Practice Guidelines for Teledermatology

Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140294/1/tmj.2016.0137.pd

P-32 Using Evidence-based medicine summaries to help answer health economic questions

High quality meta-analyses, systematic reviews, and structured literature reviews are extremely useful for understanding the quality, and strength of published findings. However, high quality review studies, are time consuming and many published studies are suboptimal – lacking rigor, statistical power, or sufficiently specified models, a particular concern for cost-related studies. ACRES (Automatic Clinical Result Extraction and Summarization) is a machine learning-based software program designed to read abstracts from PubMed, extract the key trial elements, compute ratios (e.g., absolute risk reduction (ARR)) for proposed treatments, and generate summaries for the purpose of evidence-based medicine decision making. By generating detailed summaries and three ranking categories for PubMed search results, ACRES reduced time spent examining irrelevant papers, and was 4% more accurate in identifying relevant papers than was a systematic review on diabetes education and cost that was conducted by humans in 2008

Dermatology and HIV/AIDS in Africa

Human immunodeficiency virus and the acquired immunodeficiency syndrome (HIV/AIDS) have greatly complicated dermatologic disease and the required care in most regions of Africa. Opportunistic infections, ectoparasites, Kaposi sarcoma, and skin manifestations of systemic infections are exceedingly common in patients with HIV/AIDS. Dermatologists have contributed significantly to our knowledge base about HIV/AIDS and have played an important educational role regarding the clinical manifestations historically. Because of the increased burden of skin disease in Africa due to the HIV/AIDS epidemic we must redouble our efforts to provide dermatology education to care providers in Africa. We review the burden of skin disease in Africa, how it relates to HIV/AIDS and global infectious disease, current educational strategies in Africa to address this need, and suggest potential solutions to move these efforts forward

Granulocyte Colony-Stimulating Factor for Chemotherapy-Induced Neutropenia in Patients with Small Cell Lung Cancer: The 40% Rule Revisited

Recombinant granulocyte colony-stimulating factor (G-CSF) [filgrastim and lenograstim] and pegylated G-CSF (pegfilgrastim) have been shown to reduce the severity and duration of chemotherapy-associated febrile neutropenia (FN) when administered prophylactically to cancer patients receiving chemotherapeutic regimens. The American Society of Clinical Oncology (ASCO) evidence-based clinical guidelines published in 1994, 1996 and 1997 recommended primary prophylaxis with G-CSF for cancer patients. The 2000 ASCO update, with the same recommendation, highlights the importance of economic considerations in decision making for CSFs. This paper reviews the available cost-effectiveness evidence on the use of G-CSF as primary prophylaxis against FN in patients with small cell lung cancer (SCLC). Cost-effectiveness ratios from a healthcare payer perspective supported the use of filgrastim as primary prophylaxis for people with SCLC, on the basis of both clinical and economic benefits, treated with chemotherapeutic regimens that have an FN rate in the range of 40-60%. However, when indirect and patient out-of-pocket costs attributable to severe FN are included, available evidence suggests that the risk threshold may be reduced by more than half. Given that FN rates associated with chemotherapeutic regimens for SCLC are generallyCost-effectiveness, Febrile-neutropenia, Filgrastim, Granulocyte-colony-stimulating-factors, Lenograstim, Pegfilgrastim, Small-cell-lung-cancer