tbuckley/cabot-search huggingface dataset:
Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure
Authors: Kelly Kyanko, Kashika M. Sahay, Yongfei Wang, Shu-Xia Li, Michelle Schreiber, Melissa Hager, Raquel Myers, Wanda Johnson, Jing Zhang, Harlan Krumholz, Lisa G. Suter, Elizabeth W. Triche
Journal: JAMA Network Open (2024)

Importance Medicare Advantage (MA) enrollment is rapidly expanding, yet Centers for Medicare &amp;amp;amp; Medicaid Services (CMS) claims-based hospital outcome measures, including readmission rates, have historically included only fee-for-service (FFS) beneficiaries. Objective To assess the outcomes of incorporating MA data into the CMS claims-based FFS Hospital-Wide All-Cause Unplanned Readmission (HWR) measure. Design, Setting, and Participants This cohort study assessed differences in 30-day unadjusted readmission rates and demographic and risk adjustment variables for MA vs FFS admissions. Inpatient FFS and MA administrative claims data were extracted from the Integrated Data Repository for all admissions for Medicare beneficiaries from July 1, 2018, to June 30, 2019. Measure reliability and risk-standardized readmission rates were calculated for the FFS and MA cohort vs the FFS-only cohort, overall and within specialty subgroups (cardiorespiratory, cardiovascular, medicine, surgery, neurology), then changes in hospital performance quintiles were assessed after adding MA admissions. Main Outcome and Measure Risk-standardized readmission rates. Results The cohort included 11 029 470 admissions (4 077 633 [37.0%] MA; 6 044 060 [54.8%] female; mean [SD] age, 77.7 [8.2] years). Unadjusted readmission rates were slightly higher for MA vs FFS admissions (15.7% vs 15.4%), yet comorbidities were generally lower among MA beneficiaries. Test-retest reliability for the FFS and MA cohort was higher than for the FFS-only cohort (0.78 vs 0.73) and signal-to-noise reliability increased in each specialty subgroup. Mean hospital risk-standardized readmission rates were similar for the FFS and MA cohort and FFS-only cohorts (15.5% vs 15.3%); this trend was consistent across the 5 specialty subgroups. After adding MA admissions to the FFS-only HWR measure, 1489 hospitals (33.1%) had their performance quintile ranking changed. As their proportion of MA admissions increased, more hospitals experienced a change in their performance quintile ranking (147 hospitals [16.3%] in the lowest quintile of percentage MA admissions; 408 [45.3%] in the highest). The combined cohort added 63 hospitals eligible for public reporting and more than 4 million admissions to the measure. Conclusions and Relevance In this cohort study, adding MA admissions to the HWR measure was associated with improved measure reliability and precision and enabled the inclusion of more hospitals and beneficiaries. After MA admissions were included, 1 in 3 hospitals had their performance quintile changed, with the greatest shifts among hospitals with a high percentage of MA admissions.
Patient-Reported Outcomes in Phase 3 Clinical Trials for Blood Cancers: A Systematic Review
Authors: Kishan Patel, Alexandra Ivanov, Tajmah Jocelyn, Andrew Hantel, Jacqueline S. Garcia, Gregory A. Abel
Journal: JAMA Network Open (2024)

Importance Published research suggests that patient-reported outcomes (PROs) are neither commonly collected nor reported in randomized clinical trials (RCTs) for solid tumors. Little is known about these practices in RCTs for hematological malignant neoplasms. Objective To evaluate the prevalence of PROs as prespecified end points in RCTs of hematological malignant neoplasms, and to assess reporting of PROs in associated trial publications. Evidence Review All issues of 8 journals known for publishing high-impact RCTs ( NEJM, Lancet, Lancet Hematology, Lancet Oncology, Journal of Clinical Oncology, Blood, JAMA, and JAMA Oncology ) between January 1, 2018, and December 13, 2022, were searched for primary publications of therapeutic phase 3 trials for adults with hematological malignant neoplasms. Studies that evaluated pretransplant conditioning regimens, graft-vs-host disease treatment, or radiotherapy as experimental treatment were excluded. Data regarding trial characteristics and PROs were extracted from manuscripts and trial protocols. Univariable analyses assessed associations between trial characteristics and PRO collection or reporting. Findings Ninety RCTs were eligible for analysis. PROs were an end point in 66 (73%) trials: in 1 trial (1%) as a primary end point, in 50 (56%) as a secondary end point, and in 15 (17%) as an exploratory end point. PRO data were reported in 26 of 66 primary publications (39%): outcomes were unchanged in 18 and improved in 8, with none reporting worse PROs with experimental treatment. Trials sponsored by for-profit entities were more likely to include PROs as an end point (49 of 55 [89%] vs 17 of 35 [49%]; P &amp;amp;lt; .001) but were not significantly more likely to report PRO data (20 of 49 [41%] vs 6 of 17 [35%]; P = .69). Compared with trials involving lymphoma (18 of 29 [62%]) or leukemia or myelodysplastic syndrome (18 of 28 [64%]), those involving plasma cell disorders or multiple myeloma (27 of 30 [90%]) or myeloproliferative neoplasms (3 of 3 [100%]) were more likely to include PROs as an end point ( P = .03). Similarly, compared with trials involving lymphoma (3 of 18 [17%]) or leukemia or myelodysplastic syndrome (5 of 18 [28%]), those involving plasma cell disorders or multiple myeloma (16 of 27 [59%]) or myeloproliferative neoplasms (2 of 3 [67%]) were more likely to report PROs in the primary publication ( P = .01). Conclusions and Relevance In this systematic review, almost 3 of every 4 therapeutic RCTs for blood cancers collected PRO data; however, only 1 RCT included PROs as a primary end point. Moreover, most did not report resulting PRO data in the primary publication and when reported, PROs were either better or unchanged, raising concern for publication bias. This analysis suggests a critical gap in dissemination of data on the lived experiences of patients enrolled in RCTs for hematological malignant neoplasms.
The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols
Authors: James L. Bernat
Journal: The American Journal of Bioethics (2024)

Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act.
Surgeon and Surgical Trainee Experiences After Adverse Patient Events
Authors: Sara P. Ginzberg, Julia A. Gasior, Jesse E. Passman, Jacob Stein, Shimrit Keddem, Jacqueline M. Soegaard Ballester, Caitlin B. Finn, Jennifer S. Myers, Rachel R. Kelz, Judy A. Shea, Heather Wachtel
Journal: JAMA Network Open (2024)

Importance Adverse patient events are inevitable in surgical practice. Objectives To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. Design, Setting, and Participants In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. Main Outcomes and Measures The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Results Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. Conclusions and Relevance In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.
Ethical and Equity Guidance for Transplant Programs Considering Thoracoabdominal Normothermic Regional Perfusion (TA-NRP) for Procurement of Hearts
Authors: Denise M. Dudzinski, Jay D. Pal, James N. Kirkpatrick
Journal: The American Journal of Bioethics (2024)

Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP. We present a multidisciplinary analysis of the relevant ethical issues arising from DCDD-NRP heart procurement, including application of the Dead Donor Rule and the Uniform Definition of Death Act, and provide recommendations to facilitate ethical analysis and input from all interested parties. We also recommend informed consent, as distinct from typical "authorization," for cadaveric organ donation using TA-NRP.
Mental health outcomes of transgender and gender diverse students in schools: a systematic literature review
Authors: Mahaila Day, Annette Brömdal
Journal: International Journal of Transgender Health (2024)

Introduction This systematic literature review (SLR) investigates the effects school environments have on the mental health outcomes of transgender and gender diverse students. Current literature highlights the need to support the mental health of transgender and gender diverse students in school, however the research synthesizing the existing research is limited. This SLR brings together existing literature exploring the school experience and mental health outcomes for this cohort in schools.
A global consensus on the definitions, diagnosis and management of fibrostenosing small bowel Crohn’s disease in clinical practice
Authors: Dominik Bettenworth, Mark E. Baker, Joel G. Fletcher, Vipul Jairath, Cathy Lu, Willem Bemelman, Geert d’Haens, Andre d’Hoore, Axel Dignass, Iris Dotan, Roger Feakins, Phillip Fleshner, Christina Ha, Gaylyn Henderson, Ruishen Lyu, Julian Panes, Gerhard Rogler, Ren Mao, Jordi Rimola, William J. Sandborn, Siew C. Ng, Britta Siegmund, Mark Silverberg, Stuart A. Taylor, Bram Verstockt, Ilyssa O. Gordon, David H. Bruining, Brian G. Feagan, Florian Rieder
Journal: Nature Reviews Gastroenterology & Hepatology (2024)

