19,991 results match your criteria direct effectiveness


Using an economic evaluation approach to support specialist nursing services for people with Parkinson's in a regional community.

J Adv Nurs 2021 Jun 12. Epub 2021 Jun 12.

Charles Sturt University, School of Nursing, Midwifery and Indigenous Health, Orange, New South Wales, Australia.

Aim: This study aims to provide economic evidence of the cost-effectiveness of employing specialist Parkinson's nurses in a regional community in Australia.

Study Design: This retrospective study utilized hospital service usage data to compare outcomes for people with Parkinson's disease before and after the employment of a specialist Parkinson's nurse in a regional community.

Methods: A representative sample was drawn from the target population of people with a diagnosis of Parkinson's admitted to a regional hospital over a 4-year period (2013-2014 and 2016-2017). Read More

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The Effect of Gamma and Microwave Radiation Sterilization on Periodontological Grafts for Microbiological Evaluation.

APMIS 2021 Jun 12. Epub 2021 Jun 12.

Hacettepe University, Faculty of Dentistry, Department of Periodontology, 06100, Sıhhiye Ankara, Turkey.

Purpose: Periodontological grafts are materials used in dentistry to regenerate lost gingival soft tissues or bone parts. In the case of direct contact with blood, the possibility of disease transmission from the source to the patient is high. This source can be an animal or a human. Read More

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Physiotherapists' perspectives on barriers to implementation of direct access of physiotherapy services in the United Arab Emirates: A cross-sectional study.

PLoS One 2021 11;16(6):e0253155. Epub 2021 Jun 11.

Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE.

Background: There are two primary ways of accessing physiotherapy for service users around the world. The direct access, as opposed to the indirect access which requires a referral from a general physician, has several merits including better quality, timeliness, cost effectiveness of treatment and better probability of preventing acute conditions from turning into chronic ailments. Despite these benefits, several countries including the UAE, do not allow direct access to physiotherapists. Read More

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Off-label reduced-dose apixaban does not reduce hemorrhagic risk in Taiwanese patients with nonvalvular atrial fibrillation: A retrospective, observational study.

Medicine (Baltimore) 2021 Jun;100(23):e26272

Department of Internal Medicine, Division of Cardiology, National Cheng Kung University Hospital.

Abstract: East Asians are reportedly at high risk of anticoagulant-related bleeding; therefore, some physicians prefer to prescribe low-dose direct oral anticoagulants (DOACs). Little is known about the therapeutic effectiveness and safety of off-label reduced-dose apixaban in East Asians with nonvalvular atrial fibrillation (AF). We aimed to investigate the effectiveness and safety of off-label reduced-dose apixaban in Taiwanese patients with nonvalvular AF. Read More

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Comparative efficacy and safety of metronomic chemotherapy in breast cancer: A protocol for network meta-analysis protocol.

Medicine (Baltimore) 2021 Jun;100(23):e26255

Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China.

Background: Metronomic chemotherapy (MC) strategy has been used in breast cancer for more than a decade since it was first proposed. The purpose of this study is to systematically evaluate its efficacy and safety for breast cancer patients at various stages, as well as to clarify the most effective medication strategy when applying MC and discover its most sensitive subpopulation in breast cancer patients.

Method: We will systematically retrieve random controlled trials evaluating the efficacy and safety of MC in breast cancer on PubMed, Cochrane Library, Embase, and web of science to perform this network meta-analysis. Read More

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Medical abortion offered in pharmacy versus clinic-based settings.

Cochrane Database Syst Rev 2021 Jun 11;6:CD013566. Epub 2021 Jun 11.

Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon, USA.

Background: Medical abortion is usually offered in a clinic or hospital, but could potentially be offered in other settings such as pharmacies. In many countries, pharmacies are a common first point of access for women seeking reproductive health information and services. Offering medical abortion through pharmacies is a potential strategy to improve access to abortion. Read More

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Effectiveness of a simple medication adjustment protocol for optimizing peri-cardioversion rate control: A derivation and validation cohort study.

