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12 records – page 1 of 2.

A cost-effectiveness analysis of screening for silent atrial fibrillation after ischaemic stroke.

https://arctichealth.org/en/permalink/ahliterature267230
Source
Europace. 2015 Feb;17(2):207-14
Publication Type
Article
Date
Feb-2015
Author
Lars-Åke Levin
Magnus Husberg
Piotr Doliwa Sobocinski
Viveka Frykman Kull
Leif Friberg
Mårten Rosenqvist
Thomas Davidson
Source
Europace. 2015 Feb;17(2):207-14
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Aged
Asymptomatic Diseases
Atrial Fibrillation - complications - diagnosis - economics
Brain Ischemia - diagnosis - etiology
Cost-Benefit Analysis
Electrocardiography - economics
Electrocardiography, Ambulatory - economics
Humans
Markov Chains
Mass Screening - economics
Quality-Adjusted Life Years
Secondary Prevention - economics
Stroke - diagnosis - economics - etiology
Sweden
Abstract
The purpose of this study was to estimate the cost-effectiveness of two screening methods for detection of silent AF, intermittent electrocardiogram (ECG) recordings using a handheld recording device, at regular time intervals for 30 days, and short-term 24 h continuous Holter ECG, in comparison with a no-screening alternative in 75-year-old patients with a recent ischaemic stroke.
The long-term (20-year) costs and effects of all alternatives were estimated with a decision analytic model combining the result of a clinical study and epidemiological data from Sweden. The structure of a cost-effectiveness analysis was used in this study. The short-term decision tree model analysed the screening procedure until the onset of anticoagulant treatment. The second part of the decision model followed a Markov design, simulating the patients' health states for 20 years. Continuous 24 h ECG recording was inferior to intermittent ECG in terms of cost-effectiveness, due to both lower sensitivity and higher costs. The base-case analysis compared intermittent ECG screening with no screening of patients with recent stroke. The implementation of the screening programme on 1000 patients resulted over a 20-year period in 11 avoided strokes and the gain of 29 life-years, or 23 quality-adjusted life years, and cost savings of €55 400.
Screening of silent AF by intermittent ECG recordings in patients with a recent ischaemic stroke is a cost-effective use of health care resources saving costs and lives and improving the quality of life.
PubMed ID
25349228 View in PubMed
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Cost-effectiveness of dabigatran compared with warfarin for patients with atrial fibrillation in Sweden.

https://arctichealth.org/en/permalink/ahliterature123099
Source
Eur Heart J. 2013 Jan;34(3):177-83
Publication Type
Article
Date
Jan-2013
Author
Thomas Davidson
Magnus Husberg
Magnus Janzon
Jonas Oldgren
Lars-Åke Levin
Author Affiliation
Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linköping SE-581 83, Sweden. thomas.davidson@liu.se
Source
Eur Heart J. 2013 Jan;34(3):177-83
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - economics - therapeutic use
Atrial Fibrillation - drug therapy - economics
Benzimidazoles - economics - therapeutic use
Cost-Benefit Analysis
Drug Costs
Humans
Life expectancy
Quality-Adjusted Life Years
Stroke - economics - prevention & control
Sweden
Warfarin - economics - therapeutic use
beta-Alanine - analogs & derivatives - economics - therapeutic use
Abstract
Patients with atrial fibrillation have a significantly increased risk of thromboembolic events such as ischaemic stroke, and patients are therefore recommended to be treated with anticoagulation treatment. The most commonly used anticoagulant consists of vitamin K antagonist such as warfarin. A new oral anticoagulation treatment, dabigatran, has recently been approved for stroke prevention among patients with atrial fibrillation. The purpose of this study was to estimate the cost-effectiveness of dabigatran as preventive treatment of stroke and thromboembolic events compared with warfarin in 65-year-old patients with atrial fibrillation in Sweden.
A decision analytic simulation model was used to estimate the long-term (20-year) costs and effects of the different treatments. The outcome measures are the number of strokes prevented, life years gained, and quality-adjusted life years (QALYs) gained. Costs and effect data are adjusted to a Swedish setting. Patients below 80 years of age are assumed to start with dabigatran 150 mg twice a day and switch to 110 mg twice a day at the age of 80 years due to higher bleeding risk. The price of dabigatran in Sweden is €2.82 (Swedish kronor 25.39) per day for both doses. The cost per QALY gained for dabigatran compared with warfarin is estimated at €7742, increasing to €12 449 if dabigatran is compared with only well-controlled warfarin treatment.
Dabigatran is a cost-effective treatment in Sweden, as its incremental cost-effectiveness ratio is below the normally accepted willingness to pay limit.
Notes
Comment In: Eur Heart J. 2013 Jan;34(3):166-722809680
PubMed ID
22733833 View in PubMed
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The cost-effectiveness of introducing nucleic acid testing to test for hepatitis B, hepatitis C, and human immunodeficiency virus among blood donors in Sweden.

