PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1928

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Citation - WoS: 3
Citation - Scopus: 3
Cancer Chemotherapy Treatment Patterns and Febrile Neutropenia in the Us Veterans Health Administration
(2014) Wang, Li; Dale, David C; Barron, Richard; Langeberg, Wendy J; Başer, Onur
Background: The Veterans Health Administration (VHA) is the largest integrated health care system in the United States and a major cancer care provider. Objective: To use VHA database to conduct a population-based study of patterns of myelosuppressive chemotherapy use and to assess the incidence and management of febrile neutropenia (FN) among VHA patients with lung, colorectal, or prostate cancer or non-Hodgkin lymphoma (NHL). Methods: Data were extracted for the initial myelosuppressive chemotherapy course for 27,899 patients who began treatment in the period 2006 to 2011. FN-related costs were defined as claims containing FN diagnosis. Results: Most patients were men (98.0%); most were 65 years or older (55.8%). Patients received a mean 3.4 to 3.9 chemotherapy cycles/course (median cycle duration 34-43 days). The incidence of FN among patients with lung, colorectal, or prostate cancer or NHL was 10.2%, 4.6%, 5.4%, and 17.3%, respectively. Primary or secondary prophylactic antibiotics/colony-stimulating factors were received by 21% and 12% of patients, respectively. Antibiotics were more commonly given as primary or secondary prophylaxis for patients with lung, colorectal, and prostate cancer; colony-stimulating factors were more common for patients with NHL. Among patients with FN, those with lung cancer had the highest inpatient mortality (10%); patients with NHL had the highest costs ($24,571) and the longest hospital length of stay (15.4 days). Conclusions: VHA cancer care was generally consistent with National Comprehensive Cancer Network recommendations; however, compared with the general population, chemotherapy cycles were longer, combination chemotherapy was used less, and treatment to prevent FN was used less, differences that may be attributed to the unique VHA patient population. The impact of these practices warrants further investigation.
Citation - WoS: 14
Citation - Scopus: 13
Hepatic Decompensation in Patients With Hiv/Hepatitis B Virus (hbv)/Hepatitis C Virus (hcv) Triple Infection Versus Hiv/Hcv Coinfection and the Effect of Anti-Hbv Nucleos(t)ide Therapy
(2014) Wang, Li; Devine, Scott; Lo Re, Vincent, III; Olufade, Temitope; Başer, Onur
The incidence rate of hepatic decompensation was higher in patients with human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) triple infection than in those with HIV/HCV coinfection (24.1 vs 10.8 events per 1000 person-years; hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.12–3.18). Compared with HIV/HCVinfected patients, the rate of decompensation was increased among HIV/HBV/HCV-infected patients receiving no anti-HBV therapy (HR, 2.48; 95% CI, 1.37–4.49) but not among those who did receive such therapy (HR, 1.09; 95% CI, .40–2.97)
Citation - WoS: 25
Citation - Scopus: 25
Impact of Switching From an Initial Tumor Necrosis Factor Inhibitor on Health Care Resource Utilization and Costs Among Patients With Rheumatoid Arthritis
(2015) Roy, Sanjoy; Ganguli, Arijit; Xie, Lin; Başer, Onur; Cifaldi, Mary
Purpose: Despite improved clinical outcomes for the majority of patients, nearly 30% of patients with rheumatoid arthritis (RA) who initiate tumor necrosis factor antagonist (anti-TNF) biologic agents fail to respond to their first-line anti-TNF and switch to another anti-TNF or a non-TNF biologic. How this change affects health care costs and resource utilization is unknown. We therefore compared RA patients taking first-line anti-TNFs who switched to a second anti-TNF versus those patients who switched to an alternate biologic. Methods: Health care claims data were obtained from a large US database for eligible adults with confirmed RA diagnoses who initiated anti-TNF treatment and switched to another biologic. Health care costs and utilization during the first 12 months' postswitch were compared. Generalized linear models were used to adjust for differences in demographic and clinical characteristics before switching. Findings: Patients who switched to a second anti-TNF rather than a non-TNF biologic were generally younger (53.0 vs. 55.3 years; P < 0.0001) and less likely to be female (79.7% vs. 82.7%; P = 0.0490). Of the 3497 eligible patients