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"Decision model"

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https://www.readbyqxmd.com/read/28087821/selection-of-first-line-therapy-in-multiple-sclerosis-using-risk-benefit-decision-analysis
#1
David Bargiela, Matthew T Bianchi, M Brandon Westover, Lori B Chibnik, Brian C Healy, Philip L De Jager, Zongqi Xia
OBJECTIVE: To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis. METHODS: We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs)...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28078461/cost-effectiveness-of-prophylactic-appendectomy-a-markov-model
#2
Karina Newhall, Benjamin Albright, Anna Tosteson, Elissa Ozanne, Thadeus Trus, Philip P Goodney
BACKGROUND: Appendectomy is the most common emergency surgery performed in the USA. Removal of a non-inflamed appendix during unrelated abdominal surgery (prophylactic or incidental appendectomy) can prevent the downstream risks and costs of appendicitis. It is unknown whether such a strategy could be cost saving for the health system. METHODS: We considered hypothetical patient cohorts of varying ages from 18 to 80, undergoing elective laparoscopic abdominal and pelvic procedures...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28067770/assessment-of-pansharpening-methods-applied-to-worldview-2-imagery-fusion
#3
Hui Li, Linhai Jing, Yunwei Tang
Since WorldView-2 (WV-2) images are widely used in various fields, there is a high demand for the use of high-quality pansharpened WV-2 images for different application purposes. With respect to the novelty of the WV-2 multispectral (MS) and panchromatic (PAN) bands, the performances of eight state-of-art pan-sharpening methods for WV-2 imagery including six datasets from three WV-2 scenes were assessed in this study using both quality indices and information indices, along with visual inspection. The normalized difference vegetation index, normalized difference water index, and morphological building index, which are widely used in applications related to land cover classification, the extraction of vegetation areas, buildings, and water bodies, were employed in this work to evaluate the performance of different pansharpening methods in terms of information presentation ability...
January 5, 2017: Sensors
https://www.readbyqxmd.com/read/28066734/the-hip-restoration-algorithm
#4
REVIEW
Allston Julius Stubbs, Halis Atil Atilla
BACKGROUND: Despite the rapid advancement of imaging and arthroscopic techniques about the hip joint, missed diagnoses are still common. As a deep joint and compared to the shoulder and knee joints, localization of hip symptoms is difficult. Hip pathology is not easily isolated and is often related to intra and extra-articular abnormalities. In light of these diagnostic challenges, we recommend an algorithmic approach to effectively diagnoses and treat hip pain. METHODS: In this review, hip pain is evaluated from diagnosis to treatment in a clear decision model...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28065628/health-utility-of-early-hemiarthroplasty-vs-delayed-total-hip-arthroplasty-for-displaced-femoral-neck-fracture-in-elderly-patients-a-markov-model
#5
Lauren M Uhler, W Randall Schultz, Austin D Hill, Karl M Koenig
BACKGROUND: Treatment for femoral neck fracture among patients aged 65 years or older varies, with many surgeons preferring hemiarthroplasty (HA) over total hip arthroplasty (THA). There is evidence that THA may lead to better functional outcomes, although it also carries greater risk of mortality and dislocation rates. METHODS: We created a Markov decision model to examine the expected health utility for older patients with femoral neck fracture treated with early HA (performed within 48 hours) vs delayed THA (performed after 48 hours)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28052810/clinical-effectiveness-and-cost-effectiveness-of-surgical-options-for-the-management-of-anterior-and-or-posterior-vaginal-wall-prolapse-two-randomised-controlled-trials-within-a-comprehensive-cohort-study-results-from-the-prospect-study
#6
Cathryn Glazener, Suzanne Breeman, Andrew Elders, Christine Hemming, Kevin Cooper, Robert Freeman, Anthony Smith, Suzanne Hagen, Isobel Montgomery, Mary Kilonzo, Dwayne Boyers, Alison McDonald, Gladys McPherson, Graeme MacLennan, John Norrie
BACKGROUND: The use of mesh in prolapse surgery is controversial, leading to a number of enquiries into its safety and efficacy. OBJECTIVE: To compare synthetic non-absorbable mesh inlay, biological graft and mesh kit with a standard repair in terms of clinical effectiveness, adverse effects, quality of life (QoL), costs and cost-effectiveness. DESIGN: Two randomised controlled trials within a comprehensive cohort (CC) study. Allocation was by a remote web-based randomisation system in a 1 :1 : 1 ratio (Primary trial) or 1 : 1 : 2 ratio (Secondary trial), and was minimised on age, type of prolapse repair planned, need for a concomitant continence procedure, need for a concomitant upper vaginal prolapse procedure and surgeon...
