Journal of insurance medicine (New York, N.Y.)最新文献

{"title":"Déjà Vu - A New Coronavirus Challenge.","authors":"Ross MacKenzie","doi":"10.17849/insm-49-1-5-10.1","DOIUrl":"https://doi.org/10.17849/insm-49-1-5-10.1","url":null,"abstract":"","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38886806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID - An Early Perspective.","authors":"Timothy Meagher","doi":"10.17849/insm-49-1-1-5.1","DOIUrl":"https://doi.org/10.17849/insm-49-1-1-5.1","url":null,"abstract":"<p><p>A new syndrome called \"Long COVID\" has emerged amongst the survivors of acute COVID-19 infection. Its protracted and debilitating nature will almost certainly result in many short and long-term disability claims. Insurers need to understand the nature of Long COVID, including its definition, its prevalence, its natural history, and underlying risk factors. This article will summarize current knowledge of Long COVID and provide a perspective on its evolution and its impact.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25542034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 Diabetes in China - Considering Both Insurance Products and Individual Health Factors.","authors":"Celia Zhang Ying","doi":"10.17849/insm-48-2-1-5.1","DOIUrl":"10.17849/insm-48-2-1-5.1","url":null,"abstract":"<p><p>For the past 30 years, the increase in the prevalence of type 2 diabetes mellitus (T2DM) in China has reached epidemic proportions. As a result, risk assessment guidelines need to be updated by taking into consideration of improvements in medical treatment and lifestyle intervention. This especially applies to living insurance benefit policies (such as critical illness and total permanent disability) and to medical products (hospitalization reimbursement and certain DM-related treatment benefits). This will require taking into account the current epidemic figures of T2DM in China in pricing, targeting the correct insured group for the DM products and getting the correct risk profile by applying a dynamic underwriting protocol (such as using the rewards for medical intervention, and for primary prevention efforts to screen individuals who are at high-risk of diabetes). This article analyzes both studies and surveys that been conducted in China showing the progress of this epidemic.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38032792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activity Level as a Mortality Predictor in a Population Sample after Typical Underwriting Exclusions and Laboratory Scoring.","authors":"Steven J Rigatti, Robert Stout","doi":"10.17849/insm-48-2-1-12.1","DOIUrl":"10.17849/insm-48-2-1-12.1","url":null,"abstract":"<p><p>  <b>Objectives.-</b> To quantify the effect of physical activity on the mortality rates of healthy individuals in a population sample, after controlling for other sources of mortality risk. <b>Background.-</b> The widespread availability of activity monitors has spurred life insurance companies to consider incorporating such data into their underwriting practices. Studies have shown that sedentary lifestyles are associated with poor health outcomes and higher risks of death. The aim of this paper is to investigate how well certain measures of activity predict mortality when controlled for other known predictors of mortality including a multivariate laboratory based risk score. <b>Methods.-</b> Data were obtained from the National Health and Nutrition Examination Survey (NHANES) for the years 1999 through 2014. Laboratory and biometric data were scored for mortality risk using a previously developed proprietary algorithm (CRL SmartScore). Data on activity were obtained from the NHANES questionnaires pertaining to activity. In a second analysis, data were obtained from pedometers worn for 1 week by NHANES participants (years 2003-2004, and 2005-2006 only). Before analysis, cases were selected based on commonly used life insurance underwriting criteria to remove from consideration those who have major health issues, which would ordinarily preclude an offer of life insurance. <b>Results.-</b>In fully-adjusted Cox model which included survey-based MET*hours per day as a 3-level categorical variable, the moderate and minimal levels of activity were associated with hazard ratios of 1.15 (95% CI: 1.04-1.28) and 1.38 (95% CI: 1.23-1.56), respectively, when compared to the highest level of activity. When treated as a continuous variable, the fully adjusted model the HR for MET*hours per day was 0.91 (95% CI: 0.87-0.95). In fully adjusted models using pedometer data, the percentage of wear time spent sedentary was associated with mortality (HR: 1.19, 95% CI: 1.09-1.31), while average counts per minute were negatively associated with mortality (HR: 0.82, CI: 0.75-0.90). <b>Conclusions.-</b>It is clear from these results that high proportions of sedentary time are associated with increased mortality, whether the sedentary time is quantified via questionnaire or pedometer. Because both laboratory scores and activity levels remain significant in Cox models where both are included, these factors are largely independent, indicating that they are measuring distinct influences on the risk of mortality.