Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days

BACKGROUND: From 2001 to March 2006, Planned Parenthood Federation of America (Planned Parenthood) health centers throughout the United States provided medical abortions principally by a regimen of oral mifepristone, followed 24-48 h later by vaginal misoprostol. In late March 2006, analyses of serious uterine infections following medical abortions led Planned Parenthood to change the route of misoprostol administration and to employ additional measures to minimize subsequent serious uterine infections. In August 2006, we conducted an extensive audit of medical abortions with the new buccal misoprostol regimen so that patients could be given accurate information about the success rate of the new regimen. OBJECTIVES: We sought to evaluate the effectiveness of the buccal medical abortion regimen and to examine correlates of its success during routine service delivery. METHODS: In 2006, audits were conducted in 10 large urban service points to estimate the success rates of the buccal regimen. Success was defined as medical abortion without vacuum aspiration. These audits also permitted estimates of success rates with oral misoprostol following mifepristone in a subset in which 98% of the subjects stemmed from two sites. RESULTS: The effectiveness of the buccal misoprostol-mifepristone regimen was 98.3% for women with gestational ages below 60 days. The oral misoprostol-mifepristone regimen, used by 278 women with a gestational age below 50 days, had a success rate of 96.8%. CONCLUSION: In conjunction with 200 mg of mifepristone, use of 800 mcg of buccal misoprostol up to 59 days of gestation is as effective as the use of 800 mcg of vaginal misoprostol up to 63 days of gestation.

Effectiveness of global analysis in strict independence-based automatic program parallelization

This paper presents a study of the effectiveness of global analysis in the parallelization of logic programs using strict independence. A number of well-known approximation domains are selected and tlieir usefulness for the application in hand is explained. Also, methods for using the information provided by such domains to improve parallelization are proposed. Local and global analyses are built using these domains and such analyses are embedded in a complete parallelizing compiler. Then, the performance of the domains (and the system in general) is assessed for this application through a number of experiments. We argüe that the results offer significant insight into the characteristics of these domains, the demands of the application, and the tradeoffs involved.

A comparative study of methods for automatic compile-time parallelization of logic programs

This paper presents a study of the effectiveness of three different algorithms for the parallelization of logic programs based on compile-time detection of independence among goals. The algorithms are embedded in a complete parallelizing compiler, which incorporates different abstract interpretation-based program analyses. The complete system shows the task of automatic program parallelization to be practical. The trade-offs involved in using each of the algorithms in this task are studied experimentally, weaknesses of these identified, and possible improvements discussed.

Sources of selection bias in evaluating social programs: An interpretation of conventional measures and evidence on the effectiveness of matching as a program evaluation method

This paper decomposes the conventional measure of selection bias in observational studies into three components. The first two components are due to differences in the distributions of characteristics between participant and nonparticipant (comparison) group members: the first arises from differences in the supports, and the second from differences in densities over the region of common support. The third component arises from selection bias precisely defined. Using data from a recent social experiment, we find that the component due to selection bias, precisely defined, is smaller than the first two components. However, selection bias still represents a substantial fraction of the experimental impact estimate. The empirical performance of matching methods of program evaluation is also examined. We find that matching based on the propensity score eliminates some but not all of the measured selection bias, with the remaining bias still a substantial fraction of the estimated impact. We find that the support of the distribution of propensity scores for the comparison group is typically only a small portion of the support for the participant group. For values outside the common support, it is impossible to reliably estimate the effect of program participation using matching methods. If the impact of participation depends on the propensity score, as we find in our data, the failure of the common support condition severely limits matching compared with random assignment as an evaluation estimator.

Cost-effectiveness of Transcatheter Mitral Valve Leaflet Repair for the Treatment of Mitral Regurgitation in Heart Failure

Contexte: La régurgitation mitrale (RM) est une maladie valvulaire nécessitant une intervention dans les cas les plus grave. Une réparation percutanée de la valve mitrale avec le dispositif MitraClip est un traitement sécuritaire et efficace pour les patients à haut risque chirurgical. Nous voulons évaluer les résultats cliniques et l'impact économique de cette thérapie par rapport à la gestion médicale des patients en insuffisance cardiaque avec insuffisance mitrale symptomatique. Méthodes: L'étude a été composée de deux phases; une étude d'observation de patients souffrant d'insuffisance cardiaque et de régurgitation mitrale traitée avec une thérapie médicale ou le MitraClip, et un modèle économique. Les résultats de l'étude observationnelle ont été utilisés pour estimer les paramètres du modèle de décision, qui a estimé les coûts et les avantages d'une cohorte hypothétique de patients atteints d'insuffisance cardiaque et insuffisance mitrale sévère traitée avec soit un traitement médical standard ou MitraClip. Résultats: La cohorte de patients traités avec le système MitraClip était appariée par score de propension à une population de patients atteints d'insuffisance cardiaque, et leurs résultats ont été comparés. Avec un suivi moyen de 22 mois, la mortalité était de 21% dans la cohorte MitraClip et de 42% dans la cohorte de gestion médicale (p = 0,007). Le modèle de décision a démontré que MitraClip augmente l'espérance de vie de 1,87 à 3,60 années et des années de vie pondérées par la qualité (QALY) de 1,13 à 2,76 ans. Le coût marginal était 52.500 $ dollars canadiens, correspondant à un rapport coût-efficacité différentiel (RCED) de 32,300.00 $ par QALY gagné. Les résultats étaient sensibles à l'avantage de survie. Conclusion: Dans cette cohorte de patients atteints d'insuffisance cardiaque symptomatique et d insuffisance mitrale significative, la thérapie avec le MitraClip est associée à une survie supérieure et est rentable par rapport au traitement médical.

Mobility of the elderly and handicapped: a methodology for evaluating the effectiveness of transportation improvements for the elderly and handicapped. Final report.

Transportation Department, Office of University Research, Washington, D.C.

Cost-effectiveness of countermeasures for utility pole accidents. Final report.

Federal Highway Administration, Office of Research and Development, Washington, D.C.

Final design and implementation plan for evaluating the effectiveness of FMVSS 208: occupant crash protection. Tasks #4 & #5 report.

National Highway Traffic Safety Administration, Washington, D.C.

Final design and implementation plan for evaluating the effectiveness of FMVSS 214: side door strength. Tasks #4 & #5 report.

National Highway Traffic Safety Administration, Washington, D.C.

Final design and implementation plan for evaluating the effectiveness of FMVSS 215: exterior protection. Tasks #4 & #5 report.

National Highway Traffic Safety Administration, Washington, D.C.

Final design and implementation plan for evaluating the effectiveness of FMVSS 301: fuel system integrity. Tasks #4 & #5 report.

National Highway Traffic Safety Administration, Washington, D.C.

Assessment of techniques for cost-effectiveness of highway accident countermeasures - executive summary.

Federal Highway Administration, Office of Research, Washington, D.C.

Assessment of techniques for cost-effectiveness of highway accident countermeasures. Final report.

Federal Highway Administration, Office of Research, Washington, D.C.

Cost effectiveness of small highway sign supports - a summary report. Final report.

Federal Highway Administration, Implementation Division, Washington, D.C.

Cost-effectiveness of countermeasures for utility pole accidents - appendixes A-N. Final report.

Federal Highway Administration, Office of Research and Development, Washington, D.C.