Scope of Review for Orders Confirming, Vacating, or Modifying Arbitral Awards: An End to Deferential Standards - First Options of Chicago, Inc. v. Kaplan

Congressional intent to make arbitration a viable alternative to traditional litigation is codified in the Federal Arbitration Act ( FAA ). Although the FAA and the subsequent case law have settled most questions about the details of the arbitration process, the United States Supreme Court in First Options took up the narrow issue of what standard of review should be used by an appellate court reviewing a district court decision vacating, confirming or modifying an arbitrator\u27s order.\u27 Facing the Court were two competing policies: the Court\u27s own policy of keeping standards of review simple and rational against the Congressional policy of assuring that arbitration does not become a stopping point on the way to court

Judicial Review of Contract Interpretation by Labor Arbitrators: Whose Brand of Industrial Justice - Houston Lighting & (and) Power Co. v. Int\u27l Bhd. of Elec. Workers, Local Union No. 66

The United States Supreme Court has prescribed the deference owed to an arbitrator\u27s interpretation of labor agreements. The Court\u27s decisions have made clear the narrow grounds upon which an arbitration award may be reversed. In Houston Lighting & Power Co. v. Int\u27l Bhd of Elec. Workers, Local Union No. 66, the employer claimed that the labor arbitrator had exceeded his authority by misinterpreting the labor agreement. The Fifth Circuit Court of Appeals had to weigh the policy of deference to the arbitrator\u27s interpretation against the need to ensure that the arbitrator acted within the authority which the parties to the labor agreement granted him

Impact of Atrial Fibrillation on Stroke‐Related Healthcare Costs

Background: Limited data exist on the economic implications of stroke among patients with atrial fibrillation (AF). This study assesses the impact of AF on healthcare costs associated with ischemic stroke (IS), hemorrhagic stroke (HS), or transient ischemic attack (TIA). Methods and Results: A retrospective analysis of MarketScan claims data (2005‐2011) for AF patients ≥18 years old with ≥1 inpatient claim for stroke, or ≥1 ED or inpatient claim for TIA as identified by ICD‐9‐CM codes who had ≥12 months continuous enrollment prior to initial stroke. Initial event‐ and stroke‐related costs 12 months post‐index were compared among patients with AF and without AF. Adjusted costs were estimated, controlling for demographics, comorbidities, anticoagulant use, and baseline resource use. Data from 23 807 AF patients and 136 649 patients without AF were analyzed. Unadjusted mean cost of the index event was $20 933 for IS,$59 054 for HS, $8616 for TIA hospitalization, and$3395 for TIA ED visit. After controlling for potential confounders, adjusted mean incremental costs (index plus 12‐month post‐index) for AF patients were higher than those for non‐AF patients by: $4726,$7824, and $1890 for index IS, HS, TIA (identified by hospitalization), respectively, and$1700 for TIA (identified by ED) (all P<0.01). In multivariate regression analysis, AF was associated with a 20% (IS), 13% (HS), and 18% (TIA) increase in total stroke‐related costs. Conclusion: Stroke‐related care for IS, HS, and TIA is costly, especially among individuals with AF. Reducing the risk of AF‐related stroke is important from both clinical and economic standpoints

The ENIGMA-Epilepsy working group: Mapping disease from large data sets

Epilepsy is a common and serious neurological disorder, with many different constituent conditions characterized by their electro clinical, imaging, and genetic features. MRI has been fundamental in advancing our understanding of brain processes in the epilepsies. Smaller‐scale studies have identified many interesting imaging phenomena, with implications both for understanding pathophysiology and improving clinical care. Through the infrastructure and concepts now well‐established by the ENIGMA Consortium, ENIGMA‐Epilepsy was established to strengthen epilepsy neuroscience by greatly increasing sample sizes, leveraging ideas and methods established in other ENIGMA projects, and generating a body of collaborating scientists and clinicians to drive forward robust research. Here we review published, current, and future projects, that include structural MRI, diffusion tensor imaging (DTI), and resting state functional MRI (rsfMRI), and that employ advanced methods including structural covariance, and event‐based modeling analysis. We explore age of onset‐ and duration‐related features, as well as phenomena‐specific work focusing on particular epilepsy syndromes or phenotypes, multimodal analyses focused on understanding the biology of disease progression, and deep learning approaches. We encourage groups who may be interested in participating to make contact to further grow and develop ENIGMA‐Epilepsy

El Diario de Pontevedra : periódico liberal: Ano XXIX Número 8565 - 1912 novembro 26

