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Blog - Heoro.com new additions: December 2017
Published: 04-12-2017
Our heoro.com database updates daily from PubMed with new studies relevant to health economics and outcomes research. Here are some of the key papers added during December 2017.
Patient-reported outcome studies
Arm and brachial plexopathy symptoms, measured on the Arm Symptoms Scale, were not significantly different after hypofraactionated nodal radiotherapy compared with conventional radiotherapy in women with breast cancer in Canada. Leong 2017 Go to paper on PubMed
Quality of life, measured with the SF-36, improved after bone transport for treatment-infected nonunion of tibial fractures in China. Wang 2017 Go to paper on PubMed
The Memory and Executive Screening tool was validated for the detection of cognitive impairment in patients with obstructive sleep apnoea in China; its performance was similar to the Montreal Cognitive Assessment. Mu 2017 Go to paper on PubMed
Quality of life, measured with the EORTC QLQ-C30, was higher in patients with advanced melanoma who received pembrolizumab compared with ipilimumab in the KEYNOTE-006 RCT. Petrella 2017 Go to paper on PubMed
Quality of life was similar after mastectomy and breast-conserving surgery in women with breast cancer in Taiwan, using the EORTC QLQ-C30 and QLQ-BR23. Tsai 2017 Go to paper on PubMed
A literature review found that psychological wellbeing was high after gender affirming surgery and hormone treatment in trans men, but that evidence was sparse on the cost-effectiveness of such interventions. Defreyne 2017 Go to paper on PubMed
Visual acuity and function, measured with the NEI VFQ-25 questionnaire, are worse in US adults with macular oedema secondary to retinal vein occlusion compared with the general population. Scott 2017 Go to paper on PubMed
A systematic review found 17 PRO tools that had been used in patients with refractive error; of these, the Quality of Life Impact of Refractive Correction, the Quality of Vision, and the Contact Lens Impact on Quality of Life instruments had the best quality. Kandel 2017 Go to paper on PubMed
Long-term quality of life, measured with the Duke Activity Status Index (DASI), was not affected by prior trastuzumab therapy in women with HER2+ve early breast cancer. Ganz 2017 Go to paper on PubMed
Quality of life in adults with rheumatoid arthritis, measured on the EQ-5D and SF-36 instruments, was better at 24 weeks with a treat-to-target strategy using tocilizumab compared with methotrexate; the FACIT-Fatigue scores were not significantly improved. Teitsma 2017 Go to paper on PubMed
The CBQoL tool was developed and validated to assess quality of life in people with colour blindness; quality of life was significantly lower than in normal controls in the UK. Barry 2017 Go to paper on PubMed
A systematic review found no evidence that psychological interventions are better than usual care at reducing distress in adults with type 2 diabetes. Chew 2017 Go to paper on PubMed
Quality of life, measured with the KCCQ, was consistently higher for up to three years in 84-85% of patients with aortic stenosis who underwent a transcatheter aortic valve replacement, when compared to previous scores. Baron 2017. Go to paper on PubMed
Quality of life for patients with NSCLC treated with pembrolizumab was consistently better on the EORTC QLQ-C30, and the QLQ-LC13 when compared to standard chemotherapy. Brahmer 2017. Go to paper on PubMed.
Narrative cognitive therapy was as effective as cognitive behavioural therapy in the treatment of young adults with depression over a 12 month period at improving the quality of life as measured by the Medical Outcomes Survery Short Form General Health Survey. Azevedo 2017. Go to paper on PubMed.
The care and wellbeing of pregnant women who underwent routine MRI scans was measured using the State-Trait Anxiety inventory (STAI). STAI fell from 36.81n to 32.77, 31.87 and 31.82 at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound. There were no differences in health related QoL. Edwards 2017. Go to paper on PubMed.
