We demonstrate this by assessing the cost-effectiveness of modified transesophageal echocardiography (TEE) compared with manual palpation for the detection of atherosclerosis
in the ascending aorta.
Methods: Based on a previous diagnostic accuracy study, actual Dutch reimbursement data, and evidence from literature we developed a Markov decision analytic model. Cost-effectiveness of modified TEE was assessed for a life time horizon and a health care perspective. Prevalence rates of atherosclerosis were age-dependent and Kinase Inhibitor Library order low as well as high rates were applied. Probabilistic sensitivity analysis was applied.
Results: The model synthesized all available evidence on the risk of stroke in cardiac surgery patients. The modified TEE strategy consistently resulted in more adapted surgical procedures and, hence, a lower risk of stroke and a slightly higher number of life-years. With 10% prevalence of atherosclerosis the incremental cost-effectiveness ratio was (sic)4,651 and (sic)481 per Selleck P5091 quality-adjusted life year in 55-year-old men and women, respectively. In all patients aged 65 years or older the modified TEE strategy was cost saving and resulted in additional health benefits.
Conclusions: Decision analytic modelling to assess the cost-effectiveness
of a new diagnostic test based on characteristics, costs and effects of the test itself and of the subsequent treatment options is both feasible and valuable. Our case study on modified TEE suggests that it may reduce the risk of stroke in cardiac surgery patients older than 55 years at acceptable cost-effectiveness levels.”
“We disclose a morpho-anatomical study of Asclepias curassavica L. and Asclepias mellodora St.-Hil., collected in the Province of Santa Fe, Argentina. Whole plants of both species are commercialized for external and internal use due to its attributed therapeutic properties. For each entity we provide synonyms, folk names, morphological description, common and uncommon anatomical characteristics of roots, stems and leaves. These features were analyzed by optical and scanning electron
microscopy. Photomicrographs are included in order to Autophagy assay provide adequate differentiation between entities.”
“Background: Efficient HIV prevention requires accurate identification of individuals with risky sexual behaviour. However, self-reported data from sexual behaviour surveys are prone to social desirability bias (SDB). Audio Computer-Assisted Self-Interviewing (ACASI) has been suggested as an alternative to face-to-face interviewing (FTFI), because it may promote interview privacy and reduce SDB. However, little is known about the suitability and accuracy of ACASI in urban communities with high HIV prevalence in South Africa. To test this, we conducted a sexual behaviour survey in Cape Town, South Africa, using ACASI methods.