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Ippolito M, Simone B, Safadi S, Spinuzza E, Catania T, Ingoglia G, Milazzo M, Raineri SM, Giarratano A, Gregoretti C, Cortegiani A. Effectiveness of a remote simulation training in mechanical ventilation among trainees. Pulmonology 2022:S2531-0437(22)00129-5. [PMID: 35963833 PMCID: PMC9365523 DOI: 10.1016/j.pulmoe.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Ippolito
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo 90127 , Italy.
| | - B Simone
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - S Safadi
- Division of Nephrology, Department of Medicine, University of Minnesota, Minneapolis, USA
| | - E Spinuzza
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - T Catania
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - G Ingoglia
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo 90127 , Italy
| | - M Milazzo
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - S M Raineri
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo 90127 , Italy
| | - A Giarratano
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo 90127 , Italy
| | - C Gregoretti
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Fondazione Giglio, Cefalù, Italy
| | - A Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via del Vespro 129, Palermo 90127 , Italy
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Abstract
An upsurge in Echovirus 30 (E30) infections, associated with meningitis/meningoencephalitis, has been observed in Denmark, Germany, the Netherlands, Norway and Sweden in the period April to September 2018, compared with 2015–2017. In total, 658 E30 infections among 4,537 enterovirus infections were detected in 15 countries between January and September 2018 and affected mainly newborns and 26–45 year-olds. National public health institutes are reminded to remain vigilant and inform clinicians of the ongoing epidemic.
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Affiliation(s)
- Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Benedetto Simone
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Josep Jansa
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Manukian G, Simone B, DeAngelis T, Kivolowitz C, Ko K, Simone N. Caloric Restriction Curtails Tumor Infiltrating Regulatory T Cells and Enhances Effector T Cell Activity after Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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McGirr A, Widenmaier R, Curran D, Espié E, Mrkvan T, Oostvogels L, Simone B, McElhaney JE, Burnett H, Haeussler K, Thano A, Wang X, Newson RS. The comparative efficacy and safety of herpes zoster vaccines: A network meta-analysis. Vaccine 2019; 37:2896-2909. [DOI: 10.1016/j.vaccine.2019.04.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/01/2019] [Accepted: 04/04/2019] [Indexed: 12/29/2022]
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Salvetti A, Ferrari V, Garofalo R, Gazzaniga P, Guerroni A, Metrucci A, Sessa A, Severi ML, Nati G, Ruggeri M, Rossi A, Cappellari L, Gopala K, Tosatto R, Simone B. Incidence of herpes zoster and postherpetic neuralgia in Italian adults aged ≥50 years: A prospective study. Prev Med Rep 2019; 14:100882. [PMID: 31193254 PMCID: PMC6522697 DOI: 10.1016/j.pmedr.2019.100882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/23/2022] Open
Abstract
Herpes zoster (HZ) mainly affects older adults and immunocompromised individuals and is usually characterized by a unilateral painful skin rash. Its most common complication, postherpetic neuralgia (PHN), may cause chronic debilitating pain lasting for months or years. This study (ClinicalTrials.gov Identifier: NCT01772160) aimed to estimate the HZ incidence and the proportion of HZ patients with PHN in the Italian population aged 50 years or older. From 2013 to 2016, HZ-patients were recruited when presenting with acute HZ at 75 reporting general practitioners in Italy, covering 43,875 persons aged ≥50 years. PHN was defined as ‘worst pain’ rated ≥ 3 on the Zoster Brief Pain Inventory persisting or appearing over 90 days after rash onset. The overall HZ incidence rate per 1000 person-years (PY) was estimated as 6.46 (95% confidence interval [CI]: 5.99–6.95), increasing with age to 9.12/1000 PY (95% CI: 7.50–10.99) in 75–79 year-olds. Among 391 HZ-patients who completed the study, the overall proportion with PHN was 10.23% (95% CI: 7.41–13.67) and the highest proportion was 15.56% (95% CI: 6.49–29.46) for the 75–79 year-olds. Among the 128 patients (32.7%) who reported at least one pre-existing medical condition, 35.9% reported diabetes mellitus and 32.0% reported emotional problems, stress or depression. The study confirms previous findings that HZ and PHN cause an important clinical burden in older Italian adults. It also confirmed the age-related increasing risk of HZ and PHN. HZ has a strong incidence in the Italian population, the 2nd oldest worldwide. The estimated overall HZ incidence rate was 6.46 per 1000 person-years. The most common complication, PHN, was encountered by 10.23% of HZ patients. Strengths of the study are its prospective design and its large sample. Limitation: incidence may be underestimated due to cases missed in primary care.
