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Article: Morrell, Peter S.: Moving boxes by air, the economics of international air cargo : Farnham [u.a.], Ashgate, 2011 / [rezensiert von:] David Hummels

Hummels, David / Morrell, Peter S

Journal of economic literature Bd. L.2012, 3 (Sept.), S. 807-809

2012

Language	English
Publisher	Assoc.
Publishing place	Nashville, Tenn.
Document type	Article
ZDB-ID	3076-4 ; 2010159-4
ISSN	0022-0515
ISSN	0022-0515
Database	ECONomics Information System

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Article ; Online: Inpatient Choledocholithiasis Management: a Cost-Effectiveness Analysis of Management Algorithms.

Morrell, David J / Pauli, Eric M / Hollenbeak, Christopher S

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2022 Volume 26, Issue 4, Page(s) 837–848

Abstract: Background: Choledocholithiasis is commonly encountered. It is frequently managed with laparoscopic common bile duct exploration or endoscopic retrograde cholangiopancreatography (either preoperative, intraoperative, or postoperative relative to ... ...

Abstract	Background: Choledocholithiasis is commonly encountered. It is frequently managed with laparoscopic common bile duct exploration or endoscopic retrograde cholangiopancreatography (either preoperative, intraoperative, or postoperative relative to laparoscopic cholecystectomy). The purpose of this study is to determine the most cost-effective method to manage inpatient choledocholithiasis. Methods: A decision tree model was created to evaluate the cost-effectiveness of laparoscopic common bile duct exploration and preoperative, intraoperative, and postoperative endoscopic retrograde cholangiopancreatography. The primary outcome was incremental cost-effectiveness ratio with a ceiling willingness to pay threshold assumed of $100,000 per quality-adjusted life year. Model parameters were determined through review of published literature and institutional data. Costs were from the perspective of the healthcare system with a time horizon of 1 year. Sensitivity analyses were performed on model parameters. Results: In the base case analysis, laparoscopic common bile duct exploration was cost-effective, resulting in 0.9909 quality-adjusted life years at an expected cost of $18,357. Intraoperative endoscopic retrograde cholangiopancreatography yielded more quality-adjusted life years (0.9912) at a higher cost ($19,717) with an incremental cost-effectiveness ratio of $4,789,025, exceeding the willingness to pay threshold. Both preoperative and postoperative endoscopic retrograde cholangiopancreatographies were eliminated for being both more costly and less effective. Laparoscopic common bile duct exploration remained cost-effective if the probability of successful biliary clearance was above 0.79, holding all other variables constant. If its base cost remained below $18,400 and intraoperative endoscopic retrograde cholangiopancreatography base cost rose above $18,200, then laparoscopic common bile duct exploration remained cost-effective. Conclusion: Laparoscopic common bile duct exploration is the most cost-effective method to manage choledocholithiasis. Efforts to ensure availability of local expertise and resources for this procedure are warranted.
MeSH term(s)	Algorithms ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Cholecystectomy, Laparoscopic/methods ; Choledocholithiasis/surgery ; Cost-Benefit Analysis ; Humans ; Inpatients
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-022-05249-5
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Article ; Online: Is preparation of a sterile operative field before percutaneous endoscopic gastrostomy necessary? A cost-effectiveness analysis.

Morrell, David J / Liu, Alexander T / Pauli, Eric M / Winder, Joshua S

Surgical endoscopy

2022 Volume 36, Issue 9, Page(s) 6949–6953

Abstract: Background: Despite the non-sterile nature of the alimentary tract, percutaneous endoscopic gastrostomy (PEG) procedures are often performed after creating a sterile surgical field to reduce infection risk. Our group has previously demonstrated no ... ...

