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11841. Cost-effectiveness analysis of oral N-acetylcysteine as a preventive treatment in chronic bronchitis Full Text available with Trip Pro

analyses were performed on the number of AECBs, cost of medications, and percentage of hospitalisations. Estimated benefits used in the economic analysis NAC therapy would prevent approximately 0.6-0.7 AECBs for 6 months. Cost results A patient with chronic bronchitis treated with NAC generates direct costs of SFr 700 compared with SFr 869 in the placebo patient, or SFr 945 in the non-compliant patient. Indirect costs were SFr 779 in the NAC patient and SFr 1,324 in the placebo patient. Total costs (...) were not discounted due to the short time horizon of the study (less than 1 year). Quantities and costs were reported separately. Direct costs related to the costs of NAC treatment, the management of an AECB, and hospitalisations. The quantity/cost boundary adopted was that of the health service. The estimation of quantities and costs was based on actual data. Costs were collected from an insurance agency and a drug reference book. The price year was 1998. Statistical analysis of costs

2000 NHS Economic Evaluation Database.

11842. Should noncardiac chest pain be treated empirically? A cost-effectiveness analysis

strategy. Methods used to derive estimates of effectiveness Effectiveness estimates were also based on the opinion of 5 general internal medicine fellows at Boston University and a Delphi process involving 5 general internists and 3 gastroenterologists. Estimates of effectiveness and key assumptions The probability of upper gastrointestinal (UGI) endoscopy as the first test was 0.67 and the probability of UGI series as the first test was 0.33. The probability of 24-hour monitoring as the next test (...) was that of the hospital. The estimation of quantities and costs was based on actual data. Investigation data were derived from Boston Medical Centre 1996 charge data. These were converted to costs using a cost centre-specific cost-to-charge ratio. Provocative test costs were obtained from Cleveland Clinic 1996 charge data. Medication costs were based on the 1996 Red Book average wholesale price. The price year was 1996. Indirect Costs Indirect costs were not included. Currency US dollars ($). Sensitivity analysis

2000 NHS Economic Evaluation Database.

11843. Cost efficacy of the diagnosis and therapy of renovascular hypertension

from the 1993 Red Book and adding a 10% retail mark-up plus a $2.00 pharmacy fee per 100 units of medication. Average cost of medications per year, lifetime costs (for two and three drugs) plus 10% retail mark-up, diagnostic charges and cost per patient were calculated. The diagnostic and therapeutic cost per 1000 patients was based on a 77% cure or improvement rate by angioplasty. There was nothing mentioned with respect to marginal and average costs. Currency US dollars ($) Sensitivity analysis (...) articles were identified from the references of these reports. Criteria for inclusion in the final analysis were: (1) Data were reported during the last five years (1983-1993), (2) Studies had angiographic corroboration of results, (3) Patients included in more than one report were analysed only once, (4) No multi-centre studies were found with uniform protocols and were, therefore, not included, (5) No renal transplantation studies were included, (6) To represent a clinically screened general

1996 NHS Economic Evaluation Database.

11844. The cost-effectiveness of competing strategies for the prevention of recurrent peptic ulcer hemorrhage

the authors' assumptions and published data. The unit costs were derived from the Drug Topics Red Book, American Medical Association Current Procedural Terminology codebook, and Medicare Reimbursement Fee Schedule. The price year was likely to have been 2000. Statistical analysis of costs The costs were treated deterministically in the base-case. Indirect Costs The indirect costs were not considered. Currency US dollars ($). Sensitivity analysis Sensitivity analyses were performed to investigate (...) ranking all alternatives, strategy 8 was the only one that was not dominated. In general, all test/retest strategies were more cost-effective than test-and-treat strategies. "Selective" H. pylori eradication was not cost-effective within each sub-group of strategies. The model was sensitive to a few critical variables. More specifically, the cost of the carbon-labelled UBT, the H. pylori eradication rate, the haemorrhage rate, and the prevalence of H. pylori. Authors' conclusions The most cost

2002 NHS Economic Evaluation Database.

11845. Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine

placebo-controlled trial. The participants were allocated in a ratio of 2:1 to receive vaccine or placebo. Randomisation was performed using 6-unit blocks. Each participant was assigned to the next available sequential allocation number according to a predetermined, computer-generated randomisation schedule. Both the study participants and site personnel were blinded to the intervention assignment until all the outcome data had been gathered and analysed. The patients were followed during (...) effects (medical care costs, including provider visits, tests and medications). Costs saved due to vaccination, such as medical care costs avoided, were considered when calculating the net costs of the vaccination programme. A Monte Carlo simulation was performed in order to estimate the mean case break-even costs per patient associated with the vaccine and its administration. The cost/resource boundary adopted for the analysis of the direct costs was that of the health service provider. Resource use

