The American College of Surgeons (ACS) will host the seventh annual Leadership & Advocacy Summit May 19–22 at the Renaissance Washington, DC, Downtown Hotel. The summit is a dual meeting offering comprehensive and specialized sessions that provide volunteer leaders and advocates with the skills and tools necessary to be effective in those roles. Registration for the event is now open at facs.org/summit.
 

Leadership Summit

The Leadership Summit provides a venue for members to network with ACS leaders, attend professional development sessions, and engage with colleagues to determine new and innovative ways to face challenges and enhance their leadership skills. It begins Saturday evening, May 19, with a Welcome Reception open to all registrants, followed by a full day of programming on Sunday, May 20.

Advocacy Summit

The Advocacy Summit provides a unique opportunity to obtain the knowledge and skills necessary to become a surgeon advocate. With several legislative priorities for Congress to consider before the 2018 midterm elections, surgeons are encouraged to travel to Washington to learn about and participate in this unique political climate.

Since last year’s summit, the Division of Advocacy and Health Policy (DAHP) has been focused on an extensive list of federal legislative priorities, including reducing administrative practice burdens; modifying and implementing new physician payment reforms; improving electronic health record and health information technology interoperability; increasing funding for trauma systems; enhancing cancer care and accreditation; and addressing surgical workforce and graduate medical education issues. ACS staff also will help members and attendees navigate the many additional legislative changes that lie ahead.

The Advocacy Summit will begin after the Leadership Summit on Sunday, May 20, with a dinner and keynote address. Past speakers have included television journalist Chuck Todd, political commentator Chris Matthews, U.S. Army Gen. (Retired) Stanley A. McChrystal, author Thomas Goetz, and journalists Bob Woodward and George Will. Sessions planned for the following day will focus on the political environment in Washington, and speakers will provide updates on important health care policies and issues that detract from surgeons’ ability to provide quality patient care. Attendees will then apply this knowledge in face-to-face meetings with their senators and representatives and congressional staff. This portion of the program provides an opportunity to demonstrate surgery’s strength on Capitol Hill regarding issues of importance to surgeons and the surgical patient.

During this three-day conference, participants can expect to receive comprehensive advocacy training and learn how to use these skills throughout the year, not just in Washington. The Advocacy Summit is a great place to interact and share ideas with other surgeon advocates; meet face-to-face with key health care policymakers and legislators; and, perhaps most importantly, become the constituents their legislators know and trust to offer advice on surgical issues.

The ACS Professional Association political action committee (ACSPA-SurgeonsPAC) sponsors various events for members and SurgeonsPAC contributors. These events provide contributors with unique networking opportunities and advanced educational sessions aimed at providing an insider’s perspective on how College members can remain active participants in the political process.

In addition to raising funds to elect or re-elect congressional candidates who support a pro-surgeon, pro-patient agenda, SurgeonsPAC will host a reception at which PAC contributors will be recognized for their commitment to the surgical profession. Other SurgeonsPAC-sponsored events include an annual drawing with a grand prize valued at $3,000, a political luncheon featuring a renowned guest speaker, and presentation of the 2017 PAC awards. Resident engagement opportunities will be provided as well. In addition, the SurgeonsPAC information booth will provide attendees with a venue to meet DAHP staff to learn more about the College’s advocacy and political efforts.

For more information about the Advocacy Summit, contact Michael Carmody, ACS Congressional Affairs Coordinator, at [email protected] or 202-672-1511. For more information about SurgeonsPAC activities, e-mail [email protected] or call 202-672-1520.
 

The American College of Surgeons (ACS) will host the seventh annual Leadership & Advocacy Summit May 19–22 at the Renaissance Washington, DC, Downtown Hotel. The summit is a dual meeting offering comprehensive and specialized sessions that provide volunteer leaders and advocates with the skills and tools necessary to be effective in those roles. Registration for the event is now open at facs.org/summit.
 

Leadership Summit

The Leadership Summit provides a venue for members to network with ACS leaders, attend professional development sessions, and engage with colleagues to determine new and innovative ways to face challenges and enhance their leadership skills. It begins Saturday evening, May 19, with a Welcome Reception open to all registrants, followed by a full day of programming on Sunday, May 20.

Advocacy Summit

The Advocacy Summit provides a unique opportunity to obtain the knowledge and skills necessary to become a surgeon advocate. With several legislative priorities for Congress to consider before the 2018 midterm elections, surgeons are encouraged to travel to Washington to learn about and participate in this unique political climate.

Since last year’s summit, the Division of Advocacy and Health Policy (DAHP) has been focused on an extensive list of federal legislative priorities, including reducing administrative practice burdens; modifying and implementing new physician payment reforms; improving electronic health record and health information technology interoperability; increasing funding for trauma systems; enhancing cancer care and accreditation; and addressing surgical workforce and graduate medical education issues. ACS staff also will help members and attendees navigate the many additional legislative changes that lie ahead.

The Advocacy Summit will begin after the Leadership Summit on Sunday, May 20, with a dinner and keynote address. Past speakers have included television journalist Chuck Todd, political commentator Chris Matthews, U.S. Army Gen. (Retired) Stanley A. McChrystal, author Thomas Goetz, and journalists Bob Woodward and George Will. Sessions planned for the following day will focus on the political environment in Washington, and speakers will provide updates on important health care policies and issues that detract from surgeons’ ability to provide quality patient care. Attendees will then apply this knowledge in face-to-face meetings with their senators and representatives and congressional staff. This portion of the program provides an opportunity to demonstrate surgery’s strength on Capitol Hill regarding issues of importance to surgeons and the surgical patient.

During this three-day conference, participants can expect to receive comprehensive advocacy training and learn how to use these skills throughout the year, not just in Washington. The Advocacy Summit is a great place to interact and share ideas with other surgeon advocates; meet face-to-face with key health care policymakers and legislators; and, perhaps most importantly, become the constituents their legislators know and trust to offer advice on surgical issues.

