RFA HS-92-03 Projects: Study of
Patient Outcomes Associated with Pharmaceutical Therapy
Comparative Outcomes
of Ambulatory Pharmaceutical Agents
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Principal Investigator: Joseph Lau, M.D., New England Medical Center
Grant Number: HS07782
Project Period: 03/93-02/97
NTIS Number: PB98-115405
Summary: The project developed a computer-based
automatic process called Real-Time Meta-Analysis System (RTMAS). This process organizes, routinely
updates, and displays randomized controlled trials (RCT) and meta-analyses
of pharmaceuticals in a simple and easy to understand matrix format. This significantly reduces the time
required to conduct a systematic review and/or meta-analysis of the
effectiveness or comparative effectiveness of one or more therapeutic
agents. A major contribution of the
project is in the methodological improvement of meta-analysis with the
development of control rate meta-regression. This latter methodological innovation was
supported in a well-recognized study on the discrepancies between
meta-analysis and a large RCT.
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Publications to Date
The Asilomar
Working Group on Recommendations for Reporting of Clinical Trials in the
Biomedical Literature (1996). Checklist of information for inclusion in
reports of clinical trials. Annals of
Internal Medicine 124(8):741-3.
Barza, M., Ioannidis, J.P., Cappelleri, J.C., & Lau, J. (1996). Single or multiple
daily doses of aminoglycosides: a meta-analysis. British Medical Journal 312(7027):338-45.
Berkey, C.S., Mosteller, F., Lau, J., & Antman, E.M. (1996). Uncertainty of the time of
first significance in random effects cumulative meta-analysis. Controlled Clinical Trials 17(5):357-71.
Bonis, P.A., Ioannidis, J.P., Cappelleri, J.C., Kaplan, M.M., & Lau, J. (1997). Correlation
of biochemical response to interferon alfa with histological improvement in
hepatitis C: a meta-analysis of diagnostic test characteristics. Hepatology 26(4):1035-44.
Cappelleri, J.C., & Trochim, W.M. (1994). An illustrative statistical analysis of
cutoff-based randomized clinical trials. Journal
of Clinical Epidemiology 47(3):261-70.
Cappelleri, J.C., & Trochim, W.M. (1995). Ethical and scientific features of cutoff-based
designs of clinical trials: a simulation study. Medical Decision Making 15(4):387-94.
Cappelleri, J.C., Darlington, R.B., & Trochim, W.M. (1994). Power
analysis of cutoff-based randomized clinical trials. Evaluation Review 18(2):141-52.
Cappelleri, J.C., Fiore, L., Brophy, M., & Lau, J. (1994). Efficacy and safety of
anticoagulant and antiplatelet therapy versus anticoagulant therapy after
heart-valve replacement: A meta-analysis [abstract]. Controlled
Clinical Trials: Design, Methods, and Analysis 15(3, suppl.):47S-48S.
Cappelleri, J.C., Fiore, L.D., Brophy, M.T., Deykin, D., & Lau, J. (1995). Efficacy and
safety of combined anticoagulant and antiplatelet therapy versus anticoagulant
monotherapy after mechanical heart-valve replacement: A meta-analysis. American Heart Journal 130(3, pt. 1):547-52.
Cappelleri, J.C., Ioannidis, J.P., Schmid, C.H., de Ferranti, S.D., Aubert, M., Chalmers, T.C., & Lau, J. (1996). Large trials vs. meta-analysis of smaller trials: how do their
results compare? Journal of the American
Medical Association 276(16):1332-8.
Cappelleri, J.C., Lau, J., Kupelnick, B., & Chalmers, T.C. (1994). Efficacy and safety of
different aspirin dosages on vascular diseases: A meta-analysis [abstract]. Clinical
Research 42(2):289A.
Cappelleri, J.C., Lau, J., Kupelnick, B., & Chalmers, T.C. (1995). Efficacy and safety of
different aspirin dosages on vascular diseases in high-risk patients. A
metaregression analysis. Online Journal
of Current Clinical Trials Doc No. 174: Mar 14.
