University of Colorado Denver

About: University of Colorado Denver is a education organization based out in Denver, Colorado, United States. It is known for research contribution in the topics: Population & Health care. The organization has 27444 authors who have published 57213 publications receiving 2539937 citations. The organization is also known as: CU Denver & UCD.

Locoregional Failure 10 Years After Mastectomy and Adjuvant Chemotherapy With or Without Tamoxifen Without Irradiation: Experience of the Eastern Cooperative Oncology Group

Abstract: PURPOSE: To assess patterns of failure and how selected prognostic and treatment factors affect the risks of locoregional failure (LRF) after mastectomy in breast cancer patients with histologically involved axillary nodes treated with chemotherapy with or without tamoxifen without irradiation. PATIENTS AND METHODS: The study population consisted of 2,016 patients entered onto four randomized trials conducted by the Eastern Cooperative Oncology Group. The median follow-up time for patients without recurrence was 12.1 years (range, 0.07 to 19.1 years). RESULTS: A total of 1,099 patients (55%) experienced disease recurrence. The first sites of failure were as follows: isolated LRF, 254 (13%); LRF with simultaneous distant failure (DF), 166 (8%); and distant only, 679 (34%). The risk of LRF with or without simultaneous DF at 10 years was 12.9% in patients with one to three positive nodes and 28.7% for patients with four or more positive nodes. Multivariate analysis showed that increasing tumor size, increasi...

Teprotumumab for Thyroid-Associated Ophthalmopathy

Abstract: BackgroundThyroid-associated ophthalmopathy, a condition commonly associated with Graves’ disease, remains inadequately treated. Current medical therapies, which primarily consist of glucocorticoids, have limited efficacy and present safety concerns. Inhibition of the insulin-like growth factor I receptor (IGF-IR) is a new therapeutic strategy to attenuate the underlying autoimmune pathogenesis of ophthalmopathy. MethodsWe conducted a multicenter, double-masked, randomized, placebo-controlled trial to determine the efficacy and safety of teprotumumab, a human monoclonal antibody inhibitor of IGF-IR, in patients with active, moderate-to-severe ophthalmopathy. A total of 88 patients were randomly assigned to receive placebo or active drug administered intravenously once every 3 weeks for a total of eight infusions. The primary end point was the response in the study eye. This response was defined as a reduction of 2 points or more in the Clinical Activity Score (scores range from 0 to 7, with a score of ≥3 ...

Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990

Abstract: Intrapartum hypoxic events (“birth asphyxia”) may result in stillbirth, neonatal or postneonatal mortality, and impairment. Systematic morbidity estimates for the burden of impairment outcomes are currently limited. Neonatal encephalopathy (NE) following an intrapartum hypoxic event is a strong predictor of long-term impairment. Linear regression modeling was conducted on data identified through systematic reviews to estimate NE incidence and time trends for 184 countries. Meta-analyses were undertaken to estimate the risk of NE by sex of the newborn, neonatal case fatality rate, and impairment risk. A compartmental model estimated postneonatal survivors of NE, depending on access to care, and then the proportion of survivors with impairment. Separate modeling for the Global Burden of Disease 2010 (GBD2010) study estimated disability adjusted life years (DALYs), years of life with disability (YLDs), and years of life lost (YLLs) attributed to intrapartum-related events. In 2010, 1.15 million babies (uncertainty range: 0.89–1.60 million; 8.5 cases per 1,000 live births) were estimated to have developed NE associated with intrapartum events, with 96% born in low- and middle-income countries, as compared with 1.60 million in 1990 (11.7 cases per 1,000 live births). An estimated 287,000 (181,000–440,000) neonates with NE died in 2010; 233,000 (163,000–342,000) survived with moderate or severe neurodevelopmental impairment; and 181,000 (82,000–319,000) had mild impairment. In GBD2010, intrapartum-related conditions comprised 50.2 million DALYs (2.4% of total) and 6.1 million YLDs. Intrapartum-related conditions are a large global burden, mostly due to high mortality in low-income countries. Universal coverage of obstetric care and neonatal resuscitation would prevent most of these deaths and disabilities. Rates of impairment are highest in middle-income countries where neonatal intensive care was more recently introduced, but quality may be poor. In settings without neonatal intensive care, the impairment rate is low due to high mortality, which is relevant for the scale-up of basic neonatal resuscitation.

Enhancing the Interpretation of Significant Findings: The Role of Mixed Methods Research

Abstract: The present essay outlines how mixed methods research can be used to enhance the interpretation of significant findings. First, we define what we mean by significance in educational evaluation research. With regard to quantitative-based research, we define the four types of significance: statistical significance, practical significance, clinical significance, and economic significance. With respect to qualitative-based research, we define a significant finding as one that has meaning or representation. Second, we describe limitations of each of these types of significance. Finally, we illustrate how conducting mixed methods analyses can be used to enhance the interpretation of significant findings in both quantitative and qualitative educational evaluation and policy research. Consequently, mixed methods research represents the real "gold standard" for studying phenomena. Key Words: Quantitative Research, Qualitative Research, Mixed Methods, Significance, Meaning and Verstehen ********** Setting the Scene One argument posited by proponents of mixed methods studies is that they address much more comprehensive research purposes than do quantitative or qualitative research alone (Newman, Ridenour, Newman, & DeMarco, 2003). Consistent with this assertion, and expanding on Rossman and Wilson's (1985) work, Greene, Caracelli, and Graham (1989) categorized the following five general purposes of mixed-methodological studies: (a) triangulation (i.e., seeking convergence and corroboration of findings from different methods that study the same phenomenon); (b) complementarity (i.e., seeking elaboration, illustration, enhancement, and clarification of the findings from one method with results from the other method); (c) development (i.e., using the findings from one method to help inform the other method); (d) initiation (i.e., discovering paradoxes and contradictions that lead to a re-framing of the research question); and (e) expansion (i.e., seeking to expand the breadth and range of inquiry by using different methods for different inquiry components). As observed by Greene et al. (1989), every mixed methodological study can be classified as having one or more of these five purposes. In recent years, the advantages of mixed methods research have been increasingly recognized. In particular, as noted by Onwuegbuzie and Leech (in press), combining quantitative and qualitative research enables evaluation researchers to be more flexible and holistic in their investigative techniques, as they endeavor to address a range of complex research questions that arise. Further, mixed methods research helps investigators to develop a conceptual framework, to validate quantitative results by linking the information extracted from the qualitative phase of the study, and to construct indices from qualitative data that can be utilized to analyze quantitative data (Madey, 1982). Also, by conducting mixed methods studies, researchers are in a better position to combine empirical precision with descriptive precision (Onwuegbuzie, 2003a). In addition, by employing a pragmatist lens (i.e., using both quantitative and qualitative techniques), rather than using a single lens (i.e., conducting monomethod studies), investigators are able to zoom in to microscopic detail or to zoom out to indefinite scope (Willems & Raush, 1969). As such, mixed research investigations afford researchers with the opportunity to combine macro and micro levels of a study (Onwuegbuzie & Leech, in press). Compared to their monomethod counterparts, mixed methods researchers are more able to utilize quantitative research to inform the qualitative portion of research studies, and vice versa. For example, the inclusion of qualitative data can help investigators to explain relationships emerging from quantitative data. Similarly, the inclusion of quantitative data can help compensate for the fact that qualitative data typically cannot be generalized (Onwuegbuzie & Johnson, 2004). …

Diagnosis and Detection of Sarcoidosis An Official American Thoracic Society Clinical Practice Guideline

Abstract: Background: The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or mo...