247 research outputs found
sj-docx-1-mpp-10.1177_23814683221083839 – Supplemental material for Sample Size and Model Prediction Accuracy in EQ-5D-5L Valuations Studies: Expected Out-of-Sample Accuracy Based on Resampling with Different Sample Sizes and Alternative Model Specifications
No full textSupplemental material, sj-docx-1-mpp-10.1177_23814683221083839 for Sample Size and Model Prediction Accuracy in EQ-5D-5L Valuations Studies: Expected Out-of-Sample Accuracy Based on Resampling with Different Sample Sizes and Alternative Model Specifications by Tonya Moen Hansen, Knut Stavem and Kim Rand in MDM Policy & Practice</p
Switching from one reference biological to another in stable patients for non-medical reasons: a literature search and brief review
No full textBackground: The practice of non-medical switch (NMS) from a reference biological (originator) to a biosimilar is widely accepted in some countries. However, there is little documentation on the impact of NMS from one originator to another originator. Objectives: To assess the consequences for patients of NMS from one biological originator to another, based on existing literature. The focus was on efficacy and cost of treatment with TNF-α-inhibitors in three disease areas. Methods: A literature search was conducted in Ovid (PubMed, EMBASE) and abstracts from meetings in key therapeutic areas, to identify studies reporting efficacy, safety or costs by switching between originator biologics. Results: 167 references were identified and abstracts screened; 36 papers reviewed in full text, and 6 fulfilled the inclusion criteria. Three clinical studies of NMS had very small sample sizes, but suggested that NMS is beneficial. The remaining three studies used administrative data with little clinical information, indicating that NMS was disadvantageous and associated with increased health care utilization and costs. Conclusions: There is very limited documentation on NMS from one originator biological to another, and the literature suffers from methodological limitations. The results are mixed and preclude drawing an overriding conclusion. Future studies, are warranted
Tax systems in the reforming socialist economies of Europe
No full textAs socialist countries move toward market systems, fiscal policy is an important part of their reform agenda. First, they need to reorient public spending to focus more on the provision of"public"goods. Second, they need to adopt more selective, predictable, and nondiscretionary means to finance such spending. The goal of this paper is to lay out some of the broad trends and issues now emerging as socialist economies attempt to reform their systems of taxation. The primary focus is on Eastern Europe, although many of the same trends and issues arise in the reforming socialized countries of Asia and Africa. Particular attention is paid to Hungary and Poland, which are most advanced in the tax reform process. The experiences they have had and the problems they are facing provide valuable lessons for those countries just starting on the reform process.Public Sector Economics&Finance,Environmental Economics&Policies,Economic Theory&Research,Banks&Banking Reform,Municipal Financial Management
Reliability and validity of the ESRD Symptom Checklist – Transplantation Module in Norwegian kidney transplant recipients
No full textAbstract Background The aim of the study was to validate the Norwegian version of a self-administered 43-item questionnaire designed to assess quality of life in kidney transplant recipients, the End-Stage Renal Disease Symptom Checklist – Transplantation Module (ESRD-SCL). Methods In total, 53 kidney transplant recipients from one university-affiliated hospital responded to a questionnaire including the ESRD-SCL and the Short Form 36 (SF-36). We assessed internal consistency reliability and test-retest reliability with 2 weeks between assessments. Construct validity was assessed by correlations of the ESRD-SCL subscales with related and unrelated SF-36 scales, demographic, and clinical characteristics. Results Subscales of the ESRD-SCL showed good internal consistency reliability (Cronbach's = 0.72–0.81) and for the aggregate total scale α was 0.94. Test-retest reliability median 14 days apart was excellent with intraclass coefficients ranging from 0.87 to 0.95. The pattern of correlations of the ESRD-SCL scales with related and unrelated scales SF-36 scales and demographic and clinical characteristics gave support to the construct validity of the ESRD-SCL. Conclusion The Norwegian translation of the ESRD-SCL showed satisfactory internal consistency reliability, test-retest reliability and construct validity, at the level of the original German version.</p
Health status in subjects with suspected obstructive sleep apnea and comparison with a general population