Chalmers, T.C., & Lau, J. (1993). Meta-analytic stimulus for changes in clinical trials. Statistical Methods in Medical Research
2(2):161-72.
Chalmers, T.C., & Lau, J. (1993). Randomized control trials and meta-analyses in
gastroenterology: Major achievements and future potential. Annals of the New York Academy
of Sciences 703: 96-105; discussion 105-6.
Chalmers, T.C., & Lau, J. (1996). Changes in clinical trials mandated by the advent of
meta-analysis. Statistics in Medicine 15(12):1263-8; discussion 1269-72.
de Ferranti, S.D., Ioannidis, J.P., Lau, J., Anninger, W.V., & Barza, M. (1998). Are amoxycillin and folate inhibitors as effective as
other antibiotics for acute sinusitis? A meta-analysis. British Medical Journal 317(7159):632-7.
Engels, E.A., Lau, J., & Barza, M. (1998). Efficacy of quinolone prophylaxis in
neutropenic cancer patients: a meta-analysis. Journal of Clinical Oncology 16(3):1179-87.
Freedberg, K.A.
Hardy, W.D. Holzman, R.S. Tosteson, A.N. and Craven, D.E. (1996). Validating
literature-based models with direct clinical trial results: The
cost-effectiveness of secondary prophylaxis for PCP in AIDS patients. Medical Decision Making 16(1):29-35.
Giatras, I., Lau, J., & Levey, A.S. (1997). Effect
of angiotensin-converting enzyme inhibitors on the progression of nondiabetic
renal disease: a meta-analysis of randomized trials.
Angiotensin-Converting-Enzyme Inhibition and Progressive Renal Disease Study
Group. Annals of Internal Medicine 127(5):337-45.
Insua, J.T., Sacks, H.S., Lau, T.S., Lau, J., Reitman, D., Pagano, D., & Chalmers, T.C.
(1994). Drug treatment of hypertension in the elderly: a meta-analysis. Annals of Internal Medicine 121(5):355-62.
Ioannidis, J.P.A., & Lau, J. (1996). The impact of high-risk patients on the population risk
and on the population treatment effect. Journal
of Clinical Epidemiology 46(1):48-56.
Ioannidis, J.P.A., & Lau, J. (1997). The impact of high-risk patients on the results of
clinical trials. Journal of Clinical
Epidemiology 50(10):1089-98.
Ioannidis, J.P.A., Cappelleri, J.C., Lau, J., Sacks, H.S., & Skolnik, P.R. (1996). Predictive
value of viral load measurements in asymptomatic untreated HIV-1 infection: a
mathematical model. AIDS 10(3):255-62.
Ioannidis, J.P.A., Cappelleri, J.C., Lau, J., Skolnik, P.R., Melville, B., Chalmers, T.C., & Sacks, H.S. (1995). Early or deferred zidovudine therapy in HIV-infected
patients without an AIDS-defining illness. Annals
of Internal Medicine 122(11):856-66.
Ioannidis, J.P.A., Cappelleri, J.C., Sacks, H.S., & Lau, J. (1997). The relationship
between study design, results, and reporting of randomized clinical trials of
HIV infection. Controlled Clinical
Trials 18(5):431-44.
Ioannidis, J.P.A., Cappelleri, J.C., Skolnik, P.R., Lau, J., & Sacks, H.S. (1996). A
meta-analysis of the relative efficacy and toxicity of Pneumocystis carinii prophylactic regimens. Archives of Internal Medicine 156(2):177-88.
Ioannidis, J.P.A., Sacks, H.S., Cappelleri, J.C., & Lau, J. (1997) Clinical efficacy
of antiretroviral changes in treatment-experienced HIV-infected patients: A
meta-analysis. Online Journal of Current
Clinical Trials Doc No. 204; May 15.
Lau, J. (1997). Comparative
outcomes of ambulatory pharmaceutical agents: Abstract, executive summary, and
final report. Report for March 1993-February 1997. Boston, MA: New England Medical Center.
