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Medscape
a day ago
- Health
- Medscape
How Does Owning Private Equity Affect Heart Failure Care?
The acquisition of hospitals by private equity firms did not reduce 30-day mortality or hospital revisit rates among patients with heart failure, despite patients at acquired hospitals having lower clinical risk scores than those at nonacquired hospitals. Black patients were more likely to be transferred out after acquisition. METHODOLOGY: In recent years, the acquisition of US hospitals by private equity firms and investment in cardiology have intensified; however, evidence on how these affect outcomes in patients with heart failure is scarce. Researchers conducted a quasi-experimental difference-in-differences analysis to evaluate whether hospital acquisition changed clinical outcomes among Medicare fee-for-service beneficiaries aged 65 years or older with heart failure. They included 35,631 hospitalizations of such beneficiaries at 41 US hospitals acquired by private equity firms between 2013 and 2018, matched with 178,107 hospitalizations at 192 nonacquired hospitals. Primary outcomes were 30-day mortality and rehospitalization rates, including inpatient stays, emergency department visits, and observation stays. TAKEAWAY: The 30-day hospital revisit rate (difference-in-differences estimate, -0.2 percentage points; P = .49) and 30-day mortality rate (difference-in-differences estimate, +0.7 percentage points; P = .21) did not change significantly after acquisition. = .49) and 30-day mortality rate (difference-in-differences estimate, +0.7 percentage points; = .21) did not change significantly after acquisition. Cardiac catheterization rates increased significantly but clinical risk scores of patients and length of hospital stay decreased significantly at acquired hospitals compared with nonacquired hospitals ( P ≤ .03 for all). ≤ .03 for all). Although overall transfer-out rates did not change, Black patients were significantly more likely to be transferred out after acquisition (difference-in-differences estimate, +7.1 percentage points; P = .03), raising concerns about equity in transfer practices. IN PRACTICE: 'Our finding that 30-day mortality rates and 30-day hospital revisit rates did not change despite a differential decrease in clinical risk scores indicate that the growing presence of private equity in health care may have adverse implications on care and outcomes for patients with heart failure — the most common reason for hospitalization in Medicare,' the authors wrote. SOURCE: This study was led by Daniel Y. Johnson of the Beth Israel Deaconess Medical Center in Boston. It was published online on June 9, 2025, in Journal of the American College of Cardiology . LIMITATIONS: The study population was limited to adults aged 65 years or older. The researchers could not capture data from Medicare Advantage plans as these were not available for the entire study period. Additionally, data beyond 2019 could not be included due to the COVID pandemic. DISCLOSURES: This study received support from the Sarnoff Cardiovascular Research Foundation and an American Heart Association Established Investigator Award grant. One author reported receiving grants and serving as a consultant for various research institutes and pharmaceutical companies.
Medscape
2 days ago
- Health
- Medscape
Puffy Fingers or Hands Often Precede Raynaud in SSc
While Raynaud phenomenon is often the initial clinical manifestation of systemic sclerosis (SSc), over 30% of patients in two large US cohorts presented first with other manifestations — predominantly puffy fingers and hands. These patients exhibited more severe skin disease and increased joint contractures than those showing Raynaud as their initial symptom. METHODOLOGY: Researchers analyzed data from two large US cohorts to assess the clinical features of SSc in patients whose first manifestation was a non-Raynaud symptom. They included 1377 patients older than 18 years with SSc who were diagnosed within 5 years of their first non-Raynaud symptom and met standardized SSc classification criteria. Date on baseline demographics, clinical features (such as skin involvement, joint contractures, and tendon friction rubs), and the presence of specific autoantibodies were collected. Serologic testing was performed for antinuclear antibodies and SSc-specific autoantibodies using HEp-2 indirect immunofluorescence assay and other specific laboratory or clinical assays. TAKEAWAY: In both the cohorts, 31%-44% of patients had a non-Raynaud symptom — most commonly puffy fingers or hands — as their initial sign of SSc preceding the onset of Raynaud phenomenon. Black patients were more likely to present with non-Raynaud symptoms as their first manifestation than patients from other racial and ethnic backgrounds. Patients who initially presented with non-Raynaud symptoms had a significantly higher prevalence of diffuse cutaneous involvement, joint contractures, and tendon friction rubs at baseline. In both cohorts, RNA polymerase III antibody was significantly more prevalent in patients who presented with non-Raynaud phenomenon first than in those who presented with Raynaud phenomenon first ( P <.01 for both cohorts). IN PRACTICE: "Future research aimed at understanding and/or treating patients in the early stages of SSc should be inclusive of those presenting without [Raynaud phenomenon] if other risk features (eg, puffy fingers/hands, abnormal nailfold capillaries, skin tightening, tendon friction rubs, positivity for ANA and SSc-associated specific autoantibodies) are present," the authors wrote. SOURCE: This study was led by Iqtidar Hanif, MD, MS, UTHealth Houston Division of Rheumatology, Houston, Texas. It was published online on May 19, 2025, in Arthritis & Rheumatology . LIMITATIONS: The study relied on patient recall, which may have introduced bias and imprecision in reporting symptom onset. There was also a lack of standardization across sites in assessing the presence of Raynaud phenomenon. Additionally, the findings may be influenced by referral bias, as patients seen at academic medical centers are often referred by other rheumatologists or seek second opinions independently. DISCLOSURES: One of the cohorts was supported by the Scleroderma Research Foundation, and some authors reported receiving grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Some authors reported receiving financial support, grants, or consulting fees from various pharmaceutical companies.
