Gregory F . Guzauskas

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BACKGROUND AND PURPOSE Despite the availability of results from multiple newer clinical trials and changing healthcare costs, the cost-effectiveness of recombinant tissue-type plasminogen activator (r-tPA) for treatment of acute ischemic stroke within 0 to 3 hours of symptom onset was last evaluated in 1998 for the United States Using current evidence, we(More)
BACKGROUND Uncertainty regarding clopidogrel effectiveness attenuation because of a drug-drug interaction with proton pump inhibitors (PPI) has led to conflicting guidelines on concomitant therapy. In particular, the effect of this interaction in patients who undergo a percutaneous coronary intervention (PCI), a population known to have increased risk of(More)
Stroke is a significant public health problem and one of the most costly diseases in the United States. Each year, ≈800 000 Americans experience a new or recurrent stroke and 134 000 deaths occur as a result of strokes. An estimated $74 billion were spent in 2010 on stroke-related medical costs and disability. The burden of disease from stroke is expected(More)
The "big data" era represents an exciting opportunity to utilize powerful new sources of information to reduce clinical and health economic uncertainty on an individual patient level. In turn, health economic outcomes research (HEOR) practices will need to evolve to accommodate individual patient-level HEOR analyses. We propose the concept of "precision(More)
The objective of this study was to quantitatively evaluate the clinical benefits and harms of prasugrel, clopidogrel, and a CYP2C19 genotype-guided drug selection strategy for patients with acute coronary syndrome (ACS) and planned percutaneous coronary intervention (PCI). We used decision-analytic techniques to model the risks and benefits of alternative(More)
BACKGROUND AND PURPOSE Primary stroke centers (PSC) have demonstrated improved survival in patients with acute ischemic stroke (AIS). The objective of this study was to evaluate the cost-effectiveness of treating AIS patients in a PSC compared with a nonPSC hospital setting. METHODS We developed a decision analytic model to project the lifetime outcomes(More)
Stroke is a significant public health problem and one of the most costly diseases in the United States. Each year, ≈800 000 Americans experience a new or recurrent stroke and 134 000 deaths occur as a result of strokes. An estimated $74 billion were spent in 2010 on stroke-related medical costs and disability. The burden of disease from stroke is expected(More)
Introduction Mild traumatic brain injury (mTBI) is an unfortunately common repercussion of military service in a combat zone. The CONTACT study tested an individualized telephone support intervention employing problem solving therapy (PST) for mTBI in soldiers recently returned from deployment. We sought to determine the cost effectiveness of this(More)
BACKGROUND A Phase-3 study of defibrotide compared with historical controls demonstrated a 23% improvement in 100-day survival post-hematopoietic stem cell transplantation (HSCT) among patients with veno-occlusive disease with multi-organ dysfunction (VOD with MOD). AIM To estimate the budget impact and cost-effectiveness of introducing defibrotide to a(More)
Purpose:Genetic services policymakers and insurers often make coverage decisions in the absence of complete evidence of clinical utility and under budget constraints. We evaluated genetic services stakeholder opinions on the potential usefulness of decision-analytic modeling to inform coverage decisions, and asked them to identify genetic tests for(More)