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排序方式: 共有8317条查询结果,搜索用时 171 毫秒
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Julia Thornton Snider Jesse Sussell Mahlet Gizaw Tebeka Alicia Gonzalez Joshua T. Cohen Peter Neumann 《Value in health》2019,22(3):332-339
Background
Payers frequently rely on budget impact model (BIM) results to help determine drug coverage policy and its effect on their bottom line. It is unclear whether BIMs typically overestimate or underestimate real-world budget impact.Objective
We examined how different modeling assumptions influenced the results of 6 BIMs from the Institute for Clinical and Economic Review (ICER).Study Design
Retrospective analysis of pharmaceutical sales data.Methods
From ICER reports issued before 2016, we collected estimates of 3 BIM outputs: aggregate therapy cost (ie, cost to treat the patient population with a particular therapy), therapy uptake, and price. We compared these against real-world estimates that we generated using drug sales data. We considered 2 classes of BIM estimates: those forecasting future uptake of new agents, which assumed “unmanaged uptake,” and those describing the contemporaneous market state (ie, estimates of current, managed uptake and budget impact for compounds already on the market).Results
Differences between ICER's estimates and our own were largest for forecasted studies. Here, ICER's uptake estimates exceeded real-world estimates by factors ranging from 7.4 (sacubitril/valsartan) to 54 (hepatitis C treatments). The “unmanaged uptake” assumption (removed from ICER's approach in 2017) yields large deviations between BIM estimates and real-world consumption. Nevertheless, in some cases, ICER's BIMs that relied on current market estimates also deviated substantially from real-world sales data.Conclusions
This study highlights challenges with forecasting budget impact. In particular, assumptions about uptake and data source selection can greatly influence the accuracy of results. 相似文献5.
Harinakshi Sanikini David C. Muller Marisa Sophiea Sabina Rinaldi Antonio Agudo Eric J. Duell Elisabete Weiderpass Kim Overvad Anne Tjønneland Jytte Halkjær Marie-Christine Boutron-Ruault Franck Carbonnel Iris Cervenka Heiner Boeing Rudolf Kaaks Tilman Kühn Antonia Trichopoulou Georgia Martimianaki Anna Karakatsani Valeria Pala Domenico Palli Amalia Mattiello Rosario Tumino Carlotta Sacerdote Guri Skeie Charlotta Rylander María-Dolores Chirlaque López Maria-Jose Sánchez Eva Ardanaz Sara Regnér Tanja Stocks Bas Bueno-de-Mesquita Roel C.H. Vermeulen Dagfinn Aune Tammy Y.N. Tong Nathalie Kliemann Neil Murphy Marc Chadeau-Hyam Marc J. Gunter Amanda J. Cross 《International journal of cancer. Journal international du cancer》2020,146(4):929-942
Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow-up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI ≥30 vs. 18.5–25 kg/m2: HR = 1.94, 95% CI: 1.25–3.03) and women (HR = 2.66, 95% CI: 1.15–6.19); however, adjustment for waist-to-hip ratio (WHR) attenuated these associations. After mutual adjustment for BMI and HC, respectively, WHR and waist circumference (WC) were associated with EA in men (HR = 3.47, 95% CI: 1.99–6.06 for WHR >0.96 vs. <0.91; HR = 2.67, 95% CI: 1.52–4.72 for WC >98 vs. <90 cm) and women (HR = 4.40, 95% CI: 1.35–14.33 for WHR >0.82 vs. <0.76; HR = 5.67, 95% CI: 1.76–18.26 for WC >84 vs. <74 cm). WHR was also positively associated with GC in women, and WC was positively associated with GC in men. Inverse associations were observed between parity and EA (HR = 0.38, 95% CI: 0.14–0.99; >2 vs. 0) and age at first pregnancy and GNC (HR = 0.54, 95% CI: 0.32–0.91; >26 vs. <22 years); whereas bilateral ovariectomy was positively associated with GNC (HR = 1.87, 95% CI: 1.04–3.36). These findings support a role for hormonal pathways in upper gastrointestinal cancers. 相似文献
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Julie A. Schmidt Georgina K. Fensom Sabina Rinaldi Augustin Scalbert Paul N. Appleby David Achaintre Audrey Gicquiau Marc J. Gunter Pietro Ferrari Rudolf Kaaks Tilman Kühn Heiner Boeing Antonia Trichopoulou Anna Karakatsani Eleni Peppa Domenico Palli Sabina Sieri Rosario Tumino Bas Bueno-de-Mesquita Antonio Agudo Maria-Jose Sánchez María-Dolores Chirlaque Eva Ardanaz Nerea Larrañaga Aurora Perez-Cornago Nada Assi Elio Riboli Konstantinos K. Tsilidis Timothy J. Key Ruth C. Travis 《International journal of cancer. Journal international du cancer》2020,146(3):720-730
