scholarly journals A Multicenter Cost-of-Illness and Long-term Socioeconomic Follow-up Study in the Severe Typhoid Fever in Africa Program: Study Protocol

2019 ◽  
Vol 69 (Supplement_6) ◽  
pp. S459-S465 ◽  
Author(s):  
Enusa Ramani ◽  
Seeun Park ◽  
Trevor Toy ◽  
Ursula Panzner ◽  
Ondari D Mogeni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Economic ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Cost Of Illness ◽  
Economic Data ◽  
The Cost ◽  
Economic Studies

Abstract Background There are limited data on typhoid fever cost of illness (COI) and economic impact from Africa. Health economic data are essential for measuring the cost-effectiveness of vaccination or other disease control interventions. Here, we describe the protocol and methods for conducting the health economic studies under the Severe Typhoid Fever in Africa (SETA) program. Methods The SETA health economic studies will rely on the platform for SETA typhoid surveillance in 4 African countries—Burkina Faso, Ethiopia, Ghana, and Madagascar. A COI and long-term socioeconomic study (LT-SES) will be its components. The COI will be assessed among blood culture–positive typhoid fever cases, blood culture–negative clinically suspected cases (clinical cases), and typhoid fever cases with pathognomonic gastrointestinal perforations (special cases). Repeated surveys using pretested questionnaires will be used to measure out-of-pocket expenses, quality of life, and the long-term socioeconomic impact. The cost of resources consumed for diagnosis and treatment will be collected at health facilities. Results Results from these studies will be published in peer-reviewed journals and presented at scientific conferences to make the data available to the wider health economics and public health research communities. Conclusions The health economic data will be analyzed to estimate the average cost per case, the quality of life at different stages of illness, financial stress due to illness, and the burden on the family due to caregiving during illness. The data generated are expected to be used in economic analysis and policy making on typhoid control interventions in sub-Saharan Africa.

A Prospective, Randomized Trial Comparing a Transparent Dressing and a Dry Gauze on the Exit Site of Long Term Central Venous Catheters of Hemodialysis Patients

2003 ◽  
Vol 4 (2) ◽  
pp. 56-61 ◽  
Author(s):  
I. Le Corre ◽  
M. Delorme ◽  
S. Cournoyer
Keyword(s):  
Quality Of Life ◽  
Hemodialysis Patients ◽  
Exit Site ◽  
Skin Preparation ◽  
Drying Time ◽  
Skin Reactions ◽  
Significant Difference ◽  
The Cost

The objective of this study was to assess the risk of bacteremia, estimate the cost and evaluate the quality of life by using a transparent dressing (TD) versus (vs) a dry gauze (DG) on the exit site of long term central I.V. catheters (LTCC) of hemodialysis patients. This 6-months preliminary study was conducted on 58 patients (pts) randomized to receive DG replaced 3 times/week (29 pts) or TD replaced every 7 days (29 pts). Data on patients, conditions of the exit site, local infection, bacteremia, quality of life and cost related to each type of dressing were collected. Two pts in the DG group experienced bacteremia related to their LTCC vs 1 pt in the group TD. A total of 7 (DG) vs 13 (TD) pts experienced skin condition changes at the catheter exit site. Some skin reactions, erythema and pruritus, did occur initially in the group TD and was due in part to insufficient drying time of the skin preparation solution. The estimated individual, weekly costs for using the DG was $7.60 vs $4.72 Canadian dollars for the TD. The SF-36™ scores did not show a significant difference between the 2 groups during the study (3.8 (PCS), 6.4 (MCS) at study end). Although this study was statistically underpowered, it suggests that the incidence of bacteremia was not increased with the use of a TD. Moreover, the use of a TD allowed fewer dressing changes, lowered total treatment costs, with no observed unfavorable impact on the quality of life and without significant local complications of the exit site. Based on the positive results observed in this pilot study, further study is warranted to examine the cost effectiveness of long-term use of TD dressings on dialysis catheter exit sites.

scholarly journals Can polygenic risk scores contribute to cost-effective cancer screening? A systematic review

2021 ◽  
Author(s):  
Padraig Dixon ◽  
Edna Keeney ◽  
Jenny C Taylor ◽  
Sarah Wordsworth ◽  
Richard Martin
Keyword(s):  
Systematic Review ◽  
Health Economic ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cost Effective ◽  
Risk Scores ◽  
Polygenic Risk ◽  
The Cost ◽  
Economic Studies

