Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists.

Subjective health expectations of patients with rheumatoid arthritis (RA) and rheumatologists remain understudied. We measured subjective expectations regarding treatment effects of biologicals as well as future length and quality of life. Moreover, we compared expectations regarding treatment effects to actual treatment effects.

In-vivo T1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy.

Background: In hypertrophic cardiomyopathy (HCM), autopsy studies revealed both increased focal and diffuse deposition of collagen fibers. Late gadolinium enhancement imaging (LGE) detects focal fibrosis, but is unable to depict interstitial fibrosis. We hypothesized that with T1 mapping, which is employed to determine the myocardial extracellular volume fraction (ECV), can detect diffuse interstitial fibrosis in HCM patients.

Longer-term effects of ADAS use on speed and headway control in drivers diagnosed with Parkinson's disease.

Objective: An advanced driver assistance system (ADAS) provided information about speed limits, speed, speeding, and following distance. Information was presented to the participants by means of a head-up display.

Methods: Effects of the information on speed and headway control were studied in a longer-term driving simulator study including 12 repeated measures spread out over 4 weeks.

Quality of life of nursing home residents with dementia: validation of the German version of the ICECAP-O.

Objectives: To validate the ICECAP-O capability wellbeing measure's German translation in older people with dementia living in a nursing home, and to investigate the influence of proxy characteristics on responses.

Method: Cross-sectional study. For 95 residents living in a German nursing home, questionnaires were completed by nursing professionals serving as proxy respondents.

Quality of life instruments for economic evaluations in health and social care for older people: a systematic review.

Gaining health may not be the main goal of healthcare services aimed at older people, which may (also) seek to improve wellbeing. This emphasizes the need of finding appropriate outcome measures for economic evaluation of such services, particularly in long-term care, capturing more than only health-related quality of life (HrQol). This review assesses the usefulness of HrQol and wellbeing instruments for economic evaluations specifically aimed at older people, focusing on generic and preference-based questionnaires measuring wellbeing in particular.

Value for money: economic evaluation of two different caries prevention programmes compared with standard care in a randomized controlled trial.

A cost-effectiveness analysis was conducted during a 3-year randomized controlled clinical trial in a general dental practice in the Netherlands in which 230 6-year-old children (± 3 months) were assigned to either regular dental care, an increased professional fluoride application (IPFA) programme or a non-operative caries treatment and prevention (NOCTP) programme. Information on resource use during the 3-year period was documented by the dental nurse at every patient visit, such as treatment time, travel time and travel distance. Caries increment scores (at D3MFS level) were used to assess effectiveness.

How to estimate productivity costs in economic evaluations.

Productivity costs are frequently omitted from economic evaluations, despite their often strong impact on cost-effectiveness outcomes. This neglect may be partly explained by the lack of standardization regarding the methodology of estimating productivity costs. This paper aims to contribute to standardization of productivity cost methodology by offering practical guidance on how to estimate productivity costs in economic evaluations.

The perseverance time of informal carers of dementia patients: validation of a new measure to initiate transition of care at home to nursing home care.

Background: Health care systems aim to involve as much informal care as possible and dementia patients prefer to stay home as long as they can. In this context, perseverance time (Pt)-the period that the informal carer indicates to be able to maintain current care if the situation remains stable-is an important concept.

Objective: The aim of this study was to introduce the concept Pt and validate it in a sample of informal carers of dementia patients living at home.

Three-dimensional speckle tracking echocardiography for the preclinical diagnosis of hypertrophic cardiomyopathy.

The aim is to detect early changes in myocardial mechanics in hypertrophic cardiomyopathy (HCM) mutation carriers, three-dimensional speckle tracking echocardiography (3DSTE) was used for screening of family members in the HCM population. Eighty subjects were divided as: HCM mutation carriers (n = 23), manifest HCM patients (n = 28), and normal controls (n = 29). They prospectively underwent 3DSTE for left atrial (LA) and left ventricle (LV) strain analysis.

Do people desire to be healthier than other people? A short note on positional concerns for health.

Contrary to traditional economic postulates, people do not only care about their absolute position but also about their relative position. However, empirical evidence on positional concerns in the context of health is scarce, despite its relevance for health care policy. This paper presents a first explorative study on positional concerns in the context of health.

The value of a QALY: individual willingness to pay for health gains under risk.

Background: There is an increased interest in the monetary value of a quality-adjusted life-year (QALY). Past studies commonly derived willingness to pay (WTP) for certain future QALY gains. However, obtaining valid WTP per QALY estimates proved to be difficult.

How to include informal care in economic evaluations.

Economic evaluations of health interventions aim to support decision making in healthcare. To effectively do so, evaluations need to include all relevant costs and effects of an intervention. Informal care provided by family or friends is an important element of care for many patients, but can have a profound impact on the health and well-being of carers.