Metabolomics may reveal novel insights into the etiology of prostate cancer, for which few risk factors are established. We investigated the association between patterns in baseline plasma metabolite profile and subsequent prostate cancer risk, using data from 3,057 matched case–control sets from the European Prospective Investigation into Cancer and Nutrition (EPIC). We measured 119 metabolite concentrations in plasma samples, collected on average 9.4 years before diagnosis, by mass spectrometry (AbsoluteIDQ p180 Kit, Biocrates Life Sciences AG). Metabolite patterns were identified using treelet transform, a statistical method for identification of groups of correlated metabolites. Associations of metabolite patterns with prostate cancer risk (OR1SD) were estimated by conditional logistic regression. Supplementary analyses were conducted for metabolite patterns derived using principal component analysis and for individual metabolites. Men with metabolite profiles characterized by higher concentrations of either phosphatidylcholines or hydroxysphingomyelins (OR1SD = 0.77, 95% confidence interval 0.66–0.89), acylcarnitines C18:1 and C18:2, glutamate, ornithine and taurine (OR1SD = 0.72, 0.57–0.90), or lysophosphatidylcholines (OR1SD = 0.81, 0.69–0.95) had lower risk of advanced stage prostate cancer at diagnosis, with no evidence of heterogeneity by follow-up time. Similar associations were observed for the two former patterns with aggressive disease risk (the more aggressive subset of advanced stage), while the latter pattern was inversely related to risk of prostate cancer death (OR1SD = 0.77, 0.61–0.96). No associations were observed for prostate cancer overall or less aggressive tumor subtypes. In conclusion, metabolite patterns may be related to lower risk of more aggressive prostate tumors and prostate cancer death, and might be relevant to etiology of advanced stage prostate cancer. 相似文献
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Carlos Ferrer Albiach Antonio Conde Moreno Marta Rodríguez Cordón Virginia Morillo Macías Ana Bouché Babiloni Inmaculada Beato Tortajada Ángel Sánchez Iglesias Alicia Francés Muñoz 《Clinical & translational oncology》2010,12(1):22-26
Hypoxia is related to poor prognosis because it is associated to chemo-and radioresistance. During recent years the evolution
of imaging methods like PET/CT and MRI has meant the appearance of new perspectives with direct implications in radiation
therapy. We discuss previous experiences in staging, planning and in the follow-up process with these techniques for measuring
tumour hypoxia. 相似文献
8.
Alicia E. Ronco M. Cecilia Sobrero Gustavo D. Bulus Rossini Pablo R. Alzuet Bernard J. Dutka 《Environmental toxicology》1995,10(1):35-39
Toxicity testing of sediment samples from the Rio Santiago and its main tributaries was performed using a battery of tests that included the ECHA dipstick biocide monitor, the MetPad test, the lettuce seed germination and the root elongation test, the nematode test, spot plate test, and the SOS Chromotest. Assessment was carried out on organic extracts, pore water, and direct sediment. Results of bioassays showed toxicity sources from tributaries and canals flowing into the river and areas being degraded by insults from industrial spills. © by John Wiley & Sons, Inc. 相似文献
9.
Abstract Pericardial tamponade remains a diagnostic challenge
to the clinician especially when the patient is well compensated
hemodynamically. We report an unusual case
who sought medical help 1 month after having been
stabbed in his chest. An investigation revealed a perforation
of the myocardium and a pericardial tamponade.
The patient survived thanks to a large organized clot
that plugged the perforation. The patient was exposed
to increased risk due to delayed onset, recognition, and
therapy of the tamponade. Most reports on this subject
deal with acute pericardial tamponade. Only few cases
of delayed pericardial tamponade have been reported.
A review of the relevant literature and the therapeutic
approaches are discussed. 相似文献
10.
Alicia Gómez-Barrio David Montero-Pereira Juan J. Nogal-Ruiz José A. Escario Susana Muelas-Serrano Vladimir V. Kouznetsov Leonor Y. Vargas Méndez Juan M. Urbina Gonzáles Carmen Ochoa 《Acta parasitologica / Witold Stefański Institute of Parasitology, Warszawa, Poland》2006,51(1):73-78
A study of some antiparasitic properties of several homoallylamines and related tetrahydroquinolines and quinolines, previously
described, was carried out using in vitro activity assays against the epimastigote form of Trypanosoma cruzi and against Trichomonas vaginalis. Unspecific cytotoxicity against murine macrophages was also studied. Although the antichagasic and trichomonacidal activities
are not comparable to those of the standard drugs, nifurtimox and metronidazole, some of the compounds exhibit an interesting
specific antiparasitic activity. 相似文献