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Cite this article as: Bhatt N, Turakhia M, Fogarty T J. (August 01, 2016) Cost-Effectiveness of Cardiac Radiosurgery for Atrial Fibrillation: Implications for Reducing Health Care Morbidity, Utilization, and Costs. Cureus 8(8): e720. doi:10.7759/cureus.720
In the United States(U.S.), atrial fibrillation (AF) is the second-most common cardiovascular condition after hypertension, affecting four million Americans each year. Individuals with AF are three times more likely to be hospitalized over the span of a year when compared to medically matched control groups. The considerably large clinical population of individuals with AF mandates that the cost-effectiveness and efficacy of current treatment regimens for AF have egregious implications for health care spending and public health. Unfortunately, catheter ablation for AF treatment has been shown to make only modest gains in quality-adjusted life years, has yet to demonstrate cost-utility advantages over conventional therapies for AF, and has a reported rate of recurrence for AF that is notably high. Thus, there is a major unmet clinical need for a therapeutic option to treat AF that produces more consistent and efficacious results that are cost-effective. Cardiac radiosurgery as a therapy for AF has the potential to be remarkably cost-effective and produce robust patient outcomes. CyberHeart Inc. has developed the world’s first-ever cardiac radiosurgery (CRS) system designed to ablate the heart non-invasively. Procedures that ablate the heart utilizing the Cyberheart CRS system are anticipated to allow higher efficacy and more consistent results than current techniques such as catheter ablation. The aim of this study is to present the current healthcare utilization and expenditures in AF treatment, report the cost-effectiveness of catheter ablation for AF, and project the potential cost-effectiveness of cardiac radiosurgery for the treatment of AF.
Patients with AF have a multitude of cost determinants and are observed to have notably high health care utilization and expenditures. AF has been reported to account for 350,000 hospitalizations, 5 million office visits, and 276,000 emergency room visits over a one-year period, and is a major driver of healthcare costs in the U.S. and worldwide . In the U.S. it is estimated that AF resulted in $16 billion in costs to Medicare alone for newly diagnosed patients and in the European Union (E.U). It has been approximated that expenditures on AF are more than €13.5 billion [27, 29]. Approximations of the average cost for a patient in the U.S. with AF per year range from $20,613 to $40,169 . Individuals with AF are three times more likely to be hospitalized over the span of a year when compared to medically matched control groups . Consequently, the cost-effectiveness and efficacy of AF treatment are tremendously important for the future of healthcare spending.
There is a major unmet clinical need for a therapeutic option to treat AF that produces more consistent and efficacious results, yielding lower complication rates, and allows treatment to be more cost-effective. Catheter ablation as a therapy to restore sinus rhythm to patients with AF has a reported rate of recurrence that ranges between 50-80% for one to three years after the initial procedure. The reported amount of patients that do not have AF recurrence after undergoing a catheter ablation after five years has been reported to be 59.4% [4, 20, 23, 34]. Because the greater majority of patients that have AF recurrence do not require hospitalization, it is likely that the already notably high recurrence rate of catheter ablation is even higher than the rate of recurrence reported in the literature. Such a high recurrence rate necessitates that repeat ablation procedures are performed to treat AF, which unfortunately have higher risks for complications and increase total costs for patients. Accordingly, studies on the cost-effectiveness of catheter ablation for AF have displayed that it is not economically beneficial or cost-effective as a first-line therapy for patients that are older than 50 years [28, 39].
Cardiac radiosurgery has a tremendous potential to provide therapy for AF that results in improved clinical outcomes that are more cost-effective than current treatment options for AF. CyberKnife SRS has already been established to be cost-effective for the treatment of intracranial neoplasms and cancer metastases located on the body [46, 47, 49]. CyberHeart CRS system is a cutting edge technology that delivers radiation to cardiac targets with impeccable accuracy to non-invasively ablate the heart. Because its proprietary technology allows clinicians to use an anatomic approach and predetermine the exact size and shape of the cardiac ablation on a computer program, procedures that ablate the heart utilizing the Cyberheart CRS system are anticipated to allow higher efficacy and more consistent results than current techniques such as catheter ablation. In addition to providing improved clinical outcomes, CyberHeart procedures for the treatment of AF are projected to be less expensive than catheter ablation procedures. A CyberHeart procedure for AF has an expected Medicare reimbursement of $8,000, which is comparably lower than the reported $12,500 Medicare reimbursement of catheter ablation for AF. The anticipated decrease in costs for a CyberHeart procedure for AF occurs because CRS does not require cardiac anesthesia, cardiothoracic surgical backup, or other support that is required for catheter ablation. While current research is ongoing to further validate the efficacy of the CyberHeart CRS system in an FDA approved clinical investigation, the benefits of non-invasively ablating the heart with CRS to treat AF in a cost-effective manner will undoubtedly have incredible implications that can radically improve the lives of the millions of individuals that suffer from symptomatic AF.