There was no significant difference in mean QOL by race at baseline or follow-up, measured with the Peripheral Arterial Questionnaire (PAQ), in black or white patients with PAD. Zaitoun 2017. Go to paper on PubMed
Costs and resource use studies
Episodes of non-sustained ventricular fibrillation predicted an increased risk of hospitalisation in adults with an implantable cardiac defibrillator for heart failure in Turkey. Ucar 2017 Go to paper on PubMed
Length of stay was shorter and complication rates the same when laparoscopic cholecystectomy for acute cholecystitis is performed at night compared with daytime surgery in the USA. Siada 2017 Go to paper on PubMed
Disabled adults in the USA incur healthcare costs that are 3 to 7 times higher than non-disabled adults; access to care is likely to be restricted if the Affordable Care Act is repealed. Kennedy 2017 Go to paper on PubMed
The rate of surgery and radiotherapy for stage I non-small-cell lung cancer in the US increased between 2000 and 2010; mortality decreased by 3.5% per year over the same period. Kapadia 2017 Go to paper on PubMed
Ophthalmologists in the USA typically prescribe opioids 7 times a year for a mean 5 days each time; 1% wrote more than 100 prescriptions per year. Patel 2017 Go to paper on PubMed
Length of stay is longer for US patients admitted to hospital under the care of their primary care physician than those supervised by hospitalists or generalists, but 30-day mortality and readmission rates are lower. Stevens 2017 Go to paper on PubMed
The incidence of community-acquired pneumonia requiring hospitalisation in Korea in 2009 to 2013 was 626 per 100,000 population; the mean direct costs were US$1851 per admission. Choi 2017 Go to paper on PubMed
Top-down measurement of healthcare professional costs, based on spending data from the Brazilian Hospitalization System, is as accurate as a bottom-up approach of costing hours of time spent caring for patients with adverse events due to primaquine exposure in G6PD deficiency. Peixoto 2017 Go to paper on PubMed
Early appendicectomy reduces resource use and costs of care in children with ruptured appendicitis compared with a conservative approach with delayed elective surgery in the USA. Church 2017 Go to paper on PubMed
The in-hospital acute and elective costs per case for percutaneous coronary intervention in Japan were USD $14,3840 and $11,030 respectively. Proceedure related complications were independent predictors of high costs. Inohara 2017. Go to paper on PubMed
Using the Cost-effectiveness of Preventing AIDS Complications (CEPAC)-Pediatric model it was found that NAAT testing of infants for HIV infection is cost-saving in South Africa: US$1790 per infant tested vs $1830 per infant without 2nd test. Dunning 2017. Go to paper on PubMed
The US Presidents Malaria Initiative (PMI) is highly cost effective with an estimate of $94 per DALY averted. A 44% reduction in PMI funding could result in an additional 67 million cases of malaria and 290649 more deaths between 2017 and 2020. Winskill 2017. Go to paper on Pubmed
Liposomal amphotericin B is a cost effective alternative to SbV and AmB-D in the treatment of mucocutaneous leishmaniasis (ICER US$18,816.23 vs SbV and US$24,504.65 vs AmB-D) due to its higher effectiveness, safety and shorter course. Mistro 2017. Go to paper on PubMed.
Repetitive Transcranial Magnetic Stimulation was identified as the dominant therapy compared with antidepressant medication, for treatment of major depressive disorder after first line treatment failure in newly diagnosed patients. QALYs ranged from $2952 in older patients to $11,140 in younger patients. Voigt 2017. Go to paper on PubMed
Among adolescents and young adults with type 1 diabetes, daily financial incentives improved their glucose monitoring adherence during the incentive period, but did not significantly improve their glycaemic control. Wong 2017. Go to paper on PubMed
In 2012 4.8% of Medicare spending was potentially preventable, of which 73.8% was incurred by high cost patients. High cost frail elderly persons accounted for 43.9% of the potentially preventable spending at a cost of $6593 per person. Figueroa 2017. Go to paper on PubMed.
