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  1. Article: A mission shaped by the A.S.P.E.N community.

    Tappenden, Kelly A

    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

    2008  Volume 23, Issue 3, Page(s) 260

    MeSH term(s) Forecasting ; Gastroenterology/standards ; Gastroenterology/trends ; Humans ; Societies, Medical/standards ; Societies, Medical/trends
    Language English
    Publishing date 2008-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1177/0884533608320381
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  2. Article ; Online: Anatomical and physiological considerations in short bowel syndrome: Emphasis on intestinal adaptation and the role of enterohormones

    Tappenden, Kelly A.

    Nutrition in Clinical Practice. 2023 May, v. 38 Suppl S1 p.S27-S34

    2023  

    Abstract: Short bowel syndrome (SBS)–associated intestinal failure (IF) is a complex, life‐threatening condition that requires complex care of multiple factors impacting the patient's long‐term prognosis. Various etiologies result in SBS‐IF, with three primary ... ...

    Abstract Short bowel syndrome (SBS)–associated intestinal failure (IF) is a complex, life‐threatening condition that requires complex care of multiple factors impacting the patient's long‐term prognosis. Various etiologies result in SBS‐IF, with three primary anatomical subtypes occurring following intestinal resection. Depending on the extent and segment(s) of the intestine resected, malabsorption can be nutrient specific or sweeping; however, such issues and the associated prognosis for the patient can be predicted with analysis of the residual intestine, along with baseline nutrient and fluid deficits and extent of malabsorption. The provision of parenteral nutrition/intravenous (PN‐IV) fluids and antisymptomatic agents is fundamental; however, optimal management should focus on intestinal rehabilitation, wherein intestinal adaptation is prioritized and PN‐IV fluids are weaned over time. Key strategies to maximize intestinal adaptation include hyperphagic consumption of an individualized SBS diet and the appropriate use of trophic agents, such as a glucagon‐like peptide 2 analog.
    Keywords diet ; glucagon-like peptide 2 ; intestines ; intravenous injection ; malabsorption ; parenteral feeding ; patients ; prognosis ; resection
    Language English
    Dates of publication 2023-05
    Size p. S27-S34.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note REVIEW
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10991
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  3. Article ; Online: A systematic review of whole disease models for informing healthcare resource allocation decisions.

    Jin, Huajie / Tappenden, Paul / Ling, Xiaoxiao / Robinson, Stewart / Byford, Sarah

    PloS one

    2023  Volume 18, Issue 9, Page(s) e0291366

    Abstract: Background: Whole disease models (WDM) are large-scale, system-level models which can evaluate multiple decision questions across an entire care pathway. Whilst this type of model can offer several advantages as a platform for undertaking economic ... ...

    Abstract Background: Whole disease models (WDM) are large-scale, system-level models which can evaluate multiple decision questions across an entire care pathway. Whilst this type of model can offer several advantages as a platform for undertaking economic analyses, the availability and quality of existing WDMs is unknown.
    Objectives: This systematic review aimed to identify existing WDMs to explore which disease areas they cover, to critically assess the quality of these models and provide recommendations for future research.
    Methods: An electronic search was performed on multiple databases (MEDLINE, EMBASE, the NHS Economic Evaluation Database and the Health Technology Assessment database) on 23rd July 2023. Two independent reviewers selected studies for inclusion. Study quality was assessed using the National Institute for Health and Care Excellence (NICE) appraisal checklist for economic evaluations. Model characteristics were descriptively summarised.
    Results: Forty-four WDMs were identified, of which thirty-two were developed after 2010. The main disease areas covered by existing WDMs are heart disease, cancer, acquired immune deficiency syndrome and metabolic disease. The quality of included WDMs is generally low. Common limitations included failure to consider the harms and costs of adverse events (AEs) of interventions, lack of probabilistic sensitivity analysis (PSA) and poor reporting.
    Conclusions: There has been an increase in the number of WDMs since 2010. However, their quality is generally low which means they may require significant modification before they could be re-used, such as modelling AEs of interventions and incorporation of PSA. Sufficient details of the WDMs need to be reported to allow future reuse/adaptation.
    MeSH term(s) Humans ; Acquired Immunodeficiency Syndrome ; Checklist ; Cost-Benefit Analysis ; Critical Pathways ; Resource Allocation
    Language English
    Publishing date 2023-09-14
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0291366
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  4. Book ; Conference proceedings: Intestinal failure: current and emerging therapies including transplantation

    Tappenden, Kelly A.

