Simulating future public health benefits of tobacco control interventions: a systematic review of models

2020 ◽  
pp. tobaccocontrol-2019-055425 ◽  
Author(s):  
Ankur Singh ◽  
Nick Wilson ◽  
Tony Blakely
Keyword(s):  
Systematic Review ◽  
Tobacco Control ◽  
Age Groups ◽  
Simulation Models ◽  
Time Lags ◽  
Future Trends ◽  
Medline Search ◽  
Policy Model ◽  
Life Years ◽  
The Impact

BackgroundTo prioritise tobacco control interventions, simulating their health impacts is valuable. We undertook a systematic review of tobacco intervention simulation models to assess model structure and input variations that may render model outputs non-comparable.MethodsWe applied a Medline search with keywords intersecting modelling and tobacco. Papers were limited to those modelling health outputs (eg, mortality, health-adjusted life years), and at least two of cancer, cardiovascular and respiratory diseases. Data were extracted for each simulation model with ≥3 arising papers, including: model type, untimed or with time steps and trends in business-as-usual (BAU) tobacco prevalence and epidemiology.ResultsOf 1911 papers, 186 met the inclusion criteria, including 13 eligible simulation models. The SimSmoke model had the largest number of publications (n=46), followed by Benefits of Smoking Cessation on Outcomes (n=12) and Tobacco Policy Model (n=10). Two of 13 models only estimated deaths averted, 1 had no time steps, 5 had no future trends in BAU tobacco prevalence, 9 had no future trends in BAU disease epidemiology and 7 had no time lags from quitting tobacco to reversal of health harm.ConclusionsConsiderable heterogeneity exists in simulation models, making outputs substantively non-comparable between models. Ranking of interventions by one model may be valid. However, this may not be true if, for example, interventions that differentially affect age groups (eg, a tobacco-free generation policy vs increased cessation among adults) do not account for plausible future trends. Greater standardisation of model structures and outputs will allow comparison across models and countries, and for comparisons of the impact of tobacco control interventions with other preventive interventions.

scholarly journals Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031598 ◽  
Author(s):  
Clare Meernik ◽  
Hannah M Baker ◽  
Sarah D Kowitt ◽  
Leah M Ranney ◽  
Adam O Goldstein
Keyword(s):  
Systematic Review ◽  
Risk Perceptions ◽  
Longitudinal Research ◽  
Age Groups ◽  
Experimental Studies ◽  
Final Analysis ◽  
Eligibility Criteria ◽  
Product Appeal ◽  
The Impact

ObjectivesGiven the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults.DesignPubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018.Eligibility criteriaQuantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation.Data extraction and synthesisThree authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure.ResultsThe review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies).ConclusionThis review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.

scholarly journals The Seroprevalence of SARS-CoV-2 in Europe: A Systematic Review

2021 ◽  
Author(s):  
Natasha Marcella Vaselli ◽  
Daniel Hungerford ◽  
Ben Shenton ◽  
Arwa Khashkhusha ◽  
Nigel A. Cunliffe ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Age Groups ◽  
Significant Heterogeneity ◽  
Community Studies ◽  
Past Infection ◽  
Significant Difference ◽  
The Impact

AbstractBackgroundA year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection.ObjectivesThis systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity.MethodsWe searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019 - 30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country.Results109 studies were included spanning 17 European countries, that estimated the seroprevalence of SAR-CoV2 from samples obtained between November 2019 – August 2020. A total of 53/109 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence among different age groups and the majority of studies reported there was no significant difference by gender.ConclusionThis review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.

scholarly journals Neurological diseases in Peru: a systematic analysis of the global burden disease study

2020 ◽  
Vol 78 (5) ◽  
pp. 282-289
Author(s):  
Carlos ALVA-DÍAZ ◽  
Andrely HUERTA-ROSARIO ◽  
Kevin PACHECO-BARRIOS ◽  
Roberto A. MOLINA ◽  
Alba NAVARRO-FLORES ◽  
...  
Keyword(s):  
Disease Burden ◽  
Neurological Diseases ◽  
Age Groups ◽  
Epidemiological Data ◽  
Global Burden ◽  
Years Of Life Lost ◽  
Systematic Analysis ◽  
Life Years ◽  
Disease Study ◽  
The Impact

