Empirical Testing of Alternative Search Methods to Retrieve Utility Values for Health Economic Modelling.

Objectives: The objective of this study is to compare different information retrieval methods that can be used to identify utility inputs for health economic models.

Methods: The usual practice of using systematic review methods was compared with two alternatives (iterative searching and rapid review), using a health technology assessment (HTA) case study in ulcerative colitis (UC). We analysed whether there were differences in the utility values identified when using the alternative search methods.

Differential diagnosis of small hepatocellular nodules in cirrhosis: surrogate histological criteria of TERT promoter mutations.

Aims: The differential diagnosis of small hepatocellular nodules in cirrhosis between dysplastic nodules and hepatocellular carcinoma (HCC) remains challenging on biopsy. As TERT promoter (pTERT) mutations may indicate the nodules already engaged in the malignant process, the aim of this study was to identify histological criteria associated with pTERT mutations by detecting these mutations by ddPCR in small formalin-fixed paraffin-embedded (FFPE) hepatocellular nodules arising in cirrhosis.

Methods And Results: We built a bicentric cohort data set of 339 hepatocellular nodules < 2 cm from cirrhotic samples, divided into a test cohort of 299 resected samples and a validation cohort of 40 biopsies.

Guidance on the use of complex systems models for economic evaluations of public health interventions.

To help health economic modelers respond to demands for greater use of complex systems models in public health. To propose identifiable features of such models and support researchers to plan public health modeling projects using these models. A working group of experts in complex systems modeling and economic evaluation was brought together to develop and jointly write guidance for the use of complex systems models for health economic analysis.

Intrathymic growing bronchogenic cyst mimicking thymoma: A case report.

Intrathymic bronchogenic cysts are extremely rare lesions, and the differential diagnosis with a banal thymic cyst or a solid tumor can be problematic. Thymic carcinomas arising within thymic cysts have also been reported. We report a case of radical thymectomy for a slowly growing small thymic cyst.

Frame Score, Grazing and Delayed Feedlot Entry Effect on Performance and Economics of Beef Steers from Small- and Large-Framed Cows in an Integrated Crop-Livestock System.

When selling small-framed steers at weaning, profitability is diminished. The hypothesis is that by using a vertically integrated business model that includes retained ownership, extended grazing, abbreviated feedlot finishing, and selling at slaughter, profitability would increase. Crossbred yearling steers ( = 288) from small size Aberdeen Angus (Lowline) × Red Angus × Angus × Angus cows and moderate to large size Red Angus × Angus × Simmental × Gelbvieh cows calved May-June were randomly assigned (complete randomized design), in a 3 y study, to feedlot control (FLT) and extended grazing (GRZ) frame score treatment groups.

The Cost-Effectiveness of Expanding the UK Newborn Bloodspot Screening Programme to Include Five Additional Inborn Errors of Metabolism.

Glutaric aciduria type 1, homocystinuria, isovaleric acidaemia, long-chain hydroxyacyl CoA dehydrogenase deficiency and maple syrup urine disease are all inborn errors of metabolism that can be detected through newborn bloodspot screening. This evaluation was undertaken in 2013 to provide evidence to the UK National Screening Committee for the cost-effectiveness of including these five conditions in the UK Newborn Bloodspot Screening Programme. A decision-tree model with lifetable estimates of outcomes was built with the model structure and parameterisation informed by a systematic review and expert clinical judgment.

Rehabilitation medicine in palliative care of chronic neurological conditions.

Background: People living with long-term neurological conditions (LTNC) often require palliative care. Rehabilitation medicine specialists often coordinate the long-term care of these patients.

Objective: The aim of the present review was to undertake systematic literature searches to identify the evidence on palliative care for people with LTNC to guide rehabilitation medicine specialists caring for these patients in the UK.

The SIPHER Consortium: Introducing the new UK hub for systems science in public health and health economic research.

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy. Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made.

Effect of Reflection and Deliberation on Health State Values: A Mixed-Methods Study.

Background: Health economists ask members of the general public to value health states, but it is recognized that individuals construct their preferences during the valuation tasks. Conventional methods rely on one-off interviews that do not give participants time to reflect and deliberate on their preferences.

Objective: This study investigates the effect of reflection and deliberation on health state preferences using the EQ-5D questionnaire and time trade-off valuation method.

Identification, Review, and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report.

Cost-effectiveness models that present results in terms of cost per quality-adjusted life-year for health technologies are used to inform policy decisions in many parts of the world. Health state utilities (HSUs) are required to calculate the quality-adjusted life-years. Even when clinical studies assessing the effectiveness of health technologies collect data on HSUs to populate a cost-effectiveness model, which rarely happens, analysts typically need to identify at least some additional HSUs from alternative sources.

Rheumatoid arthritis treated with 6-months of first-line biologic or biosimilar therapy: an updated systematic review and network meta-analysis.

