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"Decision analysis"

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https://www.readbyqxmd.com/read/28923330/decision-making-process-by-users-and-providers-of-health-care-services-during-the-ah1n1-epidemic-influenza-in-mexico-lessons-learned-and-challenges-ahead
#1
Víctor Huízar-Hernández, Armando Arredondo, Marta Caballero, Angélica Castro-Ríos, Sergio Flores-Hernández, Rogelio Pérez-Padilla, Hortensia Reyes-Morales
OBJECTIVE: The aim of the study was to analyze, using a decision analysis approach, the probability of severity of illness due to delayed utilization of health services and inappropriate hospital medical treatment during the 2009 AH1N1 influenza epidemic in Mexico. METHODS: Patients with influenza AH1N1 confirmed by the polymerase chain reaction (PCR) test from two hospitals in Mexico City, were included. Path methodology based upon literature and validated by clinical experts was followed...
April 2017: Archives of Medical Research
https://www.readbyqxmd.com/read/28917629/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-a-qualitative-study-with-experts-suggests-that-test-accuracy-data-alone-is-rarely-sufficient-for-decision-making
#2
Reem A Mustafa, Wojtek Wiercioch, Matthew Ventresca, Jan Brozek, Holger J Schünemann
OBJECTIVE: To identify the critical factors that determine recommendations and other decisions about health care related tests and diagnostic strategies (HCTDS). METHODS: We used a qualitative descriptive approach and conducted semi-structured in-depth interviews with 24 international experts (informants) in evidence and decisions about HCTDS. RESULTS: Although test accuracy (TA) was the factor most commonly considered by organizations when developing recommendations about HCTDS, informants agreed that TA is necessary but rarely, if ever, sufficient and may be misleading when solely considered...
September 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28899588/costs-associated-with-single-use-and-conventional-sets-for-distal-radius-plating
#3
Bryce Fugarino, Mary Patricia Fox, Cristina Terhoeve, Nicholas Pappas
PURPOSE: Volar plating of distal radius fractures is an increasingly common procedure. Presterilized, single-use volar plate fixation sets have been purported to increase operating room efficiency and decrease cost. The purpose of this study was to compare the actual cost of using a conventional set compared with the projected cost of using its single-use counterpart. METHODS: We retrospectively analyzed 30 consecutive cases of volar plate fixation in which conventional instrument sets were used...
September 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28879558/second-opinion-strategies-in-breast-pathology-a-decision-analysis-addressing-over-treatment-under-treatment-and-care-costs
#4
Anna N A Tosteson, Qian Yang, Heidi D Nelson, Gary Longton, Samir S Soneji, Margaret Pepe, Berta Geller, Patricia A Carney, Tracy Onega, Kimberly H Allison, Joann G Elmore, Donald L Weaver
PURPOSE: To estimate the potential near-term population impact of alternative second opinion breast biopsy pathology interpretation strategies. METHODS: Decision analysis examining 12-month outcomes of breast biopsy for nine breast pathology interpretation strategies in the U.S. health system. Diagnoses of 115 practicing pathologists in the Breast Pathology Study were compared to reference-standard-consensus diagnoses with and without second opinions. Interpretation strategies were defined by whether a second opinion was sought universally or selectively (e...
September 6, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28873246/multicriteria-decision-framework-for-cybersecurity-risk-assessment-and-management
#5
Alexander A Ganin, Phuoc Quach, Mahesh Panwar, Zachary A Collier, Jeffrey M Keisler, Dayton Marchese, Igor Linkov
Risk assessors and managers face many difficult challenges related to novel cyber systems. Among these challenges are the constantly changing nature of cyber systems caused by technical advances, their distribution across the physical, information, and sociocognitive domains, and the complex network structures often including thousands of nodes. Here, we review probabilistic and risk-based decision-making techniques applied to cyber systems and conclude that existing approaches typically do not address all components of the risk assessment triplet (threat, vulnerability, consequence) and lack the ability to integrate across multiple domains of cyber systems to provide guidance for enhancing cybersecurity...
September 5, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28871512/decision-making-and-priority-setting-the-evolving-path-towards-universal-health-coverage
#6
Francesco Paolucci, Ken Redekop, Ayman Fouda, Gianluca Fiorentini
Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions...
