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"Decision analysis"

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https://www.readbyqxmd.com/read/28321120/decision-analysis-of-allogeneic-hematopoietic-stem-cell-transplantation-for-patients-with-myelodysplastic-syndrome-stratified-according-to-the-revised-international-prognostic-scoring-system-ipss-r
#1
M G Della Porta, C H Jackson, E P Alessandrino, M Rossi, A Bacigalupo, M T van Lint, M Bernardi, B Allione, A Bosi, S Guidi, V Santini, L Malcovati, M Ubezio, C Milanesi, E Todisco, M T Voso, P Musto, F Onida, A P Iori, R Cerretti, G Grillo, A Molteni, P Pioltelli, L Borin, E Angelucci, E Oldani, S Sica, C Pascutto, V Ferretti, A Santoro, F Bonifazi, M Cazzola, A Rambaldi
Allogeneic hematopoietic stem cell transplantation (allo-SCT) represents the only curative treatment for patients with myelodysplastic syndrome (MDS), but involves non-negligible morbidity and mortality. Crucial questions in clinical decision making include the definition of optimal timing of the procedure and the benefit of cytoreduction before transplant in high risk patients. We carried out a decision analysis on 1728 MDS who received supportive care, transplantation or hypomethylating agents (HMAs). Risk assessment was based on the revised International Prognostic Scoring System (IPSS-R)...
March 21, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28298450/cost-effectiveness-study-of-criteria-to-screen-herpes-simplex-pcr-tests-from-cerebrospinal-fluid
#2
Ronald G Hauser, Sheldon M Campbell, Cynthia A Brandt, Shiyi Wang
Background: The absence of markers of inflammation in the cerebrospinal fluid (CSF) commonly predict the absence of herpes simplex virus (HSV) central nervous system (CNS) infection. Consequently, multiple authors have proposed and validated criteria to defer HSV PCR tests from CSF in immune competent hosts with normal CSF white cells and protein (≤5 cells/mm(3), ≤50 mg/dL, respectively). Immune competence equates to age ≥2 years without HIV or transplant. Adoption of the criteria may erroneously exclude HSV infected persons from a necessary diagnostic test, or alternatively, reduce the costs associated with HSV tests with minimal to no effect on patient care...
March 15, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28298052/allograft-augmentation-of-hamstring-autograft-for-younger-patients-undergoing-anterior-cruciate-ligament-reconstruction
#3
Cale A Jacobs, Jeremy M Burnham, Eric Makhni, Chaitu S Malempati, Eric Swart, Darren L Johnson
BACKGROUND: Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. HYPOTHESIS: Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure...
March 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28292498/treacle-and-smallpox-two-tests-for-multicriteria-decision-analysis-models-in-health-technology-assessment
#4
Alec Morton
Multicriteria decision analysis (MCDA) is rightly receiving increasing attention in health technology assessment. Nevertheless, a distinguishing feature of the health domain is that technologies must actually improve health, and good performance on other criteria cannot compensate for failure to do so. We argue for two reasonable tests for MCDA models: the treacle test (can a winning intervention be incompletely ineffective?) and the smallpox test (can a winning intervention be for a disease that no one suffers from?)...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28286136/is-a-positive-developmental-behavioral-screening-score-sufficient-to-justify-referral-a-review-of-evidence-and-theory
#5
R Christopher Sheldrick, Daryl Garfinkel
In their recommendations on screening for autism and developmental disabilities, the American Academy of Pediatrics recommends referral subsequent to a positive screening result. In this paper, we argue that positive screening results are not always sufficient to justify a referral. We demonstrate that while positive predictive values are often low, they actually overstate the probability of having a disorder for many children who screen positive. Moreover, recommended screening thresholds are seldom set to ensure that the benefits of referral will equal or exceed the costs and risk of harm, which is a necessary condition for an optimal threshold in the field of decision analysis...
March 7, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#6
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28280653/microvascular-decompression-versus-stereotactic-radiosurgery-for-trigeminal-neuralgia-a-decision-analysis
#7
Ian Berger, Nikhil Nayak, James Schuster, John Lee, Sherman Stein, Neil R Malhotra
INTRODUCTION:  Both microvascular decompression (MVD) and stereotactic radiosurgery (SRS) have been demonstrated to be effective in treating medically refractory trigeminal neuralgia. However, there is controversy over which one offers more durable pain relief and the patient selection for each treatment. We used a decision analysis model to calculate the health-related quality of life (QOL) for each treatment. METHODS:  We searched PubMed and the Cochrane Database of Systematic Reviews for relevant articles on MVD or SRS for trigeminal neuralgia published between 2000 and 2015...
January 26, 2017: Curēus
https://www.readbyqxmd.com/read/28256925/markov-chain-decision-model-for-urinary-incontinence-procedures
#8
Sameer Kumar, Nidhi Ghildayal, Neha Ghildayal
Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective...
