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Comparison of the Natural History of Genital HPV Infection among Men by Country: Brazil, Mexico, and the United States.
Sudenga SL, Torres BN, Silva R, Villa LL, Lazcano-Ponce E, Abrahamsen M, Baggio ML, Salmeron J, Quiterio M, Giuliano AR
(2017) Cancer Epidemiol Biomarkers Prev 26: 1043-1052
MeSH Terms: Adult, Aged, Brazil, Genital Diseases, Male, Genitalia, Male, Genotype, Health Policy, Humans, Incidence, Male, Mass Vaccination, Mexico, Middle Aged, Papillomaviridae, Papillomavirus Infections, Papillomavirus Vaccines, Prevalence, Risk Factors, Sex Factors, Time Factors, United States, Young Adult
Show Abstract · Added August 15, 2017
Male genital human papillomavirus (HPV) prevalence and incidence has been reported to vary by geographical location. Our objective was to assess the natural history of genital HPV by country among men with a median of 48 months of follow-up. Men ages 18-70 years were recruited from United States ( = 1,326), Mexico ( = 1,349), and Brazil ( = 1,410). Genital specimens were collected every 6 months and HPV genotyping identified 37 HPV genotypes. Prevalence of HPV was compared between the three countries using the Fisher exact test. Incidence rates and 95% confidence intervals were calculated. The median time to HPV clearance among men with an incident infection was estimated using the Kaplan-Meier method. The prevalence and incidence of the genital HPV types known to cause disease in males (HPV 16 and 6) was significantly higher among men from Brazil than men from Mexico. Prevalence and incidence of those genital HPV types in the United States varied between being comparable with those of Mexico or Brazil. Although genital HPV16 duration was significantly longer in Brazil ( = 0.04) compared with Mexico and the United States, HPV6 duration was shortest in Brazil ( = 0.03) compared with Mexico and the United States. Men in Brazil and Mexico often have similar, if not higher prevalence of HPV compared with men from the United States. Currently, there is no routine screening for genital HPV among males and while HPV is common in men, and most naturally clear the infection, a proportion of men do develop HPV-related diseases. Men may benefit from gender-neutral vaccine policies. .
©2017 American Association for Cancer Research.
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22 MeSH Terms
Biomarker Tests for Molecularly Targeted Therapies--The Key to Unlocking Precision Medicine.
Lyman GH, Moses HL
(2016) N Engl J Med 375: 4-6
MeSH Terms: Advisory Committees, Biomarkers, Clinical Laboratory Techniques, Financing, Government, Genomics, Health Policy, Humans, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Precision Medicine, Research Support as Topic, United States, United States Dept. of Health and Human Services, United States Food and Drug Administration
Added May 5, 2017
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13 MeSH Terms
Harnessing next-generation informatics for personalizing medicine: a report from AMIA's 2014 Health Policy Invitational Meeting.
Wiley LK, Tarczy-Hornoch P, Denny JC, Freimuth RR, Overby CL, Shah N, Martin RD, Sarkar IN
(2016) J Am Med Inform Assoc 23: 413-9
MeSH Terms: Health Policy, Humans, Medical Informatics, Precision Medicine, Societies, Medical, United States
Show Abstract · Added March 14, 2018
The American Medical Informatics Association convened the 2014 Health Policy Invitational Meeting to develop recommendations for updates to current policies and to establish an informatics research agenda for personalizing medicine. In particular, the meeting focused on discussing informatics challenges related to personalizing care through the integration of genomic or other high-volume biomolecular data with data from clinical systems to make health care more efficient and effective. This report summarizes the findings (n = 6) and recommendations (n = 15) from the policy meeting, which were clustered into 3 broad areas: (1) policies governing data access for research and personalization of care; (2) policy and research needs for evolving data interpretation and knowledge representation; and (3) policy and research needs to ensure data integrity and preservation. The meeting outcome underscored the need to address a number of important policy and technical considerations in order to realize the potential of personalized or precision medicine in actual clinical contexts.
© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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6 MeSH Terms
Medicaid and marketplace eligibility changes will occur often in all states; policy options can ease impact.
Sommers BD, Graves JA, Swartz K, Rosenbaum S
(2014) Health Aff (Millwood) 33: 700-7
MeSH Terms: Adult, Eligibility Determination, Health Insurance Exchanges, Health Policy, Humans, Income, Insurance Coverage, Medicaid, Middle Aged, Patient Protection and Affordable Care Act, State Government, United States, Young Adult
Show Abstract · Added February 19, 2015
Under the Affordable Care Act (ACA), changes in income and family circumstances are likely to produce frequent transitions in eligibility for Medicaid and health insurance Marketplace coverage for low- and middle-income adults. We provide state-by-state estimates of potential eligibility changes ("churning") if all states expanded Medicaid under health reform, and we identify predictors of rates of churning within states. Combining longitudinal survey data with state-specific weighting and small-area estimation techniques, we found that eligibility changes occurred frequently in all fifty states. Higher-income states and states that had more generous Medicaid eligibility criteria for nonelderly adults before the ACA experienced more churning, although the differences were small. Even in states with the least churning, we estimated that more than 40 percent of adults likely to enroll in Medicaid or subsidized Marketplace coverage would experience a change in eligibility within twelve months. Policy options for states to reduce the frequency and impact of coverage changes include adopting twelve-month continuous eligibility for adults in Medicaid, creating a Basic Health Program, using Medicaid funds to subsidize Marketplace coverage for low-income adults, and encouraging the same health insurers to offer plans in Medicaid and the Marketplaces.
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13 MeSH Terms
The dormant National Health Care Workforce Commission needs congressional funding to fulfill its promise.
Buerhaus PI, Retchin SM
(2013) Health Aff (Millwood) 32: 2021-4
MeSH Terms: Advisory Committees, Financing, Government, Health Policy, Health Services Research, Health Workforce, Humans, Organizational Objectives, Patient Protection and Affordable Care Act, United States
Show Abstract · Added March 7, 2014
Congress established the National Health Care Workforce Commission under section 5101 of the Affordable Care Act to provide data on the health care workforce and policy advice to both Congress and the administration. Although members of the Workforce Commission were appointed September 30, 2010, Congress has been unable to appropriate the $3 million requested by the administration to fund the commission. Consequently, the commission has never met and is not operational. As a new era of insurance coverage, care delivery, and payment reforms unfolds, the commission is needed to recommend policies that would help the nation achieve the goals of increased access to high-quality care and better preparation, configuration, and distribution of the nation's health workforce. In a climate where fiscal policy is dominated by spending on health care, the commission can also stimulate innovations aimed at reducing the cost of health care and achieving greater value and transparency.
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9 MeSH Terms
An academic, business, and community alliance to promote evidence-based public health policy: the case of primary seat belt legislation.
Goldzweig IA, Schlundt DG, Moore WE, Smith PE, Zoorob RJ, Levine RS
(2013) J Health Care Poor Underserved 24: 1364-77
MeSH Terms: Adolescent, Adult, Commerce, Community Networks, Evidence-Based Practice, Female, Health Policy, Health Promotion, Humans, Male, Middle Aged, Public Health, Risk Reduction Behavior, Seat Belts, Universities, Young Adult
Show Abstract · Added March 7, 2014
An academic, business, and community alliance comprising 285 organizations, including 43 national groups represented on a Blue Ribbon Panel organized by the U.S. Secretary of Transportation, targeted Arkansas, Florida, Mississippi, Minnesota, Tennessee, and Wisconsin for high involvement/intervention consisting of community organization and other political action to support passage of primary seat belt laws. State-level alliance activities began in January 2003. All six states enacted a primary seat belt law between 2004 and 2009. From January 2003 to May 2010, passage of primary legislation was 4.5 times as likely (95% CI 1.90, 10.68) in states with high versus low alliance involvement. Positive interaction between high alliance involvement and offers of federal incentives may have occurred as well. This evidence of success suggests that academic-business-community alliances for action to promote evidence-based public health policy may be effective.
