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Arnon D. Cohen

Bio: Arnon D. Cohen is an academic researcher from Clalit Health Services. The author has contributed to research in topics: Population & Odds ratio. The author has an hindex of 41, co-authored 374 publications receiving 7913 citations. Previous affiliations of Arnon D. Cohen include University of Milan & University of Connecticut.


Papers
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Journal Article
01 Jul 2011-Harefuah
TL;DR: The introduction of pneumococcal vaccination as a quality measure in CHS, coupled by other managerial and service-related actions, substantially increased the vaccination rates.
Abstract: Background The incidence of invasive pneumococcal infections in industrialized countries is above 50/100,000 annuaty in adults over the age of 65 years. The Israel Ministry of Health recommends 23-valent polysaccharide anti-pneumococcaL vaccination for patients with immune suppression or chronic diseases and citizens above the age of 65 years. Methods in 1.1.2008 pneumococcal vaccination for adults was introduced as a quality measure in CLalit Health Services (CHS). At the time of the introduction of pneumococcaL vaccination as a new quality measure in CHS, as one of 70 quality measures in community medicine, the target population included all CHS enrollees over 65 years of age and patients with specific chronic diseases. The relative weight of this quality measure within the set of CHS quality measures was set at 3.19%. The goal for the measure was set at 75%. Pneumococcal vaccination was paired with the influenza vaccination campaign. Mandatory copayment was reduced from NIS 57 to NIS 25 for enroLLees without supplementary medical insurance, and from NIS 11 to NIS 5 for enrollees with supplementary insurance. An alert for performing pneumococcaL vaccination for the target population was introduced into the medical software used by all CHS physicians. Results During a period of two years foLLowing the introduction of pneumococcaL vaccination as a quality measure in CHS, approximately 400,000 CHS enrollees within the target population received pneumococcaL vaccination, and the rate of immunization increased 10-fold (with respect to August 2007). Conclusion The introduction of pneumococcal vaccination as a quality measure in CHS, coupled by other managerial and service-related actions, substantially increased the vaccination rates.

2 citations

Journal Article
01 May 2016-Harefuah
TL;DR: This is a novel project developing an objective system of measurement, directly assessing the quality of continuity of care for the individual patient in the Southern Region of Clalit Health Services and Soroka University Medical Center.
Abstract: INTRODUCTION The southern district of Clalit Health Services and Soroka University Medical Center are combined in an organizational configuration: the Southern Region. The Region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. An objective continuous method of assessment was needed to evaluate the continuity of care between the community and the hospital. AIMS To produce objective tools for quantification based on pre-existing data systems, which enable ongoing assessment of the quality of continuity of care between the community and hospital, and the impact of the introduction of novel means of improvement. METHODS We defined a set of measurements that exemplify continuity of care in different areas of transition between community and hospital, all directly retrievable from existing computerized data sources. RESULTS About forty different measurements have been defined, in different clinical areas. Of these, a dozen have already been implemented by mapping the process and the main obstacles that the patient goes through, followed by implementation of appropriate solutions. CONCLUSIONS The application of an objective system of assessment of the results of continuity of care, utilizing pre-existing data sources, is essential for advancing the initiative, and is a breakthrough in the quantification of continuity of care. DISCUSSION Continuity of care between community and hospital has been applied in the Southern Region to dozens of quality measurements. This is a novel project developing an objective system of measurement, directly assessing the quality of continuity of care for the individual patient.

2 citations

Journal ArticleDOI
TL;DR: To examine over‐screening of older Israelis for colon and breast cancer, a large number of them are thought to be elderly and likely to have had prior cancer treatment.
Abstract: Objectives To examine over-screening of older Israelis for colon and breast cancer. Design Cross sectional. Setting Clalit Health Services (CHS), Israel's largest health maintenance organization (HMO), provides care for more than half of the country's population and operates a national age-based programs for cancer screening. Participants All community-dwelling members aged 65 to 79 in 2014 (N = 370,876). Measurements We used CHS data warehouse to evaluate cancer screening during 2014. Life expectancy (LE) was estimated using the validated Schonberg index. Results Almost one-quarter (23.1%; 15.6% of adults aged 65–74, 42.7% of adults aged 75–79) of the study population had an estimated LE of less than 10 years. Annual fecal occult blood test and biannual mammography rates among adults aged 65 to 74 with a LE of 10 years or longer were 37.1% and 70.0%, respectively. Rates dropped after age 75 (4.0%, 19.5%) and to a lesser extent with a LE of less than 10 years (31.6%, 56.4%). Prostate-specific antigen testing is not part of the national screening program, and the proportion of people tested (42.6%), did not vary similarly with age of 75 and older (43.2%) or LE of less than 10 years (38.1%). Conclusion The cancer screening inclusion criteria of the national referral system have a strong effect on receipt of screening; LE considerations are less influential. Some method of estimating LE could be incorporated into algorithms to improve individualized cancer screening to reduce over- and underscreening of older adults.

1 citations


Cited by
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Journal ArticleDOI
TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations

01 Jan 1990
TL;DR: An overview of the self-organizing map algorithm, on which the papers in this issue are based, is presented in this article, where the authors present an overview of their work.
Abstract: An overview of the self-organizing map algorithm, on which the papers in this issue are based, is presented in this article.

2,933 citations

Journal ArticleDOI
TL;DR: The theory proposed here provides a taxonomy for numerical linear algebra algorithms that provide a top level mathematical view of previously unrelated algorithms and developers of new algorithms and perturbation theories will benefit from the theory.
Abstract: In this paper we develop new Newton and conjugate gradient algorithms on the Grassmann and Stiefel manifolds. These manifolds represent the constraints that arise in such areas as the symmetric eigenvalue problem, nonlinear eigenvalue problems, electronic structures computations, and signal processing. In addition to the new algorithms, we show how the geometrical framework gives penetrating new insights allowing us to create, understand, and compare algorithms. The theory proposed here provides a taxonomy for numerical linear algebra algorithms that provide a top level mathematical view of previously unrelated algorithms. It is our hope that developers of new algorithms and perturbation theories will benefit from the theory, methods, and examples in this paper.

2,686 citations

DOI
05 Nov 2009
TL;DR: 结节病易误诊,据王洪武等~([1])收集国内18篇关于此第一印象中拟诊 结核5例,为此应引起临床对本 病诊
Abstract: 结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

1,821 citations

Journal ArticleDOI
23 Jul 2015
TL;DR: The greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic β-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications.
Abstract: Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular comorbidities), owing to hyperglycaemia and individual components of the insulin resistance (metabolic) syndrome. Environmental factors (for example, obesity, an unhealthy diet and physical inactivity) and genetic factors contribute to the multiple pathophysiological disturbances that are responsible for impaired glucose homeostasis in T2DM. Insulin resistance and impaired insulin secretion remain the core defects in T2DM, but at least six other pathophysiological abnormalities contribute to the dysregulation of glucose metabolism. The multiple pathogenetic disturbances present in T2DM dictate that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic β-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications. For an illustrated summary of this Primer, visit: http://go.nature.com/V2eGfN.

1,757 citations