Multi-trait selection indexes for sustainable UK hill sheep production

2001 ◽  
Vol 73 (3) ◽  
pp. 413-423 ◽  
Author(s):  
J. Conington ◽  
S.C. Bishop ◽  
B. Grundy ◽  
A. Waterhouse ◽  
G. Simm
Keyword(s):  
Production Systems ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Breeding Goal ◽  
Agricultural College ◽  
Selection Indexes ◽  
Sheep Production ◽  
The Uk ◽  
Mature Size ◽  
Original Index

AbstractThree selection indexes for the UK hill sheep sector are derived to suit the extremes of hill production systems. These are: (i) intensive, where all surplus lambs not required for breeding are finished for slaughter, (ii) extensive, where all surplus ‘store’ lambs are sold to other farmers for finishing, and (iii) semi-intensive, which is intermediate between the two extremes, i.e. farms finish some lambs for slaughter and sell others as store lambs. Parameters for 12 breeding goal and index traits were estimated using a total of 3962 lamb records and 5944 ewe lambing records from Scottish Blackface sheep on two Scottish Agricultural College experimental hill farms. The breeding goal comprised carcass, maternal and survival traits. The evaluation of these indexes showed that improvements in maternal traits are possible, along with more modest improvements in carcass quality traits. Responses to selection are expected to be lower for the extensive farm in general, compared with the intensive farm. Evaluations of alternative indexes show that an index using measurements of fat and muscle on ewes rather than on lambs may be more cost-effective to implement in practice, compared with the original index, although this change results in a higher (i.e. undesirable) gain in mature size. Sensitivity analyses showed that in general, the indexes are robust to changes in economic values and to changes in heritability estimates.

A bio-economic approach to estimating economic values for UK hill sheep

2000 ◽  
Vol 2000 ◽  
pp. 39-39 ◽  
Author(s):  
J. Conington ◽  
S. Bishop ◽  
A. Waterhouse ◽  
G. Simm
Keyword(s):  
Production Systems ◽  
Farm Size ◽  
Economic Values ◽  
Physical Constraints ◽  
Sheep Industry ◽  
Breeding Goal ◽  
Selection Indexes ◽  
Sheep Production ◽  
Combine Information ◽  
Economic Selection

Profitability of sheep production systems depends on several different animal characteristics rather than a single trait. Economic selection indexes combine information from more than one trait into an overall score, to maximise genetic gain. Economic values (EVs) are required for each trait in the breeding goal so that selection emphasis is proportional to the economic importance of each trait. Defining clear breeding goals is more complex for hill breeds than for other sectors of the sheep industry because they provide breeding females in addition to lambs for slaughter. The aims of this paper are to i) describe how EVs for breeding goal traits suitable for UK hill sheep were derived for a combination of carcass, maternal and ‘sustainability’ traits using a bio-economic model, and ii) show how these EVs vary between different production systems as a result of the differences in the physical constraints of farm size, pasture availability and the biological limits of sheep in extensive rearing environments.

scholarly journals A Cost-Effectiveness Analysis of Newborn Screening for Severe Combined Immunodeficiency in the UK

2019 ◽  
Vol 5 (3) ◽  
pp. 28 ◽  
Author(s):  
Alice Bessey ◽  
James Chilcott ◽  
Joanna Leaviss ◽  
Carmen de la Cruz ◽  
Ruth Wong
Keyword(s):  
Cost Effectiveness ◽  
Severe Combined Immunodeficiency ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Combined Immunodeficiency ◽  
Tree Model ◽  
Life Years ◽  
The Uk ◽  
The Cost ◽  
The Impact

Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia.

scholarly journals Cost-effectiveness of an insertable cardiac monitor in a high-risk population in the UK

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e001037 ◽  
Author(s):  
Claudia I Rinciog ◽  
Laura M Sawyer ◽  
Alexander Diamantopoulos ◽  
Mitchell S V Elkind ◽  
Matthew Reynolds ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
High Risk Population ◽  
Risk Population ◽  
Life Years ◽  
The Uk ◽  
The Cost