    proceedings of the NIH-sponsored Workshop on Intestinal Failure, February 7 - 8, 2004, A.S.P.E.N.'s Nutrition Week 2004, Las Vegas, Nevada

    (Gastroenterology ; 130,2, Suppl. 1)

    2006  

    Institution National Institutes of Health
    American Society of Parenteral and Enteral Nutrition
    Event/congress Workshop on Intestinal Failure (2004, LasVegasNev.) ; Clinical Nutrition Week (2004, LasVegasNev.)
    Series title Gastroenterology ; 130,2, Suppl. 1
    Collection
    Language English
    Size S169 S. : Ill., graph. Darst.
    Publisher Saunders
    Publishing place Philadelphia, Pa
    Publishing country United States
    Document type Book ; Conference proceedings
    HBZ-ID HT014673880
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    Ui V Zs 44 -130,Suppl.1- verfügbar in Königswinter Königswinter

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  5. Article ; Online: Epidemiology, survival, costs, and quality of life in adults with short bowel syndrome

    Winkler, Marion / Tappenden, Kelly

    Nutrition in Clinical Practice. 2023 May, v. 38 Suppl S1 p.S17-S26

    2023  

    Abstract: Short bowel syndrome (SBS) is a rare disorder with known physical, psychosocial, and economic burdens and significant morbidity and mortality. Many individuals with SBS require long‐term home parenteral nutrition (HPN). The incidence and prevalence of ... ...

    Abstract Short bowel syndrome (SBS) is a rare disorder with known physical, psychosocial, and economic burdens and significant morbidity and mortality. Many individuals with SBS require long‐term home parenteral nutrition (HPN). The incidence and prevalence of SBS is difficult to determine because it is often based on HPN usage and may not account for those who receive intravenous fluids or achieve enteral autonomy. The most common etiologies associated with SBS are Crohn's disease and mesenteric ischemia. Intestinal anatomy and remnant bowel length are prognostic for HPN dependency, and enteral autonomy confers a survival advantage. Health economic data confirm that PN‐related costs are higher for hospitalizations than at home; yet significant healthcare resource utilization is necessary for successful HPN, and patients and families report substantial financial distress that impacts quality of life (QOL). An important advancement in QOL measurement is the validation of HPN‐ and SBS‐specific QOL questionnaires. In addition to the known factors negatively impacting QOL, such as diarrhea, pain, nocturia, fatigue, depression, and narcotic dependency, research has shown that the volume and number of PN infusions per week is associated with QOL. Although traditional QOL measurements describe how underlying disease and therapy influence life, they do not assess how symptoms and functional limitations affect the QOL of patients and caregivers. Patient‐centered measures and conversation focused on psychosocial issues helps patients with SBS and HPN dependency better cope with their disease and treatment. This article presents a brief overview of SBS, including epidemiology, survival, costs, and QOL.
    Keywords Crohn disease ; caregivers ; diarrhea ; epidemiology ; financial economics ; health services ; intestines ; intravenous injection ; ischemia ; morbidity ; mortality ; pain ; parenteral feeding ; quality of life
    Language English
    Dates of publication 2023-05
    Size p. S17-S26.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note REVIEW
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10964
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  6. Article ; Online: Estimation of Transition Probabilities for State-Transition Models: A Review of NICE Appraisals.

    Srivastava, Tushar / Latimer, Nicholas R / Tappenden, Paul

    PharmacoEconomics

    2021  Volume 39, Issue 8, Page(s) 869–878

    Abstract: State transition models are used to inform health technology reimbursement decisions. Within state transition models, the movement of patients between the model health states over discrete time intervals is determined by transition probabilities (TPs). ... ...

    Abstract State transition models are used to inform health technology reimbursement decisions. Within state transition models, the movement of patients between the model health states over discrete time intervals is determined by transition probabilities (TPs). Estimating TPs presents numerous issues, including missing data for specific transitions, data incongruence and uncertainty around extrapolation. Inappropriately estimated TPs could result in biased models. There is limited guidance on how to address common issues associated with TP estimation. To assess current methods for estimating TPs and to identify issues that may introduce bias, we reviewed National Institute for Health and Care Excellence Technology Appraisals published from 1 January, 2019 to 27 May, 2020. Twenty-eight models (from 26 Technology Appraisals) were included in the review. Several methods for estimating TPs were identified: survival analysis (n = 11); count method (n = 9); multi-state modelling (n = 7); logistic regression (n = 2); negative binomial regression (n = 2); Poisson regression (n = 1); and calibration (n = 1). Evidence Review Groups identified several issues relating to TP estimation within these models, including important transitions being excluded (n = 5); potential selection bias when estimating TPs for post-randomisation health states (n = 2); issues concerning the use of multiple data sources (n = 4); potential biases resulting from the use of data from different populations (n = 2), and inappropriate assumptions around extrapolation (n = 3). These issues remained unresolved in almost every instance. Failing to address these issues may bias model results and lead to sub-optimal decision making. Further research is recommended to address these methodological problems.
    MeSH term(s) Cost-Benefit Analysis ; Humans ; Probability ; Survival Analysis ; Technology Assessment, Biomedical ; Uncertainty
    Language English
    Publishing date 2021-05-19
    Publishing country New Zealand
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-021-01034-5
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  7. Article ; Online: Improving Transparency in Decision Models: Current Issues and Potential Solutions.

