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5. Cost Effectiveness of Sequencing 34 Cancer-Associated Genes as an Aid for Treatment Selection in Patients with Metastatic Melanoma

Author

Li, Yonghong, Bare, Lance A, Bender, Richard A, Sninsky, John J, Wilson, Leslie S, Devlin, James J, and Waldman, Frederic M

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Health Services, Cost Effectiveness Research, Biotechnology, Cancer, Genetics, Clinical Research, Good Health and Well Being, Cost-Benefit Analysis, Decision Support Techniques, Genetic Predisposition to Disease, Health Expenditures, High-Throughput Nucleotide Sequencing, Humans, Melanoma, Models, Economic, Mutation, Neoplasm Metastasis, Proto-Oncogene Proteins B-raf, Quality-Adjusted Life Years, Sensitivity and Specificity, Sequence Analysis, DNA, Pharmacology and Pharmaceutical Sciences, Oncology & Carcinogenesis, Pharmacology & Pharmacy, Pharmacology and pharmaceutical sciences
Abstract

ObjectiveTo determine whether a next-generation sequencing (NGS) panel of 34 cancer-associated genes would cost-effectively aid in the treatment selection for patients with metastatic melanoma, compared with a single-site BRAF V600 mutation test.MethodsA decision model was developed to estimate the costs and health outcomes of the two test strategies. The cost effectiveness of these two strategies was analyzed from a payer perspective over a 2-year time horizon with model parameters taken from the literature.ResultsIn the base case, the gene sequencing panel strategy resulted in a cost of US$120,022 and 0.721 quality-adjusted life years (QALYs) per patient, whereas the single-site mutation test strategy resulted in a cost of US$128,965 and 0.704 QALYs. Thus, the gene sequencing panel strategy cost US$8943 less per patient and increased QALYs by 0.0174 per patient. Sensitivity analyses showed that, compared with the single-site mutation test strategy, the gene sequencing panel strategy had a 90.9% chance of having reduced costs and increased QALYs, with the cost of the gene sequencing panel test having minimal effect on the incremental cost.ConclusionCompared with the single-site mutation test, the use of an NGS panel of 34 cancer-associated genes as an aid in selecting therapy for patients with metastatic melanoma reduced costs and increased QALYs. If the base-case results were applied to the 8900 patients diagnosed with metastatic melanoma in the USA each year, the gene sequencing panel strategy could result in an annual savings of US$79.6 million and a gain of 155 QALYs.

Published
2015

11. Prediction of Future Medical Costs by Modifiable Measures of Health

Author

Haji-Sheikhi,Farnoosh, Fragala,Maren S, Bare,Lance A, Rowland,Charles M, Goldberg,Steven E, Haji-Sheikhi,Farnoosh, Fragala,Maren S, Bare,Lance A, Rowland,Charles M, and Goldberg,Steven E

Abstract

Farnoosh Haji-Sheikhi, Maren S Fragala, Lance A Bare, Charles M Rowland, Steven E Goldberg Quest Diagnostics, Secaucus, NJ, USACorrespondence: Maren S Fragala, Quest Diagnostics, 500 Plaza Dr, Secaucus, NJ, 07094, USA, Tel +1 508 728 2923, Email Maren.S.Fragala@QuestDiagnostics.comIntroduction: Strategies to mitigate rising health-care costs are a priority for patients, employers, and health insurers. Yet gaps currently exist in whether health risk assessment can forecast medical claims costs. This study examined the ability of a health quotient (HQ) based on modifiable risk factors, age, sex, and chronic conditions to predict future medical claims spending.Methods: The study included 18,695 employees and adult dependents who participated in health assessments and were enrolled in an employer-sponsored health plan. Linear mixed effect models stratified by chronic conditions and adjusted for age and sex were utilized to evaluate the relationship between the health quotient (score of 0– 100) and future medical claims spending.Results: Lower baseline health quotient was associated with higher medical claims cost over 2 years of follow up. For participants with chronic condition(s), costs were &dollar;3628 higher for those with a low health quotient (< 73; N = 2673) compared to those with high health quotient (> 85; N = 1045), after adjustment for age and sex (P value = 0.004). Each one-unit increase in health quotient was associated with a decrease of &dollar;154 (95% CI: 87.4, 220.3) in average yearly medical claims costs during follow up.Discussion: This study used a large employee population with 2 years of follow-up data, which provides insights that are applicable to other large employers. Results of this analysis contribute to our ability to predict health-care costs using modifiable aspects of health, objective laboratory testing and chronic condition status.Keywords: employee population, healthcare spend, health quotient, health risk assessment

Published
2023

12. Cardiometabolic Risk Increased in Working-Aged Adults During the COVID-19 Pandemic.

Author

Fragala, Maren S., Matsushita, Fumika, Chen, Zhen, and Bare, Lance A.

