[Superiority, equivalence and not inferiority studies for clinical trials].

Several not conventional medicine treatments aspirate to legislative acknowledgments of full integration in the health system. On the other hand, registered drugs not always produce the promised effects and, often, constitute an additional cause of dead. Moving from recent debates on the therapeutic effectiveness, this article describes and analyses those aspects of the medical-scientific methodology that assert, in probabilistic terms, the health alterations due to properties of administered drugs and not to chance.

Pharmacoutilization and costs of osteoarthritis: changes induced by the introduction of a cyclooxygenase-2 inhibitor into clinical practice.

Objective: To establish whether the introduction of a cyclooxygenase-2 inhibitor has led to changes in pharmacoutilization in the treatment of osteoarthritis (OA) in clinical practice.

Methods: Administrative and general practice databases were cross-linked to analyse the use of non-steroidal anti-inflammatory drugs (NSAIDs) and gastroprotective agents (GPAs) before and after the introduction of rofecoxib. Costs of treatment and costs of hospitalization for gastrointestinal events were also considered.

Clinical and economic outcomes of pneumonia in children: a longitudinal observational study in an Italian paediatric hospital.

Rationale, Aims And Objectives: Antibiotic prescription for acute lower respiratory infections (ALRI) in hospitalized children can have a major impact on cure and costs. We performed a longitudinal study to explore the appropriateness of prescriptions, the predictors of therapeutic patterns, and the main outcomes: readmission, length of stay (LOS) and costs.

Methods: Ninety-nine children who were inpatients of a paediatric hospital receiving antibiotic treatment for community acquired ALRI were consecutively enrolled.

Cost-minimization analysis of simvastatin versus atorvastatin for maintenance therapy in patients with coronary or peripheral vascular disease.

Background: Previous health economic studies have demonstrated the cost-effectiveness of simvastatin in the treatment of coronary heart disease (CHD) based on clinical results of the Scandinavian Simvastatin Survival Study. A prior analysis evaluated the "cost of getting to goal," but ignored all costs after titration. However, when evaluating the cost-effectiveness of long-term therapies, it is important to consider the maintenance costs as well.

Dermatan sulfate versus unfractionated heparin for the prevention of venous thromboembolism in patients undergoing surgery for cancer. A cost-effectiveness analysis.

Background: In a recent clinical trial, dermatan sulfate was found to be more effective than unfractionated heparin (UFH), but equally well tolerated, for the prevention of deep vein thrombosis (DVT) after major surgery for cancer.

Objective: To perform a cost-effectiveness analysis of dermatan sulfate versus UFH in this clinical setting.

Design And Setting: This was a retrospective economic analysis using data from a randomised clinical trial, and was performed from the hospital perspective.

Cost-effectiveness study of imipenem/cilastatin versus meropenem in intra-abdominal infections.

Background: The efficacy of two carbapenems, imipenem/cilastatin (I/C, 1.5 g daily) versus meropenem (3 g daily) in intra-abdominal infections was assessed in a recent multicenter randomized clinical trial. The aim of this article is to perform a cost-effectiveness analysis as in real-world practice according to the findings of this clinical trial.

A comparative economic analysis of simvastatin versus atorvastatin: results of the Surrogate Marker Cost-Efficacy (SMaC) study.

Health care payers have become increasingly interested in economic analyses to guide the allocation of limited health care resources. The Surrogate Marker Cost-Efficacy (SMaC) study was undertaken to assess the economics of treatment with simvastatin versus treatment with atorvastatin in reducing low-density lipoprotein cholesterol (LDL-C) in patients in 10 European countries, based on the results of a 1-year, double-blind, parallel-group clinical trial. Participants were between 18 and 80 years of age (n = 177; median age, 57; 94 men and 83 women).

[Epidemiology and social/health implications of hydatidosis in Sardinia].

All surgically treated cases of hydatidosis registered in Sardinia from 1969 to 1984 have been analysed. The 16-year period clearly shows that unilocular hydatid disease caused by larvae of tapeworm, Echinococcus granulosus, is endemic in Sardinia. In this region there are foci of human infection notably in the sheep rearing areas, of Nuoro and Sassari.

[Hydatidosis in Sardinia. Co-involved parameters and hypothesis for a control campaign].

Although hydatidosis provokes in man and livestock losses of economic significance, there has been no comprehensive study on this disease. This article is an account of Sardinia as an important area of echinococcosis-hydatidosis. The incidence and distribution of infection in the intermediate and definitive hosts are reviewed and the current status of hydatid disease is evaluated.

Hydatidosis in Sardinia: review and recommendations.

In Sardinia, hydatidosis due to Echinococcus granulosus is endemic and constitutes a current and important problem in the economy and public health. This paper reviews the epidemiological aspects, including the geographical distribution, and the socio-cultural factors involved in the dissemination of hydatidosis. Hospital data indicate that about 200 people undergo surgery for hydatid cysts every year with an average of 8.

Cost-effectiveness analysis of echinococcosis-hydatidosis eradication project in Sardinia.

In this study we attempt to evaluate the convenience of a campaign to eradicate the echinococcosis in Sardinia vs a 'do-nothing' or do-very-little policy adopted at this time. The main conditions which have to be met in setting up the eradication programme are identified as follows: (a) precise knowledge of the real diffusion of the parasitosis in man and animals; (b) eradication project control (action research); (c) health education; (d) reduction of stray canine population; (e) anthelmintics distribution and permanent health control to registered dogs. In Italy, echinococcosis-hydatidosis is present in many regions but in none has reached the diffusion rate present in Sardinia where over 200 patients per year are surgically treated, with a prevalence rate of 13.