Summary: Researchers announce a new study that aims to identify new biomarkers that can be detected during the earliest stages of Alzheimer’s disease.
Source: University of Oxford.
A new multimillion pound study, which will see the most thorough and rigorous series of tests to detect Alzheimer’s disease ever performed on volunteers, is announced today (Monday 22 August). The Deep and Frequent Phenotyping study is funded by the National Institute of Health Research and the MRC and hopes to dramatically improve the success rate of clinical trials for treatments in Alzheimer’s disease.
This landmark £6.9million research project has been designed to identify measurable characteristics, known as biomarkers, which can detect the occurrence of Alzheimer’s disease very early on in the progression of the disease – when a person may have no obvious symptoms./.../
Between 2002 and 2012, 99% of clinical trials into treatments for Alzheimer’s disease failed.
The tests will include wearable devices that will give researchers detailed information on people’s movement and gait, and sophisticated retinal imaging that will look at subtle changes affecting a person’s central and peripheral vision.
An estimated 46.8m people worldwide were living with dementia in 2015, and with an ageing population in most developed countries, predictions suggest this number may double by 2050. Currently, there is no known cure for the disease, and few treatments which are available treat symptoms of the disease, rather than slow or stop its progression.
Alert from my friend Stephen Leeder - News release
17 AUGUST 2016 | GENEVA -WHO has today named Mr Michael R. Bloomberg, philanthropist and former three-term Mayor of the City of New York, as Global Ambassador for Noncommunicable Diseases (NCDs).
NCDs (including heart disease, stroke, cancer, diabetes and chronic respiratory diseases) and injuries are responsible for 43 million deaths each year - almost 80% of all deaths worldwide. Each year, 16 million people die from NCDs before the age of 70. Road traffic crashes account for a further 1.25 million deaths each year and are the leading cause of death among young people, aged 15–29 years. The premature death and disability from NCDs and injury can largely be prevented, through implementing proven, cost effective measures.
For the past decade, Bloomberg has been working with WHO on tobacco control and injury prevention. “Michael Bloomberg is a valued partner and has a long track record of supporting WHO in the areas of tobacco control, improving data for health, road safety and drowning prevention,” said Dr Margaret Chan, WHO Director-General. “I am therefore absolutely delighted to be able to appoint him as Global Ambassador for Noncommunicable Diseases. This will enable us to strengthen our response together to the major public health challenges of NCDs and injuries.”/.../
Aloyzio AchuttiemAMICOR - Há 15 horasGlobal, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 *Dataset* · January 2015 - 1st Mohsen Naghavi - 2nd Haidong Wang 39.64 · University of Washington Seattle - + 709 3rd Rafael Lozano 45.02 · University of Washington Seattle - Last Christopher J. L. Murray Show more authors *Abstract* Figure appendix 1: Probability of death from birth to exact age 15 years (15q0) by country and sex for major causes in 2013. An interactive versi...mais »
Lo And Behold, Reveries Of The Connected World August 19, 2016 by Amara D. Angelica [image: LO AND BEHOLD] In the movie “Lo and Behold, Reveries Of The Connected World,” released today, legendary documentarian Werner Herzog discovers and explores the internet in a series of ten impressionistic vignettes. These range from internet pioneers (Leonard Kleinrock, Robert Kahn, Danny Hillis), AI/roboticists (Sebastian Thrun, Tom Mitchell, “Raj” Rajkumar, Joydeep Biswas), and Mars explorers (with Elon Musk — … more…
Mayo Clinic, collaborators working to advance aging research via clinical trials August 19, 2016 [image: (credit: iStock)] Aging is the largest risk factor for most chronic diseases, and care for the elderly currently accounts for 43 percent of the total health care spending in the U.S. --- about 1 trillion dollars a year Mayo Clinic and other members of the Geroscience Network* have developed strategies for taking new drugs to clinical trials — specifically, drugs that target processes underlying multiple age-related diseases and disabilities. And they’ve written six supporting ar...mais »
