scholarly journals Scope and costs of autorefraction and photoscreening for childhood amblyopia—a systematic narrative review in relation to the EUSCREEN project data

Eye ◽  
2020 ◽  
Author(s):  
Anna M. Horwood ◽  
◽  
Helen J. Griffiths ◽  
Jill Carlton ◽  
Paolo Mazzone ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Large Scale ◽  
English Language ◽  
Cost Effective ◽  
Original Data ◽  
Community Services ◽  
Narrative Review ◽  
Effective Option ◽  
Automated Screening ◽  
Project Data

Abstract Background Amblyopia screening can target reduced visual acuity (VA), its refractive risk factors, or both. VA testing is imprecise under 4 years of age, so automated risk-factor photoscreening appears an attractive option. This review considers photoscreening used in community services, focusing on costs, cost-effectiveness and scope of use, compared with EUSCREEN project Country Reports describing how photo- and automated screening is used internationally. Methods A systematic narrative review was carried out of all English language photoscreening literature to September 10th 2018, using publicly available search terms. Where costs were considered, a CASP economic evaluation checklist was used to assess data quality. Results Of 370 abstracts reviewed, 55 reported large-scale community photoscreening projects. Five addressed cost-effectiveness specifically, without original data. Photoscreening was a stand-alone, single, test event in 71% of projects. In contrast, 25 of 45 EUSCREEN Country Reports showed that if adopted, photoscreening often supplements other tests in established programmes and is rarely used as a stand-alone test. Reported costs varied widely and evidence of cost-effectiveness was sparse in the literature, or in international practice. Only eight (13%) papers compared the diagnostic accuracy or cost-effectiveness of photoscreening and VA testing, and when they did, cost-effectiveness of photoscreening compared unfavourably. Discussion Evidence that photoscreening reduces amblyopia or strabismus prevalence or improves overall outcomes is weak, as is evidence of cost-effectiveness, compared to later VA screening. Currently, the most cost-effective option seems to be a later, expert VA screening with the opportunity for a re-test before referral.

Performance Evaluation of Reflective Crack Mitigation Techniques for Soil-Cement Bases

2020 ◽  
Vol 2674 (11) ◽  
pp. 901-914
Author(s):  
Mohammad Reza-Ul-Karim Bhuyan ◽  
Mohammad Jamal Khattak
Keyword(s):  
Cost Effectiveness ◽  
Large Scale ◽  
Cost Effective ◽  
Pavement Management ◽  
Crack Control ◽  
Soil Cement ◽  
Chip Seal ◽  
Effective Option ◽  
Cost Effective Technique ◽  
Two Parameters

The Louisiana Department of Transportation and Development (DOTD), U.S., has been using chip seal as an interlayer over cement stabilized base courses over the last several years to mitigate the reflective cracking for flexible pavements. Furthermore, DOTD is also changing the soil-cement base type from traditional cement stabilized design (CSD) to cement treated design (CTD) as another technique to control reflective cracks. There have been no large-scale studies conducted to determine the effectiveness of chip seal interlayer over CSD bases or CTD bases (without any interlayer) as a way of reflective crack control. Therefore, the focus of this study is to evaluate both these techniques by using the available time-series distress data (roughness, cracking, and rutting) in the pavement management system. With the help of this distress data, the performance of all different categories of projects was evaluated by two parameters: average service lives (SL) and benefit areas. Along with the ascertained cost, the SL and benefit areas were also used to determine benefit/cost (B/C) ratios for each category of projects. Subsequently, the cost-effectiveness of chip seal interlayer over CSD bases and CTD bases was assessed by the comparison of the B/C ratios. The performance and cost-effectiveness of few stone interlayer projects were also reported in this study. Finally, it was concluded that the chip seal interlayer is the least cost-effective option and CTD bases without any interlayer appeared to be the most cost-effective technique for reflective crack mitigation in Louisiana.

scholarly journals Cost-Effectiveness Analysis of a Large-Scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