Abstract	Background: Despite the non-sterile nature of the alimentary tract, percutaneous endoscopic gastrostomy (PEG) procedures are often performed after creating a sterile surgical field to reduce infection risk. Our group has previously demonstrated no statistically significant difference in the rate of surgical site infection (SSI) following PEG performed with or without sterile operative fields. The purpose of this study is to evaluate the cost-effectiveness of working with or without sterile operative fields during PEG. Methods: A decision tree model of PEG with and without sterile operative fields was created to evaluate the cost-effectiveness of these two methods. The primary outcome was incremental cost-effectiveness ratio with a ceiling willingness to pay threshold assumed of $100,000 per quality-adjusted life year (QALY). Costs were from the perspective of the healthcare system with a time horizon for the model of 90 days. Sensitivity analyses were performed on all model parameters. Results: In the base case analysis, sterile operative field PEG was cost-effective resulting in 0.2225 QALYs at an expected cost of $2,099. PEG procedures without a sterile operative field yielded less QALYs (0.2224) at a higher cost ($2,199) and were dominated. These procedures became cost-effective when the expected cost was < $1618 (e.g., $140 less than sterile operative field PEG) or when the SSI rate was < 1.6% (e.g., 0.2% higher than sterile operative field PEG) while holding all other variables constant. Conclusion: PEG procedures performed without a sterile operative field can be cost-effective compared to procedures performed with a sterile operative field if the rates of SSI remain similar. Cost savings from foregoing a sterile operative field appear to be offset if the SSI rate increases > 0.2% above that of sterile operative field PEG procedures.
MeSH term(s)	Cost Savings ; Cost-Benefit Analysis ; Gastrostomy/methods ; Humans ; Quality-Adjusted Life Years ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control
Language	English
Publishing date	2022-01-31
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09057-5
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Article ; Online: Examining engagement effects in an adaptive preventive intervention for college student drinking.

Patrick, Megan E / Sur, Aparajita / Arterberry, Brooke / Peterson, Sarah / Morrell, Nicole / Vock, David M

Journal of consulting and clinical psychology

2023 Volume 91, Issue 11, Page(s) 652–664

Abstract: Objective: This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention (API) was associated with reduced binge drinking and alcohol-related consequences.: Method: Incoming students were ... ...

Abstract	Objective: This study determined the characteristics of engagement and whether engagement in an adaptive preventive intervention (API) was associated with reduced binge drinking and alcohol-related consequences. Method: Incoming students were recruited for a sequential multiple assignment randomized trial (SMART; Results: Precollege binge drinking, intention to pledge a fraternity/sorority, and higher conformity motives were most associated with lower odds of Stage 1 engagement. Action (readiness to change) and PNF engagement were associated with Stage 2 engagement. API engagement was associated with significant reductions in alcohol-related consequences among heavy drinkers. Compared to the control, we estimated the API would reduce the relative increase in alcohol-related consequences from baseline to follow-up by 25%, had all API students engaged. Conclusions: Even partial engagement in each component of the "light-touch" API rendered benefits. Analyses suggested that had all students in the intervention group engaged, the API would significantly reduce the change in alcohol-related consequences over the first semester in college. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Humans ; Female ; Male ; Alcohol Drinking in College ; Binge Drinking/epidemiology ; Binge Drinking/prevention & control ; Motivation ; Intention ; Students ; Universities ; Alcohol Drinking/prevention & control
Language	English
Publishing date	2023-08-31
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	121321-0
ISSN	1939-2117 ; 0022-006X
ISSN (online)	1939-2117
ISSN	0022-006X
DOI	10.1037/ccp0000845
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Article ; Online: Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis: outcomes of a dedicated anesthesia and surgery protocol.

Morrell, David J / Chau, Marvin H / Winder, Joshua S / Stredny, Edward S / Alli, Vamsi V / Sinz, Elizabeth H / Hazard, Sprague W / Simmons, Zachary / Pauli, Eric M

Surgical endoscopy

2023 Volume 37, Issue 6, Page(s) 4338–4344

Abstract: Background: Patients requiring percutaneous endoscopic gastrostomy (PEG) for amyotrophic lateral sclerosis (ALS) related dysphagia represent a clinical challenge. Diminished pulmonary function and aspiration risks can lead to anesthesia-related ... ...

