PMD23 COST-EFFECTIVENESS OF SPECIFIC USE OF THE LANCET BD QUIKHEEL® IN SCREENING PROGRAM OF NEONATAL CONGENITAL HYPOTHYROIDISM IN MEXICO

AbstractObjectivesAdequate treatment of congenital hypothyroidism (CH) is required for normal growth and sexual development. To evaluate pubertal development in patients with permanent CH detected by a statewide Neonatal Screening Program of Paraná and, secondly, to evaluate adult height (AH) in a subgroup of patients.MethodsClinical, laboratory, and auxological data obtained from medical records of 174 patients (123 girls).ResultsMedian chronological age (CA) at treatment initiation was 24 days, and mean initial levothyroxine dose was 11.7 ± 1.9 μg/kg/day; mean CA at puberty onset was 11.5 ± 1.3 years (boys) and 9.7 ± 1.2 years (girls); mean CA in girls who underwent menarche (n=81) was 12.1 ± 1.1 years. Thyroid-stimulating hormone (TSH) values above the normal range were observed in 36.4% of the boys and 32.7% of the girls on puberty onset, and in 44.6% around menarche. Among 15 boys and 66 girls who had reached the AH, the median height z-score value was significantly greater than the target height (TH) z-score value in boys (p=0.01) and in girls (p<0.001). Boys with normal TSH values at puberty onset had greater mean AH z-score compared with boys with TSH values above the normal range (p=0.04).ConclusionsIn this group, pubertal development in girls with CH was not different from that reported in healthy girls in the general Brazilian population. Boys with higher TSH at puberty onset may have an increased risk of not reaching their potential height compared with those with normal TSH during this period. In a subgroup who attained AH, the median AH z-score was greater than the median TH z-score.

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PCN166 Cost-Effectiveness of Colorectal Cancer Screening Program in the Czech Republic

Value in Health ◽

10.1016/j.jval.2020.08.303 ◽

2020 ◽

Vol 23 ◽

pp. S452

Author(s):

O. Ngo ◽

J. Kouřil ◽

I. Svobodová ◽

D. Krejčí ◽

L. Dušek ◽

...

Keyword(s):

Colorectal Cancer ◽

Czech Republic ◽

Cost Effectiveness ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Screening Program ◽

The Czech Republic ◽

Cancer Screening Program

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Incidence and Interrelated Factors in Patients With Congenital Hypothyroidism as Detected by Newborn Screening in Guangxi, China

Global Pediatric Health ◽

10.1177/2333794x14567193 ◽

2015 ◽

Vol 2 ◽

pp. 2333794X1456719 ◽

Cited By ~ 3

Author(s):

Xin Fan ◽

Shaoke Chen ◽

Jiale Qian ◽

Suren Sooranna ◽

Jingi Luo ◽

...

Keyword(s):

Newborn Screening ◽

Congenital Hypothyroidism ◽

Screening Program ◽

Thyroid Stimulating Hormone ◽

Who Guidelines ◽

Newborn Screening Program ◽

Study Results ◽

Stimulating Hormone

Background. A newborn screening program (NSP) for congenital hypothyroidism (CH) was carried out in Guangxi in order to understand the incidence of CH and the factors interrelated to major types of CH in this region of China. Methods. During 2009 to 2013, data from 930 612 newborns attending NSP in Guangxi were collected. Patients were classified with either permanent CH (PCH) or transient CH (TCH) after 2 years of progressive study. Results. A total of 1210 patients were confirmed with CH with an incidence of 1/769, including 68 PCH and 126 TCH cases with incidences of 1/6673 and 1/3385, respectively. The frequency of thyroid stimulating hormone values greater than 5 mIU/L was 7.2%, which, based on WHO guidelines, suggests that the population was mildly iodine deficient. Conclusions. The incidence of CH was high in Guangxi. Approximately two thirds of CH patients were TCH, which may be due to a deficiency in iodine within the population.

