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Shah AP, Nathan S. Challenges in Implementation of Institutional Protocols for Patients With Acute Coronary Syndrome. Am J Cardiol 2018; 122:356-363. [PMID: 29778236 DOI: 10.1016/j.amjcard.2018.03.354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 12/22/2022]
Abstract
The diagnosis of acute coronary syndrome (ACS) encompasses ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (non-STEMI and unstable angina). In recent years, there have been improvements in the rates of death, cardiogenic shock, and recurrent myocardial infarction in patients with ACS, primarily due to the introduction of new pharmacological and interventional therapies, as well as the introduction of and adherence to new treatment guidelines. However, ACS still represents a considerable public health burden. Treatment recommendations for STEMI and non-ST-segment elevation differ and there is wide variation in practice patterns and adherence among and within hospitals especially for the latter diagnosis. Adoption of institutional protocols may help decrease variability and improve quality of care, efficiency, and, ultimately, patient outcomes. This report discusses the process of developing and implementing institutional protocols for patients with ACS, from initial medical contact to discharge and beyond.
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Affiliation(s)
- Atman P Shah
- Section of Cardiology, Department of Medicine, The University of Chicago, Chicago, Illinois.
| | - Sandeep Nathan
- Section of Cardiology, Department of Medicine, The University of Chicago, Chicago, Illinois
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Cost-utility analysis of physician-pharmacist collaborative intervention for treating hypertension compared with usual care. J Hypertens 2017; 35:178-187. [PMID: 27684354 DOI: 10.1097/hjh.0000000000001126] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To estimate long-term costs and outcomes attributable to a physician-pharmacist collaborative intervention compared with physician management alone for treating essential hypertension. METHODS A Markov model cohort simulation with a 6-month cycle length to predict acute coronary syndrome, stroke, and heart failure throughout lifetime was performed. A cohort of 399 patients was obtained from two prospective, cluster randomized controlled clinical trials implementing physician-pharmacist collaborative interventions in community-based medical offices in the Midwest, USA. Framingham risk equations and other algorithms were used to predict the vascular diseases. SBP reduction due to the interventions deteriorated until 5 years. Direct medical costs using a payer perspective were adjusted to 2015 dollar value, and the main outcome was quality-adjusted life years (QALYs); both were discounted at 3%. The intervention costs were estimated from the trials, whereas the remaining parameters were from published studies. A series of sensitivity analyses including changing patient risks of vascular diseases, probabilistic sensitivity analysis, and a cost-effectiveness acceptability curve were performed. RESULTS The lifetime incremental costs were $26 807.83 per QALY (QALYs gained = 0.14). The intervention provided the greatest benefit for the high-risk patients, moderate benefit for the trial patients, and the lowest benefit for the low-risk patients. If a payer is willing to pay $50 000 per QALY gained, in 48.6% of the time the intervention would be cost-effective. CONCLUSION Team-based care such as a physician-pharmacist collaboration appears to be a cost-effective strategy for treating hypertension. The intervention is most cost-effective for high-risk patients.
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Chen CL, Yen DHT, Lin CS, Tsai SH, Chen SJ, Sheu WHH, Hsu CW. Glycated hemoglobin level is an independent predictor of major adverse cardiac events after nonfatal acute myocardial infarction in nondiabetic patients: A retrospective observational study. Medicine (Baltimore) 2017; 96:e6743. [PMID: 28471967 PMCID: PMC5419913 DOI: 10.1097/md.0000000000006743] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency department of 2 medical centers from January 2011 to September 2014. All patients received primary percutaneous coronary intervention and were divided into 4 groups according to the interquartile range of average HbA1c level (Group I, ≤5.6%; Group II, 5.6%-5.8%; Group III, 5.8%-6.0%; and Group IV, >6.0%). Multivariate logistic analysis was performed to estimate the correlation of HbA1c with major adverse cardiac events (MACEs) after AMI. In total, 267 eligible patients were enrolled; 48 patients (18%) developed MACEs within a median follow-up of 178 days. Univariate analysis showed HbA1c > 6.0%, with a higher risk of MACEs in Group IV than in Group I (odds ratio [OR]: 2.733; 95% confidence interval [CI]: 1.123-6.651 vs OR: 1.511; 95% CI: 0.595-3.835). Multivariate analysis revealed an approximately 3.8 times higher risk of MACEs in Group IV than in Group I (OR: 3.769; 95% CI: 1.30-10.86). The HbA1 level is a significant predictor of MACEs after AMI in nondiabetic patients.