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Affiliation(s)
- Andrea Salvetti
- Investigator site, Piazza Ponchielli 1, Toscana, Grosseto, GR 58100, Italy
| | - Vincenzo Ferrari
- Investigator site, Via Terranova 2, Puglia, Parabita, LE 73052, Italy
| | - Remigio Garofalo
- Investigator site, Via B. di Fredi 24, Toscana, Civitella Paganico, GR 58045, Italy
| | - Pietro Gazzaniga
- Investigator site, Via Garibaldi 1, Piemonte, Frugarolo, AL 15065, Italy
| | - Alessandro Guerroni
- Investigator site, Via Vittorio Veneto 44/A, Lombardia, Sesto Calende, VA 21018, Italy
| | - Antonio Metrucci
- Investigator site, Viale della Repubblica snc, Puglia, Cutrofiano, LE 73020, Italy
| | - Aurelio Sessa
- Investigator site, Via Cavour 26, Lombardia, Arcisate, VA, 21051, Italy
| | | | - Giulio Nati
- Investigator site, Via Pietro Tacchini 7, Lazio, Roma, RM 00197, Italy
| | - Mauro Ruggeri
- Investigator site, Central Site, Società Italiana di Medicina Generale (SIMG), Via del Pignoncino 9 SIMG, Toscana, Firenze, FI 50142, Italy
| | - Alessandro Rossi
- Investigator site, Central Site, Società Italiana di Medicina Generale (SIMG), Via del Pignoncino 9 SIMG, Toscana, Firenze, FI 50142, Italy
| | | | - Kusuma Gopala
- GSK, Embassy Links, Cunningham Road, SRT Road, #5, Bangalore 560052, India
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Simone B, Manukian G, Ko K, DeAngelis T, Bhattacharya S, Berger A, Simone N. Harnessing Metabolism with Radiation Therapy to Modulate Host Immunity in the Tumor Microenvironment. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simone B, Campbell K, Han Y, Li Y, Patay Z, Broniscer A, Merchant T, Tinkle C. Patterns of Disease Progression after Conformal Radiation Therapy for Diffuse Intrinsic Pontine Glioma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Jauneikaite E, Kapatai G, Davies F, Gozar I, Coelho J, Bamford KB, Simone B, Begum L, Katiyo S, Patel B, Hoffman P, Lamagni T, Brannigan ET, Holmes AH, Kadhani T, Galletly T, Martin K, Lyall H, Chow Y, Godambe S, Chalker V, Sriskandan S. Serial Clustering of Late-Onset Group B Streptococcal Infections in the Neonatal Unit: A Genomic Re-evaluation of Causality. Clin Infect Dis 2018; 67:854-860. [PMID: 29509833 PMCID: PMC6117446 DOI: 10.1093/cid/ciy174] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/28/2018] [Indexed: 11/13/2022] Open
Abstract
Background Invasive Group B streptococcus (GBS) is a major cause of serious neonatal infection. Current strategies to reduce early-onset GBS disease have no impact on late-onset disease (LOD). Although GBS LOD is viewed as a sporadic event in the community, LOD arising within the neonatal intensive care unit (ICU) raises questions about mode of acquisition. Methods Following a cluster of 4 GBS LOD cases, enhanced surveillance for all GBS LOD was undertaken over 2 years in the neonatal ICU supported by neonatal rectal screening. GBS isolates were serotyped and genome-sequenced. Results Twelve late -onset invasive GBS episodes were identified (incidence 0.6/1000 live births). Genomic analysis revealed that 11/12 GBS isolates (92%) were linked to at least one other LOD isolate. Isolates from the first cluster were serotype V, resistant to macrolides and lincosamides, and sequencing confirmed isolates were indistinguishable, or distinguishable by only one SNP difference, from each other. Rectal carriage was rare. Prospective surveillance identified three further clusters of LOD due to serotypes Ia (3 cases), Ib (2 cases), and III (2 cases), that would not have been identified without surveillance and genome sequencing, leading to a re-evaluation of interventions required to prevent GBS LOD. Conclusion Acquisition routes for LOD GBS in the neonatal ICU are poorly understood; cases may not necessarily be sporadic. Within this neonatal ICU, our data suggest that a single case of LOD GBS sepsis should be considered a potential nosocomial transmission event warranting prompt investigation, heightened infection prevention vigilance and action where required.