The ACS Professional Association political action committee (ACSPA-SurgeonsPAC) sponsors various events for members and SurgeonsPAC contributors. These events provide contributors with unique networking opportunities and advanced educational sessions aimed at providing an insider’s perspective on how College members can remain active participants in the political process.

In addition to raising funds to elect or re-elect congressional candidates who support a pro-surgeon, pro-patient agenda, SurgeonsPAC will host a reception at which PAC contributors will be recognized for their commitment to the surgical profession. Other SurgeonsPAC-sponsored events include an annual drawing with a grand prize valued at $3,000, a political luncheon featuring a renowned guest speaker, and presentation of the 2017 PAC awards. Resident engagement opportunities will be provided as well. In addition, the SurgeonsPAC information booth will provide attendees with a venue to meet DAHP staff to learn more about the College’s advocacy and political efforts.

For more information about the Advocacy Summit, contact Michael Carmody, ACS Congressional Affairs Coordinator, at [email protected] or 202-672-1511. For more information about SurgeonsPAC activities, e-mail [email protected] or call 202-672-1520.
 

The American College of Surgeons (ACS) will host the seventh annual Leadership & Advocacy Summit May 19–22 at the Renaissance Washington, DC, Downtown Hotel. The summit is a dual meeting offering comprehensive and specialized sessions that provide volunteer leaders and advocates with the skills and tools necessary to be effective in those roles. Registration for the event is now open at facs.org/summit.
 

Leadership Summit

The Leadership Summit provides a venue for members to network with ACS leaders, attend professional development sessions, and engage with colleagues to determine new and innovative ways to face challenges and enhance their leadership skills. It begins Saturday evening, May 19, with a Welcome Reception open to all registrants, followed by a full day of programming on Sunday, May 20.

Advocacy Summit

The Advocacy Summit provides a unique opportunity to obtain the knowledge and skills necessary to become a surgeon advocate. With several legislative priorities for Congress to consider before the 2018 midterm elections, surgeons are encouraged to travel to Washington to learn about and participate in this unique political climate.

Since last year’s summit, the Division of Advocacy and Health Policy (DAHP) has been focused on an extensive list of federal legislative priorities, including reducing administrative practice burdens; modifying and implementing new physician payment reforms; improving electronic health record and health information technology interoperability; increasing funding for trauma systems; enhancing cancer care and accreditation; and addressing surgical workforce and graduate medical education issues. ACS staff also will help members and attendees navigate the many additional legislative changes that lie ahead.

The Advocacy Summit will begin after the Leadership Summit on Sunday, May 20, with a dinner and keynote address. Past speakers have included television journalist Chuck Todd, political commentator Chris Matthews, U.S. Army Gen. (Retired) Stanley A. McChrystal, author Thomas Goetz, and journalists Bob Woodward and George Will. Sessions planned for the following day will focus on the political environment in Washington, and speakers will provide updates on important health care policies and issues that detract from surgeons’ ability to provide quality patient care. Attendees will then apply this knowledge in face-to-face meetings with their senators and representatives and congressional staff. This portion of the program provides an opportunity to demonstrate surgery’s strength on Capitol Hill regarding issues of importance to surgeons and the surgical patient.

During this three-day conference, participants can expect to receive comprehensive advocacy training and learn how to use these skills throughout the year, not just in Washington. The Advocacy Summit is a great place to interact and share ideas with other surgeon advocates; meet face-to-face with key health care policymakers and legislators; and, perhaps most importantly, become the constituents their legislators know and trust to offer advice on surgical issues.

The ACS Professional Association political action committee (ACSPA-SurgeonsPAC) sponsors various events for members and SurgeonsPAC contributors. These events provide contributors with unique networking opportunities and advanced educational sessions aimed at providing an insider’s perspective on how College members can remain active participants in the political process.

In addition to raising funds to elect or re-elect congressional candidates who support a pro-surgeon, pro-patient agenda, SurgeonsPAC will host a reception at which PAC contributors will be recognized for their commitment to the surgical profession. Other SurgeonsPAC-sponsored events include an annual drawing with a grand prize valued at $3,000, a political luncheon featuring a renowned guest speaker, and presentation of the 2017 PAC awards. Resident engagement opportunities will be provided as well. In addition, the SurgeonsPAC information booth will provide attendees with a venue to meet DAHP staff to learn more about the College’s advocacy and political efforts.

For more information about the Advocacy Summit, contact Michael Carmody, ACS Congressional Affairs Coordinator, at [email protected] or 202-672-1511. For more information about SurgeonsPAC activities, e-mail [email protected] or call 202-672-1520.
 

The annual American College of Surgeons (ACS) Accredited Education Institutes (AEI) Surgical Simulation Summit will take place March 16−17 at the Swissôtel Chicago, IL.

Retired Army Lieutenant General James B. Peake, MD, FACS, senior vice-president, CGI Federal, and immediate past-president, American Telemedicine Association, will deliver the keynote address, which will focus on advances in technology that would affect simulation-based surgical education and training and areas for research and development to advance the field. A special panel on advances in technology will follow. Meeting sessions will include an interactive debate about industry’s role in training and credentialing of new technology, and participants will have access to interactive workshops, scientific paper presentations, posters, and networking opportunities.

New this year is a pre-meeting Simulation Research Summit on March 15, the goal of which is development of a research agenda for the future that focuses on three core areas: impact of simulation training on patient safety and outcomes, the value proposition of simulation, and simulation use for physician credentialing. David M. Gaba, MD, associate dean for immersive and simulation-based learning and professor of anesthesiology, perioperative, and pain medicine at Stanford School of Medicine, CA, will kick off the inaugural Simulation Research Summit with a keynote address. A separate registration fee applies for the pre-meeting.