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Affiliation(s)
- Chin-Lan Chen
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University
| | - David H.-T. Yen
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University
- Department of Emergency Medicine, Taipei Veterans General Hospital
| | | | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center
- Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei
| | - Wayne H.-H. Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung
| | - Chin-Wang Hsu
- Department of Emergency and Critical Medicine, Wan Fang Hospital
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Berikol GB, Yildiz O, Özcan İT. Diagnosis of Acute Coronary Syndrome with a Support Vector Machine. J Med Syst 2016; 40:84. [DOI: 10.1007/s10916-016-0432-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
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Goyal A, de Lemos JA, Peng SA, Thomas L, Amsterdam EA, Hockenberry JM, Peterson ED, Wang TY. Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes 2015; 8:567-75. [DOI: 10.1161/circoutcomes.115.001650] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 09/16/2015] [Indexed: 11/16/2022]
Abstract
Background—
Little is known about whether enrollment versus nonenrollment in Medicare’s prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI).
Methods and Results—
Using Medicare records linked to Acute Coronary Treatment and Intervention Outcomes Network Registry–Get With The Guidelines, we identified 59 149 Medicare beneficiaries (age ≥65 years) discharged after AMI between January 2007 and December 2010. We described trends in Medicare Part D enrollment, and compared the following 30-day and 1-year outcomes: all-cause death, all-cause readmissions, and major adverse cardiac events (a composite of all-cause death or readmission for AMI or stroke) between Part D enrollees and nonenrollees, after adjustment for patient and hospital factors. From 2007 to 2010, 29 264 (49.5%) patients with AMI enrolled in Medicare were also participating in Part D by hospital discharge. All-cause 30-day death was more common among enrollees versus nonenrollees (4.0% versus 3.3%), but this difference was not statistically significant after multivariable adjustment (adjusted hazard ratio, 1.06 [95% confidence interval, 0.97–1.17]). Enrollees also had higher unadjusted risks of 30-day all-cause readmissions or major adverse cardiac events, and 1-year mortality, all-cause readmissions, or major adverse cardiac events, but these were attenuated after multivariable adjustment. Adherence to key secondary prevention medications (statins, β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and P2Y
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antagonists) remained low (range, 55%–64%) at 1 year post discharge among Part D enrollees.
Conclusions—
Only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees. There remain opportunities for improvement in medication adherence among patients with prescription drug coverage.
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Affiliation(s)
- Abhinav Goyal
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - James A. de Lemos
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - S. Andrew Peng
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - Laine Thomas
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - Ezra A. Amsterdam
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - Jason M. Hockenberry
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - Eric D. Peterson
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
| | - Tracy Y. Wang
- From the Department of Medicine, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Internal Medicine, UT Southwestern Medical School, Dallas, TX (J.A.d.L.); Department of Biostatistics and Bioinformatics (L.T) and Department of Medicine (E.D.P., T.Y.W.), Duke Clinical Research Institute, Durham, NC (S.A.P.); Department of Internal Medicine, University of California, Davis Medical Center, Sacramento (E.A.A.); Department of Health Policy and Management, Emory Rollins School of
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Bonafede MM, Johnson BH, Richhariya A, Gandra SR. Medical costs associated with cardiovascular events among high-risk patients with hyperlipidemia. CLINICOECONOMICS AND OUTCOMES RESEARCH 2015; 7:337-45. [PMID: 26089693 PMCID: PMC4467662 DOI: 10.2147/ceor.s76972] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES This study descriptively examined acute and longer term direct medical costs associated with a major cardiovascular (CV) event among high-risk coronary heart disease risk-equivalent (CHD-RE) patients. It also gives a firsthand look at fatal versus nonfatal CV events. METHODS The MarketScan(®) Commercial Claims and Encounters Database was used to identify adults with a CV event in 2006-2012 with hyperlipidemia or lipid-lowering therapy use in the 18 months prior to one of the following inpatient CV events: myocardial infarction, ischemic stroke, unstable angina, transient ischemic attack, percutaneous coronary intervention, or coronary artery bypass graft (CABG). Patients were required to have a preindex diagnosis of at least one of the following: peripheral arterial disease, abdominal aortic aneurysm, carotid artery disease, or diabetes. A subset analysis was conducted with patients with data linkable to the Social Security Administration Master Death File. Direct medical costs were reported for each quarter following a CV event, for up to 36 months after the first CV event. RESULTS In total, 38,609 CHD-RE patients were included, mean age 57 years, 31% female. CABG, myocardial infarction, and percutaneous coronary intervention were the most frequent and most expensive first CV events, accounting for >75% of all first CV events with mean first quarter costs ranging from $17,454 (nonfatal transient ischemic attack) to $125,690 (fatal CABG). Overall, 15% of those with a first CV event went on to have a second event during the 36-month study period with mean first quarter nonfatal and fatal costs similar to first event levels. Third CV events were rare, happening in less than 3% of patients. CONCLUSION CV events among CHD-RE patients were costly regardless of sequence, averaging $47,433 in the first 90 days following an event and remaining high, never returning to preevent levels. When fatal, first CV event costs were 1.2 to 2.9 times higher than when nonfatal.