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Affiliation(s)
- Elita Jauneikaite
- Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, United Kingdom
| | - Georgia Kapatai
- National Infection Service, Public Health England, United Kingdom
| | | | - Ioana Gozar
- Imperial College Healthcare NHS Trust, United Kingdom
| | - Juliana Coelho
- National Infection Service, Public Health England, United Kingdom
| | | | - Benedetto Simone
- London and South East Field Epidemiology Services, United Kingdom
| | - Lipi Begum
- North West London Health Protection Team, Public Health England, United Kingdom
| | - Shannon Katiyo
- London and South East Field Epidemiology Services, United Kingdom
| | - Bharat Patel
- National Infection Service, Public Health England, United Kingdom
| | - Peter Hoffman
- National Infection Service, Public Health England, United Kingdom
| | - Theresa Lamagni
- National Infection Service, Public Health England, United Kingdom
| | | | - Alison H Holmes
- Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, United Kingdom
| | | | | | - Kate Martin
- Imperial College Healthcare NHS Trust, United Kingdom
| | | | - Yimmy Chow
- North West London Health Protection Team, Public Health England, United Kingdom
| | - Sunit Godambe
- Imperial College Healthcare NHS Trust, United Kingdom
| | - Victoria Chalker
- National Infection Service, Public Health England, United Kingdom
| | - Shiranee Sriskandan
- Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, United Kingdom
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Simone B, Dan T, Palagani A, DeAngelis T, Schiewer M, Knudsen K, Dicker A, Simone N. Caloric Restriction Augments the Molecular Effects of Radiation in Both Hormone-Sensitive and Hormone-Insensitive Prostate Cancers by Decreasing Inflammation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Simone B, Balasegaram S, Gobin M, Anderson C, Charlett A, Coole L, Maguire H, Nichols T, Rawlings C, Ramsay M, Oliver I. Evaluation of the measles, mumps and rubella vaccination catch-up campaign in England in 2013. Vaccine 2014; 32:4681-8. [PMID: 24996125 DOI: 10.1016/j.vaccine.2014.05.077] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 05/27/2014] [Accepted: 05/31/2014] [Indexed: 11/26/2022]
Abstract
In January-March 2013 in England, confirmed measles cases increased in children aged 10-16 years. In April-September 2013, the National Health System and Public Health England launched a national measles-mumps-rubella (MMR) campaign based on data from Child Health Information Systems (CHIS) estimating that approximately 8% in this age group were unvaccinated. We estimated coverage at baseline, and, of those unvaccinated (target), the proportion vaccinated up to 20/08/2013 (mid-point) to inform further public health action. We selected a sample of 6644 children aged 10-16 years using multistage sampling from those reported unvaccinated in CHIS at baseline and validated their records against GP records. We adjusted the CHIS MMR vaccine coverage estimates correcting by the proportion of vaccinated children obtained through sample validation. We validated 5179/6644 (78%) of the sample records. Coverage at baseline was estimated as 94.7% (95% confidence intervals, CI: 93.5-96.0%), lower in London (86.9%, 95%CI: 83.0-90.9%) than outside (96.1%, 95%CI 95.5-96.8%). The campaign reached 10.8% (95%CI: 7.0-14.6%) of the target population, lower in London (7.1%, 95%CI: 4.9-9.3) than in the rest of England (11.4%, 95%CI: 7.0-15.9%). Coverage increased by 0.5% up to 95.3% (95% CI: 94.1-96.4%) but an estimated 210,000 10-16 year old children remained unvaccinated nationally. Baseline MMR coverage was higher than previously reported and was estimated to have reached the 95% campaign objective at midpoint. Eleven per cent of the target population were vaccinated during the campaign, and may be underestimated, especially in London. No further national campaigns are needed but targeted local vaccination activities should be considered.