From 2010 to 2015 there was an annual average of 3,401,553 tests for 411,295 distinct patients on their first test requisition for the year. The MARR increased from 8.1% to 9.0% through this period. Brack 2017. Go to paper on PubMed
The implementation of the MOQI APRN model in 16 nursing homes lead to a reduction in hospital visits, emergency room visits, Medicare expenditures for hospitalisations and Medicare expenditures for emergency room visits for long stay nursing home residents. Rantz 2017. Go to paper on PubMed
The mean costs for moderate/high-risk vs. low-risk hospitalisations for childbirth were $6145 and $5397, respectively. Delivery type (Cesarian section vs. vaginal birth), LOS, urban/rural hospital status, geographic regions, calendar year of hospitalisation, teaching status, payer types and serious maternal morbidity factors significantly affected costs. Law 2017. Go to paper on PubMed
Economic modelling studies
Endovascular repair of ruptured abdominal aortic aneurysms reduced 3-year mortality and costs and increased QALYs compared with open repair, making it cost-effective in the UK and Canada. IMPROVE Trial investigaotrs 2017 Go to paper on PubMed
A systematic review of economic evaluations in pancreatic ductal adenocarcinoma found that half had a Drummond score of less than 7, but that quality was improving. Gerard 2017 Go to paper on PubMed
Genetic screening using molecular genetic diagnostics cost US$32,000 more than conventional cytogenetics diagnostics for acute myeloid leukaemia, but increased survival by 7 months, giving an ICER of US$4928 per extra month of life in Germany. Horster 2017 Go to paper on PubMed
Extracapsular dissection reduced resource use and costs compared with superficial parotidectomy with similar outcomes in patients with benign parotid lesions in the USA. Kato 2017 Go to paper on PubMed
A systematic review and economic evaluation concluded that direct oral anticoagulants reduce mortality compared with warfarin in adults with atrial fibrillation, and that apixaban is the most cost-effective. Lopez-Lopez 2017 Go to paper on PubMed
Adding azithromycin to cephalosporins is cost-effective as antibiotic prophylaxis in nonelective Caesarian sections compared with cephalosporins alone, with lower costs and higher QALYs. Skeith 2017 Go to paper on PubMed
Intensive screening for cervical cancer and CIN reduces mortality in women but increases the risk of preterm birth and infant mortality; the most cost-effective approach depends on the woman's age and wish for children in the future. Kamphuis 2017 Go to paper on PubMed
A universal blood type and screen strategy to prepare for transfusion in obstetric haemorrhage is not cost-effective in the USA; a universal clot hold strategy was cost-effective, at $2,878 per emergency-release transfusion prevented. Einerson 2017 Go to paper on PubMed
Expanding access to treatment for hepatitis C to primary care was cost-effective in the USA, with an ICER of $10,351 per QALY gained compared with standard practice. Rattay 2017 Go to paper on PubMed
The Smile Train program for cleft lip and palate repair is cost-effective in central and Eastern Africa, with a cost of $62.8 per DALY averted. Hamze 2017 Go to paper on PubMed
A vaccine for dengue is cost-effective in Latin America and the Asia-Pacific region, saving I$18.36 per person vaccinated compared with no vaccine from a societal perspective. El Fezzazi 2017 Go to paper on PubMed
Combined chemohormonal therapy led to greater QALYs than androgen suppression alone and was cost-effective in prostate cancer in Brazil; the ICERs were up to 6 times lower in patients with metastatic versus non-metastatic disease. Aguiar 2017 Go to paper on PubMed
Tele-ophthalmology screening of people with type 2 dibetes for retinopathy was cost-effective in Canada compared with face-to-face screening, with average savings of $1007 per person screened. Kanjee 2017 Go to paper on PubMed
Testing migrants to the US for latent TB infection is cost-effective in those with HIV infection, diabetes and no comorbidity; the IGRA test was usually the most cost-effective option. Tasillo 2017 Go to paper on PubMed
Three-monthly zoledronic acid is the most cost-effective option to prevent sekeletal events in women with bone metastases from breast cancer in the USA, compared with monthly zoledronate or denosumab. Shapiro 2017 Go to paper on PubMed
A combined strategy of increasing access to health care and promoting guideline-based care was the most cost-effective approach to minimising days of duty lost due to travellers' diarrhoea in US military deployed overseas. Schrader 2017 Go to paper on PubMed
Active monitoring is the most cost-effective strategy for managing precancerous anal lesions in HIV positive men below the age of 30 who have sex with men; treating the lesion plus HPV vaccination is the most cost-effective strategy in those aged 38 and older in the USA. Deshmukh 2017 Go to paper on PubMed
An integrated programme for West Nile virus surveillance in Italy is cost-saving compared with usual surveillance, as it reduces unnecessary screening of blood donations. Paternoster 2017 Go to paper on PubMed
