scholarly journals An Engineering Perspective of External Cardiac Loop Recorder: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-16 ◽  
Author(s):  
Avvaru Srinivasulu ◽  
N. Sriraam
Keyword(s):  
Cost Effective ◽  
Instrumentation Amplifier ◽  
Processing Unit ◽  
Loop Recorder ◽  
Rural People ◽  
Analog To Digital ◽  
Comparative Review ◽  
Long Time ◽  
The Cost

External cardiac loop recorder (ELR) is a kind of ECG monitoring system that records cardiac activities of a subject continuously for a long time. When the heart palpitations are not the frequent and nonspecific character, it is difficult to diagnose the disease. In such a case, ELR is used for long-term monitoring of heart signal of the patient. But the cost of ELR is very high. Therefore, it is not prominently available in developing countries like India. Since the design of ELR includes the ECG electrodes, instrumentation amplifier, analog to digital converter, and signal processing unit, a comparative review of each part of the ELR is presented in this paper in order to design a cost effective, low power, and compact kind of ELR. This review will also give different choices available for selecting and designing each part of the ELR system. Finally, the review will suggest the better choice for designing a cost effective external cardiac loop recorder that helps to make it available even for rural people in India.

The Cost-Effectiveness of an RCT to Establish Whether 5 or 10 Years of Bisphosphonate Treatment Is the Better Duration for Women With a Prior Fracture

2009 ◽  
Vol 29 (6) ◽  
pp. 678-689 ◽  
Author(s):  
Matt D. Stevenson ◽  
Jeremy E. Oakley ◽  
Myfawny Lloyd Jones ◽  
Alan Brennan ◽  
Juliet E. Compston ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Fracture Prevention ◽  
Published Data ◽  
Bisphosphonate Treatment ◽  
Net Benefit ◽  
England And Wales ◽  
Term Efficacy ◽  
The Cost

Purpose. Five years of bisphosphonate treatment have proven efficacy in reducing fractures. Concerns exist that long-term bisphosphonate treatment may actually result in an increased number of fractures. This study evaluates, in the context of England and Wales, whether it is cost-effective to conduct a randomized controlled trial (RCT) and what sample size may be optimal to estimate the efficacy of bisphosphonates in fracture prevention beyond 5 years. Method. An osteoporosis model was constructed to evaluate the cost-effectiveness of extending bisphosphonate treatment from 5 years to 10 years. Two scenarios were run. The 1st uses long-term efficacy data from published literature, and the 2nd uses distributions elicited from clinical experts. Results of a proposed RCT were simulated. The expected value of sample information technique was applied to calculate the expected net benefit of sampling from conducting such an RCT at varying levels of participants per arm and to compare this with proposed trial costs. Results. Without further information, the better duration of bisphosphonate treatment was estimated to be 5 years using the published data but 10 years using the elicited expert opinions, although in both cases uncertainty was substantial. The net benefit of sampling was consistently high when between 2000 and 5000 participants per arm were recruited. Conclusions. An RCT to evaluate the long-term efficacy of bisphosphonates in fracture prevention appears to be cost-effective for informing decision making in England and Wales.

scholarly journals Cost-effective Analysis of Proton Pump Inhibitors in Long-term Management of Gastroesophageal Reflux Disease: A Narrative Review

2019 ◽  
Vol 55 (5) ◽  
pp. 292-305
Author(s):  
Shazia Jamshed ◽  
Akshaya Srikanth Bhagavathula ◽  
Sheikh Muhammad Zeeshan Qadar ◽  
Umaira Alauddin ◽  
Sana Shamim ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Gastroesophageal Reflux Disease ◽  
Cost Effective ◽  
The Other ◽  
Cost Effectiveness Ratio ◽  
On Demand ◽  
Step Down ◽  
The Cost ◽  
Term Management