https://arctichealth.org/en/permalink/ahliterature140718
Source
Transfusion. 2011 Feb;51(2):421-9
Publication Type
Article
Date
Feb-2011
Author
Thomas Davidson
Bengt Ekermo
Hans Gaines
Birgitta Lesko
Britt Åkerlind
Author Affiliation
Center for Medical Technology Assessment, Department of Clinical and Experimental Medicine, Linköping University, Sweden. Thomas.Davidson@liu.se
Source
Transfusion. 2011 Feb;51(2):421-9
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Viral - blood
Blood Donors
Blood Safety - economics - methods
Blood Transfusion - economics
Cost-Benefit Analysis
DNA, Viral - blood
Female
HIV - genetics - immunology - isolation & purification
HIV Infections - diagnosis - economics - epidemiology - prevention & control - virology
Hepacivirus - genetics - immunology - isolation & purification
Hepatitis B - diagnosis - economics - epidemiology - prevention & control - virology
Hepatitis B virus - genetics - immunology - isolation & purification
Hepatitis C - diagnosis - economics - epidemiology - prevention & control - virology
Humans
Infant, Newborn
Male
Mass Screening - economics - methods
Nucleic Acid Amplification Techniques - economics
Pregnancy
Quality-Adjusted Life Years
RNA, Viral - blood
Serologic Tests - economics
Sweden - epidemiology
Abstract
The purpose of this study was to estimate the cost-effectiveness of using individual-donor nucleic acid testing (ID-NAT) in addition to serologic tests compared with the sole use of serologic tests for the identification of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in Sweden.
The two strategies analyzed were serologic tests and ID-NAT plus serologic tests. A health-economic model was used to estimate the lifetime costs and effects. The effects were measured as infections avoided and quality-adjusted life-years (QALYs) gained. A societal perspective was used.
The largest number of viral transmissions occurred with serologic testing only. However, the risks for viral transmissions were very low with both strategies. The total cost was mainly influenced by the cost of the test carried out. The cost of using ID-NAT plus serologic tests compared to serologic tests alone was estimated at Swedish Krona (SEK) 101 million (USD 12.7 million) per avoided viral transmission. The cost per QALY gained was SEK 22 million (USD 2.7 million).
Using ID-NAT for testing against HBV, HCV, and HIV among blood donors leads to cost-effectiveness ratios that are far beyond what is usually considered cost-effective. The main reason for this is that with current methods, the risks for virus transmission are very low in Sweden.
PubMed ID
20849409 View in PubMed
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Costs and health-related quality of life in relation to caries.