Lau, J., & Chalmers, T.C. (1994). Should intravenous magnesium be given to patients with acute
myocardial infarction? [abstract]. Clinical Research 42(2):290A.
Lau, J., & Chalmers, T.C. (1995). The rational use of therapeutic drugs in the 21st century: important
lessons from cumulative meta-analyses of randomized control trials. International Journal of Technology
Assessment in Health Care 11(3):509-22.
Lau, J., Schmid, C.H., & Chalmers, T.C. (1995). Cumulative meta-analysis of clinical trials
builds evidence for exemplary medical care. Journal
of Clinical Epidemiology 48(1):45-57; discussion 59-60.
Levey, A.S., Schmid, C.H., & Lau, J. (1998). Antilymphocyte antibodies, renal
transplantation, and meta-analysis [editorial; comment]. Annals
of Internal Medicine 128(10):863-5.
Pedrini, M.T., Levey, A.S., Lau, J., Chalmers, T.C., & Wang, P.H. (1996). The effect of
dietary protein restriction on the progression of diabetic and nondiabetic
renal diseases: a meta-analysis. Annals
of Internal Medicine 124(7):627-32.
Reichardt, C.S., Trochim, W.M.K., & Cappelleri, J.C. (1995). Reports of the death of
regression-discontinuity analysis are greatly exaggerated. Evaluation Review 19(1):39-63.
Schmid, C.H., Cappelleri, J.C., & Lau, J. (1994). Applying Bayesian meta-regression to
the study of thrombolytic therapy [abstract]. Clinical Research 42(2):290A.
Wang, P.H., Lau, J., & Chalmers, T.C. (1994). Meta-analysis of the effect of intensive
therapy on nephropathy in type I diabetes mellitus. In C.E. Mogensen (Ed.) The
Kidney and Hypertension in Diabetes Mellitus, 2nd ed. Norwell, MA: Kluwer Academic Publishers. pp. 361-8.
Working Group on
Recommendations for Reporting of Clinical Trials in the Biomedical Literature.
(1994). Call for comments on a proposal to improve reporting of clinical trials
in the biomedical literature. Annals of
Internal Medicine 121(11):894-5.
Zucker, D.R., Schmid, C.H., McIntosh, M.W., D'Agostino, R.B., Selker, H.P., & Lau, J.
(1997). Combining single patient (N-of-1) trials to estimate population
treatment effects and to evaluate individual patient responses to treatment. Journal of Clinical Epidemiology 50(4):401-10.
Computer-Based Prospective Drug Utilization Review
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Principal Investigator: William M. Tierney, M.D., Regenstrief Institute, Indianapolis, IN 46202-2859
Grant Number: HS07763
Project Period: 07/93-01/97
NTIS Number: PB2002-102310
Summary: The investigators developed an automated
medical system that incorporated existing treatment guidelines. A randomized controlled clinical trial
was conducted to demonstrate the impact of this computer-based system on
patient-centered outcomes. The trial
concluded without a positive result, which demonstrates the difficulties in
implementing a computer-based treatment guideline system and the need for
further research in the field.
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Publications to Date
Bates, A.S., Harris, L.E., Tierney, W.M., & Wolinsky, F.D. (1998). Dimensions and
correlates of physician work satisfaction in a midwestern city. Medical Care 36(4):610-7.
Berg, A.O., Atkins, D., & Tierney, W. (1997). Clinical practice guidelines in practice
and education. Journal of General
Internal Medicine 12(2, suppl.):S25-33.
Callahan, C.M., & Tierney, W.M. (1995). Health services use and mortality among older
primary care patients with alcoholism. Journal
of the American Geriatrics Society 43(12):1378-83.
Callahan, C.M., Dittus, R.S., & Tierney, W.M. (1996). Primary care physicians' medical
decision making for late-life depression. Journal
of General Internal Medicine 11(4):218-25.
Callahan, C.M., Hendrie, H.C., & Tierney, W.M. (1996). The recognition and treatment of
late-life depression: a view from primary care. Internal Journal of Psychiatry in Medicine 26(2):155-71; discussion 173-5.