Neuroscientists identify cortical links to adrenal medulla (mind-body connection) August 19, 2016 [image: Cortical pathways to the adrenal medulla. Cortical areas on the lateral surface and the medial wall of the hemisphere are the source of neurons that influence the adrenal medulla. (credit: Richard P. Dum et al./PNAS)] May help explain why meditation and exercises such as yoga and Pilates can be helpful in dealing with stress Neuroscientists at the University of Pittsburgh have identified the neural networks that connect the cerebral cortex to the adrenal medulla — the inner pa...mais »
Medscape Medical News > Neurology Calcium Supplements Linked to Dementia in CVD Pauline Anderson August 17, 2016 Elderly women who take calcium supplements and had a history of stroke or white matter lesions (WMLs) may face an increased risk for dementia, a new study suggests. Although it's too soon to make recommendations based on these new findings, clinicians may want to consider this new information in older patients who have had a stroke, said co-lead author Silke Kern, MD, PhD, Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory, Department of Psychiatry an...mais »
*Alzheimer's / Dementia News* Could memory loss be reversed with a common painkiller? 11 Aug 2016 Poor protein control key to Alzheimer's progression 11 Aug 2016 Mediterranean diet may slow cognitive decline, prevent Alzheimer's 10 Aug 2016
- Academy eBriefings - Microbes in the CityMapping the Urban Genome - Overview - Meeting Report ▼ - Media - Resources - Speakers - Sponsorship Keynote Speakers: Jo Handelsman (White House Office of Science and Technology Policy), W. Ian Lipkin (Columbia University), Curtis Huttenhower (Harvard T.H. Chan School of Public Health), and Coby Schal (North Carolina State University)Presented by New York University and the New York Academy of Sciences Reported by Alan Dove | Posted March 16, 2016 Overview At the New York Acad...mais »
Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals FREE Stephen Sidney, MD, MPH1; Charles P. Quesenberry Jr, PhD1; Marc G. Jaffe, MD 2; Michael Sorel, MPH1; Mai N. Nguyen-Huynh, MD3; Lawrence H. Kushi, ScD1; Alan S. Go, MD1,4,5; Jamal S. Rana, MD, PhD1,6,7 [+] Author Affiliations *JAMA Cardiol. *2016;1(5):594-599. doi:10.1001/jamacardio.2016.1326. Text Size: A A A Article Figures Tables Supplemental Content References Comments ABSTRACT ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS |ARTICLE INFORMATION | REFERENCES *Importance* ...mais »
[image: Edge.org] Edge.orgCONVERSATIONS - VIDEOS - ANNUAL QUESTION - EVENTS - NEWS - LIBRARY - ABOUT Summer Reading: Highlights From the Edge Archive *"Deliciously creative, the variety astonishes. Intellectual skyrockets of stunning brilliance. Nobody in the world is doing what *Edge* is doing...the greatest virtual research university in the world.* — Denis Dutton, Founding Editor, *Arts & Letters Daily* [ED NOTE: It’s summer and a good time to reflect on twenty years of *Edge*. Each week through the rest of the season, we will revisit five highlights from the *Edg...mais »
Back Up Plans May Prevent You From Achieving Your Goals NEUROSCIENCE NEWSAUGUST 16, 2016 *Summary: According to researchers, making backup plans can reduce goal performance and could hurt your chances of achieving your ultimate goal.* *Source: University of Wisconsin-Madison.* *When it comes to setting organizational and personal goals, making a backup plan has been seen as a sensible way to deal with uncertainty — to be prepared if things don’t go as expected.* However, new research from the Wisconsin School of Business at the University of Wisconsin–Madison challenges that conventiona...mais »
[image: exercise benefits] Exercise Beneficial Effects Change With Your Age Milla Bengtsson June 8, 2016 For older adults, a 30-minute workout may not be as effective, even at the cellular level, as it was when you were younger. Age, according to a new study, may be an important part of a cell’s ability to respond to activity. In the study, led by Tinna Traustadóttir of Northern Arizona University, a group of men ages 18 to 30 were tested against a group of older men 55 years and older. Study participants were generally healthy, non-smokers, who were not taking antioxidant supplement...mais »