ABSTRACT Background: Disease burden indicators assess the impact of disease on a population. They integrate mortality and disability in a single indicator. This allows setting priorities for health services and focusing resources. Objective: To analyze the burden of neurological diseases in Peru from 1990-2015. Methods: A descriptive study that used the epidemiological data published by the Institute for Health Metrics and Evaluation of Global Burden of Diseases from 1990 to 2015. Disease burden was measured using disability-adjusted life years (DALY) and their corresponding 95% uncertainty intervals (UIs), which results from the addition of the years of life lost (YLL) and years lived with disability (YLD). Results: The burden of neurological diseases in Peru were 9.06 and 10.65%, in 1990 and 2015, respectively. In 2015, the main causes were migraine, cerebrovascular disease (CVD), neonatal encephalopathy (NE), and Alzheimer’s disease and other dementias (ADD). This last group and nervous system cancer (NSC) increased 157 and 183% of DALY compared to 1990, respectively. Young population (25 to 44 years old) and older (>85 years old) were the age groups with the highest DALY. The neurological diseases produced 11.06 and 10.02% of the national YLL (CVD as the leading cause) and YLD (migraine as the main cause), respectively. Conclusion: The burden of disease (BD) increased by 1.6% from 1990 to 2015. The main causes were migraine, CVD, and NE. ADD and NSC doubled the DALY in this period. These diseases represent a significant cause of disability attributable to the increase in the life expectancy of our population among other factors. Priority actions should be taken to prevent and treat these causes.

scholarly journals Estimation of economic burden of COVID-19 using Disability-Adjusted Life Years (DALYs) and Productivity Losses in Kerala state, India

2020 ◽  
Author(s):  
Denny John ◽  
Narassima MS ◽  
Jaideep C Menon ◽  
Guru Rajesh Jammy
Keyword(s):  
Global Economy ◽  
Age Groups ◽  
Premature Mortality ◽  
Baseline Scenario ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Males And Females ◽  
Kerala State ◽  
The Impact

Abstract Background: The COVID-19 pandemic has had a huge impact on the global economy and stressed the health care systems worldwide. Measuring the burden of disease on health and economy is essential for system preparedness by way of allocation of funds and human resources.Methods: The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL) and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India. The impact of disease on various age-gender cohorts has been analyzed. Sensitivity Analysis has been conducted by adjusting six variables with a total of 21 scenarios. Results: Severity of infection and mortality were higher among older sub-group of patients, and male were more susceptible than female in most of the age groups. DALY for the baseline scenario was 15,924.24 and 8,669.32 for males and females respectively. The CPL due to premature mortality was 26,80,36,179 and 42,510,946 for males and females respectively. Conclusion: People aged more than 50 were disproportionately affected by the disease, with presence of comorbidities further raising vulnerability.

scholarly journals Which interactions matter in economic evaluations? A systematic review and simulation study

2020 ◽  
Author(s):  
Helen A Dakin ◽  
Alastair Gray
Keyword(s):  
Systematic Review ◽  
Statistical Significance ◽  
Simulated Data ◽  
Economic Evaluations ◽  
Net Benefit ◽  
Life Years ◽  
Randomised Controlled ◽  
Main Effects ◽  
Effect Ratio ◽  
The Impact

Abstract Background: We aimed to assess the magnitude of interactions in costs, quality-adjusted life-years (QALYs) and net benefits within a sample of published economic evaluations of factorial randomised controlled trials (RCTs), evaluate the impact that different analytical methods would have had on the results and compare the performance of different criteria for identifying which interactions should be taken into account.Methods: We conducted a systematic review of full economic evaluations conducted alongside factorial RCTs and reviewed the methods used in different studies, as well as the incidence, magnitude, statistical significance, and type of interactions observed within the trials. We developed the interaction-effect ratio as a measure of the magnitude of interactions relative to main effects. For those studies reporting sufficient data, we assessed whether changing the form of analysis to ignore or include interactions would have changed the conclusions. We evaluated how well different criteria for identifying which interactions should be taken into account in the analysis would perform in practice, using simulated data generated to match the summary statistics of the studies identified in the review.Results: Large interactions for economic endpoints occurred frequently within the 40 studies identified in the review, although interactions rarely changed the conclusions. Conclusions: Simulation work demonstrated that in analyses of factorial RCTs, taking account of all interactions or including interactions above a certain size (regardless of statistical significance) minimised the opportunity cost from adopting treatments that do not in fact have the highest true net benefit.

scholarly journals Cost-Effectiveness Analysis of Imaging Modalities for Breast Cancer Surveillance Among BRCA1/2 Mutation Carriers: A Systematic Review

2022 ◽  
Vol 11 ◽  
Author(s):  
Jiaxin Li ◽  
Ziqi Jia ◽  
Menglu Zhang ◽  
Gang Liu ◽  
Zeyu Xing ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cancer Surveillance ◽  
Cochrane Library ◽  
Mutation Carriers ◽  
Life Years ◽  
Screening Strategies ◽  
The Impact

BackgroundBRCA1/2 mutation carriers are suggested with regular breast cancer surveillance screening strategies using mammography with supplementary MRI as an adjunct tool in Western countries. From a cost-effectiveness perspective, however, the benefits of screening modalities remain controversial among different mutated genes and screening schedules.MethodsWe searched the MEDLINE/PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases to collect and compare the results of different cost-effectiveness analyses. A simulated model was used to predict the impact of screening strategies in the target group on cost, life-year gained, quality-adjusted life years, and incremental cost-effectiveness ratio (ICER).ResultsNine cost-effectiveness studies were included. Combined mammography and MRI strategy is cost-effective in BRCA1 mutation carriers for the middle-aged group (age 35 to 54). BRCA2 mutation carriers are less likely to benefit from adjunct MRI screening, which implies that mammography alone would be sufficient from a cost-effectiveness perspective, regardless of dense breast cancer.ConclusionsPrecision screening strategies among BRCA1/2 mutation carriers should be conducted according to the acceptable ICER, i.e., a combination of mammography and MRI for BRCA1 mutation carriers and mammography alone for BRCA2 mutation carriers.Systematic Review RegistrationPROSPERO, identifier CRD42020205471.