No full textAbstractThe purpose of this study was to assess health status (HS) in patients with clinical suspicion of obstructive sleep apnea (OSA) in order to estimate the dose response relationship between HS and OSA severity, and to compare HS in this clinical cohort with a general population sample (N = 5000). Patients referred to an overnight sleep study due to suspected OSA, whom also responded to the SF-36 questionnaire, were included (N = 418). Of these, 194 showed normal findings, while 111, 60 and 53 demonstrated mild, moderate and severe OSA, respectively. Mean age was 47.5 (SD 11.9) and 69% were males. Only the mental health scale (p = 0.015) and mental component summary score (p = 0.023) were associated with OSA severity. This association, however, disappeared in multivariable analysis. All SF-36 scores in the sleep study group were lower than that of the general population sample, in both unadjusted and multivariable linear regression analysis. In this study, there was a lack of association between OSA severity and general HS. However, as a whole, patients in this clinical population referred to an overnight sleep study due to suspected OSA had impaired HS on all scales compared to a general population, with greatest differences in the vitality domain.</jats:p
Comparison of EQ-5D-3L and 5L versions following operative fixation of closed ankle fractures
No full textPURPOSE: To undertake the first testing and comparison of measurement properties for the EuroQol EQ-5D-3L and 5L in patients with ankle problems. METHODS: The cross-sectional postal survey of 959 patients aged ≥ 18 years, who underwent surgical treatment (ORIF) for unstable and closed ankle fractures in Eastern Norway. Both the EQ-5D-3L and 5L were included in a postal questionnaire in 2015, 3–6 years post surgery. Missing data, floor and ceiling effects, and response consistency were assessed. Tests of validity included comparisons with scores for the SF-36 and widely used ankle-specific instruments. The 5L version was assessed for test–retest reliability. RESULTS: There were 567 (59%) respondents; 501 completed both versions and 182 (61%) the 5L retest questionnaire. The 5L outperformed the 3L in tests of data quality and classification efficiency. Correlations with scores for other instruments largely met expectations, those for the 5L being slightly higher. All 5L scores had acceptable levels of reliability. For the 5L index, the smallest detectable differences for group and individual comparisons were 0.02 and 0.20, respectively. CONCLUSION: The 5L outperformed the 3L in terms of data quality, number of health states assessed and tests of validity. The 5L is recommended in research and other applications following surgery for ankle fracture but further testing including responsiveness to change is recommended at clinically relevant follow-up periods
Prepaid financing of primary health care in Guinea-Bissau : an assessment of 18 village health posts
No full textWith population growth increasing and budgets declining, the need for cost recovery in health care has grown. This paper discusses a prepayment scheme for drugs and limited primary health care at 18 village health posts in Guinea-Bissau. At these health posts, adverse selection was reduced because enrollment in each village was almost universal. The villager provided construction materials and labor and indicated their willingness to pay more if drugs were available on a timely basis. Villagers'willingness to prepay was often linked to better service, with drugs more readily available and midwidves better trained. Still, the quality of service at village health posts can only be as good as the support they get from the rest of the health care system. Authorities must strengthen health center support services and improve the drug resupply system.Health Monitoring&Evaluation,Health Systems Development&Reform,Housing&Human Habitats,Agricultural Knowledge&Information Systems,Regional Rural Development
Long‐term seizure outcome of surgery versus no surgery for drug‐resistant partial epilepsy: A review of controlled studies
No full textPsychometric properties of the Brief Pain Inventory among patients with osteoarthritis undergoing total hip replacement surgery
No full textAbstract Background Pain is a cardinal symptom of osteoarthritis (OA) of the hip and important for deciding when to operate. This study assessed the internal consistency reliability, validity and responsiveness of the Brief Pain Inventory (BPI) among patients with OA undergoing total hip replacement (THR). Methods We prospectively included 250 of 356 patients who were accepted to the waiting list for primary THR surgery. All participants responded to the BPI, WOMAC and SF-36 at baseline and 1 year after surgery. Results Internal consistency reliability (Cronbach's α) was >0.80 for the BPI, the WOMAC and five of the eight SF-36 scales The pattern of associations of the two BPI scales with corresponding and non-corresponding scales of the WOMAC and SF-36 largely supported the construct validity of the BPI. The responsiveness indices for change from baseline to 1 year after THR ranged from 1.52 to 2.05 for the BPI scales, from 1.69 to 2.84 for the WOMAC scales, and from 0.25 (general health) to 2.77 (bodily pain) for the SF-36 scales. Conclusions The BPI showed acceptable reliability, construct validity and responsiveness in patients with OA undergoing THR. BPI is short and therefore is easy to use and score, though the instrument offers few advantages over and duplicates scales of more comprehensive instruments, such as the WOMAC and SF-36.</p
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