Introduction: Diagnostic testing is common in the emergency department. The value of some testing is questionable. The purpose of this study was to assess how varying levels of benefit, risk, and costs influenced an individual’s desire to have diagnostic testing.
Methods: A survey through Amazon Mechanical Turk presented hypothetical clinical situations: low risk chest pain and minor traumatic brain injury. Each scenario included three given variables (benefit, risk, and cost), that was independently randomly varied over four possible values (0.1%, 1%, 5%, 10% for benefit and risk and $0, $100, $500, and $1000 for the individual’s personal cost for receiving the test). Benefit was defined as the probability of finding the target disease (traumatic intracranial hemorrhage or acute coronary syndrome).
Results: A total of 1000 unique respondents completed the survey. Increasing benefit from 0.1% to 10%, the percent of respondents who accepted a diagnostic test went from 28.4% to 53.1%. [OR: 3.42 (2.57-4.54)] As risk increased from 0.1% to 10%, this number decreased from 52.5% to 28.5%. [OR: 0.33 (0.25-0.44)] Increasing cost from $0 to $1000 had the greatest change of those accepting the test from 61.1% to 21.4%, respectively. [OR: 0.15 (0.11-0.2)]
Conclusions: The desire for testing was strongly sensitive to the benefits, risks and costs. Many participants wanted a test when there was no added cost, regardless of benefit or risk levels, but far fewer elected to receive the test as cost increased incrementally. This suggests that out of pocket costs may deter patients from undergoing diagnostic testing with low potential benefit.
In a sensitive cochlea, the basilar membrane response to transient excitation of any kind--normal acoustic or artificial intracochlear excitation--consists of not only a primary impulse but also a coda of delayed secondary responses with varying amplitudes but similar spectral content around the characteristic frequency of the measurement location. The coda, sometimes referred to as echoes or ringing, has been described as a form of local, short term memory which may influence the ability of the auditory system to detect gaps in an acoustic stimulus such as speech. Depending on the individual cochlea, the temporal gap between the primary impulse and the following coda ranges from once to thrice the group delay of the primary impulse (the group delay of the primary impulse is on the order of a few hundred microseconds). The coda is physiologically vulnerable, disappearing when the cochlea is compromised even slightly. The multicomponent sensitive response is not yet completely understood. We use a physiologically-based, mathematical model to investigate (i) the generation of the primary impulse response and the dependence of the group delay on the various stimulation methods, (ii) the effect of spatial perturbations in the properties of mechanically sensitive ion channels on the generation and separation of delayed secondary responses. The model suggests that the presence of the secondary responses depends on the wavenumber content of a perturbation and the activity level of the cochlea. In addition, the model shows that the varying temporal gaps between adjacent coda seen in experiments depend on the individual profiles of perturbations. Implications for non-invasive cochlear diagnosis are also discussed.
While collaboration with industry is paramount to innovation, the recent emphasis on industrial relationship transparency has sparked new guidelines, research studies, and standardizations focused on re-defining conflict of interest. There is limited data on defining the specific financial amount wherein a conflict of interest is relevant. This study is the first to assess the potential financial effects on high-quality clinical data, or the “indirect sponsorship”.
Criss CN, MacEachern MP, Matusko N, Dimick JB, Maggard-Gibbons M, Gadepalli SK. The Impact of Corporate Payments on Robotic Surgery Research: A Systematic Review. Ann Surg. 2019 Mar; 269 (3): 389-396. doi: 10.1097/SLA.0000000000003000. PMID: 30067545. https://doi.org/10.1097/SLA.0000000000003000
The search data supports a literature review project on lifestyle therapies for the management of atrial fibrillation. The data included in the dataset are the reproducible search strategies (in docx) and the exported results of all citations from all databases (txt and ris files). These searches and exported result files contain all citations originating from the database searches that were considered for inclusion.
We used data collected from participants of the Early Life Exposures in Mexico to ENvironmental Toxicants (ELEMENT) study, which consists of three sequentially-enrolled birth cohorts of pregnant women. Research protocols of this study were approved by the Institutional Review Board at University of Michigan and the Mexico National Institute of Public Health. We obtained informed consent from mothers and informed assent from children prior to enrollment.
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Liu, Y., Ettinger, A. S., Téllez-Rojo, M., Sánchez, B. N., Zhang, Z., Cantoral, A., Hu, H., & Peterson, K. E. (2020). Prenatal Lead Exposure, Type 2 Diabetes, and Cardiometabolic Risk Factors in Mexican Children at Age 10–18 Years. The Journal of Clinical Endocrinology & Metabolism, 105(1), 210–218. https://doi.org/10.1210/clinem/dgz038
Crouzon FGFR2-C342Y/+ and wild type littermate pups on a BALB/c congenic background were injected with lentivirus expressing TNAP enzyme or phosphate buffered saline shortly after birth. Mice were euthanized 4 weeks after birth for analyses.
Nam, H. K., Vesela, I., Schutte, S. D., & Hatch, N. E. (2020). Viral delivery of tissue nonspecific alkaline phosphatase diminishes craniosynostosis in one of two FGFR2C342Y/+ mouse models of Crouzon syndrome. PLOS ONE, 15(5), e0234073. https://doi.org/10.1371/journal.pone.0234073
Kue, J., & Meurer, W. (2020). Association between blood pressure, race, ethnicity and likelihood of admission to the hospital from United States emergency departments – A cross sectional study. F1000Research, 9, 1116. https://doi.org/10.12688/f1000research.24757.1
This is the bacterial DNA data extracted from the gram stain slides. The targeted bacteria genera and species include: Atopobium spp., bacterial vaginosis-associated bacterium (BVAB) types 1, 2 and 3 in the order Clostridiales, Escherichia coli, Gardnerella vaginalis, Group B Streptococcus, Lactobacillus spp., Mobiluncus spp., Mycoplasma spp., and Ureaplasma spp. We also used a primer set for Lactic Acid Bacteria (LAB) that includes lactic acid producing bacteria of the genera Lactobacillus, Pediococcus, Leuconostoc, and Weissella. We calculated the relative proportion of each bacterial taxon using the bacterial copies measured by each specific bacteria primer divided by the total bacterial copies. The limit of detection was 100 copies and readings lower than the limit were considered negative
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Wen A, Srinivasan U, Goldberg D, Owen J, Marrs CF, Misra D, Wing DA, Ponnaluri S, Miles-Jay A, Bucholz B, Abbas K, Foxman B. Selected vaginal bacteria and risk of preterm birth: an ecological perspective. J Infect Dis. 2014 Apr 1;209(7):1087-94. https://doi.org/10.1093/infdis/jit632. Epub 2013 Nov 22. PMID: 24273044; PMCID: PMC3952673. and Foxman B, Wen A, Srinivasan U, Goldberg D, Marrs CF, Owen J, Wing DA, Misra D. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol. 2014 Mar;210(3):226.e1-7. https://doi.org/10.1016/j.ajog.2013.10.003. Epub 2013 Oct 4. PMID: 24096128; PMCID: PMC3943817.