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Affiliation(s)
- Benedetto Simone
- Field Epidemiology Service (Victoria Office), Public Health England, 151 Buckingham Palace Road, London SW1W 9SZ, United Kingdom; European Programme for Intervention Epidemiology Training (EPIET), ECDC, Sweden.
| | - Sooria Balasegaram
- Field Epidemiology Service (Victoria Office), Public Health England, 151 Buckingham Palace Road, London SW1W 9SZ, United Kingdom
| | - Maya Gobin
- Field Epidemiology Service (Bristol Office), Public Health England, 2 Rivergate Temple Quay, Bristol BS1 6EH, United Kingdom
| | - Charlotte Anderson
- Field Epidemiology Service (Victoria Office), Public Health England, 151 Buckingham Palace Road, London SW1W 9SZ, United Kingdom
| | - André Charlett
- Statistics, Modelling and Economics Dept, Centre for Infectious Disease Surveillance and Control, Public Health England, Health Protection Directorate, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
| | - Louise Coole
- Field Epidemiology Services (Leeds office), Public Health England, Quarry House, Quarry Hill, Leeds LS2 7UE, United Kingdom
| | - Helen Maguire
- Field Epidemiology Service (Victoria Office), Public Health England, 151 Buckingham Palace Road, London SW1W 9SZ, United Kingdom
| | - Tom Nichols
- Statistics, Modelling and Economics Dept, Centre for Infectious Disease Surveillance and Control, Public Health England, Health Protection Directorate, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
| | - Chas Rawlings
- Field Epidemiology Service (Victoria Office), Public Health England, 151 Buckingham Palace Road, London SW1W 9SZ, United Kingdom
| | - Mary Ramsay
- Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
| | - Isabel Oliver
- Field Epidemiology Service (Bristol Office), Public Health England, 2 Rivergate Temple Quay, Bristol BS1 6EH, United Kingdom; University of Bristol, School of Social and Community Medicine, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom
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Simone B, Atchison C, Ruiz B, Greenop P, Dave J, Ready D, Maguire H, Walsh B, Anderson S. Investigating an outbreak of Clostridium perfringens gastroenteritis in a school using smartphone technology, London, March 2013. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.19.20799] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- B Simone
- Field Epidemiology Services (Victoria), Public Health England, London, United Kingdom
- These authors contributed equally
- European Programme for Intervention Epidemiology (EPIET), European Centre for Disease Control (ECDC), Stockholm, Sweden
| | - C Atchison
- South West London Health Protection Team, Public Health England, London, United Kingdom
- These authors contributed equally
| | - B Ruiz
- Commercial Environmental Health, London Borough of Richmond Upon Thames, London, United Kingdom
| | - P Greenop
- Commercial Environmental Health, London Borough of Richmond Upon Thames, London, United Kingdom
| | - J Dave
- PHE Public Health Laboratory London, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - D Ready
- PHE Public Health Laboratory London, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - H Maguire
- European Programme for Intervention Epidemiology (EPIET), European Centre for Disease Control (ECDC), Stockholm, Sweden
- Field Epidemiology Services (Victoria), Public Health England, London, United Kingdom
| | - B Walsh
- South West London Health Protection Team, Public Health England, London, United Kingdom
| | - S Anderson
- Field Epidemiology Services (Victoria), Public Health England, London, United Kingdom
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Dan T, Simone B, Simone C, Scuito L, Smith S, Danforth D, Camphausen K, Simone N. Cosmetic Outcomes and Quality of Life are Similar in Patients Receiving Breast Conservation Versus Mastectomy: 25-Year Follow-up of the NCI Randomized Trial. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Simone B, Jin L, Dan T, Savage J, Minassian H, Lim M, Rosenberg A, Palazzo J, Simone N. Caloric Restriction Coupled With Radiation Increases Overall Survival in a Metastatic Breast Cancer Model. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simone B, De Stefano V, Leoncini E, Zacho J, Martinelli I, Emmerich J, Rossi E, Folsom AR, Almawi WY, Scarabin PY, den Heijer M, Cushman M, Penco S, Vaya A, Angchaisuksiri P, Okumus G, Gemmati D, Cima S, Akar N, Oguzulgen KI, Ducros V, Lichy C, Fernandez-Miranda C, Szczeklik A, Nieto JA, Torres JD, Le Cam-Duchez V, Ivanov P, Cantu-Brito C, Shmeleva VM, Stegnar M, Ogunyemi D, Eid SS, Nicolotti N, De Feo E, Ricciardi W, Boccia S. Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T: a meta-analysis involving over 11,000 cases and 21,000 controls. Eur J Epidemiol 2013; 28:621-47. [PMID: 23900608 DOI: 10.1007/s10654-013-9825-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 07/02/2013] [Indexed: 12/16/2022]
Abstract