Callahan, C.M., Hendrie, H.C., Nienaber, N.A., & Tierney, W.M. (1996). Suicidal ideation
among older primary care patients. Journal
of the American Geriatrics Society 44(10):1205-9.
Callahan, C.M., Kesterson, J.G., & Tierney, W.M. (1997). Association of symptoms of
depression with diagnostic test charges among older adults. Annals of Internal Medicine 126(6):426-32.
Callahan, C.M., Wolinsky, F.D., Stump, T.E., Nienaber, N.A., Hui, S.L., & Tierney, W.M.
(1998). Mortality, symptoms, and functional impairment in late-life depression.
Journal of General Internal Medicine 13(11):746-52.
Harris, L.E., Luft, F.C., Rudy, D.W., & Tierney, W.M. (1995). Correlates of health care
satisfaction in inner-city patients with hypertension and chronic renal
insufficiency. Social Sciences and Medicine 41(12):1639-45.
Harris, L.E., Luft, F.C., Rudy, D.W., Kesterson, J.G., & Tierney, W.M. (1998). Effects of
multidisciplinary case management in patients with chronic renal insufficiency.
American Journal of Medicine 105(6):464-71.
Harris, L.E., Weinberger, M., & Tierney, W.M. (1997). Assessing inner-city patients'
hospital experiences. A controlled trial of telephone interviews versus mailed
surveys. Medical Care 35(1):70-6.
Litzelman, D.K., & Tierney, W.M. (1996). Physicians' reasons for failing to comply with
computerized preventive care guidelines. Journal
of General Internal Medicine 11(8):497-9.
McDonald, C.J., Tierney, W.M., Overhage, J.M., Martin, D.K., Smith, B., Wodniak, C., Blevins, L., Warvel, J., Warvel, J., Meeks-Johnson, J., et al. (1994). The Regenstrief
Medical Record System—experience with MD order entry and
community-wide extensions. Proceedings of
the Annual Symposium on Computer Applications in Medical Care 1059.
McDonald, C.J., & Overhage, J.M. (1994). Guidelines you can follow and can trust. An ideal
and an example [editorial;
comment]. Journal of the American Medical Association
271(11):872-3.
Melfi, C.A., Drake, B.G., & Tierney, W.M. (1996).
The role of public opinion in drug resource allocation decisions. PharmacoEconomics 9(2):106-12.
Murray, M.D., & Tierney, W.M. (1996). Predicting exacerbations of
reactive airways disease using electronic medical records [abstract]. Journal
of General Internal Medicine 11(suppl.):52.
Murray, M.D., & Tierney, W.M. (1996). Using computer-based records to predict mortality
risk for inner-city patients with reactive airways disease [abstract]. Journal
of General Internal Medicine 11(suppl.):53.
Murray, M.D., Harris, L.E., Overhage, J.M., Zhou, X.H., Smith, F., &
Tierney, W.M. (1997). Association between medication possession ratio and
reported compliance [abstract]. Journal of General
Internal Medicine 12(suppl.):77.
Murray, M.D., Loos, B., Tu, W., Eckert, G.J., Zhou, X.H., & Tierney, W.M. (1998). Effects
of computer-based prescribing on pharmacist work patterns. Journal of the American Medical Informatics Association 5(6):546-53.
Murray, M.D., Loos, B., Tu, W., Eckert, G.J., Zhou, X.H., & Tierney, W.M. (1999). Work
patterns of ambulatory care pharmacists with access to electronic
guideline-based treatment suggestions. American
Journal of Health System Pharmacy 56(3):225-32.
Murray, M.D., Rupp, M.T., Overhage, J.M., Ebbeler, D.E., Main, J.W., & Tierney, W.M. (1995).
Multidimensional work sampling in an outpatient pharmacy. Pharmacy Practice Management Quarterly 15(3):44-56.
Murray, M.D., Stang, P., & Tierney, W.M. (1997). Health care use by inner-city patients
with asthma. Journal of Clinical
Epidemiology 50(2):167-74.
