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https://www.readbyqxmd.com/read/29771338/cost-effectiveness-analysis-of-an-adherence-promotion-intervention-for-children-with-leukemia-a-markov-model-based-simulation
#1
Meghan E McGrady, Mark H Eckman, Maureen M O'Brien, Ahna L H Pai
Objective: Improving medication adherence among children with B-cell precursor acute lymphoblastic leukemia (B-ALL) has the potential to reduce relapse rates but requires an investment in resources. An economic evaluation is needed to understand the potential costs and benefits of delivering adherence-promotion interventions (APIs) as part of standard clinical care. Methods: A Markov decision analytic model was used to simulate the potential incremental cost-effectiveness per quality-adjusted life year (QALY) to be gained from an API for children with B-ALL in first continuous remission compared with treatment as usual (TAU, no intervention)...
May 15, 2018: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#2
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29764881/protocol-for-an-economic-evaluation-of-who-stops-childhood-obesity-stepped-wedge-cluster-randomised-controlled-trial
#3
Rohan Sweeney, Marj Moodie, Phuong Nguyen, Penny Fraser, Kristy Bolton, Andrew Brown, Jennifer Marks, Nic Crooks, Claudia Strugnell, Colin Bell, Lynne Millar, Liliana Orellana, Steven Allender
INTRODUCTION: Prevention of overweight and obesity in childhood is a priority because of associated acute and chronic conditions in childhood and later in life, which place significant burden on health systems. Evidence suggests prevention should engage a range of actions and actors and target multiple levels. The Whole of Systems Trial Of Prevention <u>S</u>trategies for childhood obesity (WHO STOPS) will evaluate the outcomes of a novel systems-based intervention that aims to engage whole communities in a locally led multifaceted response...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29764322/biting-the-hands-that-feed-the-alligators-a-case-study-in-morbid-obesity-extremes-end-of-life-care-and-prohibitions-on-harming-and-accelerating-the-end-of-life
#4
Michael J Malinowski
Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29754324/cost-utility-analysis-of-an-intervention-designed-to-reduce-the-critical-handling-error-of-insufficient-inspiratory-effort
#5
Rebecca Forster, Aran Ratcliffe, Megan Lewis, Amy Crossley, Julio López Bastida, William C N Dunlop
OBJECTIVES: Up to 70-80% of patients use inhalers incorrectly. Dry-powder inhalers (DPIs) require forceful inhalation for optimal delivery, and approximately 40% of Global Initiative for Asthma (GINA)-defined Step-3+ patients inhale corticosteroid and long-acting beta-agonist through DPIs. The CRITIKAL study (Price et al. in J Allergy Clin Immunol Pract 5:1071-e9-1081-e9, 2017) found a statistically significant association between 'insufficient inspiratory effort' error and increased risk of uncontrolled asthma and hospitalisation-requiring exacerbations...
May 12, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29751618/a-cost-benefit-analysis-of-an-active-travel-intervention-with-health-and-carbon-emission-reduction-benefits
#6
Ralph Chapman, Michael Keall, Philippa Howden-Chapman, Mark Grams, Karen Witten, Edward Randal, Alistair Woodward
Active travel (walking and cycling) is beneficial for people&rsquo;s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions outcomes. The ACTIVE before-and-after quasi-experimental study estimated the net benefits of health and other outcomes from New Zealand&rsquo;s Model Communities Programme using an empirical analysis comparing two intervention cities with two control cities...
May 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29746619/voluntary-community-human-immunodeficiency-virus-testing-linkage-and-retention-in-care-interventions-in-kenya-modeling-the-clinical-impact-and-cost-effectiveness
#7
Liem B Luong Nguyen, Yazdan Yazdanpanah, David Maman, Sitima Wanjala, Alexandra Vandenbulcke, Jianthi Price, Robert A Parker, William Hennequin, Pierre Mendiharat, Kenneth A Freedberg
Background: In southwest Kenya, the prevalence of human immunodeficiency virus (HIV) infection is about 25%. Médecins Sans Frontières has implemented a voluntary community testing (VCT) program, with linkage to care and retention interventions, to achieve the Joint United Nations Program on HIV and AIDS (UNAIDS) 90-90-90 targets by 2017. We assessed the effectiveness and cost-effectiveness of these interventions. Methods: We developed a time-discrete, dynamic microsimulation model to project HIV incidence over time in the adult population in Kenya...