December 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28045615/cost-comparison-of-genetic-testing-strategies-in-women-with-epithelial-ovarian-cancer
#7
Jonathan R Foote, Micael Lopez-Acevedo, Adam H Buchanan, Angeles Alvarez Secord, Paula S Lee, Cynthia Fountain, Evan R Myers, David E Cohn, Shelby D Reed, Laura J Havrilesky
PURPOSE: The advent of multigene panels has increased genetic testing options for women with epithelial ovarian cancer (EOC). We designed a decision model to compare costs and probabilities of identifying a deleterious mutation or variant of uncertain significance (VUS) using different genetic testing strategies. METHODS: A decision model was developed to compare costs and outcomes of two testing strategies for women with EOC: multigene testing (MGT) versus single-gene testing for BRCA1/2...
January 3, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28042671/monte-carlo-decision-curve-analysis-using-aggregate-data
#8
Iztok Hozo, Athanasios Tsalatsanis, Benjamin Djulbegovic
BACKGROUND: Decision curve analysis (DCA) is an increasingly used method for evaluating diagnostic tests and predictive models but its application requires individual patient data. The Monte Carlo (MC) method can be used to simulate probabilities and outcomes of individual patients and offers an attractive option for application of DCA. METHODS: We constructed a MC decision model to simulate individual probabilities of outcomes of interest. These probabilities were contrasted against the threshold probability at which a decision-maker is indifferent between key management strategies: treat all, treat none, or use predictive model to guide treatment...
January 2, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28027614/decision-modelling-in-donation-after-circulatory-death-dcd-liver-transplantation
#9
K A McLean, J Camilleri-Brennan, S R Knight, T Drake, R Ots, C A Shaw, S J Wigmore, E M Harrison
INTRODUCTION: Donation after circulatory death (DCD) liver allografts are increasingly used for transplantation. However, the post-transplantation clinical and quality of life outcomes of DCD recipients are traditionally considered to be inferior compared with donation after brain death (DBD) allograft recipients. Decision making for such marginal organs can be difficult. This study investigated the optimal decision to accept or decline a DCD liver allograft for a patient based on their current health...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28025631/amniotic-band-syndrome-perinatal-hospice-and-palliative-care-versus-active-management
#10
Shadi Rezai, Justin Faye, Annika Chadee, Sri Gottimukkala, Ruchi Upadhyay, Carla Lara, Benamanahalli H Rajegowda, Andrew D Corwin, Rasila V Lala, Jessica Vernon, Dilfuza Nuritdinova, Stephen Chasen, Cassandra E Henderson
Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28024315/patient-physician-and-health-system-factors-influencing-the-quality-of-antidepressant-and-sedative-prescribing-for-older-community-dwelling-adults
#11
Rian Marie Extavour, Matthew Perri
OBJECTIVE: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults. DATA SOURCES/STUDY SETTING: Office visits from the 2010 National Ambulatory Medical Care Survey. STUDY DESIGN: A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28019009/restrictive-versus-liberal-red-blood-cell-transfusion-strategy-after-hip-surgery-a-decision-model-analysis-of-healthcare-costs
#12
Mario V Fusaro, Nathan D Nielsen, Alexandra Nielsen, Magali J Fontaine, John R Hess, Robert M Reed, Sylvain DeLisle, Giora Netzer
BACKGROUND: Red blood cell transfusion related to select surgical procedures accounts for approximately 2.8 million transfusions in the United States yearly and occurs commonly after hip fracture surgeries. Randomized controlled trials have demonstrated lack of clinical benefit with higher versus lower transfusion thresholds in postoperative hip fracture repair patients with cardiac disease or risk factors for cardiac disease. The economic implications of a higher versus lower hemoglobin (Hb) threshold have not yet been investigated...