Visit the ACS website at www.facs.org/education/accreditation/aei/surgical-simulation-summit to view the Surgical Simulation Summit program, register for the meeting, and reserve a hotel room. The deadline to register for the summit is March 2.

For more information about the meeting or the AEI program, contact Cathy Wojcik, Manager, Program for Accreditation of Education Institutes, at [email protected].
 

The annual American College of Surgeons (ACS) Accredited Education Institutes (AEI) Surgical Simulation Summit will take place March 16−17 at the Swissôtel Chicago, IL.

Retired Army Lieutenant General James B. Peake, MD, FACS, senior vice-president, CGI Federal, and immediate past-president, American Telemedicine Association, will deliver the keynote address, which will focus on advances in technology that would affect simulation-based surgical education and training and areas for research and development to advance the field. A special panel on advances in technology will follow. Meeting sessions will include an interactive debate about industry’s role in training and credentialing of new technology, and participants will have access to interactive workshops, scientific paper presentations, posters, and networking opportunities.

New this year is a pre-meeting Simulation Research Summit on March 15, the goal of which is development of a research agenda for the future that focuses on three core areas: impact of simulation training on patient safety and outcomes, the value proposition of simulation, and simulation use for physician credentialing. David M. Gaba, MD, associate dean for immersive and simulation-based learning and professor of anesthesiology, perioperative, and pain medicine at Stanford School of Medicine, CA, will kick off the inaugural Simulation Research Summit with a keynote address. A separate registration fee applies for the pre-meeting.

Visit the ACS website at www.facs.org/education/accreditation/aei/surgical-simulation-summit to view the Surgical Simulation Summit program, register for the meeting, and reserve a hotel room. The deadline to register for the summit is March 2.

For more information about the meeting or the AEI program, contact Cathy Wojcik, Manager, Program for Accreditation of Education Institutes, at [email protected].
 

The annual American College of Surgeons (ACS) Accredited Education Institutes (AEI) Surgical Simulation Summit will take place March 16−17 at the Swissôtel Chicago, IL.

Retired Army Lieutenant General James B. Peake, MD, FACS, senior vice-president, CGI Federal, and immediate past-president, American Telemedicine Association, will deliver the keynote address, which will focus on advances in technology that would affect simulation-based surgical education and training and areas for research and development to advance the field. A special panel on advances in technology will follow. Meeting sessions will include an interactive debate about industry’s role in training and credentialing of new technology, and participants will have access to interactive workshops, scientific paper presentations, posters, and networking opportunities.

New this year is a pre-meeting Simulation Research Summit on March 15, the goal of which is development of a research agenda for the future that focuses on three core areas: impact of simulation training on patient safety and outcomes, the value proposition of simulation, and simulation use for physician credentialing. David M. Gaba, MD, associate dean for immersive and simulation-based learning and professor of anesthesiology, perioperative, and pain medicine at Stanford School of Medicine, CA, will kick off the inaugural Simulation Research Summit with a keynote address. A separate registration fee applies for the pre-meeting.

Visit the ACS website at www.facs.org/education/accreditation/aei/surgical-simulation-summit to view the Surgical Simulation Summit program, register for the meeting, and reserve a hotel room. The deadline to register for the summit is March 2.

For more information about the meeting or the AEI program, contact Cathy Wojcik, Manager, Program for Accreditation of Education Institutes, at [email protected].
 

Registration is now open to attend American College of Surgeons (ACS) 2018 General Surgery Coding Workshops. With Medicare and third-party payor policy and coding changes taking effect this year, it is imperative that surgeons have accurate and up-to-date information to protect reimbursement from Medicare and other payors and to optimize efficiency.

During the coding workshop, you will learn how to report surgical procedures and medical services and will have access to the tools necessary to succeed, including a coding workbook to keep for future reference with checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

The ACS will offer the following seven coding workshops in 2018:

• Southlake, TX, January 25¬–26

• Las Vegas, NV, February 8–10

• Orlando, FL, February 22–23

• Chicago, IL, April 12–13

• New York, NY, May 17–19

• Nashville, TN, August 9–10

• Chicago, IL, November 1–3


For the first time, the ACS also will offer a three-day course, including a day devoted to trauma and critical care coding at the Las Vegas, New York City, and (November) Chicago workshops.

To register, visit www.karenzupko.com/workshops2/gensurg-workshops. For more details, visit the ACS website at www.facs.org/advocacy/practmanagement/workshops or e-mail [email protected].

Registration is now open to attend American College of Surgeons (ACS) 2018 General Surgery Coding Workshops. With Medicare and third-party payor policy and coding changes taking effect this year, it is imperative that surgeons have accurate and up-to-date information to protect reimbursement from Medicare and other payors and to optimize efficiency.

During the coding workshop, you will learn how to report surgical procedures and medical services and will have access to the tools necessary to succeed, including a coding workbook to keep for future reference with checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

The ACS will offer the following seven coding workshops in 2018:

• Southlake, TX, January 25¬–26

• Las Vegas, NV, February 8–10

• Orlando, FL, February 22–23

• Chicago, IL, April 12–13

• New York, NY, May 17–19

• Nashville, TN, August 9–10

• Chicago, IL, November 1–3


For the first time, the ACS also will offer a three-day course, including a day devoted to trauma and critical care coding at the Las Vegas, New York City, and (November) Chicago workshops.

To register, visit www.karenzupko.com/workshops2/gensurg-workshops. For more details, visit the ACS website at www.facs.org/advocacy/practmanagement/workshops or e-mail [email protected].

Registration is now open to attend American College of Surgeons (ACS) 2018 General Surgery Coding Workshops. With Medicare and third-party payor policy and coding changes taking effect this year, it is imperative that surgeons have accurate and up-to-date information to protect reimbursement from Medicare and other payors and to optimize efficiency.

