Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study.

Background: In Zimbabwe, an estimated 500,000 people work in the sector of artisanal and small-scale gold mining (ASGM). Two million Zimbabweans are dependent on this sector. Using mercury is common to extract gold from ore.

Comparing the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners and the urban population in Zimbabwe using the EuroQol (EQ-5D-3L+C) questionnaire: a cross-sectional study.

Background: The role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Besides limited epidemiological data, no data about the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners exist. The aim of the project was to access HRQoL of ASGM workers to improve the data base and compare the data to the urban Zimbabwean population.

Recommendations for primary studies evaluating therapeutic medical devices were identified and systematically reported through reviewing existing guidance.

Objectives: The aim of the study was to review existing recommendations on study design, conduct, analysis, and reporting for primary studies of therapeutic medical devices (TMDs) and the closely related field of interventional procedures.

Study Design And Setting: We performed a targeted literature review of publications with recommendations for study design, conduct, analysis, and reporting for primary studies of TMDs and related technologies. We combined an electronic database search with a systematic screening of tables of content of selected journals and scanning the reference lists of relevant articles.

Ten recommendations for assessing the comparative effectiveness of therapeutic medical devices: a targeted review and adaptation.

Objectives: The aim of this study was to review existing guidance on the methods for evaluation of the comparative effectiveness (CE) of therapeutic medical devices (TMDs) and develop recommendations for systematic reviews (SRs) of CE of TMDs as part of health technology assessments.

Study Design And Setting: We performed a targeted literature review of evaluation frameworks and recommendations for evaluation methods for TMDs and related technologies. An electronic database search was combined with systematic screening of tables of content of selected journals and scanning the reference lists of relevant papers.

Five year trends (2008-2012) in cardiac implantable electrical device utilization in five European nations: a case study in cross-country comparisons using administrative databases.

Aims: Common methodologies for analysis of analogous data sets are needed for international comparisons of treatment and outcomes. This study tests using administrative hospital discharge (HD) databases in five European countries to investigate variation/trends in pacemaker (PM) and implantable cardioverter defibrillator (ICD) implant rates in terms of patient characteristics/management, device subtype, and initial implantation vs. replacement, and compares findings with existing literature and European Heart Rhythm Association (EHRA) reports.

A bias-adjusted evidence synthesis of RCT and observational data: the case of total hip replacement.

Evaluation of clinical effectiveness of medical devices differs in some aspects from the evaluation of pharmaceuticals. One of the main challenges identified is lack of robust evidence and a will to make use of experimental and observational studies (OSs) in quantitative evidence synthesis accounting for internal and external biases. Using a case study of total hip replacement to compare the risk of revision of cemented and uncemented implant fixation modalities, we pooled treatment effect estimates from OS and RCTs, and simplified existing methods for bias-adjusted evidence synthesis to enhance practical application.

Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey.

In artisanal small-scale gold mining, mercury is used for gold-extraction, putting miners and nearby residents at risk of chronic metallic mercury vapor intoxication (CMMVI). Burden of disease (BoD) analyses allow the estimation of the public health relevance of CMMVI, but until now there have been no specific CMMVI disability weights (DWs). The objective is to derive DWs for moderate and severe CMMVI.

Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma.

Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values.

A preliminary study on health effects in villagers exposed to mercury in a small-scale artisanal gold mining area in Indonesia.

Cisitu is a small-scale gold mining village in Indonesia. Mercury (Hg) is used to extract gold from ore, heavily polluting air, soil, fish and rice paddy fields with Hg. Rice in Cisitu is burdened with mercury.

Disease profile and health-related quality of life (HRQoL) using the EuroQol (EQ-5D + C) questionnaire for chronic metallic mercury vapor intoxication.

Background: Toxic mercury is still being used today for example by workers mining gold, resulting in diverse health symptoms in users and individuals in proximity. A considerable burden of disease (BoD) can be assumed, while previous analyses were limited by data scarcity. Besides limited epidemiological data, neither data about the health-related quality of life (HRQoL) nor about the disease severity (disability weight, DW) is available.

Systematic overview of cost-effectiveness thresholds in ten countries across four continents.

Aim: To provide an overview of thresholds for incremental cost-effectiveness ratios (ICERs) representing willingness-to-pay (WTP) across multiple countries and insights into exemptions pertaining to the ICER (e.g., cancer).

Viral hepatitis: Cost-effectiveness of direct-acting antivirals for chronic hepatitis C.

A new study has reported the long-term effectiveness and cost-effectiveness of the direct-acting antivirals telaprevir and boceprevir for the treatment of chronic hepatitis C. These findings have the potential to be used to guide clinical and reimbursement decisions for treating populations with a high prevalence of HCV infection.

Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

Objectives: The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI).

Cost-effectiveness of primary HPV screening for cervical cancer in Germany--a decision analysis.

Objectives: To systematically evaluate the long-term effectiveness and cost-effectiveness of HPV-based primary cervical cancer screening in the German health care context using a decision-analysis approach.

Methods: A Markov-model for HPV-infection and cervical cancer was developed for the German health care context, and applied to evaluate various screening strategies that differ by screening interval and test algorithms, including HPV-testing alone or in combination with cytology. German clinical, epidemiological, and economic data, and test accuracy data from international meta-analyses were used.

Risks in the application of medical devices: human factors in the medical environment.

Objective: The more complex a medical device is, the more difficult it is to control the hazards associated with its use. A substantial percentage of harm or injuries to patients resulting from treatment can be attributed to errors. No one knows exactly how many victims have been claimed by medical errors.

Health assessment of artisanal gold miners in Tanzania.

In 2003 UNIDO (United Nations Industrial Development Organization) conducted an environmental and health assessment in a small-scale mining area in Tanzania. BGS (British Geological Survey) performed the environmental assessment. The Institute of Forensic Medicine - University of Munich performed the health assessment.

Health assessment of artisanal gold miners in Indonesia.

Small scale miners use mercury to extract gold from ore in many countries. An environmental and health assessment was performed in Indonesia in two regions, Galangan in Central Kalimantan and Talawaan in Northern Sulawesi. The environmental assessment showed severe mercury contamination of the sediments, and increased mercury levels in local fish.