Abstract

Background: Public health measures necessary to mitigate the spread of coronavirus disease 2019 (COVID-19) impacted lifestyles and health practices. This multiyear cohort analysis of U.S. working-aged adults aims to evaluate the impact of the COVID-19 pandemic on metabolic syndrome and explores contributing factors. Methods: This longitudinal study (n = 19,543) evaluated year-to-year changes in metabolic syndrome and cardiometabolic risk factors through employer-sponsored annual health assessment before and during the COVID-19 pandemic using logistic mixed-effects model. Results: From prepandemic to pandemic (2019 to 2020), prevalence of metabolic syndrome increased by 3.5% for men and 3.0% for women, across all ethnic groups. This change was mainly driven by increased fasting glucose (7.3%) and blood pressure (5.2%). The increased risk of metabolic syndrome was more likely to occur in individuals with an elevated body mass index (BMI) combined with insufficient sleep or physical activity. Conclusions: Cardiometabolic risk increased during the COVID-19 pandemic compared with before the pandemic in a working-aged adult population, more so for those with a high BMI, unhealthy sleep, and low physical activity practices. Given this observation, identification of risk and intervention (including lifestyle and medical) is increasingly necessary to reduce the cardiovascular and metabolic risk, and improve working-aged population health. [ABSTRACT FROM AUTHOR]

Published
2023
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20. A follow-up study of a genome-wide association scan identifies a susceptibility locus for venous thrombosis on chromosome 6p24.1

Author

Morange, Pierre-Emmanuel, Bezemer, Irene, Saut, Noemie, Bare, Lance, Burgos, Gwenaelle, Brocheton, Jessy, Durand, Herve, Biron-Andreani, Christine, Schved, Jean-Francois, Pernod, Gilles, Galan, Pilar, Drouet, Ludovic, Zelenika, Diana, Germain, Marine, Nicaud, Viviane, Heath, Simon, Ninio, Ewa, Delluc, Aurelien, Munzel, Thomas, Zeller, Tanja, Brand-Herrmann, Stefan-Martin, Alessi, Marie-Christine, Tiret, Laurence, Lathrop, Mark, Cambien, Francois, Blankenberg, Stefan, Emmerich, Joseph, Tregouet, David-Alexandre, and Rosendaal, Frits R.

Subjects
Human genome -- Research, Single nucleotide polymorphisms -- Analysis, Genetic transcription -- Analysis, Venous thrombosis -- Genetic aspects, Biological sciences
Abstract

A multistage strategy was used to obtain strong evidence for implication of the HIVEP1 locus as a candidate for venous thrombosis (VT) risk. The results provide first evidence for the role of a genetic variant on the risk of VT outside the traditional coagulation/fibrinolysis cascade.

Published
2010

22. Gene variants associated with deep vein thrombosis

Author

Bezemer, Irene D., Bare, Lance A., Doggen, Carine J.M., Tong, Carmen, Arellano, Andre R., Rowland, Charles M., Young, Bradford A., Reitsma, Pieter H., Devlin, James J., Rosendaal, Frits R., and Catanese, Joseph

Subjects
Venous thrombosis -- Health aspects, Venous thrombosis -- Causes of, Genes -- Research, Genetic variation -- Risk factors
Abstract

A study to ascertain whether gene variation could be associated as a cause of deep vein thrombosis (DVT) was conducted. Results showed that certain genetic variation was associated with DVT.

