Interpreting the Notion of "Nonbeneficial"

PEDIATRICS ◽  
1991 ◽  
Vol 88 (3) ◽  
pp. 637-639
Author(s):  
OLLE JANE Z. SAHLER
Keyword(s):  
Resource Allocation ◽  
Cost Effectiveness ◽  
Medical Research ◽  
Program Effectiveness ◽  
Primary Concern ◽  
Focus Attention ◽  
Research And Practice ◽  
Balanced Budgets

Resource allocation is of increasing concern as we seek to provide necessary services to our citizens within the confines of balanced budgets. Of particular interest to those allocating resources is the issue of efficiency or cost effectiveness (cost/those who benefit). Although budgetary constraints tend to focus attention on cost effectiveness, consideration of program effectiveness (the number of people who actually benefit/those who theoretically could benefit), itself, must be a primary concern of medical research and practice. Without this information, we cannot be assured that our patients are receiving the best care possible, let alone secure funding for programs that promise the best return for each dollar spent.

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

scholarly journals Colorectal cancer screening:potential pitfalls

2001 ◽  
Vol 24 (1) ◽  
pp. 148 ◽  
Author(s):  
John Duggan
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Medical Research ◽  
Colorectal Cancer Screening ◽  
National Health ◽  
Research Council ◽  
Medical Research Council

The National Health and Medical Research Council has recently issued guidelines on colo-rectal cancer, and givensignificant support to Colorectal Cancer Screening. However, the evidence of cost-effectiveness is inconclusiveaccording to the Cochrane Centre.I argue that it would be wise to undertake trials that are appropriately funded. Otherwise, there is a risk that muchmoney will be spent that cannot subsequently be justified.

HIV Screening of Surgeons and Dentists: A Cost-Effectiveness Analysis

1994 ◽  
Vol 15 (10) ◽  
pp. 635-645 ◽  
Author(s):  
Randall L. Sell ◽  
Albert J. Jovell ◽  
Joanna E. Siegel
Keyword(s):  
Cost Effectiveness ◽  
Hiv Transmission ◽  
Program Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Hiv Positive ◽  
Hiv Screening ◽  
Case Scenario ◽  
Screening Programs ◽  
Voluntary Program

AbstractObjective:To assess the cost-effectiveness of human immunodeficiency virus (HIV) screening strategies of surgeons and dentists.Design:We constructed a model to project costs and HIV transmissions prevented over 15 years for four screening scenarios: 1) one-time voluntary screening, 2) one-time mandatory screening, 3) annual voluntary screening, and 4) annual mandatory screening. One-time screening occurs only in the first year of the program; annual screening occurs once each year. Under mandatory screening, all practitioners are tested and risks of practitioner-to-patient transmission are eliminated for all practitioners testing positive. Voluntary screening assumes 90% of HIV-positive and 50% of HIV-negative practitioners are tested, and risks of transmission in the clinical setting are eliminated for 90% of HIV-positive surgeons and dentists. All costs and benefits are discounted at 5% per annum over 15 years.Results:Using “best-case” scenario assumptions, we find for surgeons that a one-time voluntary screening program would be most cost-effective, at $899,336 for every HIV transmission prevented. For dentists, the one-time voluntary program also is the most cost-effective, at $139,571 per transmission prevented. Annual mandatory programs were least cost-effective for both surgeons and dentists, at $63.3 million and $2.2 million per transmission prevented, respectively.Conclusions:HIV screening of surgeons and dentists ranks among the more expensive medical lifesaving programs, even using liberal assumptions about program effectiveness. Frequency of screening and whether testing is mandatory or voluntary dramatically affect cost per transmission prevented; these features should be considered carefully in designing specific HIV screening programs.

scholarly journals The Methodological Quality and Challenges in Conducting Economic Evaluations of Newborn Screening: A Scoping Review

2020 ◽  
Vol 6 (4) ◽  
pp. 94
Author(s):  
Pasquale Cacciatore ◽  
Laurenske A. Visser ◽  
Nasuh Buyukkaramikli ◽  
Catharina P. B. van der Ploeg ◽  
M. Elske van den Akker-van Marle
Keyword(s):  
Resource Allocation ◽  
Cost Effectiveness ◽  
Newborn Screening ◽  
Scoping Review ◽  
Methodological Quality ◽  
Economic Evaluations ◽  
Screening Programs ◽  
Methodological Challenges ◽  
Life Years

