scholarly journals A Method for Partitioning the Attributable Fraction of Multiple Time-Dependent Coexisting Risk Factors for an Adverse Health Outcome

2013 ◽  
Vol 103 (1) ◽  
pp. 177-182 ◽  
Author(s):  
Haiqun Lin ◽  
Heather G. Allore ◽  
Gail McAvay ◽  
Mary E. Tinetti ◽  
Thomas M. Gill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Outcome ◽  
Attributable Fraction ◽  
Time Dependent ◽  
Multiple Time ◽  
Adverse Health Outcome ◽  
Adverse Health

Do health benefits explain the price premiums for organic foods?

2000 ◽  
Vol 15 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Fred Kuchler ◽  
Katherine Ralston ◽  
J. Robert Tomerlin
Keyword(s):  
Health Outcome ◽  
Consumer Preferences ◽  
Health Benefits ◽  
Organic Food ◽  
Adverse Health Outcome ◽  
Price Premiums ◽  
Adverse Health ◽  
The Cost ◽  
Typical Consumer ◽  
Value Of Health

AbstractThis paper examines whether the dollar value of health benefits that consumers derive from organic food could account for the price premiums they pay. Price and sales data from realized transactions are inadequate to reveal consumer preferences for health benefits. Our exploratory alternative method estimates the value of health benefits to a hypothetical consumer who assesses risks as risk assessors do and values a unit reduction in all fatal risks equally, regardless of the source of any risk. Under these assumptions, our estimates of the value of health benefits derived from substituting an organic diet for a conventionally produced diet approach zero. For a common organic product, apple juice, we estimated the cost of reducing risks by buying the organic characteristic. The cost of averting each adverse health outcome is 27 to 461 times as large as the value of benefits. If the characteristics of our hypothetical consumer match those of the typical consumer, two inferences follow from our estimates of benefits and costs. First, the typical consumer is unlikely to purchase organic food for health reasons. Second, consumers who choose organic food could differ from typical consumers in several dimensions: perceptions of the level of risk from dietary intake of pesticides, perceptions of the nature of adverse health outcomes from pesticides, or in the importance attached to other attributes of organic food. Our analysis is exploratory partially because there are several behavioral assumptions implicit in the values we calculate. Also, we focus on risks that can be quantitatively estimated, measuring the probability of an adverse health outcome with readily accessible data. Currently, only cancer risks can be measured in terms of probabilities from readily accessible data.

Adverse Outcomes Associated with Inappropriate Drug Use in Nursing Homes

2005 ◽  
Vol 39 (3) ◽  
pp. 405-411 ◽  
Author(s):  
Matthew Perri ◽  
Ajit M Menon ◽  
Aparna D Deshpande ◽  
Shashank B Shinde ◽  
Rong Jiang ◽  
...  
Keyword(s):  
Health Outcome ◽  
Drug Use ◽  
Nursing Homes ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Inappropriate Drug ◽  
Adverse Health Outcome ◽  
Adverse Health ◽  
Inappropriate Medication Use ◽  
Inappropriate Drug Use

BACKGROUND: Little empirical evidence exists regarding the influence and outcomes of inappropriate medication use among elderly nursing home residents. OBJECTIVE: To identify the prevalence of inappropriate medication use among elderly patients in Georgia nursing homes using the Beers criteria and identify the relationship between inappropriate drug use and the likelihood of an adverse health outcome. METHODS: A cohort design was used to review 1117 patient medical records in 15 Georgia nursing homes with a high risk of polypharmacy. Prevalence of inappropriate medication use among elderly patients, as defined by the Beers criteria, was estimated. The adverse health outcomes of hospitalizations, emergency department visits, or deaths were identified from Medicaid claims data. RESULTS: A total of 519 (46.5%) patients received at least one inappropriate medication and 143 (12.8%) patients experienced at least one adverse health outcome. Logistic regression revealed that the total number of medications taken (OR 1.139, 95% CI 1.105 to 1.173) significantly increased the likelihood of receiving an inappropriate drug, while having a diagnosis of “dementia” (OR 0.748, 95% CI 0.565 to 0.991) decreased the likelihood. Inappropriate medication use increased the likelihood of experiencing at least one adverse health outcome more than twofold (OR 2.34, 95% CI 1.61 to 3.40). Propoxyphene use alone was significantly associated with the occurrence of an adverse health outcome (OR 2.39, 95% CI 1.54 to 3.71). CONCLUSIONS: Inappropriate drug use was common in our study cohort. Inappropriate use of medication in the elderly, particularly propoxyphene, is associated with a higher risk of adverse health outcomes.