May 8, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29744129/contributing-factors-of-pregnant-women-s-beliefs-towards-mode-of-delivery-a-cross-sectional-study-from-iran
#8
Fereshteh Zamani-Alavijeh, Marzieh Araban, Akbar Hassanzadeh, Khadije Makhouli
Background: Delivery is a critical event in every woman's life. Under some medical conditions, women sometimes undergo a cesarean section to save the life of themselves and their infant. Understanding the factors associated with choosing the type of delivery leads to more effective health interventions and the promotion of maternal and newborn health. The aim of this study is to determine contributing factors in pregnant women's beliefs toward the mode of delivery in a sample of women referring to Hojatieh Hospital in Isfahan, Iran...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29739384/menos4-trial-a-multicentre-randomised-controlled-trial-rct-of-a-breast-care-nurse-delivered-cognitive-behavioural-therapy-cbt-intervention-to-reduce-the-impact-of-hot-flushes-in-women-with-breast-cancer-study-protocol
#9
Deborah Fenlon, Jacqueline Nuttall, Carl May, James Raftery, Jo Fields, Emma Kirkpatrick, Julia Abab, Mary Ellis, Taylor Rose, Priya Khambhaita, Angeliki Galanopoulou, Tom Maishman, Jo Haviland, Gareth Griffiths, Lesley Turner, Myra Hunter
BACKGROUND: Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity...
May 8, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29738400/using-a-validated-middle-age-and-geriatric-risk-tool-to-identify-early-48hr-hospital-mortality-and-associated-cost-of-care
#10
Ariana Lott, Jack Haglin, Hesham Saleh, Jordan Hall, Kenneth A Egol, Sanjit R Konda
OBJECTIVES: 1) Demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk for mortality within the first two days of hospitalization and 2) determine the cost of care for this cohort of patients DESIGN:: Prospective cohort study SETTING:: Single Level 1 Trauma Center PATIENTS:: Patients 55 years and older who were evaluated in the emergency department setting by Orthopaedics or who met American College of Surgeons Tier 1-3 criteria INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional statusMain Outcome Measurements: length of stay, inpatient mortality, time between presentation and time of death, and direct variable costs of hospitalization RESULTS:: A total of 1470 consecutive patients (mean age of 72...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29733020/spontaneous-true-gastroduodenal-artery-aneurysm-rupture-after-an-inguinal-hernia-operation
#11
Haldun Kar, Volkan Çakır, Hasan Fatih Tanyeli, Salih Can Çelik, Özgün Akgül
Gastroduodenal artery aneurysms are a very rare subtype of visceral artery aneurysms. These are divided into two groups as true and pseudoaneurysms. Pseudogastroduodenal artery aneurysms, which develops secondary to pancreatitis, is seen more frequently, whereas the true aneurysms are much less common. Spontaneous rupture may be fatal. Sudden onset of abdominal pain and hypotension are the most important clinical findings. Endovascular interventions are the gold standard for diagnosis. Regardless of their sizes, GDA aneurysms should be treated as soon as possible...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29723964/bleeding-after-percutaneous-transhepatic-biliary-drainage-incidence-causes-and-treatments
#12
REVIEW
Keith B Quencer, Anthony S Tadros, Keyan B Marashi, Ziga Cizman, Eric Reiner, Ryan O'Hara, Rahmi Oklu
Of all procedures in interventional radiology, percutaneous transhepatic biliary drainage (PTBD) is amongst the most technically challenging. Successful placement requires a high level of assorted skills. While this procedure can be life-saving, it can also lead to significant iatrogenic harm, often manifesting as bleeding. Readers of this article will come to understand the pathophysiology and anatomy underlying post-PTBD bleeding, its incidence, its varied clinical manifestations and its initial management...
May 1, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29723595/cost-effectiveness-benefits-of-a-disease-management-program-the-remadhe-trial-results
#13
Edimar Alcides Bocchi, Fátima das Dores da Cruz, Sara MIchelly Brandão, Victor Issa, Silvia Moreira Ayub-Ferreira, Hans-Peter Brunner-La Rocca, Sandra Sanders-van Wijk
BACKGROUND: Published studies have generated mixed, controversial results regarding the cost-effectiveness of heart failure-disease management programs (HF-DMP). This study assessed the cost-effectiveness of an HF-DMP in ambulatory patients compared with usual care (UC). METHODS: In the prospective, randomized REMADHE trial, we evaluated incremental costs per quality-adjusted life-year (QALY) and life-year (LY) gained as effectiveness ratios (ICERs) over a study period of 2...