ObjectiveTo evaluate the cost-effectiveness of insertable cardiac monitors (ICMs) compared with standard of care (SoC) for detecting atrial fibrillation (AF) in patients at high risk of stroke (CHADS2 >2), using a UK National Health Service (NHS) perspective.MethodsUsing patient characteristics and clinical data from the REVEAL AF trial, a Markov model assessed the cost-effectiveness of detecting AF with an ICM compared with SoC. Costs and benefits were extrapolated across modelled patient lifetime. Ischaemic and haemorrhagic strokes, intracranial and extracranial haemorrhages and minor bleeds were modelled. Diagnostic and device costs were included, plus costs of treating stroke and bleeding events and costs of oral anticoagulants (OACs). Costs and health outcomes, measured as quality-adjusted life years (QALYs), were discounted at 3.5% per annum. One-way deterministic and probabilistic sensitivity analyses (PSA) were undertaken.ResultsThe total per-patient cost for ICM was £13 360 versus £11 936 for SoC (namely, annual 24 hours Holter monitoring). ICMs generated a total of 6.50 QALYs versus 6.30 for SoC. The incremental cost-effectiveness ratio (ICER) was £7140/QALY gained, below the £20 000/QALY acceptability threshold. ICMs were cost-effective in 77.4% of PSA simulations. The number of ICMs needed to prevent one stroke was 21 and to cause a major bleed was 37. ICERs were sensitive to assumed proportions of patients initiating or discontinuing OAC after AF diagnosis, type of OAC used and how intense the traditional monitoring was assumed to be under SoC.ConclusionsThe use of ICMs to identify AF in a high-risk population is cost-effective for the UK NHS.

scholarly journals Cost-effectiveness analysis of tranexamic acid for the treatment of traumatic brain injury, based on the results of the CRASH-3 randomised trial: a decision modelling approach

2020 ◽  
Vol 5 (9) ◽  
pp. e002716
Author(s):  
Jack Williams ◽  
Ian Roberts ◽  
Haleema Shakur-Still ◽  
Fiona E Lecky ◽  
Rizwana Chaudhri ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tranexamic Acid ◽  
Randomised Trial ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Risk Of Death ◽  
Life Years ◽  
Markov Decision Model ◽  
The Uk ◽  
The Cost

IntroductionAn estimated 69 million traumatic brain injuries (TBI) occur each year worldwide, with most in low-income and middle-income countries. The CRASH-3 randomised trial found that intravenous administration of tranexamic acid within 3 hours of injury reduces head injury deaths in patients sustaining a mild or moderate TBI. We examined the cost-effectiveness of tranexamic acid treatment for TBI.MethodsA Markov decision model was developed to assess the cost-effectiveness of treatment with and without tranexamic acid, in addition to current practice. We modelled the decision in the UK and Pakistan from a health service perspective, over a lifetime time horizon. We used data from the CRASH-3 trial for the risk of death during the trial period (28 days) and patient quality of life, and data from the literature to estimate costs and long-term outcomes post-TBI. We present outcomes as quality-adjusted life years (QALYs) and 2018 costs in pounds for the UK, and US dollars for Pakistan. Incremental cost-effectiveness ratios (ICER) per QALY gained were estimated, and compared with country specific cost-effective thresholds. Deterministic and probabilistic sensitivity analyses were also performed.ResultsTranexamic acid was highly cost-effective for patients with mild TBI and intracranial bleeding or patients with moderate TBI, at £4288 per QALY in the UK, and US$24 per QALY in Pakistan. Tranexamic acid was 99% and 98% cost-effective at the cost-effectiveness thresholds for the UK and Pakistan, respectively, and remained cost-effective across all deterministic sensitivity analyses. Tranexamic acid was even more cost-effective with earlier treatment administration. The cost-effectiveness for those with severe TBI was uncertain.ConclusionEarly administration of tranexamic acid is highly cost-effective for patients with mild or moderate TBI in the UK and Pakistan, relative to the cost-effectiveness thresholds used. The estimated ICERs suggest treatment is likely to be cost-effective across all income settings globally.

Cost-effectiveness of zoledronic acid versus placebo in the management of skeletal metastases in lung cancer patients (LC pts): Comparison across three European countries

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 8081-8081
Author(s):  
J. Stephens ◽  
S. Kaura ◽  
M. F. Botteman
Keyword(s):  
Zoledronic Acid ◽  
Bone Metastases ◽  
Diagnosis Related Groups ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Skeletal Metastases ◽  
Lung Cancer Patients ◽  
Life Years ◽  
Economic Analyses ◽  
The Uk

