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371 records – page 1 of 38.

The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with Type 2 diabetes detected by screening.

https://arctichealth.org/en/permalink/ahliterature47804
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Publication Type
Article
Date
Sep-2000
Author
T. Lauritzen
S. Griffin
K. Borch-Johnsen
N J Wareham
B H Wolffenbuttel
G. Rutten
Author Affiliation
Department of General Practice, University of Aarhus, Denmark.
Source
Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Cost-Benefit Analysis
Denmark - epidemiology
Diabetes Mellitus, Type 2 - diagnosis - economics - epidemiology - therapy
England - epidemiology
Female
Humans
Hyperglycemia - complications - economics - therapy
Intervention Studies
Male
Mass Screening - economics
Middle Aged
Multicenter Studies
Netherlands - epidemiology
Practice Guidelines
Prevalence
Primary Health Care - economics
Randomized Controlled Trials - methods
Risk factors
Vascular Diseases - etiology - mortality - therapy
Abstract
OBJECTIVE: The overall aims of the ADDITION study are to evaluate whether screening for prevalent undiagnosed Type 2 diabetes is feasible, and whether subsequent optimised intensive treatment of diabetes, and associated risk factors, is feasible and beneficial. DESIGN: Population-based screening in three European countries followed by an open, randomised controlled trial. SUBJECTS AND METHODS: People aged 40-69 y in the community, without known diabetes, will be offered a random capillary blood glucose screening test by their primary care physicians, followed, if equal to or greater than 5.5 mmol/l, by fasting and 2-h post-glucose-challenge blood glucose measurements. Three thousand newly diagnosed patients will subsequently receive conventional treatment (according to current national guidelines) or intensive multifactorial treatment (lifestyle advice, prescription of aspirin and ACE-inhibitors, in addition to protocol-driven tight control of blood glucose, blood pressure and cholesterol). Patients allocated to intensive treatment will be further randomised to centre-specific interventions to motivate adherence to lifestyle changes and medication. Duration of follow-up is planned for 5 y. Endpoints will include mortality, macrovascular and microvascular complications, patient health status and satisfaction, process-of-care indicators and costs.
PubMed ID
11063279 View in PubMed
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[Adrenal cortex hyperplasia in newborn infants. Promising results after screening]

https://arctichealth.org/en/permalink/ahliterature59956
Source
Lakartidningen. 1989 Mar 29;86(13):1151
Publication Type
Article
Date
Mar-29-1989
Author
O. Westphal
Source
Lakartidningen. 1989 Mar 29;86(13):1151
Date
Mar-29-1989
Language
Swedish
Publication Type
Article
Keywords
Adrenal Hyperplasia, Congenital - epidemiology - psychology
Humans
Infant, Newborn
Mass Screening - economics
Sweden
PubMed ID
2704265 View in PubMed
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Advanced cutaneous malignant melanoma: a systematic review of economic and quality-of-life studies.

https://arctichealth.org/en/permalink/ahliterature157950
Source
Value Health. 2008 Mar-Apr;11(2):259-71
Publication Type
Article
Author
Richard P Cashin
Philip Lui
Márcio Machado
Michiel E H Hemels
Patricia K Corey-Lisle
Thomas R Einarson
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Source
Value Health. 2008 Mar-Apr;11(2):259-71
Language
English
Publication Type
Article
Keywords
Antineoplastic Agents - economics - therapeutic use
Canada
Cost-Benefit Analysis
Humans
Mass Screening - economics
Melanoma - diagnosis - drug therapy - economics - secondary
Neoplasm Metastasis
Palliative Care
Quality of Life
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic - economics
Skin Neoplasms - diagnosis - drug therapy - economics - pathology
United States
Abstract
Metastatic melanoma (MM), a major concern for health-care providers, is increasing. We systematically reviewed published articles describing the impact of interventions (drugs and screening) on quality of life (QoL) in patients with MM, and articles that measured QoL in MM.
We searched secondary databases including MEDLINE, Embase, CINAHL, Cochrane, and DARE from inception to 2006 using MESH terms "melanoma" and "metastases." Economic articles were subject to established quality assessment procedures.
We found 13 QoL and five economic studies (three cost-effectiveness, two cost-utility; average quality = 83% +/- 7%). No strong evidence was found in this review for cost-effectiveness of interferons in Canada (incremental cost-effectiveness ratio [ICER] = $55,090/quality-adjusted life-year) or temozolomide in the United States (ICER = $36,990/Life-year gained based on nonsignificant efficacy differences). Melanoma screening was not cost-effective in the United States ($150,000-931,000/life-saved) or Germany (no survival benefit). From the 13 QoL studies,eight measured baseline QoL; six studied the same population, generating similar results using different approaches/outcomes. Tools used included GLQ-8, QLQ-C30, QLQ-36, QWB-SA, and SF-36. Baseline scores QoL scores ranged from 0.60 to 0.69. Another five studies (N = 959 patients) were randomized trials analyzing QoL in patients treated with dacarbazine alone, dacarbazine +/- interferon, dacarbazine + fotemustine, interleukin +/- histamine, and temozolomide. Little difference was found in QoL scores between drugs or between baseline and end point.
Cost-effectiveness has not been widely demonstrated for treatment of MM. Only two studies with unimpressive results exist for treatments. Screening was not cost-effective in the United States or Germany. Generally, no significant improvements in QoL were found for any alternative for treating MM. A need exists for effective treatments that improve duration and QoL.
PubMed ID
18380638 View in PubMed
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Age- and sex-specific prevalence of scoliosis and the value of school screening programs.

