Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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Meta Analysis
Esophageal Doppler monitoring during colorectal resection offers cost-effective improvement of hemodynamic control.
Hemodynamic control can improve the outcome of surgery. Esophageal Doppler monitoring measures blood flow by ultrasound waves. This work investigates the cost-effectiveness of this procedure during colorectal resection. ⋯ Although the information regarding the clinical effectiveness of esophageal Doppler monitoring in colorectal resection is limited, strategies including this form of blood flow monitoring may be cost-effective. Further comparisons of Doppler monitoring against other hemodynamic monitoring systems should be undertaken.
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Generic health status measures such as the short form health survey (SF-36) and EuroQol-5D (EQ-5D) are increasingly being used to inform health policy. They are claimed to be applicable across disease areas and have started to be used within mental health research. This review aims to assess the construct validity and responsiveness of four generic health status measures in schizophrenia, including the preference-based SF-6D and EQ-5D. ⋯ Although the evidence base is limited in a number of important respects, including problems with the measures used to develop constructs in the validation studies, it is sufficient to raise doubts about the use of generic measures of health like the EQ-5D and SF-36 in patients with schizophrenia.
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The Work Productivity and Activity Impairment Questionnaire (WPAI) is an instrument that measures work impairment in the setting of different diseases. One previous study validating the WPAI in Crohn's disease (CD) patients suggested that its reproducibility may be unsatisfactory. This study evaluated the validity and reproducibility of the Spain Spanish version of the WPAI questionnaire in CD patients. ⋯ This study confirms the validity of WPAI for measuring work impairment in CD patients. In contrast to previous studies, the test reproducibility was adequate.
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Comparative Study
Patient access to new cancer drugs in the United States and Australia.
In light of the current debate on the use value and potential impact of comparative effectiveness research on patient access, it may prove insightful to compare a health-care system that systematically bases its reimbursement decisions on comparative effectiveness evidence with the United States (US) system that hitherto has only been informed by such evidence on an ad hoc basis. ⋯ Our analysis points to a possible trade-off in market access to oncology drugs. Although more oncology drugs are available in the US and a higher percentage of available drugs are covered, the evidence-based approach adopted by Australia has contributed to reduced prices, thereby improving affordability for payers and patients for those medications deemed cost-effective by the reimbursement authority.