Abstract	Background: Patients requiring percutaneous endoscopic gastrostomy (PEG) for amyotrophic lateral sclerosis (ALS) related dysphagia represent a clinical challenge. Diminished pulmonary function and aspiration risks can lead to anesthesia-related complications, and gastric displacement from hemidiaphragm elevation may preclude safe gastric access. This study reports the efficacy and outcomes of a dedicated anesthesia/surgery management protocol for ALS patients undergoing PEG. Methods: In 2013, a PEG placement protocol for ALS patients was developed emphasizing efficient pre-operative evaluation, rapidly metabolized anesthetic agents, and minimization of opioid use. Outcomes were analyzed retrospectively. Preoperative weight loss, pulmonary function tests, total analgesia, procedural time, and 90-day morbidity and mortality were recorded. Results: From 2013-2019, 67 ALS patients (mean age 65.3 years, 52.2% female) received a PEG under the protocol. Mean percentage weight loss 6 months before PEG was 9.3 ± 5.1% with 38.8% of patients meeting criteria for severe malnutrition. Mean anesthesia time (propofol induction to anesthesia emergence) was 34.5 ± 10.8 min and mean operative time (endoscope insertion to dressing placement) was 16.4 ± 8.2 min. Regional anesthesia with liposomal bupivacaine was performed in 76.1%. All attempts at PEG placement were successful. With a mean follow-up of 6.1 ± 6.8 months, all PEGs were functional and there were no surgical site complications. Thirty-day readmission rate was 7.0% and 90-day mortality was 22.4% (46.7% occurring within 30 days). Mean time from surgery to death was 8.8 ± 7.8 months. Conclusions: Protocols for optimizing PEG may help overcome challenges present in the ALS patient population. Despite patient comorbidities, protocol implementation and dedicated team members resulted in a high procedural success rate and low complication rate. Further study is warranted to optimize the timing of PEG placement in relation to ALS disease progression and determine the utility of regional anesthesia during PEG placement.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Amyotrophic Lateral Sclerosis/complications ; Amyotrophic Lateral Sclerosis/surgery ; Gastrostomy/methods ; Retrospective Studies ; Anesthesia ; Weight Loss
Language	English
Publishing date	2023-02-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-09896-w
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Article ; Online: The cost of laser refractive surgery and supplementary sulcus lens implantation for pseudophakic ametropia and astigmatism, the leeds experience.

Okonkwo, Arthur / Blizzard, Robert / Anand, Seema / Morrell, Andrew / Bardan, Ahmed Shalaby / Dunleavy, David

Eye (London, England)

2022 Volume 37, Issue 11, Page(s) 2169–2171

MeSH term(s)	Humans ; Astigmatism/etiology ; Astigmatism/surgery ; Refractive Errors ; Refractive Surgical Procedures ; Lasers ; Refraction, Ocular ; Lenses, Intraocular ; Pseudophakia/complications ; Pseudophakia/surgery
Language	English
Publishing date	2022-12-14
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	91001-6
ISSN	1476-5454 ; 0950-222X
ISSN (online)	1476-5454
ISSN	0950-222X
DOI	10.1038/s41433-022-02351-5
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Article ; Online: SAGES peritoneal dialysis access guideline update 2023.

Haggerty, Stephen P / Kumar, Sunjay S / Collings, Amelia T / Alli, Vamsi V / Miraflor, Emily / Hanna, Nader M / Athanasiadis, Dimitrios I / Morrell, David J / Ansari, Mohammed T / Abou-Setta, Ahmed / Walsh, Danielle / Stefanidis, Dimitrios / Slater, Bethany J

Surgical endoscopy

2023 Volume 38, Issue 1, Page(s) 1–23

Abstract: Background: Minimally invasive surgery has been used for both de novo insertion and salvage of peritoneal dialysis (PD) catheters. Advanced laparoscopic, basic laparoscopic, open, and image-guided techniques have evolved as the most popular techniques. ... ...

