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Browse FSI scholarship on geopolitics, global health, energy, cybersecurity and more.

Featured Publications

Everything Counts: Building a Control Regime for Nonstrategic Nuclear Warheads in Europe

Building a Control Regime for Nonstrategic Nuclear Warheads in Europe

A new report led by Rose Gottemoeller on non-strategic nuclear warhead policies in Europe, particulary in light of Russia's changing status in the global nuclear community.
3D mockup cover of APARC's volume 'South Korea's Democracy in Crisis'

South Korea’s Democracy in Crisis

A close look at what is driving illiberalism and democratic delcine in today’s Korea, including political polarization, politicization of institutions, societal inequality, education, and social media.
System Error book cover and authors

System Error: Where Big Tech Went Wrong and How We Can Reboot

A forward-thinking manifesto which reveals how big tech’s obsession with optimization and efficiency has sacrificed fundamental human values.

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Douglas K. Owens
Journal Articles

Health outcomes and costs of community mitigation strategies for an influenza pandemic in the United States.

Daniella Perlroth, Glass RJ, Davey VJ, Cannon D, Alan M. Garber, Douglas K. Owens
Clinical Infectious Diseases, 2010 January 15, 2010

BACKGROUND: The optimal community-level approach to control pandemic influenza is unknown. METHODS: We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization.

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Journal Articles

CABG versus PCI for multivessel coronary artery disease - authors' reply

Mark A. Hlatky, Dena M. Bravata, Kathryn M. McDonald, Douglas Owens
The Lancet, 2009 December 31, 2009
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Journal Articles

Quality improvement strategies for children with asthma: A systematic review

Dena M. Bravata, Gienger AL, Jon-Erik Holty, Vandana Sundaram, Nayer Khazeni, Paul H. Wise, Kathryn McDonald, Douglas Owens
Pediatrics and Adolescent Medicine, 2009 December 31, 2009

Abstract

OBJECTIVE:

To evaluate the evidence that quality improvement (QI) strategies can improve the processes and outcomes of outpatient pediatric asthma care.

DATA SOURCES:

Cochrane Effective Practice and Organisation of Care Group database (January 1966 to April 2006), MEDLINE (January 1966 to April 2006), Cochrane Consumers and Communication Group database (January 1966 to May 2006), and bibliographies of retrieved articles.

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Journal Articles

Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009

Nayer Khazeni, Hutton DW, Alan M. Garber, Hupert N, Douglas Owens
Annals of Internal Medicine, 2009 December 12, 2009

Background: Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.

Objective: To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.

Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.

Data Sources: Literature and expert opinion.

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Journal Articles

Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for an Influenza A (H5N1) Pandemic

Nayer Khazeni, Hutton DW, Alan M. Garber, Douglas Owens
Annals of Internal Medicine, 2009 December 12, 2009

Background: The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century.

Objective: To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies.

Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.

Data Sources: Literature and expert opinion.

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Journal Articles

Cost-Effectiveness of Alternative Imaging Strategies for the Diagnosis of Small-bowel Crohn's Disease

Barrett Levesque, Cipriano LE, Chang SL, Lee KK, Douglas Owens, Alan Garber
Clinical Gastroenterology and Hepatology, 2009 November 1, 2009

BACKGROUND AND AIMS:: The cost-effectiveness of alternative approaches to the diagnosis of small-bowel Crohn's disease is unknown. This study evaluates whether CT-Enterography (CTE) is a cost-effective alternative to small bowel follow-through (SBFT) and whether capsule endoscopy is a cost-effective third test in patients in whom a high suspicion of disease remains after two previous negative tests.

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Working Papers

Hormonal Testing and Pharmacologic Treatment of Erectile Dysfunction: A Clinical Practice Guideline From the American College of Physicians.

