Chest
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Observational Study
Association of Medication Adherence and Clinical Outcomes in Sarcoidosis.
Sarcoidosis, one of the most common interstitial lung diseases, has significant health disparities. Approximately 50% of individuals affected with sarcoidosis will undergo spontaneous remission, but those who do not undergo remission often require long-term or lifelong treatment to prevent disease progression. We sought to assess the association between medication adherence and clinical outcomes in sarcoidosis. ⋯ This is the first observational study of medication adherence in sarcoidosis. We found that higher medication adherence was associated with better HRQoL, with blacks more likely to report nonadherence. Medication adherence may be an important target to improve patient-reported outcomes and health disparities in sarcoidosis.
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Considerable heterogeneity persists in the conduct and reporting of statistical analyses in the medical literature. Authors submitting manuscripts to CHEST are encouraged to adhere to the following guidelines where possible.
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We have entered the era of "big data" and with that the explosion of interest in prediction modeling. With this explosion comes the challenge of evaluating statistical prediction models, both from the standpoint of an author as well as a reviewer. This article provides guidance for the evaluation and critique of a statistical prediction model. Hopefully, this will improve the quality of statistical prediction modeling studies and facilitate their review.
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Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied. ⋯ This population-based study provides evidence for sex-specific associations between maternal prenatal and postnatal distress, as well as the development of AD and asthma. The findings support recommendations for greater psychosocial support of mothers during pregnancy and early childhood to prevent childhood atopic disease.
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Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial pressures and is managed by vasodilator therapies. Current guidelines encourage PAH management in specialty care centers (SCCs), but evidence is sparse regarding improvement in clinical outcomes and correlation to vasodilator use with referral. ⋯ The UPMC SCC demonstrated improved outcomes in mortality and hospitalizations. The SCC benefit was multifactorial, with more frequent vasodilator therapy and disease monitoring. These findings provide robust evidence for early and regular referral of patients with PAH to SCCs.