2021 ◽  
Author(s):  
Y. Natalia Alfonso ◽  
Adnan A Hyder ◽  
Olakunle Alonge ◽  
Shumona Sharmin Salam ◽  
Kamran Baset ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Societal Perspective ◽  
Large Scale ◽  
Operating Cost ◽  
Cost Effective ◽  
Economic Benefits ◽  
Program Cost ◽  
Rural Bangladesh ◽  
Life Years ◽  
The Cost

Abstract Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche intervention in preventing child drowning. Estimates of the effectiveness of the crèches was based on prior studies and the program cost was assessed using monthly program expenditures captured prospectively throughout the study period from two different implementing agencies. The study evaluated the cost-effectiveness from both a program and societal perspective. Results showed that from the program perspective the annual operating cost of a crèche was $416.35 (95%C.I.: $222 to $576), the annual cost per child was $16 (95%C.I.: $9 to $22) and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,803 (95%C.I.: $9,051 to $27,625). From the societal perspective (including parents time valued) the ICER per life saved was -$176,62 (95%C.I.: -$347,091 to -$67,684)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $2,020, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Based on the evidence, the creche intervention has great potential for reducing child drowning at a cost that is reasonable.

scholarly journals Economic Evaluation of Five Tobacco Control Policies Across Seven European Countries

2019 ◽  
Vol 22 (7) ◽  
pp. 1202-1209
Author(s):  
Teresa Leão ◽  
Julian Perelman ◽  
Luke Clancy ◽  
Martin Mlinarić ◽  
Jaana M Kinnunen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tobacco Control ◽  
Large Scale ◽  
Cost Effective ◽  
World Health ◽  
Economic Evaluations ◽  
Short Term ◽  
Healthy Life ◽  
Control Policies ◽  
Tobacco Control Policies

Abstract Introduction Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. Methods Cost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%–50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness. Findings Nonschool bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programs up to €481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity. Conclusions All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates. Implications Economic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates.

scholarly journals Extracting Outcomes from Appellate Decisions in US State Courts

2020 ◽  
Author(s):  
Alina Petrova ◽  
John Armour ◽  
Thomas Lukasiewicz
Keyword(s):  
Large Scale ◽  
English Language ◽  
Learning System ◽  
State Courts ◽  
Research Attention ◽  
Textual Description ◽  
Set Up ◽  
Access Project ◽  
Project Data ◽  
F Measure

Predicting the outcome of a legal process has recently gained considerable research attention. Numerous attempts have been made to predict the exact outcome, judgment, charge, and fines of a case given the textual description of its facts and metadata. However, most of the effort has been focused on Chinese and European law, for which there exist annotated datasets. In this paper, we introduce CASELAW4 — a new dataset of 350k common law judicial decisions from the U.S. Caselaw Access Project, of which 250k have been automatically annotated with binary outcome labels of AFFIRM or REVERSE by our hybrid learning system. To our knowledge, it is the first attempt to perform outcome extraction (a) on such a large volume of English-language judicial opinions, (b) on the Caselaw Access Project data, and (c) on US State Courts of Appeal cases, and it paves the way to large-scale outcome prediction and advanced legal analytics using U.S. Case Law. We set up baseline results for the outcome extraction task on the new dataset, achieving an F-measure of 82.32%.

PP167 Cost Effectiveness Of Universal Childhood Vaccination Against Hepatitis A

2021 ◽  
Vol 37 (S1) ◽  
pp. 24-24
Author(s):  
Cristina Valcarcel-Nazco ◽  
Carmen Guirado-Fuentes ◽  
Lidia García-Pérez ◽  
Renata Linertová ◽  
Javier Mar ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis A ◽  
National Health System ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Childhood Vaccination ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Effective Option ◽  
Intermediate Endemicity

