Specialist Care and Primary Care Provider Performance 4.4.08
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Contrary to the hypothesis, patients seeing a cardiovascular specialist for uncontrolled hypertension were more likely to have their hypertension treatment intensified by their primary care provider. However, those seeing an unrelated specialist were less likely to have their treatment intensified. This suggests primary care providers still consider themselves responsible for hypertension management even when patients see specialists. The study analyzed over 15,000 patients and 70,000 visits from six primary care practices to determine the relationship between specialist care, patient characteristics, and likelihood of primary care providers intensifying hypertension treatment.
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![Specialist care and primary care provider performance on a quality of care measure: example of management of uncontrolled hypertension 1 Barbara J. Turner, MD 2 C Hollenbeak, PhD, 1 Mark G. Weiner, MD, 3 Craig Roberts, PharmD 1 University of Pennsylvania School of Medicine, Philadelphia, PA, 2 Pennsylvania State University, Hershey, PA, 2 Pfizer Global Pharmaceuticals, New York, NY We hypothesized that, when the patient sees a cardiovascular (CV) disease specialist, the PCP might defer HTN management to that specialist. Conversely, in patients with comorbidities that are unrelated to CV disease (eg COPD), care from specialists for these unrelated conditions should permit the PCP to focus more on managing uncontrolled HTN. In generalized estimating equation logistic regression models, we examined specialist care and adjust for: patient demographic, clinical conditions (weight, tobacco use, blood pressure, diagnoses), HTN treatment, visit adherence, and PCP characteristics as well as for clustering of visits within patient. We repeated the analysis clustering on physician. Table 1 – Demographics by patient and visit Table 2 Clinical conditions by patient & visit Specialist care Related specialist(s) 1 2 3,835 474 24.9 3.1 20,724 3,270 29.3 4.6 Unrelated specialist(s) Mean 2.40 1.71 2.68 1.89 Table 3 – Unrelated and related specialist visits Table 4 – Logistic regression: likelihood of treatment intensification Contrary to our hypothesis, patients with care from a related specialist such as a cardiologist were more likely to have HTN treatment intensified by the PCP while those with care from an unrelated specialist were less likely. These results suggest that PCPs are not relieved of the responsibility to address uncontrolled HTN by care from specialists Care from a related specialist may be reflect unmeasured severity of illness but we did adjust for comorbidities, level of BP, and HTN meds. *Selected variables from full model ,[object Object],[object Object],[object Object],Unit of Analysis Patients Visits Unit of Analysis Patients Visits Total 15,497 100 70,559 100 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Quality of care measures may hold the primary care physician (PCP) accountable for achieving goals even when a patient is co-managed by a specialist. Background Methods Analysis Objectives Results Unit of Analysis Characteristic Patients Visits Total 15,497 100 70,559 100 Mean Age (SD) 59.6 14.9 61.9 14.7 Women (%) 9,357 60.4 44,656 64.3 Black Race (%) 7,960 51.5 41,163 38.0 Median income in zipcode (mean $, SD) 44,466 23,958 41,748 22,823 Insurance type (N, %) Commercial 10,703 69.2 47,782 67.7 Medicaid 2,502 16.2 13,624 19.3 Medicare 5,508 35.6 29,687 42.0 Self pay 273 1.8 976 1.4 Antihypertensive meds in regimen (N,%) 0-1 10,638 68.8 40,407 57.2 2+ 4,821 31.2 30,150 32.8 Results Conclusions Results Clinical conditions Total 15,497 100 70,559 100 Related comorbidities Single 2,300 14.9 7,998 11.3 Multiple 873 5.6 1,927 2.7 Diabetes 4,943 32.0 31,533 44.7 Chronic renal disease 999 6.5 6,969 9.9 Unrelated comorbidities (mean) 1.92 1.68 2.23 1.83 Specialist care AOR 95% CI P value Treatment from related specialties (versus zero) One 1.10 1.05 - 1.16 <0.0001 Both 1.52 1.36 - 1.70 <0.0001 Treatment from unrelated specialties (versus one) Two 0.92 0.87 –0.97 0.001 Three 0.88 0.82 –0.93 <0.0001 Four 0.88 0.81 –0.94 0.001 Five or more 0.88 0.80 –0.96 0.007 Clinical Conditions* AOR 95% CI P value Related comorbidities (versus zero) Single Multiple 1.14 1.17 1.06-1.22 1.02-1.33 <0.001 <0.001 Diabetes 0.67 0.64-0.70 <0.001 Chronic renal failure 0.95 0.88-1.03 0.22 Unrelated comorbidity (per comorbidity) 0.96 0.94-0.98 <0.001 Limitations](https://image.slidesharecdn.com/turnerbarbara-specialistcareandprimarycareproviderperformance-4-4-08-100818150708-phpapp02/85/Specialist-Care-and-Primary-Care-Provider-Performance-4-4-08-1-320.jpg)
