bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of a short-term register for health technology assessment where the evidence base is poor
Authors: Patrick Hannah , Gallaugher Sally , Czoski-Murray Carolyn , Wheeler Robert , Chattle Marc , Marlow Mirella , Lyratzopoulos Georgios , Campbell Bruce 
Published: January 2010

Objectives: This study reviews the coverage and usefulness of a short-term register, established specifically for health technology assessment of a novel interventional procedure (minimally invasive repair of pectus excavatum, or the Nuss procedure).Methods: Coverage of the register during 2004–07 was assessed by comparison with Hospital Episodes Statistics (HES) for England. Its usefulness was assessed by comparing safety and efficacy data with the published literature and by feedback from committee members who in 2009 were involved in reviewing NICE's original guidance from 2003.Results: The register reported 260 cases from thirteen UK hospitals during nearly 9 years. During a coverage evaluation period of 3 years, there were 152 registered Nuss procedures. An additional 246 repairs of pectus excavatum were undertaken in twenty-six previously unidentified hospitals. Of the 246, 23 were Nuss procedures (from two hospitals), 140 were open procedures (from eleven hospitals), and 3 were coding errors. No details were available for eighty cases undertaken at ten hospitals. The quantity of published literature had increased substantially since publication of original guidance in 2003. It related mostly to technical and safety outcomes, whereas the register included patient reported outcomes. The literature and the register reported similar rates of major adverse events such as bar displacement (2–10 percent). Committee members considered that the Register made a useful contribution to guidance development.Conclusions: This study shows that a register set up to support a health technology assessment process can produce useful data both about safety and about patient-reported outcomes. Coverage may be improved by active follow-up based on routine hospital statistics. Improvement in coding for new procedures is needed in the United Kingdom.
Comparison of the assessment of five new interventional procedures in different countries
Authors: Plumb Jonathan , Lyratzopoulos Georgios , Gallo Helen , Campbell Bruce 
Published: January 2010

Objectives:The aim of this study was to identify and compare health technology assessments of the same new interventional procedures produced in different countries.Methods:We selected five new interventional procedures and studied related assessments produced in different countries.Results:There were twenty assessments (range, 3–5 per procedure) from nine countries—fourteen from Australia, Canada, and United Kingdom. The number of primary RCTs cited by the assessments ranged from 0 to 13. In the assessment reports, “headline” statements about the strength of evidence for efficacy (73 percent) were made more frequently than for safety (53 percent). These statements were scored for their apparent judgment of the strength of the evidence—1 (poor) to 5 (strong)—and received scores of 3 or less in all but four cases. Recommendations about additional research were included in 55 percent of the assessments. Statements in assessments about other aspects of use of the procedures were included more infrequently—in 35 percent for patient selection, in 20 percent for consent issues, and in 15 percent for types of clinical teams. Recommendations about appropriate healthcare settings, or about operator training, were included only in assessments produced by a single organization.Conclusion:There was a only small number of assessments world-wide, for a range of new procedures with potentially high impact. Where available, assessments were produced on a relatively poor evidence base. International collaboration in evidence appraisal and review, and in the gathering of new data through research or registers, could improve the advice available to healthcare systems worldwide about the adoption of new interventional procedures.
Cost-effectiveness of screening for colorectal cancer in France using a guaiac test versus an immunochemical test
Authors: Lejeune Catherine , Dancourt Vincent , Arveux Patrick , Bonithon-Kopp Claire , Faivre Jean 
Published: January 2010

Objectives: The aim of this study was to compare the cost and the effectiveness of two biennial fecal occult blood screening tests for colorectal cancer: a guaiac nonrehydrated test (G-FOBT) and an immunochemical test (I-FOBT) with the absence of screening.Methods: A Markov model was developed to compare these strategies in a general population of subjects aged 50 to 74 over a 20-year period.Results: Compared with the absence of screening, G-FOBT and I-FOBT were associated with a decrease in colorectal cancer mortality of 17.4 percent and 25.2 percent, respectively. With regard to cost-effectiveness, expressed as cost per life-year gained, I-FOBT was the most effective and most costly alternative. Compared with no screening, G-FOBT and I-FOBT presented similar discounted incremental cost-effectiveness ratios: €2,739 and €2,819 respectively per life-year gained. When compared with G-FOBT, I-FOBT presented an incremental cost-effectiveness ratio of €2,988 per life-year gained. Sensitivity analyses showed the strong influence of the I-FOBT lead time, of the participation rate to screening for I-FOBT, and of the purchase price of the I-FOBT on the discounted incremental cost-effectiveness ratios.Conclusions: Compared with the absence of screening and with G-FOBT, the biennial two-stool immunochemical test can be considered a promising method for mass screening for colorectal cancer.
Cost-effectiveness analysis of the optimal threshold of an automated immunochemical test for colorectal cancer screening: Performances of immunochemical colorectal cancer screening
Authors: Berchi Célia , Guittet Lydia , Bouvier Véronique , Launoy Guy 
Published: January 2010

