Should Scotland provide genome-wide sequencing for the diagnosis of rare developmental disorders? A cost-effectiveness analysis.

Aims: This study aims to evaluate the cost effectiveness of genetic and genomic testing strategies for the diagnosis of rare developmental disorders in NHS Scotland.

Methods: Six genetic and genomic testing strategies were evaluated using a decision tree model. First-line, second-line and last-resort trio genome sequencing (GS), and second-line and last-resort trio exome sequencing (ES) were compared with standard genetic testing.

The effects of minimum unit pricing for alcohol on food purchases: Evaluation of a natural experiment.

Background: On the 1st of May 2018 Scotland became the first country to introduce minimum unit pricing (MUP) for alcohol sales. The objective of this study is to identify the effects of this policy instrument on food purchasing by evaluating a natural experiment.

Methods: Longitudinal analysis compares regions with similar characteristics but differing exposure to MUP (Scotland and the north of England).

Continuing the sequence? Towards an economic evaluation of whole genome sequencing for the diagnosis of rare diseases in Scotland.

Novel developments in genomic medicine may reduce the length of the diagnostic odyssey for patients with rare diseases. Health providers must thus decide whether to offer genome sequencing for the diagnosis of rare conditions in a routine clinical setting. We estimated the costs of singleton standard genetic testing and trio-based whole genome sequencing (WGS), in the context of the Scottish Genomes Partnership (SGP) study.

What can Secondary Data Tell Us about Household Food Insecurity in a High-Income Country Context?

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007⁻2012) was conducted to calculate weekly food expenditure and its ratio to equivalised income for households below average income (HBAI) and above average income (non-HBAI). Diet Quality Index (DQI) scores were calculated for this survey and the Scottish Health Survey (SHeS, 2008 and 2012).

"A Lot of People Are Struggling Privately. They Don't Know Where to Go or They're Not Sure of What to Do": Frontline Service Provider Perspectives of the Nature of Household Food Insecurity in Scotland.

This qualitative study explored frontline service providers' perceptions of the nature of food insecurity in Scotland in 2015 to inform national policy and the provision of locally-based support for 'at risk' groups. A country-wide in-depth interview study was undertaken with informants from 25 health, social care, and third sector organisations. The study investigated informants' perspectives associated with how food insecurity was manifesting itself locally, and what was happening at the local level in response to the existence of food insecurity.

Tackling alcohol misuse: purchasing patterns affected by minimum pricing for alcohol.

Background: Alcohol consumption is associated with a range of health and social harms that increase with the level of consumption. Policy makers are interested in effective and cost-effective interventions to reduce alcohol consumption and associated harms. Economic theory and research evidence demonstrate that increasing price is effective at the population level.

Costs and benefits of tele-endoscopy clinics in a remote location.

We assessed the cost and benefits of tele-endoscopy clinics in a remote location in Scotland. Before the introduction of a tele-endoscopy service, patients whose symptoms suggested possible cancer of the airways had to travel to the mainland (to Aberdeen) to receive an endoscopy. The costs of staff, capital, disposables and travel were estimated for the tele-endoscopy clinic and for the conventional, mainland clinic.

Head and neck cancer assessment by flexible endoscopy and telemedicine.

We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment.

Mapping the EORTC QLQ C-30 onto the EQ-5D instrument: the potential to estimate QALYs without generic preference data.

Objectives: The aim of this article is to map the European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30 onto the EQ-5D measure to enable the estimation of health state values based on the EORTC QLQ C-30 data. The EORTC QLQ C-30 is of interest because it is the most commonly used instrument to measure the quality of life of cancer patients.

Methods: Regression analysis is used to establish the relationship between the two instruments.

Cost-effectiveness of telephone or surgery asthma reviews: economic analysis of a randomised controlled trial.

Background: Only about a third of people with asthma attend an annual review. Clinicians need to identify cost-effective ways to improve access and ensure regular review.

Aim: To compare the cost-effectiveness of nurse-led telephone with face-to-face asthma reviews.