Cost-effectiveness of fracture prevention treatments in the elderly

2004 ◽  
Vol 20 (2) ◽  
pp. 184-191 ◽  
Author(s):  
Rachael L. Fleurence
Keyword(s):  
Vitamin D ◽  
United Kingdom ◽  
High Risk ◽  
Fracture Prevention ◽  
The Elderly ◽  
High Risk Population ◽  
Male Population ◽  
Female Population ◽  
Hip Protectors ◽  
The United Kingdom

Objectives:The cost-effectiveness of fracture prevention treatments (vitamin D and calcium and hip protectors) in male and female populations older than seventy years of age in the United-Kingdom was investigated.Methods:A Markov model was developed to follow up, over lifetime, a hypothetical cohort of males and females at high-risk and general risk of fracture. Patients could sustain hip, wrist, vertebral, and/or other fractures. Fracture rates were obtained from population surveys in the United Kingdom. Effectiveness and quality of life data were identified from the clinical literature. Costs were those incurred by the UK National Health Service, and were obtained from several published sources. Uncertainty was explored through probabilistic sensitivity analysis.Results:In the general-risk female (male) population, the incremental cost per Quality Adjusted Life Year (QALY) was $11,722 ($47,426) for hip protectors. In the male high-risk population, the incremental cost per QALY was $17,017 for hip protectors. In the female high-risk population, hip protectors were cost-saving. Vitamin D and calcium alone was dominated by hip protectors in all four subgroups.Conclusions:Current information available on interventions to prevent fractures in the elderly in the United Kingdom, suggests that, at the decision-maker's ceiling ratio of $20,000 per QALY, hip protectors are cost-effective in the general female population and high-risk male population, and cost-saving in the high-risk female population, despite the low compliance rate with the treatment.

scholarly journals Results of Annual Screening in Phase I of the United Kingdom Familial Ovarian Cancer Screening Study Highlight the Need for Strict Adherence to Screening Schedule

2013 ◽  
Vol 31 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Adam N. Rosenthal ◽  
Lindsay Fraser ◽  
Ranjit Manchanda ◽  
Philip Badman ◽  
Susan Philpott ◽  
...  
Keyword(s):  
United Kingdom ◽  
High Risk ◽  
Surgical Intervention ◽  
Transvaginal Ultrasound ◽  
High Risk Population ◽  
Predictive Values ◽  
Strict Adherence ◽  
Screening Interval ◽  
The United Kingdom ◽  
The Impact

Purpose To establish the performance characteristics of annual transvaginal ultrasound and serum CA125 screening for women at high risk of ovarian/fallopian tube cancer (OC/FTC) and to investigate the impact of delayed screening interval and surgical intervention. Patients and Methods Between May 6, 2002, and January 5, 2008, 3,563 women at an estimated ≥ 10% lifetime risk of OC/FTC were recruited and screened by 37 centers in the United Kingdom. Participants were observed prospectively by centers, questionnaire, and national cancer registries. Results Sensitivity for detection of incident OC/FTC at 1 year after last annual screen was 81.3% (95% CI, 54.3% to 96.0%) if occult cancers were classified as false negatives and 87.5% (95% CI, 61.7% to 98.5%) if they were classified as true positives. Positive and negative predictive values of incident screening were 25.5% (95% CI, 14.3 to 40.0) and 99.9% (95% CI, 99.8 to 100) respectively. Four (30.8%) of 13 incident screen-detected OC/FTCs were stage I or II. Compared with women screened in the year before diagnosis, those not screened in the year before diagnosis were more likely to have ≥ stage IIIc disease (85.7% v 26.1%; P = .009). Screening interval was delayed by a median of 88 days before detection of incident OC/FTC. Median interval from detection screen to surgical intervention was 79 days in prevalent and incident OC/FTC. Conclusion These results in the high-risk population highlight the need for strict adherence to screening schedule. Screening more frequently than annually with prompt surgical intervention seems to offer a better chance of early-stage detection.

scholarly journals Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan

2021 ◽  
Vol 18 (11) ◽  
pp. 5670
Author(s):  
Misaki Nakamoto ◽  
Takatoshi Nakagawa ◽  
Masahiko Murata ◽  
Motohiro Okada
Keyword(s):  
Family Health ◽  
The Elderly ◽  
Health Economy ◽  
Suicide Mortality ◽  
Male Population ◽  
Female Population ◽  
Income Household ◽  
Working Age ◽  
Dual Income ◽  
Work Family

To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.

scholarly journals SARS-CoV-2 testing and sequencing for international arrivals reveals significant cross border transmission of high risk variants into the United Kingdom

2021 ◽  
pp. 101021
Author(s):  
Gareth H Williams ◽  
Alexander Llewelyn ◽  
Ruben Brandao ◽  
Kaiya Chowdhary ◽  
Keeda-Marie Hardisty ◽  
...  
Keyword(s):  
United Kingdom ◽  
High Risk ◽  
Cross Border ◽  
The United Kingdom ◽  
Risk Variants

scholarly journals Treatment Patterns With Lipid-Altering Drugs In High-Risk Vascular Disease In The United Kingdom

2014 ◽  
Vol 17 (3) ◽  
pp. A122
Author(s):  
Z. Zhao ◽  
Y. Zhu ◽  
J. Collins ◽  
R. Donaldson ◽  
W. Engelman ◽  
...  
Keyword(s):  
United Kingdom ◽  
High Risk ◽  
Vascular Disease ◽  
Treatment Patterns ◽  
The United Kingdom

scholarly journals An estimate of phytate intake and molar ratio of phytate to zinc in the diet of the people in the United Kingdom

2010 ◽  
Vol 13 (9) ◽  
pp. 1380-1388 ◽  
Author(s):  
F Amirabdollahian ◽  
R Ash
Keyword(s):  
United Kingdom ◽  
Elderly Population ◽  
The Elderly ◽  
Molar Ratio ◽  
Daily Consumption ◽  
Nutrition Survey ◽  
Molar Ratios ◽  
The United Kingdom ◽  
The People ◽  
Phytate Content

AbstractObjectiveTo estimate the phytate intake and molar ratio of phytate to zinc in the diet of the people in the United Kingdom.DesignTables of the phytate content of foods were developed from twenty-eight published and unpublished studies. They were then applied to the nutrient databank of the National Diet and Nutrition Survey (NDNS). The study is a retrospective analysis of data on daily consumption of foods and drinks from the NDNS of children, adolescents, adults and the elderly based on 4–7 d weighed intakes.SubjectsA total of 6786 British participants aged 1·5 years and above, who participated in the NDNS, 1992–2001.SettingEngland, Scotland and Wales.ResultsThe median daily intakes of phytate for children, adolescents, adults and the elderly population were 496, 615, 809 and 629 mg/d, respectively. Although there were differences in phytate intakes between men and women, and for children, adolescents and elderly populations, after adjusting for differences in energy intake, there was no significant variation. The median phytate-to-zinc molar ratios for children, adolescents, adults and the elderly population were 11·8, 10·4, 9·7 and 8·7, respectively. Overall, the main sources of phytate were cereal and cereal products (e.g. breakfast cereals and breads), vegetables, potatoes and savoury snacks (e.g. chips and crisps), hot drinks and miscellaneous foods (e.g. commercial toddler foods and drinks, chocolate and soups), fruits and nuts.ConclusionsThe present study estimated the dietary intake of phytate and the phytate-to-zinc molar ratio of the diet of the UK population, which can be used for estimating the average requirement of zinc. Further research should focus on the completion and validation of the tables of phytate content of UK foods, to assess (and if necessary improve) the accuracy and precision of these findings.

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