Background: Most industrialized countries, including France, have undertaken to generalize colorectal cancer screening using guaiac fecal occult blood tests (G-FOBT). However, recent researches demonstrate that immunochemical fecal occult blood tests (I-FOBT) are more effective than G-FOBT. Moreover, new generation I-FOBT benefits from a quantitative reading technique allowing the positivity threshold to be chosen, hence offering the best balance between effectiveness and cost. We aimed at comparing the cost and the clinical performance of one round of screening using I-FOBT at different positivity thresholds to those obtained with G-FOBT to determine the optimal cut-off for I-FOBT.Methods: Data were derived from an experiment conducted from June 2004 to December 2005 in Calvados (France) where 20,322 inhabitants aged 50–74 years performed both I-FOBT and G-FOBT. Clinical performance was assessed by the number of advanced tumors screened, including large adenomas and cancers. Costs were assessed by the French Social Security Board and included only direct costs.Results: Screening using I-FOBT resulted in better health outcomes and lower costs than screening using G-FOBT for thresholds comprised between 75 and 93 ng/ml. I-FOBT at 55 ng/ml also offers a satisfactory alternative to G-FOBT, because it is 1.8-fold more effective than G-FOBT, without increasing the number of unnecessary colonoscopies, and at an extra cost of €2,519 per advanced tumor screened.Conclusions: The use of an automated I-FOBT at 75 ng/ml would guarantee more efficient screening than currently used G-FOBT. Health authorities in industrialized countries should consider the replacement of G-FOBT by an automated I-FOBT test in the near future.
Willingness to pay for allergy-vaccination among Danish patients with respiratory allergy
Authors: Petersen Karin Dam , Gyrd-Hansen Dorte , Linneberg Allan , Dahl Ronald , Larsen Jørgen Nedergaard , Løwenstein Henning , Kronborg Christian 
Published: January 2010

Objective: The aim of this study was to elicit willingness to pay (WTP) for allergen-specific subcutaneous injection immunotherapy (SCIT) in a cohort of respondents suffering from allergic-rhinoconjunctivitis (a-RC)/asthma, and to investigate how patients self-select to SCIT according to need.Methods: A random sample of the general population was screened for a-RC/asthma and asked if they were willing to consider SCIT. They were asked to state their WTP for SCIT by way of a discrete choice question (DC-q), an open-ended WTP question (o-WTP-q), and questions relating to their sociodemographic background and the severity of their a-RC/asthma. The characteristics of respondents demanding SCIT were compared with the characteristics of respondents who have actually received SCIT to establish possible barriers to demand.Results: Our results suggest that respondents do well in self-selecting themselves to SCIT on the basis of need according to disease burden measured in terms of a-RC classification, number of contacts with a general practitioner, number of sick days, and potential quality-adjusted life-year loss. Mean WTP for SCIT was estimated at €655 (median, €267) (o-WTP-q) and €903 (95 percent confidence limit, 348–1,459) (DC-q).Conclusion: Characteristics of respondents, who consider SCIT and are willing to pay for SCIT, suggest that allergy sufferers select themselves appropriately according to need and not according to other characteristics, such as income or education. There is a significant discrepancy between those who hypothetically consider SCIT and those demanding SCIT in real life. This study suggests that there are barriers to entry related to age and education, but not to income.
Do the 15D scores and time trade-off (TTO) values of hospital patients' own health agree?
Authors: Honkalampi Tarja , Sintonen Harri 
Published: January 2010