Genetic and environmental factors interact in determining the risk of venous thromboembolism (VTE). The risk associated with the polymorphic variants G1691A of factor V (Factor V Leiden, FVL), G20210A of prothrombin (PT20210A) and C677T of methylentetrahydrofolate reductase (C677T MTHFR) genes has been investigated in many studies. We performed a pooled analysis of case-control and cohort studies investigating in adults the association between each variant and VTE, published on Pubmed, Embase or Google through January 2010. Authors of eligible papers, were invited to provide all available individual data for the pooling. The Odds Ratio (OR) for first VTE associated with each variant, individually and combined with the others, were calculated with a random effect model, in heterozygotes and homozygotes (dominant model for FVL and PT20210A; recessive for C677T MTHFR). We analysed 31 databases, including 11,239 cases and 21,521 controls. No significant association with VTE was found for homozygous C677T MTHFR (OR: 1.38; 95 % confidence intervals [CI]: 0.98-1.93), whereas the risk was increased in carriers of either heterozygous FVL or PT20210 (OR = 4.22; 95 % CI: 3.35-5.32; and OR = 2.79;95 % CI: 2.25-3.46, respectively), in double heterozygotes (OR = 3.42; 95 %CI 1.64-7.13), and in homozygous FVL or PT20210A (OR = 11.45; 95 %CI: 6.79-19.29; and OR: 6.74 (CI 95 % 2.19-20.72), respectively). The stratified analyses showed a stronger effect of FVL on individuals ≤ 45 years (p value for interaction = 0.036) and of PT20210A in women using oral contraceptives (p-value for interaction = 0.045). In this large pooled analysis, inclusive of large studies like MEGA, no effect was found for C677T MTHFR on VTE; FVL and PT20210A were confirmed to be moderate risk factors. Notably, double carriers of the two genetic variants produced an impact on VTE risk significantly increased but weaker than previously thought.
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Affiliation(s)
- Benedetto Simone
- Institute of Public Health - Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, L.go F.Vito 1, 00168, Rome, Italy
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Simone B, Mazzucco W, Gualano MR, Agodi A, Coviello D, Dagna Bricarelli F, Dallapiccola B, Di Maria E, Federici A, Genuardi M, Varesco L, Ricciardi W, Boccia S. The policy of public health genomics in Italy. Health Policy 2013; 110:214-9. [PMID: 23466031 DOI: 10.1016/j.healthpol.2013.01.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/17/2013] [Accepted: 01/25/2013] [Indexed: 10/27/2022]
Abstract
Italy has a monitoring system for genetic testing, consisting in a periodic census of clinical and laboratory activities performed in the country. The experience is limited, however, concerning the translation of genomic testing for complex diseases into clinical practice. For the first time the Italian Ministry of Health has introduced a policy strategic plan on genomics and predictive medicine within the 2010-2012 National Prevention Plan. This achievement was supported by the Italian Network for Public Health Genomics (GENISAP) and will likely contribute to the integration of public health genomics into health care in the country. Our experience might be of interest not only in Italy, but in other high-income countries, struggling to keep a healthy economy and healthy citizens.
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Affiliation(s)
- Benedetto Simone
- Institute of Hygiene, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
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Jin L, Simone B, Sano Y, Lim M, Zhao S, Savage JE, Baserga R, Camphausen K, Simone NL. Abstract P6-01-03: Decreasing the metastatic potential in Triple Negative Breast Cancer through the miR-17 cluster. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In animal models of breast cancer, caloric restriction (CR), or a 25–30% reduction of calories, has decreased tumor initiation and progression. We sought to determine if CR could be used as a novel therapeutic intervention to enhance cytotoxic therapies such as radiation (RT) and alter the molecular profile of triple negative breast cancer (TNBC), which displays a poor prognosis.
Methods/Results: In two murine models of TNBC (4T1 which is highly metastatic and 67NR which is locally aggressive), mice with palpable tumors were treated with radiation, caloric restriction (30% intake reduction) or both. 3 times per week measurements revealed significant tumor regression with RT or diet modification, and an even greater regression is observed combining diet modification with RT. Concurrently, many reports have shown that TNBC is most distinct from other breast tumor subtypes due to up-regulation of the miR-17-92 cluster which we have shown by RT-PCR is downregulated with both CR and radiation (RT) and even further decreased with the combination. cDNA arrays done on all conditions revealed that the top 5 statistically significant GO terms with high fold changes were all associated with extracellular matrix and metastases. In silico analysis demonstrated 5 ECM related genes that were targets of the miR-17 cluster: collagen 4 alpha 1 (COL4A1), collagen 4 alpha 3 (COL4A3), laminin alpha 3 (LAMA3), metallopeptidase inhibitor 2 and 3 (TIMP2 and TIMP3) and these were inversely correlated with the miRs.
