scholarly journals A systematic review of the quality and scope of decision modelling studies in child oral health research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Greig D. Taylor ◽  
Katherine Carr ◽  
Helen J. Rogers ◽  
Chris R. Vernazza
Keyword(s):  
Economic Evaluation ◽  
Oral Health ◽  
Analytical Models ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Decision Modelling ◽  
Modelling Studies ◽  
The Mean ◽  
Child Oral Health

Abstract Background Decision analytic models are often used in economic evaluations to estimate long-term costs and effects of treatment which span beyond the time-frame of a clinical trial, therefore providing a better understanding of the long-term implications of decisions that conventional trial-based economic evaluations fail to provide. This is particularly relevant for considering oral health interventions in children as treatments may affect adult oral health. However, in the field of child oral health there has not been an evaluation of the quality and scope of decision analytical models which extend into adulthood. The aim of this review is to examine the scope and quality of decision modelling studies, with horizons extending into adulthood, within the field of child oral health. Methods The following databases were searched: NHS Economic Evaluation Database (CRD York), MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, the Cochrane Library and Econlit. Full economic evaluations, in the field of child oral health, published after 1997 which included a decision model with a horizon that extended beyond the age of 18 years old were included. Included studies were appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by calibrated reviewers. Results Four hundred studies were identified, of which nine met the inclusion criteria. Of the nine, eight were cost-effectiveness models. The majority focussed on the prevention or management of dental caries. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 82% (median = 85%, range = 54–100%). Discounting of costs and performing an incremental analysis were noted as key methodological weaknesses. The mean percentage of applicable CHEERS criteria met by each study was 82% (median = 87%, range = 32–96%). Justifying the type of model, analytical methods used, and sources of funding were most commonly unreported. Conclusions There is a paucity of decision analytical models in the field of child oral health. Most of those that are available are of high methodological and reporting quality.

scholarly journals Health economic measures in schizophrenia research

2007 ◽  
Vol 191 (S50) ◽  
pp. s42-s45 ◽  
Author(s):  
Paul McCrone
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Cost Utility ◽  
Outcome Data ◽  
Cost Utility Analysis ◽  
Economic Evaluations ◽  
Utility Analysis ◽  
Short Term ◽  
Effectiveness Analysis

BackgroundIt is essential in economic evaluations of schizophrenia interventions that all relevant costs are identified and measured appropriately Also of importance is the way in which cost data are combined with information on outcomesAimsTo examine the use of health economicsin evaluations of interventions for schizophreniaMethodsAreview of the key methods used to estimate costs and to link costs and outcomes was conductedResultsCosts fall on a number of different agencies and can be short term or long term. Cost-effectiveness analysis and cost-utility analysis are the most appropriate methods for combing cost and outcome dataConclusionsSchizophrenia poses a number of challenges for economic evaluation

Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review

2020 ◽  
Author(s):  
Juan Antonio Ruiz-Roca ◽  
Dora Martin-Fuentes ◽  
Yolanda Martinez-Beneyto ◽  
Ricardo Elias Oñate-Sanchez
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Elderly Patients ◽  
Soft Tissues ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Term Care

Abstract Background: elderly patients who spend long periods hospitalised or those who are in a situation of institutionalisation represent a risk group in this regard, since many of them suffer a degree of dependence and need help to perform the basic personal care tasks. It is therefore important to learn more about the oral health status of this group of patients in order to make a proper assessment of the situation as well as to develop protocols for its management. The purpose of this study was to conduct a systematic review to ascertain the oral health status of elderly patients institutionalised or hospitalised for a long period of time.Methods: a systematic review of the literature published in three different databases (PubMed, Embase and Cochrane Library) was conducted, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or care centre for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were assessed in some way. The selected articles were subjected to a thorough analysis.Results: The search strategy covered 1,014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was3, with a sample consisting of 773 patients in which most of them were women with an average age older than 70 years old.Conclusions: the oral health of patients aged more than 65 is worse than that of the rest of the population. Long-term in hospitals or being institutionalised in a retirement home makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programmes for the personnel.

scholarly journals The potential of economic evaluation studies to improve health screening and assessment policies for asylum seekers in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Biddle ◽  
K Wahedi ◽  
K Bozorgmehr
Keyword(s):  
Economic Evaluation ◽  
Asylum Seekers ◽  
Evaluation Studies ◽  
Scientific Evidence ◽  
Research Process ◽  
Health Screening ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Targeted Screening ◽  
Modelling Studies