who switched from first-line anti-TNFs, 2563 (73.3%) switched to another anti-TNF and 934 (26.7%) switched to a non-TNF. Adalimumab was the most frequently prescribed (43.4%) second-line anti-TNF, and abatacept was the most common non anti-TNF (71.4%). Patients who switched to a second anti-TNF remained on their first medication for a significantly shorter period (342.5 vs 420.6 days; P < 0.0001) and had lower comorbidity indices and higher disease severity at baseline than those who switched to a non anti-TNF. After adjusting for baseline differences, patients who switched to second anti-TNFs versus a non-TNF incurred lower RA-related costs ($20,938.9 vs $22,645.2; P = 0.0010) and total health care costs ($34,894.6 vs $38,437.2; P = 0.0010) 1 year postswitch. These differences were driven by increased physician office visit costs among the non-TNF group. Implications: Among the anti-TNF initiators who switched therapy, more patients switched to a second anti-TNF than to a non-TNF. Switching to a second anti-TNF treatment was associated with lower all-cause and RA-related health care costs and resource utilization than switching to a non-TNF. Because switching therapy may be unavoidable, finding a treatment algorithm mitigating this increase to any extent should be considered. These data are limited by their retrospective design. Additional confounding variables that could not be controlled for may affect results. (C) 2015 The Authors. Published by Elsevier HS journals, Inc.
Citation - WoS: 30
Citation - Scopus: 29
Out-Of Inr Values and Outcomes Among New Warfarin Patients With Non-Valvular Atrial Fibrillation
(2015) Schein, Jeffrey R; Wang, Li; Damaraju, Chandrasekharrao, V; Nelson, Winnie W; Başer, Onur
Background Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. Objective To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Setting Adult non-valvular atrial fibrillation patients (a parts per thousand yen18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Method Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. Main outcome measure The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. Results 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio < 2:13.66 for acute coronary syndrome; 10.30 for ischemic stroke; 2.93 for transient ischemic attack; 1.81 for systemic embolism; and 4.55 for major bleeding. Poisson regression confirmed that during periods with international normalized ratio < 2, patients were at increased risk of developing acute coronary syndrome (relative risk ratio: 7.9; 95 % confidence interval 6.9-9.1), ischemic stroke (relative risk ratio: 7.6; 95 % confidence interval 6.5-8.9), transient ischemic attack (relative risk ratio: 8.2; 95 % confidence interval 6.1-11.2), systemic embolism (relative risk ratio: 6.3; 95 % confidence interval 4.4-8.9) and major bleeding (relative risk ratio: 2.6; 95 % confidence interval 2.2-3.0). During time periods with international normalized ratio > 3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). Conclusion In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.
Citation - WoS: 23
Citation - Scopus: 25
Acoustic Particle Palpation for Measuring Tissue Elasticity
(American Institute of Physics, 2015) El Ghamrawy, Ahmed; Körük, Hasan; Choi, James J; Pouliopoulos, Antonios N
We propose acoustic particle palpation—the use of sound to press a population of acoustic particles against an interface—as a method for measuring the qualitative and quantitative mechanical properties of materials. We tested the feasibility of this method by emitting ultrasound pulses across a tunnel of an elastic material filled with microbubbles. Ultrasound stimulated the microbubble cloud to move in the direction of wave propagation, press against the distal surface, and cause deformations relevant for elasticity measurements. Shear waves propagated away from the palpation site with a velocity that was used to estimate the material’s Young’s modulus.
Citation - WoS: 8
Citation - Scopus: 8
Out-Of International Normalized Ratio Values and Healthcare Cost Among New Warfarin Patients With Non-Valvular Atrial Fibrillation
(2015) Wang, Li; Nelson, Winnie W.; Schein, Jeffrey R.; Damaraju, Chandrasekharrao, V; Başer, Onur
Patients with out-of-range international normalized ratio (INR) values <2.0 and >3.0 have been associated with increased risk of thromboembolic and bleeding events. INR monitoring is costly, because of associated physician and nurse time, laboratory resource use, and dose adjustments.