Abstract	Background: Minimally invasive surgery has been used for both de novo insertion and salvage of peritoneal dialysis (PD) catheters. Advanced laparoscopic, basic laparoscopic, open, and image-guided techniques have evolved as the most popular techniques. The aim of this guideline was to develop evidence-based guidelines that support surgeons, patients, and other physicians in decisions on minimally invasive peritoneal dialysis access and the salvage of malfunctioning catheters in both adults and children. Methods: A guidelines committee panel of the Society of American Gastrointestinal and Endoscopic Surgeons reviewed the literature since the prior guideline was published in 2014 and developed seven key questions in adults and four in children. After a systematic review of the literature, by the panel, evidence-based recommendations were formulated using the Grading of Recommendations Assessment, Development and Evaluation approach. Recommendations for future research were also proposed. Results: After systematic review, data extraction, and evidence to decision meetings, the panel agreed on twelve recommendations for the peri-operative performance of laparoscopic peritoneal dialysis access surgery and management of catheter dysfunction. Conclusions: In the adult population, conditional recommendations were made in favor of: staged hernia repair followed by PD catheter insertion over simultaneous and traditional start over urgent start of PD when medically possible. Furthermore, the panel suggested advanced laparoscopic insertion techniques rather than basic laparoscopic techniques or open insertion. Conditional recommendations were made for either advanced laparoscopic or image-guided percutaneous insertion and for either nonoperative or operative salvage. A recommendation could not be made regarding concomitant clean-contaminated surgery in adults. In the pediatric population, conditional recommendations were made for either traditional or urgent start of PD, concomitant clean or clean-contaminated surgery and PD catheter placement rather than staged, and advanced laparoscopic placement rather than basic or open insertion.
MeSH term(s)	Adult ; Child ; Humans ; Catheterization/methods ; Catheters, Indwelling ; Kidney Failure, Chronic ; Laparoscopy ; Peritoneal Dialysis/methods ; Peritoneum
Language	English
Publishing date	2023-11-21
Publishing country	Germany
Document type	Guideline ; Journal Article ; Review ; Systematic Review
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10550-8
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Article ; Online: Laparoscopic sleeve gastrectomy in patients with complex abdominal wall hernias.

Morrell, David J / Pauli, Eric M / Lyn-Sue, Jerome R / Haluck, Randy S / Rogers, Ann M

Surgical endoscopy

2020 Volume 35, Issue 7, Page(s) 3881–3889

Abstract: Background: Patients with severe obesity and complex abdominal wall hernias (CAWH) present a challenging clinical dilemma. Their body mass index (BMI) is often prohibitive of successful ventral hernia repair (VHR) and the CAWH presents technical ... ...

Abstract	Background: Patients with severe obesity and complex abdominal wall hernias (CAWH) present a challenging clinical dilemma. Their body mass index (BMI) is often prohibitive of successful ventral hernia repair (VHR) and the CAWH presents technical challenges when pursuing bariatric surgery. Our hernia center policy is to refer patients with severe obesity for evaluation with the surgical weight loss program. This study describes outcomes of laparoscopic sleeve gastrectomy (LSG) in patients with both severe obesity and CAWH. Methods: A retrospective analysis was performed on data prospectively collected between 2014 and 2020. CAWH patients referred for and undergoing LSG were included. Revisional bariatric surgery patients were excluded. The dataset was augmented with operative time, BMI changes, length of stay (LOS), hernia characteristics, postoperative complications, time from referral to weight loss surgery, and time from LSG to VHR. Results: Twenty patients (10 males, mean age 54.3 years) met inclusion criteria. Mean BMI at LSG was 45.6 ± 6.1 kg/m Conclusions: LSG can be performed successfully even in patients with CAWH. Outcomes do not appear to differ significantly from typical patients undergoing LSG. Further study with larger cohorts is warranted to better delineate complication rates in this population as well as to determine long-term outcomes.
MeSH term(s)	Body Mass Index ; Gastrectomy ; Hernia, Ventral/surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/complications ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2020-07-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-020-07831-x
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Article ; Online: Endoscopic management of colovesical and colovaginal fistulas with over-the-scope clips: A single-institution case series.

DeLong, Colin G / Scow, Jeffrey S / Morrell, David J / Knoedler, John J / Alli, Vamsi V / Winder, Joshua S / Pauli, Eric M

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 24, Issue 3, Page(s) 314–321

Abstract: Aim: Conventional surgical management of colovesical and colovaginal fistulas can be morbid and is contraindicated in many patients. Our aim in this work is to evaluate our experience in the management of colovesical and colovaginal fistulas with ... ...

