Publications by authors named "Ivan Castilla"
Introduction: Our aim was to describe the development and validation of an obesity model representing the cardiovascular risks associated with different body mass index (BMI) categories, through simulation, designed to evaluate the epidemiological and economic impact of population policies for obesity.
Methods: A discrete event simulation model was built in R considering the risk of cardiovascular events (heart failure, stroke, coronary heart disease, and diabetes) associated with BMI categories in the Spanish population. The main parameters included in the model were estimated from Spanish hospital discharge records and the Spanish Health Survey and allowed both first-order and second-order (probabilistic sensitivity analysis) uncertainty to be programmed into the model.
Newborn screening programs are a fundamental tool for secondary prevention or pre-symptomatic detection of certain conditions. The implementation of a newborn screening program requires an evaluation of effectiveness, safety, cost-effectiveness, feasibility and budget impact. Economic evaluation aims to contribute to the sustainability and solvency of health systems, especially when it comes to informing about financing health interventions with public funds.
View Article and Find Full Text PDFBackground: Many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions. Information on the system's willingness to pay per effectiveness unit, normally measured as quality-adjusted life-years (QALYs), however, is not available in most countries. This is partly because of the controversy that remains around the use of a cost-effectiveness threshold, about what the threshold ought to represent, and about the appropriate methodology to arrive at a threshold value.
View Article and Find Full Text PDFRisk and protective factors such as obesity, hypercholesterolemia, physical activity, and hypertension can play a role in the development of dementia. Our objective was to measure the effect of modification of risk and protective factors on the prevalence and economic burden of dementia in the aging Spanish population during 2010-2050. A discrete event simulation model including risk and protective factors according to CAIDE (Cardiovascular Risk Factors, Aging and Incidence of Dementia) Risk Score was built to represent the natural history of dementia.
View Article and Find Full Text PDFBackground And Objectives: There are conflicting views as to whether testing for biotinidase deficiency (BD) ought to be incorporated into universal newborn screening (NBS) programs. The aim of this study was to evaluate the cost-effectiveness of adding BD to the panel of conditions currently screened under the national NBS program in Spain.
Methods: We used information from the regional NBS program for BD that has been in place in the Spanish region of Galicia since 1987.
Background: The use of cerebrospinal fluid (CSF) biomarkers could facilitate early detection of Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI) and the differential diagnosis between AD and non-AD dementias.
Objective: To determine the cost-effectiveness of the use of amyloid-β peptide (Aβ42), total tau and phosphorylated tau proteins in CSF to diagnose AD in MCI and dementia patients.
Methods: An economic evaluation was performed by means of cost-effectiveness analysis comparing two AD diagnostic alternatives: the combined determination of Aβ42 proteins, total tau and phosphorylated tau in CSF as biomarkers of AD, and the standard clinical diagnosis based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINDS-ADRDA) criteria.
Background: To assess the cost-utility of gastric bypass versus usual care for patients with severe obesity in Spain.
Methods: We have implemented a discrete-event simulation model with two branches: one branch involves gastric bypass, thereby reducing patients' BMI, and another branch where patients do not undergo surgery. The model analyzes the emergence of comorbidities (stroke, coronary obstructive disease, diabetes, and breast cancer) associated with obesity during a lifetime horizon.