Published
2008

31. Additional file 1: Table S1. of Use of low density lipoprotein particle number levels as an aid in statin treatment decisions for intermediate risk patients: a cost-effectiveness analysis

Author

Shiffman, Dov, Arellano, Andre, Caulfield, Michael, Louie, Judy, Bare, Lance, Devlin, James, and Melander, Olle

Abstract

Health outcomes and costs for different statin treatment strategies for primary prevention of cardiovascular disease in 100,000 hypothetical intermediate risk patients: Base-case analysis. Table S2. Deterministic Sensitivity Analysis. Incremental Cost and Incremental QALY per 100,000 patients for all parameters for the Test and HST strategy 1 compared with the MST strategy. Table S3. Deterministic Sensitivity Analysis. Incremental Cost and Incremental QALY per 100,000 patients for all parameters for the Test and MST strategy 1 compared with the Do-Not-Treat strategy. Table S4. Deterministic Sensitivity Analysis Incremental Cost and Incremental QALY per 100,000 patients for all parameters for the HST strategy compared 1 with the MST strategy. (DOCX 67 kb)

Published
2016
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34. Vascular associated gene variants in patients with preeclampsia:results from the Danish National Birth Cohort

Author

Lykke, Jacob A, Bare, Lance A, Olsen, Jørn, Lagier, Robert, Tong, Carmen, Arellano, Andre, Paidas, Michael J, and Langhoff-Roos, Jens

Subjects
female genital diseases and pregnancy complications, reproductive and urinary physiology
Abstract

Objective. Preeclampsia has been linked to subsequent vascular disease with many shared predisposing factors. We investigated the association between severe preeclampsia, and its subtypes, and specific vascular-related polymorphisms. Design. The study was a retrospective nested case-cohort design. Setting. Pregnant Danish women participating in the Danish National Birth Cohort. Population. 263 cases of severe preeclampsia and 1851 random controls were selected from the Danish National Birth Cohort. Methods. We validated all cases of severe preeclampsia and genotyped for 108 single nucleotide polymorphisms (SNPs) that were selected based on previous publications on the association with vascular disease. Logistic models were used for statistical analyses. Main outcome measures. Maternal polymorphisms in genomic models. Results. We found 17 of 108 SNPs associated with severe preeclampsia (p

Published
2012
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37. Genetic Variations Associated With Recurrent Venous Thrombosis

Author

Vlieg, Astrid van Hylckama, primary, Flinterman, Linda E., additional, Bare, Lance A., additional, Cannegieter, Suzanne C., additional, Reitsma, Pieter H., additional, Arellano, Andre R., additional, Tong, Carmen H., additional, Devlin, James J., additional, and Rosendaal, Frits R., additional

Published
2014
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39. Abstract 18: Apo(a) Isoform Size Is Associated with Myocardial Infarction in a Study of an Admixed Population from the Central Valley of Costa Rica

Author

Bare, Lance A, primary, Rowland, Charles M, additional, Koschinsky, Marlys L, additional, Boffa, Michael B, additional, Tong, Carmen H, additional, Arellano, Andre R, additional, Catanese, Joseph J, additional, Shiffman, Dov, additional, Devlin, James J, additional, and Campos, Hannia, additional

Published
2012
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40. Genetic variants in the KIF6 region and coronary event reduction from statin therapy

Author

Li, Yonghong, primary, Sabatine, Marc S., additional, Tong, Carmen H., additional, Ford, Ian, additional, Kirchgessner, Todd G., additional, Packard, Christopher J., additional, Robertson, Michele, additional, Rowland, Charles M., additional, Bare, Lance A., additional, Shepherd, James, additional, Devlin, James J., additional, and Iakoubova, Olga A., additional

Published
2010
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43. GOSR2 Lys67Arg Is Associated With Hypertension in Whites

Author

Meyer, Tamra E., primary, Shiffman, Dov, additional, Morrison, Alanna C., additional, Rowland, Charles M., additional, Louie, Judy Z., additional, Bare, Lance A., additional, Ross, David A., additional, Arellano, Andre R., additional, Chasman, Daniel I., additional, Ridker, Paul M., additional, Pankow, James S., additional, Coresh, Josef, additional, Malloy, Mary J., additional, Kane, John P., additional, Ellis, Stephen G., additional, Devlin, James J., additional, and Boerwinkle, Eric, additional

Published
2008
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45. Association of Gene Variants With Incident Myocardial Infarction in the Cardiovascular Health Study