Farmers in Vietnam who use human excrement for fertilisers are at higher risk of acquiring helminth infections than those who use other fertilisers, but have the highest cost savings. Composting the excrement for 6 months before use reduces the risk of infection but increases costs, although costs remain highest for use of artificial fertilisers alone. Tran-Thi 2017 Go to paper on PubMed
Clinical examination is the most cost-effective way to screen for congenital heart defects in newborn infants in China; adding pulse oximetry can further improve clinical outcomes. Tobe 2017 Go to paper on PubMed
Stepped care for individuals with PTSD in the aftermath of a natural disaster is associated with greater reach and higher effectiveness than usual care, with an ICER of $3428.71 to $6857.68 per disability-adjusted life year avoided, and $0.80 to $1.61 per PTSD-free day. Cohen 2017. Go to paper on PubMed
Mortality studies
In-hospital cardiac arrest occurred in 0.4% of people admitted to Veterans Association hospitals in the USA between 2008 and 2012; overall survival to discharge was 31.2%, with a range of 20.3% to 45.4% across hospitals. Bradley 2017 Go to paper on PubMed
Mortality models using random forest methodology were as accurate at predicting mortality after STEMI in women in the US as logistic regression models. Mansoor 2017 Go to paper on PubMed
28-day mortality in adults admitted to hospital with sepsis in Taiwan was 19.8% in 2013-2016; a risk score based on immune system dysfunction could predict mortality. Fang 2017 Go to paper on PubMed
One-year mortality was increased in patients undergoing transcatheter aortic valve implantation if they also had advanced chronic kidney disease or impaired left ventricular function. Levi 2017 Go to paper on PubMed
Cardiac events and mortality from atrial fibrillation are increasing in the USA, from 249 events per 100,000 population in 2006 to 268/100,000 in 2014 for primary AF. Jackson 2017 Go to paper on PubMed
In adults with atrial fibrillation in Sweden, women who were taking levothyroxine had lower mortality than those not taking this drug; mortality with or without levothyroxine was no different in men, and there was no significant impact on myocardial infarction, stroke or heart failure rates. Wandell 2017 Go to paper on PubMed
Mortality in children with dilated cardiomyopathy improved in the US between 1990-1999, when mortality was 18%, to 9% in 2000 to 2009; heart transplant rates were 24% in both time periods. Singh 20176 Go to paper on PubMed
Inducing labour at 40 weeks in nulliparous women aged 35 to 50 years in the UK could reduce perinatal mortality compared with an expectant policy; 562 women would need to have labour induced to prevent one perinatal death. Knight 2017 Go to paper on PubMed
Inhaled nitric oxide was no better than placebo gas at reducing mortality and bronchopulmonary dysplasia in preterm infants in the USA. Hasan 2017 Go to paper on PubMed
Mortality in trauma patients in the USA was 20% in those with fibrinolysis shutdown, 16% in those with hyperfibrinolysis and 9% in others. Moore 2017 Go to paper on PubMed
Zoledronic acid added to neoadjuvant chemotherapy increased disease-free survival in triple negative breast cancer but not in postmenopausal women with breast cancer in Japan. Ishikawa 2017 Go to paper on PubMed
The most accurate model to predict death in premature infants with surgical necrotising enterocolitis in the USA is the American College of Surgeons National Surgical Quality Improvement Program Pediatric model. Bhatt 2017 Go to paper in PubMed
Overall survival in very premature infants varied from 78% to 93% in developed countries internationally; variation was greatest for infants born at 24 weeks' gestation. Helenius 2017 Go to paper on PubMed
Between 70-78% of ovarian cancers in the USA are type II; screening for ovarian cancer with annual transvaginal ultrasound is less sensitive for type II tumours (65% compared with 81% for other ovarian tumours) and survival is significantly worse.
2.1% of US Medicare general internist admissions were managed by locums 2009-2014. The 30 day mortality was the same as with permanent staff but significantly higher costs and mean length of stay, but significantly lower 30-day readmissions. Blumenthal 2017. Go to paper on PubMed
Mortality in infants affected by severe small-for-gestational age (SGA) birth weight was higher than full term infants of normal weight (2.8/1000 vs 0.6/1000). Mortality rate increased to 22.9/100 for preterm birth (PTB) and to 60/1000 for PTB and SGA. Ray 2017. Go to paper on PubMed
Hospital mortality among adults in Japan admitted with acute heart failure was 8.3% overall. Mortality could be predicted by a model that included catecholamine administration, minimum platelet concentration, maximum blood urea nitrogen, total bilirubin, and C-reactive protein levels. Yagyu 2017. Go to paper on PubMed
The risk of stillbirth and perinatal death of pregnancies beyoind 24 weeks' gestation in England in 2013-15 decreased linearly per unit increase in the mother's haemoglobin concentration at first visit; the risk of stillbirth and perinatal death was five-fold higher in women with moderate-severe anaemia at first visit. Nair 2017. Go to paper on PubMed.