scholarly journals Analysis of FFR Measurement Clinical Impact and Cost-Effectiveness Compared to Angiography In Multi-Arterial Patients Undergoing PCI

2018 ◽  
Author(s):  
Fernando Mendes Sant'Anna ◽  
Lucas Bonacossa Sant'Anna
Keyword(s):  
Cost Effectiveness ◽  
Clinical Impact

scholarly journals Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e85197 ◽  
Author(s):  
Ingrid V. Bassett ◽  
Darshini Govindasamy ◽  
Alison S. Erlwanger ◽  
Emily P. Hyle ◽  
Katharina Kranzer ◽  
...  
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Cape Town ◽  
Clinical Impact ◽  
Hiv Screening ◽  
Impact Cost

scholarly journals Clinical impact and cost-effectiveness of a 176-condition expanded carrier screen

2019 ◽  
Vol 21 (9) ◽  
pp. 1948-1957 ◽  
Author(s):  
Kyle A. Beauchamp ◽  
Katherine A. Johansen Taber ◽  
Dale Muzzey
Keyword(s):  
Cost Effectiveness ◽  
Clinical Impact

scholarly journals Clinical Impact and Cost-effectiveness of Genotype Testing at Human Immunodeficiency Virus Diagnosis in the United States

2019 ◽  
Vol 70 (7) ◽  
pp. 1353-1363 ◽  
Author(s):  
Emily P Hyle ◽  
Justine A Scott ◽  
Paul E Sax ◽  
Lucia R I Millham ◽  
Caitlin M Dugdale ◽  
...  
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
The United States ◽  
Clinical Impact ◽  
Reverse Transcriptase Inhibitors ◽  
First Line ◽  
Immunodeficiency Virus ◽  
Quality Adjusted Life

AbstractBackgroundUS guidelines recommend genotype testing at human immunodeficiency virus (HIV) diagnosis (“baseline genotype”) to detect transmitted drug resistance (TDR) to nonnucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors. With integrase strand inhibitor (INSTI)-based regimens now recommended as first-line antiretroviral therapy (ART), the of baseline genotypes is uncertain.MethodsWe used the Cost-effectiveness of Preventing AIDS Complications model to examine the clinical impact and cost-effectiveness of baseline genotype compared to no baseline genotype for people starting ART with dolutegravir (DTG) and an NRTI pair. For people with no TDR (83.8%), baseline genotype does not alter regimen selection. Among people with transmitted NRTI resistance (5.8%), baseline genotype guides NRTI selection and informs subsequent ART after adverse events (DTG AEs, 14%). Among people with transmitted NNRTI resistance (7.2%), baseline genotype influences care only for people with DTG AEs switching to NNRTI-based regimens. The 48-week virologic suppression varied (40%–92%) depending on TDR. Costs included $320/genotype and $2500–$3000/month for ART.ResultsCompared to no baseline genotype, baseline genotype resulted in <1 additional undiscounted quality-adjusted life-day (QALD), cost an additional $500/person, and was not cost-effective (incremental cost-effectiveness ratio: $420 000/quality-adjusted life-year). In univariate sensitivity analysis, clinical benefits of baseline genotype never exceeded 5 QALDs for all newly diagnosed people with HIV. Baseline genotype was cost-effective at current TDR prevalence only under unlikely conditions, eg, DTG-based regimens achieving ≤50% suppression of transmitted NRTI resistance.ConclusionsWith INSTI-based first-line regimens in the United States, baseline genotype offers minimal clinical benefit and is not cost-effective.

scholarly journals The Clinical Impact and Cost-effectiveness of Measles-Mumps-Rubella Vaccination to Prevent Measles Importations Among International Travelers From the United States

