scholarly journals Examination of in Factor V Leiden and Prothrombin II Thrombophilic Mutations in Czech Young Women Using ddPCR—Prevalence and Cost–Benefit Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1656
Author(s):  
Petra Riedlova ◽  
Dagmar Kramna ◽  
Silvie Ostrizkova ◽  
Hana Tomaskova ◽  
Vitezslav Jirik
Keyword(s):  
Risk Factors ◽  
Czech Republic ◽  
Young Women ◽  
Cost Benefit Analysis ◽  
Factor V Leiden ◽  
Cost Benefit ◽  
Factor V ◽  
Benefit Analysis ◽  
The Czech Republic ◽  
Factor Ii

Background: Thrombophilic mutations in genes for factor V Leiden and factor II prothrombin are among the most important risk factors for developing the thromboembolic disease (TED), along with the use of oral contraceptives (OCs) or smoking. Aim: This study aimed to investigate the occurrence of risk factors in young women using droplet digital PCR (ddPCR) and, based on the results of this investigation, to perform a cost–benefit analysis of ddPCR-based screening in young women starting to take OCs compared to the treatment costs of patients who develop preventable TED in the Czech Republic. Methods: In this cross-sectional study, female university students filled in a questionnaire and provided a blood sample for DNA isolation and ddPCR analysis of both aforementioned genetic risk factors. The results, along with data from literature and web search, were used for cost–benefit analysis valid for the Czech Republic. Results: Out of 148 participants, 30 (20%) were smokers and 49 (33%) took OCs. A mutation was confirmed in 6 women (4.1%) in the factor V gene and in 3 women (2%) in the factor II gene, respectively. A model calculation on a cohort of 50,000 women starting to use contraceptives in the Czech Republic every year showed that at maximum compliance, (i.e., non-use of OC and smoking cessation), screening could prevent 68 cases of TED over the course of the mean period of OC use (5.7 years). Economically, the costs of testing in this cohort (2.25 mil. USD) would be significantly lower than prevented treatment costs (16 mil. USD at maximum compliance); the cost–benefit break-even point would be at 14.1% compliance. Conclusion: The cost–benefit analysis based on our results indicates that screening for factor V Leiden and factor II prothrombin in young women before starting to use OCs would, in the conditions of the Czech Republic, likely be highly economically effective.

An Evaluation of Customer-Centric Benefits Associated with Knowledge Management

2011 ◽  
pp. 124-145 ◽  
Author(s):  
Petra Marešová ◽  
Vladimír Bureš ◽  
Richard Brunet-Thornton ◽  
Tereza Otcenášková
Keyword(s):  
Knowledge Management ◽  
Czech Republic ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Analysis Method ◽  
Benefit Analysis ◽  
Monitoring Methods ◽  
Market Environment ◽  
The Czech Republic ◽  
Current Trends

Growing concern over the state of Knowledge Management (KM) in the Czech Republic has compelled both researchers and practitioners to document current trends. Our study in particular demonstrates that there is a growing awareness to promote KM as the appropriate vehicle to enhance and increase competitiveness and profitability no matter to what specific industry the enterprises may belong. Through KM adoption, the organisation develops a more customer-concentrated approach that sequentially increases internal efficiencies. Research in this area continues. It aspires to provide KM managers with the appropriate tools leading to successful KM implementation especially within the Czech Republic. This chapter analyses existing KM benefits and monitoring methods, and also explores a modified Cost-Benefit Analysis method focused on KM projects. It centres the customer and the general market environment as knowledge sources used to evaluate the appropriateness of a KM project.

scholarly journals A Common Prothrombin Variant (20210 G to A) Increases the Risk of Myocardial Infarction in Young Women

Blood ◽  
1997 ◽  
Vol 90 (5) ◽  
pp. 1747-1750 ◽  
Author(s):  
F.R. Rosendaal ◽  
D.S. Siscovick ◽  
S.M. Schwartz ◽  
B.M. Psaty ◽  
T.E. Raghunathan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Confidence Interval ◽  
Young Women ◽  
Odds Ratio ◽  
Factor V Leiden ◽  
Clotting Factor ◽  
Factor V ◽  
Coronary Risk Factors ◽  
Factor Ii

