhagic Cystitis ◽  
Kidney Injury ◽  
Urine Specific Gravity ◽  
Hydration Status ◽  
Time To Initiation ◽  
Adequate Hydration ◽  
Administration Time ◽  
Secondary Endpoints ◽  
Chemotherapy Initiation

OBJECTIVES Adequate hydration status prior to chemotherapy initiation prevents nephrotoxicity in patients receiving potentially nephrotoxic regimens. The purpose of this study was to evaluate the time to initiation of ifosfamide administration between patients receiving standard 6-hour pre-hydration versus 1-hour rapid pre-hydration. METHODS A retrospective study was conducted to determine the primary endpoint of time to ifosfamide administration. Patients 1 to 21 years of age who received ifosfamide with standard 6-hour pre-hydration (125 mL/m2/hr for 6 hours) between September 2017 and January 2018 or 1-hour rapid pre-hydration (750 mL/m2/hr for 1 hour) between September 2018 and March 2019 were included. Secondary endpoints included the incidence of hemorrhagic cystitis, incidence of acute kidney injury (AKI), urine specific gravity, amount of time that ifosfamide was delayed from the originally scheduled administration time, the number of times ifosfamide was delayed greater than 4 hours from the originally scheduled administration time, and length of stay. RESULTS A total of 128 patients were included; 68 patients received standard 6-hour pre-hydration and 60 patients received 1-hour rapid pre-hydration prior to ifosfamide administration. Time to ifosfamide administration was reduced from an average of 9.3 hours to 2.4 hours (p < 0.0001). There was no incidence of hemorrhagic cystitis or AKI in either group. CONCLUSIONS The 1-hour rapid pre-hydration protocol significantly reduced the time to ifosfamide administration without an increase in adverse effects.

Abstract WP46: Blood Pressure, Clinical Improvement And Recanalization Following Acute MCA Occlusion

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Nandakumar Nagaraja ◽  
Steven Warach ◽  
Amie W Hsia ◽  
Sungyoung Auh ◽  
Lawrence L Latour ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Improvement ◽  
Clinical Information ◽  
Collateral Flow ◽  
Stroke Patients ◽  
Mca Occlusion ◽  
The Mean ◽  
The Difference ◽  
Pre Treatment ◽  
B Test

Background: Blood pressure (BP) drop in the first 24 hours after stroke onset may occur in response to vessel recanalization. Clinical improvement could be due to recanalization or better collateral flow with persistent occlusion. We hypothesize that patients with combination of significant improvement on the NIHSS and a drop in BP at 24hr post tPA is associated with recanalization. Methods: We included intravenous t-PA patients from the Lesion Evolution of Stroke Ischemia On Neuroimaging (LESION) registry who had pre-treatment and 24 hour MRA scan, NIHSS scores at those times and an M1 MCA occlusion at baseline, but excluded those on pressors, pre tPA SBP<120 and tandem ICA occlusion. We classified recanalization status on the 24 hour MRA as none, partial or complete. We abstracted all BP measurements for the first 24 hours from the chart and calculated BP drop as the difference of the triage pre-tPA BP and the average of the last 3 hour readings preceding the 24 hour MRI. NIHSS improvement was defined as ≥4points improvement on NIHSS or NIHSS of 0 at 24hour. Patients with combination of drop in BP and NIHSS improvement were compared with others for recanalization status on 24hr MRA by Kendall Tau-b test. Results: Seventeen patients met the study criteria. There were 13 women, the mean age was 76 years and the median baseline NIHSS was 15. On the 24 hour MRA, 3, 8 and 6 patients had none, partial and complete recanalization, respectively. Patients with NIHSS improvement and a SBP drop ≥20 mmHg were more like to have recanalization at 24 hrs (57% Vs 0%, p=0.03). Similar patterns were seen for patients with NIHSS improvement and DBP drop ≥5mmHg (50% Vs 0%, p=0.04) or MAP drop ≥20mmHg (50% Vs 0%, p=0.04). Complete recanalization was only associated with the combination of NIHSS improvement with SBP drop ≥ 20mmHg (66% Vs 0%, p=0.04). A significant association was not found for recanalization with NIHSS improvement alone or drop in BP alone. Conclusion: There is an association of clinical improvement and BP drop in patients who recanalize. Bedside clinical information may be useful in the management of stroke patients.

scholarly journals Asymmetric Fixed-effects Models for Panel Data

2019 ◽  
Vol 5 ◽  
pp. 237802311982644 ◽  
Author(s):  
Paul D. Allison
Keyword(s):  
Logistic Regression ◽  
Panel Data ◽  
Opposite Direction ◽  
Difference Method ◽  
Fixed Effects ◽  
Regression Models ◽  
Social Phenomena ◽  
Logistic Regression Models ◽  
Fixed Effects Models ◽  
The Difference

Standard fixed-effects methods presume that effects of variables are symmetric: The effect of increasing a variable is the same as the effect of decreasing that variable but in the opposite direction. This is implausible for many social phenomena. York and Light showed how to estimate asymmetric models by estimating first-difference regressions in which the difference scores for the predictors are decomposed into positive and negative changes. In this article, I show that there are several aspects of their method that need improvement. I also develop a data-generating model that justifies the first-difference method but can be applied in more general settings. In particular, it can be used to construct asymmetric logistic regression models.

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