2018 ◽  
Vol 69 (2) ◽  
pp. 306-315 ◽  
Author(s):  
Emily P Hyle ◽  
Naomi F Fields ◽  
Amy Parker Fiebelkorn ◽  
Allison Taylor Walker ◽  
Paul Gastañaduy ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Hot Spots ◽  
Cost Effective ◽  
The United States ◽  
Clinical Impact ◽  
Sensitivity Analyses ◽  
Best Value ◽  
Measles Outbreaks ◽  
The Impact

Abstract Background Measles importations and the subsequent spread from US travelers returning from abroad are responsible for most measles cases in the United States. Increasing measles-mumps-rubella (MMR) vaccination among departing US travelers could reduce the clinical impact and costs of measles in the United States. Methods We designed a decision tree to evaluate MMR vaccination at a pretravel health encounter (PHE), compared with no encounter. We derived input parameters from Global TravEpiNet data and literature. We quantified Riskexposure to measles while traveling and the average number of US-acquired cases and contacts due to a measles importation. In sensitivity analyses, we examined the impact of destination-specific Riskexposure, including hot spots with active measles outbreaks; the percentage of previously-unvaccinated travelers; and the percentage of travelers returning to US communities with heterogeneous MMR coverage. Results The no-encounter strategy projected 22 imported and 66 US-acquired measles cases, costing $14.8M per 10M travelers. The PHE strategy projected 15 imported and 35 US-acquired cases at $190.3M per 10M travelers. PHE was not cost effective for all international travelers (incremental cost-effectiveness ratio [ICER] $4.6M/measles case averted), but offered better value (ICER <$100 000/measles case averted) or was even cost saving for travelers to hot spots, especially if travelers were previously unvaccinated or returning to US communities with heterogeneous MMR coverage. Conclusions PHEs that improve MMR vaccination among US international travelers could reduce measles cases, but are costly. The best value is for travelers with a high likelihood of measles exposure, especially if the travelers are previously unvaccinated or will return to US communities with heterogeneous MMR coverage.

Clinical impact and cost-effectiveness of co-trimoxazole prophylaxis in patients with HIV/AIDS in Côte d’Ivoire: a trial-based analysis

AIDS ◽  
2005 ◽  
Vol 19 (12) ◽  
pp. 1299-1308 ◽  
Author(s):  
Yazdan Yazdanpanah ◽  
Elena Losina ◽  
Xavier Anglaret ◽  
Sue J Goldie ◽  
Rochelle P Walensky ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Clinical Impact ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Hiv Aids

scholarly journals Clinical impact and cost-effectiveness of primary cytology versus human papillomavirus testing for cervical cancer screening in England

2019 ◽  
Vol 29 (4) ◽  
pp. 669-675
Author(s):  
Irenjeet Bains ◽  
Yoon Hong Choi ◽  
Kate Soldan ◽  
Mark Jit
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Clinical Impact ◽  
Hpv Testing ◽  
Life Years ◽  
The Impact

ObjectivesIn England, human papillomavirus (HPV) testing is to replace cytological screening by 2019–2020. We conducted a model-based economic evaluation to project the long-term clinical impact and cost-effectiveness of routine cytology versus HPV testing.MethodsAn individual-based model of HPV acquisition, natural history, and cervical cancer screening was used to compare cytological screening and HPV testing with cytology triage for women aged 25–64 years (with either 3- or 5-year screening intervals for women aged under 50 years). The model was fitted to data from England's National Health Service Cervical Screening Programme. Both clinical and economic outcomes were projected to inform cost-effectiveness analyses.ResultsHPV testing is likely to decrease annual cytology testing (by 2.76 million), cervical cancer incidence (by 290 cases), and health system costs (by £13 million). It may increase the number of colposcopies, although this could be reduced without leading to more cancers compared with primary cytology by increasing the interval between screens to 5 years. The impact in terms of quality-adjusted life-years (QALYs) depends on the quality of life weight given to colposcopies versus cancer.ConclusionsEngland's move from cytology to HPV screening may potentially be life-saving and cost-effective. Cost-effectiveness can be improved further by extending the interval between screens or using alternative triage methods such as partial or full genotyping.

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