2003 NHS Economic Evaluation Database.

11846. Long-term effects of a collaborative care intervention in persistently depressed primary care patients

of General Internal Medicine 2002; 17(10): 741-748 PubMedID Other publications of related interest Hunkeler E, Meresman J, Hargreaves W, et al. Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Archives of Family Medicine 2000;9:700-8. Lin E, Simon G, Katon W, et al. Can enhanced acute-phase treatment of depression improve long-term outcomes. A report on randomized trials in primary care. American Journal of Psychiatry 1999;156:643-5. Indexing (...) . Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology A multifaceted, stepped, collaborative care intervention developed for the management of persistently depressed patients was examined. The intervention targeted patients, physicians, and the process of care. Patients received a book and companion videotape. Sessions with psychiatrists and telephone

2002 NHS Economic Evaluation Database.

11847. Effectiveness and costs of omeprazole vs ranitidine for treatment of symptomatic gastroesophageal reflux disease in primary care clinics in West Virginia

the patients nor physicians were blinded to the treatment group. The control of further prescriptions and other medical care was handed over to the patients' usual physician. Five clinics affiliated to a university-based department of family medicine participated in the study. The patients were enrolled over 24 months and followed up for 24 weeks. The outcome data were collected at 2, 4, 12 and 24 weeks through telephone interviews by a trained research co-ordinator, who was blind to the patients (...) . The results were verified by consulting the patient's medical notes. The cost of outpatient appointments, diagnostic services and inpatient stays were based on the actual charges from the university accounting and billing system. The costs of medications were taken from the Red Book average wholesale prices. No data were collected for over-the-counter medication for heartburn since it was deemed unfeasible to collect accurate data. Since data were collected for all of the medical costs, no imputation

2000 NHS Economic Evaluation Database.

11848. Cost effectiveness of pramipexole in Parkinson's disease in the US

Clinic at the University of Iowa Hospitals and Clinics or the Iowa Methodist Hospital in Des Moines. Drug costs were estimated using average wholesale price information from the 1997 Red Book or from the manufacturers. Nursing home costs were inferred from published data on nursing home use by Parkinson's patients and the general elderly population and were based on 1993 Medicaid average reimbursement to nursing homes. The price year was 1997. Statistical analysis of costs Not reported. Indirect (...) published between 1993 and 1998. The price year was 1997. Source of effectiveness data Clinical trials, a review of the literature, and consultations with a clinical expert provided effectiveness data. Modelling A model was used to link Unified Parkinson Disease Rating Scale (UPDRS) Parts II and III scores to costs and quality adjusted life years (QALYs). Medical, ancillary, and community care costs were estimated as a multivariate function of UPDRS scores and other variables using a 3-equation system

1998 NHS Economic Evaluation Database.

11849. Organisation and cost-effectiveness of antenatal haemoglobinopathy screening and follow up in a community-based programme

confirmatory tests. In addition to the main screening programme, follow-up services were also assessed. These included counselling and post-termination support where necessary. Type of intervention Screening. Economic study type Cost-effectiveness analysis. Study population The study population comprised women attending the antenatal clinic of a district general hospital in an inner London health district, where 45% of the population are from ethnic minority groups. Setting The setting was a hospital (...) effectiveness and cost data The costing was undertaken retrospectively on the same patient sample as that used in the effectiveness study. Study sample The study sample consisted of 2,101 women booking in at the antenatal clinic, whose samples were referred for screening during the study period. The authors selected the sample from an area with a relatively high prevalence of ethnic minority groups, and where the hospital had a well-established universal and community-based antenatal screening programme

2000 NHS Economic Evaluation Database.

11850. AT(1) receptor blockers: cost-effectiveness within the South African context

extracted from studies published between 1996 and 1998. Economic data were based on a source published in 2000. Source of effectiveness data A systematic literature review carried out by the authors generated the effectiveness data used in the study. Modelling It is likely that a decision analytic model was used but details were not provided. Outcomes assessed in the review The outcome measure chosen in the review was reduction in sitting diastolic blood pressure (SDBP (mmHg)). Study designs and other (...) suitable trial was required. Sources searched to identify primary studies MEDLINE and Cochrane databases were searched, supplemented by an Internet search of the US National Library of Medicine. Criteria used to ensure the validity of primary studies Not stated. Methods used to judge relevance and validity, and for extracting data Not stated. Number of primary studies included In total 13 papers were included in the analysis: 2 candesartan, 7 losartan, 2 valsartan, and 2 irbesartan. Methods

