1
|
Amir J, Chodick G, Pardo J. Revised Protocol for Secondary Prevention of Congenital Cytomegalovirus Infection With Valaciclovir Following Infection in Early Pregnancy. Clin Infect Dis 2023; 77:467-471. [PMID: 37157938 DOI: 10.1093/cid/ciad230] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND A previous randomized placebo-controlled study found valaciclovir to be effective in reducing the rate of vertical cytomegalovirus transmission from mother to fetus. The better results in women infected in the first trimester compared to the periconception period were attributed to the timing of treatment. The aim of the present study was to evaluate valaciclovir efficacy in this setting using a revised protocol. METHODS All pregnant women treated with valaciclovir in 2020-2022 who met the same criteria as in the original study were identified retrospectively from the database of the same medical center. Treatment, however, was initiated earlier: up to 9 weeks or 8 weeks from the presumed time of infection in women infected in the periconception period or the first trimester, respectively. The primary endpoint was rate of vertical cytomegalovirus transmission. Results were compared with the placebo arm in the previous study. RESULTS Among 178 women who completed valaciclovir treatment, amniocentesis was positive for cytomegalovirus in 14 women (7.9%), significantly (P < .001) lower compared with 14 of 47 (30%) in the placebo arm in the previous study. The proportion of positive amniocentesis in the valaciclovir was significantly lower than the placebo arm both among women infected in the first trimester (14/119 vs 11/23; odds ratio [OR] = 0.15; 95% confidence interval [CI]: .05-.45, P < .001), as well as among those infected in the periconception period (0/59 vs 3/24, OR = 0; 95% CI 0-.97, P = .02). CONCLUSIONS This study provides further evidence of the efficacy of valaciclovir in preventing vertical transmission of cytomegalovirus after primary maternal infection. Efficacy is improved with earlier treatment.
Collapse
Affiliation(s)
- Jacob Amir
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Chodick
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Pardo
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Ben-Aharon I, Rotem R, Cercek A, Half E, Goshen-Lago T, Chodick G, Kelsen D. 333P Pharmaceutical agents as potential drivers in development of early-onset colorectal cancer (EOCRC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
3
|
Apter L, Sharman Moser S, Wollner M, Chodick G, Siegelmann-Danieli N. EP08.02-017 Time on Treatment for Patients Treated With Anti-EGFR Tyrosine Kinase Therapy for Metastatic NSCLC: Real-World Experience Data. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
4
|
Machtinger R, Fallach N, Goldstein I, Chodick G, Schiff E, Orvieto R, Mashiach R. Ovarian stimulation for fertility treatments and risk of breast cancer: a matched cohort study. Hum Reprod 2021; 37:577-585. [PMID: 34871410 DOI: 10.1093/humrep/deab270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 10/17/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is there a difference in the breast cancer risk among women who underwent ART treatments compared to those who underwent medically assisted reproduction (MAR) infertility treatments or women of reproductive age in the general population? SUMMARY ANSWER The risk of breast cancer among women treated by ART was similar to the risk among women treated by MAR and women who did not undergo fertility treatments. WHAT IS KNOWN ALREADY Studies investigating breast cancer risk in women who have undergone fertility treatments have provided conflicting results. STUDY DESIGN, SIZE, DURATION A retrospective, population-based cohort study included women who underwent ART or MAR treatments and women who did not undergo fertility treatments from 1994 to 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Women who underwent ART were matched one to one with women who underwent MAR treatments and one to one with woman from the general population of reproductive age, by year of birth and year of first delivery or nulliparity status. MAR women were also matched to ART women by treatment initiation calendar year. All included women were members of Maccabi Healthcare Services. Data regarding demographics, fertility treatments, BRCA mutation and possible confounders were obtained from the computerized database of electronic health records. The incidence of breast cancer after fertility treatments was compared to the matched controls. MAIN RESULTS AND THE ROLE OF CHANCE Of 8 25 721 women of reproductive age, 32 366 women who underwent ART were matched with patients treated by MAR (n = 32 366) and 32 366 women of reproductive age. A total of 984 women (1.0%) were diagnosed with breast cancer (mean follow-up period, 9.1 ± 6.3 years; interquartile range [IQR], 3.8-13.7 years). The incidence rates of breast cancer per 10 000 person-years were 11.9 (95% CI, 10.7-13.3), 10.7 (95% CI, 9.6-11.9) and 10.7 (95% CI, 9.6-12.0) in the ART group, MAR group and general population, respectively. The crude risk for breast cancer was similar in the ART group compared with the general population (hazard ratio (HR) = 1.10, 95% CI, 0.94-1.28) and in the ART group compared with the MAR group (HR = 1.00, 95% CI, 0.86-1.16). Further adjustment for age, BMI, smoking, socioeconomic status and parity did not substantially impact the hazard rates for breast cancer (ART vs general population: HR = 1.10, 95% CI, 0.94-1.28; ART vs MAR: HR = 0.99, 95% CI, 0.85-1.16). Among women diagnosed with breast cancer, the prevalence of BRCA1/2 mutations and tumour staging did not differ between the ART, MAR and general population groups. Among women who underwent ART, no correlation was found between breast cancer and the number of ART cycles or the use of recombinant medications or urine-derived medications. LIMITATIONS, REASONS FOR CAUTION The mean age of women at the end of follow-up was only 42 years thus the study was not powered to detect potential differences in the risk of postmenopausal breast cancer. In addition, we did not sub-classify the exposed patients by the reason for infertility. WIDER IMPLICATIONS OF THE FINDINGS Breast cancer incidence following ART was comparable to that in the general population or following MAR. Women undergoing fertility treatments and their clinicians may be reassured about the safety of assisted reproduction technologies in terms of premenopausal breast cancer risk. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was used and there are no competing interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- R Machtinger
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Fallach
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - I Goldstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - G Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - E Schiff
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Orvieto
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Mashiach
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
5
|
Reiner-Benaim A, Neuberger A, Chodick G, Henig O. Use of antibiotics and factors associated with treatment failure among 152,245 patients with pneumonia treated in the community - a retrospective cohort study. Eur J Clin Microbiol Infect Dis 2021; 41:99-108. [PMID: 34622350 DOI: 10.1007/s10096-021-04357-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/29/2021] [Indexed: 11/25/2022]
Abstract
This study aims to evaluate risk factors associated with treatment failure and the antibiotics prescribed by primary care physicians in a large patient cohort treated for pneumonia in the community. A retrospective cohort study based on the databases of Maccabi Healthcare Services that provide healthcare to a quarter of the Israeli population. Included patients were > 12 years and diagnosed with pneumonia in the outpatient setting. Cohort 1 included patients with community-acquired pneumonia (CAP), whereas cohort 2 included patients with a documented pneumonia diagnosis following hospital discharge. Treatment failure (TF) was defined as either the use of a second line antibiotic OR hospital admission within 3-14 days OR death within 30 days of diagnosis. Risk factors for TF in the study cohorts were analyzed using multivariable logistic regression. During the study period, 148,376 patients were included in cohort 1 and 3,869 patients in cohort 2, with mean ages of 46.5 ± 20.3 and 63.8 ± 19.5 years, respectively. The most commonly used antibiotics were cephalosporins (36%) and macrolides (35.5%). TF occurred in 12% of cohort 1 and was associated with older age, comorbid conditions, use of non-respiratory fluoroquinolones, and penicillin. Atypical coverage (either macrolides or tetracyclines) was associated with a lower risk of failure. Among cohort 2, TF was higher (16.4%, p < 0.001) and was associated with older age, prior cancer, and congestive heart failure. Treatment failure was associated with comorbid conditions and increasing age. Among young patients with CAP and no comorbid conditions, macrolides or tetracyclines may suffice.
