Maria Jakobsson - Academia.edu (original) (raw)

Papers by Maria Jakobsson

Acute care and palliative care are described as different incompatible organisational care cultur... more Acute care and palliative care are described as different incompatible organisational care cultures, with contrasts and contradictions. Few studies have observed the actual meeting between these two cultures. Purpose: To study the meeting and interaction of two different organisational care cultures, palliative care and curative acute wards, when a palliative care consultation team introduces consulting services to acute wards regarding end-of-life palliative care. Methods: An ethnographic study design was used, including observations, interviews and diary entries. A palliative care consultation team visited surgical and internal medicine wards during one year. An integrative bedside education approach was used, where physicians and nurses experienced in PC tried to embed PC principles and interventions into daily practice. The analysis was inspired by Spradley’s ethnography.Results: Three themes were found in the study: 1) Values, illusions, and wording in the acute care culture; 2...

Journal of Clinical Oncology, 2022

315 Background: Axitinib, a tyrosine kinase inhibitor of vascular endothelial growth factor recep... more 315 Background: Axitinib, a tyrosine kinase inhibitor of vascular endothelial growth factor receptors 1-3, was approved in 2012 for the treatment of metastatic renal cell carcinoma (mRCC) after failure of prior treatment with sunitinib or a cytokine. Outside of randomized clinical trials, it is important to describe the clinical outcomes of more heterogeneous populations. This analysis aimed to describe time-to-treatment discontinuation (TTD) and overall survival (OS) for second-line (2L) axitinib in a real-world setting for a nationwide Swedish mRCC cohort. Methods: This retrospective analysis utilized the Swedish Health Data Registers, covering the entire Swedish population. Patients (aged ≥ 18 years) with mRCC had ≥ 1 filled prescription of axitinib in the 2L setting, after an anti-angiogenic targeted therapy, from marketing approval until December 2019. This analysis relied on data relating to dispensed pack size, strength and according to dosing as recommended by the product la...

British journal of cancer, Jan 16, 2013

This retrospective register study assessed overall survival (OS) and influential factors on OS in... more This retrospective register study assessed overall survival (OS) and influential factors on OS in Swedish renal cell carcinoma (RCC) patients. Using three merged national health registers, Cox proportional-hazards analysis was conducted and, in three models, it was used to assess the impact of cytokine (interferon-α and tyrosine kinase inhibitor (TKI; sunitinib or sorafenib) treatment on OS in metastatic (m)RCC. From 2000 to 2008, 8009 patients were diagnosed with RCC and 2753 with mRCC (2002-2008). Median OS in RCC patients diagnosed from 2006 to 2008 compared with 2000-2005 was not reached vs 47.9 months (P<0.001), and in mRCC patients diagnosed from 2006 to 2008 compared with 2002-2005, was 12.4 vs 9.6 months, respectively (P=0.004). Factors associated with significantly improved OS in RCC were female gender, lower age, and previous nephrectomy, and, in mRCC female gender, previous nephrectomy, and any TKI prescription (Model 1: median-adjusted OS, 19.4 months (TKI patients) v...

European Competition Journal, 2011

... Research assistants Anthony Alcorn, Brian Cross, Fulvio Cajina, Tamma Carleton, Paul Golaszew... more ... Research assistants Anthony Alcorn, Brian Cross, Fulvio Cajina, Tamma Carleton, Paul Golaszewski, Wendy Hanson, Amanda Kalamar, Karl Kindler, Michael Madi-gan, MadeleineMcChesney, Sophie Meadows, Anne Miles, Brian Murphy, Elisabeth Murphy, Joseph Remy and ...

Using a sample of 96 mergers notified to the EU Commission and logit regression techniques, we an... more Using a sample of 96 mergers notified to the EU Commission and logit regression techniques, we analyse the Commission’s decision process. We find that the probability of a phase 2 investigation and of a prohibition of the merger increases with the parties ’ market shares. The probability increases also when the Commission finds high entry barriers or that post-merger collusion is easy. We do not find significant effects of “political ” variables, such as the nationality of the merging firms or the identity of the commissioner.

Evolution of Overall Survival in Renal Cell Carcinoma (2000-2008) : Results From a Swedish Popula... more Evolution of Overall Survival in Renal Cell Carcinoma (2000-2008) : Results From a Swedish Population-based Study

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012

389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diag... more 389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diagnosed before (2000-2005) and after (2006-2008) the introduction of targeted therapies, plus factors and treatment options influencing OS. METHODS Three Swedish national health registers were used: the Swedish Cancer register (diagnosis and death), the National Patient Register (in-/out-patient data), and the Swedish Prescribed Drug Register. From 2000-2008, 3,243 patients were identified with mRCC; 602 were recorded as receiving 1st-line treatment. Cox proportional hazards regression analysis, including estimation of adjusted OS, was used in three models with the covariates: diagnosis period, age, gender, institution size, nephrectomy status, geographic region (all models); mRCC treatments, defined as any tyrosine kinase inhibitor (TKI; Model 1; n=417); sunitinib (SU), sorafenib (SO), and interferon-alfa (IFN-α) in the 1st-line setting (Model 2; n=602 [SU=244, SO=110, IFN-α=248]); and va...

