PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study evaluates cost-effectiveness of strategies to treat infant tear-duct obstruction

2011-05-10
(Press-News.org) When infants' tear ducts are blocked, the decision about when to intervene and the cost-effectiveness of doing so depend on how likely it is the problem will self-resolve, according to a report in the May issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

It is not uncommon for babies to be born with blockage of the tear ducts, a condition known as congenital nasolacrimal duct obstruction (NLDO). In many cases, the condition will resolve spontaneously by the time a child is one year old. For affected infants at least six months old, physicians can try to open the duct in the office under local anesthesia, or they can pursue watchful waiting and, if spontaneous resolution does not occur, perform a deferred intervention (probing of the duct) in a surgical facility.

Both options have risks and benefits, note the authors. Consequently, "controversy remains among surgeons as to the preferred approach." Part of the challenge is taking into account the rate of spontaneous resolution, which ranges from 32 percent to 95 percent.

Using modeling and analysis, Kevin D. Frick, Ph.D., from The Johns Hopkins University, Baltimore, and colleagues calculated how spontaneous resolution rates, intervention success rates, and intervention setting affect costs and outcomes. They used data from the 2009 Medicare Fee Schedule, a 2008 study of NLDO treatment conducted by the Pediatric Eye Disease Investigator Group, and information from the scientific literature. They constructed decision trees for two options—immediate office-based probing surgery to clear the blockage, versus watchful waiting and deferred facility-based probing surgery as needed. Analytical variables included the percentage of cases resolving spontaneously and the cost of treating the condition in different types of facilities.

Under the assumption that the spontaneous resolution rate is 75 percent, immediate office-based duct-probing surgery would be more expensive than waiting ($771 vs. $641) and slightly less effective than delayed facility-based probing surgery. However, under the assumption that spontaneous resolution rates are below 68 percent, immediate office-based probing surgery costs less than deferred facility-based surgery, but is slightly less effective. Immediate intervention, when 50 percent to 90 percent of cases are expected to resolve on their own, may result in a shorter duration of symptoms. Varying the setting of intervention affected the cost. A change in the expected spontaneous resolution rate from 68 percent to 60 percent would increase the cost of success from a wait-and-see approach to $5,000. The authors conclude, "A more precise estimate of the spontaneous resolution rate of NLDO is critical for establishing which approach is the clinically or economically obvious choice or whether trade-offs between costs and outcomes need to be considered carefully."

###

(Arch Ophthalmol. 2011;129[5]:603-609. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was partially supported by a grant through a cooperative agreement with the National Eye Institute of the National Institutes of Health, Department of Health and Human Services. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact Kevin D. Frick, Ph.D., call Tim Parsons at 410-955-7619 or e-mail tmparson@jhsph.edu.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

END



ELSE PRESS RELEASES FROM THIS DATE:

Colonoscopy screenings may occur more often than recommended; benefit uncertain in some older adults

2011-05-10
Among Medicare beneficiaries, a large portion of colonoscopies for screening purposes are performed more frequently than recommended intervals. But among older patients treated at Veterans Affairs facilities, warranted follow-up colonoscopies for patients with positive fecal blood tests often do not occur, or cause burden when they do. These findings are from two reports posted online today that will appear in the August 8 print issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Colonoscopy, a screening test used for the detection of colorectal ...

ASG Bowl Partners With Walmart to Offer Discounted Prescription Drugs to Bowling Center Employees

2011-05-10
ASG Bowl, the Official Insurance Partner of Strike Ten Entertainment and the leading distributor of strategic insurance solutions for bowling proprietors nationwide, has announced an exclusive partnership with Walmart to offer discounted prescription pharmaceuticals to bowling proprietors. The program provides bowling center employees with access to more than 300 different prescription pharmaceuticals for just $4/prescription with a 30-day supply, and only $10/prescription with a 90-day supply. Prescription drugs that are currently not included in the program will still ...

Screening tool appears to increase pulmonary embolism diagnosis rate; no decrease in related deaths

2011-05-10
The introduction of multidetector row computed tomographic pulmonary angiography (CTPA) was associated with an apparent increase in the diagnosis of pulmonary embolism (PE), but with only minimal changes in mortality (death), suggesting the possibility of overdiagnosis, according to a report in the May 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. This article is part of the Less Is More series in the journal. Pulmonary embolism usually occurs when a blood clot blocks a blood vessel in the lungs. If not treated, PE can be fatal. Therefore, ...

Health professionals appear concerned about bias in commercially funded continuing medical education

2011-05-10
Commercial funding of continuing medical education (CME) and the potential for bias appear to concern many health care practitioners and researchers, but many reported being unwilling to pay higher fees to eliminate or offset commercial funding sources, according to a report in the May 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Although over the past several years, the role of pharmaceutical and medical device manufacturers in directing CME has been reduced, these entities still fund a substantial proportion of costs. Organizations such ...

Lotus Spas Delivers a New European Spa Range to the Block!

2011-05-10
Lotus Spas are proud to announce a new range of hot tubs to Europe. Our new range of spas is split into two collections both offering the highest build quality and standards of craftsmanship to bring a total of 8 different spas to the market. Engineered in Canada, the spas are built to withstand even the harshest of Canadian winters and they have been credited as being an "Energy Efficient Appliance" by the California Energy Commission (CEC), which is amongst the most stringent in the world, as well as complying with all European industry standards. All ...