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I. INTRODUCTION
DEFINITION
HISTORY
NEED TO STUDY BIOSTATISTICS
SAMPLING
METHODS OF PRESENTATION OF DATA
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METHODS OF ANALYZING THE DATA
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Patients who seek homeopathic treatment are likely to improve considerably. These
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How healthy are chronically ill patients after eight years of homeopathic tre...
Que tan saludables se encuentran los pacientes después de 8 años de tratamiento homeopatico, resultados de un largo estudio.
3.3. The Reality of Non-Compliance
The document discusses various forms of non-compliance with medication regimens, including forgetting to take medications, taking less than the recommended dose, and failing to fill prescriptions. It notes that non-compliance is a major cause of wasted medication and occurs in about 50% of patients. Reasons for non-compliance include medication costs, fear of side effects, distrust of doctors, and reluctance to acknowledge illness. Having multiple prescriptions can also increase non-compliance rates.
Journal club
This journal club discussion summarizes a randomized controlled trial that compared the glucose-lowering drug rosiglitazone to metformin and glyburide in patients with recently diagnosed type 2 diabetes. The study was well-designed, experimental in nature, and included over 4,000 patients followed for a median of 4 years. The primary outcome was time to monotherapy failure based on fasting glucose levels. The results showed that rosiglitazone delayed monotherapy failure better than the other drugs and had a lower incidence of progression to higher fasting glucose levels. However, the study also reported some safety concerns with rosiglitazone like increased risk of heart failure. Overall, the discussant found the study to be valid and that the
Case control study – part 1
- The document provides an overview of planning and conducting a case control study to investigate the potential association between DPT vaccination and neurological illness.
- It discusses defining cases and controls, selecting cases and controls, matching cases and controls, sources of bias, and applications of case control studies. Key points covered include selecting incident cases, defining eligibility criteria for both cases and controls, choosing appropriate control groups, sampling methods, and when and how to perform matching to reduce bias.
- The goal of the study would be to test whether neurological illness occurs more frequently in children who received the DPT vaccine compared to children who did not, in order to help inform vaccination practices and alleviate parents' and doctors' concerns following isolated reports
Drug induced diabetes
Many medications can cause drug-induced diabetes by increasing insulin resistance or affecting insulin secretion. Widely used medications like thiazide diuretics, beta-blockers, and statins weakly increase diabetes risk, while steroids, antipsychotics, immunosuppressants, protease inhibitors confer a high risk. Diabetes induced by medications may not always be permanent and blood glucose levels could return to normal after stopping the medication, but lifestyle changes are often needed to manage drug-induced diabetes.
Biostatistics
I. INTRODUCTION
DEFINITION
HISTORY
NEED TO STUDY BIOSTATISTICS
SAMPLING
METHODS OF PRESENTATION OF DATA
METHODS OF SUMMARIZING THE DATA
: Measures of Central Tendency
: Mean
: Median
: Mode
: Measures of Dispersion
: range
: Mean deviation
: Standard deviation
: Coefficient of variation
CORRELATION & REGRESSION
NORMAL DISTRIBUTION AND NORMAL CURVE.