Author

Shiffman, Dov, primary, O’Meara, Ellen S., additional, Bare, Lance A., additional, Rowland, Charles M., additional, Louie, Judy Z., additional, Arellano, Andre R., additional, Lumley, Thomas, additional, Rice, Kenneth, additional, Iakoubova, Olga, additional, Luke, May M., additional, Young, Bradford A., additional, Malloy, Mary J., additional, Kane, John P., additional, Ellis, Stephen G., additional, Tracy, Russell P., additional, Devlin, James J., additional, and Psaty, Bruce M., additional

Published
2008
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46. Obstetric Complications in Patients with Hereditary Thrombophilia Identified Using the LCx Microparticle Enzyme Immunoassay

Author

Kocher, Olivier, primary, Cirovic, Christine, additional, Malynn, Elizabeth, additional, Rowland, Charles M., additional, Bare, Lance A., additional, Young, Bradford A., additional, Henslee, Jerry G., additional, Laffler, Thomas G., additional, Huff, Jeffrey B., additional, Kruskall, Margot S., additional, Wong, Geoffrey, additional, and Bauer, Kenneth A., additional

Published
2007
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47. Gene Variants of VAMP8 and HNRPUL1 Are Associated With Early-Onset Myocardial Infarction

Author

Shiffman, Dov, primary, Rowland, Charles M., additional, Louie, Judy Z., additional, Luke, May M., additional, Bare, Lance A., additional, Bolonick, Joel I., additional, Young, Bradford A., additional, Catanese, Joseph J., additional, Stiggins, Charles F., additional, Pullinger, Clive R., additional, Topol, Eric J., additional, Malloy, Mary J., additional, Kane, John P., additional, Ellis, Stephen G., additional, and Devlin, James J., additional

Published
2006
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49. Identification of motilin mRNA in the brain of man and rabbit. Conservation of polymorphism of the motilin gene across species

Author

Depoortere, Inge, De Clercq, Pierre, Svoboda, Michal, Bare, Lance, Peeters, Theo L, Depoortere, Inge, De Clercq, Pierre, Svoboda, Michal, Bare, Lance, and Peeters, Theo L

Abstract

The data regarding the identity of motilin-like immunoreactivity in the central nervous system are controversial. The aim of the present study was to clarify whether motilin mRNA is present in the brain of rabbit and man. Total RNA, prepared from several regions of the rabbit brain, was subjected to RT- PCR aimed at amplifying a 294 bp cDNA fragment of the rabbit motilin precursor. The amplified product was subcloned and sequenced. The sequence showed 7 differences compared to the one reported for the duodenal precursor (I). However the duodenal precursor from the rabbit used in the present study revealed identical substitutions. One of these, involving amino acid -11 of the signal peptide, was shown to be due to gene polymorphism, as has also been described at this site in man. By radioimmunoassay the highest concentration of motilin (fmol/mg protein) was detected in the hippocampus (4788 ± 295), the lowest in the telencephalon (2127 ± 221). Using a similar approach, but starting from commercial human brain mRNA, the sequence of a comparable cDNA fragment of the human brain motilin precursor was obtained. Its sequence was identical with the one published for the human intestinal precursor (41). Our study demonstrates that motilin mRNA is present in the brain of man and rabbit. Together with our recent findings of central motilin receptors, they suggest a central role for motilin., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
1997

50. Genetic Variations Associated With Recurrent Venous Thrombosis.

Author

van Hylckama Vlieg, Astrid, Flinterman, Linda E., Bare, Lance A., Cannegieter, Suzanne C., Reitsma, Pieter H., Arellano, Andre R., Tong, Carmen H., Devlin, James J., and Rosendaal, Frits R.

Subjects
SINGLE nucleotide polymorphisms, VENOUS thrombosis risk factors, DISEASE relapse, CARDIOVASCULAR diseases risk factors
Abstract

The article presents a study that investigates and assesses the effectiveness of genetic multiple single nucleotide polymorphism (SNP) in predicting the recurrence of venous thrombosis in patients in the Netherlands. Researchers carried out multiple environmental and genetic assessment (MEGA) on the venous thrombosis risk factors of patients from March 1999 to September 2004. Moreover, they found that SNP is correlated with venous thrombosis recurrence.

Published
2014
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