Jessica A. Myers

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INTRODUCTION The Orphan Drug Act encourages drug development for rare conditions. However, some orphan drugs become top sellers for unclear reasons. We sought to evaluate the extent and cost of approved and unapproved uses of orphan drugs with the highest unit sales. METHODS We assessed prescription patterns for four top-selling orphan drugs: lidocaine(More)
BACKGROUND Among the large number of cohort studies that employ propensity score matching, most match patients 1:1. Increasing the matching ratio is thought to improve precision but may come with a trade-off with respect to bias. OBJECTIVE To evaluate several methods of propensity score matching in cohort studies through simulation and empirical analyses.(More)
Recent theoretical studies have shown that conditioning on an instrumental variable (IV), a variable that is associated with exposure but not associated with outcome except through exposure, can increase both bias and variance of exposure effect estimates. Although these findings have obvious implications in cases of known IVs, their meaning remains unclear(More)
CONTEXT The Orphan Drug Act incentivizes medication development for rare diseases, offering substantial financial benefits to the manufacturer. Orphan products constitute most new drug approvals in oncology, but safety and efficacy questions have emerged about some of these agents. OBJECTIVES To define characteristics of orphan cancer drugs and their(More)
BACKGROUND Adjusting for laboratory test results may result in better confounding control when added to administrative claims data in the study of treatment effects. However, missing values can arise through several mechanisms. METHODS We studied the relationship between availability of outpatient lab test results, lab values, and patient and system(More)
BACKGROUND Admission to a room previously occupied by a patient with certain multidrug-resistant organisms (MDROs) increases the risk of acquisition. Traditional cleaning strategies do not remove all environmental MDROs. We evaluated the environmental and clinical impact of hydrogen peroxide vapor (HPV) room disinfection. METHODS We performed a 30-month(More)
BACKGROUND The effects of clinical-trial funding on the interpretation of trial results are poorly understood. We examined how such support affects physicians' reactions to trials with a high, medium, or low level of methodologic rigor. METHODS We presented 503 board-certified internists with abstracts that we designed describing clinical trials of three(More)
OBJECTIVE Previous study findings have suggested that patients with chronic diseases such as rheumatoid arthritis (RA) do not receive optimal preventive medical services, including cancer screening tests. This study was undertaken to evaluate cancer screening rates in RA patients compared to non-RA control populations. METHODS Using data from a large US(More)
Longitudinal healthcare claims databases are frequently used for studying the comparative safety and effectiveness of medications, but results from these studies may be biased due to residual confounding. It is unclear whether methods for confounding adjustment that have been shown to perform well in small, simple nonrandomized studies are applicable to the(More)
In recent years, the number of studies using a cluster-randomized design has grown dramatically. In addition, the cluster-randomized crossover design has been touted as a methodological advance that can increase efficiency of cluster-randomized studies in certain situations. While the cluster-randomized crossover trial has become a popular tool, standards(More)