During the coding workshop, you will learn how to report surgical procedures and medical services and will have access to the tools necessary to succeed, including a coding workbook to keep for future reference with checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits™ for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units.

The ACS will offer the following seven coding workshops in 2018:

• Southlake, TX, January 25¬–26

• Las Vegas, NV, February 8–10

• Orlando, FL, February 22–23

• Chicago, IL, April 12–13

• New York, NY, May 17–19

• Nashville, TN, August 9–10

• Chicago, IL, November 1–3


For the first time, the ACS also will offer a three-day course, including a day devoted to trauma and critical care coding at the Las Vegas, New York City, and (November) Chicago workshops.

To register, visit www.karenzupko.com/workshops2/gensurg-workshops. For more details, visit the ACS website at www.facs.org/advocacy/practmanagement/workshops or e-mail [email protected].

The opioid abuse epidemic took center stage during a hearing of the House Ways and Means Committee, during which Alex Azar, secretary of the Department of Health & Human Services, defended the White House budget proposal for fiscal year 2019.

The president’s budget, released Feb. 13, allocates $5 billion in new resources over the next 5 years to combat the opioid abuse epidemic

Courtesy Ways & Means Committee

[email protected]

The opioid abuse epidemic took center stage during a hearing of the House Ways and Means Committee, during which Alex Azar, secretary of the Department of Health & Human Services, defended the White House budget proposal for fiscal year 2019.

The president’s budget, released Feb. 13, allocates $5 billion in new resources over the next 5 years to combat the opioid abuse epidemic

Courtesy Ways & Means Committee

[email protected]

The opioid abuse epidemic took center stage during a hearing of the House Ways and Means Committee, during which Alex Azar, secretary of the Department of Health & Human Services, defended the White House budget proposal for fiscal year 2019.

The president’s budget, released Feb. 13, allocates $5 billion in new resources over the next 5 years to combat the opioid abuse epidemic

Courtesy Ways & Means Committee

[email protected]

The Food and Drug Administration has approved apalutamide for the treatment of patients with castration-resistant nonmetastatic prostate cancer.

Approval was based on a median metastasis-free survival for patients taking apalutamide of 40.5 months, compared with 16.2 months for patients taking a placebo in a randomized clinical trial of 1,207 patients with nonmetastatic, castration-resistant prostate cancer. All patients also received hormone therapy, either with gonadotropin-releasing hormone analogue therapy or with surgical castration.

[email protected]

The Food and Drug Administration has approved apalutamide for the treatment of patients with castration-resistant nonmetastatic prostate cancer.

Approval was based on a median metastasis-free survival for patients taking apalutamide of 40.5 months, compared with 16.2 months for patients taking a placebo in a randomized clinical trial of 1,207 patients with nonmetastatic, castration-resistant prostate cancer. All patients also received hormone therapy, either with gonadotropin-releasing hormone analogue therapy or with surgical castration.

[email protected]

The Food and Drug Administration has approved apalutamide for the treatment of patients with castration-resistant nonmetastatic prostate cancer.

Approval was based on a median metastasis-free survival for patients taking apalutamide of 40.5 months, compared with 16.2 months for patients taking a placebo in a randomized clinical trial of 1,207 patients with nonmetastatic, castration-resistant prostate cancer. All patients also received hormone therapy, either with gonadotropin-releasing hormone analogue therapy or with surgical castration.

[email protected]

JACKSONVILLE, FLA. – Low health literacy is a common problem in Veterans Affairs health systems, and patients with low health literacy scores are 50% more likely to return to the hospital within 30 days of discharge after surgery than patients with high health literacy, investigators found in a study of surgery patients at VA medical centers.

“Low health literacy is prevalent among VA surgery patients and is associated with surgical readmissions,” said Samantha Baker, MD, of the University of Alabama at Birmingham and the VA Birmingham Healthcare System. She presented the findings at the Association for Academic Surgery/Society of University Surgeons Academic Surgical Congress.

utah778/Thinkstock

SOURCE: Baker S et al. Academic Surgical Congress.

JACKSONVILLE, FLA. – Low health literacy is a common problem in Veterans Affairs health systems, and patients with low health literacy scores are 50% more likely to return to the hospital within 30 days of discharge after surgery than patients with high health literacy, investigators found in a study of surgery patients at VA medical centers.

“Low health literacy is prevalent among VA surgery patients and is associated with surgical readmissions,” said Samantha Baker, MD, of the University of Alabama at Birmingham and the VA Birmingham Healthcare System. She presented the findings at the Association for Academic Surgery/Society of University Surgeons Academic Surgical Congress.

utah778/Thinkstock

SOURCE: Baker S et al. Academic Surgical Congress.

JACKSONVILLE, FLA. – Low health literacy is a common problem in Veterans Affairs health systems, and patients with low health literacy scores are 50% more likely to return to the hospital within 30 days of discharge after surgery than patients with high health literacy, investigators found in a study of surgery patients at VA medical centers.

“Low health literacy is prevalent among VA surgery patients and is associated with surgical readmissions,” said Samantha Baker, MD, of the University of Alabama at Birmingham and the VA Birmingham Healthcare System. She presented the findings at the Association for Academic Surgery/Society of University Surgeons Academic Surgical Congress.

utah778/Thinkstock

SOURCE: Baker S et al. Academic Surgical Congress.

JACKSONVILLE, FLA. – Octogenarians with small-bowel obstruction are about seven times more likely to have open than laparoscopic surgery, but the minimally invasive approach in these patients has been found to reduce their hospital stays and risk of pneumonia afterward, according to results of an observational study of data from the American College of Surgeons National Surgical Quality Improvement Program database.

Dmitrii Kotin/Thinkstock

[email protected]

SOURCE: Chang E et al. Academic Surgical Congress.

