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"Decision analysis"

Ashleigh A McGirr, Kevin L Schwartz, Upton Allen, Melinda Solomon, Beate Sander
Background Children with cystic fibrosis (CF) are at higher risk of severe respiratory syncytial virus (RSV) infection, which can lead to a decline in lung function. A monoclonal antibody, palivizumab (PMB), effectively prevents RSV hospitalizations; however, the high cost of PMB, approximately C$10,000 per patient per RSV season, limits its widespread use. We assess the cost-effectiveness of PMB prophylaxis in CF children less than 2 years of age from the Canadian healthcare payer's perspective. Methods In 2014, a Markov cohort model of CF disease and infant RSV infections in the Canadian setting was developed based on literature data...
October 21, 2016: Human Vaccines & Immunotherapeutics
Maria Agapova, Brian B Bresnahan, Mitchell Higashi, Larry Kessler, Louis P Garrison, Beth Devine
The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating...
October 19, 2016: Journal of Evaluation in Clinical Practice
Satoshi Nagase, Tomokazu Iyoda, Hiroshi Kanno, Tomohide Akase, Ichiro Arakawa, Tadao Inoue, Yoshio Uetsuka
Phase III clinical trials have comfirmed that the S-1 plus oxaliplatin(SOX)is inferior to the capecitabine plus oxaliplatin (COX)regimen in the treatment of metastatic colorectal cancer.On the basis of these findings, we compared, using a clinical decision analysis-based approach, the cost-effectiveness of the SOX and COX regimens.Herein, we simulated the expected effects and costs of the SOX and COX regimens using the markov model.Clinical data were obtained from Hong's 2012 report.The cost data comprised the costs for pharmacist labor, material, inspection, and treatment for adverse event, as well as the total cost of care at the advanced stage...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Travis J Wilder, William G Williams
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
Carlos M Mery, Keila N Lopez, Silvana Molossi, S Kristen Sexson-Tejtel, Rajesh Krishnamurthy, E Dean McKenzie, Charles D Fraser, Scott B Cantor
OBJECTIVES: The goal of this study was to use decision analysis to evaluate the impact of varying uncertainties on the outcomes of patients with anomalous aortic origin of a coronary artery. METHODS: Two separate decision analysis models were created: one for anomalous left coronary artery (ALCA) and one for anomalous right coronary artery (ARCA). Three strategies were compared: observation, exercise restriction, and surgery. Probabilities and health utilities were estimated on the basis of existing literature...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Amanda K Debes, Robert H Gilman, Carolyne Onyango-Makumbi, Andrea Ruff, Richard Oberhelman, David W Dowdy
BACKGROUND: The objective of this analysis was to assess the cost-effectiveness of TB diagnosis using Microscopic Observation Drug Susceptibility (MODS), Xpert MTB/RIF (Xpert), and empiric treatment for all patients, in addition to current clinical diagnostic practices in children less than 5 years of age in a national tuberculosis (TB) referral hospital in Uganda. METHODS: A decision analysis was conducted from the healthcare perspective, with a primary outcome of incremental cost effectiveness expressed as cost per year of life gained (YLG)...
October 3, 2016: Pediatric Infectious Disease Journal
Georgi Iskrov, Tsonka Miteva-Katrandzhieva, Rumen Stefanov
BACKGROUND: Limited resources and expanding expectations push all countries and types of health systems to adopt new approaches in priority setting and resources allocation. Despite best efforts, it is difficult to reconcile all competing interests, and trade-offs are inevitable. This is why multi-criteria decision analysis (MCDA) has played a major role in recent uptake of value-based reimbursement. MCDA framework enables exploration of stakeholders' preferences, as well as explicit organization of broad range of criteria on which real-world decisions are made...
