Lauren E Cipriano

Lauren E Cipriano
The University of Western Ontario | UWO · Ivey Business School

PhD

About

47
Publications
4,489
Reads
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2,155
Citations
Additional affiliations
July 2013 - present
Western University
Position
  • Professor (Assistant)

Publications

Publications (47)
Article
Full-text available
Purpose of review Atrial fibrillation is being increasingly diagnosed after ischemic stroke and transient ischemic attack (TIA). Patient characteristics, frequency and duration of paroxysms, and the risk of recurrent ischemic stroke associated with atrial fibrillation detected after stroke and TIA (AFDAS) may differ from atrial fibrillation already...
Article
We thank Nielsen et al for their positive comments regarding our meta-analysis and for highlighting the hurdles in designing studies to estimate the risk of stroke in patients with atrial fibrillation and a CHA2DS2-VASc score of 1. Among people with nonvalvular atrial fibrillation, CHA2DS2-VASc score of 1 is estimated to comprise 12.4% of patients...
Article
Full-text available
Background and purpose: Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina. Methods: We prospectively identified all first-ever s...
Article
Background and Purpose— The CHA2DS2-VASc score aims to improve risk stratification of ischemic stroke among patients with atrial fibrillation to identify those who can safely forego oral anticoagulation. Oral anticoagulation treatment guidelines remain uncertain for CHA2DS2-VASc score of 1. We conducted a systematic review and meta-analysis of the...
Article
Full-text available
This longitudinal population-based study explores trends in declining dementia rates using health care administrative data from the Canadian Institute for Health Information for the province of Ontario, Canada.Stroke and dementia pose significant threats to the adult brain and share the same treatable risk factors.1 Stroke incidence in high-income...
Article
Neurovascular Units: A New Cost Effective Model? - Volume 42 Issue 5 - Antonia Nucera, Lauren Cipriano, Vladimir Hachinski
Article
Guidelines suggest that only poststroke atrial fibrillation episodes lasting 30 s or longer should be considered for anticoagulation. However, little evidence supports this recommendation. We performed a systematic review and meta-analysis to investigate the frequency of poststroke atrial fibrillation lasting less than 30 s in stroke and transient...
Article
Among patients with atrial fibrillation, the risk of stroke is highest for those with a history of stroke; however, oral anticoagulants can lower the risk of recurrent stroke by two-thirds. No consensus has been reached about how atrial fibrillation should be investigated in patients with stroke, and its prevalence after a stroke remains uncertain....
Conference Paper
Chronic hepatitis C (HCV) is a significant public health problem affecting 2.7-3.9 million Americans. Quantifying mortality rates of HCV-infected individuals permits more accurate estimates of the potential benefits of HCV screening and treatment. With 5% of older Americans infected with HCV, cost-effectiveness analyses of expanded HCV screening an...
Article
To identify best-fitting input sets using model calibration, individual calibration target fits are often combined into a single goodness-of-fit (GOF) measure using a set of weights. Decisions in the calibration process, such as which weights to use, influence which sets of model inputs are identified as best-fitting, potentially leading to differe...
Conference Paper
Purpose: CDC guidelines recommend hepatitis C virus (HCV) screening for the 1945-1965 birth cohorts. Since HCV prevalence is decreasing with birth-year, age-specific screening is less cost-effective in later cohorts. To inform the optimal time to discontinue screening, collecting additional information may be valuable, though when this information...
Conference Paper
Purpose: Calibrating disease natural history models involves changing model inputs to match multiple targets. To identify the best-fitting input set(s), the model's fit to each individual target is often combined into an overall goodness-of-fit measure. We apply a new approach which utilizes the principle of Pareto-optimality for selecting best-fit...
Article
Background: Transcatheter aortic valve replacement (TAVR) seems to improve the survival and quality of life of patients with aortic stenosis ineligible for surgical aortic valve replacement. Methods and results: We used a decision analytic Markov model to estimate lifetime costs and benefits in a hypothetical cohort of patients with severe, symp...
Article
Objective: A subset of patients with stage IA and IB non-small cell lung cancer (NSCLC) is ineligible for surgical resection and undergoes radiation therapy. Radiofrequency ablation (RFA) and stereotactic body radiotherapy are newer potentially attractive alternative therapies. Materials and methods: We added RFA and stereotactic body radiothera...
Article
Full-text available
No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74...
Conference Paper
Purpose: Nearly 2 million Americans are unaware that they are infected with chronic hepatitis C (HCV). HCV screening and treatment may be more efficient in identifiable subgroups with higher HCV prevalence, especially when coupled with programs to reduce mortality risks from comorbidities. No single study contains data needed to estimate subgroup-s...
Article
Full-text available
To estimate the cost, effectiveness, and cost effectiveness of HIV and HCV screening of injection drug users (IDUs) in opioid replacement therapy (ORT). Dynamic compartmental model of HIV and HCV in a population of IDUs and non-IDUs for a representative U.S. urban center with 2.5 million adults (age 15-59). We considered strategies of screening ind...
Article
The natural history model underlying the MGH Lung Cancer Policy Model (LCPM) does not include the two-stage clonal expansion model employed in other CISNET lung models. We used the LCPM to predict numbers of U.S. lung cancer deaths for ages 30-84 between 1975 and 2000 under four scenarios as part of the comparative modeling analysis described in th...
Article
The aim was to examine the cost-effectiveness of magnetic resonance enterography (MRE) compared with computed tomography enterography (CTE) for routine imaging of small bowel Crohn's disease (CD) patients to reduce patients' life-time radiation-induced cancer risk. We developed a Markov model to compare the lifetime costs, benefits (measured in qua...
Article