Yahoo
08-06-2025
- Health
- Yahoo
Ontada Unveils Comprehensive Data on Social Determinants of Health and Outcomes of Early-Onset Colorectal Cancer at ASCO
Findings show Black and Hispanic Patients Have 30% Higher Risk of Advanced-Stage Diagnosis BOSTON, May 30, 2025--(BUSINESS WIRE)--Ontada®, a leader in real-world oncology data and insights, is proud to present its latest research findings in a pivotal oral presentation at the American Society of Clinical Oncology (ASCO) Annual Meeting. The study, titled, "Real-world Social Determinants of Health and Outcomes of Early-onset Colorectal Cancer: An Analysis of a Large Nationally Representative US Community Oncology Network," provides critical data on the impact of social determinants on the outcomes of early-onset colorectal cancer (EO-CRC) patients, and offers one of the largest studies of EO-CRC to date. Over 104,000 patients with CRC were studied, including nearly 15,000 patients with early-onset CRC. Key Data Findings Racial and ethnic disparities: A higher burden of EO-CRC was observed among patients of Black and American Indian/Alaskan Native race and Hispanic/Latino ethnicity. Obesity as a risk factor: There was a 5% higher prevalence of obesity among patients with early-onset CRC versus average onset CRC. More advanced stage at diagnosis for EO-CRC: Patients with EO-CRC have an 11% greater likelihood of diagnosis at Stage III or IV disease as compared to average-onset disease. Poorer survival associated with advancing age: At each cancer stage, patients with EO-CRC had a longer overall survival as compared to patients with average-onset CRC, reflecting existing knowledge about cancer survival decreasing with advancing age. Importance of screening and earlier diagnosis: Among all patients with CRC, including early-onset diagnosis, disease stage at diagnosis was the strongest predictor of overall survival, reflecting the importance of earlier detection and screening programs for all. "Understanding the complex interplay between social factors and cancer incidence and outcomes is crucial for developing effective, patient-centered care strategies, and this research underscores the importance of understanding and then intervening on social determinants of health to improve care for patients with EO-CRC," said Jessica K. Paulus, ScD, senior director, Real-World Research, Ontada. "Ontada's data provides a clear and compelling picture of the impact of social determinants on the outcomes of patients with EO-CRC. By leveraging our unique data emanating from the nationally representative The US Oncology Network and our measures of social determinants at scale, we can drive meaningful changes in clinical practice and policy, ultimately improving patient care and outcomes." Study Methodology This retrospective observational cohort study examined adult CRC patients within The US Oncology Network and non-Network practices, encompassing over 2,700 community-based providers treating more than 1.4 million patients annually. All patients diagnosed with CRC between 2000 and 2024 were included; patients were categorized as EO-CRC if they were <50 years at first diagnosis and average-onset (AO)-CRC otherwise. Over 104,000 patients with CRC were studied, including nearly 15,000 patients with early-onset CRC. Patient characteristics were sourced from iKnowMed, an oncology-specific electronic health record system, and descriptively summarized. Overall Survival (OS) was assessed from diagnosis using Kaplan-Meier methods. Other Research at ASCO 2025 Ontada is showcasing its research capabilities at ASCO with 12 accepted abstracts on topics such as using large language models to extract cancer data, accelerating Phase 2 clinical development with real-world data in HER2-positive metastatic breast cancer, validating real-world event-free survival in early-stage triple negative breast cancer, analyzing outcomes of BRAF-mutated melanoma patients, and providing a descriptive epidemiology of Waldenström Macroglobulinemia. "At Ontada, we are at the forefront of transforming cancer care through the power of real-world data and insights," said Christine Davis, president, Ontada. "Our extensive research at ASCO 2025 underscores our commitment to driving meaningful advancements in oncology. This research will not only highlight the critical role of real-world evidence in improving patient outcomes but also demonstrate our dedication to addressing the complex challenges faced by cancer patients and healthcare providers." Ontada is a part of McKesson, which has an unmatched portfolio of oncology businesses and partners that provide research, insights, technologies, and services that are helping address barriers and improve cancer and specialty care. At ASCO, McKesson-supported businesses including The US Oncology Network, Ontada, and Sarah Cannon Research Institute (SCRI), are part of approximately 170 accepted abstracts and presentations. These are inclusive of oral and poster presentations, educational sessions, late-breaking studies, and early-phase studies. For a comprehensive list of Ontada abstracts and presentations, visit Ontada's ASCO 2025 Site. Additionally, visit the Ontada Booth (#35093) at the McCormick Place Convention Center from May 30 – June 3 to explore the data presented at ASCO 2025 and experience Ontada's solutions firsthand. About Ontada® Ontada is an oncology technology and insights business dedicated to transforming the fight against cancer. Part of McKesson Corporation, Ontada was founded on the core belief that precise insights – delivered exactly at the point of need – can save more