2016: Frontiers in Public Health
Matthew C Brondum, Zachary A Collier, Christopher S Luke, Buddy L Goatcher, Igor Linkov
Wild pigs are a widespread invasive species that pose significant environmental and social risks. A number of wild pig eradication and control measures exist, but many eradication campaigns are ultimately unsuccessful. Decision making regarding how to design and execute an eradication plan is difficult because of multiple costs and benefits spanning various decision criteria that are associated with different eradication and control countermeasures. Moreover, multiple stakeholders are often involved with differing and sometimes competing objectives, and wild pigs are adaptive adversaries, meaning that the ideal countermeasure may change over time...
October 12, 2016: Science of the Total Environment
Adwoa Hughes-Morley, Bridget Young, Roelie J Hempel, Ian T Russell, Waquas Waheed, Peter Bower
BACKGROUND: Trials increasingly experience problems in recruiting participants. Understanding the causes of poor recruitment is critical to developing solutions. We interviewed people who had declined a trial of an innovative psychological therapy for depression (REFRAMED) about their response to the trial invitation, in order to understand their decision and identify ways to improve recruitment. METHODS: Of 214 people who declined the trial, 35 (16 %) gave permission to be contacted about a qualitative study to explore their decision...
October 12, 2016: Trials
Simon Walusimbi, Brendan Kwesiga, Rashmi Rodrigues, Melles Haile, Ayesha de Costa, Lennart Bogg, Achilles Katamba
BACKGROUND: Microscopic Observation Drug Susceptibility (MODS) and Xpert MTB/Rif (Xpert) are highly sensitive tests for diagnosis of pulmonary tuberculosis (PTB). This study evaluated the cost effectiveness of utilizing MODS versus Xpert for diagnosis of active pulmonary TB in HIV infected patients in Uganda. METHODS: A decision analysis model comparing MODS versus Xpert for TB diagnosis was used. Costs were estimated by measuring and valuing relevant resources required to perform the MODS and Xpert tests...
October 10, 2016: BMC Health Services Research
Junli Du, Manlin Li, Zhifa Yuan, Mancai Guo, Jiuzhou Song, Xiaozhen Xie, Yulin Chen
BACKGROUND: The knowledge base-driven pathway analysis is becoming the first choice for many investigators, in that it not only can reduce the complexity of functional analysis by grouping thousands of genes into just several hundred pathways, but also can increase the explanatory power for the experiment by identifying active pathways in different conditions. However, current approaches are designed to analyze a biological system assuming that each pathway is independent of the other pathways...
October 6, 2016: BMC Bioinformatics
M L Avila, L R Brandão, S Williams, M I Montoya, J Stinson, A Kiss, B M Feldman
BACKGROUND: Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis defined by the presence of characteristic signs and symptoms. We developed a discriminative and evaluative index for the assessment of upper and lower extremity (UE/LE) pediatric PTS. METHODS: The items to be included in the index were voted for by 26 pediatric thrombosis experts invited to participate in a Delphi survey. Subsequent item weighting was based on item importance elicited using multi-criteria decision analysis (MCDA); 122 health care providers and patients/parents participated in item weighting...
October 6, 2016: Journal of Thrombosis and Haemostasis: JTH
Lane Koenig, Qian Zhang, Matthew S Austin, Berna Demiralp, Thomas K Fehring, Chaoling Feng, Richard C Mather, Jennifer T Nguyen, Asha Saavoss, Bryan D Springer, Adolph J Yates
BACKGROUND: Demand for total hip arthroplasty (THA) is high and expected to continue to grow during the next decade. Although much of this growth includes working-aged patients, cost-effectiveness studies on THA have not fully incorporated the productivity effects from surgery. QUESTIONS/PURPOSES: We asked: (1) What is the expected effect of THA on patients' employment and earnings? (2) How does accounting for these effects influence the cost-effectiveness of THA relative to nonsurgical treatment? METHODS: Taking a societal perspective, we used a Markov model to assess the overall cost-effectiveness of THA compared with nonsurgical treatment...