2000 NHS Economic Evaluation Database.

11851. The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States

, in other words, actual data. The price year for the cost estimates from these sources was 1999. The estimates were supplemented with data from published material dating between 1997 and 2000. The cost of medication was taken from the Drug Topics Red Book, 2000, also actual data. The authors reported that these costs were altered to account for the additional costs related to supplies, clinical and biochemical monitoring, and the treatment of drug-related side effects. Statistical analysis of costs (...) used to measure benefit in the economic analysis. The QALYs were calculated by multiplying each year lived in a given state by a health-related quality of life (HRQL) score for that state. The HRQL weights were based on a review of published literature and the "modified" Delphi approach. The Delphi panel consisted of hepatologists, gastroenterologists, and general internists at the authors' institution. The authors reported that the HRQL weights measured in their study were elicited using

2002 NHS Economic Evaluation Database.

11852. Nonpharmacologic relief of pain during labor: systematic reviews of five methods

pain. Searching PsycINFO, CINAHL, PubMed, the Cochrane Controlled Trials Register, AMED and MIDIRS were searched for relevant studies published in the English language between 1950 and 2001. The search terms were reported in the paper. Books, personal files and the references of retrieved articles were also searched. Personal communications, abstracts and unpublished theses were also included if there was sufficient information about the study design to judge the quality of it. Study selection (...) (5 studies), staff nurses or retired nurses (2 studies), or the source of support was not specified (2 studies). Participants included in the review Studies that assessed women in any or all of the stages of labour were eligible for inclusion. Outcomes assessed in the review Studies that reported pain-related outcomes were eligible for inclusion. The primary pain-related outcomes reported in the review were maternal assessments of pain and use of analgesic medications. The review also secondarily

2002 DARE.

11853. Management of Thyroid Cancer

Oncologist, Northern Centre for Cancer Treatment, Newcastle-upon-Tyne Malcolm Prentice BSc, FRCP, Consultant Physician and Endocrinologist, Mayday University Hospital, Croydon Rajesh V Thakker MD, FRCP, FRCPath, FMedSci, May Professor of Medicine, University of Oxford John Watkinson MSc, MS, FRCS(Eng), DLO, Consultant Otolaryngologist/Head and Neck Surgeon, Queen Elizabeth Medical Centre, Birmingham Anthony P Weetman MD, DSc, FRCP, FMedSci, Professor of Medicine and Dean of Medicine, University (...) , FRCS, Professor of Surgery, University of Bristol Jayne Franklyn MD, PhD, FRCP, FMedSci, Professor of Medicine, Birmingham Caroline Owen Hafiz MSc, RGN, Head and Neck Support Counsellor/Nurse, Queen Elizabeth Hospital, Birmingham Clive Harmer FRCP, FRCR, Head of Thyroid Unit, Royal Marsden NHS Trust, London GAW Hornett MA, FRCGP, General Practitioner, Wonersh, Guildford Julian Kabala FRCR, Consultant Radiologist, Bristol Julia Lawrence, Patient representative, Chipping Sodbury Anne Marie McNicol

2007 British Association of Endocrine and Thyroid Surgeons

11854. Clinical practice guidelines for the psychosocial care of adults with cancer

in the treatment unit and evidence to support their implementation 38 3.1 General interactional skills 42 3.2.1 Recommended steps for telling a person they have cancer, a recurrence or metastases 45 3.2.2 Recommended steps for discussing prognosis with individuals with cancer 50 3.2.3 Recommended steps for discussing treatment options and encouraging involvement in decision-making 62 3.2.4 Recommended steps involved in adequately preparing a patient for a potentially threatening medical procedure 64 3.2.5 (...) oncologists, medical oncologists, general practitioners, nurses, social workers, psychologists, psychiatrists, physiotherapists and occupational therapists. While most aspects of psychosocial care are common to all cancers, there are some aspects that will be relevant to specific cancers and to specific stages of treatment. It is recognised that while some aspects of psychosocial care are common to all the health professionals involved in a patient’s treatment and care, different members of the treatment

2002 Cancer Australia

11855. Breast imaging - a guide for practice

Health and Medical Research Council (NHMRC), 1 Breast imaging: a guide for practice simply provides a series of recommendations and suggestions for practice. The guide is particularly relevant for clinicians who refer women to breast imaging services and for clinicians reporting on the results. It is therefore primarily targeted at general practitioners, radiologists, surgeons, breast physicians, pathologists and oncologists. In addition, the guide also contains information relevant to those solely (...) as outlined by the National Health and Medical Research Council (NHMRC), 1 Breast imaging: a guide for practice simply provides a series of recommendations and suggestions for practice. The guide is particularly relevant for clinicians who refer women to breast imaging services and for clinicians reporting on the results. It is therefore primarily targeted at general practitioners, radiologists, surgeons, breast physicians, pathologists and oncologists. In addition, the guide also contains information

