Unannounced versus announced hospital surveys: a nationwide cluster-randomized controlled trial.

Objective: To evaluate the effectiveness of unannounced versus announced surveys in detecting non-compliance with accreditation standards in public hospitals.

Design: A nationwide cluster-randomized controlled trial.

Setting And Participants: All public hospitals in Denmark were invited.

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy.

Health effectiveness and cost-effectiveness of telehealthcare for heart failure: study protocol for a randomized controlled trial.

Background: Several heart failure studies have shown promising results for implementing telehealthcare. These studies have led to clinical and political interest in telehealthcare as a way to improve heart failure outcomes and lower costs. However, there is a need for large-scale clinical trials with cost-effectiveness assessments.

Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease.

Objectives: To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD).

Methods: The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months of follow-up. A total of 150 patients with COPD were randomised into two groups receiving usual care and case management in addition to usual care.

A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial.

Background: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care.

Subjects with osteoporosis to remain at high risk for fracture despite benefit of prior bisphosphonate treatment-a Danish case-control study.

Unlabelled: The benefits of pharmaceutical treatment for osteoporosis may be limited for a number of patients, as they continue to experience fractures. Alternative treatments may be considered for subjects whom remain at high risk for future fractures.

Introduction: Previous studies have investigated the effects of good adherence to anti-osteoporosis medication.

Systematic review of the cost-effectiveness of implementing guidelines on low back pain management in primary care: is transferability to other countries possible?

Objective: The primary aim is to identify, summarise and quality assess the available literature on the cost-effectiveness of implementing low back pain guidelines in primary care. The secondary aim is to assess the transferability of the results to determine whether the identified studies can be included in a comparison with a Danish implementation study to establish which strategy procures most value for money.

Design: Systematic review.

Catalog of 199 register-based definitions of chronic conditions.

Introduction: The aim of the current study was to present and discuss a broad range of register-based definitions of chronic conditions for use in register research, as well as the challenges and pitfalls when defining chronic conditions by the use of registers.

Materials And Methods: The definitions were defined based on information from nationwide Danish public healthcare registers. Medical and epidemiological specialists identified and grouped relevant diagnosis codes that covered chronic conditions, using the International Classification System version 10 (ICD-10).

Cost Effectiveness of Protease Inhibitor Monotherapy Versus Standard Triple Therapy in the Long-Term Management of HIV Patients: Analysis Using Evidence from the PIVOT Trial.

Background: Protease inhibitor (PI) monotherapy can maintain virological suppression in the majority of patients once it has been established on triple therapy and may also have the potential for substantial cost savings arising from the use of fewer drugs. However, the cost effectiveness of PI monotherapy has yet to be demonstrated.

Objectives: In this study we examine the cost effectiveness of PI monotherapy with prompt return to combination therapy in the event of viral load rebound compared with ongoing triple therapy (OT) in patients with suppressed viral load on combination antiretroviral therapy (ART) in the UK.

Effect of Anticoagulation on Hospitalization Costs After Intracranial Hemorrhage in Atrial Fibrillation: A Registry Study.

Background And Purpose: Intracranial hemorrhage (ICH) is the most feared adverse event with oral anticoagulant therapy in patients with atrial fibrillation. The health economic aspects of resuming oral anticoagulant therapy after ICH are unknown. The aim was to estimate hospitalization costs of thromboembolism and hemorrhage subsequent to ICH in 2 patient groups with atrial fibrillation surviving the first 90 days post ICH: (1) patients resuming warfarin therapy within 90 days post ICH and (2) patients discontinuing therapy.

Interaction between functional health literacy and telehomecare: Short-term effects from a randomized trial.

This study was conducted as part of a randomized, controlled trial, and explored whether the introduction of a Danish telehomecare intervention, referred to as 'the Telekit', and its associated educational components affect functional health literacy. The study sample consisted of 60 chronic obstructive pulmonary disease patients in the intervention group who received the Telekit, and 56 in the control group; all participants were collected from the large-scale, randomized TeleCare North trial by consecutive sampling. To avoid recall bias, the design did not include a baseline measurement, comparing instead the post-intervention measurements between the intervention and control groups.

Adjustment of foreign EQ-5D-3L utilities can increase their transferability.

Background: Foreign utilities of the EQ-5D-3L (3-level version of the EuroQol-5 Dimension of health questionnaire) are not readily transferrable to economic evaluations conducted from a national perspective. It has been advised to avoid transferring mean utilities from one country to another without adjusting them; yet no such method exists.

Purpose: The present study aimed to develop a method for adjusting mean utilities to increase their transferability from one country to another.

The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS).

Introduction: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a common, severe condition affecting 0.2 to 0.4 per cent of the population.

A Health Economic Evaluation of Stroke Prevention in Atrial Fibrillation: Guideline Adherence Versus the Observed Treatment Strategy Prior to 2012 in Denmark.

Background: In 2012 the European Society of Cardiology (ESC) published new guidelines on pharmacological stroke prophylaxis in non-valvular atrial fibrillation (AF). The health economics of adhering to these guidelines in clinical practice remains to be elucidated.

Objective: This paper offers a health economic evaluation of two stroke-prophylactic treatment strategies: complete national adherence to the ESC guidelines on stroke prophylaxis in AF versus stroke-prophylactic treatment prior to 2012 in Denmark.