8081 Background: Zoledronic acid (ZOL) reduces the risk of skeletal-related events (SREs) in LC pts with bone metastases. The present retrospective analysis compared the economic impact of ZOL in LC pts in France, Germany, and the United Kingdom (UK). Methods: Estimated direct costs and quality-adjusted life-years (QALYs) experienced by LC pts with bone metastases receiving placebo (PBO) or ZOL were modeled and compared. Overall survival (OS), SRE incidence, and number of infusions administered were obtained from a 21-mo randomized clinical trial comparing the proportion of pts who experienced an on-study SRE with 4 mg ZOL or PBO every 3 wk (Rosen et al. JCO. 2003). Costs of treatments and SREs were estimated using national reimbursement listings (eg, diagnosis-related groups), private databases, and published literature. Mean number of SREs was calculated by multiplying mean SRE rate by OS for LC pts in the study. For QALYs, OS was multiplied by a utility factor of 0.53. Consistent with similar economic analyses, it was assumed that quality of life (QOL) decreased 20% to 80% (depending on the SRE type) for 1 mo after each SRE experienced. Sensitivity analyses were performed to test the effects of alternate scenarios, with < €30,000/QALY considered cost-effective. Results: During the median OS of 179 days, PBO pts (n = 120) experienced a mean of 2.07 SREs vs 1.32 SREs among ZOL pts (n = 124). QALYs were estimated at 0.352/pt (ZOL pts) and 0.335/pt (PBO pts). Use of ZOL resulted in a net increase of 0.017 QALY/pt vs PBO. ZOL drug-related costs were €1,610, €1,510 and €1,597 per pt in France, Germany, and the UK, respectively. Use of ZOL resulted in reductions in SRE costs of €2,221, €2,031, and €2,014 per pt, respectively. Overall, ZOL saved €598 per pt in France, €521 in Germany, and €417 in the UK. In sensitivity analyses, ZOL was cost-effective under a variety of scenarios (total range, -€98,356 to +€34,052 per QALY). Conclusions: ZOL leads to fewer SREs, better estimated QOL, and lower estimated costs relative to PBO in German, French, and UK LC pts with bone metastases. Use of ZOL in these populations is therefore cost-saving and highly cost-effective. [Table: see text]

Cost-effectiveness of zoledronic acid in the prevention of skeletal-related events in patients with bone metastases from renal cell carcinoma: Comparison between France, Germany, and the United Kingdom

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5106-5106
Author(s):  
M. F. Botteman ◽  
S. Kaura
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Life Years ◽  
Health Related ◽  
Skeletal Related Events ◽  
The Uk

5106 Background: Zoledronic acid (ZOL) significantly reduces the risk of new skeletal-related events (SREs) in patients (pts) with bone metastases from RCC. This study assessed and compared the cost-effectiveness of ZOL in pts with RCC from French, German, and United Kingdom (UK) societal perspectives. Methods: This analysis was based on a retrospective analysis of RCC pts with bone metastases who were enrolled in a 9-mo trial of ZOL or placebo (PBO) plus concomitant antineoplastic therapy. A model was developed to simulate costs and quality-adjusted life-years (QALYs) experienced by study pts. The model included data and assumptions regarding SRE incidence, mortality, drug and administration costs, SRE costs, reduced quality of life (QOL) because of SREs and bone pain, and therapy duration. SRE costs were estimated using diagnosis-related group tariff information and published literature. Consistent with similar economic analyses, it was assumed that QOL decreased 20% to 80% (depending on SRE type) for 1 mo after each SRE experienced. Sensitivity analyses were performed to test the effects of alternate assumptions, with < 30,000/QALY considered cost-effective. Results: Compared with PBO-treated pts (n = 19), ZOL-treated pts (n = 27) experienced 1.07 fewer SREs/pt and gained discounted QALYs of approximately 0.1563 in France and Germany and 0.1575 in the UK. Discounted SRE-related costs were substantially lower among pts treated with ZOL vs PBO (-4,196 in France, -3,880 in Germany, and -3,355 in the UK). After including drug therapy costs, ZOL saved 1,358, 1,223, and 719 per pt in France, Germany, and the UK, respectively. In multivariate sensitivity analyses, ZOL saved costs in 67% to 77% of cases, depending on the country. ZOL resulted in a cost per QALY gained < 30,000 in approximately 93% of cases. Conclusions: Treatment with ZOL reduces SREs, improves QOL, and lowers health-related costs compared with PBO in French, German, and UK pts with bone metastases from RCC. Use of ZOL in these populations therefore provides health-related cost savings and is a cost-effective use of healthcare resources. [Table: see text]

Breeding for reduced methane emissions in extensive UK sheep systems

2012 ◽  
Vol 150 (5) ◽  
pp. 570-583 ◽  
Author(s):  
D. J. COTTLE ◽  
J. CONINGTON
Keyword(s):  
Production Systems ◽  
Selection Index ◽  
Farming Systems ◽  
Cost Effective ◽  
Carbon Price ◽  
Methane Emissions ◽  
Direct Selection ◽  
Production Traits ◽  
The Uk ◽  
Carbon Prices