Abstract This presentation will discuss the potential for conducting economic evaluation studies in the field of migration and health, by focusing on health screening and assessment for newly arriving asylum seekers. We use three economic case studies from Germany to illustrate this potential, reflecting on the benefits of an economic approach, the contribution of modelling studies, the quality and reliability of the underlying data sources and other lessons learnt in the research process. Screening for illness among newly arriving individuals has the potential to expand access to essential services and overcome access barriers, thus improving efficiency by preventing costs of late presentations. This is demonstrated by a recent modelling study on the cost-utility of screening for depression. However, an overview of different screening policies in Germany shows that unnecessary procedures which are not supported by sound scientific evidence may lead to inefficiencies in excess of €3.1 million, which could be more effectively invested in other parts of the health system. Finally, efficiency gains could be made by assessing who benefits most from screening, and designing targeted screening approaches for these groups, as in the case of targeted screening for active tuberculosis by country of origin. We will end the presentation by reflecting on the potential role for economic evaluations health policy-making, and the challenges of communicating and translating the nuances of economic evidence into practice.

Long-Term Effect of an Oral Health Promotion Program for Schoolchildren after the Interruption of Educational Activities

2007 ◽  
Vol 32 (1) ◽  
pp. 37-41 ◽  
Author(s):  
A. Antonio ◽  
A. Kelly ◽  
Daniella Valle ◽  
Roberto Vianna ◽  
Luís Eduardo Quintanilha
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Health Promotion Program ◽  
Long Term Effects ◽  
Oral Health Promotion ◽  
Educational Activities ◽  
Promotion Program ◽  
Gingival Bleeding ◽  
The Mean

This study aimed to verify the long-term effects of an oral-health-promotion program for 203 schoolchildren 24 months after the interruption of educational activities. They were clinically examined to assess dental plaque and gingival bleeding at baseline, immediately after the educational phase (EP), and 12 and 24 months after withdrawal of the EP. The mean plaque scores gradually increased after interruption of the EP,and in the last assessment they were higher than the baseline scores, but similar to the ones verified 12 months after withdrawal of the EP. The mean gingival bleeding scores were maintained after interruption of the EP. However, it was verified that in the last assessment they were lower than the previous evaluations. And, in all analyses, it was far from the baseline mean scores (P < 0.05). Analysis indicated that the duration of the program favorably influenced its outcome.

scholarly journals How are we evaluating the cost-effectiveness of companion biomarkers for targeted cancer therapies? A systematic review

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mikyung Kelly Seo ◽  
John Cairns
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Health State ◽  
Cancer Therapies ◽  
Companion Diagnostics ◽  
Targeted Cancer Therapies ◽  
Biomarker Testing ◽  
The Cost

Abstract Background Despite the increasing economic assessment of biomarker-guided therapies, no clear agreement exists whether existing methods are sufficient or whether different methods might produce different cost-effectiveness results. This study aims to examine current practices of modeling companion biomarkers when assessing the cost-effectiveness of targeted cancer therapies. It investigates the current methods in modeling the characteristics of companion diagnostics based on existing economic evaluations of biomarker-guided therapies in cancer. Methods A literature search was performed using Medline, Embase, EconLit, Cochrane library for economic evaluations of biomarker-guided therapies with companion diagnostics in cancer. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies were selected using pre-specified eligibility criteria based on the PICO framework. To make the included studies more comparable, we qualitatively synthesized the data under nine domains of methods where consensus was deemed lacking. Results Only four of the twenty-two studies included in this review were found to be of good quality with respect to incorporating the characteristics of companion biomarkers in economic evaluations. However, many evaluations focused on a pre-selected patient group rather than including all patients regardless of their biomarker status. Companion biomarker characteristics captured in evaluations were often limited to the cost or the accuracy of the test. Often, only the costs of biomarker testing were modelled. Clinical outcomes and health state utilities were often not included due to the limited data generated by clinical trials. Methods of economic evaluation were not applied consistently in assessments of companion cancer biomarkers for targeted therapies. It was also shown that conflicting cost-effectiveness results were likely depending on what comparator arm was chosen and what comparison structure was designed in the model. Conclusion We found no consistent approach applied in assessing the value of companion biomarker tests and including the characteristics of biomarkers in an economic evaluation of targeted oncology therapies. Currently, many economic evaluations fail to capture the full value of companion biomarkers beyond sensitivity/specificity and cost related to biomarker testing.

