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"Decision analysis"

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https://www.readbyqxmd.com/read/28109544/cost-effectiveness-of-prophylactic-cranial-irradiation-with-hippocampal-avoidance-in-limited-stage-small-cell-lung-cancer
#1
Xuanlu M Qu, Mark V Mishra, Glenn S Bauman, Ben Slotman, Minesh Mehta, Vinai Gondi, Alexander V Louie
BACKGROUND AND PURPOSE: Prophylactic cranial irradiation (PCI) in limited stage small cell lung cancer (LS-SCLC) prevents brain metastases and improves survival, with the potential for neurocognitive toxicity. RTOG0933 demonstrated that hippocampal avoidance (HA) during whole brain radiotherapy preserves neurocognition. This study's objective was to evaluate the cost-effectiveness of HA-PCI in LS-SCLC through decision analysis. MATERIALS AND METHODS: A Markov model was developed to simulate the clinical course of LS-SCLC who received HA-PCI or conventional PCI (C-PCI)...
January 18, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28095876/multi-criteria-decision-analysis-mcda-testing-a-proposed-mcda-framework-for-orphan-drugs
#2
C Schey, P F M Krabbe, M J Postma, M P Connolly
BACKGROUND: Since the introduction of the orphan drugs legislation in Europe, it has been suggested that the general method of assessing drugs for reimbursement is not necessarily suitable for orphan drugs. The National Institute for Health and Clinical Excellence indicated that several criteria other than cost and efficacy could be considered in reimbursement decisions for orphan drugs. This study sought to explore the multi-criteria decision analysis (MCDA) framework proposed by (Orphanet J Rare Dis 7:74, 2012) to a range of orphan drugs, with a view to comparing the aggregate scores to the average annual cost per patient for each product, and thus establishing the merit of MCDA as a tool for assessing the value of orphan drugs in relation to their pricings...
January 17, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28087821/selection-of-first-line-therapy-in-multiple-sclerosis-using-risk-benefit-decision-analysis
#3
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/28074438/is-there-variation-in-procedural-utilization-for-lumbar-spine-disorders-between-a-fee-for-service-and-salaried-healthcare-system
#4
Andrew J Schoenfeld, Heeren Makanji, Wei Jiang, Tracey Koehlmoos, Christopher M Bono, Adil H Haider
BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified...
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28073489/cost-comparison-of-initial-lobectomy-versus-fine-needle-aspiration-for-diagnostic-workup-of-thyroid-nodules-in-children
#5
Katherine J Baxter, Heather L Short, Mitali A Thakore, Jeremy G Fisher, David H Rothstein, Kurt F Heiss, Mehul V Raval
BACKGROUND: Though uncommon in children, pediatric thyroid nodules carry a higher risk of malignancy than adult nodules. While fine-needle aspiration (FNA) has been well established as the initial diagnostic test in adults, it has been more slowly adopted in children. The purpose of this study was to examine the comparative cost of FNA versus initial diagnostic lobectomy (DL) in the pediatric patient with an ultrasound-confirmed thyroid nodule. METHODS: A decision tree model was created using an adolescent with an asymptomatic thyroid nodule as the reference case...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28068242/cost-effectiveness-analysis-of-preoperative-versus-postoperative-radiation-therapy-in-extremity-soft-tissue-sarcoma
#6
Xuanlu M Qu, Alexander V Louie, Jonathan Ashman, Nabil Wasif
PURPOSE: Surgery combined with radiation therapy (RT) is the cornerstone of multidisciplinary management of extremity soft tissue sarcoma (STS). Although RT can be given in either the preoperative or the postoperative setting with similar local recurrence and survival outcomes, the side effect profiles, costs, and long-term functional outcomes are different. The aim of this study was to use decision analysis to determine optimal sequencing of RT with surgery in patients with extremity STS...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28061043/an-overview-of-r-in-health-decision-sciences
#7
Hawre Jalal, Petros Pechlivanoglou, Eline Krijkamp, Fernando Alarid-Escudero, Eva Enns, M G Myriam Hunink
As the complexity of health decision science applications increases, high-level programming languages are increasingly adopted for statistical analyses and numerical computations. These programming languages facilitate sophisticated modeling, model documentation, and analysis reproducibility. Among the high-level programming languages, the statistical programming framework R is gaining increased recognition. R is freely available, cross-platform compatible, and open source. A large community of users who have generated an extensive collection of well-documented packages and functions supports it...
