An analysis of effectiveness of after
Measuring intervention effectiveness
However, this would not change the conclusions of the present analysis. The LYGs with treatment varied according to age at diagnosis Table 1. Several analyses were performed in which the costs used in the base case analysis were varied. Effectiveness: Years of Life Gained Mortality rates were calculated based on specific national mortality rates by age and sex for the general population. The use of sensitivity analysis indicates that the results obtained are robust to changes in the parameters used, whilst the use of probabilistic simulation analysis helps to clarify the study results. This assumption is reflected in the sensitivity analysis to take into account the case of first-degree relatives of genetically diagnosed patients. Figure 2. The analysis was performed from the perspective of the National Health System payer perspective. This has important economic and health implications, because the health benefit LYG is greater the earlier the diagnosis of FH. Diagnosis and treatment does not mean that patients' age- and sex-adjusted mortality risk becomes the same as that of the general population, but that the mortality risk in the population identified and treated is lower than that in an untreated population with FH. METHODS We performed a cost-effectiveness analysis in which the target strategy was the genetic screening, and subsequent treatment with statins, of the immediate family members parents, siblings, children of patients with a prior genetic diagnosis of FH. New cases diagnosed by the screening program were expected to gain a mean of 3. It was assumed that treatment would also include two annual visits to a specialist.
In this case, the incremental ratio of the technology in question is euros per LYG, which is very reasonable. To do this, we assumed that index cases were diagnosed genetically and that genetic screening was then performed in family members.
Sensitivity Analysis We performed a univariate sensitivity analysis in the deterministic model to evaluate its impact on cost and effectiveness of screening. Systematic review and meta-analysis of the effectiveness of pharmacist-led medication reconciliation in the community after hospital discharge.
Before and after study design limitations
Indeed, ischemic disease leads to huge productivity losses in Spain. New cases diagnosed by the screening program were expected to gain a mean of 3. The figures for a 20 year old female were The analysis was performed from the perspective of the National Health System payer perspective. Both strategies included follow-up and treatment of individuals who had had a cardiovascular event. Controlled studies evaluating pharmacist-led medication reconciliation in the community after hospital discharge were included. The results are supplemented by the mapping of the cost-effectiveness plane and the acceptability curve. The model performed Monte Carlo type simulations.
Study Limitations Certain difficulties were encountered when trying to estimate health outcomes for this study. Specifically, we used the age and sex distribution of patients under 60 years of age from that cohort.
Reduction in clinically relevant discrepancies was reported in two studies. However, this would not change the conclusions of the present analysis. It would likewise be recommendable to use quality adjusted life years as the final endpoint.
Cost per Life Year Gained The incremental cost per LYG was calculated as the cost of screening plus patient treatment less savings resulting from a reduction in the incidence of coronary events, all divided by LYGs.
We systematically review the literature to evaluate intervention effectiveness in terms of discrepancy identification and resolution, clinical relevance of resolved discrepancies and healthcare utilisation, including readmission rates, emergency department attendance and primary care workload.
The base case used the Ministry of Health and Consumer Affairs reference price for simvastatin 40 mg.
The figures for a 20 year old female were Such trials will likely never be performed as they would be ethically unacceptable in this population, given the well-known benefits of statin therapy in FH. METHODS We performed a cost-effectiveness analysis in which the target strategy was the genetic screening, and subsequent treatment with statins, of the immediate family members parents, siblings, children of patients with a prior genetic diagnosis of FH.
based on 79 review