Objectives: The aim of this study was to estimate an empirical relationship and degree of agreement between the TTO values of patients’ own health and their 15D scores.Methods: A total of 863 hospital patients aged 18–93 years filled in the 15D questionnaire to establish their 15D score and valued their present health with TTO. Wilcoxon signed rank test, the Spearman rank correlation coefficient and Tobit models were used to analyze the relation between the 15D and TTO scores.Results: The null hypothesis of no tendency for one set of scores to be higher or lower than the other set could not be rejected. Apart from dummies for few patients groups, no additional information to the 15D score was found that would have explained significantly the variance in the TTO valuations of patients’ own health. The agreement between these to sets of scores turned out quite good at the aggregate level.Conclusions: To the extent that mean TTO valuations of patients own health are valid for QALY calculations as they at least theoretically should be, and if experience of health states to be valued counts, the 15D scores are also valid without any transformation in a large group of heterogeneous patients. However, in certain patient groups, the agreement was not as good as overall.
Coverage with Evidence Development: Applications and issues
Authors: Trueman Paul , Grainger David L. , Downs Kristen E. 
Published: January 2010

Objectives: The aim of this study was to describe the current issues surrounding Coverage with Evidence Development (CED). CED is characterized by restricted coverage for a new technology in parallel with targeted research when the stated goal of the research or data collection is to provide definitive evidence for the clinical or cost-effectiveness impact of the new technology.Methods: Presented here is information summarized and interpreted from presentations and discussions at the 2008 Health Technology Assessment International (HTAi) meeting and additional information from the medical literature. This study describes the differences between CED and other conditional coverage agreements, provides a brief history of CED, describes real-world examples of CED, describes the areas of consensus between the stakeholders, discusses the areas for future negotiation between stakeholders, and proposes criteria to assist stakeholders in determining when CED could be appropriate.Results: Payers could interpret the evidence obtained from a CED program either positively or negatively, and a range of possible changes to the reimbursement status of the new technology may result. Striking an appropriate balance between the demands for prompt access to new technology and acknowledging that some degree of uncertainty will always exist is a critical challenge to the uptake of this innovative form of conditional coverage.Conclusions: When used selectively for innovative procedures, pharmaceuticals, or devices in the appropriate disease areas, CED may provide patients access to promising medicines or technologies while data to minimize uncertainty are collected.
Epidemiology of nosocomial candidaemia in a university hospital: a 12-year study
Authors: GÜRCÜOĞLU E. , ENER B. , AKALIN H. , SINIRTAŞ M. , EVCI C. , AKÇAĞLAR S. , YILMAZ E. , HEPER Y. 
Published: January 2010

SUMMARYThe incidence of nosocomial candidaemia was evaluated in a retrospective study in a Turkish tertiary-care hospital. Over a 12-year period (1996–2007), a total of 743 episodes of candidaemia occurred in 743 patients, accounting for an average incidence of 1·9 episodes/1000 admissions and 2·9 episodes/10 000 patient-days per year. The annual incidence was almost constant during the study period except for 1996 when it was significantly higher in comparison with other years (P<0·05). The most common species isolated was Candida albicans (45%), followed by C. parapsilosis (26%), C. tropicalis (7%), C. krusei (7%), and C. glabrata (3·5%). A significant increase in C. albicans isolates causing candidaemia linked to a decrease in C. parapsilosis isolates in adult patients and C. krusei isolates in children was found between the two 6-year study periods. This trend reflects improved infection control at Uludağ University Hospital. Ninety percent of isolates were susceptible to fluconazole (⩽8 μg/ml) and resistance was found only in C. glabrata and C. parapsilosis isolates. Regular local surveillance of Candida spp. is important in order to develop empirical treatment protocols to reduce the incidence and mortality of candidaemia.
Suicidality and suicide in older people
Authors: Bonnewyn Anke , Shah Ajit , Demyttenaere Koen 
Published: January 2010

SummarySuicide is accepted as a major health problem worldwide, especially in the young and middle aged. It is, however, a significant health problem in older people as well, and those aged 65 years and over generally have the highest suicide rates compared with all other age groups. In research literature from the last decade, there has been an increased interest in disentangling the phenomenon of suicide in later life. This paper aims to critically review the literature on suicide and suicidality in later life published from 2000 to 2009. Prevalence rates as well as risk and protective factors are mapped and correlates reviewed. The association between suicidality and help-seeking behaviour is considered. Finally, potential prevention strategies are reviewed.
First Report of Meloidogyne enterolobii on Arrowroot in China
Authors: Zhuo K. , Hu M. X. , Liao J. L. , Rui K. 
Published: January 2010