Polygenic risk is known to influence susceptibility to cancer. The use of data on polygenic risk, in conjunction with other predictors of future disease status, may offer significant potential for preventative care through risk-stratified screening programmes. An important element in the evaluation of screening programmes is their cost-effectiveness. We undertook a systematic review of papers evaluating the cost-effectiveness of screening interventions informed by polygenic risk scores compared to more conventional screening modalities. We included papers reporting cost-effectiveness outcomes in the English language published as articles or uploaded onto preprint servers with no restriction on date, type of cancer or form of polygenic risk modelled. We excluded papers evaluating screening interventions that did not report cost-effectiveness outcomes or which had a focus on monogenic risk. We evaluated studies using the Quality of Health Economic Studies checklist. Ten studies were included in the review, which investigated three cancers: prostate (n=5), colorectal (n=3) and breast (n=2). All study designs were cost-utility papers implemented as Markov models (n=6) or microsimulations (n=4). Nine of ten papers scored highly (score >75 on a 0-100) scale) when assessed using the Quality of Health Economic Studies checklist. Eight of ten studies concluded that polygenic risk informed cancer screening was likely to be more cost-effective than alternatives. However, the included studies lacked robust external data on the cost of polygenic risk stratification, did not account for how very large volumes of polygenic risk data on individuals would be collected and used, did not consider ancestry-related differences in polygenic risk, and did not fully account for downstream economic sequalae stemming from the use of polygenic risk data in these ways. These topics merit attention in future research on how polygenic risk data might contribute to cost-effective cancer screening.

scholarly journals Long-Term Follow-Up and Individual Item Analysis of Quality of Life Assessments Related to Laparoscopic-Assisted Colectomy in the COST Trial 93-46-53 (INT 0146)

2011 ◽  
Vol 18 (9) ◽  
pp. 2422-2431 ◽  
Author(s):  
Chee-Chee H. Stucky ◽  
Barbara A. Pockaj ◽  
Paul J. Novotny ◽  
Jeff A. Sloan ◽  
Daniel J. Sargent ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Item Analysis ◽  
Individual Item ◽  
Long Term Follow Up ◽  
Laparoscopic Assisted ◽  
The Cost

scholarly journals Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

2009 ◽  
Vol 161 (suppl_1) ◽  
pp. S51-S64 ◽  
Author(s):  
Maria Koltowska-Häggström ◽  
Anders F Mattsson ◽  
Stephen M Shalet
Keyword(s):  
Quality Of Life ◽  
Health Economic ◽  
Clinical Practice ◽  
Treatment Effects ◽  
Disease Onset ◽  
Medical Decision ◽  
Specific Patient ◽  
The Impact

Quality of life (QoL) has emerged as an important construct that has found numerous applications across healthcare-related fields, ranging from research and clinical evaluation of treatment effects to pharmacoeconomic evaluations and global healthcare policy. Impairment of QoL is one of the key clinical characteristics in adult GHD and has been extensively studied in the Pfizer International Metabolic Database (KIMS). We provide summarized evidence on GH treatment effects for both clinical and health economic applications based on the KIMS data. The primary focus is on those aspects of QoL research that cannot be investigated in the traditional clinical trial setting, such as specific patient subgroups, cross-country comparisons and long-term follow-up. First, the impact of age, gender, disease onset, primary aetiology, extent of hypopituitarism, previous radiotherapy and obesity on QoL before and during long-term GH replacement is discussed. Secondly, the studies on QoL in relation to country-specific normative values are reviewed. Finally, health economic data derived from KIMS including both burden of disease and utility assessment are evaluated. We conclude that the wide spectrum of analyses performed on the KIMS data allows for practical application of the results not only to research and clinical practice but also to health policy and global medical decision making.

scholarly journals Economic Evaluation of Quality Improvement Interventions Targeting Elderly Population in Long-term Care: A Scoping Review 

2020 ◽  
Author(s):  
Asif Raza Khowaja ◽  
Christina Krause ◽  
Colleen Kennedy ◽  
Ben Ridout ◽  
Craig Mitton
Keyword(s):  
Quality Of Life ◽  
Resource Allocation ◽  
Quality Improvement ◽  
Cost Effectiveness ◽  
Elderly Population ◽  
Long Term Care ◽  
Term Care ◽  
Economic Studies

