| 8 | Direct costs of carcinoid syndrome diarrhea among adults in the United States显示文摘BACKGROUND The burden of carcinoid syndrome(CS)among patients with neuroendocrine tumors is substantial and has been shown to result in increased healthcare resource use and costs.The incremental burden of CS diarrhea(CSD)is less well understood,particularly among working age adults who make up a large proportion of the population of patients with CS.AIM To estimate the direct medical costs of CSD to a self-insured employer in the United States.METHODS CS patients with and without CSD were identified in the IBM®MarketScan®Database,including the Medicare Supplemental Coordination of Benefits database.Eligible patients had≥1 medical claim for CS with continuous health plan enrollment for≥12 mo prior to their first CS diagnosis and for≥30 d after,no claims for acromegaly,and no clinical trial participation during the study period(2014-2016).Baseline demographic and clinical characteristics,including comorbidities and treatment,were analyzed using descriptive statistics.Measures of healthcare resource use and costs were compared between patients with and without CSD,including Emergency Department(ED)visits,hospital admissions and length of stay,physician office visits,outpatient services,and prescription claims,using univariate and multivariate analyses to evaluate associations of CSD with healthcare resource use and costs,controlling for baseline characteristics.RESULTS Overall,6855 patients with CS were identified of which 4,043 were eligible for the analysis(1352 with CSD,2691 with CS only).Baseline demographic and clinical characteristics were similar between groups with the exception of age,underlying tumor type,and health insurance plan.Patients with CSD were older,had more comorbidities,and received more somatostatin analog therapy at baseline.Patients with CSD required greater use of healthcare resources and incurred higher costs than their peers without CSD,including hospitalizations(44%vs 25%)and ED visits(55%vs 31%).The total adjusted annual healthcare costs per patient were 50%higher(+$23865)among those with CSD,driven by outpatient services(+56%),prescriptions(+48%),ED visits(+26%),physician office visits(+21%),and hospital admissions(+11%).CONCLUSION The economic burden of CSD is greater than that of CS alone among insured working age adults in the United States,which may benefit from timely diagnosis and management. | Arvind Dasari Vijay N Joish Raul Perez-Olle Samyukta Dharba Kavitha Balaji Daniel M Halperin | 2019 | World Journal of Gastroenterology2019，25，47： | 0 |
| 9 | Recent advances in operational tropical cyclone genesis forecast显示文摘Tropical cyclone(TC)genesis prediction is a major scientific challenge to the TC operation and research community.This report surveys the current status of TC genesis forecasts by a number of major operational centers covering the key ocean basins across both hemispheres.Since IWTC-9,we see an emergence of probabilistic TC genesis forecast products by operational centers,typically supported by the statistical processing of a combination of ensemble prediction and satellite analysis,covering time periods of couple of days to weeks ahead.The prevalence of multi-center grand ensemble approach highlights the uncertainties involved and the forecast challenges in quantitative genesis prediction.While operational practice might differ across agencies,verification efforts generally report a steady or slightly improving skill level in terms of reliability,which likely results from the continual improvement in global numerical weather prediction capability. | K.K.Hon Robert Ballard Eric Blake Steph Bond Robb Gile Daniel Halperin Charles Helms Hoang Lam Xinyan Lyu Mrutyunjay Mohapatra Monica Sharma Akira Shimokobe Ralf Toumi Seonghee Won | 2023 | Tropical Cyclone Research and Review2023，12，4： | 0 |
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