Citation - Scopus: 8
Patterns of Treatment and Correction of Hyponatremia in Intensive Care Unit Patients
(W.B. Saunders, 2015) Badawi, Omar; Chiodo, Joseph; Waikar, Sushrut S.; Boklage, Susan; Dasta, Joseph; Xie, Lin; Başer, Onur
Purpose: The goal of this study was to examine the real-world patterns of care and interventions among intensive care unit (ICU) patients with hypervolemic and euvolemic hyponatremia using a large clinical database. Materials and Methods: The Phillips eICU Research Institute database was used to investigate hyponatremia treatment patterns and trends, mortality, and ICU and hospital length of stay. Demographics, clinical characteristics, and outcome variables were compared in patients corrected for hyponatremia using both a more strict and a less strict definition. Results: At admission, 35%, 55%, and 10% of patients had mild, moderate, and severe hyponatremia, respectively. At the end of an ICU stay, the percentage of patients who did not have corrected serum sodium concentration was 48% (using a more strict definition) and 24% (using a less strict definition). Using either definition of correction, patients with serum sodium correction had lower mortality and longer survival than did patients without corrected serum sodium concentration. Conclusions: A significant proportion of hyponatremia is not corrected during an ICU stay. Critically ill patients with hyponatremia who have their serum sodium corrected have lower mortality and longer survival, highlighting the need for more attention to hyponatremia and its correction in critically ill patients. © 2015 Elsevier Inc.
Citation - WoS: 18
Citation - Scopus: 18
Adding Rapid-Acting Insulin or Glp-1 Receptor Agonist To Basal Insulin: Outcomes in a Community Setting
(2015) Dalal, Mehul R; DiGenio, Andres; Xie, Lin; Başer, Onur
To evaluate real-world outcomes in patients with type 2 diabetes mellitus (T2DM)receiving basal insulin, who initiate add-on therapy with a rapid-acting insulin (RAI) or aglucagon-like peptide 1 (GLP-1) receptor agonist.Data were extracted retrospectively from a U.S. health claims database. Adults withT2DM on basal insulin who added an RAI (basal+RAI) or GLP-1 receptor agonist (basal+GLP-1) were included. Propensity score matching (1 up to 3 ratio) was used to control for differencesin baseline demographics, clinical characteristics, and health resource utilization. Endpointsincluded prevalence of hypoglycemia, pancreatic events, all-cause and diabetes-relatedresource utilization, and costs at 1 year follow-up. Overall, 6,718 matched patients were included: 5,013 basal+RAI and 1,705basal+GLP1. Patients in both groups experienced a similar proportion of any hypoglycemicevent (P = .4079). Hypoglycemic events leading to hospitalization were higher in the basal+RAIcohort (2.7% vs. 1.8%; P = .0444). The basal+GLP-1 cohort experienced fewer all-cause(13.55% vs. 18.61%; P<.0001) and diabetes-related hospitalizations (11.79% vs. 15.68%;P<.0001). The basal+GLP-1 cohort had lower total all-cause health care costs ($18,413 vs.$20,821; P = .0002), but similar diabetes-related costs ($9,134 vs. $8,985; P<.0001) comparedwith the basal+RAI cohort. Add-on therapy with a GLP-1 receptor agonist in T2DM patients receiving basalinsulin was associated with fewer hospitalizations and lower total all-cause costs compared withadd-on therapy using a RAI, and could be considered an alternative to a RAI in certain patientswith T2DM, who do not achieve effective glycemic control with basal insulin.