scholarly journals Health economic evaluation of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma: a systematic review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Haiyin Wang ◽  
Chunlin Jin ◽  
Liang Fang ◽  
Hui Sun ◽  
Wendi Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Stereotactic Body Radiotherapy ◽  
Health Economic Evaluation ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Advanced Hepatocellular Carcinoma ◽  
Noninvasive Treatment

AbstractStereotactic body radiotherapy (SBRT) is a novel noninvasive treatment for hepatocellular carcinoma. SBRT can achieve effective local control, but it requires a relatively high input of resources; this systematic review was performed to assess the cost effectiveness of SBRT in the treatment of hepatocellular carcinoma to provide a basis for government pricing and medical insurance decision-making. The PubMed, EMBASE, Cochrane Library, CNKI, Wanfang and SinoMed databases were searched to collect economic evaluations of SBRT for the treatment of hepatocellular carcinoma from the date of database inception through December 31, 2018. Two reviewers independently screened the studies, extracted the data and performed a descriptive analysis of the basic characteristics, methods of economic evaluation and main results, as well as the quality and heterogeneity of the reports. A total of 5 studies were included. Among them, the level of heterogeneity was relatively acceptable, with a median score of 90%. Four studies were cost-utility analyses (CUAs), and 1 was a cost-effectiveness analysis (CEA). The incremental cost effectiveness ratio (ICER) for sorafenib compared to SBRT was US $114,795 per quality-adjusted life year gained (cost/QALY) in patients with advanced hepatocellular carcinoma. The ICER for proton beam therapy compared to SBRT was US $6465 in patients with inoperable advanced hepatocellular carcinoma. The ICER for SBRT compared to RFA was US $164,660 for patients with unresectable colorectal cancer (CRC) with liver metastases and US $56,301 for patients with early-stage hepatocellular carcinoma. For patients with inoperable localized hepatocellular carcinoma, compared with RFA–SBRT therapy, the ICERs for SBRT–SBRT and SBRT–RFA were US $558,679 and US $2197,000, respectively; RFA–RFA was dominated. In conclusion, there is limited evidence suggesting that SBRT could be cost-effective for highly specific subpopulations of HCC patients, and further economic evaluations based on randomized controlled trials (RCTs) or cohort studies are needed.

scholarly journals Comparison of a full arch digital photographic assessment of caries prevalence in 5-year-old children to an established visual assessment method: a cross-sectional study

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicole Thomas ◽  
Elizabeth Kay ◽  
Robert Witton ◽  
Cath Quinn
Keyword(s):  
Oral Health ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Digital Images ◽  
Dental Disease ◽  
Gold Standard Method ◽  
Mean Values ◽  
Digital Epidemiology ◽  
The Mean ◽  
Child Oral Health

Abstract Introduction Digital epidemiology in dental disease screening has a number of advantages which warrant further exploration. Aim This study aimed to test the examination accuracy of digital images to evaluate child oral health by comparing the new method to a gold standard method. It also investigated the levels of diagnostic accuracy between different examiners, including dental care professionals and a lay examiner, when quantifying dental disease using images. Methods A calibrated dental examiner inspected forty 5-year-olds. In addition, three sets of digital images were taken per child. These images were assessed by six examiners. Sensitivity and specificity of caries diagnosis and inter-examiner reliability were calculated to compare the caries scores derived from examination of the images to those of the gold standard examinations. Results The mean values for sensitivity and specificity scores were 48.0% and 99.1%, respectively. The mean value for kappa showed moderate agreement between 0.43 and 0.73 (0.57). Mean values for agreement using intra-class coefficients were excellent (0.78) and good (0.73) for dt and dmft, respectively. No statistical difference in the validity of the caries scores was shown between the different image assessors. Conclusions These data demonstrate the feasibility of using digital images to screen child oral health and for nondental professionals to be recruited to carry out digital epidemiology for the oral health surveillance of children.

scholarly journals Discounting in economic evaluation of healthcare interventions: what about the risk term?