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37887984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's in a name?","authors":"N. Roberts","doi":"10.1201/b17764-12","DOIUrl":"https://doi.org/10.1201/b17764-12","url":null,"abstract":"","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46417168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Adenoma.","authors":"David S Williams","doi":"10.17849/insm-48-2-1-1.1","DOIUrl":"10.17849/insm-48-2-1-1.1","url":null,"abstract":"<p><p>Hepatic adenomas are rare, usually benign tumors of the liver with a small risk for bleeding and malignant transformation.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37613055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"20-Year Comparative Survival and Mortality of Cancer of the Esophagus by Age, Sex, Race, Stage, Grade, Cohort Entry Time-Period, Disease Duration & Selected ICD-O-3 Oncologic Phenotypes: A Systematic Review of 83,658 Cases for Diagnosis Years 1973-2014: (SEER*Stat 8.3.4)","authors":"A. Milano","doi":"10.17849/insm-48-2-113-123.1","DOIUrl":"https://doi.org/10.17849/insm-48-2-113-123.1","url":null,"abstract":"Objective.— To update trends in incidence, prevalence, short- and long-term survival and mortality of esophageal cancer using the statistical database of SEER*Stat 8.3.4 for diagnosis years 1973-2014 employing multiple case selection variables.\u0000 Methods.— A retrospective, population-based study using nationally representative data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program to evaluate 83,658 cases of esophageal cancer for diagnosis years 1973-2014 comparing multiple variables of age, sex, race, stage, grade, cohort entry time-period, disease duration, and, two histologic oncotypes. Relative survival statistics were analyzed in two cohorts: 1973-1994 and 1995-2014. Survival statistics were derived from: SEER*Stat Database: Incidence – SEER 9 Regs Research Data, November 2016 Submission (1973-2014) <Katrina/Rita Population Adjustment> Released April 2017 (Ref. 9). Case frequency and incidence data, derived from the SEER program, were used to design the table format and number of pages for this report.\u0000 Results.— In a total of 83,658 cases of esophageal cancer in the United States for diagnosis years 1973-2014, multiple variables of age, sex, race, stage, grade, cohort entry time-period, disease duration, and, two histologic oncotypes were compared. Mean age in males was 66.5 years, females 70.1 years, both male and female 67.2 years. Greater than 85% of incidence cases occurred between ages 55-85+ years with the zenith in males at 65-69 years (59.4%) and 70-74 years (60.5%) in females. The overall annual US death rate from 1975-2014 has slightly increased from 3.69 to 3.99 per 100,000 per year, and excess mortality remains exceedingly high. Of the 83,658 invasive cases, 82.6% were clinically staged and 79.4% were histologically graded.\u0000 Conclusions.— Relative frequency, incidence and time-trends, and the clinical, demographic and secular variables of age, sex, race, stage, grade, cohort-entry time-periods, and predominant clinical oncotypes were comparatively analyzed to provide a comprehensive medical-actuarial assessment of esophageal cancer survival and mortality in the 1973-2014 time-frame.","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43261896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based Claims Adjudication of Traffic Injury Claims in Ontario: Shifting the Focus from Cost to Care","authors":"K. Moodley, C. Cancelliere, R. Power, Pierre Côté","doi":"10.17849/insm-48-2-1-11.1","DOIUrl":"https://doi.org/10.17849/insm-48-2-1-11.1","url":null,"abstract":"Background.— In the Ontario automobile insurance system, claims adjusters decide whether to approve, partially approve or deny funding for clinical interventions submitted by healthcare practitione...","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67475740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hairy Cell Leukemia – A Mortality Analysis","authors":"Ahmed Okba","doi":"10.17849/INSM-48-2-136-143.1","DOIUrl":"https://doi.org/10.17849/INSM-48-2-136-143.1","url":null,"abstract":"Objectives.—To assess mortality and survival analysis for patients with hairy cell leukemia, taking into consideration the effect of new therapies. Background.—Hairy cell leukemia (HCL) is a chroni...","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67475800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CRISPR Technology Cracking into Creation","authors":"Alacia J Tarpley","doi":"10.17849/INSM-48-2-144-148.1","DOIUrl":"https://doi.org/10.17849/INSM-48-2-144-148.1","url":null,"abstract":"Medical directors of life and disability companies need to be aware of CRISPR technology and how it has beneficial and potential detrimental impacts to our industry. Clustered Interspaced Short Pal...","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67475811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}