IntroductionHepatitis A (HA) is a liver disease with a low mortality rate, but it can cause debilitating symptoms and fulminant hepatitis in some cases. Its incidence is greater in geographical areas with poor sanitation and hygiene. Spain is considered a low-endemicity country, so universal childhood immunization against HA is currently not financed by the National Health System. The aim of this study was to synthesize the scientific evidence on the cost effectiveness of universal childhood vaccination against HA.MethodsFull economic evaluations, published in the English or Spanish languages, were included if they reported outcome measures related to the prevention of HA, adverse effects, or incremental cost-effectiveness ratios (ICERs). The Medline, Embase and Cochrane Library databases were searched for articles published from the beginning of the databases to April 2018.ResultsA total of 23 economic evaluations were included: one in a country of high endemicity, nine in countries of intermediate endemicity, and 13 in countries with low endemicity. Only one Spanish study, published in 1997, was found. Studies conducted in high- and intermediate- endemicity countries concluded that a universal childhood vaccination program against HA was a cost-effective option. However, in the case of countries with low endemicity the results were heterogeneous, although most agreed that a systematic vaccination strategy would not be a cost-effective option and that the adoption of such a strategy would not be justified given the limited benefits it would offer. The results of the economic evaluations depended on parameters such as the price and duration of the vaccine effect and the program coverage.ConclusionsIn countries with low endemicity the results were heterogeneous, although most studies concluded that the implementation of a universal vaccination strategy is not justified from the point of view of cost effectiveness.

Comparative Evaluation of the Cost-Effectiveness of 58 Transportation Control Measures

1998 ◽  
Vol 1641 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Cynthia Pansing ◽  
Eric N. Schreffler ◽  
Mark A. Sillings
Keyword(s):  
Cost Effectiveness ◽  
Control Measure ◽  
Public Investment ◽  
Demand Management ◽  
Cost Effective ◽  
Alternative Fuel ◽  
Control Measures ◽  
Standardized Method ◽  
Project Data ◽  
The Cost

Often when public agencies allocate funding for transportation programs, evaluation of a project’s performance becomes an afterthought, if a consideration at all. Relatively recently, evaluation of project performance has garnered attention as a means for both assessing how cost-effectively public funds help attain transportation and air quality objectives and guiding future public investment decisions. Nonetheless, these efforts suffer at times from a lack of coordination and would benefit from the application of a standardized method. Such a standardized method is applied to evaluate the cost-effectiveness of three categories of transportation control measure (TCM) projects: fixed-route transit, transportation demand management (TDM), and alternative fuel projects. The method provides a means for estimating and quantifying travel mode effects and converting them to net emissions benefits. Three sets of funding programs implemented in California were the subjects of evaluation efforts in which the standardized method was applied. The results of these evaluations are presented, and conclusions are suggested about project cost-effectiveness on the basis of project data and comparisons across categories of projects. On the basis of the evaluation of 58 projects, TDM projects other than telecommunications projects were cost-effective compared with alternative fuel and fixed-route transit projects. In light of the key evaluation findings, an approach and framework for future evaluations of TCM projects to ensure consistency and comparability are proposed. Some future uses of the evaluation data in the form of a centralized database are also suggested.

scholarly journals Critical factors for assembling a high volume of DNA barcodes

2005 ◽  
Vol 360 (1462) ◽  
pp. 1959-1967 ◽  
Author(s):  
Mehrdad Hajibabaei ◽  
Jeremy R deWaard ◽  
Natalia V Ivanova ◽  
Sujeevan Ratnasingham ◽  
Robert T Dooh ◽  
...  
Keyword(s):  
Dna Barcoding ◽  
Large Scale ◽  
Pcr Amplification ◽  
Cost Effective ◽  
High Volume ◽  
Dna Barcodes ◽  
Museum Collections ◽  
Future Success ◽  
Effective Option ◽  
Key Steps