Collapse
Affiliation(s)
- A Reiner-Benaim
- Clinical Epidemiology Unit, Rambam Healthcare Campus, Haifa, Israel
| | - A Neuberger
- Division of Infectious Diseases, Division of Internal Medicine, Rambam Healthcare Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - G Chodick
- Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Oryan Henig
- Department of Infectious Diseases, Unit of Infection Control, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
| |
Collapse
|
6
|
Shalev Ram H, Ram S, Wiser I, Tchernin N, Chodick G, Cohen Y, Rofe G. Associations between breast implants and postpartum lactational mastitis in breastfeeding women: retrospective study. BJOG 2021; 129:267-272. [PMID: 34486797 DOI: 10.1111/1471-0528.16902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the putative associations between breast implants and postpartum lactational mastitis. DESIGN Observational retrospective study. SETTING Digital database of Maccabi Healthcare Services, integrated health maintenance organisation in Israel. POPULATION Breastfeeding mothers from 2003 to 2016 based on an initial health maintenance organisation data set of 28 383 singleton live births in Israel. METHODS Multivariate analysis and propensity score matching were used to test the extent to which breast implants were associated with lactational mastitis during the 6-month postpartum period in breastfeeding mothers. Analyses for potential confounders were adjusted for socio-economic status, smoking and parity. MAIN OUTCOME MEASURE Lactational mastitis among breastfeeding women with breast implants compared with women without breast implants. RESULTS Mothers with breast implants (n = 6099) were significantly (P < 0.001) more likely to be diagnosed with postpartum mastitis (8.3%) than mothers with no breast implants(n = 22 284) (6.6%) at an odds ratio of 1.22 (95% CI 1.09-1.35) after adjusting for confounders. CONCLUSION Breast augmentation is associated with an increased risk of postpartum lactational mastitis in the 6-month postpartum period. In light of these findings, it is important for health professionals to instruct women who have undergone breast augmentation on correct breastfeeding techniques, ways to avoid risk factors, and to be alert to signs permitting the early detection of lactational mastitis. TWEETABLE ABSTRACT A study of over 28,000 breastfeeding women has shown that breast augmentation is associated with an increased risk of postpartum lactational mastitis in the six-month postpartum period.
Collapse
Affiliation(s)
- H Shalev Ram
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynaecology, Meir Medical Centre, Kfar Saba, Israel
| | - S Ram
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel
| | - I Wiser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Tchernin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Hillel Yaffe Medical Center, Hadera, Israel
| | - G Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Maccabi Healthcare Services, Tel Aviv, Israel
| | - Y Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynaecology, Meir Medical Centre, Kfar Saba, Israel
| | - G Rofe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
7
|
Apter L, Moser SS, Arunachalam A, Burke T, Shalev V, Chodick G, Siegelmann-Danieli N. P09.39 PD-L1 Testing Patterns and Treatment in Patients With Metastatic Non-Small Cell Lung Cancer in Israel – Analysis of Real-World Data. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Naffaa ME, Rosenberg V, Watad A, Tiosano S, Yavne Y, Chodick G, Amital H, Shalev V. Adherence to metformin and the onset of rheumatoid arthritis: a population-based cohort study. Scand J Rheumatol 2020; 49:173-180. [PMID: 32208872 DOI: 10.1080/03009742.2019.1695928] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: The aim of this retrospective cohort study was to examine whether adherence to metformin treatment may be associated with lower onset of rheumatoid arthritis (RA).Method: Using the computerized databases of a 2.3-million state-mandated health services organization in Israel, we identified incident RA cases among a cohort of 113 749 adult patients who initiated metformin therapy between 1998 and 2014. Adherence was assessed by calculating the mean proportion of follow-up days covered (PDC) with metformin.Results: During the 18 year study period, there were 558 incident RA cases (61 per 100 000 person-years). Adherence to metformin treatment was associated with a lower risk of developing RA, with the lowest risk recorded among patients with a PDC of 40-59% [adjusted hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.45-0.84] compared with non-adherent patients (PDC < 20%). A mean daily metformin dose of 2550 mg or more was also associated with a lower risk of developing RA (adjusted HR 0.62, 95% CI 0.46-0.84) compared to a daily dose of 850 mg or less. In stratified analyses by gender, the negative association between adherence and the risk of RA was limited to women alone.Conclusions: Adherence to metformin treatment is associated with a reduced risk of developing RA in women. Further studies are needed to assess the effect of metformin on RA development in other patient populations.
