586 results found
Achana F, Petrou S, Khan K, et al., 2017, A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations., Eur J Health Econ
A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.
Afshin A, Forouzanfar MH, Reitsma MB, et al., 2017, Health Effects of Overweight and Obesity in 195 Countries over 25 Years, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 377, Pages: 13-27, ISSN: 0028-4793
Ahmed F, Ahmed N, Stubbens A, et al., 2017, Is there a role for smaller hospitals in the future NHS?, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 78, Pages: 424-425, ISSN: 1750-8460
Alshaikh MK, Filippidis FT, Al-Omar HA, et al., 2017, The ticking time bomb in lifestyle-related diseases among women in the Gulf Cooperation Council countries; review of systematic reviews, BMC PUBLIC HEALTH, Vol: 17, ISSN: 1471-2458
Alshamsan R, Leslie H, Majeed A, et al., 2017, Financial hardship on the path to Universal Health Coverage in the Gulf States, HEALTH POLICY, Vol: 121, Pages: 315-320, ISSN: 0168-8510
Alsharif U, El Bcheraoui C, Khalil I, et al., 2017, Burden of cancer in the Eastern Mediterranean Region, 2005–2015: findings from the Global Burden of Disease 2015 Study, International Journal of Public Health, Pages: 1-14, ISSN: 1661-8556
© 2017 The Author(s) Objectives: To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods: Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results: In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions: Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services.
Azzopardi P, Cini K, Kennedy E, et al., 2017, Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study, International Journal of Public Health, Pages: 1-18, ISSN: 1661-8556
© 2017 The Author(s) Objectives: The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10–24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. Methods: Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. Results: Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. Conclusions: Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.
Balinskaite V, Bottle A, Shaw LJ, et al., 2017, Reorganisation of stroke care and impact on mortality in patients admitted during weekends: a national descriptive study based on administrative data., BMJ Qual Saf
OBJECTIVE: To evaluate mortality differences between weekend and weekday emergency stroke admissions in England over time, and in particular, whether a reconfiguration of stroke services in Greater London was associated with a change in this mortality difference. DESIGN, SETTING AND PARTICIPANTS: Risk-adjusted difference-in-difference time trend analysis using hospital administrative data. All emergency patients with stroke admitted to English hospitals from 1 January 2008 to 31 December 2014 were included. MAIN OUTCOMES: Mortality difference between weekend and weekday emergency stroke admissions. RESULTS: We identified 507 169 emergency stroke admissions: 26% of these occurred during the weekend. The 7-day in-hospital mortality difference between weekend and weekday admissions declined across England throughout the study period. In Greater London, where the reorganisation of stroke services took place, an adjusted 28% (relative risk (RR)=1.28, 95% CI 1.09 to 1.47) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 9% higher risk (RR=1.09, 95% CI 0.91 to 1.32) in 2014. For the rest of England, a 15% (RR=1.15, 95% CI 1.09 to 1.22) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 3% higher risk (RR=1.03, 95% CI 0.97 to 1.10) in 2014. During the same period, in Greater London an adjusted 12% (RR=1.12, 95% CI 1.00 to 1.26) weekend/weekday 30-day mortality ratio in 2008 slightly increased to 14% (RR=1.14, 95% CI 1.00 to 1.30); however, it was not significant. In the rest of England, an 11% (RR=1.11, 95% CI 1.07 to 1.15) higher weekend/weekday 30-day mortality ratio declined to a non-significant 4% higher risk (RR=1.04, 95% CI 0.99 to 1.09) in 2014. We found no statistically significant association between decreases in the weekend/weekday admissions difference in mortality and the centralisation of stroke services in Greater London. CONCLUSIONS: There was a steady reduction in weekend/weekday differences i
Barbaric J, Abbott R, Posadzki P, et al., 2017, Light therapies for acne: abridged Cochrane systematic review including GRADE assessments., Br J Dermatol
We undertook a Cochrane review of randomized controlled trials (RCTs) evaluating the effects of light-based interventions for acne vulgaris. We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science and grey literature sources (September 2015). We used the Grading of Recommendations Assessment, Development and Evaluation Working Group approach to assess the quality of evidence (QoE). We included 71 RCTs (4211 participants, median sample size 31). Results from a single study (n = 266, low QoE) showed little or no difference in effectiveness on participants' assessment of improvement between 20% aminolaevulinic acid (ALA) photodynamic therapy (PDT), activated by blue light, vs. vehicle plus blue light, whereas another study (n = 180) comparing ALA-PDT (red light) concentrations showed that 20% ALA-PDT was no more effective than 15% ALA-PDT but better than 10% and 5% ALA-PDT. Pooled data from three studies (n = 360, moderate QoE) showed that methyl aminolaevulinate PDT, activated by red light, had a similar effect on changes in lesion counts vs. placebo cream with red light. Several studies compared yellow light with placebo or no treatment, infrared light with no treatment, gold microparticle suspension with vehicle and clindamycin/benzoyl peroxide (C/BPO) combined with pulsed dye laser with C/BPO alone. None of these showed any clinically significant effects. Most studies reported adverse effects, but inadequately, with scarring reported as absent, and blistering only in studies on intense pulsed light, infrared light and PDT (very low QoE). Carefully planned studies, using standardized outcome measures and common acne treatments as comparators, are needed.
