<h3>Objective</h3> Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) allows preoperative tissue confirmation of malignancy, but fear tumour cell dissemination along the track has limited its use. We hypothesised that if occurs with EUS-FNA, survival after complete resection would be impaired. aimed to evaluate association EUS-FNA long-term outcomes patients resected pancreatic cancer. <h3>Design</h3> Using linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data,...

PurposePharmacogenomics (PGx) studies how inherited genetic variations in individuals affect drug absorption, distribution, and metabolism. PGx panel testing can potentially help improve efficiency accuracy individualizing therapy. This study compared the cost-effectiveness between preemptive testing, reactive usual care (no testing) cardiovascular disease management.MethodsWe developed a decision analytic model from US payer's perspective for hypothetical cohort of 10,000 patients ≥45 years...

<h3>Importance</h3> In 2013 and 2016, the US Food Drug Administration (FDA) issued warnings recommended limited use of fluoroquinolones for patients with certain acute conditions. It is not clear how prescribers have responded to these warnings. <h3>Objective</h3> To analyze changes in prescribing after 2016 FDA examine physician characteristics associated changes. <h3>Design, Setting, Participants</h3> This cross-sectional study used Medicare administrative claims data on fee-for-service...

To assess the impact of implementing bar-code medication administration (BCMA) technology on rate errors in inpatient setting, specifically those that affect patient and result harm.Implementation new began September 2008 a staged rollout 4 or 5 units at time 11 separate waves. All corresponding administrations voluntarily reported medication-related adverse events from March 1, 2007, through 30, 2013, were included for analyses. Adherence to use BCMA number tracked compared across...

Abstract BACKGROUND: Hospice is a service that patients, families, and physicians find beneficial, yet majority of patients die without receiving hospice care. Little known about how many hospitalized are eligible at the time hospitalization. METHODS: Retrospective chart review was used to examine all adult deaths (n = 688) tertiary care center during 2009. Charts were selected for full if death nontraumatic patient had hospital admission within 12 months terminal admission. The charts...

The primary care medical home (PCMH) aims to promote delivery of high-value health care. However, growing demand for specialists due increasingly older adults with complicated and chronic disease necessitates development novel models that efficiently incorporate specialty expertise while maintaining coordination continuity the PCMH. We describe effect a model integrated community neurology (ICN) on utilization, diagnostic testing, access.This is retrospective, matched case-control comparison...

Abstract Background and Aim Optimal rectal cancer (RC) outcomes depend on accurate locoregional staging. The study sought to describe the impact of endoscopic ultrasound (EUS) RC treatment patterns survival. Methods Using Surveillance, Epidemiology, End Results‐Medicare database, identified patients with between 2005 2007. excluded stage IV disease, those not enrolled in Medicare parts A B, managed care, staged pelvic magnetic resonance imaging (because low numbers). then compared who...

Abstract Background To meet increasing demand, healthcare systems may leverage shorter appointment lengths to compensate for a limited supply of primary care providers (PCPs). Limiting the time spent with patients when evaluating acute health needs adversely affect quality and increase subsequent utilization; however, impact brief duration appointments on utilization in United States has not been examined. This study aimed assess potential inferiority (15-min) compare longer (≥ 30-min...

OBJECTIVE To examine factors associated with emergency department (ED) transport after hypoglycemia treated by medical services (EMS) and assess the impact of ED on severe recurrence. RESEARCH DESIGN AND METHODS We retrospectively analyzed electronic health records a multistate advanced life support EMS provider an integrated healthcare delivery system serving overlapping geographic area in upper Midwest. For adults diabetes for between 2013 2019, we examined rates transport, it, its...

Objective Assess algorithms for linking patients across de‐identified databases without compromising confidentiality. Data Sources/Study Setting Hospital discharges from 11 Mayo Clinic hospitals during January 2008–September 2012 (assessment and validation data). Minnesota death certificates hospital 2009 to entire state (application Study Design Cross‐sectional assessment of sensitivity positive predictive value ( PPV ) four tested by identifying readmissions posthospital mortality on the...

The aim of this study was to assess the impact historical screening compliance with effectiveness patient reminder letters on cervical cancer rates.Using population-based informatics systems, women no in prior 3 years were identified two primary care clinics, Mayo Family Clinic Northeast (NE; n = 1613) and Northwest (NW; 1088). Patients divided into groups: overdue/unknown status at start or previously compliant. NE sent over a 6 months window patients eligible for during that also as...

Oral anticoagulant (OAC) therapy has been the main treatment approach for stroke prevention decades. Warfarin is most widely prescribed OAC in United States, but difficult to manage due variability dose requirements across individuals. Pharmacogenomics may mitigate risk concerns related warfarin use by fostering opportunity facilitate individualized medicine approaches (e.g., genome-guided dosing). While various economic evaluations exist examining cost-effectiveness of pharmacogenomics...

Objectives To evaluate the ability of claims‐based risk adjustment and incremental components clinical data to identify 90‐day episode costs among lower extremity joint replacement ( LEJR ) patients according Centers for Medicare &amp; Medicaid Services CMS Comprehensive Care Joint Replacement CJR program provisions. Data Sources fee‐for‐service FFS qualifying episodes in United States, linked with from ‐qualifying performed at High Value Healthcare Collaborative HVHC Mayo Clinic 2013....

Abstract Background: While brief duration primary care appointments may improve access, they also limit the time clinicians spend evaluating painful conditions. This study aimed to evaluate whether 15-minute resulted in higher rates of opioid prescribing when compared ≥30-minute appointments. Methods: We performed a retrospective cohort using electronic health record (EHR), pharmacy, and administrative scheduling data from five practices Minnesota. Adult patients seen for acute Evaluation...

Abstract Background While brief duration primary care appointments may improve access, they also limit the time clinicians spend evaluating painful conditions. This study aimed to evaluate whether 15-minute resulted in higher rates of opioid prescribing when compared ≥ 30-minute appointments. Methods We performed a retrospective cohort using electronic health record (EHR), pharmacy, and administrative scheduling data from five practices Minnesota. Adult patients seen for acute Evaluation...

Introduction: Endoscopically placed self-expanding metal stents (SEMS) are increasingly used as a bridge to surgery or for palliation in patients with malignant bowel obstruction. We explored determinants of SEMS vs. diversionary (DS) utilization national database. Methods: Using the Surveillance, Epidemiology, and End Results-Medicare database we identified diagnosed Stage IV colorectal cancer between 2005 2007. excluded not enrolled Medicare parts A B managed care, then subsequently...

Introduction: Chemotherapeutic management of advanced colorectal cancer (CRC) has evolved with the availability biologic agents. However, pattern use these agents in United States is unclear. Hence, we studied temporal and regional trend first-line chemotherapy regimens patients stage III/IV CRC between 1997-2007, a nationally representative database. Methods: We used surveillance, epidemiology, end results-Medicare (SEER-Medicare) linked database to identify 29,714 elderly (≥66 years) CRC....

Introduction: Accurate locoregional rectal cancer staging is essential for selecting the optimal surgical approach, and identification of patients who require neoadjuvant chemoradiation, which improves outcomes. Our aim was to identify determinants accurate their impact on survival. Methods: Using Surveillance, Epidemiology, End Results-Medicare database, we identified diagnosed with between 2005 2007. We excluded stage IV disease, those not enrolled in Medicare parts A B, or managed care....