https://arctichealth.org/en/permalink/ahliterature238013
Source
Am J Public Health. 1985 Dec;75(12):1377-80
Publication Type
Article
Date
Dec-1985
Author
T. Morais
M. Bernier
F. Turcotte
Source
Am J Public Health. 1985 Dec;75(12):1377-80
Date
Dec-1985
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Costs and Cost Analysis
Female
Follow-Up Studies
Humans
Male
Mass Screening - economics
Orthopedics
Quebec
Referral and Consultation
School Health Services - economics
Scoliosis - epidemiology - pathology - therapy
Sex Factors
Abstract
A prevalence study of idiopathic scoliosis was conducted among 29,195 children of a community health district in the province of Quebec. The study was designed to determine whether a permanent screening program for idiopathic scoliosis was justified. The prevalence of the condition among school children aged 8 to 15 years was 42.0 per 1,000 in the screened population, 51.9 per 1,000 among girls, and 32.0 per 1,000 among boys. The positive predictive value of the bending test is estimated as 42.8 per cent for scolioses of 5 degrees or more; it is only 6.4 per cent when curves of 15 degrees or more are considered. The average cost of finding one child with a scoliosis of 5 degrees or more is $194. Mass screening for idiopathic scoliosis does not seem to be justified in the present state of knowledge of the disease.
Notes
Cites: J Bone Joint Surg Am. 1975 Oct;57(7):968-721194304
Cites: Pediatrics. 1977 Aug;60(2):193-6887333
Cites: J Bone Joint Surg Am. 1978 Mar;60(2):173-6641080
Cites: Int J Epidemiol. 1984 Sep;13(3):319-236490302
Cites: J Bone Joint Surg Am. 1982 Apr;64(4):481-86802853
Cites: Int J Epidemiol. 1982 Jun;11(2):101-117047422
Cites: Lancet. 1981 Oct 17;2(8251):8636116966
PubMed ID
4061707 View in PubMed
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Analysing public preferences for cancer screening programmes.