January 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28060235/orif-or-arthroplasty-for-displaced-femoral-neck-fractures-in-patients-younger-than-65-years-old-an-economic-decision-analysis
#8
Eric Swart, Paulvalery Roulette, Daniel Leas, Kevin J Bozic, Madhav Karunakar
BACKGROUND: The decision between open reduction and internal fixation (ORIF) and arthroplasty for a displaced femoral neck fracture in a patient ≤65 years old can be challenging. Both options have potential drawbacks; if a fracture treated with ORIF fails to heal it may require a revision operation, whereas a relatively young patient who undergoes arthroplasty may need revision within his/her lifetime. The purpose of this study was to employ decision analysis modeling techniques to generate evidence-based treatment recommendations in this clinical scenario...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28040829/application-of-life-cycle-assessment-on-electronic-waste-management-a-review
#9
Mianqiang Xue, Zhenming Xu
Electronic waste is a rich source of both valuable materials and toxic substances. Management of electronic waste is one of the biggest challenges of current worldwide concern. As an effective and prevailing environmental management tool, life cycle assessment can evaluate the environmental performance of electronic waste management activities. Quite a few scientific literatures reporting life cycle assessment of electronic waste management with significant outcomes have been recently published. This paper reviewed the trends, characteristics, research gaps, and challenges of these studies providing detailed information for practitioners involved in electronic waste management...
December 31, 2016: Environmental Management
https://www.readbyqxmd.com/read/28035629/cost-effectiveness-of-different-population-screening-strategies-for-hereditary-haemochromatosis-in-australia
#10
Barbara de Graaff, Amanda Neil, Lei Si, Kwang Chien Yee, Kristy Sanderson, Lyle Gurrin, Andrew J Palmer
INTRODUCTION: Amongst populations of northern European ancestry, HFE-associated haemochromatosis is a common genetic disorder characterised by iron overload. In the absence of treatment, excess iron is stored in parenchymal tissues, causing morbidity and mortality. Population screening programmes may increase early diagnosis and reduce associated disease. No contemporary health economic evaluation has been published for Australia. The objective of this study was to identify cost-effective screening strategies for haemochromatosis in the Australian setting...
December 29, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28027844/effect-of-hospital-volume-on-success-of-thumb-replantation
#11
Elham Mahmoudi, Kevin C Chung
PURPOSE: Hospital volume-outcome association has been examined for many high-risk surgical procedures. Little is known about this association for thumb replantation, a complex but essential surgical procedure to restore hand function. We aimed to determine patient and hospital characteristics that are associated with increased probability of replanted thumb survival and to examine volume-outcome association among hospitals that performed thumb replantation. METHODS: We used data from 2008 to 2012 from the National Trauma Data Bank...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28024090/cost-effectiveness-of-the-4-pillars-practice-transformation-program-to-improve-vaccination-of-adults-aged-65-and-older
#12
Kenneth J Smith, Richard K Zimmerman, Mary Patricia Nowalk, Chyongchiou J Lin
OBJECTIVES: To estimate the cost-effectiveness of an intervention to increase pneumococcal, influenza, and pertussis-containing vaccine uptake in adults aged 65 and older in primary care practices. DESIGN: Markov decision analysis model, comparing the cost-effectiveness of the 4 Pillars Practice Transformation Program with no intervention. SETTING: Diverse primary care practices in two U.S. cities. PARTICIPANTS: Clinical trial participants aged 65 and older...
December 26, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28019130/eliciting-societal-preferences-of-reimbursement-decision-criteria-for-anti-cancer-drugs-in-south-korea
#13
Sun-Hong Kwon, Sun-Kyeong Park, Ji-Hye Byun, Eui-Kyung Lee
INTRODUCTION: In order to look beyond the cost-effectiveness analysis, this study used a multi-criteria decision analysis (MCDA), which reflects societal values with regard to reimbursement decisions. This study aims to elicit societal preferences of the reimbursement decision criteria for anti cancer drugs from public and healthcare professionals. METHODS: Eight criteria were defined based on a literature review and focus group sessions: disease severity, disease population size, pediatrics targets, unmet needs, innovation, clinical benefits, cost-effectiveness, and budget impacts...