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A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program

Sexual Health ◽

10.1071/sh07043 ◽

2007 ◽

Vol 4 (3) ◽

pp. 165 ◽

Cited By ~ 77

Author(s):

Shalini Kulasingam ◽

Luke Connelly ◽

Elizabeth Conway ◽

Jane S. Hocking ◽

Evan Myers ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Hpv Vaccine ◽

Screening Program ◽

Herd Immunity ◽

Vaccination Program ◽

Catch Up ◽

The Cost ◽

Current Screening

Background: The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. Methods: A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14–26-year-olds and accounting for the benefits of herd immunity. Results: Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. Conclusions: These results suggest that adding an HPV vaccine to Australia’s current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone.

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Cost-Effectiveness Analysis of Non-Mydriatic Ultrawide- Field Fundus Photography versus Pharmacological Pupil Dilatation in Diabetic Retinopathy Screening Program

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.12238 ◽

2021 ◽

Vol 104 (5) ◽

pp. 818-824

Keyword(s):

Diabetic Retinopathy ◽

Cost Effectiveness ◽

Screening Program ◽

Cost Effective ◽

Cost Effectiveness Analysis ◽

Fundus Photography ◽

Diabetic Retinopathy Screening ◽

Effectiveness Analysis ◽

The Cost ◽

Retinopathy Screening

Background: Diabetic retinopathy (DR) causes blindness of the population in many countries worldwide. Early detection and treatment of this disease via a DR screening program is the best way to secure the vision. An annual screening program using pharmacological pupil dilatation becomes the standard method. Recently, non-mydriatic ultrawide-field fundus photography (UWF) has been proposed as a choice for DR screening. However, there was no cost-effectiveness study between the standard DR screening and this UWF approach. Objective: To compare the cost-effectiveness between UWF and pharmacological pupil dilatation in terms of hospital and societal perspectives. Materials and Methods: Patients with type 2 diabetes mellitus that visited the ophthalmology clinic at Chulabhorn Hospital for DR screening were randomized using simple randomization method. The patients were interviewed by a trained interviewer for general and economic information. The clinical characteristics of DR and staging were recorded. Direct medical costs, direct non-medical costs, and informal care costs due to DR screening were recorded. Cost analyses were calculated for the hospital and societal perspectives. Results: The present study presented the cost-effectiveness analyses of UWF versus pharmacological pupil dilatation. Cost-effectiveness analysis from the hospital perspective showed the incremental cost-effectiveness ratio (ICER) of UWF to be –13.87. UWF was a cost-effective mean in DR screening in the societal perspective when compared with pharmacologically pupil dilatation with the ICER of 76.46, under the threshold of willingness to pay. Conclusion: The UWF was a cost-effective mean in DR screening. It can reduce screening duration and bypass post-screening blurred vision. The results suggested that UWF could be a viable option for DR screening. Keywords: Diabetic retinopathy, Diabetic retinopathy screening, Non-mydriatic ultrawide-field fundus photography, Cost-effectiveness analysis

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Incidence of congenital hypothyroidism in the city of Uberaba/Minas Gerais and etiological evaluation of the affected subjects

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000500005 ◽

2012 ◽

Vol 56 (5) ◽

pp. 305-312 ◽

Cited By ~ 3

Author(s):

Heloísa Marcelina da Cunha Palhares ◽

Lilian Carla Silva ◽

Luciene Mayumi Sato ◽

Beatriz Hallal Jorge Lara ◽

Sybele de Souza Castro Miranzi ◽

...

Keyword(s):

Congenital Hypothyroidism ◽

Screening Program ◽

Minas Gerais ◽

The State ◽

Thyroid Dysgenesis ◽

Outpatient Unit ◽

Transient Hypothyroidism ◽

Molecular Studies ◽

Definition Of ◽

The City

OBJECTIVE: The objective of this study was to determine the incidence and etiology of congenital hypothyroidism (CH) in Uberaba, MG. SUBJECTS AND METHODS: From 2001 to 2010, by reviewing patient files from a public reference outpatient unit. The screening program covered 88% of live-born children. RESULTS: CH was diagnosed in 16 children, representing an incidence of 1:2,017 live-born children screened. The etiological evaluation was done in 15 children and revealed seven cases of thyroid dysgenesis, seven of dyshormonogenesis, and one case of transient hypothyroidism. One child moved away from the state before etiological investigation was carried out. CONCLUSION: We concluded that both the incidence of CH and of dyshormonogenesis as the main causes of CH were increased in the investigated region, but molecular studies are necessary for a better definition of etiology.

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