Low back pain (LBP) is a common health problem among adults of working age population, and its prevalence or incidence increases with increasing in age. The purpose of this review was to examine the real-world prevalence or incidence of LBP. A systematic review of the literature was conducted in accordance to the PRISMA guideline. Allied and Complementary Medicine Database, Cumulative Index of Nursing and Allied Health Literature, MEDLINE, SportDiscuss and Scopus electronic databases were searched using specifically developed search strategies to identify studies using patients' electronic medical records published in English up to February 2019. The quality of the included studies was assessed using a tool that consists of ten items addressing a risk of bias. The search yielded 756 published studies, of which 13 were deemed relevant and were included in this review. The included studies reported incidence or prevalence data from Canada, United States of America (USA), Sweden, Belgium, Finland, Israel, and Netherlands. All the included studies were assessed to be methodologically sound (low risk of bias). The prevalence and incidence of LBP ranged from 1.4 to 20.0% and 0.024-7.0%, respectively. Three studies reported that the Odds of LBP in male patient was higher than their female counterparts (odds ratio > 1; range 1.11-17.29). Nine studies identified the risk factors of LBP to be age, sex, and race. The remaining four studies also listed high intensity of physical activity, high spinal load, lifting, bending, and twisting as the risk factors for LBP. The results of this study highlighted there is a substantial difference within studies that estimated the prevalence and incidence of LBP. This finding could inform healthcare policy makers to critically examine the data sources of prevalence and incidence studies; this in return might help for resource allocation to manage the condition. PROSPERO registration number: CRD42017078598, https ://www.crd.york.ac.uk/prosp ero/.

This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.

with NPH therapy had changed their treatment. Conclusions: The prescription of modern therapies in the beginning of the treatment is preferred over the therapy with NPH, increasing the preference as time passes. Patients who start with modern therapies are more stable in their treatment than patients who start with NPH therapy.

85% of respondents stated that greater PMA input into clinical development would improve future launches. Conclusions: PMA teams face fewer internal launch challenges, but difficulties remain during payer negotiations due to insufficient clinical data. There is a need to better integrate PMA input early in the clinical development process to make the necessary evidence available at launch, and effectively manage senior leadership expectations around price potential and the associated evidence requirements, particularly in EU markets.

Objectives: In the current era of bundled payments, greater focus has been placed on preoperative patient optimization. This study examined the prevalence of preoperative anemia from 2007-2017 among patients undergoing elective total joint arthroplasty (TJA) and its association with transfusion. MethOds: This retrospective analysis used healthcare claims data from the Optum ClinformaticsTM Data Mart database (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017). Patient selection criteria included: hospitalization for elective TJA, age ≥ 18, and no diagnosis of a hematologic disorder. Patients were required to have at least one (90 days prior to admission) laboratory value for hemoglobin (Hgb); the most recent Hgb value was used to define anemia using the World Health Organization criteria. Logistic regression controlling for age, Charlson Score, region, payor, and procedure type evaluated the association between preoperative anemia and risk of transfusion. Results: 44,989 patients met selection criteria; mean age was 64 years and 59% were female. Overall, 85.7% of patients were preoperatively classified as non-anemic, 11.0% were anemic, and 3.3% severely anemic. Anemia category did not change over time, with 13% of patients categorized as anemic or severely anemic from 2007 to 2017. Incidence of transfusion increased from 7.1% (no anemia) to 19.9% (anemia) and 33.2% (severe anemia; P< .001). In adjusted analysis, the odds of transfusion ranged from 3.13 (anemia, 95% CI 2.88-3.40) to 6.43 (severe anemia, 95% CI 5.70-7.24) relative to normal Hgb levels. cOnclusiOns: Despite increased focus on preoperative patient optimization, there remains a significant proportion of patients undergoing TJA with anemia, where preoperative Hgb is strongly associated with risk of transfusion. This study suggests a need for increased efforts to reduce anemia prior to surgery, and for patients where Hgb may not be optimized, advanced strategies for intraoperative blood management should be employed.