Large-scale DNA barcoding projects are now moving toward activation while the creation of a comprehensive barcode library for eukaryotes will ultimately require the acquisition of some 100 million barcodes. To satisfy this need, analytical facilities must adopt protocols that can support the rapid, cost-effective assembly of barcodes. In this paper we discuss the prospects for establishing high volume DNA barcoding facilities by evaluating key steps in the analytical chain from specimens to barcodes. Alliances with members of the taxonomic community represent the most effective strategy for provisioning the analytical chain with specimens. The optimal protocols for DNA extraction and subsequent PCR amplification of the barcode region depend strongly on their condition, but production targets of 100K barcode records per year are now feasible for facilities working with compliant specimens. The analysis of museum collections is currently challenging, but PCR cocktails that combine polymerases with repair enzyme(s) promise future success. Barcode analysis is already a cost-effective option for species identification in some situations and this will increasingly be the case as reference libraries are assembled and analytical protocols are simplified.

scholarly journals Automated Screening System for Covid Safety

2021 ◽  
Vol 11 (2) ◽  
pp. 39-42
Author(s):  
Y Sai Subhash Reddy ◽  
◽  
Sri Krishna Borra ◽  
Koye Sai Vishnu Vamsi ◽  
Nandipati Jaswanth Sai ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Large Scale ◽  
Raw Materials ◽  
Cost Effective ◽  
Foreseeable Future ◽  
The World ◽  
Life Threatening ◽  
Automated Screening ◽  
The Government ◽  
Optimum Solution

COVID-19 is a life-threatening virus taking the lives of thousands of people every day throughout the world. Even though many organizations and companies worked hard and developed vaccines, production of vaccines at large scale to meet today’s demand is not an easy job as there is a shortage of raw materials and cases are rising steeply. Inoculation of every individual cannot be achieved in the foreseeable future. Even the government is vaccinating people in a phased manner prioritizing older people and people who are more vulnerable to the virus. The main objective of this work is to provide an optimum solution for COVID-19 indoor safety for industries, offices, and commercial places where footfall is high. This work focus on automation of temperature sensing and mask detection which is usually carried out by a person. Elimination of human intervention reduces the risk of contraction and spreading and avoids mistakes due to human negligence. Continuous monitoring of a person is not possible and there is no guarantee that a person who is entering a place wearing a mask puts it on until he leaves it. This research intends to implement mask detection along with surveillance which is cost effective as it does not require additional hardware setup.

scholarly journals Economic performance and cost-effectiveness of using a DEC-salt social enterprise for eliminating the major neglected tropical disease, lymphatic filariasis

2018 ◽  
Author(s):  
Swarnali Sharma ◽  
Morgan E. Smith ◽  
James Reimer ◽  
David B. O'Brien ◽  
Jean M. Brissau ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Lymphatic Filariasis ◽  
Business Strategy ◽  
Social Enterprise ◽  
Production Capacity ◽  
Cost Effective ◽  
Competitive Market ◽  
Mixed Product ◽  
Cumulative Impact ◽  
Effective Option

Background Salt fortified with the drug, diethylcarbamazine (DEC), and introduced into a competitive market has the potential to overcome the obstacles associated with tablet-based Lymphatic Filariasis (LF) elimination programs. Questions remain, however, regarding the economic viability, production capacity, and effectiveness of this strategy as a sustainable means to bring about LF elimination in resource poor settings. Methodology and Principal Findings We evaluated the performance and effectiveness of a novel social enterprise-based approach developed and tested in Léogâne, Haiti, as a strategy to sustainably and cost-efficiently distribute DEC-medicated salt into a competitive market at quantities sufficient to bring about the elimination of LF. We undertook a cost-revenue analysis to evaluate the production capability and financial feasibility of the developed DEC salt social enterprise, and a modeling study centered on applying a dynamic mathematical model localized to reflect local LF transmission dynamics to evaluate the cost-effectiveness of using this intervention versus standard annual Mass Drug Administration (MDA) for eliminating LF in Léogâne. We show that the salt enterprise because of its mixed product business strategy may have already reached the production capacity for delivering sufficient quantities of edible DEC-medicated salt to bring about LF transmission in the Léogâne study setting. Due to increasing revenues obtained from the sale of DEC salt over time, expansion of its delivery in the population, and greater cumulative impact on the survival of worms, this strategy could also represent a significantly more cost-effective option than annual DEC tablet-based MDA for accomplishing LF elimination. Significance A social enterprise approach can offer an innovative market-based strategy by which edible salt fortified with DEC could be distributed to communities both on a financially sustainable basis and at sufficient quantity to eliminate LF. Deployment of similarly fashioned intervention strategies would improve current efforts to successfully accomplish the goal of LF elimination, particularly in difficult-to-control settings.

