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Pei-Jung Lin, Wei-Shi Yeh, Peter J Neumann
OBJECTIVES: The current US mandatory newborn screening panel does not include spinal muscular atrophy, the most common fatal genetic disease among children. We assessed population preferences for newborn screening for spinal muscular atrophy, and how test preferences varied depending on immediate treatment implications. METHODS: We conducted an online willingness-to-pay survey of US adults (n = 982). Respondents were asked to imagine being parents of a newborn...
September 15, 2016: Pediatric Neurology
Amanda C Trofholz, Allan D Tate, Michael H Miner, Jerica M Berge
BACKGROUND: Research on family meals has demonstrated that family meals are protective for many aspects of child and adolescent health. It is unclear whether distractions at family meals, such as watching TV, are associated with child weight and weight-related behaviors, the emotional atmosphere at the meal, or family meal healthfulness. METHODS: Direct observational and objective data were collected on primarily low-income and minority families (n = 120) with 6-12 year old children...
October 15, 2016: Appetite
Jacinto Mosquera Nogueira, Eva Rodríguez-Míguez
Alcohol dependence causes multiple problems not only for the person suffering dependence but also for others. In this study, the contingent valuation method is proposed to measure the intangible effects of alcohol dependence from the perspective of the persons directly involved: the patients and their relatives. Interviews were conducted with 145 patients and 61 relatives. Intangible effects of alcohol dependence were determined based on willingness to pay for a hypothetical treatment for dependence, with different success scenarios (100% and 50%)...
September 29, 2016: Adicciones
Vedat Hamuryudan, Haner Direskeneli, Ihsan Ertenli, Murat Inanc, Yasar Karaaslan, Fahrettin Oksel, Suleyman Ozbek, Salih Pay, Ender Terzioglu, Dilara Balkan Tezer, Basak Hacibedel, Nurullah Akkoc
OBJECTIVES: To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. METHODS: In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. RESULTS: The study included 689 RA patients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9...
September 18, 2016: Clinical and Experimental Rheumatology
Drishti Shah, Vamshi Ruthwik Anupindi, Varun Vaidya
Chronic back pain is an extremely common health problem. The largest category for pain therapy costs includes nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However, there has been limited evidence outlining their effectiveness in terms of quality of life for the treatment of chronic back pain. The authors performed a comparative pharmacoeconomic analysis of chronic back pain patients using NSAIDs versus those using opioids alone or combination opioid analgesics. This pharmacoeconomic evaluation was conducted using the Medical Expenditure Panel Survey (MEPS)...
October 17, 2016: Journal of Pain & Palliative Care Pharmacotherapy
Adam Balkham, Sarah Alderson
BACKGROUND: The introduction of the Health and Social Care Bill (2011) changed the role of GPs to include commissioning of health services. Aim This study aimed to identify any differences in the media portrayal of GPs before and after the introduction of the Bill. METHODS: We retrospectively searched four British newspapers over the period 2009-2013 using the media database Nexis. In order to directly compare the findings of the study with the work of Tanner et al...
October 17, 2016: Primary Health Care Research & Development
Louisa G Gordon, Robbie James, Haitham W Tuffaha, Anthony Lowe, John Yaxley
PURPOSE: To evaluate the cost-effectiveness of multiparametric magnetic resonance imaging (mpMRI) to diagnose prostate cancer and direct all low-risk patients into active surveillance (AS). MATERIALS AND METHODS: A Markov cohort model was developed to assess three scenarios: 1) no mpMRI and current AS; 2) mpMRI and current AS; and 3) mpMRI and increased AS. Men were tracked from diagnosis to end-of-life. Estimates to populate the model were derived from systematic reviews, meta-analyses, epidemiological publications, and national cost reports...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
Radek Wojcik, Julia Lowin, David Vilardell, Silvia Maeso, Leonardo Ruiz, John Lear, Colin Morton
OBJECTIVE: The objective of this analysis was to estimate the relative cost-effectiveness of Actikerall * (5-FU-SA) versus cryotherapy in a secondary care setting in the UK, for lesion-directed treatment in patients with actinic keratoses (AK) of the face and scalp. METHODS: The model was a simple decision tree, with a 6-month time horizon. The perspective was that of the UK National Health Service (NHS). Modelled treatment effects included reported per-patient histological clearance and recurrence rates...
October 7, 2016: Journal of Medical Economics
Byung Soo Kim, Sung Man Chang, Su Jeong Seong, Jee Eun Park, Subin Park, Jin Pyo Hong, Jae Nam Bae, Seong Jin Cho, Bong Jin Hahm, Dong Woo Lee, Jong Ik Park, Jun Young Lee, Hong Jin Jeon, Maeng Je Cho
Many epidemiological studies suggest that overweight is associated with an elevated risk of psychiatric disorders and suicidal tendency. However, findings vary across studies, and some have contradictory results. We investigated the relationship of overweight with a range of psychiatric disorders and suicidality in the Korean general population. A multistage cluster sampling design was adopted. A total of 6,022 participants aged 18-74 years completed face-to-face interviews (response rate: 78.7%) including assessment of psychiatric disorders, suicidality, and height and weight...
November 2016: Journal of Korean Medical Science
Yanfei Jia, Xiaodong Yang
Fetal electrocardiogram (FECG) extraction is very important procedure for fetal health assessment. In this article, we propose a fast one-unit independent component analysis with reference (ICA-R) that is suitable to extract the FECG. Most previous ICA-R algorithms only focused on how to optimize the cost function of the ICA-R and payed little attention to the improvement of cost function. They did not fully take advantage of the prior information about the desired signal to improve the ICA-R. In this paper, we first use the kurtosis information of the desired FECG signal to simplify the non-Gaussian measurement function and then construct a new cost function by directly using a nonquadratic function of the extracted signal to measure its non-Gaussianity...
