Publications by authors named "Sarah McGhee"
Background: The optimal screening interval for diabetic retinopathy (DR) remains controversial. This study aimed to develop a risk algorithm to predict the individual risk of referable sight-threatening diabetic retinopathy (STDR) in a mainly Chinese population and to provide evidence for risk-based screening intervals.
Methods: The retrospective cohort data from 117,418 subjects who received systematic DR screening in Hong Kong between 2010 and 2016 were included to develop and validate the risk algorithm using a parametric survival model.
Background: Myopia is a common eye condition and projected to affect half of the global population by 2050. Controlling its progression during childhood may prevent associated ocular diseases in later life. Certain interventions retard myopia progression but their long-term costs and consequences are not well understood.
View Article and Find Full Text PDFBackground: Hong Kong is among the many populations that has experienced the combined impacts of social unrest and the COVID-19 pandemic. Despite concerns about further deteriorations in youth mental health globally, few epidemiological studies have been conducted to examine the prevalence and correlates of major depressive episode (MDE) and other major psychiatric disorders across periods of population-level changes using diagnostic interviews.
Methods: We conducted a territory-wide household-based epidemiological study from 2019 to 2022 targeting young people aged 15-24 years.
Article Synopsis
- The study investigates the impact of early intervention (EI) services on adults aged 26-55 with adult-onset psychosis, comparing its effectiveness against standard care (SC).
- Results show that a 4-year EI program leads to better social functioning and lower symptom severity compared to SC, particularly notable in the first two years.
- The findings suggest that at least two years of specialized EI treatment is beneficial for this age group, but extending it to four years offers minimal additional advantages.
Background: Financial incentive is increasingly used as a mean to promote preventive care utilization (PCU), but the current Elderly Health Care Voucher Scheme (EHCVS) in Hong Kong is ineffective for encouraging PCU.
Objective: To explore the older people's barriers to PCU and their views on financial incentive, including EHCVS, for improving private PCU.
Design And Setting: Focus-group discussions were conducted in community elderly centres located in five districts of Hong Kong.
Aims/introduction: To examine the impact of different levels of financial incentive in terms of fee subsidization on diabetic retinopathy screening in the private primary care setting in Hong Kong.
Materials And Methods: All general practitioners working in the private sector and registered in two electronic public databases were invited to participate. Consecutive patients with diabetes mellitus were then recruited by the participating practitioners.
Background: Rotavirus is a common cause of severe gastroenteritis in young children in Hong Kong (HK) with a high economic burden. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into the HK Government's Childhood Immunisation Programme (CIP) and to include the potential protective effect of the vaccine against seizures.
Methods: A decision-support model was customised to estimate the potential impact, cost-effectiveness and benefit-risk of rotavirus vaccination in children below 5 years over the period 2020-2029 in HK.
Purpose: The multidisciplinary Risk Assessment and Management Program for patients with diabetes mellitus (RAMP-DM) was found to be cost-saving in comparison with usual primary care over 5 years' follow-up. This study aimed to estimate the cost-effectiveness of RAMP-DM over lifetime.
Methods: We built a Discrete Event Simulation model to evaluate the cost-effectiveness of RAMP-DM over lifespan from public health service provider's perspective.
Aim: To evaluate the long-term cost-effectiveness of a Patient Empowerment Programme (PEP) for type 2 diabetes mellitus (DM) in primary care.
Materials And Methods: PEP participants were subjects with type 2 DM who enrolled into PEP in addition to enrolment in the Risk Assessment and Management Programme for DM (RAMP-DM) at primary care level. The comparison group was subjects who only enrolled into RAMP-DM without participating in PEP (non-PEP).
Objectives: To determine the preference of mothers in Hong Kong and their willingness to pay (WTP) for human papillomavirus (HPV) vaccination for their daughters.
Method: A discrete choice experiment survey with a two-alternative study design was developed. Data were collected from pediatric specialist outpatient clinics from 482 mothers with daughters aged between 8 and 17 years.
Objective: To assess the association between awareness of diabetic retinopathy (DR) and actual attendance for DR screening.
Design: Cross-sectional study.
Setting: Two public general outpatient clinics.
Objective: To estimate the cost-effectiveness of the multidisciplinary Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes in comparison with usual primary care in a cohort with 5 years' follow-up.
Research Design And Methods: We conducted a prospective cohort study among 17,140 propensity score-matched participants in RAMP-DM and those under usual primary care. The effectiveness measures were cumulative incidences of complications and all-cause mortality over 5 years.