Collapse
Affiliation(s)
- M E Naffaa
- Rheumatology Unit, Galilee Medical Center, Nahariya, Israel
| | - V Rosenberg
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel
| | - A Watad
- Department of Medicine 'B', The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - S Tiosano
- Department of Medicine 'B', The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Y Yavne
- Department of Medicine 'B', The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - G Chodick
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Amital
- Department of Medicine 'B', The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - V Shalev
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
9
|
Benderly M, Kalter-Leibovici O, Weitzman D, Blieden L, Buber J, Dadashev A, Mazor-Dray E, Lorber A, Nir A, Razon Y, Yalonetsky S, Chodick G, Hirsch R. P2605Depression and anxiety are associated with high healthcare resource utilization among adults with congenital heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Benderly
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
| | - O Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
| | - D Weitzman
- Maccabi Healthcare Services, Morris Kahn & Maccabi institute for research and innovation, Tel Aviv, Israel
| | - L Blieden
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - J Buber
- Chaim Sheba Medical Center, Heart Institute, Tel Hashomer, Israel
| | - A Dadashev
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - E Mazor-Dray
- Ben Gurion University of the Negev, Faculty of Health Sciences, Beer Sheva, Israel
| | - A Lorber
- Rambam Health Care Campus, Pediatric Cardiology and GUCH Unit, Haifa, Israel
| | - A Nir
- Hadassah University Medical Center, Department of Pediatric Cardiology, Jerusalem, Israel
| | - Y Razon
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - S Yalonetsky
- Rambam Health Care Campus, Pediatric Cardiology and GUCH Unit, Haifa, Israel
| | - G Chodick
- Maccabi Healthcare Services, Morris Kahn & Maccabi institute for research and innovation, Tel Aviv, Israel
| | - R Hirsch
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | | |
Collapse
|
10
|
Weil C, Mehta D, Koren G, Pinsky B, Samp JC, Chodick G, Shalev V. Sustained virological response to ombitasvir/paritaprevir/ritonavir and dasabuvir treatment for hepatitis C: Real-world data from a large healthcare provider. J Viral Hepat 2018; 25:144-151. [PMID: 28984012 DOI: 10.1111/jvh.12800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/06/2017] [Indexed: 01/08/2023]
Abstract
Treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir, with or without ribavirin (OPrD ± RBV), was the first interferon-free direct-acting antiviral for hepatitis C virus (HCV) introduced to Israel's national basket of health services in February 2015. Patients with HCV genotype 1 (GT1) and advanced fibrosis (F3-F4) were eligible for treatment in 2015. This study aimed to characterize patients initiating OPrD ± RBV and assess sustained virological response (SVR). A retrospective cohort study was performed using the database of Maccabi Healthcare Services (MHS), a 2-million-member health plan in Israel. The study population included adults who initiated OPrD ± RBV through December 2015 per health basket criteria. A gap in medication fills (>14 days between a fill's run-out and the next fill) was used to estimate adherence. SVR was defined by the viral tests at least 12-week post-treatment. The study population consisted of 403 patients (56.3% male), with a mean age of 60.7 years (SD 11.0). Overall, 71.0% were naïve to prior HCV treatment, and 95.6% were treated with a 12-week regimen. A total of 348 patients (86.4%) completed the regimen in the usual time frame (highly adherent), whereas 8.2% completed with a gap, and 4.7% purchased less than the recommended dose. SVR rates overall and among highly adherent patients were 395/403 (98.0%; 95% CI 96.1-99.1) and 346/348 (99.4%; 95% CI 97.9-99.9), respectively. GT1b patients on 12-week regimens attained SVR rates of 194/196 (fibrosis F3) and 170/176 (cirrhosis). After a first year of provision of OPrD ± RBV with good adherence, high SVR rates were achieved in various patient subgroups and comorbidities.
Collapse
Affiliation(s)
- C Weil
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel
| | - D Mehta
- Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA.,Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
| | - G Koren
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel
| | - B Pinsky
- Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA
| | - J C Samp
- Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA
| | - G Chodick
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Shalev
- Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
11
|
Lehnich AT, Rusner C, Bock E, Katz R, Chodick G, Stang A. CT Scans in der Nachsorge von Hodenkrebs – Fluch oder Segen? Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- AT Lehnich
- Universitätsklinikum Essen, IMIBE, Essen
| | - C Rusner
- Radiologisches Zentrum Bärenkaree, Altenburg
| | - E Bock
- Universitätsklinikum Essen, IMIBE, Essen
| | - R Katz
- Maccabi Health Services, Tel Aviv
| | | | - A Stang
- Universitätsklinikum Essen, IMIBE, Essen
| |
Collapse
|
12
|
Goldstein D, Shalev V, Goldshtein I, Weil C, Bourvine L, Koren S, Chodick G. Anti-Cholinergic Treatment for Overactive Bladder in a Large Health Provider. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
13
|
Eisenberg VH, Weil C, Chodick G, Shalev V. Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG 2017; 125:55-62. [DOI: 10.1111/1471-0528.14711] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 01/18/2023]
Affiliation(s)
- VH Eisenberg
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - C Weil
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Tel Aviv Israel
| | - G Chodick
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - V Shalev
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| |
Collapse
|
14
|
Moshe S, Cinamon T, Zack O, Segal N, Chodick G, Krakov A, Tal M. The need for social work services in occupational medicine. Occup Med (Lond) 2017; 67:2982683. [PMID: 28187220 DOI: 10.1093/occmed/kqx009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Affiliation(s)
| | - T Cinamon
- Maccabi Healthcare Services, Central Headquarter, 27 HaMered St, Tel-Aviv 6812509, Israel
| | | | | | | | | | - M Tal
- Occupational Medicine Department, Maccabi Healthcare Services, 43 Geulim St, Holon 5840419, Israel
| |
Collapse
|
15
|
Amarilyo G, Chodick G, Somekh I, Zalcman J, Harel L. SAT0490 Poor Long-Term Adherence To Secondary Penicillin Prophylaxis among Pediatric Patients with Rheumatic Fever. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
16
|
Yu J, Goldshtein I, Shalev V, Chodick G, Ish-Shalom S, Sharon O, Modi A. Association of gastrointestinal events and osteoporosis treatment initiation in newly diagnosed osteoporotic Israeli women. Int J Clin Pract 2015; 69:1007-14. [PMID: 26278464 PMCID: PMC5042045 DOI: 10.1111/ijcp.12676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The objective was to examine the association of gastrointestinal (GI) events and osteoporosis treatment initiation patterns among postmenopausal women following an osteoporosis diagnosis from an Israeli health plan. METHODS This retrospective analysis of claims records included women aged ≥ 55 years with ≥ 1 osteoporosis diagnosis (date of first diagnosis was index date). Osteoporosis treatment initiation was defined as use of osteoporosis therapy (oral bisphosphonates or other) during 12 months postindex. GI events (diagnosis of GI conditions) were reported for 12 months preindex and postindex (from index to treatment initiation or 1 year postindex, whichever occurred first). The association of postindex GI events (yes/no) with the initiation of osteoporosis treatment (yes/no) and with type of therapy initiated (oral bisphosphonate vs. other) were examined with logistic regression and Cox proportional hazard regression (as sensitivity analysis). RESULTS Among 30,788 eligible patients, 17.5% had preindex GI events and 13.0% had postindex GI events. About 70.6% of patients received no osteoporosis therapy within 1 year of diagnosis, 24.9% received oral bisphosphonates and 4.5% received other medications. Postindex GI events were associated with lower odds of osteoporosis medication initiation (85-86% reduced likelihood; p < 0.01). Upon treatment initiation, postindex GI was not significantly associated with the type of osteoporosis therapy initiated, controlling for baseline GI events and patient characteristics. CONCLUSIONS Among newly diagnosed osteoporotic women from a large Israeli health plan, 70.6% did not receive osteoporosis treatment within 1 year of diagnosis. The presence of GI events was associated with reduced likelihood of osteoporosis treatment initiation.