2001 Cancer Australia

11856. Clinical practice guidelines for the management of advanced breast cancer

, pathology, psychiatry, consumers, medical oncology, radiation oncology, reconstructive surgery, palliative care, counselling and support staff, nursing, general practice, epidemiology, health services management, education and research. The members of the working group are listed in Appendix A. Although men with advanced breast cancer represent one per cent of those diagnosed with breast cancer, these guidelines specifically relate to advanced breast cancer in women. The Clinical practice guidelines (...) by: • fostering and supporting a high quality and internationally recognised research base; • providing evidence based advice; • applying research evidence to health issues thus translating research into better health practice and outcomes; and • promoting informed debate on health and medical research, health ethics and related issues. NHMRC web address: http://www.nhmrc.health.gov.au This document was prepared by the iSource National Breast Cancer Centre Advanced Breast Cancer Working Group. The current

2000 Cancer Australia

11857. Experience of diagnosis: information and support needs of women diagnosed with DCIS

the treatment options available to her: “my worries about the unbalanced and excessive treatment options for a non-invasive cancer were exacerbated by my research findings, leading me to the sad conclusion that ‘informed consent’ was impossible [in the trial]”. She felt that “when most in need of support I was sent away to inform myself, feeling isolated from the medical team who seemed at that moment to be a research team more interested in future generations than in my own plight”. She commented (...) rate of 95%. 29 It is generally recommended that dissection of the axillary nodes is unnecessary in most women with DCIS. 29 In the past decade there has been considerable interest in breast conserving surgery for patients. A number of prospective randomised trials evaluating breast preservation are in progress in Europe, including the European Organisation for Research and Treatment of Cancer Trial and the UK trial (which includes a Tamoxifen arm). One prospective randomised trial has been

1999 Cancer Australia

11858. The clinical management of ductal carcinoma in situ, lobular carcinoma in situ and atypical hyperplasia of the breast

of Cancer ER oestrogen receptor FNAB fine needle aspiration biopsy GP general practitioner Gy Gray (unit of radiation dosage) HR hazard ratio HRT hormone replacement therapy IBIS International Breast Cancer Intervention Study IBT ipsilateral breast tumour IBTR ipsilateral breast tumour recurrence LCIS lobular carcinoma in situ NHMRC National Health and Medical Research Council NSABP National Surgical Adjuvant Breast and Bowel Project RFS recurrence-free survival VNPI Van Nuys Prognostic Index (...) . The suggested citation for this document is: National Breast Cancer Centre. 2003. The clinical management of ductal carcinoma in situ, lobular carcinoma in situ and atypical hyperplasia of the breast, first edition. National Breast Cancer Centre, Camperdown, NSW . Copies of this book can be ordered through: The National Breast Cancer Centre: Telephone 1800 624 973 This book can also be downloaded from the National Breast Cancer Centre website www.nbcc.org.auCONTENTS List of tables and figures iii Foreword v

2003 Cancer Australia

11859. Clinical practice guidelines for the management of early breast cancer

trials (Appendix G) 154 List of figures 1. Age-standardised incidence rates of breast cancer by age in women in Australia, 1982–1996 11vii Clinical practice guidelines for the management of early breast cancer FOREWORD In October 1995 the National Health and Medical Research Council released the Clinical practice guidelines for the management of early breast cancer. These guidelines were the first in the NHMRC’s new program and they represented a landmark in evidence-based medicine in Australia (...) intraductal carcinoma EORTC European Organization for Research and Treatment of Cancer ER oestrogen receptor FAC 5-fluorouracil, doxorubicin and cyclophosphamide FNAB fine-needle aspiration biopsy G-CSF granulocyte colony stimulating factor GP general practitioner Gy Gray HRT hormone replacement therapy IBT ipsilateral breast tumours LCIS lobular carcinoma in situ LHRH luteinizing hormone releasing hormone NBCC/ iSource National Breast Cancer Centre the Centre NHMRC National Health and Medical Research

2001 Cancer Australia

11860. Clinical practice guidelines for the psychosocial care of adults with cancer

in the treatment unit and evidence to support their implementation 38 3.1 General interactional skills 42 3.2.1 Recommended steps for telling a person they have cancer, a recurrence or metastases 45 3.2.2 Recommended steps for discussing prognosis with individuals with cancer 50 3.2.3 Recommended steps for discussing treatment options and encouraging involvement in decision-making 62 3.2.4 Recommended steps involved in adequately preparing a patient for a potentially threatening medical procedure 64 3.2.5 (...) oncologists, medical oncologists, general practitioners, nurses, social workers, psychologists, psychiatrists, physiotherapists and occupational therapists. While most aspects of psychosocial care are common to all cancers, there are some aspects that will be relevant to specific cancers and to specific stages of treatment. It is recognised that while some aspects of psychosocial care are common to all the health professionals involved in a patient’s treatment and care, different members of the treatment

2003 National Breast and Ovarian Cancer Centre

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