Abstract Background: Quality improvement (QI) has received much wider attention in public policy, given the ever-increasing aging population and growing demand of long-term care (LTC). In the policy context, health system planners and administrators need to know the evidence on cost-effectiveness for resource allocation decisions. The objectives of this study were to: identify costs and benefits of the QI strategies in the economic literature; and synthesize the methodological approaches used in the economic studies and reported evidence around the cost-effectiveness of QI strategies in LTC. Methods: A scoping review of three online databases, including PubMed, EconLit, and Google Scholar, was conducted to identify economic studies focusing on elderly population published from September 2010 to August 2020. A combination of search expressions was used to identify the original research articles. Study titles and abstracts were screened, and only full-text articles meeting the inclusion criteria were retained in the review. A standard data extraction template was used capturing patient population, intervention, comparator, the outcome of interest, and study design (PICOS). Results: The search identified 657 records, of which 16 were included in the review. The financial costs were categorized into three groups: (i) developmental, (ii) operational, and (iii) health resource utilization. The terms ‘Quality of life,’ ‘Health-related Quality of Life’, and ‘Quality of Care’ were interchangeably used to express the health outcomes. This study showed mixed results suggesting a substantial variability around cost-effectiveness of QI interventions targeting elderly population in LTC. Almost all studies reported a public payer perspective and a discount rate ranged from 0 to 7%. A poorly defined baseline, the complex nature of the intervention, a lack of appropriate comparator, and varying duration of implementation were key methodological limitations. Conclusions: This review highlights important knowledge gaps regarding societal costs and inconsistencies in reporting of the outcome measures. More research is needed to analyze long-term costs and consequences to better inform decisions on resource allocation in LTC.

Economic analysis of adjuvant interferon alfa-2b in high-risk melanoma based on projections from Eastern Cooperative Oncology Group 1684.

1997 ◽  
Vol 15 (6) ◽  
pp. 2351-2358 ◽  
Author(s):  
B E Hillner ◽  
J M Kirkwood ◽  
M B Atkins ◽  
E R Johnson ◽  
T J Smith
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
High Risk ◽  
Incremental Cost ◽  
Interferon Alfa ◽  
High Risk Melanoma ◽  
Risk Melanoma ◽  
The Cost

PURPOSE Interferon alfa-2b (IFN) in a randomized clinical trial (E1684) prolonged relapse-free and total survival in high-risk resected melanoma. However, the costs and toxicities of IFN are barriers to its widespread use. This study was undertaken to analyze the projected costs and long-term benefits of IFN by combining prospectively collected data on IFN actual dosage, time of recurrence, and survival with secondary data on long-term melanoma recurrence risks to project the cost-effectiveness of adjuvant IFN compared with observation. PATIENTS AND METHODS Two hypothetical cohorts of 50-year-old melanoma patients whose mean IFN dosage and clinical results were directly taken from E1684 were included in the study. Melanoma recurrence risks beyond 5 years were derived from international databases. Melanoma recurrence care costs and quality-of-life adjustments, when considered, were based on expert consensus. End points were incremental costs, life-years gained, and cost per life-year gained with and without quality-of-life adjustments. RESULTS The IFN cohort was projected to have an increased (undiscounted) survival of 0.52 years at 7 years and 1.90 years over a lifetime. The projected incremental cost (in 1996 United States dollars) per life-year gained in the IFN cohort ranged from $13,700 after 35 years to $32,600 at 7 years, the median follow-up of E1684. Using assigned quality-of-life values for IFN and recurrence, the lifetime cost per quality adjusted life-year increased to $15,200. Even if treatment costs for recurrence were excluded, the lifetime incremental cost per life-year gained was $21,600. CONCLUSION The cost and toxicity of IFN must be balanced against its projected benefits in high-risk melanoma. The derived cost-effectiveness and cost-utility ratios for IFN were comparable to other cancer interventions for which cost-effectiveness analysis has been performed.

Thinking Beyond Language: Intervention for Severe Aphasia

2009 ◽  
Vol 19 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Nina Simmons-Mackie
Keyword(s):  
Quality Of Life ◽  
Communication Training ◽  
Language Intervention ◽  
Specific Training ◽  
Environmental Support ◽  
Total Communication ◽  
Communication Partners

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.

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