8 results on '"Michael Grabner"'
Search Results
2. Reliability of Conclusions from Early Analyses of Real-World Data for Newly Approved Drugs in Advanced Gastric Cancer in the United States
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Michael Grabner, Astra M. Liepa, Zhanglin Lin Cui, William R. Schelman, Liya Wang, Lisa M. Hess, Lee Bowman, and Xiaohong Ivy Li
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medicine.medical_specialty ,business.industry ,Clinical study design ,Psychological intervention ,MEDLINE ,Cancer ,Retrospective cohort study ,medicine.disease ,Approved drug ,Ramucirumab ,Trastuzumab ,medicine ,Intensive care medicine ,business ,medicine.drug - Abstract
Background As real-world data resources expand and improve, there will increasingly be opportunities to study the effectiveness of interventions. There is a need to ensure that study designs explore potential sources of bias and either acknowledge or mitigate them, in order to improve the accuracy of findings. The objective of this study was to understand newly approved drug utilization patterns in real-world clinical settings over time. Methods This retrospective study included three sources of real-world data (claims, electronic health records, and recoded data from a quality care program) collected from patients diagnosed with gastric cancer who initiated therapy with either trastuzumab or ramucirumab. Linear regression was used to investigate trends in the use of these drugs for the care of patients with gastric cancer over time from Food and Drug Administration (FDA) approval. Results Eligible patients (n=1700) had consistent demographic and clinical characteristics over time. After regulatory approval, trastuzumab was used in later lines of therapy and then shifted to earlier lines (p=0.002), while ramucirumab utilization remained consistent over time after FDA approval (p=0.49). Ramucirumab augmentation, defined as the addition of the drug after initiation of a line of therapy, decreased over time (p=0.03), and trastuzumab augmentation remained consistent over time (p=0.58). Conclusion Since treatment effectiveness may change across lines of treatment, bias may arise if there are changes in the use of the drug (such as line migration) during the time period of analysis using real-world data.
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- 2020
3. Basal Insulin Initiation and Maintenance in Adults with Type 2 Diabetes Mellitus in the United States
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Magaly Perez-Nieves, Beverly Reed, Irene Hadjiyianni, Samaneh Kalirai, Lawrence Fisher, Michael Grabner, Judith J. Stephenson, Roy Daniel Pollom, Caroline Geremakis, and Jasmina I. Ivanova
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Pharmacology ,Blood glucose monitoring ,Research design ,Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Insulin ,medicine.medical_treatment ,Type 2 Diabetes Mellitus ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Medication Persistence ,Intervention (counseling) ,Internal Medicine ,medicine ,medicine.symptom ,business ,Weight gain - Abstract
Objective A survey of US adults with type 2 diabetes mellitus was conducted to better understand patients' insulin initiation experiences and treatment persistence behaviors. Research design and methods Participants were recruited from consumer panels and grouped by basal insulin treatment pattern: continuers (no gap of ≥7 days within 6 months of initiation); interrupters (gap ≥7 days, resumed treatment); discontinuers (stopped for ≥7 days, not resumed). A quota of approximately 50 respondents per persistence category was set. Results A total of 154 respondents (52 continuers, 52 interrupters, 50 discontinuers) completed the survey. Mean age was 51.4 years; 51.9% male. Continuers were more likely to report their views being considered during initiation, and less likely to report a sense of failure. Concerns included insulin dependence (64.3% agree/strongly agree), frequent blood glucose monitoring (55.2%), costs/ability to pay (53.9%), fears of or mistakes during self-injection (52.6%), and weight gain (52.6%). Continuers were motivated by benefits of insulin therapy; experienced or potential side effects were notable factors for interruption/discontinuation. Healthcare provider instruction was indicated as a reason for continuing, stopping, and restarting therapy. Conclusion Benefits of basal insulin therapy motivated continuers while side effects impacted interruption/discontinuation. Persistence on basal insulin is often influenced by provider actions. Earlier provider intervention upon signs of treatment discontinuation may promote persistence.
