scholarly journals Cost-effectiveness of MR-mammography as a solitary imaging technique in women with dense breasts: an economic evaluation of the prospective TK-Study

2020 ◽  
Author(s):  
Matthias F. Froelich ◽  
Clemens G. Kaiser
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Imaging Technique ◽  
Mr Mammography ◽  
Dense Breasts

scholarly journals Cost-effectiveness of new MDR-TB regimens: study protocol for the TB-PRACTECAL economic evaluation substudy

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036599
Author(s):  
Sedona Sweeney ◽  
Gabriela Gomez ◽  
Nichola Kitson ◽  
Animesh Sinha ◽  
Natalia Yatskevich ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Best Practice ◽  
Current Treatment ◽  
Outcome Data ◽  
London School ◽  
Main Trial ◽  
Ethical Approval ◽  
Mdr Tb ◽  
The Impact

IntroductionCurrent treatment regimens for multidrug-resistant tuberculosis (MDR-TB) are long, poorly tolerated and have poor outcomes. Furthermore, the costs of treating MDR-TB are much greater than those for treating drug-susceptible TB, both for health service and patient-incurred costs. Urgent action is needed to identify short, effective, tolerable and cheaper treatments for people with both quinolone-susceptible and quinolone-resistant MDR-TB. We present the protocol for an economic evaluation (PRACTECAL-EE substudy) alongside an ongoing clinical trial (TB-PRACTECAL) aiming to assess the costs to patients and providers of new regimens, as well as their cost-effectiveness and impact on participant poverty levels. This substudy is based on data from the three countries participating in the main trial.Methods and analysisPrimary cost data will be collected from the provider and patient perspectives, following economic best practice. We will estimate the probability that new MDR-TB regimens containing bedaquiline, pretomanid and linezolid are cost-effective from a societal perspective as compared with the standard of care for MDR-TB patients in Uzbekistan, South Africa and Belarus. Analysis uses a Markov model populated with primary cost and outcome data collected at each study site. We will also estimate the impact of new regimens on prevalence of catastrophic patient costs due to TB.Ethics and disseminationEthical approval has been obtained from the London School of Hygiene & Tropical Medicine and Médecins Sans Frontières. Local ethical approval will be sought in each study site. The results of the economic evaluation will be shared with the country health authorities and published in a peer-reviewed journal.Trial registration numberClinicalTrials.gov Registry (NCT04207112); Pre-results.

scholarly journals Cost-Effectiveness of an Exercise Programme that Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 714
Author(s):  
Isaac Aranda-Reneo ◽  
Laura Albornos-Muñoz ◽  
Manuel Rich-Ruiz ◽  
María Ángeles Cidoncha-Moreno ◽  
Ángeles Pastor-López ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Older People ◽  
Incremental Cost ◽  
Fall Risk ◽  
Community Dwelling ◽  
Effective Measure ◽  
The Individual ◽  
The Cost ◽  
Individual Training

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

scholarly journals Automated Breast Ultrasound: Technical Aspects, Impact on Breast Screening, and Future Perspectives

2021 ◽  
Author(s):  
Iris Allajbeu ◽  
Sarah E Hickman ◽  
Nicholas Payne ◽  
Penelope Moyle ◽  
Kathryn Taylor ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Breast Screening ◽  
Screening Tool ◽  
Imaging Technique ◽  
Breast Ultrasound ◽  
Computer Aided Detection ◽  
Future Perspectives ◽  
Technical Aspects ◽  
Dense Breasts ◽  
Automated Breast Ultrasound

Abstract Purpose of Review Automated breast ultrasound (ABUS) is a three-dimensional imaging technique, used as a supplemental screening tool in women with dense breasts. This review considers the technical aspects, pitfalls, and the use of ABUS in screening and clinical practice, together with new developments and future perspectives. Recent Findings ABUS has been approved in the USA and Europe as a screening tool for asymptomatic women with dense breasts in addition to mammography. Supplemental US screening has high sensitivity for cancer detection, especially early-stage invasive cancers, and reduces the frequency of interval cancers. ABUS has similar diagnostic performance to handheld ultrasound (HHUS) and is designed to overcome the drawbacks of operator dependence and poor reproducibility. Concerns with ABUS, like HHUS, include relatively high recall rates and lengthy reading time when compared to mammography. ABUS is a new technique with unique features; therefore, adequate training is required to improve detection and reduce false positives. Computer-aided detection may reduce reading times and improve cancer detection. Other potential applications of ABUS include local staging, treatment response evaluation, breast density assessment, and integration of radiomics. Summary ABUS provides an efficient, reproducible, and comprehensive supplemental imaging technique in breast screening. Developments with computer-aided detection may improve the sensitivity and specificity as well as radiologist confidence and reduce reading times, making this modality acceptable in large volume screening centers.

The economic evaluation of complementary medicine: a staged approach at the Royal London Homoeopathic Hospital

2000 ◽  
Vol 89 (S 01) ◽  
pp. S23-S26 ◽  
Author(s):  
R van Haselen
Keyword(s):  
Rheumatoid Arthritis ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Complementary Medicine ◽  
Evidence Base ◽  
Practical Implementation ◽  
Health State ◽  
Marginal Costs ◽  
Related Quality ◽  
Staged Approach

AbstractObjective: The practical implementation of a staged, multifaceted research agenda for the economic evaluation of complementary medicine (CM) at the Royal London Homoeopathic Hospital (RLHH).Method: The relative importance of economic evaluation as an evidence base of CM was assessed via a survey conducted with purchasers (n=481). The marginal costs of providing complementary care for patients with rheumatoid arthritis were calculated. The use, and changes in the use, of conventional medicines for patients’ main complaints were established retrospectively (n=499) and prospectively (n=70). Health-related quality of life (patient utility) of newly referred patients was assessed with the EQ-5D (EuroQol) instrument (n=70) on a 100 mm (0=worst, 100=best) scale.Results: Economic evaluation was rated ‘important’ as an evidence base, after safety and RCT data (‘very important’). Consultation time (doctors and dietician) contributed 29% of the total costs of treating rheumatoid arthritis. The retrospective survey showed that many patients on conventional medication were able to stop (29%) or reduce (32%) intake in the course of treatment. The median (quartiles) health state of newly referred patients was 70 mm (50,78) in men and 60 mm (36,73) in women. Some results of an interim analysis of 6 months follow-up data are reported.Conclusions: Economic evaluation of CM is becoming increasingly important and should take place by using a multifaceted, staged approach. Before embarking on randomised trials, observational data on cost, effectiveness and utility should be collected. The cost-effectiveness of CM appears to be most sensitive to the duration of the consultation.

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