    Tappenden, Paul / Caro, J Jaime

    PharmacoEconomics

    2019  Volume 37, Issue 11, Page(s) 1303–1304

    MeSH term(s) Decision Making ; Decision Support Techniques ; Humans ; Technology Assessment, Biomedical/methods ; Technology Assessment, Biomedical/standards
    Language English
    Publishing date 2019-10-22
    Publishing country New Zealand
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-019-00850-0
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  8. Article ; Online: Management of short-bowel syndrome: A survey of unmet educational needs among healthcare providers.

    Belcher, Emily / Mercer, David / Raphael, Bram P / Salinas, Gregory D / Stacy, Sylvie / Tappenden, Kelly A

    JPEN. Journal of parenteral and enteral nutrition

    2022  Volume 46, Issue 8, Page(s) 1839–1846

    Abstract: Background: Management of short-bowel syndrome with intestinal failure (SBS-IF) is complex and requires a multidisciplinary approach. Because of the rarity of SBS-IF, healthcare professionals (HCPs) often lack clinical experience with the disease and ... ...

    Abstract Background: Management of short-bowel syndrome with intestinal failure (SBS-IF) is complex and requires a multidisciplinary approach. Because of the rarity of SBS-IF, healthcare professionals (HCPs) often lack clinical experience with the disease and may benefit from education regarding SBS-IF and its management. This study identified unmet educational needs related to the management of patients with SBS-IF.
    Methods: This was a prospective, web-based survey (December 2019-January 2020) in which a series of clinical questions were posed to US HCPs after presenting three standardized SBS-IF cases to assess current practice patterns. HCPs were then asked a series of questions to identify potential knowledge gaps and unmet educational needs relating to SBS-IF management.
    Results: Overall, 558 HCPs completed the survey, with 12%-38% having a formal SBS-IF multidisciplinary team currently available to make treatment decisions within their institution. Clinicians involved in care included gastroenterologists (93%), registered dietitians (79%), gastroenterology nurse practitioners and physician assistants (37%), registered nurses (43%), social workers (45%), and psychologists/psychiatrists (27%). There was underuse of published guidelines and limited understanding of the course of intestinal adaptation. Responses to the clinical scenarios highlighted disparities in SBS-IF care delivery, including diagnosis, management goals, medications prescribed, and nutrition practices.
    Conclusions: Future SBS-IF educational interventions for HCPs should aim to improve awareness and understanding of the disease, facilitate timely diagnosis, and standardize management practices to ensure patients receive optimal interdisciplinary care as widely as possible.
    MeSH term(s) Humans ; Prospective Studies ; Short Bowel Syndrome/therapy ; Surveys and Questionnaires ; Health Personnel ; Intestines
    Language English
    Publishing date 2022-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2388
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  9. Article ; Online: A systematic review of meta-analyses assessing the validity of tumour response endpoints as surrogates for progression-free or overall survival in cancer.

    Cooper, Katy / Tappenden, Paul / Cantrell, Anna / Ennis, Kate

    British journal of cancer

    2020  Volume 123, Issue 11, Page(s) 1686–1696

    Abstract: Background: Tumour response endpoints, such as overall response rate (ORR) and complete response (CR), are increasingly used in cancer trials. However, the validity of response-based surrogates is unclear. This systematic review summarises meta-analyses ...

