Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
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Economic evaluations provide a unique opportunity to identify the optimal strategies for the diagnosis and management of traumatic brain injury (TBI), for which uncertainty is common and the economic burden is substantial. ⋯ Threshold-guided CT scanning, adherence to Brain Trauma Foundation guidelines, and care for patients with TBI, including those with nonsurgical lesions, in specialized settings appear to be economically attractive strategies.
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Randomized Controlled Trial
Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care.
To report the cost-effectiveness of a tailored handheld computerized procedural preparation and distraction intervention (Ditto) used during pediatric burn wound care in comparison to standard practice. ⋯ This economic evaluation showed the Ditto intervention to be highly cost-effective against standard practice at a minimal cost for the significant benefits gained, supporting the implementation of the Ditto intervention during burn wound care.
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Multicenter Study Comparative Study
Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis.
Several minimally invasive techniques for cardiac output monitoring such as the esophageal Doppler (ED) and arterial pulse pressure waveform analysis (APPWA) have been shown to improve surgical outcomes compared with conventional clinical assessment (CCA). ⋯ Cardiac output monitoring during high-risk abdominal surgery is cost-effective and is associated with a reduced rate of hospital mortality and major complications, whatever the device used. The two devices evaluated had negligible costs compared with the observed reduction in hospital costs. Our comparative studies suggest a larger effect with APPWA that needs to be confirmed by further studies.
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Observational Study
An Evaluation of Health Service Impacts Consequent to Switching from Brand to Generic Venlafaxine in New Zealand under Conditions of Price Neutrality.
To study the health impact on adult New Zealand patients who switch from originator brand to generic venlafaxine. ⋯ Although both products remain fully subsidized and available, there is little incentive for prescribers, pharmacists, or patients to switch to the less expensive generic brand. If savings to the national New Zealand budget are to be realized, additional policy measures should be implemented to minimize incentives for multiple and reverse switching, and prescribers, as key opinion leaders, could take the lead in promoting generics to their patients.
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A substantial gap exists between medical evidence that is known and medical evidence that is put into practice. Although the Agency for Healthcare Research and Quality (AHRQ) has a long history of developing the content of evidence, the agency now pivots to close that gap by focusing on evidence dissemination and implementation. Achieving better health outcomes requires both the generation of new patient-centered outcomes research (PCOR) knowledge and the appropriate and timely implementation of that knowledge into practice. ⋯ Toward this goal, AHRQ is actively engaging partners, such as professional societies and insurers, to make evidence central to decision making. In addition, AHRQ recently launched two programs that seek to both understand and encourage the use of evidence in clinical practice. Throughout these efforts, AHRQ will continually assess needs and adapt initiatives to ensure that PCOR translates into improved patient-centered health outcomes.