Qaseem A, Snow V, Casey DE Jr, Forceia MA, Douglas K. Owens, Shakelle P, Clinical Efficacy Assessment Subcommittee of the American College of Physicians
Annals of Internal Medicine, 2009 October 1, 2009

Description: The American College of Physicians developed this guideline to present the available evidence on hormonal testing in and pharmacologic management of erectile dysfunction. Current pharmacologic therapies include phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil, and hormonal treatment.

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Journal Articles

Cost-Effectiveness of a Potential Prophylactic Helicobacter pylori Vaccine in the United States.

Rupnow MF, Chang AH, Ross D. Shachter, Douglas Owens, Julie Parsonnet
Journal of Infectious Disease, 2009 September 14, 2009

Background. Helicobacter pylori vaccines are under development to prevent infection. We quantified the cost‐effectiveness of such a vaccine in the United States, using a dynamic transmission model.

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Journal Articles

Identification, Recombinant Expression, and Biochemical Characterization of a Flavonol 3-O-Glucosyltransferase Clone from Citrus Paradisi.

Douglas Owens, McIntosh CA
Phytochemistry, 2009 September 3, 2009

Glucosylation is a predominant flavonoid modification reaction affecting the solubility, stability, and subsequent bioavailability of these metabolites. Flavonoid glycosides affect taste characteristics in citrus making the associated glucosyltransferases particularly interesting targets for biotechnology applications in these species.

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Journal Articles

Systematic Review: Elective Induction of Labor Versus Expectant Management of Pregnancy

Caughey AB, Vandana Sundaram, Kaimal AJ, Allison Gienger, Cheng YW, Kathryn M. McDonald, Shaffer BL, Douglas Owens, Dena Bravata
Annals of Internal Medicine, 2009 August 19, 2009

Background: The rates of induction of labor and elective induction of labor are increasing. Whether elective induction of labor improves outcomes or simply leads to greater complications and health care costs is commonly debated in the literature.

Purpose: To compare the benefits and harms of elective induction of labor and expectant management of pregnancy.

Data Sources: MEDLINE (through February 2009), Web of Science, CINAHL, Cochrane Central Register of Controlled Trials (through March 2009), bibliographies of included studies, and previous systematic reviews.

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Journal Articles

Lumbar facet joint pain: time to hit the reset button.

O'Neill C, Douglas Owens
Spine Journal, 2009 August 1, 2009
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Journal Articles

A Randomized Trial of Computer-based Reminders and Audit and Feedback to Improve HIV Screening in a Primary Care Setting

Vandana Sundaram, Laura Lazzeroni, Douglass LR, Gillian Sanders, Tempio P, Douglas Owens
International Journal of STDs and AIDS, 2009 August 1, 2009

Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV in a Department of Veterans Affairs (VA) health-care system. The design of the study was a randomized controlled trial at five primary care clinics at the VA Palo Alto Health Care System. All primary care providers were eligible to participate in the study.

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Books

Grading the Strength of a Body of Evidence When Comparing Medical Interventions

Douglas K. Owens, Lohr KN, Atkins D, Treadwell JR, Reston JT, Bass EB, Chang S, Helfand M
Journal of Clinical Epidemiology, 2009 July 10, 2009

Objective

To establish guidance on grading strength of evidence for the Evidence-based Practice Center (EPC) program of the U.S. Agency for Healthcare Research and Quality.

Study Design and Setting

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Journal Articles

Potential Population Health Outcomes and Expenditures of HIV Vaccination Strategies in the United States

Long EF, Margaret Brandeau, Douglas Owens
Vaccine, 2009 July 7, 2009

Estimating the potential health benefits and expenditures of a partially effective HIV vaccine is an important consideration in the debate about whether HIV vaccine research should continue. We developed an epidemic model to estimate HIV prevalence, new infections, and the cost-effectiveness of vaccination strategies in the U.S. Vaccines with modest efficacy could prevent 300,000-700,000 HIV infections and save $30 billion in healthcare expenditures over 20 years. Targeted vaccination of high-risk individuals is economically efficient, but