Overhage, J.M., Hayward, R.S.A., Wolinsky, F.D., & Tierney, W.M. (1995). Effect of individual internist's characteristics on attitudes
toward guidelines [abstract]. Journal of General
Internal Medicine 10(4):76.
Overhage, J.M., Mamlin, B., Warvel, J., Warvel, J., Tierney, W., & McDonald, C.J. (1995). A
tool for provider interaction during patient care: G-CARE. Proceedings of the Annual Symposium on Computer Applications in Medical Care 178-82.
Overhage, J.M., Tierney, W.M., & McDonald, C.J. (1993). Computer-assisted order-writing
improves compliance with ordering guidelines [abstract]. Clinical
Research 41(3):716A.
Overhage, J.M., Tierney, W.M., & McDonald, C.J. (1993). Intelligent orders enhance
inpatient care process [abstract]. Medical Decision Making 13(4):395.
Overhage, J.M., Tierney, W.M., & McDonald, C.J. (1995). Design and implementation of the
Indianapolis Network for Patient Care and Research. Bulletin of the Medical Library Association 83(1):48-56.
Redelmeier, D.A., & Tierney, W.M. (1994). On the distinction between probability and
trickiness when diagnosing patients with chest pain [abstract]. Journal
of General Internal Medicine 9(2, suppl.):40.
Tierney, R.M. (1998).
Computer-based prospective drug therapy: Abstract, executive summary, and final
report. Report for July 1993-December 1997. Indianapolis, IN: Indiana University.
Tierney, R.M., Horton, S.M., Hannan, T.J., & Tierney, W.M. (1998). Relationships between
symptom relief, quality of life, and satisfaction with hospice care. Palliative Medicine 12(5):333-344.
Tierney, W.M., & Harris, L.E. (1996). Using electronic medical records to predict
all-cause among inner-city patients with uncomplicated hypertension [abstract]. Journal
of General Internal Medicine 11(suppl.):55.
Tierney, W.M., Murray, M.D., Gaskins, D.L., & Zhou, X.H.
(1997). Using computer-based medical records to predict mortality risk for
inner-city patients with reactive airways disease. Journal of the American Medical Informatics Association 4(4):313-21.
Tierney, W.M., Overhage, J.M., & McDonald, C.J. (1994). A plea for controlled trials in
medical informatics [editorial]. Journal of the American
Medical Informatics Association 1(4):353-5.
Tierney, W.M., Overhage, J.M., & McDonald, C.J. (1995). Toward electronic medical records
that improve care [editorial; comment]. Annals of Internal
Medicine 122(9):725-6.
Tierney, W.M., Overhage, J.M., & McDonald, C.J. (1996). Computerizing guidelines: factors
for success. Proceedings of the American
Medical Informatics Association Annual Fall Symposium 459-62.
Tierney, W.M., Overhage, J.M., & McDonald, C.J. (1997). Demonstrating the effects of an
IAIMS on health care quality and cost. Journal
of the American Medical Informatics Association 4(2, suppl.):S41-46.
Tierney, W.M., Overhage, J.M., McDonald, C.J., & Wolinsky, F.D. (1994). Medical students'
and housestaff's opinions of computerized order-writing. Academic Medicine 69(5):386-9.
Tierney, W.M., Overhage, J.M., Takesue, B.Y., Harris, L.E., Murray, M.D., Vargo, D.L., & McDonald, C.J.
(1995). Computerizing guidelines to improve care and patient outcomes: the
example of heart failure. Journal of the
American Medical Informatics Association 2(5):316-22.
Tierney, W.M., Takesue, B.Y., Vargo, D.L., & Zhou, X.H. (1996). Using electronic medical
records to predict mortality in primary care patients with heart disease:
prognostic power and pathophysiologic implications. Journal of General Internal Medicine 11(2):83-91.
Tierney, W.M., Zhou, X.H., Takesue, B.Y., & Vargo, D.L. (1994). Changing clinical data and
unstable predictions of mortality in congestive heart failure [abstract]. Journal
of General Internal Medicine 9(2, suppl.):37.