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- 2020
4. Occurrence and Characteristics of Hospitalizations During First-Line Chemotherapy Among Individuals with Metastatic Colorectal Cancer
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Michael Eleff, Joseph Singer, David M. Kern, John Barron, Collin Churchill, Michael J. Fisch, Stewart Wetmore, Michael Grabner, Daniel S. Mytelka, Amit D. Raval, and Lee Bowman
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0301 basic medicine ,medicine.medical_specialty ,Univariate analysis ,Bevacizumab ,Colorectal cancer ,business.industry ,Retrospective cohort study ,Emergency department ,Neutropenia ,medicine.disease ,Oxaliplatin ,Irinotecan ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,business ,medicine.drug - Abstract
Objective Choosing chemotherapy for metastatic colorectal cancer (mCRC) requires balancing clinical effectiveness and risk of complications. This study characterized real-world inpatient/emergency department (ED) hospitalizations during first-line chemotherapy among individuals with mCRC. Methods This retrospective cohort study used data from medical and pharmacy claims. All patients had mCRC with ≥1 claim for ≥1 of the 5 most frequently utilized first-line chemotherapy agents (fluorouracil, oxaliplatin, bevacizumab, irinotecan, capecitabine). The main outcome was all-cause hospitalizations (inpatient or ED setting) identified from claims via ICD-9/10-CM coding from index date until 30 days after the end of first-line chemotherapy or last available data. Results A total of 717 individuals (mean age 55 years; 58% male; ECOG 0/1/2+/missing in 44%/39%/6%/11%; median follow-up 116 days) met study criteria. Thirty-four distinct chemotherapy regimens were used. Overall, 40% of patients had ≥1 hospitalization (n=285; total 415 hospitalizations); 12% (n=85) had ≥2 hospitalizations. The median time to first hospitalization was 52 days; median inpatient length of stay was 4 days; infections/neutropenia (21%) and bowel-related complications (17%) were the most common issues associated with inpatient hospitalizations. In univariate analyses, insurance plan type, geographical location, ECOG, and renal disease were associated with hospitalization. In multivariable analyses, ECOG ≥1 was associated with a 67% increase (p
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- 2020
5. Clinical characteristics, patterns of lipid-lowering medication use, and health care resource utilization and costs among patients with atherosclerotic cardiovascular disease
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Mark J. Cziraky, Michael Grabner, Thomas Power, Xuehua Ke, John Barron, Peter P. Toth, Nicole Bonine, Burkhard Vangerow, Zhenxiang Zhao, and Ralph Quimbo
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Male ,Time Factors ,Databases, Factual ,Endocrinology, Diabetes and Metabolism ,030204 cardiovascular system & hematology ,lipid-lowering medications ,Drug Utilization Review ,0302 clinical medicine ,Health care ,Pharmacology (medical) ,guidelines ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Hypolipidemic Agents ,Original Research ,Medication use ,Atherosclerotic cardiovascular disease ,Hematology ,General Medicine ,Middle Aged ,Lipids ,Treatment Outcome ,treatment patterns ,health care resource utilization and costs ,Practice Guidelines as Topic ,Health Resources ,Female ,Guideline Adherence ,Lipid lowering ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Drug Costs ,Medication Adherence ,statins ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,real-world evidence ,Aged ,Retrospective Studies ,low-density lipoprotein cholesterol ,business.industry ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,Atherosclerosis ,United States ,Vascular Health and Risk Management ,Residual risk ,Managed care ,business ,Biomarkers ,ASCVD ,Resource utilization - Abstract
