Advantages of Transmuscular Quadratus Lumborum Block via Subfascial Approach Versus Extrafascial Approach for Postoperative Analgesia After Laparoscopic Cholecystectomy: A Randomized Controlled Study.

Objective: We aimed to compare the analgesic effect and incidence of lower limb weakness of transmuscular quadratus lumborum (TQL) block via subfascial approach with that via extrafascial after laparoscopic cholecystectomy (LC).

Methods: Eighty patients undergoing LC were randomized to receive ultrasound-guided bilateral TQL block via subfascial (subfascial group) or extrafascial (extrafascial group) using 30 mL of 0.33% ropivacaine unilaterally.

A review of rotavirus vaccine use in Asia and the Pacific regions: challenges and future prospects.

Introduction: Rotavirus infection causes a significant proportion of diarrhea disease burden in children <5 years of age in Asia and the Pacific regions. The World Health Organization recommends that rotavirus vaccination should be included in national immunization programs to prevent rotavirus gastroenteritis (RVGE).

Areas Covered: A literature review was performed to identify and summarize published evidence on RVGE epidemiology and status of rotavirus vaccine use, including the impact and cost-effectiveness of rotavirus vaccination programs in Asia and the Pacific regions (49 countries) during the period 2000-2018.

Cost-effectiveness evaluation of the 10-valent pneumococcal non-typeable protein D conjugate vaccine for children in Taiwan.

Background: and non-typeable (NT) are substantial contributors to morbidity and mortality of diseases including invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) worldwide. In Taiwan, 10-valent pneumococcal polysaccharide and NT protein D conjugate vaccine (PHiD-CV) and 13-valent pneumococcal conjugate vaccine (PCV13) are licensed in children against pneumococcal disease. In addition to , clinical trials suggest efficacy of PHiD-CV against NT AOM.

Economic Evaluation of Human Rotavirus Vaccine in Thailand.

Introduction: Rotavirus gastroenteritis is the leading cause of severe diarrhoea among young children < 5 years old. Previous cost-effectiveness analyses on rotavirus (RV) vaccination in Thailand have generated conflicting results. The aim of this current study is to evaluate the economic impact of introducing RV vaccination in Thailand, using updated Thai epidemiological and cost data.

Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial.

Background: Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance, and to identify associated risk factors of LAST.

A Cost-Effectiveness Analysis of the 10-Valent Pneumococcal Non-Typeable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) for Universal Mass Vaccination Implementation in New Zealand.

Objectives: Invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact of two childhood universal immunisation strategies: vaccination with a 3 + 1 schedule of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix, GSK) and the 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13, Pfizer).

Methods: A static Markov-process cohort model was used to simulate the epidemiological and economic burden of pneumococcal diseases on a single-birth cohort over its lifetime.

Burden of hospitalized childhood community-acquired pneumonia: A retrospective cross-sectional study in Vietnam, Malaysia, Indonesia and the Republic of Korea.

Background: Few studies describe the community-acquired pneumonia (CAP) burden in children in Asia. We estimated the proportion of all CAP hospitalizations in children from nine hospitals across the Republic of Korea (high-income), Indonesia, Malaysia (middle-income), and Vietnam (low/middle-income).

Methods: Over a one or two-year period, children <5 years hospitalized with CAP were identified using ICD-10 discharge codes.

Cost-effectiveness analysis of infant pneumococcal vaccination with PHiD-CV in Korea.

Background: Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) can cause invasive pneumococcal diseases (IPD), pneumonia, and acute otitis media (AOM). Both the 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and the 13-valent pneumococcal conjugate vaccine (PCV-13) are included in the National Immunization Program for infants in Korea. This study aimed to evaluate the cost-effectiveness of the 3+1 schedule of PHiD-CV versus that of PCV-13 for National Immunization Program in Korea.

Cost-effectiveness analysis of a universal mass vaccination program with a PHiD-CV 2+1 schedule in Malaysia.