The rhizome of arrowroot (Maranta arundinacea L.) is used as a source of edible starch in many tropical/subtropical areas. In July 2009, cultivated arrowroot plants in a field in Haikou, Hainan Province, China were observed to be exhibiting symptoms of decline, including stunting and yellowing. Roots of affected plants were found to have severe root galling similar to that caused by root-knot nematodes. Meloidogyne sp. females were dissected from the galls. Morphological characteristics of the females fit the description of M. enterolobii Yang & Eisenback (4). The perineal patterns were variable, with moderately high to high dorsal arch and mostly lacking lateral lines, but when present, the lines were not conspicuous, similar to those in the original description.(4). For further confirmation of species identity, isoenzyme patterns of malate dehydrogenase (Mdh) and esterase (Est) phenotypes were analyzed and partial sequences of mtDNA were obtained. Enzyme electrophoresis showed that the phenotypes of Mdh and Est were N1a and VS1-S1 respectively, which were consistent with those of M. enterolobii (1). Amplification and sequencing of the mtDNA between COII and the lRNA gene was accomplished with primers C2F3 (5′-GGTCAATGTTCAGAAATTTGTGG-3′) and 1108 (5′-TACCTTTGACCAATCACGCT-3′) (2). A DNA fragment of 705 bp was obtained and the sequence (GenBank Accession No. GQ870255) was compared with those in GenBank. A BLAST search indicated the sequence was 100% identical to the sequences of M. mayaguensis (GenBank Accession Nos. AY446969 and AY446970), a synonym of M. enterolobii (3). On the basis of these results, the root-knot nematodes isolated from arrowroot in Hainan were confirmed as M. enterolobii. This species has a high reproduction rate and a wide host range; moreover, it can induce severe galling and is able to overcome the resistance gene Mi-1 in tomato and pepper (4). M. enterolobii has become increasingly important because it has been found in many countries on diverse hosts. In China in recent years, the nematode has been reported on approximately 20 plant species belonging to five families, including Fabaceae, Cucurbitaceae, Solanaceae, Myrtaceae, and Annonaceae. To our knowledge, this is the first record of M. enterolobii parasitizing a plant (i.e., arrowroot) in the family Marantaceae in China. References: (1) P. R. Esbenshade and A. C. Triantaphyllou. J. Nematol. 17:6, 1985. (2) T. O. Powers and T. S. Harris. J. Nematol. 25:1, 1993. (3) J. Xu et al. Eur. J. Plant Pathol. 110:309, 2004. (4) B. Yang and J. D. Eisenback. J. Nematol. 15:381, 1983.
First Report of Buxus rotundifolia Root and Collar Rot Caused by Phytophthora citrophthora in Italy
Authors: Vettraino A. M. , Franceschini S. , Vannini A. 
Published: January 2010

Boxwood (Buxus spp.) includes several species of popular ornamental shrubs used in traditional and contemporary gardening. In March of 2008, a gradual and irreversible decline was observed on 6-year-old Buxus rotundifolia plants in a garden in central Italy. Of 150 boxwood plants, 70% were symptomatic, and among them, approximately 25% were completely wilted. Aboveground symptoms included stunting, necrotic bark lesions at the base of the stem, reduced growth, and leaf chlorosis. Leaves at first appeared light green, then turned yellow, bronze, or straw colored. Foliar symptoms were restricted to a few branches or extended to the whole crown. Immunological field tests (Pocket Diagnostic, CSL Diagnostics, Milan, Italy) on necrotic rootlets and bark tissues suggested the risk of the presence of Phytophthora spp. One species was consistently isolated on PARHP (2) from necrotic tissues of three symptomatic plants. Recovered isolates were heterothallic and produced aerial mycelium. Star-like compact growth was also observed on potato dextrose agar. Cultures on carrot agar submerged in saline solution (2) developed papillate, noncaducous, and sympodially branched sporangia of different shapes ranging from ovoid to obturbinate. Sporangia were 37.5 to 65.0 × 22.5 to 35.0 μm (average 49.0 × 31.0 μm); L/W ratio from 1.1 to 2.1 (average 1.6). On the basis of morphological features, these isolates belong to P. citrophthora (R.E. Sm. & E.H. Sm.) Leonian (2). The identity was confirmed by sequencing of the internal transcribed spacer region of the rDNA (NCBI Accession No. FJ874794). Inoculum for two isolates of P. citrophthora (3BO and 4BO) was produced for pathogenicity testing on 100 g of autoclaved millet grains moistened with 70 ml of V8 juice. Two, 2-liter aliquots of potting media were each amended with the infested grains (1:20 vol/vol) and five 3-year-old plants of B. rotundifolia per isolate were transplanted into the media. Plants were maintained in a growth chamber at 18 to 22°C, with relative humidity of 80%, and a 12-h photoperiod. Sterile millet grains were used to inoculate five boxwood plants for the control. After 2 months, control plants remained healthy while inoculated plants displayed root necroses and foliar symptoms similar to those observed in the field. The pathogen, consistently reisolated from roots of infected plants, reduced the root weight by an average of 25%. Root rot of boxwood plants is reported to be caused by P. citricola in Poland (4), P. parasitica in Virginia (3), and P. citrophthora in North Carolina (1). To our knowledge, this is the first report of P. citrophthora on B. rotundifolia in Europe. References: (1) Z. G. Abad et al. Plant Dis. 78:830, 1994. (2) D. C. Erwin and O. K. Ribeiro. Page 562 in: Phytophthora Diseases Worldwide. The American Phytopathological Society. St. Paul, MN, 1996. (3) M. A. Hansen. Plant Dis. Fact Sheets. 450-614W, 2000. (4) L. B. Orlikowski. J. Plant Prot. Res. 46:163, 2006.
First Report of Crown and Root Rot Caused by Binucleate Rhizoctonia AG-A on Thryptomene saxicola in Italy
Authors: Polizzi G. , Aiello D. , Castello I. , Vitale A. , Kato M. , Hyakumachi M. 
Published: January 2010