Wolinsky, F.D., Wyrwich, K.W., Nienaber, N.A., & Tierney, W.M. (1998). Generic versus
disease-specific health status measures. An example using coronary artery
disease and congestive heart failure patients. Evaluation of the Health Professions 21(2):216-43.
Wyrwich, K.W., Nienaber, N.A., Tierney, W.M., & Wolinsky, F.D. (1999). Linking clinical
relevance and statistical significance in evaluating intra-individual changes
in health-related quality of life. Medical
Care 37(5):469-78.
Wyrwich, K.W., Tierney, W.M., & Wolinsky, F.D. (1998). Does the standard error of measurement
identify clinically relevant individual change in health related quality of
life measures? Quality of Life Research 7(7):676-7.
Wyrwich, K.W., Tierney, W.M., & Wolinsky, F.D. (1999). Further evidence supporting an
SEM-based criterion for identifying meaningful intra-individual changes in
health-related quality of life. Journal
of Clinical Epidemiology 52(9):861-73.
Zhou, X.H.
(1995). Testing an underlying assumption on a ROC curve based on rating data. Medical Decision Making 15(3):276-82.
Zhou, X.H.
(1996). Empirical Bayes combination of estimated areas under ROC curves using
estimating equations. Medical Decision Making 16(1):24-8.
Zhou, X.H., Melfi, C.A., & Hui, S.L. (1997). Methods for
comparison of cost data. Annals of Internal
Medicine 127(8, pt. 2):752-6.
Improving Outcomes
in Elderly NSAID Users
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Principal Investigator: Wayne A. Ray, Ph.D., M.S., Vanderbilt University
Grant Number: HS07768
Project Period: 07/93-06/98
NTIS Number: PB2002-102310
Summary:
The investigators designed an intervention to reduce the use of
non-steroidal anti-inflammatories (NSAIDs) for osteoarthritis in an elderly
population. Two randomized
controlled trials (RCTs) were designed to test the effectiveness of a
physician education program in reducing use of NSAIDs. The first RCT, among community dwelling
elderly NSAID users, showed that a completed educational visit could
produce a 10 percent (6 to 14 percent) reduction in NSAID use. The second, a RCT for nursing home
patients, demonstrated an even greater reduction where the mean number of
days of NSAID use (7 day periods prior to and after the intervention)
decreased from 7.0 to 1.9 days in intervention home subjects compared to a
decrease from 7.0 to 6.2 days in control homes (P=0.0001).
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Publications to Date
Burnett, C.B., Steakley, C.S., & Tefft, M.C. (1995). Low-income, minority women: Barriers to cancer
screening. Annals of the New York Academy of Sciences 768:277-80.
Griffin, M.R. (1993). NSAID Use in the Elderly: Prevalence
and Problems. New Jersey: Scientific Therapeutics Information, Inc.
Griffin, M.R. (1998) Nonsteroidal anti-inflammatory drugs. In
K.D. Brandt, S. Lohmander, & M. Doherty (Eds.). Osteoarthritis. Oxford; New York:
Oxford University Press. p. 261-71.
Griffin, M.R., Brandt, K.D., Liang, M.H., Pincus, T., & Ray, W.A. (1995). Practical management of osteoarthritis. Integration of
pharmacologic and nonpharmacologic measures. Archives of Family Medicine 4(12):1049-55.
Griffin, M.R., Smalley, W.E. (1995). Drugs and ulcers: clues
about mucosal protection from epidemiologic studies. Journal of Clinical Gastroenterology 21(Suppl 1):S113-119.
Griffin, M.R., Yared, A., Ray, W.A. (2000). Nonsteroidal
anti-inflammatory drugs and acute renal failure in elderly persons. American Journal of Epidemiology 151(5):488-96.
Hochberg, M.C., Altman, R.D., Brandt, K.D., Clark, B.M., Dieppe, P.A., Griffin, M.R., Moskowitz, R.W., & Schnitzer, T.J. (1995).
Guidelines for the medical management of osteoarthritis—Part I: Osteoarthritis of the hip. Arthritis and Rheumatism 38(11):1535-40.