https://arctichealth.org/en/permalink/ahliterature310054
Source
BMC Oral Health. 2019 08 16; 19(1):187
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-16-2019
Author
Lisa Kastenbom
Alexandra Falsen
Pernilla Larsson
Karin Sunnegårdh-Grönberg
Thomas Davidson
Author Affiliation
Department of Odontology, University of Umeå, Umeå, Sweden. lisa.kastenbom@umu.se.
Source
BMC Oral Health. 2019 08 16; 19(1):187
Date
08-16-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Cost of Illness
Dental Caries - complications - economics
Health
Health status
Humans
Middle Aged
Quality of Life
Sweden
Young Adult
Abstract
Dental caries remains a common and expensive disease for both society and affected individuals. Furthermore, caries often affect individuals' health-related quality of life (HRQoL). Health economic evaluations are needed to understand how to efficiently distribute dental care resources. This study aims to evaluate treatment costs and QALY weights for caries active and inactive adult individuals, and to test whether the generic instrument EQ-5D-5?L can distinguish differences in this population.
A total of 1200 randomly selected individuals from dental clinics in Västerbotten County, Sweden, were invited to participate. Of these, 79 caries active and 179 caries inactive patients agreed to participate (response rate of 21.7%). Inclusion criteria were participants between 20 and 65?years old and same caries risk group categorization in two consecutive check-ups between 2014 and 2017.
Treatment costs showed to be twice as high in the caries active group compared to the caries inactive group and were three times higher in the caries active age group 20-29 compared to the caries inactive age group 20-29. Differences between the groups was found for number of intact teeth according to age groups. In the EQ-5D-5?L instrument, more problems relating to the dimension anxiety/depression was seen in the caries active group. QALY weights showed tendencies (non-significant) to be lower in the caries active group.
These findings highlight the need for efficient treatments and prevention strategies as well as adequate money allocation within dentistry. However, further research is needed to assess appropriate instruments for health economic evaluations.
PubMed ID
31419988 View in PubMed
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Economic evaluation of an expanded caries-preventive program targeting toddlers in high-risk areas in Sweden.

https://arctichealth.org/en/permalink/ahliterature301590
Source
Acta Odontol Scand. 2019 May; 77(4):303-309
Publication Type
Journal Article
Date
May-2019
Author
Maria Anderson
Thomas Davidson
Göran Dahllöf
Margaret Grindefjord
Author Affiliation
a Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden.
Source
Acta Odontol Scand. 2019 May; 77(4):303-309
Date
May-2019
Language
English
Publication Type
Journal Article
Keywords
Cariostatic Agents - economics
Child
Child, Preschool
Cost-Benefit Analysis
Dental Care - economics - statistics & numerical data
Dental Caries - economics - prevention & control
Female
Fluorides, Topical - economics - therapeutic use
Humans
Male
Oral Health - economics - statistics & numerical data
Oral Hygiene - economics
Pit and Fissure Sealants - economics - therapeutic use
Preventive Health Services
Randomized Controlled Trials as Topic
State Medicine - economics
Sweden
Abstract
To economically evaluate a caries-preventive program "Stop Caries Stockholm" (SCS) where a standard program is supplemented with biannual applications of fluoride varnish in toddlers and compared it with the standard preventive program.
Data from the cluster randomized controlled field trial SCS including 3403 children, conducted in multicultural areas with low socioeconomic status was used. The difference in mean caries increment between the examinations; when the toddlers were 1 and 3 years old, was outcome measure of the intervention. The program was evaluated from a societal as well as a dental health care perspective. The incremental cost-effectiveness ratio (ICER) was calculated as the incremental cost for each defs prevented.
Average dental health care costs per child at age 3 years were EUR 95.77 for the supplemental intervention and EUR 70.52 for the standard intervention. The ICER was EUR 280.56 from a dental health care perspective and EUR 468.67 and considered high.
The supplemental caries intervention program was not found to be cost-effective. The program raised costs without significantly reducing caries development. A better alternative use of the resources is recommended.
www.controlled-trials.com (ISRCTN35086887).
PubMed ID
30636456 View in PubMed
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The impact of health economic evaluations in Sweden.

