A survey of general practitioners' knowledge and clinical practice in relation to valvular heart disease.

Introduction: General practice has a key role in diagnosing patients with valvular heart disease (VHD) and referring them to appropriate services.

Methods: An anonymous survey was conducted to assess the knowledge and clinical practice behaviour of Irish general practitioners (GPs) in relation to VHD. In addition to demographic data, the survey captured information in the following domains: knowledge of VHD prevalence, knowledge of contemporary VHD treatments, barriers to diagnosis, and referral patterns.

Point-of-care testing in primary care: needs and attitudes of Irish GPs.

Background: Studies outside of Ireland have demonstrated that GPs believe point-of-care tests (POCTs) are useful and would like to have more of these tests available in daily practice. This study establishes the views of Irish GPs on this topic for the first time and also explores GPs' perceptions of barriers to having POCT devices in primary care.

Aim: To establish Irish GPs' perception of the benefits and barriers to POCT use.

Diabetic retinopathy in pregnancy: a population-based study of women with pregestational diabetes.

The aim of this observational study was to evaluate screening and progression of diabetic retinopathy during pregnancy in women with pregestational diabetes attending five antenatal centres along the Irish Atlantic seaboard. An adequate frequency of screening was defined as at least two retinal evaluations in separate trimesters. Progression was defined as at least one stage of deterioration of diabetic retinopathy and/or development of diabetic macular edema on at least one eye.

The changing diagnosis of gestational diabetes mellitus: does anyone miss out?

Our aim was to identify women diagnosed with gestational diabetes mellitus (GDM) using 1999 WHO diagnostic criteria but who would be now classified as normal glucose tolerance (NGT) using updated criteria. We demonstrate that this category change affected 3.3% women and they have a limited increased risk of adverse outcomes.

ATLANTIC-DIP: excessive gestational weight gain and pregnancy outcomes in women with gestational or pregestational diabetes mellitus.

Context: Women who have diabetes mellitus during pregnancy are at higher risk of adverse outcomes. Excessive gestational weight gain (GWG) is also emerging as a risk factor for maternofetal complications, and in 2009, the Institute of Medicine published recommendations for appropriate GWG. It is unclear whether excessive GWG confers additional risk to women with diabetes in pregnancy and whether Institute of Medicine recommendations are applicable to this population.

Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt.

Background/aims: We examined the cost and cost effectiveness of distal splenorenal shunt (DSRS) and transjugular intrahepatic portosystemic shunt (TIPS) in the prevention of variceal rebleeding.

Methods: Patients participated in a randomized controlled trial comparing DSRS to TIPS. Quality of life (QOL) was measured using SF-36 preceding randomization and yearly thereafter.

Cost effectiveness of biventricular pacemakers in heart failure patients.

Background: Biventricular pacemakers have been shown to reduce mortality and hospitalizations in heart failure (HF) patients and are indicated for those with a New York Heart Association functional class of III or IV and a QRS interval of >130 ms. However, these devices currently cost in the region of dollar US 33,500 and require replacement upon battery depletion. Therefore, determination of the cost effectiveness of resynchronization therapy is important, although little data have been published to date on this topic.

Cost effectiveness of dalteparin for preventing venous thromboembolism in abdominal surgery.

Introduction: Patients undergoing abdominal surgeries face substantial risk of experiencing venous thromboembolic events in the perioperative period. The low-molecular-weight heparin dalteparin sodium is clinically effective in reducing the incidence of venous thromboembolism (VTE) in these patients. Dalteparin may be used in low (2500 units [U]) and high (5000 U) once-daily doses for this indication.

Economic analysis of a transesophageal echocardiography-guided approach to cardioversion of patients with atrial fibrillation: the ACUTE economic data at eight weeks.

Objectives: The aim of this study was to compare the relative cost of a transesophageal echocardiography (TEE)-guided strategy versus conventional strategy for patients with atrial fibrillation (AF) >2 days duration undergoing electrical cardioversion over an eight-week period.

Background: The Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) trial found no difference in embolic rates between the two approaches. However, the TEE-guided strategy had a shorter time to cardioversion and a lower rate of composite bleeding.

Cost analysis of narrowband UVB phototherapy in psoriasis.

Background: There are few data available to health care providers regarding the costs of treating patients with psoriasis, and specifically the cost of phototherapy.

Objectives: As narrowband UVB (TL-01) has now become an established therapy for patients with psoriasis requiring phototherapy, we determined the annual cost of delivering TL-01 treatment in a university hospital.

Methods: The costing evaluation was from a hospital perspective and the strategy used was a microcosting detailed collection of resources used.

Microcosting versus DRGs in the provision of cost estimates for use in pharmacoeconomic evaluation.

Investigating the pharmacoeconomic impact of any diagnostic or therapeutic intervention in the Irish healthcare setting is currently compromised by the lack of detailed cost data. Consequently, we conducted a number of microcosting studies in the areas of acute myocardial infarction, cardiac failure and HIV, from the hospital perspective. The results of these microcosting studies were compared with the costing estimates assigned to hospital admissions, based on the diagnosis-related group system.