JACKSONVILLE, FLA. – Octogenarians with small-bowel obstruction are about seven times more likely to have open than laparoscopic surgery, but the minimally invasive approach in these patients has been found to reduce their hospital stays and risk of pneumonia afterward, according to results of an observational study of data from the American College of Surgeons National Surgical Quality Improvement Program database.

Dmitrii Kotin/Thinkstock

[email protected]

SOURCE: Chang E et al. Academic Surgical Congress.

JACKSONVILLE, FLA. – Octogenarians with small-bowel obstruction are about seven times more likely to have open than laparoscopic surgery, but the minimally invasive approach in these patients has been found to reduce their hospital stays and risk of pneumonia afterward, according to results of an observational study of data from the American College of Surgeons National Surgical Quality Improvement Program database.

Dmitrii Kotin/Thinkstock

[email protected]

SOURCE: Chang E et al. Academic Surgical Congress.

Major depressive disorder (MDD) was identified in 21% of adults in the United States during their lifetimes and 10% over 12 months, according to data published Feb. 14 from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III).

Research shows that the prevalence of depression in adolescents and adults in the United States has increased over the last 25 years. However, epidemiologic data on MDD prevalence since the 2013 publication of the DSM-5 have been limited, wrote Deborah S. Hasin, PhD, of Columbia University, New York, and her colleagues.

In a study published in JAMA Psychiatry, Dr. Hasin and her colleagues reviewed data from 36,309 adult participants in the NESARC-III who reflected DSM-5 criteria. Major depressive disorder was defined as at least 2 weeks of persistent depressed mood, anhedonia, or hopelessness reported by the individual or others observing the individual.

Overall, the 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Factors associated with a more likely 12-month diagnosis of MDD included younger age (18-29 years) and lower income (less than $19,999 per year). In addition, MDD was significantly less likely in men than it was in women (odds ratio, 0.5). Compared with the likelihood among white adults, MDD was less likely among adults who were African American (OR, 0.6), Asian/Pacific Islander (OR, 0.6), and Hispanic (OR, 0.7).

Generalized anxiety disorder was the most common comorbidity associated with MDD (adjusted OR, 5.7). Any drug disorder was three times more likely in MDD patients (aOR, 3.0), and alcohol use disorder was nearly twice as likely (aOR, 1.8). Approximately 70% of patients with lifetime MDD received some treatment. But patients with substance use disorders and depression are less likely to receive treatment for major depression disorder. “Therefore, clinician education and training in dual-disorder screening and treatment should be prioritized,” Dr. Hasin and her colleagues wrote.

The study is the first to include data on two new major depression specifiers from the DSM-5, the researchers noted. “That almost three-quarters of those with MDD had the anxious/distressed specifier confirms clinical observation and research,” they said. “In patient samples, the anxious/distressed specifier predicts a poor course of MDD.”

The study was limited by several factors, including its cross-sectional design and the potentially inconsistent differentiation of MDD from normal bereavement in patients who had been diagnosed with MDD shortly after the death of a loved one, the researchers said. However, the findings provide the first nationally representative information on MDD since the advent of the DSM-5 and highlight the high prevalence of MDD in the U.S. population and the need for further intervention, they said.

The researchers had no financial conflicts to disclose. The NESARC-III was supported by several entities, including the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the New York State Psychiatric Institute.

SOURCE: Hasin D et al. JAMA Psychiatry. 2018 Feb 14. doi: 10.1001/jamapsychiatry.2017.4602.

Major depressive disorder (MDD) was identified in 21% of adults in the United States during their lifetimes and 10% over 12 months, according to data published Feb. 14 from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III).

Research shows that the prevalence of depression in adolescents and adults in the United States has increased over the last 25 years. However, epidemiologic data on MDD prevalence since the 2013 publication of the DSM-5 have been limited, wrote Deborah S. Hasin, PhD, of Columbia University, New York, and her colleagues.

In a study published in JAMA Psychiatry, Dr. Hasin and her colleagues reviewed data from 36,309 adult participants in the NESARC-III who reflected DSM-5 criteria. Major depressive disorder was defined as at least 2 weeks of persistent depressed mood, anhedonia, or hopelessness reported by the individual or others observing the individual.

Overall, the 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Factors associated with a more likely 12-month diagnosis of MDD included younger age (18-29 years) and lower income (less than $19,999 per year). In addition, MDD was significantly less likely in men than it was in women (odds ratio, 0.5). Compared with the likelihood among white adults, MDD was less likely among adults who were African American (OR, 0.6), Asian/Pacific Islander (OR, 0.6), and Hispanic (OR, 0.7).

Generalized anxiety disorder was the most common comorbidity associated with MDD (adjusted OR, 5.7). Any drug disorder was three times more likely in MDD patients (aOR, 3.0), and alcohol use disorder was nearly twice as likely (aOR, 1.8). Approximately 70% of patients with lifetime MDD received some treatment. But patients with substance use disorders and depression are less likely to receive treatment for major depression disorder. “Therefore, clinician education and training in dual-disorder screening and treatment should be prioritized,” Dr. Hasin and her colleagues wrote.

The study is the first to include data on two new major depression specifiers from the DSM-5, the researchers noted. “That almost three-quarters of those with MDD had the anxious/distressed specifier confirms clinical observation and research,” they said. “In patient samples, the anxious/distressed specifier predicts a poor course of MDD.”

The study was limited by several factors, including its cross-sectional design and the potentially inconsistent differentiation of MDD from normal bereavement in patients who had been diagnosed with MDD shortly after the death of a loved one, the researchers said. However, the findings provide the first nationally representative information on MDD since the advent of the DSM-5 and highlight the high prevalence of MDD in the U.S. population and the need for further intervention, they said.

