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11.
Renske M.T. ten Ham Merel van Nuland Rick A. Vreman Laurens G. de Graaf Hilde Rosing André M. Bergman Alwin D.R. Huitema Jos H. Beijnen Anke M. Hövels 《Value in health》2021,24(1):121-128
ObjectivesAbiraterone acetate is registered for the treatment of metastatic castration-sensitive and resistant prostate cancer (mCRPC). Treatment outcome is associated with plasma trough concentrations (Cmin) of abiraterone. Patients with a plasma Cmin below the target of 8.4 ng/mL may benefit from treatment optimization by dose increase or concomitant intake with food. This study aims to investigate the cost-effectiveness of monitoring abiraterone Cmin in patients with mCRPC.MethodsA Markov model was built with health states progression-free survival, progressed disease, and death. The benefits of monitoring abiraterone Cmin followed by a dose increase or food intervention were modeled via a difference in the percentage of patients achieving adequate Cmin taking a healthcare payer perspective. Deterministic and probabilistic sensitivity analyses were performed to assess uncertainties and their impac to the incremental cost-effectiveness ratio (ICER).ResultsMonitoring abiraterone followed by a dose increase resulted in 0.149 incremental quality-adjusted life-years (QALYs) with €22 145 incremental costs and an ICER of €177 821/QALY. The food intervention assumed equal effects and estimated incremental costs of €7599, resulting in an ICER of €61 019/QALY. The likelihoods of therapeutic drug monitoring (TDM) with a dose increase or food intervention being cost-effective were 8.04%and 81.9%, respectively.ConclusionsMonitoring abiraterone followed by a dose increase is not cost-effective in patients with mCRPC from a healthcare payer perspective. Monitoring in combination with a food intervention is likely to be cost-effective. This cost-effectiveness assessment may assist decision making in future integration of abiraterone TDM followed by a food intervention into standard abiraterone acetate treatment practices of mCRPC patients. 相似文献
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Special Articles
Long-term care bioethics committees: A cooperative model 相似文献13.
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TP53 gene mutations predict the response to neoadjuvant treatment with 5-fluorouracil and mitomycin in locally advanced breast cancer. 总被引:9,自引:0,他引:9
Stephanie Geisler Anne-Lise B?rresen-Dale Hilde Johnsen Turid Aas Jürgen Geisler Lars Andreas Akslen Gun Anker Per Eystein L?nning 《Clinical cancer research》2003,9(15):5582-5588
PURPOSE: Recent studies have found an association between certain TP53 mutations and resistance to anthracycline-based primary medical therapy in breast cancer. The purpose of this study was to investigate whether TP53 mutational status also might influence the response to a non-anthracycline-containing regimen in primary breast cancer. EXPERIMENTAL DESIGN: Thirty-five patients with locally advanced breast cancer were investigated for TP53 mutations before receiving combination chemotherapy with 5-fluorouracil (1000 mg/m(2) on days 1 and 2) and mitomycin (6 mg/m(2) on day 2), administered every 3 weeks for 2-10 cycles in the neoadjuvant setting. RESULTS: Mutations in the TP53 gene, in particular those affecting loop domains L2 or L3 of the p53 protein, were associated with lack of response to chemotherapy (i.e., increase in the diameter product of tumor lesion by >/=25%; P = 0.177 for all mutations and P = 0.006 for those affecting L2/L3 domains, respectively). No statistically significant correlation between TP53 LOH and response to therapy was seen. CONCLUSION: This study revealed a significant association between lack of response to 5-fluorouracil and mitomycin and mutations affecting the L2/L3 domains of the p53 protein. Together with our previous finding that such mutations predict resistance to weekly doxorubicin, our data suggest that mutations affecting this particular domain of the p53 protein may cause resistance to several different cytotoxic compounds applied in breast cancer treatment. 相似文献
15.