Heart Rhythm O2 2021 Feb 12;2(1):46-52. Epub 2021 Jan 12.

Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada.

Background: Rate control medications are foundational in the management of persistent atrial fibrillation (AF). There are no guidelines for adjusting these medications prior to elective direct-current cardioversion (DCCV).

Objective: To derive and validate a preprocedural medication adjustment protocol that maintains peri-DCCV rate control and minimizes risk of postconversion bradycardia, pauses, need for pacing, and cardiopulmonary resuscitation (CPR). Read More

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February 2021

Cost-effectiveness analysis of nonoperative management versus open and laparoscopic surgery for uncomplicated acute appendicitis in Colombia.

Cost Eff Resour Alloc 2021 Jun 10;19(1):34. Epub 2021 Jun 10.

Faculty of Health Sciences, Universidad Icesi, Calle 18 No. 122-135 Pance, 70000, Cali, Colombia.

Background: Traditionally, uncomplicated acute appendicitis (AA) has been treated with appendectomy. However, the surgical alternatives might carry out significant complications, impaired quality of life, and higher costs than nonoperative treatment. Consequently, it is necessary to evaluate the different therapeutic alternatives' cost-effectiveness in patients diagnosed with uncomplicated appendicitis. Read More

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Clinical and economic impact of current ALK rearrangement testing in Spain compared with a hypothetical no-testing scenario.

BMC Cancer 2021 Jun 10;21(1):689. Epub 2021 Jun 10.

Hospital Universitario Fundacion Jimenez Diaz - CIBERONC, Madrid, Spain.

Background: Currently biomarkers play an essential role in diagnosis, treatment, and management of cancer. In non-small cell lung cancer (NSCLC) determination of biomarkers such as ALK, EGFR, ROS1 or PD-L1 is mandatory for an adequate treatment decision. The aim of this study is to determine the clinical and economic impact of current anaplastic lymphoma kinase testing scenario in Spain. Read More

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Effects of a cannabis use disorder text message-delivered treatment on young adult alcohol misuse: Differential effects by gender.

J Subst Abuse Treat 2021 May 8;132:108466. Epub 2021 May 8.

Center for Behavioral Health Research, College of Social Work, The University of Tennessee, Knoxville, TN, United States of America.

Alcohol misuse is more prevalent, frequent, and severe among young adults who use cannabis. Treatment of dual alcohol and cannabis users may have mixed results, with some studies reporting that alcohol misuse increases when cannabis use decreases (substance substitution), while others report that alcohol misuse decreases along with decreasing cannabis use (treatment spillover), and others report no association. Additionally, little research tests whether gender differences are found in treatment of dual alcohol and cannabis users, which may be expected given previous alcohol-focused treatments showing larger effects for females. Read More

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Short- and Long-term Health Care Resource Utilization and Costs Following Intracerebral Hemorrhage.

Neurology 2021 Jun 9. Epub 2021 Jun 9.

Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Objective: We sought to evaluate the short- and long-term resource utilization and costs associated with ICH, taken from an entire population. We additionally sought to evaluate the association of oral anticoagulation (OAC) and healthcare costs.

Methods: Retrospective cohort study of adult patients (≥18 years) with ICH in the entire population of Ontario, Canada (2009-2017). Read More

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Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People's Democratic Republic.

BMJ Glob Health 2021 Jun;6(6)

Infection and Immunity, Murdoch Childrens Research Institute (MCRI), Parkville, Victoria, Australia.

Introduction: Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People's Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects). Read More

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Economic evaluation for mass vaccination against COVID-19.

J Formos Med Assoc 2021 May 25. Epub 2021 May 25.

School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: Vaccine is supposed to be the most effective means to prevent COVID-19 as it may not only save lives but also reduce productivity loss due to resuming pre-pandemic activities. Providing the results of economic evaluation for mass vaccination is of paramount importance for all stakeholders worldwide.