Mayo Clinic studies how much practice makes perfect when performing colonoscopies

2011-05-10
ROCHESTER, Minn. - A colonoscopy is an invaluable procedure for detecting problems in the colon and rectum. Doctors can often diagnose gastrointestinal issues and even catch the warning signs of colorectal cancer. Perfecting the skills required for this delicate procedure takes practice. But just how much practice makes perfect? That was the question Robert E. Sedlack, M.D., and his Mayo Clinic research team set out to answer in their recently completed study of colorectal procedures. Their findings suggest much more practice is needed than gastroenterological professional ...

First human NOTES experience for sleeve gastrectomy at UCSD

2011-05-10
Sleeve gastrectomy, in which part of the stomach is removed, can be safe and effective when performed either transorally or transvaginally, according to researchers at the University of California, San Diego (UCSD) who are pioneering the surgery in the U.S. Natural orifice translumenal surgery® (NOTES) eliminates the need for a large incision for organ removal, which could increase risks for infection, incisional hernia and other problems. In their review of 14 morbidly obese patients who had undergone NOTES as part of a gastrectomy, the researchers found no complications. ...

Spencer Ivy to Provide Electric Biking Breaks with Holiday Firms

2011-05-10
Spencer Ivy launched their electric bikes in October 2010, with the aim to make cycling more accessible to people who are usually deterred due to the terrain or distance they need to cycle - whether it be for work or leisure. Expanding into the tourism industry was therefore a natural progression. Now, in addition to offering high quality and efficient electric bikes through its network of dealers in the UK and Spain, Spencer Ivy will also provide tourists with premier electric bike holidays through its partners in Wales and across the South of England. Drover Holidays ...

Oncolytic viruses effectively target and kill pancreatic cancer stem cells

2011-05-10
Oncolytic viruses quickly infect and kill cancer stem cells, which may provide a treatment for tumors that are resistant to conventional chemotherapy and radiation, particularly pancreatic cancer, according to new research from Memorial Sloan-Kettering Cancer Center in New York. The findings are especially important since pancreatic cancer has a poor prognosis and is difficult to detect and treat at early stages. Investigators led by Joyce Wong, MD, surgical researcher with Memorial Sloan-Kettering Cancer Center, investigated whether they could use oncolytic viruses, ...

UT Southwestern scientists unmask mysterious cells as key 'border patrol agents' in the intestine

2011-05-10
DALLAS – May 9, 2011 – Researchers at UT Southwestern Medical Center have uncovered new clues about how the intestine maintains friendly relations with the 100 trillion symbiotic bacteria that normally live in the digestive tract. Their latest findings, available online today and in a future edition of the Proceedings of the National Academy of Sciences, suggest that a once enigmatic cell population which lurks in the intestinal lining is essential for preventing friendly bacteria from invading into deeper tissue where they can cause debilitating conditions like inflammatory ...

LAST 30 PRESS RELEASES:

Breakthrough study reveals bumetanide treatment restores early social communication in fragile X syndrome mouse model

Neuroscience leader reveals oxytocin's crucial role beyond the 'love hormone' label

Twelve questions to ask your doctor for better brain health in the new year

Microelectronics Science Research Centers to lead charge on next-generation designs and prototypes

Study identifies genetic cause for yellow nail syndrome

New drug to prevent migraine may start working right away

Good news for people with MS: COVID-19 infection not tied to worsening symptoms

Department of Energy announces $179 million for Microelectronics Science Research Centers

Human-related activities continue to threaten global climate and productivity

Public shows greater acceptance of RSV vaccine as vaccine hesitancy appears to have plateaued

Unraveling the power and influence of language

Gene editing tool reduces Alzheimer’s plaque precursor in mice

TNF inhibitors prevent complications in kids with Crohn's disease, recommended as first-line therapies

Twisted Edison: Bright, elliptically polarized incandescent light

Structural cell protein also directly regulates gene transcription

Breaking boundaries: Researchers isolate quantum coherence in classical light systems

Brain map clarifies neuronal connectivity behind motor function

Researchers find compromised indoor air in homes following Marshall Fire

Months after Colorado's Marshall Fire, residents of surviving homes reported health symptoms, poor air quality

Identification of chemical constituents and blood-absorbed components of Shenqi Fuzheng extract based on UPLC-triple-TOF/MS technology

'Glass fences' hinder Japanese female faculty in international research, study finds

Vector winds forecast by numerical weather prediction models still in need of optimization

New research identifies key cellular mechanism driving Alzheimer’s disease

Trends in buprenorphine dispensing among adolescents and young adults in the US

Emergency department physicians vary widely in their likelihood of hospitalizing a patient, even within the same facility

Firearm and motor vehicle pediatric deaths— intersections of age, sex, race, and ethnicity

Association of state cannabis legalization with cannabis use disorder and cannabis poisoning

Gestational hypertension, preeclampsia, and eclampsia and future neurological disorders

Adoption of “hospital-at-home” programs remains concentrated among larger, urban, not-for-profit and academic hospitals

Unlocking the mysteries of the human gut

[Press-News.org] Study evaluates cost-effectiveness of strategies to treat infant tear-duct obstruction