https://arctichealth.org/en/permalink/ahliterature266499
Source
Z Evid Fortbild Qual Gesundhwes. 2014;108(7):375-82
Publication Type
Article
Date
2014
Author
Emelie Heintz
Karl Arnberg
Lars-Åke Levin
Jan Liliemark
Thomas Davidson
Source
Z Evid Fortbild Qual Gesundhwes. 2014;108(7):375-82
Date
2014
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis - economics
Cross-Cultural Comparison
Decision Making, Organizational
Delivery of Health Care - economics
Forecasting
Health Priorities - economics
Health Resources - economics - trends
Humans
Insurance, Dental - economics - trends
Insurance, Pharmaceutical Services - economics - trends
National Health Programs - economics
Reimbursement Mechanisms - economics - trends
Sweden
Abstract
The responsibility for healthcare in Sweden is shared by the central government, county councils and municipalities. The counties and municipalities are free to make their own prioritizations within the framework of the state healthcare laws. To guide prioritization of healthcare resources in Sweden, there is consensus that cost-effectiveness constitutes one of the three principles. The objective of this paper is to describe how cost-effectiveness, and hence health economic evaluations (HEE), have a role in pricing decisions, reimbursement of pharmaceuticals as well as the overall prioritization and allocation of resources in the Swedish healthcare system. There are various organizations involved in the processes of implementing health technologies in the Swedish healthcare system, several of which consider or produce HEEs when assessing different technologies: the Dental and Pharmaceutical Benefits Agency (TLV), the county councils' group on new drug therapies (NLT), the National Board of Health and Welfare, the Swedish Council on Health Technology Assessment (SBU), regional HTA agencies and the Public Health Agency of Sweden. The only governmental agency that has official and mandatory guidelines for how to perform HEE is TLV (LFNAR 2003:2). Even though HEEs may seem to have a clear and explicit role in the decision-making processes in the Swedish healthcare system, there are various obstacles and challenges in the use and dissemination of the results.
PubMed ID
25444295 View in PubMed
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The national program on standardized cancer care pathways in Sweden: Observations and findings half way through.

https://arctichealth.org/en/permalink/ahliterature297585
Source
Health Policy. 2018 Sep; 122(9):945-948
Publication Type
Evaluation Studies
Journal Article
Date
Sep-2018
Author
Ingrid Schmidt
Johan Thor
Thomas Davidson
Fredrik Nilsson
Christina Carlsson
Author Affiliation
Department of Evaluation and Analysis, System Analysis Unit, The National Board of Health and Welfare, Rålambsvägen 3, S-10630 Stockholm, Sweden. Electronic address: Ingrid.schmidt@socialstyrelsen.se.
Source
Health Policy. 2018 Sep; 122(9):945-948
Date
Sep-2018
Language
English
Publication Type
Evaluation Studies
Journal Article
Keywords
Comorbidity
Delivery of Health Care - methods - organization & administration
Humans
Medical Oncology - methods - organization & administration
National Health Programs
Patient satisfaction
Primary Health Care
Sweden
Time-to-Treatment - statistics & numerical data
Abstract
In 2015, the Swedish government initiated a national cancer reform program to standardize cancer care pathways. Primary aims included shortened waiting times among patients with suspected cancer, increased patient satisfaction and reduced regional variation. The implementation phase of the program is now more than half way through and both achievements and challenges have been identified. The ongoing evaluation demonstrates that professional engagement and adjustments on the meso- and micro-level of the system are essential to achieving sustainable improvements. Waiting times have shortened for the pathways launched first, and patients are satisfied with a more transparent process. Physicians in primary care are satisfied to inform patients about the pathways but point out problems with comorbidity and complicated diagnostic procedures related to unspecific symptoms. Mechanisms and ethical considerations behind possible crowding-out effects need to be thoroughly highlighted and discussed with staff and management. The results so far appear promising but meso- and micro-levels of the system need to be more involved in the design processes.
PubMed ID
30075866 View in PubMed
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[New national guidelines for the treatment of schizophrenia in Sweden].

