The American journal of managed care
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Uncertainty about human epidermal growth factor receptor-2 (HER2) testing practice in Canada continues to hinder efforts to improve personalized medicine. Pathologists routinely perform HER2 assessment for all tumors > 1 cm, and pathology is reported centrally to the provincial cancer registry. ⋯ Despite a universal testing policy, the rate of centralized HER2 test documentation was lower than expected and related to disease severity. Differences in regional reporting likely reflect ascertainment bias inherent to centralized pathology reporting rather than testing access. Improved HER2 reporting is encouraged for cancer registration, quality-of-care measurement, and program evaluation.
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To assess Regional Extension Centers' (RECs') health IT outreach and provider engagement efforts among primary care providers (PCPs) based in underserved areas. ⋯ The REC program serves as a unique opportunity to address the health information technology needs of PCPs working in underserved areas. Over the course of 2 years, the program has exceeded its goal of enrolling 100,000 priority primary care providers. Provider engagement is the first step in a 3-step process aimed at getting providers to adopt and become meaningful users of electronic health records. Significant work remains for the RECs to meet these objectives, and future research should evaluate the success of the REC program in meeting subsequent milestones.
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The efficacy of first-line therapeutic agents for postherpetic neuralgia (PHN) has been established in randomized, controlled clinical trials. However, pain in PHN is often refractory to treatment. Many of the patients with PHN are elderly, with additional issues of polypharmacy and comorbidity. ⋯ Few patients with PHN and physicians are satisfied with the currently available treatments. Thus, the effective management of postherpetic neuralgia remains an ongoing challenge. New and improved treatment options are therefore needed for the effective management of PHN.