The researchers had no financial conflicts to disclose. The NESARC-III was supported by several entities, including the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the New York State Psychiatric Institute.

SOURCE: Hasin D et al. JAMA Psychiatry. 2018 Feb 14. doi: 10.1001/jamapsychiatry.2017.4602.

Major depressive disorder (MDD) was identified in 21% of adults in the United States during their lifetimes and 10% over 12 months, according to data published Feb. 14 from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III).

Research shows that the prevalence of depression in adolescents and adults in the United States has increased over the last 25 years. However, epidemiologic data on MDD prevalence since the 2013 publication of the DSM-5 have been limited, wrote Deborah S. Hasin, PhD, of Columbia University, New York, and her colleagues.

In a study published in JAMA Psychiatry, Dr. Hasin and her colleagues reviewed data from 36,309 adult participants in the NESARC-III who reflected DSM-5 criteria. Major depressive disorder was defined as at least 2 weeks of persistent depressed mood, anhedonia, or hopelessness reported by the individual or others observing the individual.

Overall, the 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Factors associated with a more likely 12-month diagnosis of MDD included younger age (18-29 years) and lower income (less than $19,999 per year). In addition, MDD was significantly less likely in men than it was in women (odds ratio, 0.5). Compared with the likelihood among white adults, MDD was less likely among adults who were African American (OR, 0.6), Asian/Pacific Islander (OR, 0.6), and Hispanic (OR, 0.7).

Generalized anxiety disorder was the most common comorbidity associated with MDD (adjusted OR, 5.7). Any drug disorder was three times more likely in MDD patients (aOR, 3.0), and alcohol use disorder was nearly twice as likely (aOR, 1.8). Approximately 70% of patients with lifetime MDD received some treatment. But patients with substance use disorders and depression are less likely to receive treatment for major depression disorder. “Therefore, clinician education and training in dual-disorder screening and treatment should be prioritized,” Dr. Hasin and her colleagues wrote.

The study is the first to include data on two new major depression specifiers from the DSM-5, the researchers noted. “That almost three-quarters of those with MDD had the anxious/distressed specifier confirms clinical observation and research,” they said. “In patient samples, the anxious/distressed specifier predicts a poor course of MDD.”

The study was limited by several factors, including its cross-sectional design and the potentially inconsistent differentiation of MDD from normal bereavement in patients who had been diagnosed with MDD shortly after the death of a loved one, the researchers said. However, the findings provide the first nationally representative information on MDD since the advent of the DSM-5 and highlight the high prevalence of MDD in the U.S. population and the need for further intervention, they said.

The researchers had no financial conflicts to disclose. The NESARC-III was supported by several entities, including the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the New York State Psychiatric Institute.

SOURCE: Hasin D et al. JAMA Psychiatry. 2018 Feb 14. doi: 10.1001/jamapsychiatry.2017.4602.

A treat-to-target (T2T) strategy in daily clinical practice for patients with early rheumatoid arthritis proved successful in maintaining good disease- and patient-related outcomes over a 5-year period at two rheumatology clinics in the Netherlands.

The observational study builds on previous research on the long-term results of continuous application of T2T strategies in rheumatoid arthritis, for which there have been few published studies. “Long-term data from more recent randomized controlled clinical trials, using a T2T approach and biologicals, have shown good clinical outcomes. However, the generalizability of these results is hampered by the selection of specific patient groups in clinical trials and strict exclusion criteria. Patients seen in real-life practice may differ substantially from those in randomized clinical trials,” first author Letty G.A. Versteeg of Medisch Spectrum Twente, Enschede, the Netherlands, and her colleagues wrote in Clinical Rheumatology.

The investigators examined outcomes for 229 patients with very early RA who enrolled in the Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort during 2006-2009, which included 5 years of follow-up for 171 of the patients. These patients underwent a protocoled T2T strategy aimed at remission, defined as a 28-joint Disease Activity Score (DAS28) of less than 2.6.

“In previous publications on the [DREAM] remission induction cohort, successful implementation of T2T in daily clinical practice was demonstrated. Achieving remission within the first year of treatment was shown to be a realistic goal for an important proportion of patients,” the authors wrote.

All patients started methotrexate monotherapy at an initial dosage of 15 mg/week that could be increased to a maximum dosage of 25 mg/week in week 8. Patients took folic acid on the second day after methotrexate. By week 12, those with persistent disease activity added sulfasalazine, starting at 2,000 mg/day and increasing if necessary to a maximum of 3,000 mg/day at week 20. Patients whose DAS28 remained at 3.2 or greater at week 24 received a tumor necrosis factor inhibitor. Those who reached remission had no change in medication, and when remission lasted for at least 6 months, medication was gradually tapered and eventually discontinued. Patients who had flares in which disease activity increased to a DAS28 of 2.6 and higher restarted their last effective medication or dosage, which could subsequently be intensified if necessary. Patients with comorbidities and contraindications for medication were not excluded because deviations from the protocol were allowed. The protocol also allowed concomitant treatment with NSAIDs, prednisolone at a dosage of less than 10 mg/day, and intra-articular corticosteroid injections.

The rate of DAS28-defined remission rose to 63% (126 of 199 patients) by the end of the first year, and only 5% had high disease activity at 24 weeks. The rate of remission remained stable over the next 4 years. This rate of remission was reflected as a drop from an overall mean DAS28 of 4.93 at baseline to 2.49 at 5 years. The majority of the drop in DAS28 occurred during the first 3 months (–1.63 points), and by the end of the first year of treatment, mean disease activity stayed below 2.6 on the DAS28.

The investigators saw a sustained remission at least once in 144 of the 171 patients with 5-year outcome data available, including sustained remission for 1 year or longer in 115. Median time to the first sustained remission proved to be 50 weeks, and half had this last less than 97 weeks and half more than 97 weeks.