Hochberg, M.C., Altman, R.D., Brandt, K.D., Clark, B.M., Dieppe, P.A., Griffin, M.R., Moskowitz, R.W., & Schnitzer, T.J. (1995).
Guidelines for the medical management of osteoarthritis—Part II: Osteoarthritis of the knee. Arthritis and Rheumatism 38(11):1541-6.
Puett, D.W., & Griffin, M.R. (1994). Published trials of nonmedicinal and noninvasive
therapies for hip and knee osteoarthritis. Annals
of Internal Medicine 121(2):133-40.
Ray, W.A. (1997). Policy and
program analysis using administrative databases. Annals of Internal Medicine 127(8, pt. 2):712-8.
Ray, W.A. (1998) Economic considerations
in the use of nonsteroidal anti-inflammatory drugs. In K. Brandt, M. Doherty, L.S. Lohmander (Eds.) Osteoarthritis. New York: Oxford University Press.
Ray, W.A., & Murray, K.T. (2002). Aspirin: redundant in users of
nonaspirin, nonsteroidal antiinflammatory agents? American Heart Journal
143(3):381-2.
Ray, W.A., Stein, C.M., Byrd, V., Shorr, R., Pichert, J.W., Brandt, K.D., Pincus, T., & Griffin, M.R. (2001). Educational program for physicians to
reduce use of non-steroidal anti-inflammatory drugs among community-dwelling
elderly persons: a randomized controlled trial. Medical Care 39(5):425-35.
Ray, W.A., Stein, C.M., Daugherty, J.R., Hall, K., Arbogast, P.G., & Griffin, M.R. (2002). COX-2 selective non-steroidal anti-inflammatory drugs and risk of
serious coronary heart disease. Lancet 360(9339):1071-3.
Ray, W.A., Stein, C.M., Hall, K., Daugherty, J.R., & Griffin MR. (2002). Non-steroidal
anti-inflammatory drugs and risk of serious coronary heart disease: an
observational cohort study. Lancet 359(9301):118-23.
Smalley, W.E., & Griffin, M.R. (1996). The risks and costs of upper
gastrointestinal disease attributable to NSAIDS [review]. Gastroenterology Clinics of North
America 25(20):373-96.
Smalley, W.E., Griffin, M.R., Fought, R.L., & Ray, W.A. (1996). Excess
costs from gastrointestinal disease associated with nonsteroidal
anti-inflammatory drugs. Journal of General Internal Medicine 11(8):461-9.
Smalley, W.E., Griffin, M.R., Fought, R.L., Sullivan, L., & Ray, W.A.
(1995). Effect of a prior-authorization requirement on the use of nonsteroidal
antiinflammatory drugs by Medicaid patients. New England Journal of
Medicine 332(24):1612-7.
Smalley, W.E., Ray, W.A., Daugherty, J.R., & Griffin, M.R. (1995). Nonsteroidal anti-inflammatory drugs
and the incidence of hospitalizations for peptic ulcer disease in elderly
persons. American Journal of Epidemiology 141(6):539-45.
Smalley, W., Stein, C.M., Arbogast, P.G., Eisen, G., Ray, W.A., & Griffin, M. (2002).
Underutilization of gastroprotective measures in patients receiving
nonsteroidal antiinflammatory drugs. Arthritis and Rheumatism 46(8):2195-200.
Stein, C.M., Griffin, M.R., Taylor, J.A., Pichert, J.W., Brandt, K.D., & Ray, W.A.
(2001). Educational program for nursing home physicians and staff to reduce use
of non-steroidal anti-inflammatory drugs among nursing home residents: a
randomized controlled trial. Medical Care 39(5):436-45.
Outcomes Associated
with Therapy for Otitis Media
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Principal Investigator: Stephen Berman, M.D., University of Colorado, Denver, CO, 80262
Grant Number: HS07816
Project Period: 07/93-06/97
NTIS Number: PB98-1194980
Summary: This study focused on the comparative
cost-effectiveness of various antibiotic treatments of otitis media. The investigators used the Colorado State
Medicaid database to identify exposure and outcomes. The findings of this project suggest that
physicians often prescribed the more expensive antibiotics. However, these products were not
associated with better outcomes.