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da Silva AR, Fraga-Silva RA, Stergiopulos N, Montecucco F, Mach F. Update on the role of angiotensin in the pathophysiology of coronary atherothrombosis. Eur J Clin Invest 2015; 45:274-87. [PMID: 25586671 DOI: 10.1111/eci.12401] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/10/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Coronary atherothrombosis due to atherosclerotic plaque rupture or erosion is frequently associated with acute coronary syndromes (ACS). Significant efforts have been made to elucidate the pathophysiological mechanisms underlying acute coronary events. MATERIALS AND METHODS This narrative review is based on the material searched for and obtained via PubMed up to August 2014. The search terms we used were as follows: 'angiotensin, acute coronary syndromes, acute myocardial infarction' in combination with 'atherosclerosis, vulnerability, clinical trial, ACE inhibitors, inflammation'. RESULTS Among several regulatory components, the renin-angiotensin system (RAS) was shown as a key pathway modulating coronary atherosclerotic plaque vulnerability. Indeed, these molecules are involved in all stages of atherogenesis. Classically, the RAS is composed by a series of enzymatic reactions leading to the angiotensin (Ang) II generation and activity. However, the knowledge of RAS has expanded and become more complex. The discovery of novel components and their functions has revealed additional pathways that contribute to or counterbalance the actions of Ang II. In this review, we discussed on recent findings concerning the role of different angiotensin peptides in the pathophysiology of ACS and coronary atherothrombosis, exploring the link between these molecules and atherosclerotic plaque vulnerability. CONCLUSIONS Treatments selectively targeting angiotensins (including Mas and AT2 agonists, ACE2 recombinant, or Ang-(1-7) and almandine in oral formulations) have been tested in animal studies or in small human subgroups, expanding the perspective in the ACS prevention. These novel strategies, especially in the counter-regulatory axis ACE2/Ang-(1-7)/Mas, might be promising to reduce plaque vulnerability and inflammation.
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Affiliation(s)
- Analina R da Silva
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, Geneva, Switzerland
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Kulchaitanaroaj P, Carter BL, Goedken AM, Chrischilles EA, Brooks JM. Instrumental variable methods to assess quality of care the marginal effects of process-of-care on blood pressure change and treatment costs. Res Social Adm Pharm 2015; 11:e69-83. [PMID: 25155998 PMCID: PMC5774669 DOI: 10.1016/j.sapharm.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hypertension is poorly controlled. Team-based care and changes in the process of care have been proposed to address these quality problems. However, assessing care processes is difficult because they are often confounded even in randomized behavioral studies by unmeasured confounders based on discretion of health care providers. OBJECTIVE To evaluate the effects of process measures including number of counseling sessions about lifestyle modification and number of antihypertensive medications on blood pressure change and payer-perspective treatment costs. METHODS Data were obtained from two prospective, cluster randomized controlled clinical trials (Trial A and B) implementing physician-pharmacist collaborative interventions compared with usual care over six months in community-based medical offices in the Midwest. Multivariate linear regression models with both instrumental variable methods and as-treated methods were utilized. Instruments were indicators for trial and study arms. Models of blood pressure change and costs included both process measures, demographic variables, and clinical variables. RESULTS The analysis included 496 subjects. As-treated methods showed no significant associations between process and outcomes. The instruments used in the study were insufficient to simultaneously identify distinct process effects. However, the post-hoc instrumental variable models including one process measure at a time while controlling for the other process demonstrated significant associations between the processes and outcomes with estimates considerably larger than as-treated estimates. CONCLUSIONS Instrumental variable methods with combined randomized behavioral studies may be useful to evaluate the effects of different care processes. However, substantial distinct process variation across studies is needed to fully capitalize on this approach. Instrumental variable methods focusing on individual processes provided larger and stronger outcome relationships than those found using as-treated methods which are subject to confounding.