Overall survival (OS) in metastatic renal cell carcinoma (MRCC) : a comparison between sorafenib ... more Overall survival (OS) in metastatic renal cell carcinoma (MRCC) : a comparison between sorafenib (SO) and best supportive care (BSC)after first line treatment with sunitinib (SU) inSweden

Cancer Management and Research

Objective: To explore cost-effectiveness of targeted therapies (TTs) in the treatment of metastat... more Objective: To explore cost-effectiveness of targeted therapies (TTs) in the treatment of metastatic renal cell carcinoma (mRCC) in a real-world context using a nationwide populationbased approach. Methods: Data on patients diagnosed with mRCC between 2002 and 2012 were extracted from Swedish national health data registers. To facilitate comparisons of patients diagnosed before and after TT introduction to the market, three cohorts were derived: pre-TT introduction (preTT), patients diagnosed 2002-2005; early TT introduction (TTi), patients diagnosed 2006-2008; and late TT introduction (TTii), which was limited to patients diagnosed 2009-2010 to ensure availability of total health care resource utilization (HCRU) data. Patients were followed until end of 2012. The value of TTs across cohorts was estimated using mean HCRU costs per lifeyear (LY) gained. Data on HCRU were obtained through national health registers for dispensed medication and inpatient and outpatient care, and the associated costs were estimated using the Lin method to account for censoring. LYs gained were defined as the difference in mean survival over the study period. Results: The preTT, TTi, and TTii cohorts consisted of 1,366, 1,158, and 806 patients, respectively. Mean survival in years from mRCC diagnosis was 1.

Journal of Clinical Oncology

413 Background: The RENal COMParison (RENCOMP) study showed a significant improvement in OS for S... more 413 Background: The RENal COMParison (RENCOMP) study showed a significant improvement in OS for Swedish patients diagnosed with renal cell carcinoma (RCC) and metastatic (m)RCC in the first years following the introduction of targeted agents (TAs) in 2006 (Br J Cancer 2013;108:1541). Here we investigated whether a further improvement in OS can be detected in the more recent years of the TA era. Methods: Using data from the Swedish Cancer Register (diagnosis and death records), National Patient Register (in-/out-patient visit records), and Swedish Prescribed Drug Register (prescribed/dispensed drug records), we assessed OS in RCC and mRCC patients diagnosed during two periods after (2009–2012 and 2006–2008) and one period before (2000–2005 [RCC]; 2002–2005 [mRCC]) the introduction of TAs, and factors influencing OS in mRCC. Multivariate analysis was performed using a Cox proportional hazards model, including estimates of adjusted HR. The regression model included the covariates age, ...

Journal of Clinical Oncology

389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diag... more 389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diagnosed before (2000–2005) and after (2006–2008) the introduction of targeted therapies, plus factors and treatment options influencing OS. Methods: Three Swedish national health registers were used: the Swedish Cancer register (diagnosis and death), the National Patient Register (in-/out-patient data), and the Swedish Prescribed Drug Register. From 2000-2008, 3,243 patients were identified with mRCC; 602 were recorded as receiving 1st-line treatment. Cox proportional hazards regression analysis, including estimation of adjusted OS, was used in three models with the covariates: diagnosis period, age, gender, institution size, nephrectomy status, geographic region (all models); mRCC treatments, defined as any tyrosine kinase inhibitor (TKI; Model 1; n=417); sunitinib (SU), sorafenib (SO), and interferon-alfa (IFN-α) in the 1st-line setting (Model 2; n=602 [SU=244, SO=110, IFN-α=248]); and v...

Urologic oncology, Sep 13, 2017

This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish... more This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish patients with metastatic renal cell carcinoma (mRCC) during the pre- (2002-2005), early (2006-2008), and late (2009-2012) targeted therapy (TT) era. Three national Swedish registries identified patients with mRCC. Median OS was estimated using the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards regression. Subgroup analysis was conducted for patients with synchronous metastases (M1) and the elderly (aged≥75y). A total of 4,217 patients with mRCC were identified, including 1,533 patients with M1 and 1,275 elderly patients. For patients with mRCC diagnosed in 2002 to 2005, 2006 to 2008, and 2009 to 2012, median OS was 10.0, 13.0, and 18.0 months. Similarly, median OS improved in the M1 and elderly populations. Elderly patients were less likely to be prescribed TT (≥75 vs.<75y): 18.3 vs. 63.5% (in 2006-2008) and 28.6% vs. 55.9% (in 2009-2012). Dia...