METHODS OF ANALYZING THE DATA
SUMMARY & CONCLUSION
Staff nurses' perception of medication errors, perceived causes, and reportin...
The document discusses a research paper on staff nurses' perceptions of medication errors. Specifically, it examines their perception of errors, perceived causes, and reporting behaviors. The paper provides background on medication errors being a major cause of preventable deaths. It discusses theories that guide the study and defines key terms. Overall, the paper aims to understand nurses' views and behaviors regarding medication errors to improve policies and reduce errors and associated costs and deaths.
Cohort study
In this presentation i tried to explain in detail about cohort studies, their types, how to conduct them, their outcomes, and how to calculate sample size of these studies.
Knowledge, Attitude and Practice of Self-Medication among Medical Students
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Epcm l23,25 association and causation
This lecture was given as a part of the Introduction to Epidemiology & Community Medicine Course given for third-year medical students.
COHORT STUDY
A cohort study identifies groups of individuals who are exposed or not exposed to a particular factor and compares their outcomes over time. This document provides examples of cohort studies that compare rates of disease between groups exposed to smoking versus unexposed, and exposed to hepatitis B virus versus unexposed. It also outlines the key components of cohort studies including selecting study populations, obtaining exposure data, selecting comparison groups, follow up, and analysis.
Research Methodology - Case control study
This document discusses case control studies, an observational study design that compares individuals with a disease or condition (cases) to individuals without the disease or condition (controls) to determine associations between exposures and disease outcomes. It provides an overview of key elements of case control studies, including the selection and matching of cases and controls, measurement of exposure, analysis using odds ratios, potential biases, advantages and disadvantages compared to cohort studies, and examples of case control studies conducted.
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Palliative care could help improve the quality of life for Parkinson’s diseas...
Palliative care could help improve the quality of life for Parkinson’s diseas...Δρ. Γιώργος K. Κασάπης
A small study of individuals with Parkinson’s disease finds that adding palliative care to standard care may help raise their quality of life. Half the patients in a 210-person trial were assigned to visit physicians as usual, while the others also received palliative care — a team of a social worker, nurse, palliative medicine specialist, and chaplain visited the patient at home or via telemedicine to discuss symptoms and difficult emotions and offer support to caregivers. Patients in the combination care group had more improvement in their quality of life score (as measured by a survey that assesses physical and mental health).
These patients also scored higher on quality of life measures when their caregivers were surveyed in their stead.What Works in Chronic Care Management 6.12.09
This study analyzed data from 10 randomized controlled trials testing post-discharge care management programs for heart failure patients. It found that programs using multidisciplinary teams and in-person communication significantly reduced hospital readmissions and readmission days compared to routine care. However, programs relying only on telephone follow-up did not significantly reduce hospital use. The study concludes that payers should incentivize hospitals to adopt chronic care management programs shown to effectively reduce hospital utilization, which could lower costs for programs like Medicare that cover many patients with chronic illnesses.
Conway2019
Intensive glucose control in critically ill patients offers no benefit and increases risk of harm. A meta-analysis of 27 randomized trials involving over 17,000 critically ill adults found that intensive glucose control, aimed at tightly regulating blood glucose levels between 80-110 mg/dL, provided no reduction in mortality or other clinical benefits compared to conventional control between 140-180 mg/dL. However, intensive control was associated with a 8.3% higher risk of severe hypoglycemia. Current guidelines recommend conventional glucose control for critically ill patients experiencing persistent hyperglycemia based on the lack of benefit and risk of harm from intensive control.
Comparisonof Clinical Diagnoses versus Computerized Test Diagnoses Using the ...
The Diagnostic Paradigm from www.MarylandClinicalDiagnostics.com was able to help the former Dean of Los Angeles Chiropractic College detect medical diagnoses which he had overlooked, and he later confirmed.
