(1) Background: Periprosthetic joint infection (PJI) can be managed with one- or two-stage revision surgery protocol. Despite several studies analyzing the eradication rates between both procedures, there are no comparative studies that analyze patient-reported outcome measures (PROMs) and quality-adjusted life years (QALYs) in both treatment strategies. (2) Methods: All patients who underwent a two-stage knee revision between January 2017 to December 2018, due to a periprosthetic joint infection were included in the study. From the time interval, we selected a comparative group with the one-stage septic procedure. All patients received the following questionnaires: Oxford Knee Score, EQ-5D-5L, SSQ-8, and the SF-36. Additionally, demographic patient data were collected. The quality-adjusted life years (QALY) were calculated using the EQ-5D-5L. (3) Results: A total of 35 patients with a mean age of 67.7 years (SD = 8.9) were included in the final evaluation. The mean follow-up period was 54.5 months (SD = 5.5). There was no statistically significant difference regarding the Charlson Comorbidity Index (CCI), postoperative complications, or all evaluated questionnaires. There was no statistically significant difference in QALYs between the one- and two-stage revision. (4) Conclusion: Our study results show that the one-stage revision for PJI achieves similar PROMs compared to two-stage revision.
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http://dx.doi.org/10.3390/antibiotics11111602 | DOI Listing |
Gynecol Oncol
January 2025
Division of Gynecologic Oncology, St. Luke's University Health Network, Bethlehem, PA, United States of America.
Objective: We sought to determine the cost-effectiveness (CE) of lymph node dissection (LND) at the time of hysterectomy for endometrial intraepithelial neoplasia (EIN).
Methods: A decision analytic model was created to evaluate the strategies of routine full LND, sentinel lymph node dissection (SNLD), SNLD without advancing to full LND in the event of non-mapping, and full LND based on Mayo Criteria, versus no LND. Patients in the no LND group and those in the SLND group without advancement to full LND in the event of non-mapping who were found to have EC on final pathology and suspicious post-operative imaging underwent full LND.
EClinicalMedicine
August 2024
Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background: Lung cancer screening recommendations employ annual frequency for eligible individuals, despite evidence that it may not be universally optimal. The impact of imposing a structure on the screening frequency remains unknown. The ENGAGE framework, a validated framework that offers fully dynamic, analytically optimal, personalised lung cancer screening recommendations, could be used to assess the impact of screening structure on the effectiveness and efficiency of lung cancer screening.
View Article and Find Full Text PDFBMJ Open
January 2025
Siriraj Health Policy Unit, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Objectives: To evaluate the cost-utility of botulinum toxin A (BoNT-A) for treating upper limb (UL) and lower limb (LL) post-stroke spasticity.
Design: Using a Markov model, adopting a societal perspective and a lifetime horizon with a 3% annual discount rate, the cost-utility analysis was conducted to compare BoNT-A combined with standard of care (SoC) with SoC alone. Costs, utilities, transitional probabilities and treatment efficacy were derived from 5-year retrospective data from tertiary hospitals and meta-analysis.
PLoS One
January 2025
Department of Health Sciences, Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Objectives: Only studying effectiveness of lifestyle interventions for people with severe mental illness (SMI) is insufficient for policy making. As budgets for healthcare are limited, policy makers face the problem of allocating scarce healthcare resources. Cost-effectiveness studies are needed, but currently cost-effectiveness studies of lifestyle interventions for people with SMI delivered in ambulatory care are limited.
View Article and Find Full Text PDFAlzheimers Dement (N Y)
January 2025
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics University Medical Center Hamburg-Eppendorf Hamburg Germany.
Introduction: The societal costs of dementia and cognitive decline are substantial and likely to increase during the next decades due to the increasing number of people in older age groups. The aim of this multicenter cluster-randomized controlled trial was to assess the cost-effectiveness of a multi-domain intervention to prevent cognitive decline in older people who are at risk for dementia.
Methods: We used data from a multi-centric, two-armed, cluster-randomized controlled trial ( trial, ID: DRKS00013555).
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