March 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28237866/cost-effectiveness-of-capecitabine-and-bevacizumab-maintenance-treatment-after-first-line-induction-treatment-in-metastatic-colorectal-cancer
#9
M D Franken, E M van Rooijen, A M May, H Koffijberg, H van Tinteren, L Mol, A J Ten Tije, G J Creemers, A M T van der Velden, B C Tanis, C A Uyl-de Groot, C J A Punt, M Koopman, M G H van Oijen
AIM: Capecitabine and bevacizumab (CAP-B) maintenance therapy has shown to be more effective compared with observation in metastatic colorectal cancer patients achieving stable disease or better after six cycles of first-line capecitabine, oxaliplatin, bevacizumab treatment in terms of progression-free survival. We evaluated the cost-effectiveness of CAP-B maintenance treatment. METHODS: Decision analysis with Markov modelling to evaluate the cost-effectiveness of CAP-B maintenance compared with observation was performed based on CAIRO3 study results (n = 558)...
February 23, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28237205/value-assessment-frameworks-for-hta-agencies-the-organization-of-evidence-informed-deliberative-processes
#10
Rob Baltussen, Maarten Paul Maria Jansen, Leon Bijlmakers, Janneke Grutters, Anouck Kluytmans, Rob P Reuzel, Marcia Tummers, Gert Jan van der Wilt
Priority setting in health care has been long recognized as an intrinsically complex and value-laden process. Yet, health technology assessment agencies (HTAs) presently employ value assessment frameworks that are ill fitted to capture the range and diversity of stakeholder values and thereby risk compromising the legitimacy of their recommendations. We propose "evidence-informed deliberative processes" as an alternative framework with the aim to enhance this legitimacy. This framework integrates two increasingly popular and complementary frameworks for priority setting: multicriteria decision analysis and accountability for reasonableness...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28237201/developing-a-value-framework-the-need-to-reflect-the-opportunity-costs-of-funding-decisions
#11
Mark Sculpher, Karl Claxton, Steven D Pearson
A growing number of health care systems internationally use formal economic evaluation methods to support health care funding decisions. Recently, a range of organizations have been advocating forms of analysis that have been termed "value frameworks." There has also been a push for analytical methods to reflect a fuller range of benefits of interventions through multicriteria decision analysis. A key principle that is invariably neglected in current and proposed frameworks is the need to reflect evidence on the opportunity costs that health systems face when making funding decisions...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28236291/prioritizing-of-bacterial-infections-transmitted-through-substances-of-human-origin-in-europe
#12
Dragoslav Domanović, Alessandro Cassini, Isabelle Bekeredjian-Ding, Arlinke Bokhorst, Martijn Bouwknegt, Giuseppina Facco, George Galea, Paolo Grossi, Ramadan Jashari, Christoph Jungbauer, Jan Marcelis, Ioana Raluca-Siska, Inger Andersson-Vonrosen, Jonathan E Suk
BACKGROUND: Bacteria are the pathogens most frequently transmitted through substances of human origin (SoHO). The European Centre for Disease Prevention and Control (ECDC) organized an expert consultation, with the objective of developing a priority list of bacterial pathogens transmissible via SoHO. The list will be used to further assess risks and determine appropriate preventive measures. STUDY DESIGN AND METHODS: The 14 most frequently SoHO-transmitted bacteria identified through a scoping literature review were then prioritized during an expert workshop through a methodology based on multicriteria decision analysis...
February 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28235415/a-systematic-review-of-health-economic-models-of-opioid-agonist-therapies-in-maintenance-treatment-of-non-prescription-opioid-dependence
#13
Mersha Chetty, James J Kenworthy, Sue Langham, Andrew Walker, William C N Dunlop
BACKGROUND: Opioid dependence is a chronic condition with substantial health, economic and social costs. The study objective was to conduct a systematic review of published health-economic models of opioid agonist therapy for non-prescription opioid dependence, to review the different modelling approaches identified, and to inform future modelling studies. METHODS: Literature searches were conducted in March 2015 in eight electronic databases, supplemented by hand-searching reference lists and searches on six National Health Technology Assessment Agency websites...
February 24, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28229209/cost-effective-management-of-pelvic-fracture-urethral-injuries
#14
Niels V Johnsen, David F Penson, W Stuart Reynolds, Douglas F Milam, Roger R Dmochowski, Melissa R Kaufman
PURPOSE: To compare the cost-effectiveness of various treatment strategies in the management of pelvic fracture urethral injuries using decision analysis. METHODS: Five strategies were modeled from the time of injury to resolution of obstructed voiding or progression to urethroplasty. Management consisted of immediate suprapubic tube (SPT) placement and delayed urethroplasty; primary endoscopic realignment (PER) followed by urethroplasty in failed patients; or PER followed by 1-3 direct vision internal urethrotomies (DVIU), followed by urethroplasty...