SUMMARYSelection index theory was used to model the effects of methane (CH4) production in the breeding objective on genetic responses in Scottish Blackface sheep in hill production systems in the UK. A range of economic values (EVs) were assumed for CH4 production calculated from possible carbon prices (£/t CO2 equivalent (CO2-e)). The implicit price of carbon required for maintenance of CH4 levels or to reduce CH4 production by 0·1 kg/head/yr in a hill flock was calculated. The predicted genetic changes in CH4 production from current selection programmes that have an implicit methane EV of zero were calculated. Correlations between production traits and CH4 production were sampled from assumed normal distributions, as these correlations are currently unknown. Methane emissions are likely to increase at a rate of c. 3 kg CO2-e/ewe/yr as a result of using current industry selection indices in hill sheep farming systems in the UK. Breeding objectives for more productive hill sheep include reducing lamb losses and rearing more, heavier lambs. By placing a cost on carbon emissions to halt the genetic increase in methane, heavy penalties will be incurred by farmers in terms of reduced productivity. This amounts to £6/ewe/yr or a 5% discounted loss of £2851 per 100 ewe flock over a 10-year selection horizon. If the correlations between production traits and CH4 are positive (as expected) then an implicit carbon price of c. £272/t CO2-e is required for no genetic increase in CH4 production if methane is not measured and c. £50/t CO2-e if methane could be measured. Achievement of government targets for the whole economy of a 20% reduction in greenhouse gases (GHGs) over a 30-year period would require carbon prices (/t CO2-e) of £1396 (indirect selection) or £296 (direct selection) for the sheep industry to achieve a 20% reduction entirely via a genetic change of c. –0·1 kg methane/head/yr. These carbon prices are placed in the context of possible government policies. A combination of genetic and non-genetic measures will probably be required for cost-effective reduction in methane production to meet government targets.

scholarly journals Cost-effectiveness of polygenic risk profiling for primary open-angle glaucoma in the United Kingdom and Australia

2021 ◽  
Author(s):  
Qinqin Liu ◽  
John Davis ◽  
Xikun Han ◽  
David A Mackey ◽  
Stuart MacGregor ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Open Angle ◽  
Polygenic Risk ◽  
Risk Profiling ◽  
The Uk ◽  
The Cost

ABSTRACTObjectivePrimary open-angle glaucoma (POAG) is the most common subtype of glaucoma worldwide. Early diagnosis and intervention is proven to slow disease progression and reduce disease burden. Currently, population-based screening for POAG is not generally recommended due to cost. In this study, we evaluate the cost-effectiveness of polygenic risk profiling as a screening tool for POAG.Methods and AnalysisWe used a Markov cohort model to evaluate the cost-effectiveness of implementing polygenic risk profiling as a new POAG-screening approach in the UK and Australia. Six health states were included in this model: death, early, mild, moderate, severe, and healthy individuals. The evaluation was conducted from the healthcare payer’s perspective. We used the best available published data to calculate prevalence, transition probabilities, utility and other parameters for each health state and age group. The study followed the CHEERS checklist. Our main outcome measure was the incremental cost-effectiveness ratio (ICER) and secondary outcomes were years of blindness avoided per person and a ‘Blindness ICER’. We did one-way and two-way deterministic and probabilistic sensitivity analyses to reflect the uncertainty around predicting ICERs.ResultsOur proposed genetic screening programme for POAG in Australia is predicted to result in ICER of AU$34,252 (95% CI AU$21,324-95,497) and would avoid 1 year of blindness at ICER of AU$13,359 (95% CI: AU$8,143-37,448). In the UK, this screening is predicted to result in ICER of £24,783 (13,373-66,960) and would avoid 1 year of blindness at ICER of £10,095 (95%CI: £5,513-27,656). Findings were robust in all sensitivity analyses. Using the willingness to pay thresholds of $54,808 and £30,000, the proposed screening model is 79.2% likely to be cost-effective in Australia and is 60.2% likely to be cost-effective in the UK, respectively.ConclusionsWe describe and model the cost-efficacy of incorporating a polygenic risk score for POAG screening in Australia and the UK. Although the level of willingness to pay for Australian Government is uncertain, and the ICER range for the UK is broad, we showed a clear target strategy for early detection and prevention of advanced POAG in these developed countries.Copyrightthe Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd to permit this article (if accepted) to be published in BMJ editions and any other BMJPGL products and sublicences such use and exploit all subsidiary rights, as set out in our licence.