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that results from regurgitation of acid from the stomach into the esophagus. Treatment available for GERD includes lifestyle changes, antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and anti-reflux surgery. Aim: The aim of this review is to assess the cost-effectiveness of the use of PPIs in the long-term management of patients with GERD. Method: We searched in PubMed to identify related original articles with close consideration based on inclusion and exclusion criteria to choose the best studies for this narrative review. The first section compares the cost-effectiveness of PPIs with H2RAs in long-term heartburn management. The other sections shall only discuss the cost-effectiveness of PPIs in 5 different strategies, namely, continuous (step-up, step-down, and maintenance), on-demand, and intermittent therapies. Results: Of 55 articles published, 10 studies published from 2000 to 2015 were included. Overall, PPIs are more effective in relieving heartburn in comparison with ranitidine. The use of PPIs in managing heartburn in long-term consumption of nonsteroidal anti-inflammatory drug (NSAID) has higher cost compared with H2RA. However, if the decision-maker is willing to pay more than US$174 788.60 per extra quality-adjusted life year (QALY), then the optimal strategy is traditional NSAID (tNSAID) and PPIs. The probability of being cost-effective was also highest for NSAID and PPI co-therapy users. On-demand PPI treatment strategy showed dominant with an incremental cost-effectiveness ratio of US$2197 per QALY gained and was most effective and cost saving compared with all the other treatments. The average cost-effectiveness ratio was lower for rabeprazole therapy than for ranitidine therapy. Conclusion: Our review revealed that long-term treatment with PPIs is effective but costly. To achieve long-term cost-effective approach, we recommend on-demand approach to treat heartburn symptoms, but if the symptoms persist, treatment with continuous step-down therapy should be applied.

scholarly journals Replacement and Maintenance Decision Analysis for Hydraulic Machinery Facilities at Reservoirs under Imperfect Maintenance

Energies ◽  
2020 ◽  
Vol 13 (10) ◽  
pp. 2507
Author(s):  
Sou-Sen Leu ◽  
Tao-Ming Ying
Keyword(s):  
Cost Effective ◽  
Maintenance Cost ◽  
Imperfect Maintenance ◽  
Term Operation ◽  
Engineering Economics ◽  
Hydraulic Machinery ◽  
Effective Manner ◽  
The Cost ◽  
Replacement Time

After the long-term operation of reservoir facilities, they will become nonoperational due to the material deterioration and the performance degradation. One of crucial decisions is to determine the maintenance or replacement of the facilities in a cost-effective manner. Conventional replacement models seldom consider the maintenance effect. The facilities after maintenance are generally not as good as new, but are relatively restored. The target of this study is to establish a replacement decision model of the reservoir facilities under imperfect maintenance. By combining the theories of reliability analysis, imperfect maintenance, and engineering economics, the best timing of replacement that achieves cost-effectiveness is analyzed and proposed. Lastly, based on the design of experiments (DOE) and simulation, the regression curve chart for the economical replacement decision is established. Once the failure rate, the age of recovery after maintenance, and the ratio of maintenance cost to replacement cost are estimated based on historical data, the cost-effective replacement time of hydraulic machinery facilities will be efficiently determined.

scholarly journals Cost-Effectiveness of an Obesity Management Program for 6- to 15-Year-Old Children in Poland: Data from Over Three Thousand Participants

Obesity Facts ◽  
2020 ◽  
Vol 13 (5) ◽  
pp. 487-498
Author(s):  
Ewa Bandurska ◽  
Michał Brzeziński ◽  
Paulina Metelska ◽  
Marzena Zarzeczna-Baran
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Management Program ◽  
Obesity And Overweight ◽  
School Programs ◽  
Overweight Group ◽  
Research Findings ◽  
Public Health Challenge ◽  
The Cost