    Abstract Background: Tumour response endpoints, such as overall response rate (ORR) and complete response (CR), are increasingly used in cancer trials. However, the validity of response-based surrogates is unclear. This systematic review summarises meta-analyses assessing the association between response-based outcomes and overall survival (OS), progression-free survival (PFS) or time-to-progression (TTP).
    Methods: Five databases were searched to March 2019. Meta-analyses reporting correlation or regression between response-based outcomes and OS, PFS or TTP were summarised.
    Results: The systematic review included 63 studies across 20 cancer types, most commonly non-small cell lung cancer (NSCLC), colorectal cancer (CRC) and breast cancer. The strength of association between ORR or CR and either PFS or OS varied widely between and within studies, with no clear pattern by cancer type. The association between ORR and OS appeared weaker and more variable than that between ORR and PFS, both for associations between absolute endpoints and associations between treatment effects.
    Conclusions: This systematic review suggests that response-based endpoints, such as ORR and CR, may not be reliable surrogates for PFS or OS. Where it is necessary to use tumour response to predict treatment effects on survival outcomes, it is important to fully reflect all statistical uncertainty in the surrogate relationship.
    MeSH term(s) Clinical Trials as Topic/standards ; Humans ; Meta-Analysis as Topic ; Neoplasms/mortality ; Progression-Free Survival ; Survival ; Treatment Outcome
    Language English
    Publishing date 2020-09-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 80075-2
    ISSN 1532-1827 ; 0007-0920
    ISSN (online) 1532-1827
    ISSN 0007-0920
    DOI 10.1038/s41416-020-01050-w
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  10. Article ; Online: Fermentable Fibers Enhance Aspects of Innate and Adaptive Immunity in Piglets infected with Salmonella Typhimurium.

    Correa-Matos, Nancy J / Donovan, Sharon M / Tappenden, Kelly A

    Puerto Rico health sciences journal

    2020  Volume 39, Issue 4, Page(s) 311–318

    Abstract: ... when compared to other diets (p<0.0003). The number of ileal sulfo-acidomucins was higher (p<0.05) in FOS ... before infection compared with other diets. NFkB was inhibited in FOS following infection (p<0.05), when compared ... with CON. IL-1β expression was increased at 4h post-infection (p<0.05) in CON; however, this response was ...

    Abstract Objective: To test the hypothesis that fermentable fiber prevents Salmonella typhimurium infection-associated symptoms by enhancing innate and adaptive immune system in neonatal pigs.
    Methods: Two-d-old piglets (n=120) were randomized to receive either a nutritionally complete sow milk replacer formula (CON), or supplemented with methylcellulose (MCEL-non-fermentable), soy polysaccharides (SPS-moderately fermentable), or fructooligosaccharides (FOS-highly fermentable). On d7, piglets received an oral gavage of S. typhimurium-798, and continued receiving the same diets up to 48h post-infection. Ileal mucosal samples were obtained for further analyses.
    Results: A reduction in chloride secretion was observed in FOS when compared to other diets (p<0.0003). The number of ileal sulfo-acidomucins was higher (p<0.05) in FOS before infection compared with other diets. NFkB was inhibited in FOS following infection (p<0.05), when compared with CON. IL-1β expression was increased at 4h post-infection (p<0.05) in CON; however, this response was attenuated in the fiber groups. IL-6 expression was higher (p<0.05) in CON post- infection, higher in SPS at 24h (p<0.05), but unchanged in MCEL and FOS when compared to pre-infection values. FOS had a higher expression of neutrophil-chemoattractant IL-8 before infection (p<0.05) compared to other groups.
    Conclusion: The reduction in chloride secretion, proinflammatory cytokines expression and NFkB activation, and increased number of sulfo-acidomucins, and IL-8 expression in the fiber groups, indicates that the degree of fermentability impacts the innate and adaptive immune system, and could be the mechanisms by which dietary fibers reduce S. typhimurium infection-associated-symptoms in neonatal pigs and apply these results to infants.
    MeSH term(s) Adaptive Immunity/immunology ; Animals ; Animals, Newborn ; Cytokines/immunology ; Dietary Fiber/administration & dosage ; Dietary Fiber/pharmacology ; Fermentation ; Immunity, Innate/immunology ; Methylcellulose/administration & dosage ; Methylcellulose/pharmacology ; Oligosaccharides/administration & dosage ; Oligosaccharides/pharmacology ; Polysaccharides/administration & dosage ; Polysaccharides/pharmacology ; Random Allocation ; Salmonella Infections/immunology ; Salmonella Infections/prevention & control ; Salmonella typhimurium/isolation & purification ; Glycine max/chemistry ; Swine
    Chemical Substances Cytokines ; Dietary Fiber ; Oligosaccharides ; Polysaccharides ; fructooligosaccharide ; Methylcellulose (9004-67-5)
    Language English
    Publishing date 2020-12-15
    Publishing country Puerto Rico
    Document type Comparative Study ; Journal Article
    ZDB-ID 639137-0
    ISSN 2373-6011 ; 0738-0658
    ISSN (online) 2373-6011
    ISSN 0738-0658
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