February 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28225651/robotic-surgery-a-solution-in-search-of-a-problem-a-bayesian-analysis-of-343-robotic-procedures-performed-by-a-single-surgical-team
#15
Simona Manciu, Mihnea Dragomir, Fabiana Curea, Catalin Vasilescu
BACKGROUND: Despite the obvious technical advantages, the value of robotic surgery is highly debated and its cost-effectiveness has been questioned. The aim of this article is to provide an evaluation of the outcomes of robotic surgery in comparison to conventional laparoscopy. METHODS: A decision analysis based on the Bayes' theorem and the decision tree was used. The robotic approach was compared with the laparoscopic approach for each of the pathologies discussed in this study...
February 22, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28221673/breast-cancer-prevention-strategies-in-lobular-carcinoma-in-situ-a-decision-analysis
#16
Stephanie M Wong, Natasha K Stout, Rinaa S Punglia, Ipshita Prakash, Yasuaki Sagara, Mehra Golshan
BACKGROUND: Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. METHODS: A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies...
February 21, 2017: Cancer
https://www.readbyqxmd.com/read/28214469/cost-benefit-analysis-of-chlamydia-trachomatis-screening-in-pregnant-women-in-a-high-burden-setting-in-the-united-states
#17
Jared Ditkowsky, Khushal H Shah, Margaret R Hammerschlag, Stephan Kohlhoff, Tamar A Smith-Norowitz
BACKGROUND: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in the United States (U.S.) [1] and remains a major public health problem. We determined the cost- benefit of screening all pregnant women aged 15-24 for Chlamydia trachomatis infection compared with no screening. METHODS: We developed a decision analysis model to estimate costs and health-related effects of screening pregnant women for C. trachomatis in a high burden setting (Brooklyn, NY)...
February 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28212954/evaluation-of-copd-treatments-a-multicriteria-decision-analysis-of-aclidinium-and-tiotropium-in-the-united-states
#18
Kevin Marsh, Erica Zaiser, Panagiotis Orfanos, Suzanne Salverda, Teresa Wilcox, Shawn Sun, Shailja Dixit
BACKGROUND: Comparisons of the use of aclidinium bromide and tiotropium bromide for the treatment of chronic obstructive pulmonary disease often concentrate on key end points (exacerbations) at the expense of other benefits and risks. Multicriteria decision analysis (MCDA) can help overcome this by using stakeholder preferences to combine multiple end points into an overall value estimate. OBJECTIVES: To evaluate the use of aclidinium bromide twice daily via Pressair™ (AstraZeneca Pharmaceuticals LP, Wilmington, DE) and of tiotropium once daily via HandiHaler(®) (Boehringer Ingelheim Pharmaceuticals, Inc...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28210655/cost-of-outpatient-arthroscopic-anterior-cruciate-ligament-reconstruction-among-commercially-insured-patients-in-the-united-states-2005-2013
#19
Mackenzie M Herzog, Stephen W Marshall, Jennifer L Lund, Virginia Pate, Jeffrey T Spang
BACKGROUND: Despite the significance of anterior cruciate ligament (ACL) injuries, these conditions have been under-researched from a population-level perspective. It is important to determine the economic effect of these injuries in order to document the public health burden in the United States. PURPOSE: To describe the cost of outpatient arthroscopic ACL reconstruction and health care utilization among commercially insured beneficiaries in the United States. STUDY DESIGN: Economic and decision analysis; Level of evidence, 3...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28207981/a-multiparametric-magnetic-resonance-imaging-based-risk-model-to-determine-the-risk-of-significant-prostate-cancer-prior-to-biopsy
#20
Pim J van Leeuwen, Andrew Hayen, James E Thompson, Daniel Moses, Ron Shnier, Maret Böhm, Magdaline Abuodha, Anne-Maree Haynes, Francis Ting, Jelle Barentsz, Monique Roobol, Justin Vass, Krishan Rasiah, Warick Delprado, Phillip D Stricker
OBJECTIVES: To develop and externally validate a predictive model for detection of significant prostate cancer (PC). SUBJECTS AND METHODS: Development of the model was based on prospective cohort including 393 men who underwent mpMRI prior to biopsy. External validity of the model was then examined retrospectively in 198 men from a separate institution whom underwent a mpMRI followed by biopsy for abnormal PSA/DRE. A model was developed with age, PSA, DRE, prostate volume, previous biopsy and PIRADS score as predictors for significant PC (Gleason 7 with >5% grade 4, ≥ 20% cores positive or ≥ 7mm of PC in any core)...
February 16, 2017: BJU International
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