Collapse
Affiliation(s)
- J Yu
- Merck & Co, Inc., Kenilworth, NJ, USA
| | - I Goldshtein
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - V Shalev
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - G Chodick
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
| | | | - O Sharon
- Merck Sharp & Dohme Co. Ltd., Petah Tikya, Israel
| | - A Modi
- Merck & Co, Inc., Kenilworth, NJ, USA
| |
Collapse
|
17
|
Abstract
BACKGROUND Return to work (RTW) is a key goal in the proper management of upper limb disorders (ULDs). ULDs stem from diverse medical aetiologies and numerous variables can affect RTW. The abundance of factors, their complex interactions and the diversity of human behaviour make it difficult to pinpoint those at risk of not returning to work (NRTW) and to intervene effectively. AIMS To weigh various clinical, functional and occupational parameters that influence RTW in ULD sufferers and to identify significant predictors. METHODS A retrospective analysis of workers with ULD referred to an occupational health clinic and further examined by an occupational therapist. Functional assessment included objective and subject ive [Disability of the Arm, Shoulder and Hand (DASH) score] parameters. Quantification of work requirements was based on definitions from the Dictionary of Occupational Titles web site. RTW status was confirmed by a follow-up telephone questionnaire. RESULTS Among the 52 subjects, the RTW rate was 42%. The DASH score for the RTW group was 27 compared with 56 in the NRTW group (P < 0.001). In multivariate analyses, only the DASH score was found to be a significant independent predictor of RTW (P < 0.05). CONCLUSIONS Physicians and rehabilitation staff should regard a high DASH score as a warning sign when assessing RTW prospects in ULD cases. It may be advisable to focus on workers with a large discrepancy between high DASH scores and low objective disability and to concentrate efforts appropriately.
Collapse
Affiliation(s)
- S Moshe
- Occupational Medicine Department, Maccabi Healthcare Services, 5840419 Holon, Israel, Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel,
| | - R Izhaki
- Occupational Therapy Department, Maccabi HealthCare Services, 5836111 Holon, Israel
| | - G Chodick
- Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel, Siaal Research Center for Family Practice and Primary Care, Community Health Division, Ben-Gurion University of the Negev, 8410501 Beer-Sheva, Israel
| | - N Segal
- Occupational Medicine Department, Maccabi Healthcare Services, 5840419 Holon, Israel, Environmental and Occupational Health Department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel
| | - Y Yagev
- Siaal Research Center for Family Practice and Primary Care, Community Health Division, Ben-Gurion University of the Negev, 8410501 Beer-Sheva, Israel
| | - A S Finestone
- Department of Orthopedics, Assaf Harofeh Medical Center, 7030000 Zerifin, Israel
| | - Y Juven
- Occupational Medicine Department, Maccabi Healthcare Services, Central District, 6812509 Tel Aviv, Israel
| |
Collapse
|
18
|
Chodick G, Weitzman D, Shalev V, Weil C, Amital H. Adherence to statins and the risk of psoriasis: a population-based cohort study. Br J Dermatol 2015; 173:480-7. [PMID: 25894753 DOI: 10.1111/bjd.13850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Statins have been shown to downregulate immune mechanisms activated in psoriasis. However, previous studies on their potential role in preventing psoriasis have yielded conflicting results. OBJECTIVES To assess the relationship between adherence to statins and the risk of psoriasis. METHODS This retrospective cohort study included 205,820 health plan enrollees in Israel (mean age 55 years; 54·1% women) who initiated statin treatment from January 1998 through to September 2009. Adherence to statins, measured by the proportion of days covered (PDC), throughout the entire follow-up period (mean 6·2 years) was recorded. Diagnosis codes of psoriasis were assigned by a dermatologist or rheumatologist, or at discharge from hospital. RESULTS During 1·28 million person-years (PY) of follow-up (median 5·74 years per person; interquartile range 3·78-8·36), 5615 cases of psoriasis (incidence density rate 4·4 per 1000 PY) were recorded. Compared with patients who did not adhere to statins (PDC < 20%), patients covered by statins for 40-59% of the time had a significantly lower risk of psoriasis (P < 0·05), with hazard ratios (HRs) of 0·84 and 0·74 among men and women, respectively. Among patients who adhered better to statins (PDC ≥ 80%), HRs were 0·88 (95% CI 0·79-0·98) and 1·00 (95% CI 0·90-1·11) among men and women, respectively. CONCLUSIONS The results of the current study suggest that high and long-term adherence to statins is not associated with a meaningful reduction in the risk of developing psoriasis.