Thomas P Power,1 Xuehua Ke,2 Zhenxiang Zhao,3 Nicole Gidaya Bonine,2 Mark J Cziraky,2 Michael Grabner,2 John J Barron,2 Ralph Quimbo,2 Burkhard Vangerow,3 Peter P Toth4,5 1AIM Specialty Health, Chicago, IL, 2HealthCore, Inc., Wilmington, DE, 3Eli Lilly and Company, Indianapolis, IN, 4CGH Medical Center, Sterling, IL, 5Johns Hopkins University School of Medicine, Baltimore, MD, USA Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment.Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA. Patients had ≥12-month pre-index (baseline) and ≥12-month post-index (follow-up) health plan enrollment and no baseline lipid-lowering medication (LLM). Patient characteristics, LLM utilization patterns, HCRU, and costs were examined for all patients and by subgroups based on LLM use pattern and/or follow-up low-density lipoprotein cholesterol (LDL-C) levels.Results: A total of 128,017 ASCVD patients were identified with a mean (SD) age of 59 (13) years, 43.1% female, and 48.8% with ≥36-month follow-up. Within 12-month follow-up, 10.6% had high-intensity statins and 56.9% had no LLM fills. Baseline mean (SD) all-cause costs were $8,852 ($25,608). At 12-month follow-up, mean (SD) all-cause and ASCVD-related costs were $31,443 ($54,040) and $20,289 ($45,159), respectively. The 36-month analyses showed similar distributions. Multivariable analyses showed that age, gender, region, health insurance type, baseline comorbidities, baseline use of specific medications, baseline lipid profiles, and index ASCVD type were significantly associated with all-cause and ASCVD-related health care costs.Conclusion: Patients have nonoptimal treatment for ASCVD and substantial HCRU and costs associated with residual risk. Unmet needs and cost burdens of ASCVD patients merit additional investigation. Keywords: ASCVD, low-density lipoprotein cholesterol, lipid-lowering medications, health care resource utilization and costs, statins, treatment patterns, guidelines, real-world evidence
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- 2018
6. Real-world effectiveness, adherence and persistence among patients with type 2 diabetes mellitus initiating dulaglutide treatment
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Michael Grabner, Anita Y. M. Kwan, Laura Fernández Landó, Reema Mody, Maria Yu, Ralph M Turner, and Whitney York
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Adult ,Blood Glucose ,Male ,Agonist ,medicine.medical_specialty ,medicine.drug_class ,Recombinant Fusion Proteins ,Glucagon-Like Peptides ,Once weekly ,030209 endocrinology & metabolism ,Drug Administration Schedule ,Persistence (computer science) ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Hypoglycemic Agents ,030212 general & internal medicine ,Retrospective Studies ,Glycemic ,business.industry ,Type 2 Diabetes Mellitus ,General Medicine ,Middle Aged ,Immunoglobulin Fc Fragments ,Diabetes Mellitus, Type 2 ,Female ,Dulaglutide ,business ,medicine.drug - Abstract
To assess glycemic effectiveness, adherence and persistence within 6 months of treatment initiation with dulaglutide, a once weekly GLP-1 receptor agonist, in a US real-world setting.This retrospective claims analysis included adults (≥18 years) with T2DM from the HealthCore Integrated Research Database, who had HbA1c laboratory results around initiation and within 6 months after initiation. Glycemic control was assessed by change in HbA1c from pre-initiation to post-initiation. Patients were considered adherent if their proportion of days covered (PDC) was ≥0.80; persistence was measured as days of continuous therapy from initiation to 6 months after initiation with no gaps45 days between fills.Of the 308 analyzed patients, the majority (n = 188; 61%) were adherent to dulaglutide (mean PDC 0.76; SD 0.26), with 115 patients (37%) discontinuing treatment. Mean persistence was 152 days/5 months. Mean HbA1c decreased from 8.49% (SD 1.70, median 8.20%) at baseline to 7.59% (SD 1.51, median 7.30%) at follow-up, corresponding to a mean HbA1c change of -0.90% (95% confidence interval [CI] -1.08 to -0.73; p .01; median -0.70%). Patients who were adherent to or persistent with dulaglutide experienced larger reductions (-1.14% and -1.12% respectively), as did those without prior GLP-1 RA use (-1.03%). The proportion of patients with HbA1c7% increased from 18% to 40%.Dulaglutide was associated with a significant decrease in HbA1c levels 6 months after treatment initiation. Patients who adhered to or persisted with dulaglutide therapy, or were naïve to GLP-1 RA use, experienced greater decreases in HbA1c levels.