Methods: We developed a Markov decision tree for the economic evaluation of mass vaccination against COVID-19. Read More

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Ultrasound-Guided Phrenic Nerve Block for Lung Nodule Biopsy: Single-Center Initial Experience.

Acad Radiol 2021 Jun 7. Epub 2021 Jun 7.

Department of Radiology, Mayo Clinic Hospital, Phoenix, Arizona, and Biostatistics, Mayo Clinic, Scottsdale, Arizona. Electronic address:

Rationale And Objectives: Biopsy of lung nodules in the lower lung fields can be difficult because of breathing motion. Ipsilateral phrenic nerve block (PNB) before biopsy should make the biopsy safer, easier, and more precisely targeted. We describe the use of ultrasound-guided PNB before lung nodule biopsy, including relevant anatomy and variations, complications, and technique, along with our first 40 cases. Read More

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Chemical composition, quality control, pharmacokinetics, pharmacological properties and clinical applications of Fufang Danshen Tablet: A systematic review.

J Ethnopharmacol 2021 Jun 6:114310. Epub 2021 Jun 6.

Guangdong Engineering & Technology Research Center for Quality and Efficacy Reevaluation of Post-Market Traditional Chinese Medicine, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, 510275 Guangzhou, People's Republic of China. Electronic address:

Ethnopharmacological Relevance: Fufang Danshen Tablet (FDT) is a traditional Chinese medicine (TCM) formula composed of three Chinese medicinal materials comprising Salviae Miltiorrhizar Radix et Rhizoma (Dan-Shen in Chinese), Notoginseng Radix et Rhizoma (San-Qi), and Borneolum Syntheticum (Bing-Pian). It has been documented to exert significant effects in promoting blood circulation and removing blood stasis, and become a frequently used formula in the treatment of cardiovascular and cerebrovascular diseases.

Aim Of The Review: To systematically analyze and summarize the research findings concerning the chemical composition, quality control, pharmacokinetics, pharmacological properties, clinical applications, and toxicity of FDT, so as to point out some typical problems and provides opinions for future study. Read More

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[Transcranial direct current stimulation in neuroscientific researches - pitfalls and solutions].

Ideggyogy Sz 2021 May;74(5-6):171-182

Eötvös Loránd Tudományegyetem, Pszichológiai Intézet, Budapest.

Transcranial direct current stimulation (tDCS) is a promising brain stimulation tool which is non-invasive, easy to use and relatively cheap. Since it can change brain activity in a temporal manner, it can contribute to both clinical practice and neuroscientific research. However, the effectiveness of tDCS has been questioned considering the lack of full understanding of its mechanism of action and the seemingly contradictory results. Read More

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Cost Effectiveness of Ribociclib in Combination with Fulvestrant for the Treatment of Postmenopausal Women with HR+/HER2- Advanced Breast Cancer Who Have Received No or Only One Prior Line of Endocrine Therapy: A Canadian Healthcare Perspective.

Pharmacoeconomics 2021 Jun 9. Epub 2021 Jun 9.

Policy Analysis Inc. (PAI), 822 Boylston Street, Suite 206, Chestnut Hill, MA, 02467, USA.

Background: The MONALEESA-3 trial demonstrated the efficacy and safety of ribociclib plus fulvestrant versus placebo plus fulvestrant for patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced breast cancer (ABC). This analysis evaluated the cost effectiveness of ribociclib plus fulvestrant versus fulvestrant in patients with HR+/HER2- ABC from a Canadian healthcare payer perspective.

Methods: The incremental cost-effectiveness ratio (ICER), expressed as incremental costs per quality-adjusted life-year (QALY) gained for ribociclib plus fulvestrant versus fulvestrant, was estimated using a semi-Markov cohort model developed in Microsoft Excel, with states for progression-free, post-progression, and dead. Read More

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Maintenance therapy for untreated diffuse large B-cell lymphoma: a systematic review and network meta-analysis.

Ther Adv Hematol 2021 29;12:20406207211018894. Epub 2021 May 29.

Epidemiology and Health Statistics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, Shandong 250012, P.R. China.