Collapse
Affiliation(s)
- G Chodick
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Weitzman
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel
| | - V Shalev
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Weil
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
| | - H Amital
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel.,Department of Medicine B, Sheba Medical Center, Tel HaShomer, Israel
| |
Collapse
|
19
|
Gendelman O, Shalev V, Dahlia Weitzman D, Chodick G, Amital H. FRI0126 Characterization of Patients' Adherence and Persistence Profile (“Drug Survival”) in a “Real Life” Population of Patients Treated with Adalilumab. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
Makov M, Chodick G, Mohnike K, Otonkoski T, Huopio H, Banerjee I, Cave H, Polak M, Christesen HT, Hussain K, Deleon D, Stanley C, Cappa M, Ramos O, Zangen D, Laron Z. Congenital hyperinsulinism, neonatal diabetes and the risk of malignancies: an international collaborative study. Preliminary communication. Diabet Med 2015; 32:701-3. [PMID: 25494966 DOI: 10.1111/dme.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M Makov
- Endocrinology and Diabetes Research Unit, Schneider Children's Medical Center, Rabin Campus, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Sella T, Goren I, Shalev V, Shapira H, Zandbank J, Rosenblum J, Kimlin M, Chodick G. Incidence trends of keratinocytic skin cancers and melanoma in Israel 2006-11. Br J Dermatol 2014; 172:202-7. [DOI: 10.1111/bjd.13213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- T. Sella
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Department of Oncology; Sheba Medical Center; Tel Hashomer Israel
| | - I. Goren
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
| | - V. Shalev
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - H. Shapira
- Pathology Laboratory; Maccabi Healthcare Services; Tel Aviv Israel
| | - J. Zandbank
- Pathology Laboratory; Maccabi Healthcare Services; Tel Aviv Israel
| | - J. Rosenblum
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
| | - M.G. Kimlin
- AusSun Research Laboratory; Institute of Health and Biomedical Innovation,Queensland University of Technology; Brisbane Qld Australia
| | - G. Chodick
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| |
Collapse
|
22
|
Shalev V, Weil C, Nwankwo C, Friedman M, Kenet G, Chodick G. Establishment Of A Hepatitis C Virus (Hcv) Cohort In A Large Israeli Hmo. Value Health 2014; 17:A363. [PMID: 27200748 DOI: 10.1016/j.jval.2014.08.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Shalev
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
| | - C Weil
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | - M Friedman
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
| | - G Kenet
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - G Chodick
- Maccabi Healthcare Services and Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
23
|
Goldshtein I, Shalev V, Chodick G, Chandler J, Martin NA, Ish SS. The Use of Clinical Data Repository for the Establishment of an Osteoporosis Registry in A Large Health Organization in Israel: Epidemiologic and Pharmaepidemiologic Findings. Value Health 2014; 17:A389-A390. [PMID: 27200890 DOI: 10.1016/j.jval.2014.08.2665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - V Shalev
- Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel
| | - G Chodick
- Maccabi Healthcare Services and Tel Aviv University, Tel Aviv, Israel
| | | | | | | |
Collapse
|
24
|
Dar L, Weitzman D, Chodick G, Shalev V, Amital H. FRI0420 No Male Predominance in Offspring of Women with Rheumatoid Arthritis or Systemic Lupus Erythematosus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
25
|
Arbel Y, Raz R, Weitzman D, Steinvil A, Zeltser D, Berliner S, Chodick G, Shalev V. Red blood cell distribution width and the risk of cardiovascular morbidity and all-cause mortality: a population-based study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
26
|
Zandman-Goddard G, Shamrayevsky N, Chodick G, Agmon-Levin N, Shalev V, Amital H. FRI0388 Patterns of compliance to allopurinol in “real life population” – is everything crystal clear? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
27
|
Dubnov-Raz G, Ish-Shalom S, Chodick G, Rozen GS, Giladi A, Constantini NW. Osteocalcin is independently associated with body mass index in adolescent girls. Pediatr Obes 2012; 7:313-8. [PMID: 22577088 DOI: 10.1111/j.2047-6310.2012.00058.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 02/09/2012] [Accepted: 02/27/2012] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Osteocalcin is a bone-related protein, recently found to correlate with body mass index (BMI), waist circumference, fat percentage and metabolic syndrome in adults. The aim of this study was to determine the relationship between osteocalcin and BMI in adolescence, a time of significant bone accrual, while considering possible confounders related to bone and body composition. METHODS We analyzed data from 160 female adolescents (mean age 15.1 ± 0.7 years), which were divided into tertiles by osteocalcin levels. Across these three groups, we examined the differences in BMI with relation to age, total daily energy intake, calcium intake, physical activity (PA), total body bone mineral density, parathyroid hormone (PTH), 25(OH)-vitamin D, bone alkaline phosphatase and body fat percentage. RESULTS Mean BMI values differed significantly between participants in the three osteocalcin tertiles, including after adjustment for age, PA, PTH, energy and calcium intakes. Post-hoc analysis revealed that girls in the highest osteocalcin tertile, had a significantly lower BMI than those in the two lower ones (19.3 ± 2.2 vs. 20.6 ± 3.0 and 20.7 ± 2.9 kg m(-2), respectively, P = 0.018). There was no significant difference in energy and calcium intakes, bone mineral density, 25(OH)-vitamin D levels and PTH between study groups. CONCLUSIONS In female adolescents, BMI is inversely related to osteocalcin, even after consideration of several factors that may affect bone and fat mass. As bone mineral density, 25(OH)D and PTH did not differ between groups, it is possible that the relation between osteocalcin and BMI could be unrelated to bone tissue itself.
Collapse
Affiliation(s)
- G Dubnov-Raz
- Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
| | | | | | | | | | | |
Collapse
|
28
|
Raz R, Shavit O, Stein M, Cohen R, Schejter E, Chodick G, Shalev V. Uptake of Pap smears among women in a large Israeli HMO between 2006 and 2008. Public Health 2012; 126:594-9. [PMID: 22657092 DOI: 10.1016/j.puhe.2012.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 10/31/2011] [Accepted: 04/07/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The Papanicolaou (Pap) smear test is used in many countries as a screening procedure for cervical cancer and precancerous lesions. The actual uptake of this screening test among women at risk for cervical cancer is unknown. The aim of this study was to estimate the percentage of women who are screened by Pap smears from the relevant population at risk, and to detect factors that are independently associated with uptake of cervical screening. STUDY DESIGN Retrospective database study. METHODS This study was undertaken at Maccabi Healthcare Services (MHS), the second largest publicly funded health maintenance organization in Israel. The study population consisted of Israeli women aged 21-59 years who were insured by MHS between 2006 and 2008. Logistic regression analyses were used to determine the independent relationships between immigration and socio-economic status and cervical screening. RESULTS The study population included 489,663 women who had a total of 313,602 Pap smears between 2006 and 2008. Fifty-four percent of the women did not have a Pap smear during the study period, 32% had at least one smear, and 14% had at least two smears. Living in a low socio-economic neighbourhood and recent immigration were independently and negatively associated with screening uptake. CONCLUSION Despite the clinical guidelines and the low costs, many Israeli women who are at risk for cervical cancer are not screened.
