Update on prevalence of diagnosed systemic lupus erythematosus (SLE) by major health insurance types in the US in 2016.

OBJECTIVE: To provide current estimates of the number of patients with prevalent systemic lupus erythematosus (SLE) by major health insurance types in the US and to describe patient characteristics. Four large US health insurance claims databases were analyzed to represent different types of insurance coverage, including private insurance, Medicaid, and Medicare Supplemental. RESULTS: Overall unadjusted SLE prevalence per 100,000 persons in the US ranged from 150.1 (private insurance) to 252.9 (Medicare Supplemental insurance). Extrapolating to the US civilian population in 2016, we estimated roughly 345,000 to 404,000 prevalent SLE patients with private/Medicare insurance and 99,000 prevalent SLE patients with Medicaid insurance. Comorbidities, including renal failure/dialysis were commonly observed across multiple organ systems in SLE patients (8.4-21.1%). We estimated a larger number of prevalent SLE cases in the US civilian population than previous reports and observed extensive disease burden based on a 1-year cross-sectional analysis.

Corrigendum to "Treatment resistant depression incidence estimates from studies of health insurance databases depend strongly on the details of the operating definition" [Heliyon 4 (7) (July 2018) e00707].

[This corrects the article DOI: 10.1016/j.heliyon.2018.e00707.].

Treatment resistant depression incidence estimates from studies of health insurance databases depend strongly on the details of the operating definition.

Background: Health services databases provide population-based data that have been used to describe the epidemiology and costs of treatment resistant depression (TRD). This retrospective cohort study estimated TRD incidence and, via sensitivity analyses, assessed the variation of TRD incidence within the range of implementation choices. Methods: In three US databases widely used for observational studies, we defined TRD as failure of two medications as evidenced by their replacement or supplementation by other medications, and set maximum durations (caps) for how long a medication regimen could remain in use and still be eligible to fail. Results: TRD incidence estimates varied approximately 2-fold between the two databases (CCAE, Medicaid) that described socioeconomically different non-elderly populations; for a given cap varied 2-fold to 4-fold within each database across the other implementation choices; and if the cap was also allowed to vary, varied 6-fold or 7-fold within each database. Limitations: The main limitations were typical of studies from health services databases and included the lack of complete -rather than recent - medical histories, the limited amount of clinical information, and the assumption that medication dispensed was consumed as directed. Conclusion: In retrospective cohort studies from health services databases, TRD incidence estimates vary widely depending on the implementation choices. Unless a firm basis for narrowing the range of these choices can be found, or a different analytic approach not dependent on such choices is adopted, TRD incidence and prevalence estimates from such databases will be difficult to compare or interpret.

Effect of a Simulation Exercise on Restorative Identification Skills of First Year Dental Hygiene Students.

PURPOSE: This study explored the effectiveness of simulated mouth models to improve identification and recording of dental restorations when compared to using traditional didactic instruction combined with 2-dimensional images. Simulation has been adopted into medical and dental education curriculum to improve both student learning and patient safety outcomes. METHODS: A 2-sample, independent t-test analysis of data was conducted to compare graded dental recordings of dental hygiene students using simulated mouth models and dental hygiene students using 2-dimensional photographs. Evaluations from graded dental charts were analyzed and compared between groups of students using the simulated mouth models containing random placement of custom preventive and restorative materials and traditional 2-dimensional representations of didactically described conditions. RESULTS: Results demonstrated a statistically significant (p≤0.0001) difference: for experimental group, students using the simulated mouth models to identify and record dental conditions had a mean of 86.73 and variance of 33.84. The control group students using traditional 2-dimensional images mean graded dental chart scores were 74.43 and variance was 14.25. CONCLUSION: Using modified simulation technology for dental charting identification may increase level of dental charting skill competency in first year dental hygiene students.