scholarly journals Is single-inhaler triple therapy for COPD cost-effective in the UK? The IMPACT trial

2021 ◽  
pp. 00333-2021
Author(s):  
Alan Martin ◽  
Dhvani Shah ◽  
Kerigo Ndirangu ◽  
Glenn A Anley ◽  
Gabriel Okorogheye ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Outcomes ◽  
Triple Therapy ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Lifetime Horizon ◽  
Once Daily ◽  
Life Years ◽  
The Uk ◽  
The Impact

BackgroundThe IMPACT trial demonstrated superior outcomes following 52 weeks of once-daily single-inhaler treatment with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 μg compared with once-daily FF/VI (100/25 μg) or UMEC/VI (62.5/25 μg). This study evaluates the cost-effectiveness of FF/UMEC/VI compared with FF/VI or UMEC/VI for the treatment of chronic obstructive pulmonary disease (COPD) from a United Kingdom National Health Service perspective.MethodsPatient characteristics and treatment effects from IMPACT were populated into a hybrid decision tree/Markov economic model. Costs (GB£ inflated to 2018 equivalents) and health outcomes were modelled over a lifetime horizon, with a discount rate of 3.5% per annum applied to both. Sensitivity analyses were performed to test the robustness of key assumptions and input parameters.ResultsCompared with FF/VI and UMEC/VI, FF/UMEC/VI provided an additional 0.296 and 0.145 life years (LYs; discounted), and 0.275 and 0.118 quality-adjusted life years (QALYs), at an additional cost of £1129 and £760, respectively. Incremental cost-effectiveness ratios (ICERs) for FF/UMEC/VI were £4104/QALY and £3809/LY gained versus FF/VI and £6418/QALY and £5225/LY gained versus UMEC/VI. At a willingness-to-pay threshold of £20 000/QALY, the probability that FF/UMEC/VI was cost-effective was 96% versus FF/VI and 74% versus UMEC/VI. Results were similar in a subgroup reflecting patients recommended triple therapy in the 2019 National Institute for Health and Care Excellence COPD guideline.ConclusionsFF/UMEC/VI single-inhaler triple therapy improved health outcomes and was a cost-effective option compared with FF/VI or UMEC/VI for patients with symptomatic COPD and a history of exacerbations in the UK at recognised cost-effectiveness threshold levels.

Development of a maternal breeding goal and tools to select for this goal in UK beef production

2005 ◽  
Vol 81 (2) ◽  
pp. 221-232 ◽  
Author(s):  
T. Roughsedge ◽  
P. R. Amer ◽  
R. Thompson ◽  
G. Simm
Keyword(s):  
Beef Industry ◽  
Dual Purpose ◽  
Breeding Goal ◽  
Selection Decisions ◽  
Selection Indexes ◽  
Estimated Breeding Values ◽  
The Uk ◽  
Terminal Sire ◽  
Calving Difficulty ◽  
Selection Of

AbstractA maternal breeding goal for the UK beef industry is described and economic selection indexes are developed to assist in the selection of animals for the goal. The breeding objective is made up of general maternal ability traits, cow size, calving and carcass traits. The general maternal ability traits include calving interval, age at first calving, lifespan, maternal weaning weight and maternal calving difficulty. The calculations of economic values for the traits are outlined and discounted genetic expression coefficients are presented. Three selection indexes are illustrated. The first provides a general dualpurpose index for the selection of bulls to produce replacement heifers in most situations. The second, the hardy breed index, is designed to allow selection for improved maternal performance in extensive and hardy environments. The third, the fertile herd index, allows producers who do not have herd fertility problems to place more selection emphasis on objectives other than fertility. A sample of data from the Limousin breed was used to calculate estimated breeding values (EBVs) which were used to investigate response to the three indexes when the top 20% of sires were selected from either sires with 50 or more grand-maternal progeny or bulls with no recorded progeny. Approximately two thirds of the economic response seen in the selection of heavily used bulls was observed in bulls with no progeny for the hardy and dual-purpose indexes. Bulls were also selected using the existing UK terminal sire index and the resulting bulls assessed in the dual-purpose maternal index. There was found to be a negative economic response to the maternal aspect of the index, though a positive response was seen in the carcass objective. The indexes are presented as the sum of four subindexes emphasizing the contribution of maternal ability, cow size, calving and carcass, respectively to the total index. This further assists commercial producers in selection decisions.

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