Cost-effectiveness of MLC601 in post-stroke functional recovery compared with placebo - the CHIMES & CHIMES-E studies.

Background: Despite progress in stroke therapy (e.g., revascularisation interventions by thrombolysis and/or thrombectomy, organised stroke care), many stroke survivors will have impairment of neurological function.

Ischemic Stroke and Savings in Time to Achieve Functional Recovery: Experience from NeuroAiD.

Despite recent progress with revascularisation interventions after acute ischemic stroke, many patients remain disabled after stroke. Using data from a multi-centre, randomised, double-blind, placebo-controlled trial of a neuro-repair treatment (NeuroAiD/MLC601) with a long-term follow-up, we analysed the savings in time to functional recovery, measured by a modified Rankin Scale (mRS) score of 0 or 1, in patients receiving a 3-month oral course of MLC601. Analysis of time to recovery was assessed by a log-rank test and hazard ratios (HRs) adjusted for prognosis factors.

What are the impacts of increasing cost-effectiveness Threshold? a protocol on an empirical study based on economic evaluations conducted in Thailand.

Background: Economic evaluations have been widely used to inform and guide policy-making process in healthcare resources allocation as a part of an evidence package. An intervention is considered cost-effective if an ICER is less than a cost-effectiveness threshold (CET), where a CET represents the acceptable price for a unit of additional health gain which a decision-maker is willing to pay. There has been discussion to increase a CET in many settings such as the United Kingdom and Thailand.

Cost effectiveness analysis of a polygenic risk tailored breast cancer screening programme in Singapore.

Background: This study aimed to evaluate the cost-effectiveness of a breast cancer screening programme that incorporates genetic testing using breast cancer associated single nucleotide polymorphisms (SNPs), against the current biennial mammogram-only screening programme to aid in its implementation into the current programme in Singapore.

Methods: A Markov model was used to compare the costs and health outcomes of the current screening programme, against a polygenic risk-tailored screening programme, which can advise a long-term screening strategy depending on the individual's polygenic risk. The model took the perspective of the healthcare system, with a time horizon of 40 years, following women from the age of 35 to 74.

Indirect derivation of biological variation data and analytical performance specifications for therapeutic drug monitoring activities.

We applied the indirect approach using anonymised data from an Australian and a Singapore laboratory to derive biological variation data for a group of 10 therapeutic drugs routinely monitored. A series of inclusion and exclusion criteria were applied on the data. The within- (CVi) and between-individual (CVg) biological variation data were then derived as previously described.

Cost-benefit analysis of introducing next-generation sequencing (metagenomic) pathogen testing in the setting of pyrexia of unknown origin.

Pyrexia of unknown origin (PUO) is defined as a temperature of >38.3°C that lasts for >3 weeks, where no cause can be found despite appropriate investigation. Existing protocols for the work-up of PUO can be extensive and costly, motivating the application of recent advances in molecular diagnostics to pathogen testing.

Impact of analytical and biological variations on classification of diabetes using fasting plasma glucose, oral glucose tolerance test and HbA1c.

Historically, diabetes is diagnosed by measuring fasting (FPG) and two-hour post oral glucose load (OGTT) plasma concentration and interpreting it against recommended clinical thresholds of the patient. More recently, glycated haemoglobin A1c (HbA1c) has been included as a diagnostic criterion. Within-individual biological variation (CVi), analytical variation (CVa) and analytical bias of a test can impact on the accuracy and reproducibility of the classification of a disease.