Background: Currently, two pediatric pneumococcal conjugate vaccines are available in the private market of Malaysia-13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide and non-typeable protein D conjugate vaccine (PHiD-CV). This study aimed to evaluate the cost-effectiveness of a universal mass vaccination program with a PHiD-CV 2+1 schedule versus no vaccination or with a PCV13 2+1 schedule in Malaysia.

Methods: A published Markov cohort model was adapted to evaluate the epidemiological and economic consequences of programs with no vaccination, a PHiD-CV 2+1 schedule or a PCV13 2+1 schedule over a 10-year time horizon.

Response to Wu et al. - Cost-effectiveness analysis of infant pneumococcal vaccination in Malaysia and Hong Kong.

A recently published paper that assessed the comparative cost-effectiveness of the 2 pneumococcal conjugate vaccines (PCVs) in Malaysia and Hong Kong reported that the 13-valent PCV vaccine (PCV13) is a better choice compared to the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV or PCV10) from both a payer and societal perspective as well as under various scenarios. However, the analysis relied on a large number of assumptions that were either erroneous or did not take into account the most recent body of evidence available. A rigorous evaluation of the underlying assumptions is necessary to present a fair and balanced analysis for decision-making.

Cost-Effectiveness Analysis of Pneumococcal Vaccination with the Pneumococcal Polysaccharide NTHi Protein D Conjugate Vaccine in the Philippines.

Objectives: To compare the cost-effectiveness of a universal mass vaccination (UMV) program with a 2 + 1 schedule of a 10-valent pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) against two strategies: 1) a no-vaccination strategy and 2) a pneumococcal 13-valent conjugate vaccine (PCV13) 2 + 1 strategy in the Philippines.

Methods: A published Markov cohort model was adapted to simulate the epidemiological and economic burden of pneumococcal diseases (meningitis, bacteremia, pneumonia, and acute otitis media) within a projected birth cohort in 2012 of 1,812,137 newborns over lifetime. Analyses were conducted at an annual discount rate of 5% from the perspective of the Philippine government.

Are English and Chinese Versions of the Audit of Diabetes-Dependent Quality of Life Equivalent? An Exploratory Study Based on the Universalist Approach.

Objective: To translate and culturally adapt the UK English Audit of Diabetes-Dependent Quality of Life (ADDQOL) into Chinese for Singapore.

Methods: Translation was integrated into investigation of conceptual, item, semantic, and operation equivalence. Conceptual equivalence, item equivalence, and operation equivalence were assessed by literature review, expert judgment, and cognitive debriefing.

Aprepitant for Patients Receiving Highly Emetogenic Chemotherapy: An Economic Analysis for Singapore.

Background: Aprepitant (a neurokinin 1 receptor antagonist), in combination with a serotonin receptor antagonist (5-HT3 RA) and dexamethasone, has demonstrated superior efficacy on end points related to chemotherapy-induced nausea and vomiting (CINV) compared with standard care (combination 5-HT3 RA and dexamethasone).

Objective: To determine the cost-effectiveness of an aprepitant-containing regimen compared with current clinical practice for the prevention of CINV in patients receiving highly emetogenic chemotherapy (HEC) in Singapore.

Methods: A decision-analytic model was constructed to assess the costs and outcomes associated with an aprepitant-containing regimen compared with standard care in the prevention of CINV following HEC.

Health and economic burden of HPV-related diseases in Singapore.

Objective: To assess the health and economic burden of human papillomavirus (HPV)-related diseases (cervical cancer, cervical intraepithelial neoplasia (CIN) 1/2/3, and genital warts) in Singapore over a period of 25 years beginning in 2008.

Methods: Incidence-based modeling was used to estimate the incidence cases and associated economic burden, with the assumption that age-stratified incidence rates will remain the same throughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from the National Cancer Registry for cervical cancer, and from a combination of published data and hospital registry review for CIN1/2/3 and genital warts.

An exploratory study of response shift in health-related quality of life and utility assessment among patients with osteoarthritis undergoing total knee replacement surgery in a tertiary hospital in Singapore.

Objective: To investigate the influence of response shift (RS) on health-related quality of life (HRQOL) and utility assessment among patients undergoing total knee replacement.

