Nicolae Done

Johns Hopkins Bloomberg School of Public Health | JHSPH · Department of Health Policy and Management

Evidence on the factors of medical costs involved in the care of people with alopecia areata (AA) is limited, but mounting evidence points to significant variation in financial impact for patients with AA in the absence of effective treatments. This study explored drivers of medical costs among privately insured adults and adolescents with AA in th...

Importance: Alopecia areata (AA) is characterized by nonscarring hair loss of the scalp, face, and/or body. Alopecia totalis (AT) and alopecia universalis (AU) involve complete loss of the scalp and body hair, respectively. The epidemiology of AA in the US remains unclear, having previously been extrapolated from older studies that were limited to...

The North Star Ambulatory Assessment (NSAA) is a widely used endpoint in DMD clinical trials. Accurately predicting NSAA trajectories is important for understanding effects of novel therapies, via creation of individualized controls for treated patients, especially over longer-term (> 18 month) follow-up, when placebo controls are infeasible. We us...

Use of real-world and natural history data (RWD/NHD) as external controls for pulmonary outcomes is of interest for drug development in ambulatory Duchenne muscular dystrophy (DMD). However, differences across patient populations and RWD/NHD settings raise appropriate concerns about risk of bias. To assess this risk, we compared change in pulmonary...

Background: Invasive pneumococcal disease (IPD) is a major cause of pediatric morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) were introduced in the US in 2000 (PCV7) and 2010 (PCV13). This study estimated the annual incidence rates (IRs) and time trends of IPD to quantify the burden of disease in children before and after the intr...

Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limited. Objectives: To assess healthcare resource utili...

Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limited. Objectives: To assess healthcare resource utili...

Introduction/aims: Hereditary transthyretin-mediated amyloidosis with polyneuropathy (hATTR-PN) progressively affects patients' functionality and compromises health-related quality of life (HRQL). The aim of this study was to quantify the projected long-term treatment effects of inotersen versus placebo on HRQL measures. Methods: The inotersen p...

Introduction/aims: Hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) is a genetic condition associated with significant morbidity and mortality. We aimed to identify patient subgroups exhibiting the greatest health-related quality of life [HRQL] benefit from inotersen treatment. Methods: We examined data from the inotersen phas...

Background Acute otitis media (AOM) is a leading cause of office visits and antibiotic prescriptions in children. Pneumococcal conjugate vaccines were introduced in the USA in 2000 (7-valent, PCV7) and 2010 (13-valent, PCV13). Expanded valency PCVs are currently under development. To describe the impact of PCVs and quantify the residual burden of A...

Using external controls based on real-world or natural history data (RWD/NHD) for drug evaluations in Duchenne muscular dystrophy (DMD) is appealing given the challenges of enrolling placebo-controlled trials, especially for multi-year trials. Comparisons to external controls, however, face risks of bias due to differences in outcomes between trial...

BACKGROUND: Direct oral anticoagulants (DOACs) are an alternative to warfarin for treatment of atrial fibrillation (AF). Evidence demonstrating the efficacy and safety of DOACs has primarily been from clinical trial settings. The real-world effectiveness of DOACs in specific nontrial populations that differ in age, comorbidity burden, and socioecon...

Background Acute otitis media (AOM) leads to considerable healthcare resource utilization in children. Streptococcus pneumoniae is an important cause of AOM. Merck is developing V114, an investigational 15-valent PCV that contains PCV13 serotypes as well as 22F and 33F. To demonstrate the potential value of V114, it is important to estimate the rem...

Background Pneumonia causes significant pediatric morbidity, mortality, and healthcare resource utilization. S. pneumoniae is a leading cause of bacterial pneumonia in children. Merck is developing V114, an investigational 15-valent PCV that contains PCV13 serotypes as well as 22F and 33F. To demonstrate the potential value of V114, it is important...

Atrial fibrillation (AFib) is the second most common cardiovascular condition affecting up to 6.1 million individuals in the United States. Treatment of AFib focuses on preventing blood clots to reduce stroke risk. Traditionally, warfarin, a vitamin‐k antagonist, has been used to reduce stroke risk by two‐thirds. However, warfarin requires regular...

Background Health care operations managers need to balance scheduling frequent follow-ups for patients with chronic conditions and fitting in patients requiring care for new complaints.Objective We quantify how frequency of follow-up visits corresponds with access to care for patients receiving care from the Department of Veterans Affairs (VA).Desi...

Objective To assess the effect of Maryland's 2010 Total Patient Revenue (TPR) global budget reform in eight rural hospitals on population‐level hospital rates of utilization three years after implementation. Data Sources/Study Setting Data on all inpatient discharges and outpatient department visits from the Health Services Cost Review Commission,...

Occupational characteristics may improve or harm health later in life. Previous research, largely based on limited exposure periods, reached mixed conclusions. We use Health and Retirement Study data linked to the Department of Labor's O*Net job classification system to examine the relationship between lifetime exposure to occupational demands and...

Introduction Teledermatology has emerged as an important strategy to enhance access to high-quality skin care. VA Telederm is a provider-facing, web-based mobile app designed to integrate into the existing teledermatology workflow in the US Veterans Health Administration (VHA). In this study, we will conduct a systematic evaluation of VA Telederm o...

Objective To characterize the rate of guideline‐concordant initiation of oral anticoagulation (OAC) among elderly Veterans with atrial fibrillation (AF) and high stroke risk. Data Sources/Study Setting Veterans Health Administration (VHA) Corporate Data Warehouse (CDW) linked with Medicare claims 2011‐2015. Study Design We identified 6619 elderly...

Background: The purpose of this study is to quantify the relationship between social media use and the dissemination of research across nontraditional channels. Methods: Between June and August of 2016, the authors identified 10 plastic surgery journals with the highest impact factor and their 10 most widely circulated articles. Article age; jou...

In a substantial shift in payment policy, the State of Maryland implemented a global budget program for acute care hospitals in 2010. Goals of the program include controlling hospital use and spending. Eight rural hospitals entered the program in 2010, while urban and suburban hospitals joined in 2014. Prior analyses, which focused on urban and sub...

Financing and provision of long-term care is an increasingly important concern for many middle-income countries experiencing rapid population aging. We examine three countries (South Korea, Japan, and Germany) that use social insurance to finance medical care and have developed long-term care insurance (LTCI) systems. These countries have adopted d...

Single-payer health care systems consist of publicly financed insurance that provides basic benefits for all citizens. The design is intended to achieve universal coverage and allow greater cost control. Many states have attempted to reform their systems around single-payer principles, but none succeeded until Vermont enacted a law in May 2011. In...