To evaluate the effectiveness, as well as the cost-benefit of a hospitalwide physician educational programme in minimizing the spinal anesthesia (SA) failure rate. METHODS: A bupivacaine physician educational programme was initiated in June 2011 to minimize the SA failure rate in the Anesthesia Department of a tertiary-care hospital in Central Taiwan. We then used the patients recorded in the institution who underwent SA from January 2010 through December 2011, to evaluate the effectiveness as well as the cost-benefit of the programme, taking into consideration the cost of the training. To minimize potential impact of seasonal change, we compare two patient cohorts, the pre-training and the post-training cohorts, that were collected during July to December in 2010 and 2011, respectively. Logistic regression model was used to evaluate how well the application of the programme will predict SA failure rate, after controlling for potential impact of seasonal change. From the payer's perspective, the cost-benefit of the training was evaluated by calculating the cost needed under the SA failure rates before and after the training, based on the true number of patients undergoing SA after the training. The approved payments from the Bureau of National Health Insurance were used to do the calculation. RESULTS: There were 1841 and 2372 patients undergoing SA in the pre-training and post-training periods, respectively. The SA failure rate reduced from 2.66% to 1.39% in the two periods. The training is a predictor of lower SA failure rate (OR 0.57; 95% CI 0.41-0.79, pϭ0.001). A cost reduction of 3.13% was noted, indicating the cost-benefit of the training. CONCLUSIONS: The physician educational programme was associated with a significantly lower SA failure rate, with a RRR of 43%. Moreover, it had a significant cost-benefit profile from the payer's perspective.

Objectives: Soft tissue sarcomas (STSs) are cancers originating in connective tissue; in 50% of cases, patients initially present with or develop advanced or metastatic disease. Prognosis is poor with standard-of-care, anthracycline-containing systemic therapy; median overall survival (OS) is approximately 1 year. A recent phase 2 trial investigated olaratumab, a human anti-platelet-derived growth factor receptor alpha monoclonal antibody, in combination with doxorubicin, for treatment of advanced STS (aSTS). Our objective was to assess the clinical efficacy and safety of olaratumab compared with current standard-of-care therapies in aSTS. MethOds: We conducted a systematic literature review of phase 2 and 3 aSTS trials. Network meta-analyses (NMAs) were conducted for endpoints including OS, progression-free survival (PFS), and discontinuation due to adverse events (AEs). For survival outcomes, NMAs were performed on hazard ratios (HRs) and also using fractional polynomial models (FPMs). Results: A total of 54 comparative studies were identified, of which six studied olaratumab or current standard-ofcare therapies and could be linked in a network. The NMAs analyzed the seven regimens within the network: one regimen each for doxorubicin monotherapy (Dox), olaratumab in combination with doxorubicin (OlaDox), and gemcitabine in combination with docetaxel (GemDoc); and four different dose regimens of ifosfamide in combination with doxorubicin (IfoDox). The OlaDox regimen demonstrated improved OS compared with all included regimens; the improvement was statistically significant (P-values < 0.023 for the HR-based NMA) for all regimens except one IfoDox regimen. OlaDox also showed improved PFS compared with all included regimens; based on FPMs the improvement was statistically significant for Dox, one IfoDox regimen, and GemDoc. For safety, OlaDox showed a significantly lower rate of discontinuation due to AEs compared with all regimens except Dox and one IfoDox regimen. cOnclusiOns: OlaDox demonstrated more favorable results than comparators in terms of aSTS survival endpoints and discontinuation due to AEs.Objectives: Two systematic literature reviews were conducted to assess morbidity and mortality endpoints in patients with stage III or IV melanoma in response to treatment with granulocyte-macrophage colony-stimulating factor (GM-CSF) or dacarbazine (DTIC). MethOds: For this purpose, two literature searches were conducted in the bibliographic databases such as MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials. The systematic literature reviews were based on PICO-(Patient, Intervention, Comparator, Outcome) scheme for inclusion and exclusion criteria. Literature in English and German language was included. Endpoints assessed included overall survival (OS), objective response rate (ORR), and durable response rate (DRR). Results: The review is focused on adult patients with malignant melanoma who were treated with either GM-CSF or DTIC. The two searches identified 105 (GM-CSF) / 379 (DTIC) potentially ...