Perspective: Coupling Policymaking with Evaluation- The Case of the Opioid Crisis

The authors examine various opioid-control interventions to evaluate their effects.  These policies and interventions include prescription drug monitoring programs (PDMPs), prescription limits, restrictions on doctor shopping, abuse-deterrant formulations, and notification letters for high-volume prescribers.  The article does not shy away from describing ineffective or mixed results. 

The full article can be viewed below.  

The Opioid Epidemic: Data-Driven Case Studies

The KPMG Government Institute released an issue brief covering the opioid epidemic.  This provides context and background while also highlighting data-driven success stories from Rhode Island, Massachusetts, Pennsylvania, Oklahoma.

The full brief is below.  

Opioid Use Disorder: Endpoints for Demonstrating Effectiveness of Drugs for Medication-Assisted Treatment Guidance for Industry

This draft guidance, when finalized, will represent the current thinking of the Food and Drug Administration (FDA or Agency) on this topic. This guidance is intended to assist sponsors in developing drugs for medication-assisted treatment of opioid use disorder (OUD). This guidance addresses the clinical endpoints acceptable to demonstrate effectiveness of such drugs.

The full draft can be viewed below.  

Minimizing inequality in access to precision medicine in breast cancer by real-time population-based molecular analysis in the SCAN-B initiative

Selection of systemic therapy for primary breast cancer is currently based on clinical biomarkers along with stage. Novel genomic tests are continuously being introduced as more precise tools for guidance of therapy, although they are often developed for specific patient subgroups. The Sweden Cancerome Analysis Network – Breast (SCAN‐B) initiative aims to include all patients with breast cancer for tumour genomic analysis, and to deliver molecular subtype and mutational data back to the treating physician. An infrastructure for collection of blood and fresh tumour tissue from all patients newly diagnosed with breast cancer was set up in 2010, initially including seven hospitals within the southern Sweden regional catchment area, which has 1.8 million inhabitants. Inclusion of patients was implemented into routine clinical care, with collection of tumour tissue at local pathology departments for transport to the central laboratory, where routines for rapid sample processing, RNA sequencing and biomarker reporting were developed. More than 10 000 patients from nine hospitals have currently consented to inclusion in SCAN‐B with high (90 per cent) inclusion rates from both university and secondary hospitals. Tumour samples and successful RNA sequencing are being obtained from more than 70 per cent of patients, showing excellent representation compared with the national quality registry as a truly population‐based cohort. Molecular biomarker reports can be delivered to multidisciplinary conferences within 1 week. Population‐based collection of fresh tumour tissue is feasible given a decisive joint effort between academia and collaborative healthcare groups, and with governmental support. An infrastructure for genomic analysis and prompt data output paves the way for novel systemic therapy for patients from all hospitals, irrespective of size and location.

The full article can be viewed below.

We live in a world that’s connected wirelessly with almost as many cellular phone subscriptions as there are people on the planet. According to the International Telecommunication Union, there were almost 6 billion mobile phones in use worldwide in late 2011.1 The ubiquity of mobile technology offers tremendous opportunities for the healthcare industry to address one of the most pressing global challenges: making healthcare more accessible, faster, better and cheaper.
Unlike many other forms of communication, such as the Internet, mobile health (mHealth) will likely have a greater effect on how care is delivered for three reasons:

• Mobile devices are ubiquitous and personal;

• Competition will continue to drive lower pricing and increase functionality; and

• Mobility by its very nature implies that users are always part of a network, which radically increases the variety, velocity, volume and value of information they send and receive.

Click below to read the full study.

Stem the Tide: Addressing the Opioid Epidemic

Every day, hospitals and health systems see the effects of the nation’s opioid epidemic. According to the Centers for Disease Control and Prevention, more than 33,000 people died from an opioid-related overdose in 2015. That’s more than 90 people a day or approximately four people each hour. There are also financial implications due to increased health care and substance use disorder treatment costs, lost productivity and costs to the criminal justice system, estimated to be $78.5 billion in 2016. Across the U.S., hospitals and health systems are working to address this public health crisis. To help in their efforts, the American Hospital Association developed this toolkit to provide guidance and resources to hospitals and health systems on how to work with patients, clinicians and communities to stem the opioid epidemic. From working on the front lines of the emergency department to connecting patients with treatment and recovery resources in their communities, the nation’s hospitals and health systems are partnering with community organizations and providers to address the opioid epidemic on a daily basis.  Recognizing the multifaceted role of hospitals and health systems, the AHA developed this toolkit with input from a multidisciplinary team, including representatives from nursing, risk management, physician leadership, research and the AHA’s Section for Psychiatric and Substance Abuse Services and Committee on Clinical Leadership. In addition, we vetted the resources with subject matter experts, including psychiatrists specializing in addictions, chief clinical officers and other clinical experts, pain management professionals, and a broad array of stakeholders. This toolkit will be updated regularly to help the field move forward in addressing the opioid epidemic in communities.

The full toolkit can be viewed below.  

Abstract

Importance: Patients with cancer who die soon after starting chemotherapy incur costs of treatment without the benefits. Accurately predicting mortality risk before administering chemotherapy is important, but few patient data–driven tools exist.

Objective: To create and validate a machine learning model that predicts mortality in a general oncology cohort starting new chemotherapy, using only data available before the first day of treatment.