Methods: Consenting patients undergoing total knee replacement were interviewed to determine their HRQOL by using the six-dimensional health state short form, derived from SF-36, and the EuroQol five-dimensional questionnaire at baseline (pretest 1) and the six-dimensional health state short form, derived from SF-36, at 6 (pretest 2) and 18 months after surgery (post-test). RS was studied by using a "then-test" approach by contacting participants 18 months after surgery and asking them to evaluate their HRQOL at baseline (then-test 1) and at 6 (then-test 2) and 18 months after surgery.

The impact of health literacy on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases.

Objectives: The objective of this study was to investigate the impact of health literacy (HL) on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases.

Methods: HL was measured by the rapid estimate of adult literacy in medicine (REALM) and was characterized as low or adequate. HRQoL and utility scores were assessed using the SF-36, SF-6D, and EQ-5D.

Development and validation of a scale to measure patients' trust in pharmacists in Singapore.

Objective: To develop and validate a scale to measure patients' trust in pharmacists for use as an outcomes predictor in pharmacoeconomic and pharmaceutical care studies.

Methods: Literature review, study team discussion and focus group discussions were conducted to generate items of a candidate version to be pilot-tested for content validity. An amended candidate version was then tested among eligible Singaporeans across different ethnic and age groups.

Development and validation of a functional health literacy test.

Background: : Three validated functional health literacy tests (FHLTs) have been developed for use in healthcare settings. However, none of these tests has been shown to be readily applicable for use in the general public.

Objective: : To develop and validate an FHLT for screening the functional health literacy level of the general public and patients in healthcare settings.

Applying the Expectancy-Value Model to understand health values.

Objectives: Expectancy-Value Model (EVM) is the most structured model in psychology to predict attitudes by measuring attitudinal attributes (AAs) and relevant external variables. Because health value could be categorized as attitude, we aimed to apply EVM to explore its usefulness in explaining variances in health values and investigate underlying factors.

Methods: Focus group discussion was carried out to identify the most common and significant AAs toward 5 different health states (coded as 11111, 11121, 21221, 32323, and 33333 in EuroQol Five-Dimension (EQ-5D) descriptive system).

Validity, feasibility and acceptability of time trade-off and standard gamble assessments in health valuation studies: a study in a multiethnic Asian population in Singapore.

Objectives: To assess the validity, feasibility and acceptability of standard gamble (SG) and time trade-off (TTO) assessments in a multiethnic Asian population.

Methods: Through in-depth interviews performed among Chinese, Malay, and Indian Singaporeans (education >or= 6 years), we assessed validity of SG/TTO methods for eliciting health preferences by hypothesizing that 1) SG/TTO scores for three hypothetical health states (HS) would exhibit ranked order (decreasing scores with worse HS); and 2) more subjects would rate the most severe HS as worse than dead. Subjects also evaluated feasibility and acceptability of SG/TTO using a 10-point visual analog scale (VAS) and open-ended questions.

Are symbols useful and culturally acceptable in health-state valuation studies? An exploratory study in a multi-ethnic Asian population.

Background: Symbols have been used in health state valuation studies to help subjects distinguish the severity of various characteristics of a given health state. Symbols used in such studies need to be evaluated for their cross-cultural appropriateness because a given symbol may have different meanings or acceptability in different cultures, which may affect results of such studies.

Objectives: To evaluate if using symbols to differentiate health states of different severity is useful and culturally acceptable in a multi-ethnic, urban Asian population.

Are Asians comfortable with discussing death in health valuation studies? A study in multi-ethnic Singapore.

Background: To characterize ease in discussing death (EID) and its influence on health valuation in a multi-ethnic Asian population and to determine the acceptability of various descriptors of death and "pits"/"all-worst" in health valuation.

Methods: In-depth interviews (English or mother-tongue) among adult Chinese, Malay and Indian Singaporeans selected to represent both genders and a wide range of ages/educational levels. Subjects rated using 0-10 visual analogue scales (VAS): (1) EID, (2) acceptability of 8 descriptors for death, and (3) appropriateness of "pits" and "all-worst" as descriptors for the worst possible health state.