patients' lives. We connect the full patient journey by combining technologies used by The US Oncology Network and other community oncology providers with real-world data and research relied on by all top 15 global life sciences companies. Our work helps accelerate innovation and powers the future of cancer care. For more information, visit About McKesson Oncology and Specialty Solutions It's an unprecedented time for patients living with cancer as life sciences companies race to create new, cutting-edge therapies. With cancer care becoming more targeted, providers, life sciences companies, and payers face a multitude of challenges and complexity in the development of new treatments and making them accessible to patients in need. At McKesson, our unmatched portfolio of oncology businesses and partners provide research, insights, technologies, and services that are helping to address these hurdles and improve cancer and specialty care. McKesson is fueling discovery by helping patients participate in cutting-edge clinical trials closer to home through its joint venture with Sarah Cannon Research Institute. The US Oncology Network and McKesson Provider Solutions are advancing specialty care and high-quality cancer care in the communities where patients live by supporting the practices of thousands of independent, community-based providers. Ontada®, a McKesson business dedicated to oncology, generates real-world data (RWD) and real-world evidence (RWE), and provides clinical education and provider technology to inform and improve cancer care. As a leading distributor of oncology and specialty medicines, we are ensuring medicines make their way to those who are counting on them. And through CoverMyMeds, Biologics by McKesson, and GPO services, our work continues to help patients access, afford, and adhere to their medicines. View source version on Contacts Media Contact OntadaClaire Crye, Communications281.825.9927 GCI Health on behalf of OntadaChristine Murphy, Media Relations201.230.9636 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Medscape
07-05-2025
- Health
- Medscape
Uterine Cancer Survival Varies Widely by Race Across US
A study of 162,500 patients with uterine cancer found that survival rates varied significantly by race and geographic location, with Black patients experiencing the worst survival outcomes in areas with high and low overall diversity. METHODOLOGY: Despite known racial and ethnic disparities in uterine cancer survival in the United States, data on the association between geographic region and these disparities remain limited. A retrospective cohort study analyzed outcomes from 162,500 patients with uterine cancer (median age, 61 years at diagnosis) between 2000 and 2019 from 17 Surveillance, Epidemiology, and End Results (SEER) registries. Researchers categorized patients by race and ethnicity: 7.5% were Asian individuals, 8.6% were Black individuals, 12.8% were Hispanic individuals, and 71.1% were White individuals. Geographic locations were ranked from 0% to 100% by the US Census Bureau's Diversity Index, with higher values indicating greater diversity. Values varied from 76.0% for Hawaii to 30.8% for Iowa. The primary outcome was uterine cancer–specific survival. The median follow-up durations were 84 months for Asian patients, 59 months for Black patients, 73 months for Hispanic patients, and 93 months for White patients. TAKEAWAY: Compared with White patients, Asian patients had better cancer-specific survival (hazard ratio [HR], 0.91), whereas Black patients had worse cancer-specific survival (HR, 1.34), and cancer-specific survival for Hispanic patients was similar (HR, 1.01; 95% CI, 0.97-1.06 ). Black patients experienced worse survival than White patients in both high-diversity areas (HR, 1.34 in California and New Jersey; HR, 1.39 in Georgia) and low-diversity locations (HR, 1.34 in Louisiana; HR, 1.42 in Connecticut; HR, 1.71 in Iowa). Compared with White patients, Hispanic patients showed worse survival in Hawaii (HR, 2.09) and Georgia (HR, 1.44), whereas Asian patients demonstrated better survival in California (HR, 0.91). Black patients with low-grade endometrioid, nonendometrioid, and early-stage disease had worse survival in Louisiana than White patients (HRs 2.08, 1.29, and 1.77, respectively), and those with high-grade endometrioid disease in Seattle and nonendometrioid disease in Iowa also had worse outcomes (HRs, 2.23 and 2.01, respectively). IN PRACTICE: 'In this cohort study of patients with uterine cancer, racially and ethnically disparate uterine cancer–specific survival was observed in specific geographic locations,' the authors wrote. 'While etiologic studies that assess the causes of geographically defined racially and ethnically disparate uterine cancer survival are needed, our findings suggest that locations with the most pronounced racial and ethnic disparities should be prioritized.' SOURCE: The study, led by Caitlin E. Meade, Division of Epidemiology, College of Public Health, Ohio State University in Columbus, Ohio, was published online in JAMA Network Open . LIMITATIONS: The analysis focused was limited to 11 locations with SEER registries. The researchers noted that the low power in areas with lower diversity indices might have affected the detection of racial and ethnic disparities. The study also lacked other measures of structural inequities and systemic discrimination that could contextualize the findings. DISCLOSURES: The study received grants from the National Cancer Institute. Several authors reported receiving personal fees or grants from various sources.