Pieter Meyns Tine Roman de Mettelinge Judith van der Spank Marieke Coussens Hilde Van Waelvelde 《Developmental neurorehabilitation》2018,21(6):371-390
Objective: Motivation is suggested as an important factor in pediatric motor rehabilitation. Therefore, we reviewed the existing evidence of (motivational) motor rehabilitation paradigms, and how motivation influences rehabilitation outcome using self-determination theory as conceptual framework. Methods: PubMed and Web-of-Science databases were systematically searched until June 2015. Data were independently extracted and critiqued for quality by three authors. Studies reporting motivational aspects were included. Most studies examined new technology (e.g., virtual reality [VR]). Results: Out of 479 records, three RCT, six case-control, and six non-comparative studies were included with mixed quality. Motivation was rarely reported. Training individualization to the child’s capabilities with more variety seemed promising to increase motivation. Motivation increased when the exercises seemed helpful for daily activities. Conclusions: Motivation in pediatric rehabilitation should be comprehensively assessed within a theoretical framework as there are indications that motivated children have better rehabilitation outcomes, depending on the aspect of motivation. 相似文献
16.
Patricia Leahy‐Warren PhD MSc BSc Hdip PHN RPHN RM RGN Mary Rose Day DN MA BSc Hdip PHN RPHN RM RGN Kari Glavin PhD M.Sc PHN RN MEANS Edith Roth Gjevjon PhD MSc RN MEANS Anne Kjersti Myhrene Steffenak PhD MSc PHN RN Live S. Nordhagen MSc PHN RN Hilde Egge MSc PHN RN Elizabeth Healy MSc PHN RGN 《Public health nursing (Boston, Mass.)》2018,35(4):307-316
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Olöf Birna Kristjansdottir André Vågan Margrét Hrönn Svavarsdóttir Hilde Blindheim Børve Kari Hvinden Veerle Duprez Ann Van Hecke Lena Heyn Hilde Strømme Una Stenberg 《Patient education and counseling》2021,104(5):1030-1048
ObjectivesTo provide overview of research on training interventions for healthcare providers aimed at promoting competencies in delivering group-based patient education.MethodsA systematic literature search identified relevant studies. Data was extracted on training details, study design, outcomes and experiences. Results were summarized and qualitative data analyzed using content analysis.ResultsTwenty-seven studies exploring various training interventions were included. Ten studies used qualitative methods, eight quantitative and nine mixed methods. Use of a comparison group, validated instruments and follow-up measures was rare. Healthcare providers’ reactions to training were mostly positive. Several studies indicated positive short-term effects on self-efficacy and knowledge. Results on observed skills and patient outcomes were inconclusive. Results on healthcare providers’ experience of delivery of group-based patient education following training were categorized into 1) Benefits of training interventions, 2) Barriers to implementation and 3) Delivery support.ConclusionsFurther evaluation of training for healthcare providers delivering group-based patient education is needed before conclusions on training efficacy can be drawn. The results indicate an expanding research field still in maturation.Practice implicationsEfficacy studies evaluating theoretically grounded training with clear attention on group facilitation and follow-up support are needed. Inclusion of validated instruments and long-term outcomes is encouraged. 相似文献
18.
Erlend S. Landsend Øygunn A. Utheim Hilde R. Pedersen Neil Lagali Rigmor C. Baraas Tor P. Utheim 《Survey of ophthalmology》2018,63(1):105-113
Congenital aniridia is a rare panocular disease caused by fundamental disturbances in the development of the eye, characterized primarily by hypoplasia of the iris and macula. Severe secondary complications such as keratopathy, cataract, and glaucoma are common and often lead to considerable visual impairment or blindness. Many complications in aniridia patients are difficult to treat and present a challenge for the ophthalmologist. Increasingly, associated nonocular features of the disease are also being recognized. Over the past decades, major steps have been made in the understanding of the genetic basis of aniridia. Moreover, recent studies have prepared the ground for future treatment options based on specific mutations. Therefore, specific knowledge about genetics in aniridia has become more important than ever. We provide an overview of the field of aniridia genetics and its clinical implications. 相似文献
19.
Michael Bauer Uwe Kölsch Renate Krüger Nadine Unterwalder Karin Hameister Fabian Marc Kaiser Aglaia Vignoli Rainer Rossi Maria Pilar Botella Magdalena Budisteanu Monica Rosello Carmen Orellana Maria Isabel Tejada Sorina Mihaela Papuc Oliver Patat Sophie Julia Renaud Touraine Thusari Gomes Kirsten Wenner Xiu Xu Alexandra Afenjar Annick Toutain Nicole Philip Aleksandra Jezela-Stanek Ludwig Gortner Francisco Martinez Bernard Echenne Volker Wahn Christian Meisel Dagmar Wieczorek Salima El-Chehadeh Hilde Van Esch Horst von Bernuth 《Journal of clinical immunology》2015,35(2):168-181
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