Background: Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates.
Methods: We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing.
This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus (DM) in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP.
View Article and Find Full Text PDFWe analysed retinal nerve fibre layer (RNFL) defects in eyes with normal circumpapillary RNFL (cpRNFL) thickness using posterior pole asymmetry analysis (PPAA) and investigated the parameters of Bruch membrane opening (BMO) and neural canals using enhanced depth imaging spectral domain optical coherence tomography (EDI-SDOCT). A total of 112 preperimetric glaucomatous eyes of 92 patients were examined to obtain cpRNFL thickness using SD-OCT. Posterior pole asymmetry analysis (PPAA) and central cross-sectional images of the optic nerve head (ONH) were obtained using EDI-SDOCT.
View Article and Find Full Text PDFObjectives: To examine trends in deaths for conditions associated with secondhand smoke exposure over the years prior to and following the implementation of a smoke-free policy in Hong Kong.
Design: Time-series study.
Setting: Death registration data from Hong Kong Special Administrative Region (SAR) Government Census and Statistics Department.
Introduction: Electronic cigarettes (e-cigarettes) have gained popularity rapidly in the Western world but data in the East are scarce. We examined the awareness and ever use of e-cigarettes, and reasons for e-cigarette use in a probability sample of adults in Hong Kong.
Methods: Cross-sectional data were collected in 2014 from Chinese adults aged 15-65 in Hong Kong (819 never smokers, 800 former smokers, 800 current smokers) via computer-assisted telephone interviews (response rate: 73.
Purpose: To determine whether screening for age-related macular degeneration (AMD) during a diabetic retinopathy (DR) screening program would be cost effective in Hong Kong.
Design: We compared and evaluated the impacts of screening, grading, and vitamin treatment for intermediate AMD compared with no screening using a Markov model. It was based on the natural history of AMD in a cohort with a mean age of 62 years, followed up until 100 years of age or death.
Purpose: To determine the prevalence of diabetic retinopathy (DR), sight threatening DR (STDR), visual impairment and other eye diseases in a systematic DR screening programme among primary care Chinese patients with diabetes mellitus (DM) in Hong Kong.
Methods: Screening for DR was provided to all subjects with DM in public primary care using digital fundus photography according to the English national screening programme. STDR was defined as preproliferative DR (R2), proliferative DR (R3) and/or maculopathy (M1).
Background: Studies on the long-term effectiveness of multidisciplinary risk-stratification based management in Chinese population were rare. This study aimed to evaluate the effectiveness of a multidisciplinary risk assessment and management program for patients with diabetes mellitus (RAMP-DM) in reducing the risks of cardiovascular complications and all-cause mortality.
Methods: A prospective cohort study was conducted in 18,188 propensity score matched RAMP-DM participants and subjects with diabetes under usual primary care (9,094 subjects in each group).
Objective: Estimates of illicit cigarette consumption are limited and the data obtained from studies funded by the tobacco industry have a tendency to inflate them. This study aimed to validate an industry-funded estimate of 35.9% for Hong Kong using a framework taken from an industry-funded report, but with more transparent data sources.
View Article and Find Full Text PDFAims/introduction: To assess the feasibility, convergent validity and sensitivity of four cardiovascular risk prediction functions in Chinese diabetic patients in the primary care setting.
Materials And Methods: A cross-sectional study of 1,140 diabetic patients was carried out to compare four cardiovascular risk functions, which were respectively developed from the Framingham heart study, the USA-People's Republic of China Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology cohort (PRC), the United Kingdom Prospective Diabetes Study (UKPDS) and the Joint Asia Diabetes Evaluation program (JADE). Feasibility was assessed by the percentage of patients with complete data for risk prediction.
Background: The appropriate use of generic preference-based measures determines the accuracy of disease assessment and further decision on healthcare policy using quality adjusted life years. The discriminative capacity of different instruments would differ across disease groups. Our study was to examine the difference in utility scores for COPD patients measured by EQ-5D and SF-6D and to assist the choice of a proper instrument in this disease group.
View Article and Find Full Text PDFBackground: home visits and telephone calls are two often used approaches in transitional care, but their differential economic effects are unknown.
Objective: to examine the differential economic benefits of home visits with telephone calls and telephone calls only in transitional discharge support.
Design: cost-effectiveness analysis conducted alongside a randomised controlled trial (RCT).