Cost-effectiveness (CEA) and cost–utility analyses (CUA) have become popular types of economic evaluations (EE) used for evidence-based decision-making in healthcare resource allocation. Newborn screening programs (NBS) can have significant clinical benefits for society, and cost-effectiveness analysis may help to select the optimal strategy among different screening programs, including the no-screening option, on different conditions. These economic analyses of NBS, however, are hindered by several methodological challenges. This study explored the methodological quality in recent NBS economic evaluations and analyzed the main challenges and strategies adopted by researchers to deal with them. A scoping review was conducted according to PRISMA methodology to identify CEAs and CUAs of NBS. The methodological quality of the retrieved studies was assessed quantitatively using a specific guideline for the quality assessment of NBS economic evaluations, by calculating a general score for each EE. Challenges in the studies were then explored using thematic analysis as a qualitative synthesis approach. Thirty-five studies met the inclusion criteria. The quantitative analysis showed that the methodological quality of NBS economic evaluations was heterogeneous. Lack of clear description of items related to results, discussion, and discounting were the most frequent flaws. Methodological challenges in performing EEs of neonatal screenings include the adoption of a long time horizon, the use of quality-adjusted life years as health outcome measure, and the assessment of costs beyond the screening interventions. The results of this review can support future economic evaluation research, aiding researchers to develop a methodological guidance to perform EEs aimed at producing solid results to inform decisions for resource allocation in neonatal screening.

scholarly journals Cost-effectiveness and resource allocation (CERA) 18 years of evolution: maturity of adulthood and promise beyond tomorrow

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mihajlo Jakovljevic ◽  
Klazien Matter-Walstra ◽  
Takuma Sugahara ◽  
Tarang Sharma ◽  
Vladimir Reshetnikov ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Cost Effectiveness

scholarly journals A Waterfront View of Coastal Hazards: Contextualizing Relationships among Geographic Exposure, Shoreline Type, and Hazard Concerns among Coastal Residents

2019 ◽  
Vol 11 (23) ◽  
pp. 6687 ◽  
Author(s):  
Steven B. Scyphers ◽  
Michael W. Beck ◽  
Kelsi L. Furman ◽  
Judy Haner ◽  
Lauren I. Josephs ◽  
...  
Keyword(s):  
Climate Change ◽  
Cost Effectiveness ◽  
Coastal Communities ◽  
Coastal Hazards ◽  
Coastal Protection ◽  
Research And Practice ◽  
Living Shorelines ◽  
Ecological Objectives ◽  
Coastal Residents ◽  
Impacts Of Climate Change

Coastal communities exist on the front lines of diverse natural hazards and the growing impacts of climate change. While traditional strategies for dealing with coastal hazards have often involved the hardening or armoring of shorelines, more recent research and practice have demonstrated the value and cost-effectiveness of “living shorelines” and other ecosystem-based strategies for coastal protection. To explore potential relationships among geographic exposure (waterfront vs. inland), shoreline condition (armored vs. natural), and hazard concerns, we surveyed 583 waterfront and inland residents in the northern Gulf of Mexico. We found that overall concern for coastal hazards was similar across waterfront and inland residents, as well as among residents with both armored and natural shorelines. However, concern for specific hazards differed across these groups. Waterfront residents were significantly more concerned about major hurricanes and erosion than inland residents. Conversely, inland residents were more concerned with drought and flooding than waterfront residents. Among waterfront residents, specific hazard concerns were similar between residents with natural and armored shorelines with two key exceptions. Residents with armored shorelines reported higher concern for erosion and sea level rise than residents with natural shorelines. Our results suggest that armored shorelines do not necessarily alleviate concerns about coastal hazards. In the context of balancing social and ecological objectives in addressing coastal hazards or adapting to climate change, understanding the perceptions and behaviors of coastal residents is essential for conserving and protecting coastal ecosystems along residential shorelines.

Sign in / Sign up

Export Citation Format

Share Document