Fibrostenosis of the small bowel is common in patients with Crohn's disease. No consensus recommendations on definition, diagnosis and management in clinical practice are currently available. In this Consensus Statement, we present a clinical practice RAND/UCLA appropriateness study on the definition, diagnosis and clinical management of fibrostenosing Crohn's disease. It was conducted by a panel of 28 global experts and one patient representative. Following a systematic literature review, 526 candidate items grouped into 136 questions were generated and subsequently evaluated for appropriateness. Strictures are best defined as wall thickening, luminal narrowing and prestenotic dilation. Cross-sectional imaging is required for accurate diagnosis of fibrostenosing Crohn's disease, and it is recommended before making treatment decisions. It should also assess the degree of inflammation in the bowel wall. Multiple options for medical anti-inflammatory, endoscopic and surgical therapies were suggested, including follow-up strategies following therapy. This Consensus Statement supports clinical practice through providing guidance on definitions, diagnosis and therapeutic management of patients with fibrostenosing small bowel Crohn's disease. In this Consensus Statement, a global multidisciplinary panel of experts provides recommendations for the definitions, diagnosis and management of patients with fibrostenosing small bowel Crohn's disease.
Systematic evaluation with practical guidelines for single-cell and spatially resolved transcriptomics data simulation under multiple scenarios
Authors: Hongrui Duo, Yinghong Li, Yang Lan, Jingxin Tao, Qingxia Yang, Yingxue Xiao, Jing Sun, Lei Li, Xiner Nie, Xiaoxi Zhang, Guizhao Liang, Mingwei Liu, Youjin Hao, Bo Li
Journal: Genome biology (2024)

Abstract Background Single-cell RNA sequencing (scRNA-seq) and spatially resolved transcriptomics (SRT) have led to groundbreaking advancements in life sciences. To develop bioinformatics tools for scRNA-seq and SRT data and perform unbiased benchmarks, data simulation has been widely adopted by providing explicit ground truth and generating customized datasets. However, the performance of simulation methods under multiple scenarios has not been comprehensively assessed, making it challenging to choose suitable methods without practical guidelines. Results We systematically evaluated 49 simulation methods developed for scRNA-seq and/or SRT data in terms of accuracy, functionality, scalability, and usability using 152 reference datasets derived from 24 platforms. SRTsim, scDesign3, ZINB-WaVE, and scDesign2 have the best accuracy performance across various platforms. Unexpectedly, some methods tailored to scRNA-seq data have potential compatibility for simulating SRT data. Lun, SPARSim, and scDesign3-tree outperform other methods under corresponding simulation scenarios. Phenopath, Lun, Simple, and MFA yield high scalability scores but they cannot generate realistic simulated data. Users should consider the trade-offs between method accuracy and scalability (or functionality) when making decisions. Additionally, execution errors are mainly caused by failed parameter estimations and appearance of missing or infinite values in calculations. We provide practical guidelines for method selection, a standard pipeline Simpipe ( https://github.com/duohongrui/simpipe ; https://doi.org/10.5281/zenodo.11178409 ), and an online tool Simsite ( https://www.ciblab.net/software/simshiny/ ) for data simulation. Conclusions No method performs best on all criteria, thus a good-yet-not-the-best method is recommended if it solves problems effectively and reasonably. Our comprehensive work provides crucial insights for developers on modeling gene expression data and fosters the simulation process for users.
Lisocabtagene maraleucel in follicular lymphoma: the phase 2 TRANSCEND FL study
Authors: Franck Morschhauser, Saurabh Dahiya, M Lia Palomba, Alejandro Martin Garcia-Sancho, Juan Luis Reguera Ortega, John Kuruvilla, Ulrich Jäger, Guillaume Cartron, Koji Izutsu, Martin Dreyling, Brad Kahl, Hervé Ghesquieres, Kirit Ardeshna, Hideki Goto, Anna Maria Barbui, Jeremy S Abramson, Peter Borchmann, Isabelle Fleury, Stephan Mielke, Alan Skarbnik, Sven de Vos, Manali Kamdar, Reem Karmali, Andreas Viardot, Thalia Farazi, Omotayo Fasan, James Lymp, Min Vedal, Rina Nishii, Ariel Avilion, Jessica Papuga, Jinender Kumar, Loretta J Nastoupil
Journal: Nature Medicine (2024)