2021 ◽  
Vol 22 (3) ◽  
pp. 357-363
Author(s):  
Lars Hultkrantz
Keyword(s):  
Economic Evaluation ◽  
Economic Evaluations ◽  
National Guidelines ◽  
Long Term Outcomes ◽  
Social Rate ◽  
The Social ◽  
Health Related ◽  
Healthcare Interventions

AbstractResults from economic evaluations of long-term outcomes are strongly dependent on the chosen discount rate. A recent review of national guidelines for evaluation of healthcare interventions finds that “the level of currently used discount rates seems relatively high in many countries”. However, this conclusion comes from a comparison to rates derived or observed for investments in safe assets, while rate of return requirements are typically considerably higher when investment involves risk. This paper reviews recent literature on how to account for project-specific risk in determination of the social rate of discount and discusses implications for economic evaluation of healthcare interventions. It concludes that the available empirical evidence strongly suggests that the demand for and consumer value of health and healthcare is co-variant with income, which therefore implies that there is a non-diversifiable risk component of health-related investment.

Quality Assessment of Reporting of Economic Evaluation in Cardiac Sugery: Has it Improved?

2019 ◽  
Vol 35 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Pascale Guerre ◽  
Nermine Laaboub ◽  
Cyrille Colin ◽  
Jean-François Obadia ◽  
Christell Julien ◽  
...  
Keyword(s):  
Health Economic ◽  
Cardiac Surgery ◽  
Economic Evaluation ◽  
Health Economic Evaluation ◽  
Scientific Progress ◽  
Reporting Quality ◽  
Economic Evaluations ◽  
Quality Of Reporting ◽  
The Mean

AbstractObjectivesCardiac surgery has seen substantial scientific progress over recent decades. Health economic evaluations have become important tools for decision makers to prioritize scarce health resources. The present study aimed to identify and critically appraise the reporting quality of health economic evaluations conducted in the field of cardiac surgery.MethodsA literature search was performed to identify health economic evaluations in cardiac surgery. The consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to assess the quality of reporting of studies.ResultsA total 4,705 articles published between 1981 and 2016 were identified; sixty-nine studies fulfilled the inclusion criteria. There was a trend toward a greater number of publications and reporting quality over time. Six (8.7 percent) studies were conducted between 1981 and 1990, nine (13 percent) between 1991 and 2000, twenty-four (34.8 percent) between 2001 and 2010, and thirty (43.5 percent) after 2011. The mean CHEERS score of all articles was 16.7/24; for those published between 1980 and 1990 the mean (SD) score was 10.2 (±1.4), for those published between 1991 and 2000 it was 11.2 (±2.4), between 2001 and 2010 it was 15.3 (±4.8), and after 2011 it was 19.9 (±2.9). The quality of reporting was still insufficient for several studies after 2000, especially concerning items “characterizing heterogeneity,” “assumptions,” and “choice of model.”ConclusionsThe present study suggests that, even if the quantity and the quality of health economics evaluation in cardiac surgery has increased, there remains a need for improvement in several reporting criteria to ensure greater transparency.

scholarly journals Oral Status of elderly patients in long stay centres: A systematic review

2020 ◽  
Author(s):  
Juan Antonio Ruiz-Roca ◽  
Dora Martin-Fuentes ◽  
Yolanda Martinez-Beneyto ◽  
Ricardo Elias Oñate-Sanchez
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Elderly Patients ◽  
Soft Tissues ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Level Of Evidence

Abstract Background: Elderly patients who spend long periods hospitalized or those who are in a situation of institutionalization represent a risk group in this regard, as many of them suffer a degree of dependence and need help to perform the basic tasks of personal care. It is therefore important to learn more of the oral health status of this group of patients in order to make a proper assessment of the situation and to develop protocols for its management.The purpose of the study was to conduct a systematic review to ascertain the oral health status of elderly patients admitted to institutions or hospitalized for a long period of time. Methods: a systematic review of the literature published in two different databases (PubMed, Embase and Cochrane Library) was carried out, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or hospital center for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were evaluated in some way. The selected articles were subjected to a thorough analysis. Results: The search strategy covered1 , 014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, fivearticles were selected for our review. The level of evidence of the articles was3, a sample of 773 patients most of them were women with an average age older than 70 years old. Conclusions: the oral health of patients aged more than 65 is worse than that of the rest population. Long hospital stays or being institutionalized in a residence makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programs for the personnel responsible. Key words: “elderly inpatients”, “elderly hospitalized patients”, “long term hospitalization”, “long term inpatients”, “oral health”, “oral status”.

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