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71.
Xiao Wu Julius Chapiro Ajay Malhotra Nishita Kothary 《Journal of vascular and interventional radiology : JVIR》2021,32(1):2-12.e1
PurposeTo compare the cost-effectiveness of using doxorubicin-loaded drug-eluting embolic (DEE) transarterial chemoembolization versus that of using conventional transarterial chemoembolization for patients with unresectable hepatocellular carcinoma (HCC).Materials and MethodsA decision-analysis model was constructed over the lifespan of a payer’s perspective. The model simulated the clinical course, including periprocedural complications, additional transarterial chemoembolization or other treatments (ablation, radioembolization, or systemic treatment), palliative care, and death, of patients with unresectable HCC. All clinical parameters were derived from the literature. Base case calculations, probabilistic sensitivity analyses, and multiple two-way sensitivity analyses were performed.ResultsIn the base case calculations for patients with a median age of 67 years (range for conventional transarterial chemoembolization: 28–88 years, range for DEE-transarterial chemoembolization: 16–93 years), conventional transarterial chemoembolization yielded a health benefit of 2.11 quality-adjusted life years (QALY) at a cost of $125,324, whereas DEE-transarterial chemoembolization yielded 1.71 QALY for $144,816. In 10,000 Monte Carlo simulations, conventional transarterial chemoembolization continued to be a more cost-effective strategy. conventional transarterial chemoembolization was cost-effective when the complication risks for both the procedures were simultaneously varied from 0% to 30%. DEE-transarterial chemoembolization became cost-effective if the conventional transarterial chemoembolization mortality exceeded that of DEE-transarterial chemoembolization by 17% in absolute values. The two-way sensitivity analyses demonstrated that conventional transarterial chemoembolization was cost-effective until the risk of disease progression was >0.4% of that for DEE-transarterial chemoembolization in absolute values. Our analysis showed that DEE-transarterial chemoembolization would be more cost-effective if it offered >2.5% higher overall survival benefit than conventional transarterial chemoembolization in absolute values.ConclusionsCompared with DEE-transarterial chemoembolization, conventional transarterial chemoembolization yielded a higher number of QALY at a lower cost, making it the more cost-effective of the 2 modalities. 相似文献
72.
简要阐述了输液泵的工作原理,较详细论述了输液泵在国内外临床各科室的广泛应用,在系统分析输液泵与常规注射及输液优缺点的基础上,对输液泵产业的未来发展进行了展望,指出应加大对输液泵的研发力度,在开发通用型和中低价位输液泵产品上下功夫。 相似文献
73.
目的评估改良早期预警评分系统(MEWS评分)在心脏科门诊识别危重患者的应用效果。方法将2012年10~12月来我院就诊的心内科门诊19971例患者进行MEWS评分,据此安排就诊先后顺序,并根据病情危重程度实施必要的处置,将MEWS评分与病情转归进行比较和分析。结果MEWSO~4分患者18634例随诊,5~8分患者1063例,与专科病房及CCU/ICU做好无缝隙连接;≥9分患者274例,死亡危险性明显增加,立即进行紧急医疗干预,实施特别护理。结论简便的MEWS将心脏科患者病情分值化,使医护人员对就诊患者分诊依据更充分,具有识别潜在危重病的作用。 相似文献
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76.
目的 分析日本血吸虫病异位损害情况,为诊疗提供参考。方法 检索《中国学术期刊网络出版总库》、《万方数据知识服务平台》2007年以来所有异位日本血吸虫病的文献报道资料,进行统计分析与总结。结果 2007 —2017年共报道异位血吸虫病211例,其中脑异位损害160例,占75.83%;肺异位损害45例,占21.33%;卵巢、输卵管、眼、脊髓、皮下、腮腺异位损害各1例。胃肠等消化道血吸虫病12例。结论 脑和肺血吸虫病异位损害发生率和误诊率最高,具有呼吸系统、神经系统症状和体征血吸虫病患者应首先排除血吸虫异位损害。血吸虫病疫区要重视异位血吸虫病诊断与治疗。异位血吸虫病预后大多良好,其病原治疗药物首选吡喹酮。 相似文献
77.
《Internal medicine journal》2017,47(9):986-991
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low‐ to intermediate‐risk chest pain are admitted to hospital. Rapid‐access cardiology (RAC) services are hospital co‐located, cardiologist‐led outpatient clinics that provide rapid assessment and immediate management but not long‐term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK). We review the evidence on the effectiveness, safety and acceptability of RAC services. Our review finds that early assessment in RAC outpatient services of patients with suspected angina, without high‐risk features suspicious of an acute coronary syndrome, is safe, can reduce hospitalisations, is cost effective and has good medical practitioner and patient acceptability. However, the literature is limited in that the evaluation of this model of care has been only in the UK. It is potentially suited to other settings and needs further evaluation in other settings to assess its utility. 相似文献
78.
Retention and HIV seroconversion among drug users on methadone maintenance treatment in Yunnan,China
Y-P. Chang L. Duo A. M. V. Kumar S. Achanta H-M. Xue S. Satyanarayana R. Ananthakrishnan S. Srivastava W. Qi S-Y. Hu 《Public Health Action》2014,4(1):28-34
Setting: Thirteen methadone maintenance treatment (MMT) clinics across Yunnan, the province with the highest human immunodeficiency virus (HIV) burden in China.Objectives: To determine, among HIV-negative participants on MMT, the proportion lost to follow-up (defined as those who missed the 6-monthly follow-up examination), factors associated with loss to follow-up (LFU), HIV seroconversion rate and factors associated with seroconversion.Design: Prospective cohort study from October 2008 to April 2011. All participants were administered a pre-tested structured questionnaire to capture associated factors and offered HIV testing every 6 months. χ2 test and log-binomial regression were used for data analysis.Results: Of 1146 participants, 541 (47%) were lost to follow-up in 2.5 years. Factors associated with higher LFU proportion include <6 months of previous MMT, inconvenient location of the MMT clinic and average methadone dose ⩽60 mg/day, with adjusted relative risks (RRs) of respectively 1.4 (95%CI 1.2–1.5), 1.2 (95%CI 1.0–1.4) and 1.1 (95%CI 1.0–1.3). The overall HIV seroconversion rate was 6.6 (95%CI 3.7–11.0) per 1000 person-years. Not living with a partner contributed to higher HIV rates, with an adjusted RR of 3.6 (95%CI 1.0–12.8).Conclusion: The retention rate of MMT participants in Yunnan was not satisfactory. Decentralising service delivery in the community and making directly observed treatment more convenient has the potential to improve retention. 相似文献
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