Conclusions: CR, or altering the metabolism of breast cancer, can be combined with RT to decrease progression of TNBC tumors and that the miR-17-92 cluster is also decreased with these conditions. cDNA arrays suggest that extracellular matrix (ECM) proteins play a large role in the mechanism of action of CR and RT combined. Combination therapy with CR and RT can decrease the metastatic potential in TNBC and in part does this through the miR-17-92 cluster by way of controlling ECM.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-01-03.
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Affiliation(s)
- L Jin
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - B Simone
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - Y Sano
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - M Lim
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - S Zhao
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - JE Savage
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - R Baserga
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - K Camphausen
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
| | - NL Simone
- Thomas Jefferson University, Philadelphia, PA; National Cancer Institute, Bethesda, MD
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17
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Simone B, De Feo E, Nicolotti N, Ricciardi W, Boccia S. Methodological quality of English-language genetic guidelines on hereditary breast-cancer screening and management: an evaluation using the AGREE instrument. BMC Med 2012; 10:143. [PMID: 23171648 PMCID: PMC3520768 DOI: 10.1186/1741-7015-10-143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 11/21/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND We examined the methodological quality of guidelines on syndromes conferring genetic susceptibility to breast cancer. METHODS PubMed, EMBASE, and Google were searched for guidelines published up to October 2010. All guidelines in English were included. The Appraisal of Guidelines, Research and Evaluation (AGREE) instrument was used to assess the quality of the guidelines, and their reported evidence base was evaluated. RESULTS Thirteen guidelines were deemed eligible: seven had been developed by independent associations, and the other six had national/state endorsements. Four guidelines performed satisfactorily, achieving a score of greater than 50% in all six AGREE domains. Mean ± SD standardized scores for the six AGREE domains were: 90 ± 9% for 'scope and purpose', 51 ± 18% for 'stakeholder involvement', 55 ± 27% for 'rigour of development', 80 ± 11% for 'clarity and presentation', 37 ± 32% for 'applicability', and 47 ± 38% for 'editorial independence'. Ten of the thirteen guidelines were found to be based on research evidence. CONCLUSIONS Given the ethical implications and the high costs of genetic testing for hereditary breast cancer, guidelines on this topic should provide clear and evidence-based recommendations. Our analysis shows that there is scope for improving many aspects of the methodological quality of current guidelines. The AGREE instrument is a useful tool, and could be used profitably by guidelines developers to improve the quality of recommendations.
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Affiliation(s)
- Benedetto Simone
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
| | - Emma De Feo
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
| | - Nicola Nicolotti
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
| | - Walter Ricciardi
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
| | - Stefania Boccia
- Institute of Hygiene, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- IRCCS San Raffaele Pisana, Rome, Italy
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Simone B, Carrillo-Santisteve P, Lopalco PL. Healthcare workers role in keeping MMR vaccination uptake high in Europe: a review of evidence. Euro Surveill 2012; 17:20206. [PMID: 22790533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Measles is a highly contagious and potentially fatal disease. Europe is far from the 95% coverage rates necessary for elimination of the disease, although a safe and cost-effective vaccine is available. We reviewed the literature on studies carried out in European countries from January 1991 to September 2011 on knowledge, attitudes and practices of health professionals towards measles vaccination and on how health professionals have an impact on parental vaccination choices. Both quantitative and qualitative studies were considered: a total of 28 eligible articles were retrieved. Healthcare workers are considered by parents as a primary and trustworthy source of information on childhood vaccination. Gaps in knowledge and poor communication from healthcare workers are detrimental to high immunisation rates. Correct and transparent information for parents plays a key role in parental decisions on whether to have their children vaccinated. Healthcare workers' knowledge of and positive attitudes towards measles-mumps-rubella (MMR) vaccination are crucial to meeting the measles elimination goal. An effort should be made to overcome potential communication barriers and to strengthen vaccine education among healthcare professionals.
