Assessing therapeutic effectiveness of scalp treatments for dandruff and seborrheic dermatitis, part 1: a reliable and relevant method based on the adherent scalp flaking score (ASFS).

BACKGROUND: Dandruff and seborrheic dermatitis (D/SD) are common and troublesome scalp conditions with the primary signs and symptoms being presence of skin flakes, pruritus, a tight feeling, and sometimes erythema. AIM: To demonstrate the reliability and relevance of a clinical model for the assessment of therapeutic efficacy of a treatment using the Adherent Scalp Flaking Score (ASFS) method to quantitate the flaking severity. METHODS: Six randomized, double-blind, parallel design studies were conducted in either North America or Asia with subjects suffering from dandruff using the ASFS grading method before and after a 3-week test product treatment period. RESULTS: Treatment with a commercial potentiated 1% zinc pyrithione (ZPT) shampoo resulted in statistically significant (p < 0.0001) improvements in total ASFS compared with the placebo cosmetic shampoo. Results were consistent across all studies, geographies, and product usage protocols (controlled on-site versus home use conditions), and were associated with statistically significant improvements in self-perception of scalp condition. CONCLUSION: The ASFS-based clinical model was demonstrated to be a reliable and proven methodology to assess the effectiveness of widely used anti-dandruff treatments. The results are consistent with patient self-assessments, establishing this methodology as relevant to patient perception of product benefits.

Assessing therapeutic effectiveness of scalp treatments for dandruff and seborrheic dermatitis, part 2: the impact of gender and ethnicity on efficacy.

BACKGROUND: Dandruff and seborrheic dermatitis (D/SD) are common and troublesome scalp conditions that affect individuals independent of gender or ethnicity. AIM: To evaluate whether population gender or ethnic origins impact the magnitude of anti-dandruff therapeutic benefit obtained from use of a potentiated zinc pyrithione shampoo treatment. METHODS: A retrospective evaluation of anti-dandruff clinical data covering a single-product technology was conducted to assess whether statistically meaningful differences were observed for gender or ethnic sub-populations. An analysis of covariance was performed on the pooled subject-level data. RESULTS: Meta-analysis of clinical data involving 1114 subjects from seven trials demonstrated the lack of statistically significant impact of gender on flaking or selected biomarker measures. Similarly, a smaller population chosen to assess ethnicity demonstrated the lack of differences between Asian and Caucasian clinical sub-population responses (flaking severity). CONCLUSION: Through the use of both expert symptom grading and objective biomarker assessments, therapeutic efficacy of a potentiated zinc pyrithione shampoo was found to be independent of gender and ethnicity, being consistent with the lack of functional differences in skin from these populations.

Dental utilization by adult Medicaid enrollees who have indicators of intellectual and developmental disabilities (IDD).

The purpose of this study was to determine dental utilization and type of dental services for Medicaid-enrolled adults who had been identified as having intellectual and developmental disabilities (IDD). Using Iowa claims data, the authors identified adults who met any of five IDD criteria for inclusion during calendar year 2005. Service utilization rates, including use of preventive dental, routine restorative, and complex restorative services, were determined. Approximately 60% of adults with IDD had at least one dental visit in 2005. Among adults with at least one dental visit, 83% received a preventive service, 31% a routine restorative service, and 16% a complex dental service. Those age 65 and older had fewer preventive dental services than other age groups. In Iowa, dental utilization for adults 22-64 years of age with IDD was reasonably high (64%) in 2005, but individuals over age 65 had lower utilization (45%).

Protocol to predict the dry skin benefit from the unique in-shower body lotion product form.

A controlled exposure method was developed to predict dry skin improvement from a new in-shower body lotion product form. An in-shower body lotion is used in the shower after cleansing, and methods for cleansers and leave-on lotions are not applicable. Protocol parameters were chosen on the basis of consumer habits and practices studies and randomized clinical testing. The resulting protocol is consumer-relevant, and reliably and reproducibly predicts dry skin improvement from the in-shower body lotion product form.

Practical considerations for conducting effective billing audits.

Healthcare organizations need to ensure that they are in compliance with government regulations, especially with the increased vigilance by the HHS Office of Inspector General (OIG) in investigating fraud and abuse. After an OIG audit of claims submitted to Medicare by its teaching and resident physicians, the Clinical Practices of the University of Pennsylvania (CPUP), Philadelphia, Pennsylvania, entered into a settlement that included significant financial penalties and a five-year corporate integrity agreement. Lessons learned from the experience may be helpful to other providers in ensuring that their billing practices are in regulatory compliance. As a precautionary measure, providers can undertake their own audits, whether routine or focused. Audits can help providers uncover areas of potential abuse and take steps to correct the problems.