became cost effective over the 30W HL after treating 83 and 81 stones, respectively. The Thulium laser was more cost effective compared to the 100W HL with LPDSM after 85 cases.CONCLUSIONS: In this model the 60W Thulium laser was 67.8% faster than the 30W HL and 41.8% faster than the 100W Empower with long pulse duration and stone stabilization. The Thulium fiber laser will become cost effective after 83 and 85 cases over the 30W HL and 100W HL, respectively.
Our objective was to use community-based, national databases to evaluate diagnostic imaging and antibiotic prophylaxis practice patterns before and after the release of the 2011 American Academy of Pediatrics guidelines for acute febrile urinary tract infection. Using the National Ambulatory and Hospital Ambulatory Medical Care Surveys, urinary tract infection encounters were identified for patients aged 2 months to 18 years. Primary outcomes were utilization of antibiotics (as proxy for prophylaxis) and diagnostic imaging during encounters. Weighted multivariate logistic regression models were used to examine the association between time period (before and after 2011) and each of the primary outcomes. Among 8 588 035 weighted encounters, adjusting for covariates, there was insufficient evidence to suggest a difference between time periods for antibiotic utilization (odds ratio = 0.66, P = .12) or diagnostic imaging (odds ratio = 1.16, P = .56). Thus, we did not find evidence of changes in antibiotic utilization or diagnostic imaging practice patterns after the release of the 2011 American Academy of Pediatrics guidelines.
Objective: To quantitatively evaluate parental preferences for the various treatments for vesicoureteral reflux using crowd-sourced best-worst scaling, a novel technique in urologic preference estimation.Methods: Preference data were collected from a community sample of parents via two best-worst scaling survey instruments published to Amazon's Mechanical Turk online community. Attributes and attribute levels were selected following extensive review of the reflux literature. Respondents completed an object case best-worst scaling exercise to prioritize general aspects of reflux treatments and multi-profile case best-worst scaling to elicit their preferences for the specific differences in reflux treatments. Data were analyzed using multinomial logistic regression. Results from the object-case provided probability scaled values (PSV) that reflected the order of importance of attributes.
Results:We analyzed data for 248 and 228 respondents for object and multi-profile case BWS, respectively. When prioritizing general aspects of reflux treatment, effectiveness (PSV=20.37),
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