During the 5-year follow-up, 17% of patients received treatment with biologics, with a median start of their first biologic at about 54 weeks after baseline. This first biologic was used continuously for a median of 29 weeks, and close to one-third of patients who started a biologic switched to a second biologic after a median duration of 41 weeks on the first. About two-thirds did not need a second biologic. A total of 66% of patients who took a biologic had at least one period of sustained remission.

Functional disability improved overall at 5 years as determined by Health Assessment Questionnaire (HAQ) scores that were available for 107 patients. HAQ scores decreased from a median of 1.125 at baseline to 0.375 after 24 weeks (P less than .001), where they remained stable throughout the rest of follow-up. Overall, nearly 70% of the patients with available 5-year data had a change in their individual HAQ score that was clinically meaningful from baseline to 24 weeks.

“Our study describes long-term outcome of implementation and continuous application of T2T to RA patients in daily clinical practice. The outcomes are similar to or even better than the results of T2T randomized clinical trials, in which strict selection of patients and controlled conditions were followed. These ‘real-life data’ are of important additional value in the evidence for the effectiveness of a T2T approach in RA patients,” the investigators concluded.

They had no disclosures to report.

[email protected]

SOURCE: Versteeg G et al. Clin Rheumatol. 2018 Feb 1. doi: 10.1007/s10067-017-3962-5.

A treat-to-target (T2T) strategy in daily clinical practice for patients with early rheumatoid arthritis proved successful in maintaining good disease- and patient-related outcomes over a 5-year period at two rheumatology clinics in the Netherlands.

The observational study builds on previous research on the long-term results of continuous application of T2T strategies in rheumatoid arthritis, for which there have been few published studies. “Long-term data from more recent randomized controlled clinical trials, using a T2T approach and biologicals, have shown good clinical outcomes. However, the generalizability of these results is hampered by the selection of specific patient groups in clinical trials and strict exclusion criteria. Patients seen in real-life practice may differ substantially from those in randomized clinical trials,” first author Letty G.A. Versteeg of Medisch Spectrum Twente, Enschede, the Netherlands, and her colleagues wrote in Clinical Rheumatology.

The investigators examined outcomes for 229 patients with very early RA who enrolled in the Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort during 2006-2009, which included 5 years of follow-up for 171 of the patients. These patients underwent a protocoled T2T strategy aimed at remission, defined as a 28-joint Disease Activity Score (DAS28) of less than 2.6.

“In previous publications on the [DREAM] remission induction cohort, successful implementation of T2T in daily clinical practice was demonstrated. Achieving remission within the first year of treatment was shown to be a realistic goal for an important proportion of patients,” the authors wrote.

All patients started methotrexate monotherapy at an initial dosage of 15 mg/week that could be increased to a maximum dosage of 25 mg/week in week 8. Patients took folic acid on the second day after methotrexate. By week 12, those with persistent disease activity added sulfasalazine, starting at 2,000 mg/day and increasing if necessary to a maximum of 3,000 mg/day at week 20. Patients whose DAS28 remained at 3.2 or greater at week 24 received a tumor necrosis factor inhibitor. Those who reached remission had no change in medication, and when remission lasted for at least 6 months, medication was gradually tapered and eventually discontinued. Patients who had flares in which disease activity increased to a DAS28 of 2.6 and higher restarted their last effective medication or dosage, which could subsequently be intensified if necessary. Patients with comorbidities and contraindications for medication were not excluded because deviations from the protocol were allowed. The protocol also allowed concomitant treatment with NSAIDs, prednisolone at a dosage of less than 10 mg/day, and intra-articular corticosteroid injections.

The rate of DAS28-defined remission rose to 63% (126 of 199 patients) by the end of the first year, and only 5% had high disease activity at 24 weeks. The rate of remission remained stable over the next 4 years. This rate of remission was reflected as a drop from an overall mean DAS28 of 4.93 at baseline to 2.49 at 5 years. The majority of the drop in DAS28 occurred during the first 3 months (–1.63 points), and by the end of the first year of treatment, mean disease activity stayed below 2.6 on the DAS28.

The investigators saw a sustained remission at least once in 144 of the 171 patients with 5-year outcome data available, including sustained remission for 1 year or longer in 115. Median time to the first sustained remission proved to be 50 weeks, and half had this last less than 97 weeks and half more than 97 weeks.

During the 5-year follow-up, 17% of patients received treatment with biologics, with a median start of their first biologic at about 54 weeks after baseline. This first biologic was used continuously for a median of 29 weeks, and close to one-third of patients who started a biologic switched to a second biologic after a median duration of 41 weeks on the first. About two-thirds did not need a second biologic. A total of 66% of patients who took a biologic had at least one period of sustained remission.

Functional disability improved overall at 5 years as determined by Health Assessment Questionnaire (HAQ) scores that were available for 107 patients. HAQ scores decreased from a median of 1.125 at baseline to 0.375 after 24 weeks (P less than .001), where they remained stable throughout the rest of follow-up. Overall, nearly 70% of the patients with available 5-year data had a change in their individual HAQ score that was clinically meaningful from baseline to 24 weeks.

“Our study describes long-term outcome of implementation and continuous application of T2T to RA patients in daily clinical practice. The outcomes are similar to or even better than the results of T2T randomized clinical trials, in which strict selection of patients and controlled conditions were followed. These ‘real-life data’ are of important additional value in the evidence for the effectiveness of a T2T approach in RA patients,” the investigators concluded.

They had no disclosures to report.

[email protected]

SOURCE: Versteeg G et al. Clin Rheumatol. 2018 Feb 1. doi: 10.1007/s10067-017-3962-5.

A treat-to-target (T2T) strategy in daily clinical practice for patients with early rheumatoid arthritis proved successful in maintaining good disease- and patient-related outcomes over a 5-year period at two rheumatology clinics in the Netherlands.