Abstract Background Administrative healthcare claims data provide a mechanism for assessing and monitoring multiple sclerosis (MS) disease status across large, clinically representative “real-world” populations. The estimation of MS disease status using administrative claims can be a challenge, however, due to a lack of detailed clinical information. Retrospective claims analyses in MS have traditionally used rates of MS relapses to approximate disease status. Healthcare costs may be alternate, broader claims-based indicators of disease activity because costs reflect multiple facets of care of patients with MS, and there is a strong correlation between quality of life of patients with MS and costs of the disease. This study developed, tested, and validated a healthcare cost-based measure to serve as an indicator of overall disease status in patients with MS treated with disease-modifying drugs (DMDs) utilizing administrative claims. Methods Using IMS Health Real World Data Adjudicated Claims – US data (January 2006–June 2013), a negative binomial regression predicted annual all-cause medical costs. Coefficients reaching statistical significance (p < 0.05) and increasing costs by ≥5% were selected for inclusion into an MS-specific severity score (scale of 0 to 100). Components of the score included rehabilitation services, altered mental state, pain, disability, stiffness, balance disorder, urinary incontinence, numbness, malaise/fatigue, and infections. Coefficient weights represented each predictor’s contribution. The predictive model was derived using 50% of a random sample and tested/validated using the remaining 50%. Results Average overall predicted annual total medical cost was $11,134 (development sample, n = 11,384, vs.$10,528 actual) and $11,303 (validation sample, n = 11,385, vs.$10,620 actual). The model had consistent bias (approximately +$600 or +6$5243 predicted vs. $5233 actual cost for lowest tertile). Conclusion The algorithm developed in this study provides an initial step to helping understand and potentially predict cost changes for a commercially insured MS population

33 The impact of social media on anxiety and depression among patients with neuroendocrine carcinoma of the cervix: a Neuroendocrine Cervical Tumor Registry (NeCTuR) study

Objectives: Neuroendocrine carcinoma of the cervix (NECC) accounts for less than 1–2% of all cervical cancers. The rare nature of this disease is reflected in the limited educational resources available to patients, often leading them to seek information online through patient-led social networks. The objectives of this study were to: (1) examine social media use among NECC patients; and (2) examine their levels of anxiety and depression, and (3) correlate anxiety and depression levels with social media use. Methods: Seven surveys that assess social media use, anxiety, depression, and quality of life were distributed to known to be alive NECC patients enrolled in our Neuroendocrine Cervical Tumor Registry (NeCTuR). The primary outcome was the association between the Social Network Time Use Scale (SONTUS) global score and both the Generalized Anxiety Disorder (GAD-7) and the Center for Epidemiologic Studies Depression Scale (CES-D) total scores. Spearman's rank correlation and logistic regression were used for statistical analysis. Results: Eighty-eight patients enrolled in the study. Eighty-one patients who fully or partially completed the surveys were included.Most patients (97%) are low to average social media users. Regarding the Sisters United Facebook page, a NECC patient-led support group, 53 patients (74%) visited the page in the past 2 weeks and out of those, 42 patients (79%) reported receiving useful information. Among those who didn't visit the page (n=19), 9 patients (47%) reported that the online support group elicited anxiety and/or sadness. The mean GAD-7 and CES-D scores for the entire cohort were 7.3 and 18.1, respectively. The Spearman correlations between social media use and both anxiety and depression levels were significant (0.23 (p=0.05), GAD-7 and 0.25 (p=0.04), CES-D). The estimated odds ratio for moderate/severe anxiety as a function of the SONTUS global score was 1.26 (95% CI 1.03 to 1.55) (p=0.03) and that of depression was 1.23 (95% CI 1.01 to 1.49) (p=0.04). Conclusions: NECC patients demonstrated average social media use and relatively high levels of anxiety and depression. There seems to be an association between increased social media use and both anxiety and depression

Factors associated with early initiation of disease-modifying drug treatment in newly-diagnosed patients with multiple sclerosis

<p><b>Objective:</b> To examine the time to first disease-modifying drug (DMD) treatment and to identify factors associated with early DMD initiation in newly-diagnosed patients with MS.</p> <p><b>Methods:</b> This retrospective cohort study included newly-diagnosed patients with MS from a US administrative claims database, aged 18–65 years, with a first MS diagnosis (ICD-9-CM code: 340.xx) between January 1, 2007 and June 30, 2013 (index date), continuous eligibility for 12 months pre- and 24 months post-index, and initiated DMD treatment within 2 years. Time to first DMD within 24 months post-index was evaluated. A logistic regression model predicted earlier initiation of DMD treatment (within 60 days of MS diagnosis).</p> <p><b>Results:</b> In total, 37.4% of patients initiated DMD treatment within 2 years of MS diagnosis and were included in the primary analysis (<i>n</i> = 7,124). Mean (standard deviation [SD]) time from MS diagnosis to first DMD was 112.6 (148.3) days (median = 51); 30.7% received first DMD in <30 days, 55.1% in <60 days, and 18.5% not until ≥180 days after diagnosis. Logistic regression found that younger age; not living in the Northeast; diagnoses of balance disorders, numbness, and optical neuritis; the absence of musculoskeletal diagnoses; and a neurologist visit or MRI within 90 days before diagnosis were associated with DMD initiation within 60 days.</p> <p><b>Conclusions:</b> In this population of patients initiating DMD treatment within 2 years of MS diagnosis, mean time to first DMD was 112.6 days. Identifying factors associated with delayed treatment may provide better understanding of the reasons for delay, leading to improved disease management.</p