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Affiliation(s)
- B Simone
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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19
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Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- B Simone
- Institute of Hygiene, Universitá Cattolica del Sacro Cuore, Rome, Italy
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - P L Lopalco
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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20
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Simone B, De Feo E, Nicolotti N, Ricciardi W, Boccia S. Quality evaluation of guidelines on genetic screening, surveillance and management of hereditary colorectal cancer. Eur J Public Health 2011; 22:914-20. [PMID: 22140249 DOI: 10.1093/eurpub/ckr166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We examined the methodological quality of guidelines on colorectal cancer genetic susceptibility syndromes. METHODS PubMed, EMBASE, and Google were searched up to July 2010. Adjourned guidelines in English were included. The Appraisal of Guidelines, Research and Evaluation (AGREE) instrument was used to assess their quality, and the reported evidence base of the guidelines was evaluated. RESULTS The search yielded 17 eligible guidelines: 11 were developed by independent associations, while 6 had national\state endorsement. Only three guidelines performed satisfactorily, achieving a score >50% in all 6 AGREE domains. Mean standardized scores for the 6 AGREE domains were: 'scope and purpose', 83.9 ± 22.5%; 'stakeholder involvement', 35.6 ± 24.9%; 'rigour of development', 48.6 ± 25.3%; 'clarity and presentation', 71.6 ± 19.3%; 'applicability', 33.8 ± 30.1%; 'editorial independence', 42.2 ± 39.7%. Guidelines with national endorsement performed better in all the domains, with a statistically significant difference in three domains. Fifteen guidelines out of 17 were found to be based on research evidence. CONCLUSIONS There is scope, in many areas, for improving the guidelines analysed, among which are the involvement of various professional figures and patients' representatives, and policies for their application. The AGREE instrument is a useful tool and could also be used profitably by guideline developers to improve the quality of recommendations.
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De Feo E, Simone B, Kamgaing RS, Galli P, Hamajima N, Hu Z, Li G, Li Y, Matsuo K, Park JY, Roychoudhury S, Spitz MR, Wei Q, Zhang JH, Ricciardi W, Boccia S. p73 G4C14-to-A4T14 gene polymorphism and interaction with p53 exon 4 Arg72Pro on cancer susceptibility: a meta-analysis of the literature. Mutagenesis 2011; 27:267-73. [DOI: 10.1093/mutage/ger065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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22
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De Feo E, Simone B, Persiani R, Cananzi F, La Greca A, Amore R, Arzani D, Rausei S, Ricciardi G, Boccia S. 6508 POSTER A Case-control Study on the Effect of Apolipoprotein E Genotype on Gastric Cancer Risk and Progression. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71819-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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24
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Vella FS, Orlando P, Attanasi F, Simone B, Mundo A, Lopalco P, Schiraldi O, Antonaci S. [Autoantibodies in chronic hepatitis C. Markers of autoimmunity or non-specific events?]. Recenti Prog Med 2001; 92:107-12. [PMID: 11294098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In the light of the high prevalence of non organ-specific autoantibodies in chronic hepatitis C, the possibility that such a finding may represent the consequence of a viral, autoimmune or overlapping disease should be considered, which may in turn require a different therapeutical approach. It is known, anyway, that the diagnosis of autoimmune hepatitis is based on a set of epidemiological, clinical, biochemical, histological criteria and autoantibody pattern. In 113 cases of chronic hepatitis with HCV infection, we determined the presence of non organ-specific autoantibodies [anti-nuclear (ANA), anti-smooth muscle (SMA), anti-liver-kidney microsomal antibodies (LKM), anti-mithocondrial antibodies (AMA)] and described the epidemiological, clinical, biochemical, histological characteristics and therapeutic response to interferon. 40 patients (35%) exhibited non organ-specific autoantibodies: 25 patients were SMA positive (Vasal pattern), 4 ANA positive (Speckled pattern), 7 ANA (Speckled pattern) + SMA (Vasal pattern) positive and 4 LKM positive. All subjects with HCV infection and autoantibodies did not display additional criterias of autoimmunity, including the same outcome to interferon therapy when compared to HCV positive patients without autoantibodies. The failure to determine clinical features, associated to autoimmunity in HCV positive patients with autoantibodies, suggests that autoantibody occurrence may represent a fortuitous event during the course of HCV infection.