Objectives: The aim of this study was to estimate the effectiveness of first-line biologic disease modifying drugs(boDMARDs), and their approved biosimilars (bsDMARDs), compared with conventional (csDMARD) treatment, in terms of ACR (American College of Rheumatology) and EULAR (European League against Rheumatism) responses.

Methods: Systematic literature search, on eight databases to January 2017, sought ACR and EULAR data from randomized controlled trials (RCTs) of boDMARDs / bsDMARDs (in combination with csDMARDs, or monotherapy). Two adult populations: methotrexate (MTX)-naïve patients with severe active RA; and csDMARD-experienced patients with moderate-to-severe active RA.

Toward a theory-led metaframework for considering socioeconomic health inequalities within systematic reviews.

Objectives: To develop a theory-led framework to inform reviewers' understanding of what, how, and why health care interventions may lead to differential effects across socioeconomic groups.

Study Design And Setting: A metaframework approach combined two theoretical perspectives (socioeconomic health inequalities and complex interventions) into a single framework to inform socioeconomic health inequality considerations in systematic reviews.

Results: Four theories relating to complexity within systematic reviews and 16 health inequalities intervention theories informed the development of a metaframework.

Effect of yearling steer sequence grazing of perennial and annual forages in an integrated crop and livestock system on grazing performance, delayed feedlot entry, finishing performance, carcass measurements, and systems economics.

In a 2-yr study, spring-born yearling steers (n = 144), previously grown to gain <0.454 kg·steer-1·d-1, following weaning in the fall, were stratified by BW and randomly assigned to three retained ownership rearing systems (three replications) in early May. Systems were 1) feedlot (FLT), 2) steers that grazed perennial crested wheatgrass (CWG) and native range (NR) before FLT entry (PST), and 3) steers that grazed perennial CWG and NR, and then field pea-barley (PBLY) mix and unharvested corn (UC) before FLT entry (ANN).

The cost-effectiveness of follow-up strategies after cancer treatment: a systematic literature review.

Introduction: The cost of treatment and follow-up of cancer patients in the UK is substantial. In a budget-constrained system such as the NHS, it is necessary to consider the cost-effectiveness of the range of management strategies at different points on cancer patients' care pathways to ensure that they provide adequate value for money.

Sources Of Data: We conducted a systematic literature review to explore the cost-effectiveness of follow-up strategies of patients previously treated for cancer with the aim of informing UK policy.

Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

Background: Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice.

Methods: A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health.

The Identification, Review and Synthesis of Health State Utility Values from the Literature.

Systematic literature reviews of health-related quality of life (HRQoL) evidence that are to inform economic models can be challenging due to the volume of hits identified in searches using generic terms for HRQoL. Nevertheless, a robust review of the literature is required to ensure that the health state utility values (HSUVs) used in the economic model are the most appropriate available. This article provides a synopsis of literature relating to identifying, reviewing and synthesising HSUVs.

Are preferences over health states informed?

Background: The use of preference-elicitation tasks for valuing health states is well established, but little is known about whether these preferences are informed. Preferences may not be informed because individuals with little experience of ill health are asked to value health states. The use of uninformed preferences in cost-effectiveness can result in sub-optimal resource allocation.

How do individuals value health states? A qualitative investigation.

Despite the importance of health state values in informing resource allocation in health care, there is arguably little known about how individuals value health. Previous studies have shown that a variety of non-health factors and beliefs are important in valuing health, but there is less evidence in the literature about how individuals' beliefs affect their preferences or what role non-health factors play in the process of forming preferences. This study investigated the thought processes of 21 U.

Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for the treatment of rheumatoid arthritis not previously treated with disease-modifying antirheumatic drugs and after the failure of conventional disease-modifying antirheumatic drugs only: systematic review and economic evaluation.

Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with increasing disability, reduced quality of life and substantial costs (as a result of both intervention acquisition and hospitalisation). The objective was to assess the clinical effectiveness and cost-effectiveness of seven biologic disease-modifying antirheumatic drugs (bDMARDs) compared with each other and conventional disease-modifying antirheumatic drugs (cDMARDs). The decision problem was divided into those patients who were cDMARD naive and those who were cDMARD experienced; whether a patient had severe or moderate to severe disease; and whether or not an individual could tolerate methotrexate (MTX).

Identification of Evidence for Key Parameters in Decision-Analytic Models of Cost Effectiveness: A Description of Sources and a Recommended Minimum Search Requirement.

This paper proposes recommendations for a minimum level of searching for data for key parameters in decision-analytic models of cost effectiveness and describes sources of evidence relevant to each parameter type. Key parameters are defined as treatment effects, adverse effects, costs, resource use, health state utility values (HSUVs) and baseline risk of events. The recommended minimum requirement for treatment effects is comprehensive searching according to available methodological guidance.