Thryptomene saxicola (Hook.) Schauer is an evergreen shrub native to Western Australia and a member of the Myrtaceae. In Italy, this species was recently introduced as an ornamental plant from abroad. From July of 2008 to September 2009, a new crown and root rot of T. saxicola was observed on several stocks of approximately 20,000 1- to 3-year-old potted plants. Diseased plants were obtained from a commercial nursery in eastern Sicily, Italy. They were propagated from cuttings and grown under drip irrigation. More than 30% of the plants showed disease symptoms. Infected plants were characterized by a lack of vigor. Roots and crowns were partially or completely destroyed, and as a consequence, infected plants were chlorotic and often wilted. Early in the disease development, roots and crowns showed brown lesions. Successively, mature crown lesions turned dark brown. Longitudinal sections of crown tissues revealed a discoloration of the basal stem. Diseased tissues were surface disinfested for 1 min in 1% NaOCl, rinsed in sterile water, plated on potato dextrose agar (PDA) amended with 100 mg/liter of streptomycin sulfate, and then incubated at 25°C. A binucleate Rhizoctonia (BNR) species was consistently isolated from affected tissues of plants. Phytophthora isolates were not recovered from symptomatic tissues plated on BNPRAH (benomyl, nystatin, pentachloronitrobenzene, rifampicin, ampicillin, and hymexazol) selective medium. Fungal colonies were white with floccose, aerial hyphae. Hyphal cells were determined to be binucleate when stained with 1% safranin O and 3% KOH solution (1) and examined at ×400. Anastomosis groups were determined by pairing isolates with five different tester isolates of BNR AG-A on 2% water agar in petri plates (3). Anastomosis was observed with all tester isolates. The rDNA-ITS of one isolate of BNR (DISTEF-TS1) was sequenced (GenBank Accession No. AB514570) (2). The sequence from this isolate exhibited 99% homology with BNR AG-A (GenBank Accession No. AY738628). Pathogenicity tests were conducted on potted, healthy, 1-year-old plants of T. saxicola. Forty plants were inoculated by placing 1/cm2 plugs of PDA from 5-day-old mycelial cultures near the base of the stem. The same number of plants was treated with 1/cm2 PDA plugs as controls. Plants were kept at 25°C and 95% relative humidity on a 12-h fluorescent light/dark regimen. Root and crown rots, identical to those observed in the nursery, appeared 45 days after inoculation, and 80% of the inoculated plants died within 4 months. Control plants remained healthy. Binucleate Rhizoctonia was reisolated from symptomatic tissues, completing Koch's postulates. To our knowledge, this is the first report in the world of BNR causing disease on T. saxicola. References: (1) R. J. Bandoni. Mycologia 71:873, 1979. (2) M. Hyakumachi et al. Phytopathology 95:784, 2005. (3) C. C. Tu and J. W. Kimbrough. Mycologia 65:941, 1973.