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Publications to Date
Berman, S. (1995). Otitis
media in children. New England Journal of
Medicine 332(23):1560-5.
Berman, S. (1997). Utilization
of services for otitis media by children enrolled in Medicaid. Archives of Pediatrics and Adolescent
Medicine 151:407-13.
Berman, S. (1998). Outcomes
associated with therapy for otitis media: abstract, executive summary, and
final report. Report for July 1993-June 1997. Denver, CO: Children's Hospital.
Berman, S. (1999). A three
step approach to treating otitis media [letter; comment]. Pediatric
Infectious Diseases Journal 18(6):571-2.
Berman, S., Bondy, J., Lezotte, D., Stone, B., & Byrns, P.J. (1999). The influence of having an
assigned Medicaid primary care physician on utilization of otitis media-related
services. Pediatrics 104(5, pt. 2):1192-7.
Berman, S., Byrns, P., Roark, R., & Bondy, J. (1995). The effect of having a Medicaid primary care
provider on the utilization of otitis related services [abstract]. Pediatric
Research 37(4, pt. 2):103A.
Berman, S., Byrns, P., Roark, R., & Bondy, J. (1995). The effect of having a Medicaid primary care
provider on the utilization of otitis related services [abstract]. Archives of
Pediatrics and Adolescent Medicine 149(suppl.).
Berman, S., Byrns, P.J., Bondy, J., Smith, P.J., & Lezotte, D. (1997). Otitis media-related
antibiotic prescribing patterns, outcomes, and expenditures in a pediatric
Medicaid population. Pediatrics 100(4):585-92.
Berman, S., Wu, K., & Roark, R. (1999). Management of otitis media with effusion with prednisone in
combination with an antibiotic. International
Pediatrics 14(4):30-3.
Byrns, P.J., Bondy, J., Glazner, J.E., & Berman, S. (1997). Utilization of services for otitis
media by children enrolled in Medicaid. Archives
of Pediatrics and Adolescent Medicine 151(4):407-13.
Roark, R., Petrofski, J., Berson, E., & Berman, S. (1995). Practice variations among pediatricians
and family physicians in the management of otitis media. Archives of Pediatrics and Adolescent Medicine 149:839-44.
Outcomes of
Compliance with an AMI Practice Guideline
|
Principal Investigator: Stephen B. Soumerai, M.D., Harvard Medical School, Boston, MA 02215
Grant Number: HS07631
Project Period: 12/93-11/96
NTIS Number: PB2000-107000
Summary: This study used Medicaid data to
confirm that beta-blocker therapy reduces mortality and cardiac
hospitalizations of myocardial infarction (MI) in elderly patients. The study was the first of several
peer-reviewed articles that provided real-world confirmation of clinical
trial evidence for the benefit of these agents. |
Publications to Date
Gillman, M.W., Ross-Degnan, D., McLaughlin, T.J., Gao, X., Spiegelman, D., Hertzmark, E., Goldman, L., & Soumerai, S.B. (1999). Effects of long-acting versus short-acting calcium
channel blockers among older survivors of acute myocardial infarction. Journal of the American Geriatric Society 47(5):512-7.
Soumerai, S.B. (1998). Outcomes
of compliance with an AMI practice guideline: Abstract, executive summary, and
final report. Report for December 1993-November 1997. Boston, MA: Harvard Medical School.
Soumerai, S.B., McLaughlin, T.J., Ross-Degnan, D., Casteris, C.S., & Bollini, P. (1994). Effects of a
limit on Medicaid drug-reimbursement benefits on the use of psychotropic agents
and acute mental health services by patients with schizophrenia. New England Journal of
Medicine 331(10):650-5.
Soumerai, S.B., McLaughlin, T.J., Spiegelman, D., Hertzmark, E., Thibault, G., & Goldman, L. (1997). Adverse
outcomes of underuse of beta-blockers in elderly survivors of acute myocardial
infarction. Journal of the American
Medical Association 277(2):115-21.
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