Chronic hepatitis C virus is difficult to treat and affects approximately 3 million Americans. Protease inhibitors increase the effectiveness of standard therapy, but they are costly. A genetic assay may identify patients most likely to benefit from this treatment advance. To assess the cost-effectiveness of new protease inhibitors and an interleuk...
Article
Full-text available
Background: Chronic hepatitis C virus is difficult to treat and affects approximately 3 million Americans. Protease inhibitors increase the effectiveness of standard therapy, but they are costly. A genetic assay may identify patients most likely to benefit from this treatment advance. Objective: To assess the cost-effectiveness of new protease i...
Article
Inflammatory bowel diseases are costly chronic gastrointestinal diseases. We aimed to determine whether immediate colectomy with ileal pouch-anal anastamosis (IPAA) after diagnosis of severe ulcerative colitis (UC) was cost-effective compared to the standard medical therapy. We created a Markov model simulating 2 cohorts of 21-year-old patients wit...
Conference Paper
Purpose: Aortic stenosis, the most common valvular disease in the elderly, is associated with high morbidity and mortality. Surgical aortic valve replacement is the only treatment option available that prolongs life. Transcatheter aortic valve implantation (TAVI) is a new technology that appears to offer dramatic improvements in the quality and qua...
Article
A randomized trial has demonstrated that lung cancer screening reduces mortality. Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level. Six U.S. cohorts (men and women aged 50, 60, or 70 years) were simulated in an existing pati...
Article
Obstructive sleep apnea (OSA) is a common disorder associated with substantially increased cardiovascular risks, reduced quality of life, and increased risk of motor vehicle collisions due to daytime sleepiness. This study evaluates the cost-effectiveness of three commonly used diagnostic strategies (full-night polysomnography, split-night polysomn...
Article
A recent increase in the detection of contrast enhancing renal masses 4 cm or smaller suspicious for malignancy has led to the widespread use of nephron sparing options. Limited data exist to help clinicians decide which of these competing nephron sparing therapies is most appropriate. We performed a cost-effectiveness analysis to evaluate the rela...
Article
The objective of this analysis was to estimate costs for lung cancer care and evaluate trends in the share of treatment costs that are the responsibility of Medicare beneficiaries. The Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 1991-2003 for 60,231 patients with lung cancer were used to estimate monthly and patient-liabil...
Conference Paper
Purpose: The injection drug user (IDU) population continues to experience epidemic rates of new HIV and hepatitis C (HCV) infections. Detection of new infections during the acute phases of these diseases may provide an opportunity to improve patient outcomes and change the course of these epidemics. We aimed to compare the effectiveness and cost ef...
Article
Many myocardial infarctions and strokes occur in individuals with low-density lipoprotein cholesterol levels below recommended treatment thresholds. High sensitivity C-reactive protein (hs-CRP) testing has been advocated to identify low- and intermediate-risk individuals who may benefit from statin therapy. A decision analytic Markov model was used...
Article
To estimate the cost-effectiveness of targeted and universal screening for vasa praevia at 18-20 weeks of gestation in singleton and twin pregnancies. Cost-utility analysis based on a decision-analytic model comparing relevant strategies and life-long outcomes for mother and infant(s). Ontario, Canada. A cohort of pregnant women in 1 year. We const...
Article
The cost effectiveness of alternative approaches to the diagnosis of small-bowel Crohn's disease is unknown. This study evaluates whether computed tomographic enterography (CTE) is a cost-effective alternative to small-bowel follow-through (SBFT) and whether capsule endoscopy is a cost-effective third test in patients in whom a high suspicion of di...
Article
CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #503 Purpose Women who carry a BRCA1 or BRCA2 genetic mutation are at significantly increased risk of breast and ovarian cancer. Interventions to reduce the risk of these cancers available these women include bilateral prophylactic mastectomy (PM) and oophorectomy (PO), or bo...
Article
Full-text available
A neuroimaging-based ischemic stroke classification system that predicts costs and outcomes would be useful for clinical prognostication and hospital resource planning. The Boston Acute Stroke Imaging Scale (BASIS), a neuroimaging-based ischemic stroke classification system, was tested to determine whether it was able to predict the costs and clini...
Article
CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #6100 Purpose Women who carry a BRCA1 or BRCA2 genetic mutation are at significantly increased risk of breast and ovarian cancer. Current guidelines recommend genetic testing of women who have a greater than 10% likelihood of carrying a mutation. We sought to evaluate the cos...
Article
In 2005, the median waiting time for total hip and knee joint replacements in Ontario was greater than 6 months, which is considered longer than clinically appropriate. Demand is expected to increase and exacerbate already long waiting times. Solutions are needed to reduce waiting times and improve waiting list management. We developed a discrete e...
Article
Simulation modeling can synthesize data from single-arm studies of lung cancer screening and tumor registries to investigate computed tomography (CT) screening. This study estimated changes in lung cancer outcomes through 2005, had chest CT screening been introduced in 1990. Hypothetical individuals with smoking histories representative of 6 US coh...
Article
Currently, the median waiting time for total hip and knee replacement in Ontario is greater than 6 months. Waiting longer than 6 months is not recommended and may result in lower post-operative benefits. We developed a simulation model to estimate the proportion of patients who would receive surgery within the recommended waiting time for surgery o...
Article
In 2005, in Ontario, Canada, newborns were only screened for phenylketonuria (PKU) and hypothyroidism. Tandem mass spectrometry (MS/MS) has since been implemented as a new screening technology because it can screen for PKU and many other diseases simultaneously. We estimated the cost-effectiveness of using this technology to expand the Ontario newb...

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