Measuring the impact of caregiving on informal carers: a construct validation study of the CarerQol instrument.

Background: Informal caregivers provide a significant part of the total care needed by ill or disabled persons. Although informal care is often the preferred option of those who provide and those who receive informal care, caring can nevertheless be very straining. This study investigates construct validation of an instrument of the impact of caregiving, the CarerQol.

ENerGetIcs in hypertrophic cardiomyopathy: traNslation between MRI, PET and cardiac myofilament function (ENGINE study).

Introduction: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant heart disease mostly due to mutations in genes encoding sarcomeric proteins. HCM is characterised by asymmetric hypertrophy of the left ventricle (LV) in the absence of another cardiac or systemic disease. At present it lacks specific treatment to prevent or reverse cardiac dysfunction and hypertrophy in mutation carriers and HCM patients.

Spontaneous recovery and treatment effects in patients with homonymous visual field defects: a meta-analysis of existing literature in terms of the ICF framework.

Homonymous visual field defects (HVFDs) are a common consequence of posterior brain injury. Most patients do not recover spontaneously and require rehabiliation. To determine whether a certain intervention may help an individual patient, it is necessary to predict the patient's level of functioning and the effect of specific training.

Prospect theory in the health domain: a quantitative assessment.

It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full function had not yet been quantified in the health domain.

The impact of informal care for patients with Pompe disease: an application of the CarerQol instrument.

Background: Patients with Pompe disease, a rare progressive neuromuscular disorder, receive a considerable amount of informal care. In this study, we examined the impact of providing informal care to patients with Pompe disease.

Methods: Caregivers were administered various instruments, which measured the (impact of) informal care in the context of Pompe disease.

Intersection assistance: a safe solution for older drivers?

Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation in at-fault crashes on intersections.

Thirty down, only ten to go?! Awareness and influence of a 10-year time frame in TTO.

Background: Time trade-off (TTO) exercises typically present respondents with a limited time horizon, for example 10 years, thus implicitly considerably reducing remaining life expectancy for the average respondent. It is unclear how this affects health state valuations.

Aim: The aim of the study is to investigate how awareness of the reduced life span implied by a 10-year TTO affects health state valuations, using an experimental design.

Physical predictors of cognitive performance in healthy older adults: a cross-sectional analysis.

There is ample evidence that physical and cognitive performance are related, but the results of studies investigating this relationship show great variability. Both physical performance and cognitive performance are constructs consisting of several subdomains, but it is presently unknown if the relationship between physical and cognitive performance depends on subdomain of either construct and whether gender and age moderate this relationship. The aim of this study is to identify the strongest physical predictors of cognitive performance, to determine the specificity of these predictors for various cognitive subdomains, and to examine gender and age as potential moderators of the relationship between physical and cognitive performance in a sample of community-dwelling older adults.

Visual Scanning Training for Neglect after Stroke with and without a Computerized Lane Tracking Dual Task.

Neglect patients typically fail to explore the contralesional half-space. During visual scanning training, these patients learn to consciously pay attention to contralesional target stimuli. It has been suggested that combining scanning training with methods addressing non-spatial attention might enhance training results.

Measuring the affordability of medicines: importance and challenges.

The issue of affordability of health care services remains high on the (health) policy agenda. Determining whether health care services are affordable is complex, however, as the concept 'affordability' is inherently normative. With a focus on measuring affordability in low- and middle-income countries, we discuss different methods used to operationalize this concept.

A discrete choice experiment to obtain a tariff for valuing informal care situations measured with the CarerQol instrument.

Background / Objective: Economic evaluations adopting a societal perspective need to include informal care whenever relevant. However, in practice, informal care is often neglected, because there are few validated instruments to measure and value informal care for inclusion in economic evaluations. The CarerQol, which is such an instrument, measures the impact of informal care on 7 important burden dimensions (CarerQol-7D) and values this in terms of general quality of life (CarerQol-VAS).

Predicting productivity based on EQ-5D: an explorative study.

Background: Productivity costs are often ignored in economic evaluations. In order to facilitate productivity cost inclusion, it has been suggested to estimate productivity costs indirectly using quality of life data.

Objective: This study aimed to derive and validate an algorithm for predicting productivity losses on the basis of quality-of-life data using the EQ-5D-3L.

Productivity costs in economic evaluations: past, present, future.

Productivity costs occur when the productivity of individuals is affected by illness, treatment, disability or premature death. The objective of this paper was to review past and current developments related to the inclusion, identification, measurement and valuation of productivity costs in economic evaluations. The main debates in the theory and practice of economic evaluations of health technologies described in this review have centred on the questions of whether and how to include productivity costs, especially productivity costs related to paid work.