The observational study builds on previous research on the long-term results of continuous application of T2T strategies in rheumatoid arthritis, for which there have been few published studies. “Long-term data from more recent randomized controlled clinical trials, using a T2T approach and biologicals, have shown good clinical outcomes. However, the generalizability of these results is hampered by the selection of specific patient groups in clinical trials and strict exclusion criteria. Patients seen in real-life practice may differ substantially from those in randomized clinical trials,” first author Letty G.A. Versteeg of Medisch Spectrum Twente, Enschede, the Netherlands, and her colleagues wrote in Clinical Rheumatology.

The investigators examined outcomes for 229 patients with very early RA who enrolled in the Dutch Rheumatoid Arthritis Monitoring (DREAM) remission induction cohort during 2006-2009, which included 5 years of follow-up for 171 of the patients. These patients underwent a protocoled T2T strategy aimed at remission, defined as a 28-joint Disease Activity Score (DAS28) of less than 2.6.

“In previous publications on the [DREAM] remission induction cohort, successful implementation of T2T in daily clinical practice was demonstrated. Achieving remission within the first year of treatment was shown to be a realistic goal for an important proportion of patients,” the authors wrote.

All patients started methotrexate monotherapy at an initial dosage of 15 mg/week that could be increased to a maximum dosage of 25 mg/week in week 8. Patients took folic acid on the second day after methotrexate. By week 12, those with persistent disease activity added sulfasalazine, starting at 2,000 mg/day and increasing if necessary to a maximum of 3,000 mg/day at week 20. Patients whose DAS28 remained at 3.2 or greater at week 24 received a tumor necrosis factor inhibitor. Those who reached remission had no change in medication, and when remission lasted for at least 6 months, medication was gradually tapered and eventually discontinued. Patients who had flares in which disease activity increased to a DAS28 of 2.6 and higher restarted their last effective medication or dosage, which could subsequently be intensified if necessary. Patients with comorbidities and contraindications for medication were not excluded because deviations from the protocol were allowed. The protocol also allowed concomitant treatment with NSAIDs, prednisolone at a dosage of less than 10 mg/day, and intra-articular corticosteroid injections.

The rate of DAS28-defined remission rose to 63% (126 of 199 patients) by the end of the first year, and only 5% had high disease activity at 24 weeks. The rate of remission remained stable over the next 4 years. This rate of remission was reflected as a drop from an overall mean DAS28 of 4.93 at baseline to 2.49 at 5 years. The majority of the drop in DAS28 occurred during the first 3 months (–1.63 points), and by the end of the first year of treatment, mean disease activity stayed below 2.6 on the DAS28.

The investigators saw a sustained remission at least once in 144 of the 171 patients with 5-year outcome data available, including sustained remission for 1 year or longer in 115. Median time to the first sustained remission proved to be 50 weeks, and half had this last less than 97 weeks and half more than 97 weeks.

During the 5-year follow-up, 17% of patients received treatment with biologics, with a median start of their first biologic at about 54 weeks after baseline. This first biologic was used continuously for a median of 29 weeks, and close to one-third of patients who started a biologic switched to a second biologic after a median duration of 41 weeks on the first. About two-thirds did not need a second biologic. A total of 66% of patients who took a biologic had at least one period of sustained remission.

Functional disability improved overall at 5 years as determined by Health Assessment Questionnaire (HAQ) scores that were available for 107 patients. HAQ scores decreased from a median of 1.125 at baseline to 0.375 after 24 weeks (P less than .001), where they remained stable throughout the rest of follow-up. Overall, nearly 70% of the patients with available 5-year data had a change in their individual HAQ score that was clinically meaningful from baseline to 24 weeks.

“Our study describes long-term outcome of implementation and continuous application of T2T to RA patients in daily clinical practice. The outcomes are similar to or even better than the results of T2T randomized clinical trials, in which strict selection of patients and controlled conditions were followed. These ‘real-life data’ are of important additional value in the evidence for the effectiveness of a T2T approach in RA patients,” the investigators concluded.

They had no disclosures to report.

[email protected]

SOURCE: Versteeg G et al. Clin Rheumatol. 2018 Feb 1. doi: 10.1007/s10067-017-3962-5.

Colon and rectal cancer mortality is expected to be about 15.5/100,000 population in 2018, with the highest rate in West Virginia and lowest in Utah.

Approximately 50,630 deaths from colorectal cancer are predicted for the year in the United States by the American Cancer Society (ACS) in its Cancer Facts & Figures 2018, based on analysis of 2001-2015 data from the National Center for Health Statistics.

March is Colorectal Cancer Awareness Month. Visit www.gastro.org/CRC for tools you can use to help educate your patients about the importance of colorectal cancer screening.

[email protected]

Colon and rectal cancer mortality is expected to be about 15.5/100,000 population in 2018, with the highest rate in West Virginia and lowest in Utah.

Approximately 50,630 deaths from colorectal cancer are predicted for the year in the United States by the American Cancer Society (ACS) in its Cancer Facts & Figures 2018, based on analysis of 2001-2015 data from the National Center for Health Statistics.

March is Colorectal Cancer Awareness Month. Visit www.gastro.org/CRC for tools you can use to help educate your patients about the importance of colorectal cancer screening.

[email protected]

Colon and rectal cancer mortality is expected to be about 15.5/100,000 population in 2018, with the highest rate in West Virginia and lowest in Utah.

Approximately 50,630 deaths from colorectal cancer are predicted for the year in the United States by the American Cancer Society (ACS) in its Cancer Facts & Figures 2018, based on analysis of 2001-2015 data from the National Center for Health Statistics.

March is Colorectal Cancer Awareness Month. Visit www.gastro.org/CRC for tools you can use to help educate your patients about the importance of colorectal cancer screening.

[email protected]