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Articles by S. C. Chen
Total Records ( 2 ) for S. C. Chen
  A. M Seidler , M. L Pennie , E Veledar , S. D Culler and S. C. Chen

Objective  To assess health care resources consumed by melanoma in the population 65 years or older, a group with comparatively poor outcomes.

Design  Database analysis.

Setting  The Surveillance, Epidemiology, and End Results (SEER)–Medicare-linked population-based database for fiscal years 1991 through 1996.

Participants  A total of 1858 subjects with pathological confirmation of melanoma.

Main Outcome Measures  Resource consumption was examined by stage and treatment phase. Outcomes were measured in monthly charges obtained from the data set and costs were estimated by application of cost to charge ratios. Annual resource consumption by melanoma in patients 65 years or older in the United States was also estimated by incorporation of published SEER cancer statistics.

Results  Average monthly, per-patient melanoma charges were $2194 during the initial 4 months of treatment; they dropped by more than half to $902 during the interim phase, which varied in length depending on survival. Monthly charges increased to $3933 during the terminal 6 months of treatment. The estimated annual charge of treating melanoma in the population 65 years or older was $390 million. By using cost to charge ratios, we found the annual cost of melanoma to be up to $249 million and the per-patient lifetime costs to be $28 210 from the time of diagnosis to the time of death.

Conclusions  Melanoma care presents a significant economic burden in the elderly population, particularly in late-stage disease. If effective, prevention and early detection efforts may reduce the economic burden.

  C. H Wang , M. H. M Ma , H. C Chou , Z. S Yen , C. W Yang , C. C Fang and S. C. Chen

Background  High-dose proton pump inhibitors (PPIs) (80-mg bolus, followed by 8-mg/h continuous infusion for 72 hours) have been widely studied and used. However, to date no concrete evidence has shown that high-dose PPIs are more effective than non–high-dose PPIs.

Methods  We performed a literature search for randomized controlled trials that compared the use of high-dose PPIs vs non–high-dose PPIs in patients with bleeding peptic ulcer and determined their effects on rebleeding, surgical intervention, and mortality. Outcomes data were combined in a meta-analysis and were reported as odds ratios (ORs) with 95% confidence intervals (CIs).

Results  A total of 1157 patients from 7 high-quality randomized studies were included in this meta-analysis. High-dose PPIs and non–high-dose PPIs did not differ in their effects on the rates of rebleeding (7 studies and 1157 patients; OR, 1.30; 95% CI, 0.88-1.91), surgical intervention (6 studies and 1052 patients; 1.49; 0.66-3.37), or mortality (6 studies and 1052 patients; 0.89; 0.37-2.13). Post hoc subgroup analyses revealed that summary outcomes measures were unaffected by severity of signs of recent hemorrhage at initial endoscopy, route of PPI administration, or PPI dose.

Conclusion  Compared with non–high-dose PPIs, high-dose PPIs do not further reduce the rates of rebleeding, surgical intervention, or mortality after endoscopic treatment in patients with bleeding peptic ulcer.

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