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Affiliation(s)
- F S Vella
- Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Sezione di Medicina Interna, Università, Bari
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25
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Vella FS, Simone B, Carella A, Schiraldi O, Antonaci S. [Acute disseminated encephalomyelitis as initial clinical manifestation of common variable immunodeficiency. A case report]. Recenti Prog Med 2000; 91:365-7. [PMID: 10932921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by severe and recurrent infections which affect both lung and gastrointestinal systems. On the contrary, central nervous system involvement, related to virus infections, is an important, rare and usually fatal complication occurring in a later phase of the disease. Furthermore, CVID may predispose to a variety of autoimmune diseases. Here, we report the case of a 20 years old girl who developed acute disseminated encephalomyelitis as the first clinical feature in CVID. The infective agent was not determined and there was no history of recent vaccinations. CVID was diagnosed on the basis of the significant reduction of serum immunoglobulin concentration, in the absence of either diseases responsible for secondary immunodeficiency or functional and/or quantitative abnormalities of lymphocyte subsets, phagocytes and complement fractions. The treatment with high doses of native intravenous immunoglobulins (IVIG) combined with corticosteroids in the early phase led to a complete recovery with restitutio ad integrum. This case outlines the possible relationship between autoimmune diseases and infections in CVID, as suggested by the finding of either viral encephalitis in CVID patients and the well-known autoimmune pathogenesis of acute disseminated encephalomyelitis. In such a condition, the combination of IVIG and corticosteroids may offer considerable advantages in terms of therapeutical efficacy.
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Affiliation(s)
- F S Vella
- Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università, Bari
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26
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Cooksey JA, Kaur K, Matters MD, Simone B, Chun E, Hoekstra A. Community health centers: unrecognized partners in health professions education. J Health Care Poor Underserved 1999; 10:349-61. [PMID: 10436733 DOI: 10.1353/hpu.2010.0551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Increasing demand for health professionals with training in ambulatory and primary care practice is placing stress on existing training site capacity. Community health centers can serve as model training sites, offering comprehensive multidisciplinary health care services and teaching clinician role models. In this study, 32 Illinois community and migrant health centers and federally qualified health centers were surveyed to asses their involvement with training in the past three years. Thirty centers had offered training to students from many disciplines, with nursing (27 centers) and medicine (24) the most frequent. Most centers had established formal relationships with training institutions but generally had limited involvement with course planning. Continued participation will likely require adequate funding, with some centers also seeking stronger institutional relationships and better integration of community health issues. Educators and policy makers may need to take a more active role in supporting centers, acquiring funds, and other enabling factors.
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Abstract
The research evidence indicates that health maintenance organizations (HMOs) participating in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) At-Risk Program tend to experience favorable selection. Although favorable selection might result from patient decisions, a common conjecture is that it can be induced by HMOs through their marketing activities. The purpose of this study is to examine the relationship between HMO marketing strategies and selection bias in TEFRA At-Risk HMOs. A purposive sample of 22 HMOs that were actively marketing their TEFRA programs was selected and data on organizational characteristics, market area characteristics, and HMO marketing decisions were collected. To measure selection bias in these HMOs, the functional health status of approximately 300 enrollees in each HMO was compared to that of 300 non-enrolling beneficiaries in the same area. Three dependent variables, reflecting selection bias at the mean, the low health tail, and the high health tail of the health status distribution were created. Weighted least squares regressions were then used to identify relationships between marketing elements and selection bias. Subject to the statistical limitations of the study, our conclusion is that it is doubtful that HMO marketing decisions are responsible for the prevalence of favorable selection in HMO enrollment. It also appears unlikely that HMOs were differentially targeting healthy and unhealthy segments of the Medicare market.
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Affiliation(s)
- R Lichtenstein
- Department of Health Services Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109
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28
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Abstract
The issue of selection bias was investigated using data from 22 HMOs who are enrolling Medicare beneficiaries under Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) at-risk contracts. The study differs from previously published analyses of this issue in that it deals with the current Medicare risk program (TEFRA) rather than with earlier Demonstration Programs; as an indicator of selection bias, it utilizes beneficiary functional health status at enrollment; and it examines selection not only at the mean of the health status distribution, but at the two tails (very disabled, very able) as well. For each of the participating HMOs, the functional health status of recent Medicare enrollees was compared with that of a control group of randomly chosen fee-for-service beneficiaries. None of the HMOs experienced adverse selection, whether measured in terms of overall (mean) health status of enrollees or in terms of the proportion of the very disabled population that chose to join. Nine of the 22 HMOs were considered to have experienced favorable selection on the basis of the mean health status of new enrollees. In addition, ten more HMOs were found to have experienced favorable selection in one or both tails of the health status distribution. Although a specific cause for the observed enrollment patterns is not identified, speculation is made on factors that may or may not contribute. Evidence suggests that beneficiary self-selection is probably a more important explanation of these patterns than purposeful actions of HMOs to discourage enrollment by sicker beneficiaries (i.e., "skimming").
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Affiliation(s)
- R Lichtenstein
- Department of Health Services Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109
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