Citation - Scopus: 4
Economic Impact and Complications of Treated and Untreated Hepatitis C Virus Patients in Turkey
(2015) Altinbaş, Akif; Baser E; Kariburyo, F; Başer, Onur
Background: According to the Turkish Ministry of Health’s guidelines,standard double therapy, a combination of pegylated interferon-alphaand ribavirin, was the only treatment option for patients withhepatitis C virus (HCV) infection until the end of 2011. Objective: Theprimary objective was to compare risk-adjusted clinical and economicoutcomes between treated and untreated patients with HCV infection.Methods: Patients with HCV infection were identified from theTurkish National Health Insurance Database (2009–2011) using International Classification of Diseases, 10th Revision, Clinical Modification codes.The first prescription date was designated as the index date. Mortalityand hepatocellular carcinoma (HCC) rates and health care costs oftreated and untreated patients were compared using propensity scorematching. Baseline demographic and clinical factors were controlledin the models. Subgroup analysis was conducted for patient groupswith and without a cirrhosis diagnosis. Results: Out of 12,990 patientsincluded in the study, 1,583 were treated for HCV infection. Out of2,467 patients who had a cirrhosis diagnosis, 231 were treated,whereas out of 10,523 patients without cirrhosis, 1,352 patients weretreated. Treated patients were younger, less likely to be diagnosedwith comorbid conditions, and less likely to reside in Central orEastern Anatolia. After adjusting for baseline demographic andclinical factors, mortality (2.27% vs. 5.31%; P o 0.001) and HCC rates(0.69% vs. 1.96%; P o 0.001) were found to be lower for treatedpatients. Differences were more significant among patients diagnosedwith cirrhosis. Treated patients incurred higher risk-adjusted annualcosts (€6172 vs. €1680; P o 0.001), mainly because of pharmaceuticalcosts (€4918 vs. €583; P o 0.001). Conclusions: HCV infection treatment, although costly, significantly reduces mortality and HCC ratesin Turkey.
Citation - WoS: 29
Citation - Scopus: 26
Drivers of Cultural Success: the Case of Sensory Metaphors
(2015) Berger, Jonah; Akpınar, Ezgi
Why do some cultural items catch on and become more popular than others? Language is one of the basic foundations of culture. But what leads some phrases to become more culturally successful? There are multiple ways to convey the same thing and phrases with similar meanings often act as substitutes, competing for usage. A not so friendly person, for example, can be described as unfriendly or cold. We study how the senses shape cultural success, suggesting that compared with their semantic equivalents (e.g., unfriendly person), phrases which relate to senses in metaphoric ways (e.g., cold person) should be more culturally successful. Data from 5 million books over 200 years support this prediction: Sensory metaphors are used more frequently over time than are their semantic equivalents. Experimental evidence demonstrates that sensory metaphors are more memorable because they relate more to the senses and have more associative cues. These findings shed light on how senses shape language and the psychological foundations of culture more broadly.
Citation - WoS: 13
Citation - Scopus: 13
Therapeutically Interchangeable? a Study of Real-World Outcomes Associated With Switching Basal Insulin Analogues Among Us Patients With Type 2 Diabetes Mellitus Using Electronic Medical Records Data
(2015) Wei, W.; Gill, J.; Ye, F; Xie, L; Levin, P.; Miao, R.; Başer, Onur
Aims: To evaluate real-world clinical outcomes for switching basal insulin analogues [insulin glargine (GLA) and insulin detemir (DET)] among US patients with type 2 diabetes mellitus (T2DM). Methods: Using the GE Centricity Electronic Medical Records database, this retrospective study examined two cohorts: cohort 1, comprising patients previously on GLA and then either switching to DET (DET-S) or continuing with GLA (GLA-C); and cohort 2, comprising patients previously on DET and then either switching to GLA (GLA-S) or continuing with DET (DET-C). Within each cohort, treatment groups were propensity-score-matched on baseline characteristics. At 1-year follow-up, insulin treatment patterns, glycated haemoglobin (HbA1c) levels, hypoglycaemic events, weight and body mass index (BMI) were evaluated. Results: The analysis included 13 942 patients: cohort 1: n= 10 657 (DET-S, n= 1797 matched to GLA-C, n= 8860) and cohort 2: n= 3285 (GLA-S, n= 858 matched to DET-C, n= 2427). Baseline characteristics were similar between the treatment groups in each cohort. At 1-year follow-up, in cohort 1, patients in the DET-S subgroup were significantly less persistent with treatment, more likely to use a rapid-acting insulin analogue, had higher HbA1c values, lower HbA1c reductions and lower proportions of patients achieving HbA1c < 7.0 or < 8.0% compared with patients in the GLA-C subgroup, while hypoglycaemia rates and BMI/weight values and change from baseline were similar in the two subgroups. In cohort 2, overall, there were contrasting findings between patients in the GLA-S and those in the DET-C subgroup. Conclusions: This study showed contrasting results when patients with T2DM switched between basal insulin analogues, although these preliminary results may be subject to limitations in the analysis. Nevertheless, this study calls into question the therapeutic interchangeability of GLA and DET, and this merits further investigation.