September 4, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28864484/lifetime-risks-of-kidney-donation-a-medical-decision-analysis
#7
Bryce A Kiberd, Karthik K Tennankore
OBJECTIVE: This study estimated the potential loss of life and the lifetime cumulative risk of end-stage renal disease (ESRD) from live kidney donation. DESIGN: Markov medical decision analysis. SETTING: USA. PARTICIPANTS: 40-year-old live kidney donors of both sexes and black/white race. INTERVENTION: Live donor nephrectomy. MAIN OUTCOME AND MEASURES: Potential remaining life years lost, quality-adjusted life years (QALYs) lost and added lifetime cumulative risk of ESRD from donation...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28859640/evaluation-of-infectious-diseases-and-clinical-microbiology-specialists-preferences-for-hand-hygiene-analysis-using-the-multi-attribute-utility-theory-and-the-analytic-hierarchy-process-methods
#8
Aslı Suner, Ozlem Ege Oruc, Cagri Buke, Hacer Deniz Ozkaya, Gul Kitapcioglu
BACKGROUND: Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. METHODS: Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews...
August 31, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28858967/applying-decision-science-to-the-prioritization-of-healthcare-associated-infection-initiatives
#9
Terry H Tsai, Michael D Gerst, Cyrus Engineer, Harold P Lehmann
OBJECTIVES: Improving patient quality remains a top priority from the perspectives of both patient outcomes and cost of care. The continuing threat to patient safety has resulted in an increasing number of options for patient safety initiatives, making choices more difficult because of competing priorities. This study provides a proof of concept for using low-cost decision science methods for prioritizing initiatives. METHODS: Using multicriteria decision analysis, we developed a decision support model for aiding the prioritization of the four most common types of healthcare-associated infections: surgical site infections, central line-associated bloodstream infections, ventilator-associated events, and catheter-associated urinary tract infections...
August 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28841115/cost-of-coils-for-intracranial-aneurysms-clinical-decision-analysis-for-implementation-of-a-capitation-model
#10
Gurpreet S Gandhoke, Yash K Pandya, Ashutosh P Jadhav, Tudor Jovin, Robert M Friedlander, Kenneth J Smith, Brian T Jankowitz
OBJECTIVE The price of coils used for intracranial aneurysm embolization has continued to rise despite an increase in competition in the marketplace. Coils on the US market range in list price from $500 to $3000. The purpose of this study was to investigate potential cost savings with the use of a price capitation model. METHODS The authors built a clinical decision analytical tree and compared their institution's current expenditure on endovascular coils to the costs if a capped-price model were implemented...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28836985/providing-guidance-for-genomics-based-cancer-treatment-decisions-insights-from-stakeholder-engagement-for-post-prostatectomy-radiation-therapy
#11
James Abe, Jennifer M Lobo, Daniel M Trifiletti, Timothy N Showalter
BACKGROUND: Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy...
August 24, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28829719/cost-effectiveness-of-a-practice-based-intervention-to-improve-vaccination-rates-in-adults-less-than-65-years-old
#12
Kenneth J Smith, Mary Patricia Nowalk, Chyongchiou J Lin, Richard K Zimmerman
The cost-effectiveness of the 4 Pillars™ Practice Transformation Program to improve vaccination rates in adults <65-years-old is unknown. Two vaccines, influenza and Tdap (tetanus, diphtheria, acellular pertussis), were targeted for this age group. Cost-effectiveness of the intervention compared to control, with a primary outcome of cost per quality adjusted life year (QALY) gained, was estimated from societal and third party payer perspectives over a 10-year time horizon using a decision analysis model...
August 22, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28826754/cost-effectiveness-of-magnetic-resonance-imaging-in-cervical-spine-clearance-of-neurologically-intact-patients-with-blunt-trauma
#13
Xiao Wu, Ajay Malhotra, Bertie Geng, Renu Liu, Khalid Abbed, Howard P Forman, Pina Sanelli
STUDY OBJECTIVE: Use of magnetic resonance imaging (MRI) for cervical clearance after a negative cervical computed tomography (CT) scan result in alert patients with blunt trauma who are neurologically intact is not infrequent, despite poor evidence in regard to its utility. The objective of this study is to evaluate the utility and cost-effectiveness of using MRI versus no follow-up in this patient population. METHODS: A modeling-based decision analysis was performed during the lifetime of a 40-year-old individual from a societal perspective...