P.3.c.049 Risk of adverse health outcome and metabolic syndrome in adolescents treated with antipsychotics: preliminary results

2011 ◽  
Vol 21 ◽  
pp. S496-S497
Author(s):  
J. Merchán-Naranjo ◽  
M. Giráldez-Quiroga ◽  
C. Moreno ◽  
L. Pina ◽  
M. Parellada ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Health Outcome ◽  
Adverse Health Outcome ◽  
Preliminary Results ◽  
Adverse Health

scholarly journals 157. patient to Environment Transmission of Multidrug-resistant Bacteria Within Intensive Care Units

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S207-S208
Author(s):  
Matthew J Ziegler ◽  
Brendan Kelly ◽  
Michael Z David ◽  
Lauren Dutcher ◽  
Pam C Tolomeo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multiple Time ◽  
Extended Spectrum Beta Lactamase ◽  
Environmental Transmission ◽  
Body Culture ◽  
Clinical Culture ◽  
Multiple Time Points

Abstract Background Identifying risk factors for environmental contamination with multidrug-resistant organisms (MDROs) is essential to prioritize methods for prevention of hospital transmission. Methods Patients admitted to an ICU with an MDRO detected on clinical culture in the prior 30 days were enrolled. Patients (4 body sites) and high-touch objects (HTO) (3 composite sites) in ICU rooms were sampled. Environmental transmission was defined by shared MDRO species cultured on patient and HTO cultures obtained on multiple time points during the patient’s stay. Risk factors for environmental transmission were identified with logistic regression. Results Forty-five patients were included (median 2 days of longitudinal sampling [IQR 1–4 days]). Enrollment anatomic cultures included extended-spectrum beta-lactamase-producing Enterobacterales (ESBLE) (n=12, 27%), carbapenem-resistant organisms (CRO) (n=4, 9%), methicillin-resistant S.aureus (MRSA) (n=11, 24%), vancomycin-resistant Enterococci (VRE) (n=4, 9%), and C.difficile (CDIFF) (n=14, 31%). Patient colonization during serial sampling was common with CRO (n=21, 47%), ESBLE (n=16, 36%), and VRE (n=16, 36%) and less so with MRSA (n=7, 16%) and CDIFF (n=5, 11%). Detection of MDROs on environmental surfaces was also common with identification of CRO in 47% of patient rooms (n=21) and ESBLE in 29% (n=13); MRSA (n=2, 4%), VRE (n=9, 20%), and CDIFF (n=3, 7%) were rarer. Patient to environment transmission was observed in 40% of rooms (n=18). Thirteen (29%) rooms had foreign MDRO contamination (i.e., one not detected on a body culture), most (n=10) with CRO. Environmental MDROs were most common in bathroom/sinks (n=22), followed by surfaces near the patient (n=10), and least common surfaces often touched by staff within the room (n=6). On multivariable logistic regression, naïve to clustering by patient, recent receipt of a proton pump inhibitor (OR 2.35, 95% CI 1.00 – 5.52, P=0.049) and presence of one or more wounds (OR 2.56, 95% CI 1.05 – 6.26, P=0.038) were significantly associated with environmental transmission (OR 1.56, 95% CI 1.01 – 2.43, P=0.046) (Table 1). Conclusion MDRO contamination of patient rooms is common with detection of organisms attributed to, and foreign to, the occupant. Disclosures Michael Z. David, MD PhD, GSK (Consultant)

scholarly journals Risk Factors for Prostate Cancer Detection After a Negative Biopsy: A Novel Multivariable Longitudinal Approach

2010 ◽  
Vol 28 (10) ◽  
pp. 1714-1720 ◽  
Author(s):  
Peter H. Gann ◽  
Angela Fought ◽  
Ryan Deaton ◽  
William J. Catalona ◽  
Edward Vonesh
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Specific Antigen ◽  
Time Dependent ◽  
Negative Biopsy ◽  
Gland Volume ◽  
Piecewise Exponential ◽  
Over Time ◽  
Negative Biopsies

Purpose To introduce a novel approach for the time-dependent quantification of risk factors for prostate cancer (PCa) detection after an initial negative biopsy. Patients and Methods Data for 1,871 men with initial negative biopsies and at least one follow-up biopsy were available. Piecewise exponential regression models were developed to quantify hazard ratios (HRs) and define cumulative incidence curves for PCa detection for subgroups with specific patterns of risk factors over time. Factors evaluated included age, race, serum prostate-specific antigen (PSA) concentration, PSA slope, digital rectal examination, dysplastic glands or prostatitis on biopsy, ultrasound gland volume, urinary symptoms, and number of negative biopsies. Results Four hundred sixty-five men had PCa detected, after a mean follow-up time of 2.8 years. All of the factors were independent predictors of PCa detection except for PSA slope, as a result of its correlation with time-dependent PSA level, and race. PSA (HR = 3.90 for > 10 v 2.5 to 3.9 ng/mL), high-grade prostatic intraepithelial neoplasia/atypical glands (HR = 2.97), gland volume (HR = 0.39 for > 50 v < 25 mL), and number of repeat biopsies (HR = 0.36 for two v zero repeat biopsies) were the strongest predictors. Men with high-risk versus low-risk event histories had a 20-fold difference in PCa detection over 5 years. Conclusion Piecewise exponential models provide an approach to longitudinal analysis of PCa risk that allows clinicians to see the interplay of risk factors as they unfold over time for individual patients. With these models, it is possible to identify distinct subpopulations with dramatically different needs for monitoring and repeat biopsy.

Sign in / Sign up

Export Citation Format

Share Document