scholarly journals Azacitidine for the treatment of myelodysplastic syndrome, chronic myelomonocytic leukaemia and acute myeloid leukaemia

2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. 69-74
Author(s):  
R Edlin ◽  
M Connock ◽  
S Tubeuf ◽  
J Round ◽  
A Fry-Smith ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Acute Myeloid Leukaemia ◽  
Myelodysplastic Syndrome ◽  
Cost Effective ◽  
Effective Option ◽  
Chronic Myelomonocytic Leukaemia ◽  
Rbc Transfusion ◽  
Acute Myeloid

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of azacitidine (aza) compared with conventional care regimes (CCR) for higher risk patients with myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML), based on the evidence submission from the manufacturer to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The patient outcomes governing relative effectiveness and cost-effectiveness were defined as overall survival, time to progression (TTP) to AML, adverse events and health-related quality of life (HRQoL). The clinical evidence was derived from open label randomised controlled trial referred to as study AZA-001. It compared aza with CCR in 358 patients with higher risk MDS, CMML and AML 20–30% blasts. The outcomes reported in AZA-001 included overall survival, TTP to AML and adverse events. No HRQoL results were reported; however, outcomes likely to impact on HRQoL were provided. The results showed that: the median overall survival was 24.5 months on aza, compared with 15.0 months in the CCR group (p = 0.0001); the response rates were low (complete remission 17% aza versus 8% CCR); the median time to transformation to AML was greater in the aza group (17.8 versus 11.5 months; p < 0.0001); and of patients who were red blood cell (RBC) transfusion-dependent at baseline, 45% of those on aza became RBC transfusion-independent during the treatment period, compared with 11.8% in the CCR group (p < 0.0001). The ERG reran the submission’s search strategies after some modifications incorporating minor improvements. The ERG analysed the submitted economic model (model 1) and identified a number of inconsistencies and errors within the model. The manufacturer submitted a revised model for analysis by the ERG. Using the issues identified in the earlier analysis, the ERG conducted those repairs to the revised model that were feasible within time constraints. The ERG ran this version in probabilistic sensitivity analyses to generate cost-effectiveness acceptability frontiers. The results of these exploratory analyses indicated that: for standard-dose chemotherapy (SDC)-treated patients, of six treatment options available, best supportive care (BSC) was likely the most cost-effective option up to a threshold of £51,000/quality-adjusted life-year (QALY) [beyond £51,000/QALY, aza + low-dose chemotherapy (LDC) became cost-effective]; for LDC-treated patients, of four options available, BSC was again the most cost-effective option up to a willingness-to-pay threshold of £51,000/QALY (aza + LDC became cost-effective after £51,000/QALY); for BSC-treated patients, aza + BSC became cost-effective relative to BSC at a threshold of about £52,000/QALY. The ERG considers these results exploratory and considers that they should be viewed with caution. The AZA-001 study showed that, compared with CCR, those MDS patients receiving aza had prolonged median survival, had delayed progression to AML, had reduced dependence on transfusions and had a small improvement in response rate. Given the general paucity of economic modelling work in MDS and the limitations of the submitted industry model there is an evident need for an independent cost-effectiveness analysis of aza in MDS. At the time of writing, the guidance appraisal consultation document issued by NICE on 4 March 2010 states that azacitidine is not recommended as a treatment option for people not eligible for haemopoietic stem cell transplantation with the the following conditions: intermediate-2 and high-risk MDS according to the International Prognostic Scoring System, CMML with 10-29% marrow blasts without myeloproliferative disorder, or with AML with 20-30% blasts and multilineage dysplasia, according to World Health Organization classification.

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