January 3, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28017438/the-role-of-vaccines-and-vaccine-decision-making-to-achieve-the-goals-of-the-grand-convergence-in-public-health
#14
David C Kaslow, Jorge Kalil, David Bloom, Gianluca Breghi, Anna Maria Colucci, Ennio De Gregorio, Guru Madhavan, Genevieve Meier, Richard Seabrook, Xiaoning Xu
On 17 and 18 July 2015, a meeting in Siena jointly sponsored by ADITEC and GlaxoSmithKline (GSK) was held to review the goals of the Global Health 2035 Grand Convergence, to discuss current vaccine evaluation methods, and to determine the feasibility of reaching consensus on an assessment framework for comprehensively and accurately capturing the full benefits of vaccines. Through lectures and workshops, participants reached a consensus that Multi-Criteria-Decision-Analysis is a method suited to systematically account for the many variables needed to evaluate the broad benefits of vaccination, which include not only health system savings, but also societal benefits, including benefits to the family and increased productivity...
December 22, 2016: Vaccine
https://www.readbyqxmd.com/read/28012386/performance-evaluation-of-restaurant-food-waste-and-biowaste-to-biogas-pilot-projects-in-china-and-implications-for-national-policy
#15
Djavan De Clercq, Zongguo Wen, Fei Fan
The objective of this research was to conduct a performance evaluation of three food waste/biowaste-to-biogas pilot projects across 7 scenarios in China based on multi-criteria decision analysis (MCDA) methodology. The projects ranked included a food waste-biogas project in Beijing, a food waste-biogas project in Suzhou and a co-digestion project producing biomethane in Hainan. The projects were ranked from best to worst based on technical, economic and environmental criteria under the MCDA framework. The results demonstrated that some projects are encountering operational problems...
December 21, 2016: Journal of Environmental Management
https://www.readbyqxmd.com/read/28011033/cost-savings-and-patient-experiences-of-a-clinic-based-wide-awake-hand-surgery-program-at-a-military-medical-center-a-critical-analysis-of-the-first-100-procedures
#16
Peter C Rhee, Michelle M Fischer, Laura S Rhee, Ha McMillan, Anthony E Johnson
PURPOSE: Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. METHODS: A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#17
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who suffer from high energy blunt chest trauma, and results in severe respiratory compromise due to altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost effectiveness analysis, supported by systematic review and meta-analysis...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27976822/multi-criteria-decision-analysis-applied-to-harmful-algal-bloom-management-a-case-study
#18
Chengfang Pang, Artur Radomyski, Vrishali Subramanian, Mandana Nadimi-Goki, Antonio Marcomini, Igor Linkov
Harmful Algal Blooms (HABs) have received greater attention in recent years due to an increase in the frequency of outbreaks and a growing potential for blooms to exact considerable economic losses and negatively impact ecosystem health. Human activity has been shown to intensify HAB outbreaks through increased eutrophication, elevated local air and water temperatures, disturbance of the thermal stratification of lakes, and modification of local hydrology. With the advent of new remediation technologies and a better understanding of the ecological factors affecting HABs, mitigating the adverse effects of HABs has become more feasible than ever before, but still requires balancing mitigation efficiency, environmental impacts, costs, and stakeholder needs...
December 15, 2016: Integrated Environmental Assessment and Management
https://www.readbyqxmd.com/read/27974370/should-all-anticoagulated-patients-with-head-injury-receive-a-ct-scan-decision-analysis-modelling-of-an-observational-cohort
#19
Maxine Kuczawski, Matt Stevenson, Steve Goodacre, M Dawn Teare, Shammi Ramlakhan, Francis Morris, Suzanne Mason
OBJECTIVES: It is not currently clear whether all anticoagulated patients with a head injury should receive CT scanning or only those with evidence of traumatic brain injury (eg, loss of consciousness or amnesia). We aimed to determine the cost-effectiveness of CT for all compared with selective CT use for anticoagulated patients with a head injury. DESIGN: Decision-analysis modelling of data from a multicentre observational study. SETTING: 33 emergency departments in England and Scotland...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27972736/application-of-multi-criteria-decision-analysis-mcda-scoring-as-an-hta-methodology-for-off-patent-pharmaceuticals-opp-in-emerging-markets
#20
D Brixner, N Maniadakis, Z Kaló, S Hu, A Johnston, J Shen, K E Wijaya
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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