Poor Quality Doctors or Challenging Patients 4.8.08
The document analyzes clinical data from 11,636 patients with diabetes to determine which common comorbidities are most predictive of poor diabetes control, as measured by elevated HBA1c levels. It compares a traditional logistic regression model using dichotomous diagnosis variables to a model that employs "group mean centering" of the variables. Group mean centering identifies diagnoses that are more highly correlated within individual physicians' patient panels. The results suggest some diagnoses are robust predictors of control across both models, while others may be more influenced by unobserved physician-related factors.
J2016 - Tecson et al AJC Impact of EECP on Heart Failure Rehospitalization
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2) Only 6 patients (6.1%) had unplanned readmissions within 90 days, which was significantly lower than the predicted rate of 34%. Functional status, walk distance, and symptoms also improved after EECP based on various clinical measures.
3) In conclusion, patients who received EECP and education within 90 days of discharge had significantly lower readmission rates than predicted, and also showed improvements in functional status, walk distance, and symptoms.
PMC Measure Review RA v8FINAL Website
This document summarizes the American College of Physicians' review and recommendations for several performance measures related to the diagnosis and treatment of rheumatoid arthritis. The ACP supports measures assessing disease-modifying antirheumatic drug therapy, tuberculosis screening before biologic therapy, assessment of disease activity, and functional status assessment. The ACP recommends modifications to measures assessing DMARD therapy and disease prognosis assessment. The ACP does not support measures assessing glucocorticoid management.
Computer Decision Support Systems and Electronic Health Records: Am J Pub Hea...
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Across clinical settings, new generation CDSSs integrated with EHRs do not affect mortality and might moderately improve morbidity outcomes. (Am J Pub- lic Health. Published online ahead of print October 16, 2014: e1–e11. doi:10.2105/ AJPH.2014.302164)
Preprint review article letter to all pharmacist 2016 pharmaceutical care la...
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Serum Procalcitonin as a marker of infection in chronic kidney disease patien...
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Health care pathways and expert patients may 2012
This article summarizes the results of establishing care pathways and an expert patient program for chronic conditions like diabetes, heart failure, and COPD in Barcelona, Spain. Key results include:
- Increased detection and monitoring of the conditions through improved protocols between primary and specialized care.
- Reduced hospital admissions and length of stay for heart failure patients.
- Increased patient knowledge and self-care through the expert patient program, which may have contributed to reduced heart failure admissions.
- High satisfaction among patients in the expert patient program.
Lee et al-2015-anesthesia_&_analgesia
This randomized controlled trial evaluated the effectiveness of a perioperative smoking cessation intervention on long-term smoking abstinence rates. The intervention involved brief counseling, smoking cessation materials, referral to a quitline, and nicotine replacement therapy. At the 1-year follow-up, smoking cessation was reported in 25% of patients who received the intervention compared to 8% of control patients. Lower nicotine dependence at baseline and receiving the intervention were predictive of long-term smoking cessation. The study demonstrates that a minimally intensive perioperative smoking cessation intervention can significantly increase smoking abstinence rates not just short-term but also at 1 year postoperatively.
The Cost of PH - How Do We Manage This?
This document discusses the high costs associated with pulmonary hypertension (PH) from multiple perspectives, including direct healthcare costs, indirect costs, and costs to individuals and society. Hospitalizations are identified as a major driver of costs. Earlier diagnosis and treatment, risk-guided escalation of therapy, and care at specialized centers can help reduce costs by preventing hospitalizations and disease progression. While medications and care are costly, lack of treatment results in poor outcomes and increased costs over time. Assistance programs help many patients afford needed therapies.
ISPOR
This summarizes the outcomes of a 6-month pharmacist-provided diabetes management program for employees of the City of Toledo. The program showed improvements in clinical outcomes like A1c and blood pressure. It also improved humanistic outcomes such as patient satisfaction, knowledge, and adherence. Economic outcomes like healthcare utilization and costs improved as well, with a 62.69% reduction in total costs. The study demonstrates positive short-term outcomes across clinical, humanistic and economic domains from a pharmacist-led diabetes management program.