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Journal Articles

The Concurrent Validity and Responsiveness of the Health Utilities Index (HUI 3) Among Patients with Advanced HIV/AIDS

Nosyk B, Sun H, Bansback N, Guh DP, Li X, Paul G. Barnett, Bayoumi A, Griffin S, Vilija Joyce, Mark Holodniy, Douglas Owens, Anis AH
Quality of Life Research, 2009 June 27, 2009

Objectives To assess the concurrent validity and responsiveness of the Health Utility Index 3 (HUI3) in patients with advanced HIV/AIDS, and to determine the responsiveness of this measure, the MOS-HIV and EQ-5D to HIV-related clinical events.

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Journal Articles

Quality Improvement Strategies for Children With Asthma

Dena M. Bravata, Allison Gienger, Jon-Erik Holty, Vandana Sundaram, Nayer Khazeni, Paul H. Wise, Kathryn McDonald, Douglas Owens
Archives of Pediatrics and Adolescent Medicine, 2009 June 6, 2009

Objective To evaluate the evidence that quality improvement (QI) strategies can improve the processes and outcomes of outpatient pediatric asthma care.

Data Sources Cochrane Effective Practice and Organisation of Care Group database (January 1966 to April 2006), MEDLINE (January 1966 to April 2006), Cochrane Consumers and Communication Group database (January 1966 to May 2006), and bibliographies of retrieved articles.

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Journal Articles

Expanding Antiretroviral Options in Resource-Limited Settings-A Cost-Effectiveness Analysis

Eran Bendavid, Wood R, Katzenstein DA, Bayoumi AM, Douglas Owens
Journal of Acquired Immune Deficiency Syndromes, 2009 May 14, 2009

Background Current World Health Organization (WHO) guidelines for treatment of HIV in resource-limited settings call for 2 antiretroviral regimens. The effectiveness and cost-effectiveness of increasing the number of antiretroviral regimens is unknown.

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Journal Articles

Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain: An Evidence-Based Clinical Practice Guideline From the American Pain Society

Chou R, Loeser JD, Douglas K. Owens, Rosenquist RW, Atlas SJ, Baisden J, Carragee EJ, Grabois M, Murphy DR, Resnick DK, Stanos SP, Shaffer WO, Wall EM, For the American Pain Society Low Back Pain Guideline Panel
Spine, 2009 April 9, 2009

STUDY DESIGN: Clinical practice guideline.

OBJECTIVE: To develop evidence-based recommendations on use of interventional diagnostic tests and therapies, surgeries, and interdisciplinary rehabilitation for low back pain of any duration, with or without leg pain.

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Journal Articles

Coronary Artery Bypass Surgery Compared with Percutaneous Coronary Interventions for Multivessel Disease: A Collaborative Analysis of Individual Patient Data from Ten Randomised Trials

Mark A. Hlatky, Boothroyd DB, Dena M. Bravata, Boersma E, Booth J, Brooks MM, Carrie MD, Clayton TC, Danchin N, Flather M, Hamm CW, Hueb WA, Kahler J, Kelsey SF, King SB, Kosinski AS, Lopes N, Kathryn M. McDonald, Rodriguez A, Serruys P, Sigwart P, Stables RH, Douglas K. Owens, Pocock SJ
The Lancet, 2009 March 20, 2009

Background

Coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) are alternative treatments for multivessel coronary disease. Although the procedures have been compared in several randomised trials, their long-term effects on mortality in key clinical subgroups are uncertain. We undertook a collaborative analysis of data from randomised trials to assess whether the effects of the procedures on mortality are modified by patient characteristics.