Collapse
Affiliation(s)
- R Raz
- Medical Division, Maccabi Healthcare Services, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | | | | | |
Collapse
|
29
|
Levine H, Huerta-Hartal M, Bar-Ze'ev Y, Balicer RD, Auster O, Ankol OE, Chodick G. Smoking and Other Correlates of Health Care Services Utilization Among Mandatory Military Recruits in Israel. Nicotine Tob Res 2012; 14:742-50. [DOI: 10.1093/ntr/nts016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
Sella T, Chodick G, Lunenfeld E, Shalev V. Further evidence on the high prevalence of male factor infertility diagnosis in Israel. Isr Med Assoc J 2011; 13:386. [PMID: 21809743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
31
|
Sella T, Chodick G, Barchana M, Heymann AD, Porath A, Kokia E, Shalev V. Gestational diabetes and risk of incident primary cancer: A large population-based cohort study in Israel. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
32
|
Sella T, Shoshan A, Goren I, Shalev V, Blumenfeld O, Laron Z, Chodick G. A retrospective study of the incidence of diagnosed Type 1 diabetes among children and adolescents in a large health organization in Israel, 2000-2008. Diabet Med 2011; 28:48-53. [PMID: 21166845 DOI: 10.1111/j.1464-5491.2010.03174.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS To determine the incidence and examine temporal trends of Type 1 diabetes among children aged < 18 years, in a large Israeli health organization. METHODS All incident Type 1 diabetes cases diagnosed between 2000 and 2008 were ascertained from an automated diabetes registry based on members' electronic records and validated by comparison with the Israel Juvenile Diabetes Register. RESULTS During the study period, a total of 648 incident cases of Type 1 diabetes were identified. The average annual age-and-sex-standardized incidence was 11.09 per 100,000 person-years. There was an annual 5.82% (95% CI 1.80-9.98%) rise in incidence, with a greater relative increase in toddlers under 5 years of age. Incidence increased with age and demonstrated seasonal variation. Mean age at onset of diabetes significantly (P = 0.07) decreased from 10.21 years (SD = 4.48) in 2000-2002 to 9.25 years (SD = 4.54) in 2006-2008. Among very young patients (< 5 years), average blood glucose values at diagnosis dropped from 32.4 mmol/l (SD = 9.5) to 19.5 mmol/l (SD = 11.0) over the study period, with little change in average glucose for older children. CONCLUSIONS Incidence of diagnosed Type 1 diabetes continues to increase in Israel at a rate that is high compared with similar American and European populations. At the same time, the clinical presentation of children is changing.
Collapse
Affiliation(s)
- T Sella
- Medical Division, Maccabi Healthcare Services Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | | | | |
Collapse
|
33
|
Chodick G. Comment on: Prevalence and incidence of rheumatoid arthritis in southern Sweden 2008 and their relation to prescribed biologics. Rheumatology (Oxford) 2010; 49:1999-2000; author reply 2000. [DOI: 10.1093/rheumatology/keq236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
34
|
Abstract
AIMS To determine the incidence of postpartum diabetes mellitus in the years following a diagnosis of gestational diabetes mellitus (GDM) and to determine whether the severity of GDM, represented by the magnitude of the deviation of diagnostic tests from the normal values or requirement for medications, is associated with the development of diabetes. METHODS A retrospective cohort study was performed among 185 416 pregnant women who had glucose challenge test or 3 h oral glucose tolerance test (OGTT) in a large health maintenance organization in Israel. Subsequent diagnosis of diabetes was ascertained by using an automated patient registry. RESULTS A total of 11 270 subjects were diagnosed with GDM, comprising 6.07% of the cohort. During a total follow-up period of 1 049 334 person-years there were 1067 (16.9 per 1000 person-years) and 1125 (1.1 per 1000 person-years) diagnoses of postpartum diabetes among GDM and non-GDM women, respectively. The cumulative risk of incident diabetes in GDM patients with up to 10 years of follow-up was 15.7%, compared with 1% among the non-GDM population. Gestational diabetes mellitus was associated with nearly an eightfold higher risk of postpartum diabetes after adjusting for important confounders, such as socioeconomic status and body mass index. Among women with a history of GDM, the number of abnormal OGTT values and use of insulin were associated with a substantially higher risk for developing diabetes. CONCLUSIONS Three or four abnormal OGTT values and GDM requiring insulin or oral hypoglycaemic medications are important predictors of postpartum diabetes risk in women with a history of GDM.
Collapse
Affiliation(s)
- G Chodick
- Medical Division, Maccabi Healthcare Services, 27 Ha'Mered Street, Tel Aviv, Israel.
| | | | | | | | | | | | | |
Collapse
|
35
|
Blakely EA, Kleiman NJ, Neriishi K, Chodick G, Chylack LT, Cucinotta FA, Minamoto A, Nakashima E, Kumagami T, Kitaoka T, Kanamoto T, Kiuchi Y, Chang P, Fujii N, Shore RE. Radiation cataractogenesis: epidemiology and biology. Radiat Res 2010; 173:709-17. [PMID: 20426671 DOI: 10.1667/rrxx19.1] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- E A Blakely
- Lawrence Berkeley National Laboratory, Berkeley, California, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Benderly M, Chodick G, Lerman Y. [How to plan a controlled clinical trial?]. Harefuah 2009; 148:846-849. [PMID: 20088440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
37
|
Chodick G, Waisbourd-Zinman O, Shalev V, Kokia E, Rabinovich M, Ashkenazi S. Potential impact and cost-effectiveness analysis of rotavirus vaccination of children in Israel. Eur J Public Health 2009; 19:254-9. [DOI: 10.1093/eurpub/ckp005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
38
|
Chodick G, Heymann AD, Ashkenazi S, Kokia E, Shalev V. Long-term trends in hepatitis A incidence following the inclusion of Hepatitis A vaccine in the routine nationwide immunization program. J Viral Hepat 2008; 15 Suppl 2:62-5. [PMID: 18837837 DOI: 10.1111/j.1365-2893.2008.01032.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
For many years hepatitis A was one of the most common vaccine preventable diseases in Israel. In 1999, Israel became the first country to introduce an inactivated hepatitis A vaccine into its national childhood vaccination program. The objectives of the present study were to study trends in disease incidence after the implementation of the new vaccination policy and to assess vaccination coverage among children and adults in Israel. We used the databases of the second largest HMO in Israel (1.7 million members) to identify patients who had evidence of hepatitis A in 1998 and 2007 and to collect information on all subjects who received at least one dose of hepatitis A vaccine during the study period. Hepatitis A vaccination coverage in children <5 years and 5-14 years of age increased from 9% and 15% in 1998 to 89% and 68% in 2007, respectively. During this period the annual incidence of hepatitis A dropped from 142.4 per to 7.6 per 100 000. The most prominent reduction in the age-specific annual incidence rates was calculated in children <5 years from 239.4 per 100 000 in 1998 to 2.2 per 100 000 in 2007 and from 310.3 per 100 000 to 3.0 per 100 000 in children aged 5-14 years. In endemic areas, vaccination of infants and children against hepatitis A can greatly reduce the total burden of the disease.