2016: Computational and Mathematical Methods in Medicine
Luis Felipe Casado, Amparo Burgos, Eva González-Haba, Javier Loscertales, Tania Krivasi, Javier Orofino, Carlos Rubio-Terres, Darío Rubio-Rodríguez
OBJECTIVE: To evaluate the cost-effectiveness of obinutuzumab in combination with chlorambucil (GClb) versus rituximab plus chlorambucil (RClb) in the treatment of adults with previously untreated chronic lymphocytic leukemia (CLL) and with comorbidities that make them unsuitable for full-dose fludarabine-based therapy, from the perspective of the Spanish National Health System. METHODS: A Markov model was developed with three mutually exclusive health states: progression-free survival (with or without treatment), progression, and death...
2016: ClinicoEconomics and Outcomes Research: CEOR
Kerry Kuluski, Allie Peckham, A Paul Williams, Ross E G Upshur
Person-centred care is becoming a key component of quality in health systems worldwide. Although the term can mean different things, it typically entails paying attention to the needs and background of health system users, involving them in decisions that affect their health, assessing their care goals and implementing a coordinated plan of care that aligns with their unique circumstances. The importance of practising a person-centred approach in care delivery dominates policy and research rhetoric worldwide, yet competing goals set by policy planners to save money, eliminate waste and sustain the healthcare system challenge the implementation of such an approach...
2016: Healthcare Quarterly
Yuanyuan Ma, Anne Nolan
The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40% of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use data from The Irish Longitudinal Study on Ageing (TILDA) to examine the impact of the current system of public healthcare entitlements on GP utilisation among the older population. Using difference-in-difference propensity score matching methods, we find significant effects of changes in public healthcare entitlements on GP utilisation (i...
October 3, 2016: Health Economics
Fausto Guzzetti
Landslides are one of several natural hazards. As other natural hazards, landslides are difficult to predict, and their forecasts are uncertain. The uncertainty depends on the poor understanding of the phenomena that control the slope failures, and on the inherent complexity and chaotic nature of the landslides. This is similar to other natural hazards, including hurricanes, earthquakes, volcanic eruptions, floods, and droughts. Due to the severe impact of landslides on the population, the environment, and the economy, forecasting landslides is of scientific interest and of societal relevance, and scientists attempting to forecast landslides face known and new problems intrinsic to the multifaceted interactions between science, decision-making, and the society...
October 20, 2016: Toxicological and Environmental Chemistry
Steve King, Iain Fraser, Jesse R O'Hanley
We present findings from a choice experiment investigating improvements in the aquatic environment from mitigation of barriers to fish passage. Implemented at a local and national level, results reveal positive preferences for increased numbers of fish species as well as fish abundance. In addition, we examine if in this case the willingness to pay estimates are suitable for direct transfer between national and local settings. For both samples, we consider the extent to which stated attribute non-attendance impacts estimates of willingness to pay and the potential ability of researchers to transfer values between contexts...
December 1, 2016: Journal of Environmental Management
Y-K Pang, M Ip, J H S You
Early initiation of antifungal treatment for invasive candidiasis is associated with change in mortality. Beta-D-glucan (BDG) is a fungal cell wall component and a serum diagnostic biomarker of fungal infection. Clinical findings suggested an association between reduced invasive candidiasis incidence in intensive care units (ICUs) and BDG-guided preemptive antifungal therapy. We evaluated the potential cost-effectiveness of active BDG surveillance with preemptive antifungal therapy in patients admitted to adult ICUs from the perspective of Hong Kong healthcare providers...
September 29, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Martin Tickle, Ciaran O'Neill, Michael Donaldson, Stephen Birch, Solveig Noble, Seamus Killough, Lynn Murphy, Margaret Greer, Julie Brodison, Rejina Verghis, Helen V Worthington
BACKGROUND: Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. OBJECTIVE: To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. DESIGN: The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1...
September 2016: Health Technology Assessment: HTA
Puttarin Kulchaitanaroaj, John M Brooks, Nathorn Chaiyakunapruk, Amber M Goedken, Elizabeth A Chrischilles, Barry L Carter
OBJECTIVE: To estimate long-term costs and outcomes attributable to a physician-pharmacist collaborative intervention compared with physician management alone for treating essential hypertension. METHODS: A Markov model cohort simulation with a 6-month cycle length to predict acute coronary syndrome, stroke, and heart failure throughout lifetime was performed. A cohort of 399 patients was obtained from two prospective, cluster randomized controlled clinical trials implementing physician-pharmacist collaborative interventions in community-based medical offices in the Midwest, USA...
September 28, 2016: Journal of Hypertension
W F Zhang, S H Tang, Q Tan, Y M Liu
Objective: To investigate radioactive source term dose monitoring and estimation results in a manufacturing enterprise of ion-absorbing type rare earth ore and the possible ionizing radiation dose received by its workers. Methods: Ionizing radiation monitoring data of the posts in the control area and supervised area of workplace were collected, and the annual average effective dose directly estimated or estimated using formulas was evaluated and analyzed. Results: In the control area and supervised area of the workplace for this rare earth ore, α surface contamination activity had a maximum value of 0...
August 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Qiushi Chen, Turgay Ayer, Jagpreet Chhatwal
BACKGROUND: Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible...
September 28, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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