December 26, 2016: Transfusion
https://www.readbyqxmd.com/read/28006012/potential-cost-effectiveness-of-an-influenza-vaccination-program-offering-microneedle-patch-for-vaccine-delivery-in-children
#13
Carlos Wong, Minghuan Jiang, Joyce H S You
OBJECTIVE: The influenza vaccine coverage rate of children is low in Hong Kong. Microneedle patches (MNPs) is a technology under development for painless delivery of vaccines. This study aimed to examine the potential clinical outcomes and direct medical costs of an influenza program offering MNP vaccine to children who have declined intramuscular (IM) vaccine in Hong Kong. METHODS: A decision model was designed to compare potential outcomes between IM vaccine program and a program offering MNP vaccine to those declined IM vaccine (IM/MNP program) in a hypothetical cohort of children over one-year time horizon...
2016: PloS One
https://www.readbyqxmd.com/read/28000167/cost-effectiveness-of-different-strategies-for-the-prevention-of-venous-thromboembolism-after-total-hip-replacement-in-china
#14
Xiaoyu Yan, Xiaohua Gu, Zhenxing Xu, Houweng Lin, Bin Wu
INTRODUCTION: The aim of this study was to evaluate the cost-effectiveness of rivaroxaban and apixaban versus enoxaparin for the universal prophylaxis of venous thromboembolism (VTE) and associated long-term complications in Chinese patients after total hip replacement (THR). METHODS: A decision model, which included both acute VTE (represented as a decision tree) and the long-term complications of VTE (represented as a Markov model), was developed to assess the economic outcomes of the three prophylactic strategies for Chinese patients after THR...
December 20, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27998227/optimizing-the-use-of-gene-expression-profiling-in-early-stage-breast-cancer
#15
Hyun-Seok Kim, Christopher B Umbricht, Peter B Illei, Ashley Cimino-Mathews, Soonweng Cho, Nivedita Chowdhury, Maria Cristina Figueroa-Magalhaes, Catherine Pesce, Stacie C Jeter, Charles Mylander, Martin Rosman, Lorraine Tafra, Bradley M Turner, David G Hicks, Tyler A Jensen, Dylan V Miller, Deborah K Armstrong, Roisin M Connolly, John H Fetting, Robert S Miller, Ben Ho Park, Vered Stearns, Kala Visvanathan, Antonio C Wolff, Leslie Cope
Purpose Gene expression profiling assays are frequently used to guide adjuvant chemotherapy decisions in hormone receptor-positive, lymph node-negative breast cancer. We hypothesized that the clinical value of these new tools would be more fully realized when appropriately integrated with high-quality clinicopathologic data. Hence, we developed a model that uses routine pathologic parameters to estimate Oncotype DX recurrence score (ODX RS) and independently tested its ability to predict ODX RS in clinical samples...
December 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27993844/comparison-of-four-alternative-national-universal-anterior-cruciate-ligament-injury-prevention-programme-implementation-strategies-to-reduce-secondary-future-medical-costs
#16
Dion A Lewis, Brent Kirkbride, Christopher J Vertullo, Louisa Gordon, Tracy A Comans
BACKGROUND/AIM: Anterior cruciate ligament (ACL) injury is a common and devastating sporting injury. With or without ACL reconstruction, the risk of knee osteoarthritis (OA) and permanent disability later in life is markedly increased. While neuromuscular training programmes can prevent 50-80% of ACL injuries, no national implementation strategies exist in Australia. The aim of this study was to compare the ability of four alternative national universal ACL injury prevention programme implementation strategies to reduce future medical costs secondary to ACL injury...