Collapse
Affiliation(s)
- G Chodick
- Medical Informatics Department, Maccabi Healthcare Services, Tel Aviv, Israel.
| | | | | | | | | |
Collapse
|
39
|
Heymann AD, Chodick G, Karpati T, Kamer L, Kremer E, Green MS, Kokia E, Shalev V. Diabetes as a risk factor for herpes zoster infection: results of a population-based study in Israel. Infection 2008; 36:226-30. [PMID: 18454342 DOI: 10.1007/s15010-007-6347-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 09/19/2007] [Indexed: 01/13/2023]
Abstract
BACKGROUND Studies showed that diabetes mellitus (DM) is often accompanied by impaired cell-mediated immunity, which potentially may increase the risk for infectious diseases, including herpes zoster (HZ). However, data on the relation between DM and HZ are scarce. This case-control study explored the association between DM and HZ. PATIENTS AND METHODS This study was nested within a cohort of all members of a large health maintenance organization (HMO) in Israel. Cases totaled 22,294 members who were diagnosed with HZ between 2002 and 2006. Controls (n=88,895) were randomly selected from the remaining HMO population using frequency-matched age, sex, and duration of follow-up. Personal data on history of DM, lymphoma, leukemia, or AIDS, were obtained from computerized medical records. RESULTS Adjusted analyses showed that the risk of HZ was associated with history of leukemia, lymphoma, use of steroids or antineoplastic medications, and AIDS, particularly among patients below 45 years of age. In a multivariate analysis, DM was associated with an increased risk of HZ (OR=1.53; 95% CI: 1.44-1.62). CONCLUSIONS The data suggest that individuals with DM are at increased risk of HZ. Well-designed cohort studies may help to clarify the nature of this association.
Collapse
Affiliation(s)
- A D Heymann
- Medical Division, Maccabi Healthcare Services, 27 HaMered St, Tel Aviv, 68125, Israel
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Elis A, Rosenmann L, Chodick G, Heymann AD, Kokia E, Shalev V. The association between glycemic, lipids and blood pressure control among Israeli diabetic patients. QJM 2008; 101:275-80. [PMID: 18296748 DOI: 10.1093/qjmed/hcm150] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is recommended that in diabetes mellitus patients all risk factors for cardiovascular disease should be controlled. AIM To evaluate the rate of reaching all glycemic, lipids and blood pressure target levels among diabetic patients in Israel and to analyze demographic and clinical parameters associated with it. DESIGN A cross-sectional study. METHODS The study was conducted in Maccabi Healthcare Services, Israel's second largest health maintenance organization. All patients (n = 41 936), older than 20 years, who were listed on Maccabi Healthcare Service's diabetes mellitus computerized database and had all three study parameters (HbA1c, LDL-C and blood pressure levels during 2005) were eligible for the study. The rate of reaching HbA1c <7.0%, LDL-C <100 mg/dl and blood pressure <130/85 mmHg, as well as its association with various demographic and clinical parameters were analyzed. RESULTS Only 13% of all study patients achieved all three target levels. The parameters which were significantly associated with goal achievement were compliance to medical treatment for all three parameters (OR 1.56, 95% CI 1.44-1.69, P = 0.0001), male gender (OR 1.42, 95% CI 1.31-1.54, P = 0.0001), comorbidity with ischemic heart disease (OR 1.23, 95% CI 1.13-1.34, P = 0.0001), and >12 visits per year to family physician (OR 1.10, 95% CI 1.02-1.19, P = 0.012). CONCLUSION Non-compliance with treatment and sub-optimal follow-up by family physicians are associated with increased risk of failure to control major risk factor among diabetic patients.
Collapse
Affiliation(s)
- A Elis
- Department of Medicine A, Meir Medical Center, Kfar Saba, Israel.
| | | | | | | | | | | |
Collapse
|
41
|
Moshe S, Shilo M, Yagev Y, Levy D, Slodownik D, Chodick G, Levin M. Comparison of three methods of pre-employment medical evaluations. Occup Med (Lond) 2008; 58:46-51. [DOI: 10.1093/occmed/kqm131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
42
|
Chodick G, Bhatti P, Sigurdson AJ. Re: "Chromosomal aberrations and cancer risk: results of a cohort study from central Europe". Am J Epidemiol 2007; 166:239-40. [PMID: 17535830 DOI: 10.1093/aje/kwm166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Chodick G, Freedman DM, Kwok R, Fears T, Linet M, Kleinerman R. Improving Questionnaire-Based Assessment of Ultraviolet Radiation from Sunlight: Agreement Between Daily Diary and Recalled Time Outdoors 6 Months Later. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s29-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
44
|
Chodick G, Shalev V, Goren I, Inskip PD. Seasonality in Birth Weight in Israel; New Evidence Suggests Several Global Patterns. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s56-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
45
|
Chodick G, Ashkenazi S, Lerman Y. The risk of hepatitis A infection among healthcare workers: a review of reported outbreaks and sero-epidemiologic studies. J Hosp Infect 2006; 62:414-20. [PMID: 16488511 DOI: 10.1016/j.jhin.2005.07.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Accepted: 07/14/2005] [Indexed: 10/25/2022]
Abstract
All reports of hepatitis A (HA) outbreaks in healthcare settings published between 1975 and 2003 were studied to determine the background immunity or susceptibility of healthcare workers (HCWs) to HA. Twenty-six reports were found. The number of infected personnel ranged from one to 66 and, in most outbreaks, nurses accounted for the majority of personnel infected, reflecting high attack rates reaching 15-41%. In addition, we found 23 sero-epidemiological studies for HA among HCWs that had been performed in 13 different countries. Seroprevalence rates of HCWs with anti-HA antibody ranged between 4% among paramedical workers in Germany to 88% among hospital maintenance workers in Portugal. Effective infection control of HA outbreaks in hospitals demands early recognition, including awareness of atypical presentations of the infection, and strict adherence to universal infection control measures. Education programmes are of special importance for HCWs in neonatal, paediatric and intensive care units. The findings of the current study suggest that a pre-employment screening policy and administration of active vaccination to susceptible HCWs, particularly nurses, should be seriously considered in high-risk settings.
