Citations 2
Short delay in initiation of radiotherapy for patients with glioblastoma-effect of concurrent chemotherapy: a secondary analysis from the NRG Oncology/Radiation Therapy Oncology Group database
Blumenthal, Deborah T. , Won, Minhee , Brown, Paul D. , Bokstein, Felix , Brachman, David, Werner‐Wasik, Maria, Hunter, G.K., Valeinis, Egils , Hopkins, Kirsten, Souhami, Luís, Howard, Steven , Lieberman, Frank S. , Shrieve, Dennis C. , Wendland, Merideth M, Robinson, Clifford G. , Corn, Benjamin W. , Robinson, Clifford , Mehta, Minesh P. , Gilbert, Mark R. , Zhang, Peixin
Neuro-Oncology | February 13, 2018 | Volume: 20 | Issue: 7 | Pages: 966-974
Effectiveness of Anti-TNFα for Crohn Disease: Research in a Pediatric Learning Health System
Crandall, Wallace, Joffe, Marshall M., Colletti, Richard B. , Adler, Jeremy, Baron, Howard, Berman, James , Rosario, J. Fernando del , Grossman, Andrew B., Israel, Esther J. , Kim, Sandra C. , Lightdale, Jenifer R. , Margolis, Peter A. , Marsolo, Keith , Mehta, Devendra I. , Milov, David E., Patel, Ashish , Tung, Jeanne , Forrest, Christopher B. , Bailey, L. Charles , Zhang, Peixin , Adler, Jeremy, Hoffenberg, Edward J. , Kappelman, Michael D. , Adler, J
Pediatrics | June 17, 2014 | Volume: 134 | Issue: 1 | Pages: 37-44
OBJECTIVES: ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as a quality improvement collaborative. To test the feasibility and validity of using ICN data for clinical research, we evaluated the effectiveness of anti-tumor necrosis factor-α (anti-TNFα) agents in the management of pediatric Crohn disease (CD). METHODS: Data were collected in 35 pediatric gastroenterology practices (April 2007 to March 2012) and analyzed as a sequence of nonrandomized trials. Patients who had moderate to severe CD were classified as initiators or non-initiators of anti-TNFα therapy. Among 4130 patients who had pediatric CD, 603 were new users and 1211 were receiving anti-TNFα therapy on entry into ICN. RESULTS: During a 26-week follow-up period, rate ratios obtained from Cox proportional hazards models, adjusting for patient and disease characteristics and concurrent medications, were 1.53 (95% confidence interval [CI], 1.20–1.96) for clinical remission and 1.74 (95% CI, 1.33–2.29) for corticosteroid-free remission. The rate ratio for corticosteroid-free remission was comparable to the estimate produced by the adult SONIC study, which was a randomized controlled trial on the efficacy of anti-TNFα therapy. The number needed to treat was 5.2 (95% CI, 3.4–11.1) for clinical remission and 5.0 (95% CI, 3.4–10.0) for corticosteroid-free remission. CONCLUSIONS: In routine pediatric gastroenterology practice settings, anti-TNFα therapy was effective at achieving clinical and corticosteroid-free remission for patients who had Crohn disease. Using data from the ICN learning health system for the purpose of observational research is feasible and produces valuable new knowledge.