<b><i>Background:</i></b> Obesity and overweight, including childhood obesity and overweight, pose a public health challenge worldwide. According to the available research findings, long-term interventions focusing on dietary behavior, physical activity, and psychological support are the most effective in reducing obesity in children aged 6–18 years. There are limited studies showing the financial effectiveness of such interventions. <b><i>Objective:</i></b> The objective of the present study was to evaluate cost-effectiveness of the 6-10-14 for Health weight management program using pharmacoeconomic indicators, i.e., cost-effectiveness analysis using the incremental cost-effectiveness ratio. <b><i>Methods:</i></b> We used anthropometric data of 3,081 children included in a 1-year-long intervention with a full financial cost assessment. <b><i>Results:</i></b> The cost of removing a child from the overweight group (BMI &#x3e;85th percentile) was PLN 27,758 (EUR 6,463), and the cost of removing a child from the obese group (BMI &#x3e;95th percentile) was slightly lower, i.e., PLN 23,601 (EUR 5,495). Given the obesity-related medical costs calculated in the life-long perspective, these results can be considered encouraging. At the same time, when comparing the total costs per participant with the costs of other interventions, it can be noted that they are similar to the costs of school programs containing more than 1 type of intervention. <b><i>Conclusions:</i></b> The 6-10-14 for Health program can be considered cost-effective. As a result of committing financial resources in the approximate amount of EUR 1,790 per child, around half of the children participating in the program have improved their weight indicators.

Controllable fabrication of α-Ni(OH)2 thin films with preheating treatment for long-term stable electrochromic and energy storage applications

2020 ◽  
Vol 8 (9) ◽  
pp. 3010-3016 ◽  
Author(s):  
Chunhua Su ◽  
Meijia Qiu ◽  
Yipeng An ◽  
Siyuan Sun ◽  
Chuanxi Zhao ◽  
...  
Keyword(s):  
Thin Films ◽  
Energy Storage ◽  
Cost Effective ◽  
Fast Switching ◽  
Energy Storage Application ◽  
One Step ◽  
Energy Storage Applications ◽  
Controllable Fabrication ◽  
The Cost

Long-term stable, fast switching α-Ni(OH)2 electrodes for electrochromic energy storage application has been fabricated by one-step preheating treatment. The cost-effective fabrication is expected to expand to other metal hydroxide materials.

scholarly journals Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress

2020 ◽  
Vol 17 (14) ◽  
pp. 5234
Author(s):  
Marijke Keus Van De Poll ◽  
Gunnar Bergström ◽  
Irene Jensen ◽  
Lotta Nybergh ◽  
Lydia Kwak ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Problem Solving ◽  
Mental Disorders ◽  
Sickness Absence ◽  
Common Mental Disorders ◽  
Cost Benefit ◽  
Cost Effective ◽  
Production Loss ◽  
The Cost

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer’s perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer’s perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

A Prospective Study on the Cost-Effective Utilization of Long-Term Inpatient Video-EEG Monitoring in a Developing Country

2009 ◽  
Vol 26 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Thomas Chemmanam ◽  
Ashalatha Radhakrishnan ◽  
Sankara P. Sarma ◽  
Kurupath Radhakrishnan
Keyword(s):  
Prospective Study ◽  
Developing Country ◽  
Cost Effective ◽  
Eeg Monitoring ◽  
Effective Utilization ◽  
A Prospective Study ◽  
The Cost ◽  
Video Eeg

scholarly journals The Study of Soybean Chaff Pressing Process Depending on Its Fractional Composition and Humidity

2019 ◽  
Vol 5 (5) ◽  
pp. 160-164 ◽  
Author(s):  
V. Shishkin ◽  
E. Shulzhenko
Keyword(s):  
Fractional Composition ◽  
Complex Mixture ◽  
Cost Effective ◽  
Laboratory Unit ◽  
Long Term Storage ◽  
The Cost ◽  
Far Eastern ◽  
And Storage ◽  
Term Storage

A by-product of soybean production, as a non-grain part of the crop, can be used to meet the needs of livestock in providing complete feeding of livestock. Pressing the floor allows to reduce the volume of plant material in order to reduce the cost of storage and transportation, improve the safety of its nutrients during long-term storage. Therefore, the development of an efficient, cost-effective and less energy-intensive technology and a process line for compacting the soybean floor by pressing is a promising direction. The pile of the floor is a complex mixture of particles of different sizes, as well as voids filled with air. Equipment compaction chaff should provide a stable preparation of pellets under all the fluctuations of the moisture content and fractional composition of chaff. In 2018, research experiments were carried out in the Far Eastern Scientific–Research Institute of Mechanization and Electrification of Agriculture to study the process of pressing the soybean floor, depending on its fractional composition and humidity, on the manufactured laboratory unit for compaction with the production of soybean floor briquettes. It was found that when the humidity of the sample increases from 9 to 21%, the energy consumption decreases by 17.1%. The coefficient of compaction of the floor when the humidity changes almost does not change. By increasing the length of the sex particles from 14 to 87 mm, the compaction coefficient increases by 73.3% and the energy intensity by 6.2 %. For transportation and storage of the soybean floor briquette, it is recommended to pack it tightly with polyethylene film or tie it with twine, this will increase the shelf life and eliminate losses.

