A107 RESULTS: Patients (n=660, 100% completion rate) completed the survey. All attributes were significant predictors of choice except sleepiness. Respondents were significantly more likely to choose a treatment that provided a 10% reduction in seizure frequency (Odds Ratio [OR]=1.75, 95% CI 1.68-1.82) or avoided weight gain (3lb) (OR=0.751, 95% CI=0.731-0.772). Respondents were willing to pay an additional £39 and £20 per month for AEDs with those attributes. Furthermore, respondents who become unresponsive during a seizure placed higher levels of preference on an AED that would reduce seizure frequency. Respondents who reported higher levels of adherence to their AEDs (MMAS-8) reported better quality of life (QoL) (QOLIE-31-P and EQ-5D-5L). CONCLUSIONS: Seizure reduction is the most important AED attribute to epilepsy patients, but lack of weight gain is also valued. Higher adherence to AEDs appears to be linked with improved QoL.

Based on the cost-effective analysis, and survival adjustments necessary to match placebo groups, we would recommend abiraterone for treatment of metastatic castration-resistant prostate cancer despite not quite falling under the usually accepted willingness to pay threshold. Further analysis should examine comparative survival across the three drugs.

Citation: Foote KG, Rinella N, Tang J, et al. Cone structure persists beyond margins of short-wavelength autofluorescence in choroideremia. Invest Ophthalmol Vis Sci. 2019;60:4931-4942. https://doi.org/10.1167/ iovs.19-27979 PURPOSE. We studied the relationship between structure and function of the choriocapillaris (CC), retinal pigment epithelium (RPE), and photoreceptors in patients with choroideremia (CHM). METHODS.Six CHM patients (12 eyes) and four normal subjects (six eyes) were studied with fundus-guided microperimetry, confocal and nonconfocal adaptive optics scanning laser ophthalmoscopy (AOSLO), near-infrared and color fundus photos, short wavelength fundus autofluorescence (SW-AF), and swept-source optical coherence tomography (SS-OCT) and angiography (SS-OCTA) images. Cone spacing was represented using Z-scores (standard deviations from the mean at that eccentricity). CC flow voids were defined using a threshold of 1 SD below the normal mean. RESULTS.Cone spacing Z-scores were not significantly correlated with distance from the borders of preserved RPE, determined using either the SS-OCT or SW-AF scans. Cone spacing Z-scores were significantly correlated with CC flow voids and retinal sensitivity. Flow voids were abnormal in regions of preserved RPE and increased progressively from within À28 of the preserved area to þ28 beyond the border. Visual sensitivity decreased as CC flow voids increased approaching and beyond the border of preserved structure. CONCLUSIONS.In CHM, cone spacing Z-scores correlated with CC flow voids, and were negatively correlated with retinal sensitivity, suggesting cone degeneration accompanied reduced CC perfusion. Functional cones were found outside the presumed borders of preserved outer-retina/RPE as defined by SW-AF, but not outside the borders determined by SS-OCT. The use of SW-AF to identify the border of preserved structures may underestimate regions with cells that may be amenable to treatment.

Atherosclerosis is the leading cause of cardiovascular diseases worldwide. Trimethylamine N-oxide (TMAO), a metabolite of intestinal flora, has been shown to be closely related to the development of atherosclerosis. Previous...

Background and aims: Higher screening colonoscopy adenoma detection rates (ADRs) correlate with reduced risk of interval colorectal cancer (CRC). The Endocuff ® device has been shown to improve ADRs compared to standard colonoscopy (SC). This cost-effectiveness analysis compared interval CRC screening using Endocuff ® -assisted colonoscopy (EC) vs SC. Methods: A decision-analytic Markov model followed patients through screening, CRC diagnosis, progression, remission, and death. ADRs, CRC progression, and utilities were from literature. CRC incidence, stage distribution, and mortality were from the Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare linked databases. Screening and annual patient costs were from public databases and literature. Endocuff ® device average sales price was applied. Lifetime device and medical costs were evaluated separately for device purchaser, health plan, and accountable care organization (ACO) perspectives. Results: Consistent use of EC instead of SC was expected to reduce lifetime risks of interval CRC and related death by 0.98% and 0.19%, respectively, preventing one case per 102 patients and one death per 526 patients. Survival and quality-of-life (QoL) improved by 0.025 life-years and 0.011 quality-adjusted life-years (QALYs) per patient on average. EC instead of SC led to incremental cost-effectiveness ratios to the device purchaser of $4,421 per life-year gained and $9,843 per QALY gained, and $199 or $87 average cost-savings per patient to the health plan or ACO, respectively. Conclusion: Endocuff ® for screening colonoscopies was expected to reduce interval CRC incidence and death, improve QoL, and be cost-effective to the device purchaser and cost-saving to a health plan or ACO.