An unmet need exists for patients with relapsed/refractory (R/R) follicular lymphoma (FL) and high-risk disease features, such as progression of disease within 24 months (POD24) from first-line immunochemotherapy or disease refractory to both CD20-targeting agent and alkylator (double refractory), due to no established standard of care and poor outcomes. Chimeric antigen receptor (CAR) T cell therapy is an option in R/R FL after two or more lines of prior systemic therapy, but there is no consensus on its optimal timing in the disease course of FL, and there are no data in second-line (2L) treatment of patients with high-risk features. Lisocabtagene maraleucel (liso-cel) is an autologous, CD19-directed, 4-1BB CAR T cell product. The phase 2 TRANSCEND FL study evaluated liso-cel in patients with R/R FL, including 2L patients who all had POD24 from diagnosis after treatment with anti-CD20 antibody and alkylator ≤6 months of FL diagnosis and/or met modified Groupe d'Etude des Lymphomes Folliculaires criteria. Primary/key secondary endpoints were independent review committee-assessed overall response rate (ORR)/complete response (CR) rate. At data cutoff, 130 patients had received liso-cel (median follow-up, 18.9 months). Primary/key secondary endpoints were met. In third-line or later FL (n = 101), ORR was 97% (95% confidence interval (CI): 91.6‒99.4), and CR rate was 94% (95% CI: 87.5‒97.8). In 2L FL (n = 23), ORR was 96% (95% CI: 78.1‒99.9); all responders achieved CR. Cytokine release syndrome occurred in 58% of patients (grade ≥3, 1%); neurological events occurred in 15% of patients (grade ≥3, 2%). Liso-cel demonstrated efficacy and safety in patients with R/R FL, including high-risk 2L FL. ClinicalTrials.gov identifier: NCT04245839 .
Testing the Concerns Regarding the Global Burden of Disease—Reply
Authors: Andres Roman-Urrestarazu, Robin van Kessel
Journal: JAMA Pediatrics (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Jinlida for Diabetes Prevention in Impaired Glucose Tolerance and Multiple Metabolic Abnormalities
Authors: Hangyu Ji, Xuefei Zhao, Xinyan Chen, Hui Fang, Huailin Gao, Geng Wei, Min Zhang, Hongyu Kuang, Baijing Yang, Xiaojun Cai, Yanjin Su, Chunli Piao, Shuyu Zhao, Liyang Li, Wenliang Sun, Tianshu Xu, Qinghua Xu, Yuan Fan, Jianhua Ye, Chen Yao, Meixia Shang, Guangyao Song, Liming Chen, Qingshan Zheng, Xinhua Xiao, Li Yan, Fengmei Lian, Xiaolin Tong, Zhenhua Jia, Liying Lun, Sulin Hu, Haipeng Liu, Guangyu Cai, Huan Li, Ling Huang, Mengling Tian, Jiale Wan, Peizhen Song, Yaqin Zhang, Fan Li, Xiaoyan Hu, Jing Xu, Ying Pang, Jing Shi, Hongwei Cheng, Wenhong Tian, Huiling Wang, Gangxin Qin, Qiuju Zhao, Lulu Wang, Junting Luo, Luyv Liu, Li Zhao, Wenjiao Xie, Xinlun Cai, Gaohong Qiao, Aoran Song, Jianxiu Li, Wendan Zhang, Qiong Wu, Yanan Wang, Qijun Fang, Lijun Yue, Yuling Zhang, Li Hu, Qin You, Li Wang, Siyu Zhao, Liwei Zhang, Hui Guo, Lina Dai, Wenjuan Niu, Wei Gao, Minzhou Li, Ruixia Zhang, Yixuan Liu, Jingwen Wang, Congchao Zhang, Siyuan Li, Yurong Feng, Yingran Dai, Ren Sa, Lili Sang, Haiyan Wang, Weiwei Yin, Hong Zhang, Fengjun Sun, Li Ma, Junyong Yang, Xuanmin Zhang, Xia Gan, Yang Sheng, Yun Zhou, Junhu Lu, Tong Xu, Haoran Li, Zhen Li, Xiaoxia Pan, Li Zhang, Jialin Han, Acui Yu, Jingqing Jing, Li Huang, Xi Chen, Xuling Wang, Jilai Shi, Bingyan Wang, Guanghui Sun, Kaimin Li, Tingting Zhou, Mengying Shi, Hongli Liu, Xueling Sun, Hewei Zhang, Wenhui Hong, Nan Huang, Xiufen Chen, Jinxiang Zheng, Yongjuan Juan, Rongrong Zhou, Huidan Wang, Chunxue Zang, Yiwen Lai, Zedong Peng, Ruyu Chen, Xinhui Liu, Mengjie Cai, Xu Han
Journal: JAMA Internal Medicine (2024)

Previous studies have shown that Jinlida (JLD) granules, an approved treatment for type 2 diabetes in China, can reduce blood glucose level, reduce glycated hemoglobin (HbA1c), and improve insulin resistance in people with type 2 diabetes.
Testing the Concerns Regarding the Global Burden of Disease
Authors: Samuele Cortese, Jae Il Shin, Marco Solmi
Journal: JAMA Pediatrics (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
An Ethics Committee’s Evaluation of Normothermic Regional Perfusion (NRP) in 2018–Unsatisfactory Answers Then—and Now
Authors: Arthur R. Derse
Journal: The American Journal of Bioethics (2024)

An adult university hospital ethics committee evaluated a proposed TA-NRP protocol in the fall of 2018. The protocol raised ethical concerns about violation of the Uniform Determination of Death Act and the prohibition known as the Dead Donor Rule, with potential resultant legal consequences. An additional concern was the potential for increased mistrust by the community of organ donation and transplantation. The ethics committee evaluated the responses to these concerns as unable to surmount the ethical and legal boundaries and the ethics committee declined to endorse the procedure. These concerns endure.