scholarly journals Home-based screening for biliary atresia using infant stool colour cards: A large-scale prospective cohort study and cost-effectiveness analysis

2014 ◽  
Vol 21 (3) ◽  
pp. 126-132 ◽  
Author(s):  
Richard A. Schreiber ◽  
Lisa Masucci ◽  
Janusz Kaczorowski ◽  
JP Collet ◽  
Pamela Lutley ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Biliary Atresia ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Large Scale ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Home Based

scholarly journals Cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study: a protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050452
Author(s):  
Sarah Jane Stock ◽  
Amarnath Bhide ◽  
Heather Richardson ◽  
Mairead Black ◽  
Cassandra Yuill ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Process Evaluation ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cost Effectiveness Analysis ◽  
Cervical Ripening ◽  
Effectiveness Analysis ◽  
At Home

IntroductionThe aim of the cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study is to compare home versus in-hospital cervical ripening to determine whether home cervical ripening is safe (for the primary outcome of neonatal unit (NNU) admission), acceptable to women and cost-effective from the perspective of both women and the National Health Service (NHS).Methods and analysisWe will perform a prospective multicentre observational cohort study with an internal pilot phase. We will obtain data from electronic health records from at least 14 maternity units offering only in-hospital cervical ripening and 12 offering dinoprostone home cervical ripening. We will also conduct a cost-effectiveness analysis and a mixed methods study to evaluate processes and women/partner experiences. Our primary sample size is 8533 women with singleton pregnancies undergoing induction of labour (IOL) at 39+0 weeks’ gestation or more. To achieve this and contextualise our findings, we will collect data relating to a cohort of approximately 41 000 women undergoing IOL after 37 weeks. We will use mixed effects logistic regression for the non-inferiority comparison of NNU admission and propensity score matched adjustment to control for treatment indication bias. The economic analysis will be undertaken from the perspective of the NHS and Personal Social Services (PSS) and the pregnant woman. It will include a within-study cost-effectiveness analysis and a lifetime cost–utility analysis to account for any long-term impacts of the cervical ripening strategies. Outcomes will be reported as incremental cost per NNU admission avoided and incremental cost per quality adjusted life year gained.Research ethics approval and disseminationCHOICE has been funded and approved by the National Institute of Healthcare Research Health Technology and Assessment, and the results will be disseminated via publication in peer-reviewed journals.Trial registration numberISRCTN32652461.

scholarly journals High-Resolution Melting Is a Sensitive, Cost-Effective, Time-Saving Technique for BRAF V600E Detection in Thyroid FNAB Washing Liquid: A Prospective Cohort Study

2015 ◽  
Vol 4 (2) ◽  
pp. 73-81 ◽  
Author(s):  
Marco Marino ◽  
Maria Laura Monzani ◽  
Giulia Brigante ◽  
Katia Cioni ◽  
Bruno Madeo ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Resolution ◽  
Molecular Analysis ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Large Scale ◽  
High Resolution Melting ◽  
Cost Effective ◽  
Braf V600e Mutation ◽  
Braf V600e

Objective: The diagnostic accuracy of thyroid fine needle aspiration biopsy (FNAB) can be improved by the combination of cytological and molecular analysis. In this study, washing liquids of FNAB (wFNAB) were tested for the BRAF V600E mutation, using the sensitive and cost-effective technique called high-resolution melting (HRM). The aim was to demonstrate the feasibility of BRAF analysis in wFNAB and its diagnostic utility, combined with cytology. Design: Prospective cohort study. Methods: 481 patients, corresponding to 648 FNAB samples, were subjected to both cytological (on cells smeared onto a glass slide) and molecular analysis (on fluids obtained washing the FNAB needle with 1 ml of saline) of the same aspiration. BRAF V600E analysis was performed by HRM after methodological validation for application to wFNAB (technique sensitivity: 5.4%). Results: The cytological results of the FNAB were: 136 (21%) nondiagnostic (THY1); 415 (64%) benign (THY2); 80 (12.4%) indeterminate (THY3); 9 (1.4%) suspicious for malignancy (THY4); 8 (1.2%) diagnostic of malignancy (THY5). The BRAF V600E mutation was found in 5 THY2, 2 THY3, 6 THY4 and 6 THY5 samples. Papillary carcinoma diagnosis was histologically confirmed in all BRAF+ thyroidectomized patients. BRAF combined with cytology improved the diagnostic value compared to cytology alone in a subgroup of 74 operated patients. Conclusions: HRM was demonstrated to be a feasible method for BRAF analysis in wFNAB. Thanks to its sensitivity and cost-effectiveness, it might be routinely used on a large scale in clinical practice. In perspective, standby wFNAB samples could be analyzed a posteriori in case of indeterminate cytology and/or suspicious findings on ultrasound.

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