Background: Several clinical trials have been conducted to evaluate the role of maintenance therapy in untreated diffuse large B-cell lymphoma (DLBCL) patients with complete response or partial response following standard immunochemotherapy; however, the effect of maintenance therapy remains uncertain, and a suitable maintenance strategy has not been determined because of the lack of direct/indirect comparisons.

Methods: We performed a systematic review and Bayesian network meta-analysis (NMA) to analyze and compare the effectiveness of different maintenance regimens in newly diagnosed DLBCL patients. We searched the , , , , and for relevant papers from inception to 18 March 2021. Read More

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Preliminary effects of low-intensity focused ultrasound treatment program for cancer-related neuropathic pain.

Pain Manag 2021 Jun 9. Epub 2021 Jun 9.

Department of Anesthesiology & Critical Care, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

To evaluate the effectiveness of low-intensity focused ultrasound (LIFU) therapy in the management of cancer-related neuropathic pain (CNP). A retrospective review with 22 patients with CNP treated with LIFU therapy (frequency 3 Hz, 3 W/cm, pulse mode duty cycle 50%) was conducted. Out of the 22 patients, 15 had CNP secondary to chemotherapy-induced peripheral neuropathy. Read More

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The effects of combination levodopa-ropinirole on cognitive improvement and treatment outcome in individuals with cocaine use disorder: A bayesian mediation analysis.

Drug Alcohol Depend 2021 May 31;225:108800. Epub 2021 May 31.

Faillace Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Background: Chronic cocaine users show impairments in cognitive processes associated with dopamine (DA) circuitry. Medications aimed at bolstering cognitive functions via DA modulation might enhance treatment outcome.

Methods: The trial used a double-blind, double-dummy, parallel-group design with four treatment arms comparing placebo (PLC) to levodopa/carbidopa 800 mg/200 mg alone (LR0), levodopa plus extended release (XR) ropinirole 2 mg (LR2) or XR ropinirole 4 mg (LR4). Read More

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Cost-effectiveness of a novel hybrid closed-loop system compared with continuous subcutaneous insulin infusion in people with type 1 diabetes in the UK.

J Med Econ 2021 Jun 7. Epub 2021 Jun 7.

Medtronic International Trading Sàrl, Tolochenaz, Switzerland.

Aims: The MiniMed™ 670G insulin pump system is the first commercially available hybrid closed-loop (HCL) insulin delivery system and clinical studies have shown that this device is associated with incremental benefits in glycemic control relative to continuous subcutaneous insulin infusion (CSII) with or without continuous glucose monitoring (CGM). The aim was to evaluate the long-term cost-effectiveness of the MiniMed™ 670G system versus CSII alone in people with type 1 diabetes (T1D) in the UK.

Materials And Methods: Cost-effectiveness analysis was performed using the IQVIA CORE Diabetes Model. Read More

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Impact of direct-acting antivirals for HCV on mortality in a large population-based cohort study.

J Hepatol 2021 Jun 4. Epub 2021 Jun 4.

British Columbia Centre for Disease Control, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.

Background: We evaluated the effect of sustained virologic response(SVR) from direct acting antiviral(DAA) treatments on all-cause, liver- and drug-related mortality in a population-based cohort in British Columbia(BC), Canada.

Methods: We used data from the BC Hepatitis Testers Cohort, which includes people tested for hepatitis C virus(HCV) since 1990, linked with data on medical visits, hospitalizations, prescription drugs and mortality. We followed people who received DAAs and people who did not receive any HCV treatment to death or December 31, 2019. Read More

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Short-chain fatty acids as a potential treatment for infections: a closer look at the lungs.

Infect Immun 2021 Jun 7:IAI0018821. Epub 2021 Jun 7.

Centre d'Infection et d'Immunité de Lille, INSERM U1019, CNRS UMR 9017, University of Lille, CHU Lille, Institut Pasteur de Lille, F-59000 Lille, France.