Abstract	Aim: Conventional surgical management of colovesical and colovaginal fistulas can be morbid and is contraindicated in many patients. Our aim in this work is to evaluate our experience in the management of colovesical and colovaginal fistulas with endoscopic over-the-scope (OTS) clips. Method: A retrospective review of all patients who underwent attempted endoscopic OTS clip management of colovesical and colovaginal fistulas between 2013 and 2020 was performed. Preoperative risk factors, operative details and postoperative outcomes are reported. Results: Ten patients were identified. Fistula types were: colovesical (five), rectovesical (two), colovaginal (two) and rectovaginal (one). The aetiology of the fistula was diverticular disease in seven (70%) cases and surgical complication of pelvic surgery in three (30%). The mean defect age was 157 ± 98 days, the mean defect diameter was 4.5 mm (range 2-10 mm) and the mean fistula length was 15 mm (range 2-25 mm). In nine (90%) cases, fistula identification and cannulation were performed through the nonenteric lumen of the fistula. Initial management with an OTS clip was technically successful in eight (80%) patients. Of the eight patients who underwent OTS clip placement, long-term success (mean follow-up 218 days, range 25-673 days) was achieved after initial intervention in four (50%) patients. One patient underwent serial OTS clip procedures and achieved long-term success after four interventions; three patients have not undergone a repeat procedure after initial failure. Conclusion: Endoscopic management of colovesical and colovaginal fistulas with OTS clips offers a promising therapeutic option for patients with contraindications to conventional surgical management. Immediate technical success and long-term success rates are similar to other gastrointestinal tract applications of OTS clips.
MeSH term(s)	Colonic Diseases/surgery ; Female ; Humans ; Intestinal Fistula/etiology ; Intestinal Fistula/surgery ; Rectum ; Retrospective Studies ; Treatment Outcome ; Vaginal Fistula
Language	English
Publishing date	2021-11-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15987
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Article ; Online: The burden of cancer on primary and secondary health care services before and after cancer diagnosis in New South Wales, Australia.

Morrell, Stephen / Young, Jane / Roder, David

BMC health services research

2019 Volume 19, Issue 1, Page(s) 431

Abstract: Background: Primary and secondary healthcare service usage is assessed in the year before and following a cancer diagnosis, in cancer cases versus matched non-cancer controls in New South Wales (NSW), Australia over 2006-2012, for all invasive cancers ... ...

Abstract	Background: Primary and secondary healthcare service usage is assessed in the year before and following a cancer diagnosis, in cancer cases versus matched non-cancer controls in New South Wales (NSW), Australia over 2006-2012, for all invasive cancers collectively and for selected common sites: breast, prostate, colorectal and lung, and melanoma. Methods: The 45 and Up cohort (n ≈267,000) was linked to NSW Cancer Register (NSWCR), Emergency Department Data Collection (EDDC) and Medical Benefits Schedule (MBS) data using probabilistic record linkage. First-ever malignant cancers diagnosed after enrolment in the 45 and Up study comprised the study cases. Where possible, five controls were randomly selected per case from the 45 and Up cohort, matched by sex and year of birth. Controls comprised those with no cancer recorded on the NSWCR. For each month in the year preceding and following the cancer diagnosis, general practitioner, specialist and specified hospital ED service use was compared between cases and controls using proportions, means, and odds ratios derived from conditional logistic regression. Results: Compared to controls, cases of all cancers combined had a significantly higher likelihood of GP and specialist consultation in the year leading up to diagnosis. This was most pronounced in the 3-4 months leading up diagnosis for all cancers, similarly for lung cancer (GPs and specialists) and melanoma (GPs), and colorectal cancer (specialists). Likelihood of a GP consultation remained significantly higher in cases than controls in the 12 months following diagnosis. During most of the year preceding cancer diagnosis, the likelihood of specified ED presentations was also significantly higher in cases than controls for all cancers, and most pronounced in the 2-3 months before diagnosis. Excepting melanoma, the likelihood of specified ED presentations remained significantly elevated for most of the year following diagnosis for all cancers combined and for the selected cancers. Conclusions: People with cancer experience a higher use of primary and secondary healthcare services in the year preceding and following diagnosis, with GPs continuing to play a significant role post diagnosis. The higher likelihood of pre-diagnosis GP consultations among cancer cases requires further investigation, including whether signals might be derived to alert GPs to possibilities for earlier cancer detection.
MeSH term(s)	Cohort Studies ; Health Services/statistics & numerical data ; Humans ; Information Storage and Retrieval ; Neoplasms/diagnosis ; Neoplasms/therapy ; New South Wales/epidemiology ; Patient Acceptance of Health Care/statistics & numerical data ; Primary Health Care/statistics & numerical data ; Secondary Care/statistics & numerical data
Language	English
Publishing date	2019-06-27
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-019-4280-1
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