October 3, 2016: Clinical Orthopaedics and related Research
Andrew Vickers, Emily A Vertosick, Daniel D Sjoberg, Monique J Roobol, Freddie Hamdy, David Neal, Anders Bjartell, Jonas Hugosson, Jenny L Donovan, Arnauld Villers, Stephen Zappala, Hans Lilja
PURPOSE: The four-kallikrein panel, commercially available as the 4Kscore™, is a reflex test for prostate cancer early detection that has been extensively validated in multiple international cohorts. It has been suggested that use of such reflex tests be limited to those with PSA less than 10 ng/mL and negative DRE. We aimed to determine the value of the panel in men outside this "diagnostic grey zone". METHODS: We conducted an individual patient data meta-analysis using data from prior studies on the four-kallikrein panel...
September 27, 2016: Journal of Urology
Hector Eduardo Castro Jaramillo, Mireille Goetghebeur, Ornella Moreno-Mattar
OBJECTIVES: In 2012, Colombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute (IETS), the disbandment of the Regulatory Commission for Health and the reassignment of reimbursement decision-making powers to the Ministry of Health and Social Protection (MoHSP). These dynamic changes provided the opportunity to test Multi-Criteria Decision Analysis (MCDA) for systematic and more transparent resource-allocation decision-making...
October 3, 2016: International Journal of Technology Assessment in Health Care
Joshua D Mixson, Thomas E Brothers
OBJECTIVE: Tobacco smoking after lower extremity revascularization for claudication has repeatedly been shown to increase the risk of adverse events, such that many vascular specialists consider that refusal to abstain from smoking constitutes a major contraindication to open surgical bypass or endovascular intervention. METHODS: A Markov decision analysis (DA) model was used to compare the options of direct revascularization vs medical therapy only in smokers with claudication...
September 26, 2016: Journal of Vascular Surgery
Peter Garpenby, Karin Bäckman
Purpose From the late 1980s and onwards health care in Sweden has come under increasing financial pressure, forcing policy makers to consider restrictions. The purpose of this paper is to review experiences and to establish lessons of formal priority setting in four Swedish regional health authorities during the period 2003-2012. Design/methodology/approach This paper draws on a variety of sources, and evidence is organised according to three broad aspects: design and implementation of models and processes, application of evidence and decision analysis tools and decision making and implementation of decisions...
September 19, 2016: Journal of Health Organization and Management
Gaurav Aman Luther, Praveen Murthy, Philip E Blazar
PURPOSE: As health care costs continue to rise, providers must increasingly identify and implement cost-effective practice measures without sacrificing quality of care. Corticosteroid injections are an established treatment for trigger finger; however, numerous clinical trials have documented the limited efficacy of these injections in the diabetic population. Furthermore, the most cost-effective treatment strategy for diabetic trigger finger has not been determined. The purpose of this study was to perform a decision analysis to identify the least costly strategy for effective treatment of diabetic trigger finger using existing evidence in the literature...
September 23, 2016: Journal of Hand Surgery
Kevin W Park, Martin I Boyer, Richard H Gelberman, Ryan P Calfee, Jeffrey G Stepan, Daniel A Osei
: The purpose of this study was to determine if simultaneous bilateral carpal tunnel release (CTR) is a cost-effective strategy compared with bilateral staged CTR for the treatment of bilateral carpal tunnel syndrome. METHODS: A decision analytic model was created to compare the cost effectiveness of three strategies (ie, bilateral simultaneous CTR, bilateral staged CTR, and no treatment). Direct medical costs were estimated from 2013 Medicare reimbursement rates and wholesale drug costs in US dollars...
September 23, 2016: Journal of the American Academy of Orthopaedic Surgeons
Jun Zheng, Christoph Egger, Judit Lienert
Wastewater infrastructure management is increasingly important because of urbanization, environmental pollutants, aging infrastructures, and climate change. We propose a scenario-based multi-criteria decision analysis (MCDA) framework to compare different infrastructure alternatives in terms of their sustainability. These range from the current centralized system to semi- and fully decentralized options. Various sources of uncertainty are considered, including external socio-economic uncertainty captured by future scenarios, uncertainty in predicting outcomes of alternatives, and incomplete preferences of stakeholders...
December 1, 2016: Journal of Environmental Management
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