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16 MeSH Terms
Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.
Middleton B, Bloomrosen M, Dente MA, Hashmat B, Koppel R, Overhage JM, Payne TH, Rosenbloom ST, Weaver C, Zhang J, American Medical Informatics Association
(2013) J Am Med Inform Assoc 20: e2-8
MeSH Terms: Commerce, Health Policy, Humans, Medical Errors, Medical Informatics, Medical Records Systems, Computerized, Patient Safety, Societies, Medical, United States, User-Computer Interface
Show Abstract · Added December 10, 2013
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems.
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10 MeSH Terms
Better methods will be needed to project incomes to estimate eligibility for subsidies in health insurance exchanges.
Graves JA
(2012) Health Aff (Millwood) 31: 1613-22
MeSH Terms: Cost Sharing, Eligibility Determination, Financing, Government, Health Insurance Exchanges, Health Policy, Humans, Income, Medicaid, Patient Protection and Affordable Care Act, Tax Exemption, United States
Show Abstract · Added March 7, 2014
Under the Affordable Care Act, people who meet certain income eligibility criteria will be eligible for subsidies to offset costs of premiums and cost sharing for health insurance plans purchased through new health insurance exchanges. But determining the correct level of these subsidies will not be easy, because of several factors. These include the way in which eligibility will be calculated for participation in Medicaid or for subsidies through the exchanges; possibly inaccurate income projections; the use of different income time periods to determine eligibility; and fluctuations in income. I performed a simulation that shows that under the most likely methods to be used to determine eligibility for Medicaid or for receiving subsidies through exchanges, one-third of people with incomes initially judged to be below the Medicaid threshold would actually "churn" into an exchange at the end of the year. Other people would be wrongly deemed ineligible for advance subsidy payments because their projected income was too high, while still others judged eligible for subsidies would receive advance payments on those subsidies that were too high by $208 per year, on average. To reduce these errors, I recommend the adoption of a single eligibility standard based on income data derived from prior tax returns, along with generous accommodations during a given enrollment year for people who claim a change in circumstances, such as a change in income.
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11 MeSH Terms
Cancer screening: the journey from epidemiology to policy.
Deppen SA, Aldrich MC, Hartge P, Berg CD, Colditz GA, Petitti DB, Hiatt RA
(2012) Ann Epidemiol 22: 439-45
MeSH Terms: Breast Neoplasms, Early Detection of Cancer, Epidemiology, Health Policy, Humans, Interprofessional Relations, Lung Neoplasms, Policy Making, Politics, Professional Role, Public Health, Public Opinion, United States
Show Abstract · Added February 26, 2014
PURPOSE - Cancer screening procedures have brought great benefit to the public's health. However, the science of cancer screening and the evidence arising from research in this field as it is applied to policy is complex and has been difficult to communicate, especially on the national stage. We explore how epidemiologists have contributed to this evidence base and to its translation into policy.
METHODS - Our essay focuses on breast and lung cancer screening to identify commonalities of experience by epidemiologists across two different cancer sites and describe how epidemiologists interact with evolving scientific and policy environments.
RESULTS - We describe the roles and challenges that epidemiologists encounter according to the maturity of the data, stakeholders, and the related political context. We also explore the unique position of cancer screening as influenced by the legislative landscape where, due to recent healthcare reform, cancer screening research plays directly into national policy.
CONCLUSIONS - In the complex landscape for cancer screening policy, epidemiologists can increase their impact by learning from past experiences, being well prepared and communicating effectively.
Copyright © 2012 Elsevier Inc. All rights reserved.
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13 MeSH Terms
Variability in radiology practice in the United States: a former teleradiologist's perspective.
Abramson RG
(2012) Radiology 263: 318-22
MeSH Terms: Diagnostic Imaging, Electronic Health Records, Emergency Service, Hospital, Forecasting, Health Policy, Health Services Research, Humans, Practice Guidelines as Topic, Practice Patterns, Physicians', Public Health, Teleradiology, United States
Added March 10, 2014
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12 MeSH Terms