Dia Care-2001-Clark-1079-86 (1)
This study evaluated a comprehensive diabetes management program within a managed care organization that included risk stratification of patients and social marketing approaches. Over 12 months, the program resulted in improved glycemic control as measured by an increase in the number of patients in the low-risk HbA1c category. The majority of high-risk patients had changes made to their treatment regimens. Other clinical measures like blood pressure and LDL cholesterol also improved. Patients and providers reported greater satisfaction with the program. The risk stratification and intervention approach was successful in initiating recommended treatment changes and improving diabetes outcomes and satisfaction.
Measurement and Modeling Issues with Adherence to Pharmacotherapy
The document discusses issues related to measuring and modeling medication adherence using claims data. It covers calculating adherence measures like MPR and PDC, defining adherence thresholds, handling primary non-compliance, and addressing endogeneity and selection bias when modeling adherence as an independent variable to estimate its impact on outcomes. Regression adjustment, propensity score matching, and instrumental variables are some methods discussed to address biases in observational studies of adherence.
Cost burdenofchronic pain
This study analyzed healthcare resource utilization and costs for 12,165 patients with 24 chronic pain conditions within an integrated healthcare system in the US. The researchers found that after pharmacy costs, outpatient visits were the most utilized resource, with a mean of 18.8 visits per patient in the post-index period. Specialty visits accounted for 59% of outpatient visits. Imaging tests averaged 5.2 per patient. Opioids were the most commonly prescribed medication. Total annual direct costs for all conditions were $386 million, a 40% increase from pre-index costs. Pharmacy costs comprised 14.3% of total costs, while outpatient visits were the primary cost driver. Musculoskeletal conditions were associated with the highest overall costs
Cost burden of chronic pain
This study analyzed healthcare resource utilization and costs for 12,165 patients with 24 chronic pain conditions within an integrated healthcare system in the US. The researchers found that after pharmacy costs, outpatient visits were the most utilized resource, with a mean of 18.8 visits per patient in the post-index period. Specialty visits accounted for 59% of outpatient visits. Imaging tests averaged 5.2 per patient. Opioids were the most commonly prescribed medication. Total annual direct costs for all conditions were $386 million, a 40% increase from pre-index costs. Pharmacy costs comprised 14.3% of total costs, while outpatient visits were the primary cost driver. Musculoskeletal conditions were associated with the highest overall costs
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3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.Epstein,andy ispor poster_2013
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
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The Intersection of Attitudes and Organizational Factors by Provider Type in ...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
A Glorious Mess: Implementing Evidence-Based Social Skills Interventions in P...
A Glorious Mess: Implementing Evidence-Based Social Skills Interventions in P...
Healthcare System Supports for Internists Caring for Young Adult Patients wit...
Healthcare System Supports for Internists Caring for Young Adult Patients wit...
Elderly Adults with Dementia and Young Adults with Developmental Disabilities...
Elderly Adults with Dementia and Young Adults with Developmental Disabilities...
Is the quality of case management in a medical home associated with patient s...
Is the quality of case management in a medical home associated with patient s...
Comparison of HIV Testing with other Markers of Chronic Disease Screening 4_...
Comparison of HIV Testing with other Markers of Chronic Disease Screening 4_...
Comparison of HIV Testing with other Markers of Chronic Disease Screening
Comparison of HIV Testing with other Markers of Chronic Disease Screening
High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13
High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13
LDI Research Seminar with Art Kellermann, MD, MPH 11_28_12
LDI Research Seminar with Art Kellermann, MD, MPH 11_28_12
CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...
CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...
LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...
LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...
LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12
LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12
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The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
NVBDCP.pptx Nation vector borne disease control program
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Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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Top-Vitamin-Supplement-Brands-in-India List
Swisschem Dermacare provides the Top 10 Vitamin Supplement Brands in India. To know more about us give us call at our official number
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Top Effective Soaps for Fungal Skin Infections in India
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ABDOMINAL TRAUMA in pediatrics part one.
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Efficacy of Avartana Sneha in Ayurveda
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Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
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Cell Therapy Expansion and Challenges in Autoimmune Disease
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