Routine Ultrasound Screening in the Third Trimester: A Population-Based Study

ObjectiveTo assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.DesignA population-based study.SettingNational Public Health Insurance claim database.ParticipantsAll pregnant women in the ‘Echantillon Généraliste des Bénéficiaires’, a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.Main outcomes measuresTrends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down’s syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.ResultsDuring the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.ConclusionEven if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.

Download Full-text

Population-based study of the relationship between medial meniscus radial displacement, determined by use of ultrasound screening, and knee pain

Journal of Orthopaedic Science ◽

10.1007/s00776-014-0628-x ◽

2014 ◽

Vol 19 (6) ◽

pp. 954-958 ◽

Cited By ~ 7

Author(s):

Shinya Yanagisawa ◽

Takashi Ohsawa ◽

Kenichi Saito ◽

Tsutomu Kobayashi ◽

Tsuyoshi Tajika ◽

...

Keyword(s):

Knee Pain ◽

Radial Displacement ◽

Medial Meniscus ◽

Population Based ◽

Ultrasound Screening ◽

Population Based Study ◽

The Relationship

Download Full-text

EPID-02. COUNTY MEDIAN FAMILY INCOME AS PROGNOSTIC FACTOR IN NON-SMALL-CELL LUNG CANCER WITH BRAIN METASTASES AT PRESENTATION: A POPULATION-BASED STUDY

Neuro-Oncology ◽

10.1093/neuonc/noab196.336 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi86-vi86

Author(s):

Ignacio Jusue-Torres ◽

Alicia Hulbert ◽

Jehad Zakaria ◽

Kathy S Albain ◽

Courtney Hentz ◽

...

Keyword(s):

Lung Cancer ◽

Brain Metastasis ◽

Household Income ◽

Population Based ◽

Small Cell ◽

Proportional Hazard ◽

Small Cell Lung ◽

Population Based Study ◽

The Third ◽

Cox Proportional Hazard

Abstract INTRODUCTION The purpose of this study was to characterize the impact of household income disparities in the survival of patients with non-small cell lung cancer (NSCLC) presenting with brain metastasis on a population-based level. METHODS This is a population-based cohort study using the SEER database from 2010-2016 including 15,808 NSCLC patients presenting with brain metastasis. Two-tailed log-rank test was used to compare overall survival between groups and association with survival was quantified using hazard ratios (HR) with 95 % confidence intervals (CI) assessed with univariate and multivariate Cox proportional hazard models. RESULTS Patients living in low-income counties had a median survival of 4 months when compared to 5 months for patients living in high-income counties respectively (p< 0.0001). Patients living in first and second bottom quartiles had a median survival of 4 months and 5 months and 6 months for the third and fourth top quartiles, respectively (p< 0.0001). The 1-, 2- and 5-year survival rates for living in the lower household income quartile were 21, 10 and 3% respectively, for the second quartile 24, 10 and 3%; for the third quartile 28, 14 and 4% and for the top fourth quartile 31, 17 and 4% respectively. Multivariate cox proportional hazard analysis adjusted for age, gender, race, hispanic ethnicity, marital status, insurance status, percentage of high school education in the patient’s county, histology, presence of lung metastasis, bone metastasis, liver metastasis, radiation received, surgery performed, and chemotherapy received showed that living in higher quartile household income county is associated with decrease mortality risk (p < 0.0001) HR 0.87 95% CI (0.82-92). CONCLUSION This population-based study suggests that living in higher median household income counties is associated with increased survival time and reduced risk of mortality for patients with NSCLC who have brain metastases present at diagnosis, independent of other factors.

Download Full-text

Influence of the third generation pill controversy on prescriptions for oral contraceptives among first time users: population based study

BMJ ◽

10.1136/bmj.326.7383.254 ◽

2003 ◽

Vol 326 (7383) ◽

pp. 254-254 ◽

Cited By ~ 9

Author(s):

L. de Jong-van den Berg

Keyword(s):

Oral Contraceptives ◽

Population Based ◽

Third Generation ◽

Population Based Study ◽

The Third ◽

First Time

Download Full-text

Inverse relationship between type 1 diabetes mellitus and migraine. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008

Cephalalgia ◽

10.1177/0333102417690488 ◽

2017 ◽

Vol 38 (3) ◽

pp. 417-426 ◽

Cited By ~ 7

Author(s):

Knut Hagen ◽

Bjørn Olav Åsvold ◽

Kristian Midthjell ◽

Lars Jacob Stovner ◽

John-Anker Zwart ◽

...

Keyword(s):

Diabetes Mellitus ◽

Inverse Relationship ◽

Population Based ◽

Classical Type ◽

Cross Sectional ◽

Population Based Study ◽

The Third ◽

Type 1 Dm

Aims The aim of this cross-sectional population-based study was to investigate the associations between migraine and type 1 and type 2 diabetes mellitus (DM). Methods We used data from the second (1995–1997) and third survey (2006–2008) in the Nord-Trøndelag Health Study. Analyses were made for the 26,121 participants (30–97 years of age, median 58.3 years) with known headache and DM status in both surveys, and for the 39,584 participants in the third survey (20–97 years, median 54.1 years). The diagnosis of migraine was given to those who fulfilled the questionnaire-based migraine diagnosis in the second and/or third survey. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). Results In the multivariate analysis of the 26,121 participants in both surveys, adjusting for age, gender, years of education, and smoking, classical type 1 DM (n = 81) was associated with a lower prevalence of any headache (OR = 0.55, 95% CI 0.34–0.88),and migraine (OR = 0.47, 95% CI 0.26–0.96) compared to those without DM (n = 24,779). Correspondingly, the merged group of classical type 1 DM and latent autoimmune diabetes of adults (LADA) (n = 153) were less likely to have migraine (OR = 0.53, 95% CI 0.31–0.91). Similarly, an inverse relationship between type 1 DM and migraine was found in analyses of 39,584 participants in the third survey. No clear association was found between headache and type 2 DM. Conclusions In this cross-sectional population-based study of mainly middle-aged participants, type 1 DM was inversely associated with headache, in particular migraine.

Download Full-text