August 18, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28822106/multiple-criteria-decision-analysis-in-health-technology-assessment-for-drugs-just-another-illusion
#14
EDITORIAL
Livio Garattini, Anna Padula
No abstract text is available yet for this article.
August 18, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28815611/the-value-of-frontal-sinusotomy-for-chronic-rhinosinusitis-with-nasal-polyps-a-cost-utility-analysis
#15
George A Scangas, Ashton E Lehmann, Aaron K Remenschneider, Brooke M Su, Mark G Shrime, Ralph Metson
OBJECTIVES/HYPOTHESIS: The number of surgical procedures performed for frontal sinusitis and the associated costs have increased dramatically over the past decade. The purpose of this study was to evaluate the cost-effectiveness of endoscopic frontal sinusotomy (EFS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). STUDY DESIGN: Cohort-style Markov decision-tree economic model with a 36-year time horizon. METHODS: Matched cohorts of CRSwNP patients who underwent endoscopic sinus surgery (ESS) with (n = 139) and without (n = 49) EFS were compared to each other and to patients (n = 139) from the Medical Expenditures Survey Panel database who underwent medical management for chronic rhinosinusitis...
August 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28815602/efficacy-and-safety-of-amphotericin-b-formulations-a-network-meta-analysis-and-a-multicriteria-decision-analysis
#16
Fernanda S Tonin, Laiza M Steimbach, Helena H Borba, Andreia C Sanches, Astrid Wiens, Roberto Pontarolo, Fernando Fernandez-Llimos
OBJECTIVES: Despite its broad spectrum, conventional amphotericin B (AB) is associated with serious adverse events. Lipid-based formulations may offer safer options. We aimed to synthesize the evidence of efficacy and safety of AB formulations. METHODS: We performed a systematic review and network meta-analysis (NMA) to compare all available formulations: conventional AB; lipid complex or ABLC; colloidal dispersion or ABCD; liposomal or LAB; AB in Intralipid. Randomized controlled trials were searched in four databases...
August 17, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28800928/post-operative-bracing-after-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-a-cost-effectiveness-study
#17
REVIEW
Matthew Piazza, Saurabh Sinha, Prateek Agarwal, Arka Mallela, Nikhil Nayak, James Schuster, Sherman Stein
PURPOSE: While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. METHODS: Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures...
August 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28797706/prioritisation-of-specialist-health-care-services-not-nice-not-easy-but-it-can-be-done
#18
Pippa Anderson, Philip Webb, Sam Groves
The challenges of delivering healthcare within budget constraints are ever present. Highly specialised technologies (HSTs) have high costs of provision inevitably contributing to NHS cost pressures. Between 2012-2015 the Welsh Health Specialised Services Committee (WHSSC) developed prioritisation methods to make recommendations for HST funding in Wales. Methods adapted as the process continued but was always evidence based and supported by a prioritisation panel of stakeholders. Methods changed from discreet choice to the Portsmouth Score Card, a simple multi-criteria decision analysis (MCDA) method...
September 2017: Health Policy
https://www.readbyqxmd.com/read/28796898/comparison-of-the-levonorgestrel-releasing-intrauterine-system-hysterectomy-and-endometrial-ablation-for-heavy-menstrual-bleeding-in-a-decision-analysis-model
#19
REVIEW
Michelle Louie, Jennifer Spencer, Stephanie Wheeler, Victoria Ellis, Tarek Toubia, Lauren D Schiff, Matthew T Siedhoff, Janelle K Moulder
BACKGROUND: A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. OBJECTIVES: To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. SEARCH STRATEGY: A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years...
August 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28772164/multiple-criteria-decision-analysis-mcda-for-evaluating-new-medicines-in-health-technology-assessment-and-beyond-the-advance-value-framework
#20
Aris Angelis, Panos Kanavos
Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model...
September 2017: Social Science & Medicine
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