https://arctichealth.org/en/permalink/ahliterature19400
Source
Health Econ. 2001 Oct;10(7):617-34
Publication Type
Article
Date
Oct-2001
Author
D. Gyrd-Hansen
J. Søgaard
Author Affiliation
Institute of Public Health, University of Southern Denmark, Odense, Denmark. dgh@sam.sdu.dk
Source
Health Econ. 2001 Oct;10(7):617-34
Date
Oct-2001
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - radiography
Choice Behavior
Colorectal Neoplasms - diagnosis
Comparative Study
Consumer Satisfaction - economics - statistics & numerical data
Cost-Benefit Analysis
Denmark
Female
Financing, Personal
Health Knowledge, Attitudes, Practice
Humans
Interviews
Male
Mammography - economics - utilization
Mass Screening - economics - utilization
Middle Aged
Motivation
Stochastic Processes
Abstract
Economic evaluations generally fail to incorporate elements of intangible costs and benefits, such as anxiety and discomfort associated with the screening test and diagnostic test, as well as the magnitude of utility associated with a reduction in the risk of dying from cancer. In the present analysis, 750 respondents were interviewed and asked to rank, according to priority, a number of alternative screening programme set-ups. Focus was on colorectal cancer screening and breast cancer screening. The alternative programmes varied with respect to number of tests performed, risk reduction obtained, probability of a false positive outcome and extent of co-payment. Stated preferences were analysed using discrete ranking modelling and the relative weighting of the programme attributes identified. Applying discrete choice methods to elicit preferences within this area of health care seems justified by the face validity of the results. The signs of the coefficients are in accordance with a priori hypotheses. This paper suggests that large-scale surveys focusing on individuals' preferences for cancer screening programmes may contribute significantly to the quality of economic evaluations within this field of health care.
PubMed ID
11747045 View in PubMed
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Analysis of cost effectiveness of screening Danish men aged 65 for abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature88585
Source
BMJ. 2009;338:b2243
Publication Type
Article
Date
2009
Author
Ehlers Lars
Overvad Kim
Sørensen Jan
Christensen Søren
Bech Merete
Kjølby Mette
Author Affiliation
Institute of Public Health, Aarhus University, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark. le@folkesundhed.au.dk
Source
BMJ. 2009;338:b2243
Date
2009
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - economics - prevention & control - ultrasonography
Aortic Rupture - economics - prevention & control - ultrasonography
Cost-Benefit Analysis
Denmark
Humans
Male
Markov Chains
Mass Screening - economics
Quality of Life
Quality-Adjusted Life Years
Abstract
OBJECTIVE: To assess the cost effectiveness of screening men aged 65 for abdominal aortic aneurysm. DESIGN: Cost effectiveness analysis based on a probabilistic, enhanced economic decision analytical model from screening to death. POPULATION AND SETTING: Hypothetical population of men aged 65 invited (or not invited) for ultrasound screening in the Danish healthcare system. DATA SOURCES: Published results from randomised trials and observational epidemiological studies retrieved from electronic bibliographic databases, and supplementary data obtained from the Danish Vascular Registry. DATA SYNTHESIS: A hybrid decision tree and Markov model was developed to simulate the short term and long term effects of screening for abdominal aortic aneurysm compared with no systematic screening on clinical and cost effectiveness outcomes. Probabilistic sensitivity analyses using Monte Carlo simulation were carried out. Results were presented in a cost effectiveness acceptability curve, an expected value of perfect information curve, and a curve showing the expected (net) number of avoided deaths from abdominal aortic aneurysm over time after the introduction of screening. The model was validated by calibrating base case health outcomes and expected activity levels against evidence from the recent Cochrane review of screening for abdominal aortic aneurysm. RESULTS: The estimated costs per quality adjusted life year (QALY) gained discounted at 3% per year over a lifetime for costs and QALYs was pound43 485 (euro54,852; $71,160). At a willingness to pay threshold of pound30,000 the probability of screening for abdominal aortic aneurysm being cost effective was less than 30%. One way sensitivity analyses showed the incremental cost effectiveness ratio varying from pound32,640 to pound66,001 per QALY. CONCLUSION: Screening for abdominal aortic aneurysm does not seem to be cost effective. Further research is needed on long term quality of life outcomes and costs.
Notes
Comment In: BMJ. 2009;338:b218519553266
Comment In: BMJ. 2009;339:b304419638382
PubMed ID
19553267 View in PubMed
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An economic analysis of screening for diabetic retinopathy.

https://arctichealth.org/en/permalink/ahliterature47596
Source
J Telemed Telecare. 2002;8(1):32-5
Publication Type
Article
Date
2002
Author
Siri Bjørvig
Monika A Johansen
Kristian Fossen
Author Affiliation
Norwegian Centre for Telemedicine, University Hospital of Tromsø, Norway. siri.bjorvig@telemed.no
Source
J Telemed Telecare. 2002;8(1):32-5
Date
2002
Language
English
Publication Type
Article
Keywords
Computer Communication Networks
Cost-Benefit Analysis
Diabetic Retinopathy - diagnosis - economics
Humans
Mass Screening - economics - methods
Norway
Research Support, Non-U.S. Gov't
Telemetry - economics
Abstract
The costs of telemedicine screening for diabetic retinopathy were examined in a trial conducted in northern Norway, involving the University Hospital of Tromsø (UHT) and the primary care centre in Alta, approximately 400 km away. In Alta, specially trained nurses examined 42 diabetic patients using a digital camera to obtain images of the retina. The images were then sent by email to an eye specialist at the UHT. A cost-minimization analysis showed that at low workloads, for example 20 patients per annum, telemedicine was more expensive than conventional examination: NKr8555 versus NKr428 per patient. However, at higher workloads, telemedicine was cheaper. For example, at 200 patients per annum, telemedicine cost NKr971 and conventional examination cost NKr1440 per patient. The break-even point occurred at a patient workload of 110 per annum. Given that there are some 250 diabetic patients in Alta, telemedicine screening is the cheaper service for the public sector.
PubMed ID
11809082 View in PubMed
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An economic appraisal of two strategies in geriatric screening.