Citation - WoS: 37
Citation - Scopus: 42
The Age of Anxiety? It Depends Where You Look: Changes in Stai Trait Anxiety, 1970-2010
(Springer, 2016) Booth, Robert William; Leader, Tirza I.; Sharma, Dinkar
Purpose : Population-level surveys suggest that anxiety has been increasing in several nations, including the USA and UK. We sought to verify the apparent anxiety increases by looking for systematic changes in mean anxiety questionnaire scores from research publications. Methods : We analyzed all available mean State–Trait Anxiety Inventory scores published between 1970 and 2010. We collected 1703 samples, representing more than 205,000 participants from 57 nations. Results : Results showed a significant anxiety increase worldwide, but the pattern was less clear in many individual nations. Our analyses suggest that any increase in anxiety in the USA and Canada may be limited to students, anxiety has decreased in the UK, and has remained stable in Australia. Conclusions : Although anxiety may have increased worldwide, it might not be increasing as dramatically as previously thought, except in specific populations, such as North American students. Our results seem to contradict survey results from the USA and UK in particular. We do not claim that our results are more reliable than those of large population surveys. However, we do suggest that mental health surveys and other governmental sources of disorder prevalence data may be partially biased by changing attitudes toward mental health: if respondents are more aware and less ashamed of their anxiety, they are more likely to report it to survey takers. Analyses such as ours provide a useful means of double-checking apparent trends in large population surveys.
Citation - WoS: 8
Citation - Scopus: 7
State Anxiety Impairs Attentional Control When Other Sources of Control Are Minimal
(Taylor & Francis, 2016) Booth, Robert William; Peker, Müjde
Research suggests anxiety impairs attentional control; however, this effect has been unreliable. We argue that anxiety’s impairment of attentional control is subtle, and can be obscured by other non-emotional sources of control. We demonstrate this by examining conflict adaptation, an enhancement in attentional control following a trial with high conflict between distracter and target stimuli. Participants completed a Stroop task featuring incongruent (e.g. RED in green font; high-conflict) and control (e.g. +++ in green font; low-conflict) trials. More state-anxious participants showed greater Stroop interference following control trials, but interference was uniformly low following incongruent trials. This suggests state anxiety can impair attention, but other sources of top-down control – such as conflict adaptation – can easily overcome this impairment. This is consistent with recent theories of anxious cognition and shows that anxiety researchers must attend to the dynamics and sources of attentional control.
Citation - Scopus: 2
Brief Time Course of Trait Anxiety-Related Attentional Bias To Fearconditioned Stimuli: Evidence From the Dual-Rsvp Task
(Elsevier, 2016) Booth, Robert William
Background and objectives Attentional bias to threat is a much-studied feature of anxiety; it is typically assessed using response time (RT) tasks such as the dot probe. Findings regarding the time course of attentional bias have been inconsistent, possibly because RT tasks are sensitive to processes downstream of attention. Methods Attentional bias was assessed using an accuracy-based task in which participants detected a single digit in two simultaneous rapid serial visual presentation (RSVP) streams of letters. Before the target, two coloured shapes were presented simultaneously, one in each RSVP stream; one shape had previously been associated with threat through Pavlovian fear conditioning. Attentional bias was indicated wherever participants identified targets in the threat’s RSVP stream more accurately than targets in the other RSVP stream. Results In 87 unselected undergraduates, trait anxiety only predicted attentional bias when the target was presented immediately following the shapes, i.e. 160 ms later; by 320 ms the bias had disappeared. This suggests attentional bias in anxiety can be extremely brief and transitory. Limitations This initial study utilised an analogue sample, and was unable to physiologically verify the efficacy of the conditioning. The next steps will be to verify these results in a sample of diagnosed anxious patients, and to use alternative threat stimuli. Conclusions The results of studies using response time to assess the time course of attentional bias may partially reflect later processes such as decision making and response preparation. This may limit the efficacy of therapies aiming to retrain attentional biases using response time tasks.
