Inadequate Selection and Treatment Results in Poor Outcomes and Lack of Cost-Effectiveness

2021 ◽  
Author(s):  
Johan Hambraeus ◽  
Reza Ehsanian ◽  
David S. Cheng ◽  
Michael J. McKenna ◽  
Zachary L. McCormick
Keyword(s):  
Cost Effectiveness ◽  
Treatment Results ◽  
Poor Outcomes

Cost-Effectiveness of Housing First With Assertive Community Treatment: Results From the Canadian At Home/Chez Soi Trial

2020 ◽  
Vol 71 (10) ◽  
pp. 1020-1030 ◽  
Author(s):  
Eric A. Latimer ◽  
Daniel Rabouin ◽  
Zhirong Cao ◽  
Angela Ly ◽  
Guido Powell ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Housing First ◽  
Treatment Results ◽  
At Home

scholarly journals Cost-Effectiveness of Temozolamide for Treatment of Glioblastoma Multiforme in India

2021 ◽  
pp. 108-117 ◽  
Author(s):  
Nidhi Gupta ◽  
Shankar Prinja ◽  
Vijay Patil ◽  
Pankaj Bahuguna
Keyword(s):  
Cost Effectiveness ◽  
Glioblastoma Multiforme ◽  
Incremental Cost ◽  
National Health System ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Published Evidence ◽  
Life Years ◽  
Management Of Complications ◽  
Poor Outcomes

PURPOSE Glioblastoma multiforme (GBM) has poor outcomes following surgery and radiation. Adjuvant temozolamide along with radiation therapy has been shown to improve survival. In this paper, we evaluate the cost-effectiveness of concomitant temozolamide with radiation and maintenance temozolamide for 6 months of treatment for GBM in India. MATERIALS AND METHODS We used a Markov model to evaluate the lifetime costs and consequences of treating GBM with radiation alone versus radiation with adjuvant temozolamide. The model was calibrated using the published evidence from European Organisation for Research and Treatment of Cancer-NCIC trial on progression-free survival and overall survival to estimate the life years (LYs) and quality-adjusted LYs (QALYs). Cost of treatment and management of complications were estimated using the data from the National Health System Cost Database and Indian studies. Future cost and consequences were discounted at 3%. Incremental cost per QALY gained with temozolamide was estimated to assess cost effectiveness. RESULTS Temozolamide resulted in an increase of 0.59 (0.53-0.66) LY and 0.33 (0.29-0.40) QALY per person at an incremental cost of ₹75,120 in Indian national rupee (INR) (59,337-93,960). Overall, the use of temozolamide incurs an incremental cost of ₹212,020 INR (138,127-401,466) per QALY gained, which has a 4.7% probability to be cost-effective at 1-time per capita Gross Domestic Product (GDP) threshold. In case the current price of temozolamide could be decreased by 90%, the probability of its use for GBM being cost-effective increases to 80%. CONCLUSION Temozolamide is not cost-effective for treatment of patients with GBM in India. This evidence should be used while framing guidelines for treatment and price regulation.

scholarly journals The use of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 43-47
Author(s):  
A.V. Chuzhak
Keyword(s):  
Ankle Joint ◽  
High Efficiency ◽  
Point Of View ◽  
Tibial Fractures ◽  
Ankle Injuries ◽  
Treatment Results ◽  
Ao Classification ◽  
In Trans ◽  
Poor Outcomes ◽  
Elastic Fixation

The problem of complications and the frequency of poor outcomes in the surgical treatment of ankle fractures with ti-biofibular syndesmosis (TFS) rupture (4.8–36.8 % of cases) remains significant. It was interesting from a scientific and practical point of view to conduct a clinical study to determine the effectiveness of the newly developed method of metal osteosynthesis for tibial fractures with TFS rupture, which would combine stability of tibial fixation and not limit the elastic qualities of TFS. The aim of the study: to determine the effectiveness of combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia. Materials and methods. On the basis of own clinical researches and data of literature sources, the method of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia is developed. The effectiveness of the proposed technique was evaluated 6 months after surgery on the Kitaoka scale. We have examined 12 patients with tibial fractures type 44 B1, B2 and B3 according to the AO classification, who underwent surgery using our methods. Results. The high efficiency of using the technique of combined stable-elastic fixation for unstable injuries of the ankle joint due to trans-syndesmotic fractures of the tibia has been determined. Good and excellent treatment results 6 months after surgery were observed in all 12 people (100 %), with excellent outcomes observed in 75 % of cases. There were no satisfactory and unsatisfactory treatment results. Conclusions. The study proves the high efficiency of the proposed method for combined stable-elastic fixation of ankle injuries in unstable trans-syndesmotic fractures of the tibia with TFS damage. There were 75 % excellent and 25 % good results within 6 months after surgery. A wider introduction of this technique into the practice of traumatologists of Ukraine is proposed.

scholarly journals The cost-effectiveness of rapid HIV testing in substance abuse treatment: Results of a randomized trial

2013 ◽  
Vol 128 (1-2) ◽  
pp. 90-97 ◽  
Author(s):  
Bruce R. Schackman ◽  
Lisa R. Metsch ◽  
Grant N. Colfax ◽  
Jared A. Leff ◽  
Angela Wong ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Cost Effectiveness ◽  
Substance Abuse Treatment ◽  
Randomized Trial ◽  
Hiv Testing ◽  
Treatment Results ◽  
Rapid Hiv Testing ◽  
Abuse Treatment ◽  
The Cost

scholarly journals Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial

BMJ ◽  
1997 ◽  
Vol 314 (7091) ◽  
pp. 1381-1381 ◽  
Author(s):  
F. Creed ◽  
P. Mbaya ◽  
S. Lancashire ◽  
B. Tomenson ◽  
B. Williams ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Psychiatric Treatment ◽  
Controlled Trial ◽  
Treatment Results ◽  
Inpatient Psychiatric Treatment ◽  
Randomised Controlled

Cost-effectiveness of dental implants: a utility analysis

1990 ◽  
Vol 54 (11) ◽  
pp. 688-689 ◽  
Author(s):  
J Jacobson ◽  
B Maxson ◽  
K Mays ◽  
J Peebles ◽  
C Kowalski
Keyword(s):  
Cost Effectiveness ◽  
Dental Implants ◽  
Utility Analysis

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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