Use of Cost-Effectiveness Thresholds in Healthcare Public Policy: Progress and Challenges.

The article offers a comparative analysis of the influence of cost-effectiveness thresholds in the decision-making processes in financing policies, coverage, and price regulation of health technologies in nine countries. We investigated whether countries used cost-effectiveness thresholds for public health policy decision making and found that few countries have adopted the cost-effectiveness threshold as an official criterion for financing, reimbursement, or pricing. However, in countries where it is applied, such as Thailand, the results have been very favorable in terms of minimizing health technology prices and ensuring the financial sustainability of the health system.

Cost-Effectiveness of Tacrolimus Compared With Cyclosporine for Immunosuppression Therapy in Patients Who Underwent Heart Transplant in Colombia.

Objectives: To evaluate the cost-effectiveness of pharmacological treatment in maintenance therapy for adult heart transplant recipients from the Colombian health system perspective.

Methods: We constructed a decision tree model with a 1-year time horizon. A review of the clinical literature was performed to extract probabilities of health events and acute rejections avoided were used as the health outcome.

Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial.

Objectives: This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP).

Materials And Methods: Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH) + saline solution (SSL), and Ca(OH) + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3).

Effectiveness of 1-Visit and 2-Visit Endodontic Retreatment of Teeth with Persistent/Secondary Endodontic Infection: A Randomized Clinical Trial with 18 Months of Follow-up.

Introduction: This randomized clinical trial aimed to compare the effectiveness of endodontic retreatment of teeth with posttreatment apical periodontitis (PTAP) performed in 1 visit versus 2 visits on the reduction of cultivable bacteria (colony-forming units [CFUs]), lipopolysaccharides (LPSs), lipoteichoic acid (LTA), and the periapical lesion volume (mm) after 18 months of follow-up.

Methods: Forty patients diagnosed with PTAP were selected and randomly divided into the following 2 groups: 1-visit retreatment and 2-visit retreatment with the placement of calcium hydroxide medication for 14 days. Cone-beam computed tomographic scans were performed at 2 stages: preoperatively and after 18 months of follow-up.

Influence of different post-endodontic restorations on the fatigue survival and biomechanical behavior of central incisors.

Purpose: To evaluate the influence of different post-endodontic techniques on the fatigue survival and biomechanical behavior of crowned restored central incisors.

Methods: The crowns of 69 bovine incisors were cut, and the roots were treated endodontically and assigned randomly into three groups (n=23): resin composite buildup (BUP), glass fiber post-retained resin composite buildup (GFP), and cast post-and-core (CPC). They received full crown preparation with 2 mm ferrule, and a leucite-reinforced ceramic crown was cemented adhesively.

Effect of passive ultrasonic activation on microorganisms in primary root canal infection: a randomized clinical trial.

Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization.

Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI).

Effect of a Mandibular Advancement Device on the Upper Airway in a Patient With Obstructive Sleep Apnea.

The authors present a case of a 33-year-old male patient with obstructive sleep apnea syndrome who was treated with a mandibular advancement device with excellent results. The aim of this study is to underline the importance of new instruments that allow evaluating the upper airway with greater precision, such as cone beam tomography. Given the diagnosis and treatment, the upper airway was assessed using cone beam tomography; an increase in UA volume of 22% was observed (initial volume 22,962 mm), along with a 28% increase in area (initial area 971 mm).

Cost-Effectiveness Analysis of Diagnosis of Duchenne/Becker Muscular Dystrophy in Colombia.

Objectives: To determine the cost-effectiveness ratio of different courses of action for the diagnosis of Duchenne or Becker muscular dystrophy in Colombia.

Methods: The cost-effectiveness analysis was performed from the Colombian health system perspective. Decision trees were constructed, and different courses of action were compared considering the following tests: immunohistochemistry (IHC), Western blot (WB), multiplex polymerase chain reaction, multiplex ligation-dependent probe amplification (MLPA), and the complete sequencing of the dystrophin gene.

ß-hCG and prediction of therapeutic success in ectopic pregnancies treated with methotrexate, results from a prospective observational study.

Objective: To evaluate the diagnostic accuracy of different beta-human chorionic gonadotrophin (ß-hCG) levels measurement, for predicting success of medical treatment in cases diagnosed as tubal ectopic pregnancy (TEP).

Design: Five-year prospective observational study.

Setting: Prenatal Diagnosis Unit, Vall d'Hebron University Hospital - Barcelona.