Citation - WoS: 3
Citation - Scopus: 3
Patterns of International Normalized Ratio Values Among New Warfarin Patients With Nonvalvular Atrial Fibrillation
(2016) Schein, Jeffrey R; Wang, Li; Nelson, Winnie W.; Damaraju, Chandrasekharrao, V; Milentijevic, Dejan; Başer, Onur
Limited information exists regarding the relationship between international normalized ratio (INR) control/stability and the discontinuation of warfarin therapy among patients with nonvalvular atrial fibrillation (NVAF). This study evaluated the association between INR stabilization and warfarin discontinuation and assessed INR patterns before and after INR stabilization among patients (18 years) with NVAF who newly initiated warfarin (Veterans Health Administration datasets; October 1, 2007 through September 30, 2012). Achievement of INR stabilization (3 consecutive in-range therapeutic INR measurements 7 days apart) was examined from warfarin initiation through the end of warfarin exposure. Proportion of time in therapeutic range during warfarin exposure was calculated (Rosendaal method) and categorized as at least 60% or less than 60%. Among 34346 patients, 49.4% achieved INR stabilization (mean time to stabilization, 98 days). Approximately 40% of INR values were out-of-range, even after achieving stabilization. During 30 days following an INR 4.0 or higher, patients had more INR testing than the overall mean (2.51 vs. 1.67 tests). Warfarin discontinuation was 4.2 times more likely among patients without INR stabilization versus those with INR stabilization (P<0.00001). Patients with poor INR control (time in therapeutic range <60%) were 1.76 times more likely to discontinue warfarin within 1 year (P<0.0001). INR stabilization is a better predictor of warfarin discontinuation than poor INR control. Improved approaches are necessary to maintain appropriate anticoagulation levels among patients with NVAF.
Citation - WoS: 2
Citation - Scopus: 2
Warfarin Discontinuation in Patientswith Unprovoked Venous Thromboembolism: a Large Us Insurance Database Analysis
(2016) Mardekian, Jack; Liu, Xianchen; Phatak, Hemant; Xie, Lin; Tan, Wilson; Başer, Onur; Ramacciotti, Eduardo
This study examined warfarin therapy discontinuation and its risk factors among patients with unprovoked venous thromboembolism (VTE) in the US clinical practice setting. Adult patients with unprovoked VTE were identified from the MarketScan claims database from January 1, 2006 to December 31, 2012. The index date was defined as the date of first VTE diagnosis. Patients were required to have no VTE diagnosis in the 6 months before index date and continuous health plan enrollment for 6 months before and 12 months after the index date. Warfarin discontinuation rates and adjusted hazard ratios (HRs) were reported. Of 21,163 eligible patients, 15,463 were diagnosed with deep vein thrombosis (DVT) only (73.1%), 5027 with pulmonary embolism (PE) only (23.7%), and 673 with DVT and PE (3.2%). The average duration of warfarin therapy was 5.2 months (SD = 3.0). During 1-year follow-up, 21.4% patients discontinued therapy within 3 months, 42.8% within 6 months, and 70.1% within 12 months. PE versus DVT [HR = 0.77, 95% confidence interval (CI) = 0.74-0.80], comorbid atrial fibrillation (HR = 0.73, 95% CI = 0.66-0.81), thrombophilia (HR = 0.62, 95% CI = 0.54-0.71), and age >40 years (41-65 years: HR = 0.86, 95% CI = 0.81-0.91; >65 years: HR = 0.82, 95% CI = 0.77-0.87) were significantly associated with reduced risk of warfarin discontinuation. Alcohol abuse/dependence (HR = 1.36, 95% CI = 1.20-1.55), cancer history (HR = 1.13, 95% CI = 1.07-1.19), bleeding (HR = 1.07, 95% CI = 1.01-1.15), and catheter ablation (HR = 1.10, 95% CI = 1.00-1.20) in the 6 months before index date were significantly associated with increased risk for warfarin discontinuation. In conclusion, nearly 1 of 4 patients with unprovoked VTE discontinued warfarin within 3 months. Three of 4 patients discontinued therapy within 1 year. Younger age and multiple clinical factors are associated with warfarin therapy discontinuation.
