Nevilleroed5448

Background The bias implications of outcome misclassification arising from imperfect capture of mortality in claims-based studies are not well understood. Methods and Results We identified 2 cohorts of patients (1) type 2 diabetes mellitus (n=8.6 million), and (2) heart failure (n=3.1 million), from Medicare claims (2012-2016). Within the 2 cohorts, mortality was identified from claims using the following approaches (1) all-place all-cause mortality, (2) in-hospital all-cause mortality, (3) all-place cardiovascular mortality (based on diagnosis codes for a major cardiovascular event within 30 days of death date), or (4) in-hospital cardiovascular mortality, and compared against National Death Index identified mortality. Empirically identified sensitivity and specificity based on observed values in the 2 cohorts were used to conduct Monte Carlo simulations for treatment effect estimation under differential and nondifferential misclassification scenarios. From National Death Index, 1 544 805 deaths (549 996 [35.6%] cardiovascular deaths) in the type 2 diabetes mellitus cohort and 1 175 202 deaths (523 430 [44.5%] cardiovascular deaths) in the heart failure cohort were included. Sensitivity was 99.997% and 99.207% for the all-place all-cause mortality approach, whereas it was 27.71% and 33.71% for the in-hospital all-cause mortality approach in the type 2 diabetes mellitus and heart failure cohorts, respectively, with perfect positive predicted values. For all-place cardiovascular mortality, sensitivity was 52.01% in the type 2 diabetes mellitus cohort and 53.83% in the heart failure cohort with positive predicted values of 49.98% and 54.45%, respectively. Simulations suggested a possibility for substantial bias in treatment effects. Conclusions Approaches to identify mortality from claims had variable performance compared with the National Death Index. Investigators should anticipate the potential for bias from outcome misclassification when using administrative claims to capture mortality.The PROfound trial highlights that there is a benefit in testing genes involved in homologous recombination (HR) and forms the rationale for testing in all patients with metastatic, castration-resistant prostate cancer (mCRPC). This trial also demostrates that olaparib improves progression free survival (PFS), objective response rate (ORR), and time to pain progression in patients who harbor alterations in BRCA1, BRCA2, and ATM. These are groundbreaking findings - this is the first trial that demonstrates the efficacy of olaparib versus standard therapy in a genomically-selected patient population with metastatic prostate cancer. Although this trial does not demonstrate improvements in overall survival (OS), we believe that this may be an underestimation based on trial-design. Future studies of olaparib are likely to yield further promising results.

To examine the association between self-reported physical exercise and cognitive function.

Secondary data analysis of a prospective cohort study.

Community-dwelling older adults with normal cognitive function at baseline.

Data on self-reported physical exercise, immediate and delayed recall, clock drawing test, and orientation to time and current events were collected at baseline and annual follow-up visits. Generalized estimation equation method was used to determine the association between physical exercise and decline in cognitive function.

A total of 4,227 participants were included in the analysis, 58% women, 78% White, mean (SD) age 75.7 (7.1) years. The risk of cognitive decline was lower among those who reported moderate-to-high intensity exercise (odds ratio [OR] confidence interval [CI] = 0.45 [0.20, 0.69];

< .001) and low-intensity exercise (OR [CI] = 0.62 [0.44, 0.83]).

These results reaffirm the positive impact of physical exercise in maintaining cognitive function among older adults.

These results reaffirm the positive impact of physical exercise in maintaining cognitive function among older adults.

This study was performed to introduce an easy method of surgical smoke evacuation for patients with confirmed or suspected COVID-19 undergoing emergency surgery.

An easy, inexpensive, protective, and practical surgical smoke evacuation device/system was developed and is herein described.

The use of this surgical smoke evacuation device/system in open surgery is convenient and effective. It allows for easy, economic, useful, and protective surgical smoke evacuation.

COVID-19 infection causes direct mortality and morbidity, and its incidence has recently increased. Protection from electrosurgery-related smoke is recommended particularly during the current pandemic. see more This surgical smoke evacuation device/system is easy to use and provides a convenient and effective method of smoke evacuation during both open surgery and all cauterization interventions.

COVID-19 infection causes direct mortality and morbidity, and its incidence has recently increased. Protection from electrosurgery-related smoke is recommended particularly during the current pandemic. This surgical smoke evacuation device/system is easy to use and provides a convenient and effective method of smoke evacuation during both open surgery and all cauterization interventions.

The resistance exercise has drawn considerable attention to the level of insulin-like growth factor 1 in the serum. However, the relationship between resistance exercise and the level of insulin-like growth factor 1 in the serum is conflicting. This meta-analysis was performed to evaluate this relationship.

A systematic literature search up to May 2020 was performed and 22 studies were detected with 680 subjects. They reported relationships between resistance exercise and the level of insulin-like growth factor 1 in the serum. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated comparing the resistance exercise and the level of insulin-like growth factor 1 in the serum using the continuous method with a random or fixed-effect model.

Significantly higher insulin-like growth factor 1 was observed in subjects performing resistance training for less than 16weeks (OR, 4.03; 95% CI, 2.49-5.57,

<.001); subjects performing resistance training for more than 16weeks (OR, 11.55; 95% CI, 6.58-16.