Short-chain fatty acids (SCFAs) are the main metabolites produced by the gut microbiota via the fermentation of complex carbohydrates and fibers. Evidence suggests that SCFAs play a role in the control of infections both through direct action on microorganisms and on host signaling. This review summarizes the main microbicidal effects of SCFAs and discusses studies highlighting the effect of SCFAs in microorganism's virulence and viability. Read More

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Benefits of Digital Health Resources for Substance Use Concerns in Women: Scoping Review.

JMIR Ment Health 2021 Jun 7;8(6):e25952. Epub 2021 Jun 7.

Centre for Addiction and Mental Health, Toronto, ON, Canada.

Background: Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Read More

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Digital scribe utility and barriers to implementation in clinical practice: a scoping review.

Health Technol (Berl) 2021 Jun 2:1-7. Epub 2021 Jun 2.

Department of Dermatology, Brigham and Women's Hospital, Boston, MA USA.

Electronic health records EHRs) allow for meaningful usage of healthcare data. Their adoption provides clinicians with a central location to access and share data, write notes, order labs and prescriptions, and bill for patient visits. However, as non-clinical requirements have increased, time spent using EHRs eclipsed time spent on direct patient care. Read More

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Impact of Morphine Dependence and Withdrawal on the Reinforcing Effectiveness of Fentanyl, Cocaine, and Methamphetamine in Rats.

Front Pharmacol 2021 21;12:691700. Epub 2021 May 21.

Department of Pharmacology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.

Recent estimates suggest increased popularity of the concurrent use of opioids and stimulants, with over 50% of treatment-seeking opioid users reporting regular stimulant use. The goal of the current study was to determine how opioid dependence and withdrawal affect the reinforcing effects of fentanyl, cocaine, and methamphetamine. Male Sprague-Dawley rats were allowed to self-administer fentanyl under a progressive ratio (PR) schedule of reinforcement. Read More

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Calcitonin Gene-Related Peptide Monoclonal Antibodies Versus Botulinum Neurotoxin a in the Preventive Treatment of Chronic Migraine: An Adjusted Indirect Treatment Comparison Meta-Analysis.

Front Pharmacol 2021 19;12:671845. Epub 2021 May 19.

The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Calcitonin gene-related peptide monoclonal antibodies (CGRPmAbs) are new agents approved by the US Food and Drug Administration for preventive treatment of chronic migraine. Comparison between CGRPmAbs and previously approved Botulinum neurotoxin A (BoNT-A) will inform optimal preventive treatment of chronic migraine, but head-to-head trials are lacking. We therefore aimed to perform adjusted indirect comparison between CGRPmAbs and BoNT-A through a meta-analysis. Read More

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Efficacy of Chinese Herbal Injections for Elderly Patients With pneumonia-A Bayesian Network Meta-analysis of Randomized Control Trials.

Front Pharmacol 2021 21;12:610745. Epub 2021 May 21.

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Pneumonia is a prevalent and complicated disease among adults, elderly people in particular, and the debate on the optimal Chinese herbal injections (CHIs) is ongoing. Our objective is to investigate the comparative effectiveness of various CHIs strategies for elderly patients with pneumonia. A comprehensive search strategy was executed to identify relevant randomized controlled trials (RCTs) by browsing through several databases from their inception to first, Feb 2020; All of the direct and indirect evidence included was rated by Network meta-analysis under a Bayesian framework. Read More

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Cost-Effectiveness Analysis of Dacomitinib versus Gefitinib in the First-Line Treatment of EGFR-Positive Advanced or Metastatic Non-Small Cell Lung Cancer.

Cancer Manag Res 2021 28;13:4263-4270. Epub 2021 May 28.

Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.

Background: The objective of the study was to evaluate the economics of dacomitinib and gefitinib in the first-line treatments for EGFR-positive advanced or metastatic non-small cell lung cancer (NSCLC) from a US payer perspective.

Methods: We developed the partition survival model to compare the lifetime cost and health outcomes of dacomitinib versus gefitinib. Transition probabilities were collected from the ARCHER 1050 trial. Read More

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