Validation of the Test of Functional Health Literacy in Adults in a Danish population.

Objective: To describe how the original American full-length version of the Test of Functional Health Literacy in Adults (TOFHLA) was translated and adapted for use in the Danish setting and culture. A reliable Danish version of the TOFHLA was created and pretested using patients diagnosed with chronic obstructive pulmonary disease (COPD) as case group.

Methods: Forty-two patients with COPD completed the Danish TOFHLA and participated in a face-to-face interview concerning their basic demographics.

Cost-consequence analysis of cause of death investigation in Finland and in Denmark.

The 1990s 12-16% total autopsy rate in Denmark has until now declined to 4%, while in Finland, it has remained between 25 and 30%. The decision to proceed with a forensic autopsy is based on national legislation, but it can be assumed that the financing of autopsies influences the decision process. Only little is known about the possible differences between health economics of Finnish and Danish cause of death investigation systems.

Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes.

Background: A run chart is a line graph of a measure plotted over time with the median as a horizontal line. The main purpose of the run chart is to identify process improvement or degradation, which may be detected by statistical tests for non-random patterns in the data sequence.

Methods: We studied the sensitivity to shifts and linear drifts in simulated processes using the shift, crossings and trend rules for detecting non-random variation in run charts.

The development in body mass index, overweight and obesity in three regions in Denmark.

Background: The prevalence of overweight and obesity has increased markedly the past decades. However, recent studies have indicated that the development differ between different socio-economic groups and different geographic regions. The aim of this study was to assess the development in prevalence of overweight and obesity from 2006/2007 to 2010 by age, gender, socio-economic factors and geographical regions.

Cost-effectiveness analysis of protease inhibitor monotherapy vs. ongoing triple-therapy in the long-term management of HIV patients.

Introduction: Protease inhibitors might be sufficient to maintain complete virological suppression when used as monotherapy for HIV-1-positive patients who have achieved sustained virological suppression on combination antiretroviral therapy (ART). The present study estimated the cost-effectiveness of a strategy of switching the ART to protease inhibitor monotherapy (PIM) with prompt return to combination therapy in the event of viral load rebound compared to continuing the ongoing triple-therapy (OTT) in the long-term management of HIV-1-positive patients.

Materials And Methods: A within-trial cost-effectiveness analysis and modelling of lifetime cost-effectiveness was performed based on a randomized controlled trial of Protease Inhibitor monotherapy Versus Ongoing Triple-therapy (PIVOT).

Study protocol of an economic evaluation of an extended implementation strategy for the treatment of low back pain in general practice: a cluster randomised controlled trial.

Background: In Denmark, guidelines on low back pain management are currently being implemented; in association with this, a clinical trial is conducted. A health economic evaluation is carried out alongside the clinical trial to assess the cost-effectiveness of an extended implementation strategy to increase the general practitioners' adherence to the guidelines. In addition to usual dissemination, the extended implementation strategy is composed of visits from a guideline facilitator, stratification tools, and feedback on guideline adherence.

Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective.

Summary: Fractures after the age of 50 are frequently observed in Denmark, and many of these may be osteoporotic. This study examined the incidence of all and subsequent fractures in a 10-year period from 2001 to 2011. The incidence of subsequent fractures was high, especially following hip fracture.

In Denmark kidney transplantation is more cost-effective than dialysis.

Introduction: Approximately 5,000 Danish patients are being treated for end-stage renal disease, for which the two treatment options are dialysis and transplantation. The objective of this study was to estimate the cost-effectiveness of kidney transplantation versus dialysis from a public health-care perspective.

Material And Methods: A cost-utility analysis was conducted using a decision analytic model.

Estimation of utility values from visual analog scale measures of health in patients undergoing cardiac surgery.

Introduction: In health economic evaluations, mapping can be used to estimate utility values from other health outcomes in order to calculate quality adjusted life-years. Currently, no methods exist to map visual analog scale (VAS) scores to utility values. This study aimed to develop and propose a statistical algorithm for mapping five dimensions of health, measured on VASs, to utility scores in patients suffering from cardiovascular disease.

Health economic evaluation of single-lead atrial pacing vs. dual-chamber pacing in sick sinus syndrome.

Aims: The recent Danish Multicentre Randomized Trial on Single-Lead Atrial (AAIR) Pacing versus Dual-Chamber (DDDR) Pacing in Sick Sinus Syndrome (DANPACE) suggested DDDR pacing as standard care. However, previous findings supported the routine use of AAIR pacing. This study investigated the cost-effectiveness of DDDR pacing compared with AAIR pacing for sick sinus syndrome.

Patient related outcomes in a real life prospective follow up study: Allergen immunotherapy increase quality of life and reduce sick days.

Background: One fourth of the adult population in Europe suffer from respiratory allergy. Subcutaneous-allergen-specific-immunotherapy (SCIT) has long-term disease modifying effect on disease specific Health-Related Quality of Life (HRQoL). The purpose of this study was to assess the effect of SCIT on alternative disease outcomes in patients with grass-pollen and/or house dust mite induced allergic rhino-conjunctivitis and/or an asthma diagnosis.