Collapse
Affiliation(s)
- G Chodick
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | | | | |
Collapse
|
46
|
Lerman Y, Chodick G, Tepper S, Livni G, Ashkenazi S. Seroepidemiology of varicella-zoster virus antibodies among health-care workers and day-care-centre workers. Epidemiol Infect 2005; 132:1135-8. [PMID: 15635972 PMCID: PMC2870206 DOI: 10.1017/s0950268804002791] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Inclusion of live varicella vaccine in the routine occupational health vaccination schedule requires knowledge of the natural immunity to varicella zoster virus (VZV) among high-risk occupations. This study aims were to evaluate VZV antibody positivity among health-care workers (HCWs) and day-care-centre workers (DCWs) and to assess its association with potential risk factors. Three groups of workers were tested for VZV antibody positivity: hospitals and community clinic HCWs (n = 335), DCWs (n = 117) and blue-collar workers as controls (n = 121). The total VZV antibody positivity was 94.4%. There was no significant difference in VZV antibody positivity among study groups. DCWs had the lowest VZV seroprevalence (90.9%, 95% CI 85.7-96.1) and controls the highest (96.6%, 95% CI 93.2-99.9). This high VZV antibody positivity suggests that no special occupational measures are indicated in health-care or day-care occupational settings in Israel. On-going monitoring of the natural immunity to VZV is necessary to detect trends over time.
Collapse
Affiliation(s)
- Y Lerman
- Department of Epidemiology & Preventive Medicine, Sackler Faculty of Medicine, Tel-Aviv University, PO Box 39040, Tel-Aviv, Israel
| | | | | | | | | |
Collapse
|
47
|
Shalev V, Chodick G, Heymann AD, Kokia E. Gender differences in healthcare utilization and medical indicators among patients with diabetes. Public Health 2005; 119:45-9. [PMID: 15560901 DOI: 10.1016/j.puhe.2004.03.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2003] [Revised: 03/03/2004] [Accepted: 03/15/2004] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe differences in healthcare utilization and health indicators of patients with diabetes, according to gender. STUDY DESIGN A population-based outcome study conducted on 21,277 diabetic patients between the ages of 45 and 64 years who are members of the second largest health maintenance organization in Israel. METHODS Data on healthcare utilization (process indicators) and health problems (outcome indicators) were obtained from computerized medical records that are stored routinely by the organization. The study period was the year 2002. RESULTS Significantly (P < 0.05) lower healthcare utilization was observed in men compared with women for all indicators examined (number of visits to physicians and the performance of urine, lipids and creatinine tests). Nonetheless, men showed better health outcomes (lower low-density lipoprotein cholesterol, triglycerides, HbA1c). CONCLUSIONS Women who suffer from diabetes use more healthcare services and have a higher morbidity rate compared with men. Future research should seek to identify the factors contributing to this observation, which can potentially make an important contribution to the development of disease management strategies that target diabetic women.
Collapse
Affiliation(s)
- V Shalev
- Medical Division, Maccabi Healthcare Services, 27 HaMered Street, Tel Aviv 68125, Israel
| | | | | | | |
Collapse
|
48
|
Abstract
BACKGROUND The effectiveness of health promotion campaigns is hard to measure due to complex outcome and external factors. This study presents a method to evaluate a mass women's health promotion campaign held in a large health maintenance organization (HMO) in Israel. METHODS This population-based study used administrative and medical databases to examine whether postal invitation to 120,231 HMO-female members increased adherence with certain preventive medicine recommendations (LDL-C, bone density test, and mammography breast cancer screening). A comparison was made using three different reference data: pre- and post-campaign periods (1998-2003), HMO-male members who were not targeted by the campaign, and rates of urine tests, which were also not targeted by the campaign. RESULTS During the 2 months following the campaign, adherence with mammography (3.8%) and LDL-C (12.5%) reached their maximum rates in 5 years. Adherence with bone density test increased from 2.3% in 2000 to 2.8% in the campaign period. No similar trends were observed for urine or LDL-C tests among men. CONCLUSIONS The use of multiple reference groups through the analysis of administrative and medical databases supports the association between the campaign and improved adherence with screening tests. A similar methodology may be adopted for the analysis of mass health promotion campaigns in large HMOs.
Collapse
Affiliation(s)
- A D Heymann
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | | | | |
Collapse
|
49
|
Chodick G, Ashkenazi S, Aloni H, Peled T, Lerman Y. Hepatitis A virus seropositivity among hospital and community healthcare workers in Israel-the role of occupation, demography and socioeconomic background. J Hosp Infect 2003; 54:135-40. [PMID: 12818588 DOI: 10.1016/s0195-6701(03)00124-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hospital and community-clinic workers were tested for hepatitis A virus antibodies (HAV)-IgG to identify variables associated with presence of (HAV-IgG) and to determine whether sociodemographic background may explain all differences in HAV seropositivty among healthcare workers. Logistic regression analysis was used to identify variable associated with HAV-immunity. Multivariate logistic regression analysis revealed that HAV-seroprevalence correlated significantly (P<0.01) with age, siblings, residence in rural areas and origin. Nurse aides had an increased risk for HAV seropositivity (OR=5.04; 95% CI: 1.49-17.08) whereas physicians had a lower risk (OR=0.54: 95% CI: 0.30-0.98). Age and socioeconomic background were independently correlated with HAV immunity but did not explain all difference in HAV-seroprevalence. The higher susceptibility and elevated incidence of hepatitis A amongst physicians, prioritize primary prevention in this group.
Collapse
Affiliation(s)
- G Chodick
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | | | | | | | | |
Collapse
|
50
|
Chodick G, Lerman Y, Peled T, Aloni H, Ashkenazi S. Cost-benefit analysis of active vaccination campaigns against hepatitis A among daycare centre personnel in Israel. Pharmacoeconomics 2001; 19:281-291. [PMID: 11303416 DOI: 10.2165/00019053-200119030-00006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To evaluate, in economic terms, active vaccination campaigns against hepatitis A in comparison with the use of nonspecific immune globulin for the prevention of the disease among daycare centre employees in Israel. SETTING Hypothetical analysis of the costs and benefits related to vaccination campaigns of workers currently employed in daycare centres in Israel. METHODS A cost-benefit analysis was performed, comparing mass and selective active vaccination strategies for the daycare centre working force. Direct and indirect costs of diagnosis, treatment and immunisation as well as productivity loss were considered. A Markov-based model was developed using data from previous epidemiological studies and literature. RESULTS The benefit-to-cost ratios of selective and mass active vaccination strategies were 1.50 [net present value (NPV) $US606 396] and 0.04 (NPV-$US2.36 million), respectively (2000 values). CONCLUSION Under these study assumptions, the practice of administering hepatitis A active vaccine to serologically proven non-immune daycare centre workers has a cost-benefit justification, and should be widely considered in countries with a similar hepatitis A epidemiology to that in this study.
Collapse
Affiliation(s)
- G Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | |
Collapse
|