https://arctichealth.org/en/permalink/ahliterature299579
Source
Lakartidningen. 2019 01 28; 116:
Publication Type
Journal Article
Date
01-28-2019
Author
Sofia von Malortie
Ellinor Cronqvist
Gunilla Ringbäck
Lena Flyckt
Karin Bodlund
Mussie Msghina
David Rosenberg
Thomas Davidson
Author Affiliation
Socialstyrelsen - Stockholm, Sweden Socialstyrelsen - Stockholm, Sweden.
Source
Lakartidningen. 2019 01 28; 116:
Date
01-28-2019
Language
Swedish
Publication Type
Journal Article
Keywords
Antipsychotic Agents - therapeutic use
Humans
Physician's Role
Practice Guidelines as Topic
Psychiatric Rehabilitation
Schizophrenia - therapy
Sweden
Abstract
Schizophrenia affects about 0.7 % of the population and is characterized by hallucinations, delusions and reduced functioning affecting the ability to study, work and socialize. Life expectancy for patients with schizophrenia is approximately 15-20 years shorter mostly due to cardiovascular disease. Stigmatization is  common despite the fact that it is a treatable disorder with a combination of medication and psychosocial interventions. Case management, psycho-education and supported employment are proven strategies, but less than half of individuals with schizophrenia are adequately treated. The National Board of Health and Welfare is currently launching updated National Guidelines (2018). The aim is to provide an overview of evidence-based interventions enabling patients with schizophrenia to live a fairly normal life. An evaluation has revealed that previous guidelines for antipsychotic medications have been satisfactorily implemented, but not those for psychosocial interventions. These will now be emphasized as »central recommendations« and will be followed up with specific indicators based on data from national registers.
PubMed ID
30694520 View in PubMed
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Point-of-care monitoring of warfarin treatment in community dwelling elderly--A randomised controlled study.

https://arctichealth.org/en/permalink/ahliterature278738
Source
J Telemed Telecare. 2015 Jul;21(5):298-301
Publication Type
Article
Date
Jul-2015
Author
Thomas Davidson
Ann Lindelöf
Torbjörn Wallén
Tomas L Lindahl
Claes Hallert
Source
J Telemed Telecare. 2015 Jul;21(5):298-301
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Drug Monitoring - methods
Female
Health Care Costs
Health status
Humans
Male
Point-of-Care Systems - economics - standards
Prospective Studies
Quality of Life
Sweden
Warfarin - therapeutic use
Abstract
The objective of this study was to assess clinical effectiveness and costs of launching point-of-care monitoring of warfarin treatment in community dwelling frail elderly patients. A prospective multicentre controlled randomised study over 12 months comparing a point-of-care strategy with usual monitoring routines was carried out in primary healthcare centres and anticoagulation clinics in southeast Sweden. The subjects were community dwelling elderly across rural southeast Sweden on chronic warfarin treatment. Main outcome measures were time in therapeutic range (TTR), rate of treatment-related adverse events and costs. The study comprised 103 elderly people (61% women) mean age 86 yrs (range 75-98) treated with warfarin for median 9 yrs (range 1-18). Patients randomised to start point-of-care monitoring (n?=?55) showed 75.9% in TTR before trial vs. 72.6% during trial (ns). The patients randomised to continue on usual monitoring routines (n?=?48) showed 75.2% in TTR prior to trial vs. 72.9% during trial (ns). The point-of-care monitoring showed potential savings of SEK 624 per patient annually (based partly on effects that were not statistically significant). The study shows that point-of-care monitoring of warfarin treatment in community dwelling elderly in rural areas is as effective as usual monitoring routines and that it may offer savings to society.
PubMed ID
25766854 View in PubMed
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Pulp exposures in adults--choice of treatment among Swedish dentists.

https://arctichealth.org/en/permalink/ahliterature105611
Source
Swed Dent J. 2013;37(3):153-60
Publication Type
Article
Date
2013
Author
Fredrik Frisk
Thomas Kvist
Susanna Axelsson
Gunnar Bergenholtz
Thomas Davidson
Ingegerd Mejare
Anders Norlund
Arne Petersson
Hans Sandberg
Sofia Tranaeus
Magnus Hakeberg
Author Affiliation
The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Source
Swed Dent J. 2013;37(3):153-60
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Chi-Square Distribution
Dental Pulp Capping - statistics & numerical data
Dental Pulp Exposure - therapy
Dentist's Practice Patterns - statistics & numerical data
Female
Guideline Adherence
Humans
Logistic Models
Male
Middle Aged
Pulpectomy - statistics & numerical data
Pulpotomy - statistics & numerical data
Questionnaires
Root Canal Obturation - statistics & numerical data
Specialty Boards
Sweden
Young Adult
Abstract
This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
PubMed ID
24341168 View in PubMed
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12 records – page 1 of 2.