December 19, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27966287/transoral-laser-microsurgery-versus-radiation-therapy-in-the-management-of-t1-and-t2-laryngeal-glottic-carcinoma-which-modality-is-cost-effective-within-the-uk
#17
Matthew Prettyjohns, Stuart Winter, Cyrus Kerawala, Vinidh Paleri
OBJECTIVES: To identify the most cost effective treatment strategy in patients with early stage (T1and T2) cancers of the laryngeal glottis. DESIGN: A Markov decision model populated using data from updated systematic reviews and meta analyses, with attributable costs from NHS sources. Data on local control and mortality was obtained from updates of existing systematic reviews conducted for the NICE guideline on cancer of the upper aerodigestive tract. Procedure costs were sourced from NHS reference costs 2013/14 by applying tariffs associated with the appropriate health resource group code...
December 14, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27943142/research-on-the-influencing-factors-of-reverse-logistics-carbon-footprint-under-sustainable-development
#18
Qiang Sun
With the concerns of ecological and circular economy along with sustainable development, reverse logistics has attracted the attention of enterprise. How to achieve sustainable development of reverse logistics has important practical significance of enhancing low carbon competitiveness. In this paper, the system boundary of reverse logistics carbon footprint is presented. Following the measurement of reverse logistics carbon footprint and reverse logistics carbon capacity is provided. The influencing factors of reverse logistics carbon footprint are classified into five parts such as intensity of reverse logistics, energy structure, energy efficiency, reverse logistics output, and product remanufacturing rate...
December 9, 2016: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/27939409/cost-effectiveness-of-arthroscopic-rotator-cuff-repair-versus-reverse-total-shoulder-arthroplasty-for-the-treatment-of-massive-rotator-cuff-tears-in-patients-with-pseudoparalysis-and-nonarthritic-shoulders
#19
Grant J Dornan, J Christoph Katthagen, Dimitri S Tahal, Maximilian Petri, Joshua A Greenspoon, Patrick J Denard, Stephen S Burkhart, Peter J Millett
PURPOSE: To determine the most cost-effective treatment strategy for patients with massive rotator cuff tears and pseudoparalysis of the shoulder without osteoarthritis of the glenohumeral joint (PP without OA). Specifically, we aimed to compare arthroscopic rotator cuff repair (ARCR) versus reverse total shoulder arthroplasty (RTSA) and investigate the effect of patient age on this decision. METHODS: A Markov decision model was used to compare 3 treatment strategies for addressing PP without OA: (1) ARCR with option to arthroscopically revise once, (2) ARCR with immediate conversion to RTSA on potential failure, and (3) primary RTSA...
December 6, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27927502/observational-analysis-of-changing-trends-in-level-of-evidence-of%C3%A2-scoliosis-research-society-annual-meeting-podium-presentations-in%C3%A2-the-new-millennium-2001-2013
#20
Nanjundappa S Harshavardhana, John P Dormans
STUDY DESIGN: Observational quantitative evaluation of all Scoliosis Research Society annual meeting (SRS-AM) podium presentations over a 6-year period in the new millennium for changing trends in Level of Evidence (LoE). OBJECTIVES: To report the LoE of SRS-AM podium presentations over a 13-year period in the new millennium and to compare the trends in LoE over a 3-year period between the two decades, that is, 2001-2003 versus 2011-2013. SUMMARY OF BACKGROUND DATA: LoE is a rating system introduced by the American Academy of Orthopaedic Surgeons (AAOS) in 2003 to reflect the quality of clinical studies...
May 2016: Spine Deformity
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