Chronic Pain Linked to Partners of People With Depression NEUROSCIENCE NEWSAUGUST 16, 2016 *Summary: A new study reports people with partners who suffer from depression are more likely to suffer from chronic pain.* *Source: University of Edinburgh.* *Partners of people with depression are more likely to suffer from chronic pain, research has found..* The study shows that the two conditions share common causes – some of which are genetic whilst other causes originate from the environment that partners share. Experts say their findings shed new light on the illnesses and could one day he...mais »
Aloyzio AchuttiemAMICOR - Há 4 dias[image: dna epithelial cell mitosis] ANK3 Gene Linked To Mood, Stress And Longevity Denise Rosenfeld May 24, 2016 The visible effects of depression and stress that can be seen in a person’s face, and contribute to shorter lives, can also be found in alterations in genetic activity, according to newly published research. In a series of studies involving both C. elegans worms and human cohorts, researchers from the Indiana University School of Medicine and the Scripps Research Institute have identified a series of genes that may modulate the effects of good or bad mood and response to ...mais »
DIABETES & ENDOCRINOLOGY PERSPECTIVE MORE - [image: Butter and Health: What Does the Evidence Say?]*Butter and Health: What Does the Evidence Say?*Is butter a dietary pleasure or a poison? Dr Boris Hansel reviews the latest evidence and the impact it has on nutritional advice. *Medscape Diabetes & Endocrinology*, August 12, 2016 12 comments *Editor's Note:* *The following is an edited commentary by endocrinologist-nutritionist Boris Hansel, MD, an obesity management specialist who practices in Paris, France. This commentary has been translated from French.* Butt...mais »
Exercise and Diet Can Reduce Build Up of Protein Linked to Alzheimer’sby Neuroscience News Researchers report a healthy diet, regular exercise and a normal BMI can help protect against the build up of proteins associated with Alzheimer's disease. Read more of this post
A Neural Basis For The Mind-Body Connection?by Neuroscience News Researchers have identified a neural network that connects the adrenal medulla to the cerebral cortex. [image: Image shows a brain.] *Read more of this post* *Neuroscience News* | August 15, 2016 at 2:49 pm | Tags: adrenal medulla, cerebral cortex,cognition, emotion, emotional stress, exercise, mid-body connection, motor funcion, neural networks, Neuroscience, Open Access, open science, stress, yoga | Categories: Featured,Neuroscience, Open Neuroscience Articles | URL: http://wp.me/p4sXNK-8Jy Comment See all comments ...mais »
Em comemoração ao Dia da Infância, celebrado em 24 de agosto, o projeto Vi-Vendo aplicará testes de visão em crianças entre 5 e 10 anos de idade. Os exames serão feitos na Capelania, que fica no Campus I da Universidade Católica de Pelotas (UCPel), das 9 às 11h e das 14 às 17h.
Todas as crianças com a faixa etária contemplada podem comparecer à programação. O exame é gratuito, mas serão aceitas doações de agasalhos ou um quilo de alimento não-perecível. No teste de visão é utilizada a Escala de Snellen e através dela as crianças são informadas se tem ou não problemas.
A aplicação do teste é simples, de baixo custo e pode ser feita em cerca de dois minutos. Para fazê-lo, é preciso a utilização de uma tabela (escala que utiliza a letra E em diversas posições) e que deve ficar a cinco metros da criança. O local também deve ser tranquilo e bem iluminado. Caso o teste aponte algum problema, ele deve ser repetido em um outro dia, por uma outra pessoa. Através do teste, que pode ser aplicado por qualquer pessoa treinada, suspeitas de déficit visual podem ser detectadas e preventivamente tratadas.
O exame faz parte do programa UCPel Mais Saudável, e virou projeto de lei, aprovado pela Câmara de Vereadores de Pelotas. No entanto, ainda falta regulamentação pela Prefeitura de Pelotas, que determinou a realização de estudo e planejamento para a implantação do programa com segurança e eficácia.
Figure appendix 1: Probability of death from birth to exact age 15 years (15q0) by country and sex for major causes in 2013. An interactive version of this figure is available at http://vizhub.healthdata.org/le. The set of causes is mutually exclusive and collectively exhaustive.Article