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Affiliation(s)
- Puttarin Kulchaitanaroaj
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA.
| | - Barry L Carter
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA; Department of Family Medicine, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Amber M Goedken
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA, USA
| | | | - John M Brooks
- Department of Health Services Policy and Management, Arnold School of Public Health, Center for Rehabilitation and Reconstruction Sciences, University of South Carolina, Columbia, SC, USA
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Ghushchyan V, Nair KV, Page RL. Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both. Vasc Health Risk Manag 2014; 11:25-34. [PMID: 25565859 PMCID: PMC4284047 DOI: 10.2147/vhrm.s72331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS) alone and with common cardiovascular comorbidities. METHODS A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exclusive cohorts were evaluated: ACS only, ACS with atrial fibrillation (AF), ACS with heart failure (HF), and ACS with both conditions. Direct costs were calculated for all-cause and cardiovascular-related health care resource utilization. Indirect costs were determined from productivity losses from missed days of work. Regression analysis was developed for each outcome controlling for age, US census region, insurance coverage, sex, race, ethnicity, education attainment, family income, and comorbidity burden. A negative binomial regression model was used for health care utilization variables. A Tobit model was utilized for health care costs and productivity loss variables. RESULTS Total health care costs were greatest for those with ACS and both AF and HF ($38,484±5,191) followed by ACS with HF ($32,871±2,853), ACS with AF ($25,192±2,253), and ACS only ($17,954±563). Compared with the ACS only cohort, the mean all-cause adjusted health care costs associated with ACS with AF, ACS with HF, and ACS with AF and HF were $5,073 (95% confidence interval [CI] 719-9,427), $11,297 (95% CI 5,610-16,985), and $15,761 (95% CI 4,784-26,738) higher, respectively. Average wage losses associated with ACS with and without AF and/or HF amounted to $5,266 (95% CI -7,765, -2,767), when compared with patients without these conditions. CONCLUSION ACS imposes a significant economic burden at both the individual and society level, particularly when with comorbid AF and HF.
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Affiliation(s)
- Vahram Ghushchyan
- College of Business and Economics, American University of Armenia, Yerevan, Armenia ; Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA
| | - Kavita V Nair
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA
| | - Robert L Page
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA ; Department of Physical Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
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Olson WH, Ma YW, Laliberté F, Lefebvre P, Crivera C, Schein JR, Fields LE, Dea K, Germain G, Lynch SM. Prasugrel vs. clopidogrel in acute coronary syndrome patients treated with prasugrel. J Clin Pharm Ther 2014; 39:663-72. [DOI: 10.1111/jcpt.12209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/25/2014] [Indexed: 01/06/2023]
Affiliation(s)
- W. H. Olson
- Janssen Scientific Affairs; LLC; Raritan NJ USA
| | - Y.-W. Ma
- Johnson & Johnson Consumer Companies Inc.; Horsham PA USA
| | | | | | - C. Crivera
- Janssen Scientific Affairs; LLC; Raritan NJ USA
| | | | | | - K. Dea
- Groupe d'analyse, Ltée; Montréal QC Canada
| | - G. Germain
- Groupe d'analyse, Ltée; Montréal QC Canada
| | - S. M. Lynch
- Department of Sociology; Duke University; Durham NC USA
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