Citation - WoS: 3
Citation - Scopus: 2
The Economic Impact of Symptomatic Menopause Among Low-Socioeconomic Women in the United States
(2016) Başer, Onur; Keshishian, A; Xie, Lin; Wang, Yuexi
Background: Menopausal symptoms have a significant negative impact on patient's quality of life and increase healthcare costs among women. Methods: This retrospective analysis used data from a U.S. national database (01 January 2008-31 December 2010). Patients with a diagnosis of menopause symptoms or a prescription claim for hormone therapy were matched to control patients. Healthcare resource utilization and costs during the 6-month follow-up period were compared. Generalized linear models were used to adjust for differences in baseline and demographic characteristics between the cohorts. Results: A total of 71,076 patients were included in each cohort. Patients with menopausal symptoms were more likely to have depression and anxiety and incurred significantly higher follow-up healthcare costs ($7237 vs $6739, p < 0.001) and healthcare utilization during the 6-month follow-up period. Conclusion: Patients diagnosed with menopausal symptoms or treated with hormone therapy incurred significantly higher healthcare costs than those without menopausal symptoms or treatment.
Citation - WoS: 8
Citation - Scopus: 6
Satisfaction With Life, Meaning in Life, Sad Childhood Experiences, and Psychological Symptoms Among Turkish Students
(SAGE Publications, 2016) Cömet, Itır Tarı; Özgülük, S. Burcu; Atalay, Zümra
The aim of the current study was to investigate the contributions of sad childhood experiences, depression, anxiety, and stress, existence of a sense of meaning, and pursuit of meaning in explaining life satisfaction of young adults in Turkey. The sample comprised 400 undergraduate students (M age = 20.2 yr.) selected via random cluster sampling. There were no statistically significant differences between men and women in terms of their scores on depression, existence of meaning, pursuit of meaning, and life satisfaction scores. However, there were statistically significant differences between men and women on the sad childhood experiences, anxiety and stress. In heirarchical regression analysis, the model as a whole was significant. Depression and existence of meaning in life made unique significant contributions to the variance in satisfaction in life. Students with lower depression and with a sense of meaning in life tended to be more satisfied with life.
Citation - WoS: 40
Citation - Scopus: 38
Clinical and Economic Burden Associated With Cardiovascular Events Among Patients With Hyperlipidemia: a Retrospective Cohort Study
(2016) Wang, Li; Quek, Ruben G. W; Fox, Kathleen M; Gandra, Shravanthi R; Li, Lu; Başer, Onur
Background: Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia. Methods: Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate-and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period). Results: Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75 % of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE. Conclusions: Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.
Citation - WoS: 12
Citation - Scopus: 14
Emotional Dependency and Dysfunctional Relationship Beliefs as Predictors of Married Turkish Individuals’ Relationship Satisfaction
(Cambridge University Press, 2016) Çetinkaya Yıldız, Evrim; Kemer, Gülşah; Bulgan, Gökçe
In this study, we examined married individuals’ relationship satisfaction in relation to their emotional dependency and dysfunctional relationship beliefs. Our participants consisted of 203 female and 181 male, a total of 384 married individuals from urban cities of Turkey. Controlling the effects of gender and length of marriage, we performed a hierarchical regression analysis. Results revealed that married Turkish individuals’ relationship satisfaction was significantly explained by their emotional dependency (sr2 = .300, p < .001), and perceptions of interpersonal rejection (sr2 = .075, p < .001) and unrealistic relationship expectations (sr2 = .028, p < .001). However, interpersonal misperception did not make a significant contribution to the participants’ relationship satisfaction (p > .05). When compared to perceptions of interpersonal rejection and unrealistic relationship expectations, emotional dependency had the largest role in explaining participants’ satisfaction with their marriages. We discuss the results in light of current literature as well as cultural relevance. We also provide implications for future research and mental health practices.