scholarly journals A Magic Bullet? The Potential Impact of E-Cigarettes on the Toll of Cigarette Smoking

2020 ◽  
Author(s):  
David Mendez ◽  
Kenneth E Warner
Keyword(s):  
Harm Reduction ◽  
Tobacco Control ◽  
Smoking Status ◽  
Vital Statistics ◽  
Control Measures ◽  
Magic Bullet ◽  
Health Crisis ◽  
Life Years ◽  
Quitting Smoking ◽  
The Impact

Abstract Introduction We examine the proportion of US smoking-produced mortality that e-cigarettes might eliminate under assumptions regarding vaping’s ability to increase smoking cessation, vaping’s health risks, and the possibility that vaping will increase smoking among young people. Methods We employ a dynamic population simulation model that tracks individuals from ages 0 to 110, differentiated by gender and smoking status. Using data from the US Census, the National Vital Statistics Reports, Cancer Prevention Study II, and the National Health Interview Survey, we estimate the number of smoking-related life-years lost (LYL) from 2018 to 2100 in a no-vaping scenario. We then compare results for model runs that assess the impact of vaping under a variety of assumptions. Results The combination of assumptions produces 360 possible scenarios. 357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143 000 to 65 million. Most scenarios result in millions of individuals quitting smoking due to vaping. On average, vaping-induced quitters gain an extra 1.2–2.0 years of life compared to smokers who quit without vaping. The impact of vaping is greatest when it most helps smokers who otherwise have the greatest difficulty quitting smoking. While the numbers of LYS are generally large across all scenarios, they often represent a small fraction of the toll of smoking. Conclusions Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not “the” answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures. Implications E-cigarettes hold the potential to reduce cigarette smoking’s enormous toll. By itself, however, tobacco harm reduction, as embodied in vaping, is no magic bullet. Going forward, tobacco control will require vigilant application of the evidence-based measures that have brought us so much success in combatting smoking. It will require, as well, the search for and adoption of novel means of attacking the remaining problem. Harm reduction can, and many would say should, be a part of the complex formula that will eventually bring about the demise of smoking.

scholarly journals Influenza and its relationship to circulatory disorders

2004 ◽  
Vol 133 (2) ◽  
pp. 255-262 ◽  
Author(s):  
D. M. FLEMING ◽  
K. W. CROSS ◽  
R. S. PANNELL
Keyword(s):  
Influenza A ◽  
Cross Correlation ◽  
Age Groups ◽  
Correlation Coefficients ◽  
Mortality Data ◽  
Time Lags ◽  
Emergency Admissions ◽  
Circulatory Disorders ◽  
Incident Cases ◽  
The Impact

Three sources of data (general practice episode data from the Weekly Returns Service of the Royal College of General Practitioners, national hospital admission data for England and national mortality data by date of death) were examined separately in each winter (1994/1995 to 1999/2000) to investigate the impact of influenza on circulatory disease. Weekly data on incidence (clinical new episodes) hospital emergency admissions and deaths certified to circulatory disorders and to respiratory diseases (chapters VII and VIII of ICD9) during influenza epidemic periods (defined from combined clinical/virological surveillance) were examined in age groups 45–64, 65–74 and [ges ]75 years. Data collected in the four winters in which there were substantial influenza A epidemics were consolidated for the period 6 weeks before to 6 weeks after each peak of the epidemic, and associations between the variables at different time lags examined by calculating cross-correlation coefficients. We also examined deaths due to ischaemic heart disease (IHD) as a proportion of all circulatory deaths and deaths due to influenza/pneumonia as a proportion of all respiratory deaths. There were no increases of GP episodes nor of emergency admissions for circulatory disorders in any of the three age groups during epidemic periods. Increased circulatory deaths occurred in all age groups and particularly in the oldest group. The large cross-correlation coefficients of deaths (circulatory and respiratory) with GP respiratory episodes at weekly lags of 0, −1 and 1 were evidence that the deaths and episode distributions were contemporaneous. The ratios of excess circulatory deaths relative to excess respiratory deaths during epidemic periods were 0·74 (age 45–64), 0·72 (65–74) and 0·57 ([ges ]75 years). Increased circulatory deaths contemporary with new incident cases of respiratory episodes but with no concomitant increase in admissions suggests rapid death during the acute phase of illness. Influenza contingency planning needs to take account of these deaths in determining policy for prophylaxis and in providing facilities for cardio-respiratory resuscitation.

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