April 30, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29717699/self-management-education-for-adults-with-poorly-controlled-epilepsy-smile-uk-a-randomised-controlled-trial
#14
Leone Ridsdale, Alison McKinlay, Gabriella Wojewodka, Emily J Robinson, Iris Mosweu, Sarah J Feehan, Adam J Noble, Myfanwy Morgan, Stephanie Jc Taylor, Paul McCrone, Sabine Landau, Mark Richardson, Gus Baker, Laura H Goldstein
BACKGROUND: Epilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting. OBJECTIVES: To determine the effectiveness and cost-effectiveness of Self-Management education for people with poorly controlled epILEpsy [SMILE (UK)]...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29713689/improving-rates-of-implantable-cardioverter-defibrillator-deactivation-in-end-of-life-care
#15
M R Javaid, Suzanne Squirrell, Fahad Farooqi
Implantable cardioverter defibrillators (ICDs) save lives in selected patients at risk of sudden cardiac death. However, in patents suffering with terminal illness, ICD therapy could pose a risk of unnecessary futile shocks which could lead to undignified discomfort in their final days of life. National guidelines advise that patients approaching the end of their natural life should be offered a compassionate choice of having their defibrillator deactivated. Following an actual clinical incident involving a patient receiving avoidable ICD shocks in his final hours, we identified shortcomings in communication and gaps in knowledge about ICD management in end-of-life care...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29712519/systematic-review-of-health-economic-studies-in-cranial-neurosurgery
#16
Won Hyung A Ryu, Michael M H Yang, Sandeep Muram, W Bradley Jacobs, Steven Casha, Jay Riva-Cambrin
OBJECTIVE As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures. METHODS The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29706099/economic-evaluation-of-human-urinary-kallindinogenase-for-patients-with-acute-ischemic-stroke-in-china
#17
Ziyi Lin, Xiuqin Rao, Zhijun Zhang, Jianwei Xuan
OBJECTIVES: In China, both human urinary kallindinogenase (HUK) and 3-n-butylphthalide (NBP) were recommended for clinical use to improve cerebral blood circulation during an acute ischemic stroke (AIS). The objective was to evaluate the economic value of HUK versus NBP for patients with AIS from a Chinese payer's perspective. METHODS: An economic evaluation based on data of patients who have been treated with either HUK (N = 488) or NBP (N = 885) from a prospective, phase IV, multicenter, clinical registry study (Chinese Acute Ischemic Stroke Treatment Outcome Registry, CASTOR) was conducted to analyze the cost and effectiveness of HUK versus NBP for AIS in China...
April 30, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29703561/tension-hydrothorax-emergency-decompression-of-a-pleural-cause-of-cardiac-tamponade
#18
E E Vinck, J C Garzón, T Peterson, R Villarreal, L Cabrera, L Van den Eijnden
INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701338/arterial-vascular-complications-in-peripheral-venoarterial-extracorporeal-membrane-oxygenation-support
#19
Rita Augusto, Marisa Passos Silva, Jacinta Campos, Andreia Coelho, Nuno Coelho, Ana Carolina Semião, Evelise Pinto, Daniel Brandão, Alexandra Canedo
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) has been evolved as a life-saving measure for patients requiring emergent support of respiratory and cardiac function.The femoral artery is the standard site for vascular access when initiating adult venoarterial (VA) ECMO.Cannulation-related complications are a known source of morbidity and it has been speculated that patients undergoing ECMO via femoral arterial cannulation are more likely to develop peripheral vascular complications (up to 70%)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698341/early-hospital-discharge-after-helicopter-transport-of-pediatric-trauma-patients-analysis-of-rates-of-over-and-undertriage
#20
Aodhnait S Fahy, Stephanie F Polites, Cornelius A Thiels, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, Scott P Zietlow, Donald H Jenkins, Martin D Zielinski
OBJECTIVES: Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. METHODS: Children (<18 years) who underwent trauma activation at a level I trauma center between 2011 and 2013 were identified and reviewed...
April 24, 2018: Pediatric Emergency Care
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