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Policy Briefs

Maternal and Neonatal Outcomes of Elective Induction of Labor

Caughey AB, Vandana Sundaram, Kaimal AJ, Cheng YW, Allison Gienger, Little SE, Lee JF Lee JF, Shaffer BL Shaffer BL , Tran SH, Padula A, Kathryn M. McDonald, Long EF, Douglas Owens, Dena Bravata
Evidence report/technology assessment, 2009 March 1, 2009

Background: Induction of labor is on the rise in the U.S., increasing from 9.5 percent in 1990 to 22.1 percent in 2004. Although, it is not entirely clear what proportion of these inductions are elective (i.e. without a medical indication), the overall rate of induction of labor is rising faster than the rate of pregnancy complications that would lead to a medically indicated induction. However, the maternal and neonatal effects of induction of labor are unclear. Many studies compare women with induction of labor to those in spontaneous labor.

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Journal Articles

Health-related Quality of Life in a Randomized Trial of Antiretroviral Therapy for Advanced HIV Disease

Vilija Joyce, Paul G. Barnett, Bayoumi AM, Griffin SC, Kyriakides TC, Wei Yu, Vandana Sundaram, Mark Holodniy, Brown ST, Cameron W, Youle M, Sculpher M, Anis AH, Douglas Owens
Journal of Acquired Immune Deficiency Syndromes, 2009 January 1, 2009

OBJECTIVE: To assess and compare alternative approaches of measuring preference-based health-related quality of life (HRQoL) in treatment-experienced HIV patients and evaluate their association with health status and clinical variables. DESIGN: Cross-sectional study.

SETTING: Twenty-eight Veterans Affairs hospitals in the United States, 13 hospitals in Canada, and 8 hospitals in the United Kingdom.

PATIENTS: Three hundred sixty-eight treatment-experienced HIV-infected patients enrolled in the Options in Management with Antiretrovirals randomized trial.

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Journal Articles

Screening for HIV in health care settings: a guidance statement from the American College of Physicians and HIV Medicine Association

A Qaseem, V Snow, R Hopkins Jr., Douglas Owens, Clinical Efficacy Assessment Subcommittee
Annals of Internal Medicine, 2009 January 1, 2009

The American College of Physicians (ACP) developed this guidance statement to present the available evidence on screening for HIV in health care settings. METHODS: This guidance statement is derived from an appraisal of available guidelines on screening for HIV. Authors searched the National Guideline Clearinghouse to identify guidelines on screening for HIV in the United States and used the AGREE (Appraisal of Guidelines Research and Evaluation) instrument to evaluate guidelines from the U.S. Preventive Services Task Force and the Centers for

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Journal Articles

Cost-effectiveness of voluntary HIV screening in Russia

Swati Tole, AM Bayoumi, Cristina Galvin, TN Vinichenko, Margaret Brandeau, Douglas Owens
International Journal of STD and AIDS, 2009 January 1, 2009

Russia has one of the world's fastest growing HIV epidemics, and HIV screening has been widespread. Whether such screening is an effective use of resources is unclear. We used epidemiologic and economic data from Russia to develop a Markov model to estimate costs, quality of life and survival associated with a voluntary HIV screening programme compared with no screening in Russia. We measured discounted lifetime health-care costs and quality-adjusted life years (QALYs) gained. We varied our inputs in sensitivity analysis. Early identification of HIV

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Journal Articles

Isolated disease of the proximal left anterior descending artery. comparing the effectiveness of percutaneous coronary interventions and coronary artery bypass surgery

John R. Kapoor, Allison L. Gienger, Reza Ardehali, Robin Varghese, Marco V. Perez, Vandana Sundaram, Kathryn M. McDonald, Douglas K. Owens, Mark A. Hlatky, Dena Bravata
JACC: Cardiovascular Interventions, 2008 December 31, 2008

Objectives: This study sought to systematically compare the effectiveness of percutaneous coronary intervention and coronary artery bypass surgery in patients with single-vessel disease of the proximal left anterior descending (LAD) coronary artery.

Background: It is uncertain whether percutaneous coronary interventions (PCI) or coronary artery bypass grafting (CABG) surgery provides better clinical outcomes among patients with single-vessel disease of the proximal LAD.

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