In this paper, the aim is to analyse the existence of collusion in asym-metric asphalt-procuremen... more In this paper, the aim is to analyse the existence of collusion in asym-metric asphalt-procurement auctions. Firms that behave competitively should have private costs that are independent, conditional on available …rm-and auction-speci…c information. The hypothesis of conditional in-dependence can be tested and if it is rejected, a possible explanation is collusion. Using a constrained strategy equilibrium concept in solving for equilibrium bid strategies and …rms' private costs makes it possible to test the hypothesis of conditional independence while at the same time controlling for …rms' strategic considerations. The analysis is based on bid data from procurement auctions carried out in Sweden during the 1990's. The …ndings are that the hypothesis of conditional independence can be rejected for about half the …rm-pairs that are tested. Given that the model is correctly speci…ed, this suggests that collusive behaviour is plausible in the investigated market.

Using a unique data set of procurement auctions carried out by the Swedish National Road Administ... more Using a unique data set of procurement auctions carried out by the Swedish National Road Administration, this paper addresses the issue of bid rigging in the Swedish asphalt-paving sector. Both market char-acteristics and the fact that the Swedish Competition Authority in 2003 initiated legal proceedings against a group of …rms active in the market in-dicate the existence of collusive behaviour. If …rms act competitively, they should submit independent bids, conditional on …rm-and auction-speci…c di¤erences. Reduced-form equations are estimated and the hypothesis of conditional independence is tested by analysing if the di¤erence between observed and predicted bids correlates between …rms. If negative corre-lation is observed, one possible explanation is bid rigging. The overall results indicate that collusion may be widespread in the industry and suggest further investigation of the market.

European Journal of Cancer

Background: Multicenter studies provide valuable information regarding trx patterns and outcomes ... more Background: Multicenter studies provide valuable information regarding trx patterns and outcomes for rare cancers. Trx modalities and toxicities of sunitinib (SU), sorafenib (SOR), and bevacizumab (BEV) for advanced RCC in clinical practices across 5 Western European countries in 2005-2010 are reported here. Material and Methods: Medical records, not part of a disease based registry, were retrospectively reviewed for 746 RCC pts in 11 tertiary oncology centers. Pts were 18 years, had diagnosis of advanced RCC, received SU (n = 532), SOR (n = 159; 1 with IFN), or BEV (n = 55; 21 with IFN or temsirolimus) as first anti-angiogenic trx. Prior trx with cytokines, chemotherapy, and radiotherapy was permitted. Data were collected on all adverse events (AEs) and trx modifications, including trx discontinuation (d/c), interruption, and dose reduction. Trx duration was estimated using Kaplan-Meier analysis. Results: Mean age ranged from 59 (y) (BEV) to 63 y (SOR). Over 74% of pts in each group were males. 31.4% (SU), 52.2% (SOR), and 61.8% (BEV) pts were cytokine pre-treated. The 2 most common any grade AEs were SU (fatigue: 61.3%, mucositis/stomatitis: 46.4%), SOR (hand-foot syndrome [HFS]: 44.7%, diarrhea: 43.4%), and BEV (fatigue: 47.3%, pain: 18.2%). Median trx duration was 10.5 months (m) for SU, 8.1 m for SOR, and 7.7 m for BEV. Among pts with trx d/c due to AEs, common AEs associated with d/c were: SU (fatigue: 61.1%), SOR (HFS: 37.5%), and BEV (fatigue: 44.4%). For SU and SOR, trx d/c within 18 weeks for any reason was 31.9% and 23.7%, respectively, with 51.8% and 43.8% of these due to AEs. Rates of trx modifications are in Table. Conclusions: In this large chart review study, it was found that fatigue and HFS were major contributors to trx d/c, and 87−95% of pts experienced at least 1 trx mod, more than half due to AEs for oral agents (56% SU and 53% SOR). Early trx d/c was common and often due to AEs. Newer agents with better tolerability will broaden trx options.

Journal of Clinical Oncology, 2022

British journal of cancer, Jan 16, 2013

European Competition Journal, 2011

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012

Cancer Management and Research

Journal of Clinical Oncology

389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diag... more 389 Background: This retrospective register study assessed OS in all mRCC patients in Sweden diagnosed before (2000–2005) and after (2006–2008) the introduction of targeted therapies, plus factors and treatment options influencing OS. Methods: Three Swedish national health registers were used: the Swedish Cancer register (diagnosis and death), the National Patient Register (in-/out-patient data), and the Swedish Prescribed Drug Register. From 2000-2008, 3,243 patients were identified with mRCC; 602 were recorded as receiving 1st-line treatment. Cox proportional hazards regression analysis, including estimation of adjusted OS, was used in three models with the covariates: diagnosis period, age, gender, institution size, nephrectomy status, geographic region (all models); mRCC treatments, defined as any tyrosine kinase inhibitor (TKI; Model 1; n=417); sunitinib (SU), sorafenib (SO), and interferon-alfa (IFN-α) in the 1st-line setting (Model 2; n=602 [SU=244, SO=110, IFN-α=248]); and v...

Urologic oncology, Sep 13, 2017

European Journal of Cancer