https://arctichealth.org/en/permalink/ahliterature73117
Source
Scand J Soc Med. 1994 Dec;22(4):293-8
Publication Type
Article
Date
Dec-1994
Author
G. Johansen
Author Affiliation
Nordic School of Public Health, Gothenburg, Sweden.
Source
Scand J Soc Med. 1994 Dec;22(4):293-8
Date
Dec-1994
Language
English
Publication Type
Article
Keywords
Aged
Comparative Study
Cost-Benefit Analysis
Female
Geriatric Assessment
Health Services Needs and Demand - economics
Humans
Male
Mass Screening - economics
Patient Acceptance of Health Care
Primary Health Care - economics
Questionnaires - economics
Sweden
Abstract
Screening for preventive geriatric health-care has become common in many Norwegian municipalities. Different methods are used to screen for unreported need of intervention. There is little information available about which is the most costeffective method. This article describes a comparison of two screening models. The first screening was conducted by means of a personal interview held at a health clinic and the second by a postal questionnaire. The results show that a postal questionnaire study was more cost-effective than the health-clinic consultation. It demanded no more resources than the health-clinic model, but had a wider effect because it covered a broader spectrum with regard to response, proportion of the total population and the proportion of respondents for whom an intervention was implemented.
PubMed ID
7716440 View in PubMed
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An economic evaluation of screening for Chlamydia trachomatis in adolescent males.

https://arctichealth.org/en/permalink/ahliterature75124
Source
JAMA. 1993 Nov 3;270(17):2057-64
Publication Type
Article
Date
Nov-3-1993
Author
M. Genç
L. Ruusuvaara
P A Mårdh
Author Affiliation
Uppsala University Centre for STD Research, Sweden.
Source
JAMA. 1993 Nov 3;270(17):2057-64
Date
Nov-3-1993
Language
English
Publication Type
Article
Keywords
Adolescent
Azithromycin - therapeutic use
Carboxylic Ester Hydrolases - urine
Chlamydia Infections - diagnosis - drug therapy - prevention & control - urine
Chlamydia trachomatis
Cost-Benefit Analysis
Decision Support Techniques
Doxycycline - therapeutic use
Humans
Immunoenzyme Techniques - economics
Male
Mass Screening - economics - methods
Research Support, Non-U.S. Gov't
Sweden
Abstract
OBJECTIVE--To assess the cost-effectiveness of identifying asymptomatic carriers of Chlamydia trachomatis among adolescent males. DESIGN--Cost-effectiveness analysis based on cohort analytic studies previously reported and average salaries and costs of medical care in Sweden. SETTING--Adolescent males attending a primary care center for routine health checks. PARTICIPANTS--Estimates of costs and benefits are based on a cohort of 1000 adolescent males and their female contacts. INTERVENTION--Screening with enzyme immunoassay (EIA), either on leukocyte esterase (LE)--positive urine samples (LE-EIA screening) or on all urine samples (EIA screening), was compared with no screening (no treatment or contact tracing). The effects of confirming positive EIA results with a blocking assay and alternative antibiotic regimens on the outcome of the screening strategies were also evaluated. RESULTS--Compared with no screening, the LE-EIA and EIA screening strategies reduced the overall costs when the prevalence of chlamydial infection in males exceeded 2% and 10%, respectively. Enzyme immunoassay screening achieved an overall cure rate that was 12.2% to 12.6% (95% confidence interval) better, but reduced the incremental savings by at least $2144 per cured male, in comparison with LE-EIA screening. Confirmation of positive EIA results reduced the overall cost of the LE-EIA screening strategy when the prevalence of C trachomatis among males was less than 8%. Compared with a 7-day course of doxycycline, a single oral dose of azithromycin administered under supervision in the clinic improved the cure rates of both EIA and LE-EIA screening strategies by 15.1% to 16.3% and 11.2% to 12.0%, respectively, while reducing the corresponding overall costs by 5% and 9%, respectively, regardless of the prevalence of chlamydial infection in males. CONCLUSION--The use of LE-EIA screening combined with treatment of positive cases with azithromycin was the most cost-effective intervention strategy focusing on asymptomatic male carriers of C trachomatis. Positive EIA results should be confirmed when screening low-risk populations.
Notes
Comment In: JAMA. 1993 Nov 3;270(17):2097-88411579
PubMed ID
8411572 View in PubMed
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371 records – page 1 of 38.