Abstract Using specimens from a population-based case control study among women ages 18 to 44 years in western Washington, we assessed the relationship between carriership of a genetic clotting factor II variant (20210 G→A) and myocardial infarction (MI). The factor II variant was previously shown to be present in 1% to 2% of the population, to increase the levels of factor II, and to be associated with venous thrombotic disease. Personal interviews and blood samples were obtained from 79 women with a first myocardial infarction and 381 control women identified through random-digit telephone dialing. Polymerase chain reaction (PCR) method was used to determine the factor II genotypes. The factor II 20210 G to A transition was present more often in women with MI (5.1%) than among control women (1.6%). The age-adjusted odds ratio for MI was 4.0 (95% confidence interval 1.1 to 15.1). The relative risk was high when another major cardiovascular risk factor was also present, such as smoking (odds ratio 43.3, 95% confidence interval 6.7 to 281), and the risk seemed limited to those with other risk factors. These results, in which the effect of major coronary risk factors is enhanced fourfold to sixfold by the prothrombin variant, are similar to those previously reported for another genetic clotting abnormality, factor V Leiden. We conclude that factor II 20210 G to A increases the risk of myocardial infarction in young women, especially in the women with other major risk factors for coronary heart disease.

A Concept for Long-Term Anticoagulation Based On the Individual Risk of Lethal Pulmonary Embolism (PE) and Lethal Bleeding Using Oral Anticoagulants.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4174-4174
Author(s):  
Rainer B. Zotz ◽  
Christoph Sucker ◽  
Andrea Gerhardt
Keyword(s):  
Risk Factors ◽  
Oral Anticoagulation ◽  
Factor V Leiden ◽  
Bleeding Risk ◽  
Individual Risk ◽  
Factor V ◽  
Benefit Analysis ◽  
Initial Event ◽  
Risk Benefit Analysis

Abstract Abstract 4174 Objectives Indications for an indefinite oral anticoagulation are a matter of debate in patients with a first unprovoked proximal DVT. Methods An individual risk-benefit analysis is made using published prospective studies by determining the patient-specific lethal risk of bleeding under oral anticoagulation compared with the estimation of lethal PE-risk by type of initial thrombosis (spontaneous vs. secondarily caused, with or without PE). Results According to this risk-benefit analysis, long-term oral anticoagulation is indicated to prevent lethal PE in all patients with low risk of bleeding (1% per year, 0.1 % lethal bleeding per year) in the risk group with lethal PE > 0.2 % per year. This risk group includes patients with idiopathic proximal thrombosis and PE in the initial event (also without thrombophilic risk factors) and patients with an idiopathic initial event without PE, who have relevant thrombophilic risk factors with a relative risk ≥ 2, such as antithrombin deficiency, homozygous factor V Leiden or a combined heterozygous factor V Leiden and prothrombin G20210A mutation. In case of a higher bleeding tendency (0.3% lethal bleeding per year in a patient group with 1-2 bleeding risk factors like age >65 or diabetes) other risk-benefit estimations are present. Conclusions Our individual risk stratification is in contrast to current therapy recommendations, which generally consider long-term oral anticoagulation for patients with an idiopathic initial proximal DVT with a low bleeding risk, but do not specify these in individual cases. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Using Monte Carlo for the Assessment of a Brokered Bank Deposit Business

2013 ◽  
Vol 4 (2) ◽  
pp. 43-52
Author(s):  
Jan Vlachý
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Statistical Simulation ◽  
Third Party ◽  
Strategic Decision ◽  
Benefit Analysis ◽  
The Czech Republic ◽  
Business Negotiation ◽  
Project Assessment

This paper addresses the issue of a cost-benefit analysis when considering the use of third-party distribution channels for saving accounts. Whilst static budgeting methods seem to be generally appropriate for conventional banking projects based on branching or internet, they provide grossly misleading estimates of commissioning expenses, which can lead to completely unrealistic project assessment and poorly designed commission schedules. Using a case study based on actual project experience in the Czech Republic, the author applies a numerical statistical simulation model serving as a potent tool for strategic decision-making as well as business negotiation.

Knowledge Management as a Tool for Influencing Customers

2015 ◽  
pp. 565-586
Author(s):  
Richard Brunet-Thornton ◽  
Petra Marešová ◽  
Vladimír Bureš ◽  
Tereza Otčenášková
Keyword(s):  
Knowledge Management ◽  
Czech Republic ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Research Protocol ◽  
Market Environment ◽  
The Czech Republic ◽  
Intangible Benefits ◽  
Active Research ◽  
The Cost

This chapter revisits an earlier published model of the Cost-Benefit Analysis method focused on KM projects. Although it continues to centre on the customer and the general market environment as knowledge sources used to evaluate the appropriateness of a Knowledge Management (KM) project, it expands the discussion to incorporate the latest research on this topic. In addition, the tangible and intangible benefits of a successful KM deployment continue to be stressed; it highlights the various barriers and sets recommendations that may be pursued. Given the on-going nature of this condition in the Czech Republic, the authors continue to pursue an active research protocol.

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