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- 2018
7. Stories about building history told by wooden elements – case studies from Eastern Austria
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Günther Buchinger, Michael Grabner, and Markus Jeitler
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0106 biological sciences ,Engineering ,010504 meteorology & atmospheric sciences ,Visual Arts and Performing Arts ,business.industry ,Conservation ,Felling ,01 natural sciences ,Archaeology ,Drying time ,Architecture ,Dendrochronology ,business ,River danube ,010606 plant biology & botany ,0105 earth and related environmental sciences - Abstract
The intention of this article is to show the benefit of an interdisciplinary approach within the various disciplines of building research (architectural archeology, art history, archive research, dendrochronology, etc.).The exact determination of the age of historical timber is undoubtedly the most important contribution of dendrochronology to building research. The significance of dendrochronological dates is discussed in detail—problems of reuse, repair, drying time, and differences between felling and building dates are demonstrated. Several case studies in Eastern Austria showed a difference of two to four years between felling and building.To answer questions of where the timber came from, dendroprovenancing was introduced to Eastern Austria. First results showed that it will be possible to differentiate the origin of timber between Eastern Austria and regions where rafts started towards Vienna, via the river Danube. The results showed that it is important to combine building archaeology and ...
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- 2017
8. Genetic parameters of growth and wood quality traits inPicea abies
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Michael Grabner, Guillaume Chantre, Helena Pereira, Gwynn Lloyd Jones, Rupert Wimmer, Ulrich Müller, Sabine Rosner, José Carlos Rodrigues, Bo Karlsson, Björn Hannrup, Philippe Rozenberg, Isabelle Le Bayon, Lars Wilhelmsson, Christine Cahalan, Research Institute, University of Wales, Association Forêt Cellulose (AFOCEL), Universität für Bodenkultur Wien [Vienne, Autriche] (BOKU), Centre Technique du Bois et de l'Ameublement, Universidade Técnica de Lisboa, Universidade de Lisboa (ULISBOA), Unité de recherche Amélioration, Génétique et Physiologie Forestières (AGPF), and Institut National de la Recherche Agronomique (INRA)
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0106 biological sciences ,Coefficient of variation ,HERITABILITE ,Biology ,complex mixtures ,01 natural sciences ,DENSITE DU BOIS ,RENDEMENT EN PATE ,chemistry.chemical_compound ,ANGLE DU FIL DU BOIS ,[SDV.SA.SF]Life Sciences [q-bio]/Agricultural sciences/Silviculture, forestry ,Genetic variation ,Botany ,Lignin ,Gene–environment interaction ,040101 forestry ,EPICEA COMMUN ,technology, industry, and agriculture ,DIMENSION DES TRACHEIDES ,Forestry ,Picea abies ,04 agricultural and veterinary sciences ,biology.organism_classification ,CORRELATION GENETIQUE ,Lumen Diameter ,Horticulture ,chemistry ,PROPRIETE DU BOIS ,Tracheid ,0401 agriculture, forestry, and fisheries ,010606 plant biology & botany - Abstract
International audience; Genetic parameters were estimated for wood and growth traits in two 19-yr-old clonal trials and a 40-yr-old full-sib progeny trial of Norway spruce [Picea abies (L.) Karst.]. In the clonal trials high (>0.4) broad-sense heritabilities were found for wood density traits, lignin content, number of internal cracks, growth traits, spiral grain and number of resin canals. Moderate (0.2-0.4) heritabilities were found for tracheid lumen diameter and cell wall thickness, microfibril angle and tracheid length, while low heritabilities (
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- 2004
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