scholarly journals Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

2019 ◽  
Vol 7 (22) ◽  
pp. 3837-3840
Author(s):  
Faridah Baroroh ◽  
Andriana Sari ◽  
Noviana Masruroh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
Hypertension Therapy ◽  
The Mean ◽  
The Cost

BACKGROUND: he achievement of optimal hypertension therapy requires cost-effective medicine. The treatment of hypertensive patients needs for long-term medication have made medical costs a prime issue in health economics. AIM: This study aims to determine the cost effectiveness of candesartan therapy compared to candesartan-amlodipine therapy on hypertensive outpatients. METHODS: This is a prospective cohort study that compares candesartan therapy to candesartan-amlodipine therapy at a public hospital from payers’ perspective. The outcome is the percentage of targeted blood pressure decrease after three months of therapy. The cost effectiveness analysis uses the Incremental Cost Effectiveness Ratio (ICER) based on the ratio of cost difference to the outcome in both therapy groups. RESULTS: As many as 111 patients participated in this research, comprising 40 candesartan therapy patients and 71 patients with the combination of candesartan-amlodipine. Of the participants, 63.96% were female, 57.66% were aged 60 or older, and 56.32% had diabetes mellitus as the most common complication. Results show that the average direct medical cost per patient for a therapy of three months with candesartan was IDR 1,050,536 ± 730,007 and IDR 760,040 ± 614,290 for a candesartan-amlodipine therapy. The mean decline of systolic and diastolic blood pressure under candesartan therapy is less than that of candesartan-amlodipine, although without any significant difference (p > 0.05). It follows that the effectiveness of candesartan (85%) is greater than that of the candesartan-amlodipine combination (84.50%). Candesartan therapy is thereby more cost-effective with an ICER value of IDR 580,993/%. CONCLUSION: Hypertension therapy by candesartan is more cost-effective than candesartan-amlodipine therapy with a cost addition of IDR 580,993.

scholarly journals Comparative Review on the Cost-Effectiveness Analysis of Relief Teams’ Deployment to Sudden-Onset Disasters

2019 ◽  
Vol 34 (04) ◽  
pp. 415-421 ◽  
Author(s):  
Andrea Bartolucci ◽  
Darren Walter ◽  
Tony Redmond
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Sudden Onset ◽  
Cost Effectiveness Analysis ◽  
Humanitarian Response ◽  
Lengths Of Stay ◽  
Effectiveness Analysis ◽  
Comparative Review ◽  
Detailed Assessment ◽  
The Cost

AbstractWhen a disaster exceeds the capacity of the affected country to cope with its own resources, the provision of external rescue and health services is required, and the deployment of relief units requested. Recently, the cost of international relief and the belief that such deployment is cost-effective has been questioned by the international community; unfortunately, there is still little informed debate and few detailed data are available. This paper presents the results of a comparative review on the cost-effectiveness analysis (CEA) of search and rescue (SAR) and Emergency Medical Team (EMT) deployment. The aim of this work is to provide an overview of the topic, highlight the criteria used to assess the effectiveness, and identify gaps in existing literature. The results show that both deployments are highly expensive, and their success is strongly related to the time they need to be operational; SAR deployments are characterized by limited outcomes in terms of lives saved, and EMTs by insufficient data and lack of detailed assessment. This research highlights that the criteria used to assess the effectiveness need to be explored further, considering different purposes, lengths of stay, and different activities performed, especially for any comparison. This study concludes that data reporting should be mandatory for humanitarian response agencies.

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