Barber RM, Fullman N, Sorensen RJD, et al., 2017, Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015, LANCET, Vol: 390, Pages: 231-266, ISSN: 0140-6736
There has been an increase in the incidence of scarlet fever with most cases presenting in General Practice and Emergency Departments. Cases present with a distinctive macro-papular rash, usually in children. This article aims to increase awareness of scarlet fever by highlighting key symptoms and stating potential complications if untreated. In patients who have the typical symptoms, a prescription of a suitable antibiotic such as phenoxymethylpenicillin (Penicillin V) should be made immediately to reduce the risk of complications and the spread of infection.
Belisario JSM, Doherty K, O'Donoghue J, et al., 2017, A bespoke mobile application for the longitudinal assessment of depression and mood during pregnancy: protocol of a feasibility study, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Bottle A, Kim D, Aylin P, et al., 2017, Routes to diagnosis of heart failure: observational study using linked data in England., Heart
OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis. RESULTS: 36 748 patients had a diagnosis of HF recorded that met the inclusion criteria between 1 January 2010 and 31 March 2013. For 29 113 (79.2%) patients, this was first recorded in hospital. In the 5 years prior to diagnosis, 15 057 patients (41.0%) had a primary care consultation with one of three key HF symptoms recorded, 17 724 (48.2%) attended for another reason and 3967 (10.8%) did not see their general practitioner. Only 24% of those with recorded HF symptoms followed a pathway aligned with guidelines (echocardiogram and/or serum natriuretic peptide test and specialist referral), while 44% had no echocardiogram, natriuretic peptide test or referral. CONCLUSIONS: Patients follow various pathways to the diagnosis of HF. However, few appear to follow a pathway supported by guidelines for investigation and referral. There are likely to be missed opportunities for earlier HF diagnosis in primary care.
Car LT, Papachristou N, Urch C, et al., 2017, Prioritizing medication safety in care of people with cancer: clinicians' views on main problems and solutions, JOURNAL OF GLOBAL HEALTH, Vol: 7, ISSN: 2047-2978
Carruthers J, Holmes A, Majeed A, 2017, A suspected viral rash in pregnancy, BMJ-BRITISH MEDICAL JOURNAL, Vol: 356, ISSN: 1756-1833
Carruthers J, Holmes A, Majeed A, 2017, Authors' reply to Mannion., BMJ, Vol: 357
Carruthers J, Holmes A, Majeed A, 2017, Incorrect information on immunoglobulin as preventive treatment for varicella Reply, BMJ-BRITISH MEDICAL JOURNAL, Vol: 357, ISSN: 1756-1833
Chang KC-M, Majeed A, Vamos EP, et al., 2017, The authors respond to "NHS Health Check: national evaluation findings and implications", CANADIAN MEDICAL ASSOCIATION JOURNAL, Vol: 189, Pages: E173-E173, ISSN: 0820-3946
Cliffe C, Hillyard M, Joseph A, et al., 2017, The transgender patient in primary care: practical advice for a 10-minute consultation, BJGP Open, Pages: BJGP-2017-0103-BJGP-2017-0103
Cowling TE, Harris M, Majeed A, 2017, Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey, BMJ QUALITY & SAFETY, Vol: 26, Pages: 360-371, ISSN: 2044-5415
Dieleman J, Campbell M, Chapin A, et al., 2017, Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries, LANCET, Vol: 389, Pages: 1981-2004, ISSN: 0140-6736
Dieleman JL, Campbell M, Chapin A, et al., 2017, Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries, LANCET, Vol: 389, Pages: 2005-2030, ISSN: 0140-6736
El Bcheraoui C, Charara R, Khalil IA, et al., 2017, Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990–2015, International Journal of Public Health, Pages: 1-13, ISSN: 1661-8556
© 2017 The Author(s) Objectives: The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. Methods: We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Results: Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Conclusions: Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.
El-Osta A, Woringer M, Pizzo E, et al., 2017, Does use of point-of-care testing improve cost-effectiveness of the NHS Health Check programme in the primary care setting? A cost-minimisation analysis, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Elmontsri M, Almashrafi A, Banarsee R, et al., 2017, Status of patient safety culture in Arab countries: a systematic review, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Elmontsri M, Almashrafi A, Banarsee R, et al., 2017, Status of patient safety culture in Arab countries: a systematic review, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Elmontsri M, Banarsee R, Majeed A, 2017, Key priority areas for patient safety improvement strategy in Libya: a protocol for a modified Delphi study, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Feigin VL, Abajobir AA, Abate KH, et al., 2017, Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015, LANCET NEUROLOGY, Vol: 16, Pages: 877-897, ISSN: 1474-4422
Fullman N, Barber RM, Abajobir AA, et al., 2017, Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016, LANCET, Vol: 390, Pages: 1423-1459, ISSN: 0140-6736
Gakidou E, Afshin A, Abajobir AA, et al., 2017, Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, LANCET, Vol: 390, Pages: 1345-1422, ISSN: 0140-6736
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