Recent data from the medical literature and other sources were used in an analysis of the cost-effectiveness of coronary artery bypass graft surgery (CABG) in symptomatic patients. Health effectiveness was expressed as the gain in quality-adjusted life expectancy, allowing for a range of subjective weights attached to symptomatic benefits. Costs included those of surgery, medical management of ...

BACKGROUND Treatment options for end-stage heart failure include inotrope-dependent medical therapy, orthotopic heart transplantation (OHT), left ventricular assist device (LVAD) as destination therapy or bridge to transplant. METHODS AND RESULTS We developed a state-transition model to simulate 4 treatment options and associated morbidity and mortality. Transition probabilities, costs, and u...

OBJECTIVES To investigate the long-term clinical and economic outcomes associated with exenatide versus insulin glargine as "add-on" treatments to oral therapy in individuals with Type 2 diabetes inadequately controlled with combination oral agents in the Swiss setting. METHODS A computer simulation model of diabetes was used to project complications, life expectancy, quality-adjusted life ex...

BACKGROUND Clozapine is currently restricted to patients who have failed at least two trials of other antipsychotic medications because of concerns that its use as a first-line agent would lead to greater mortality, mainly through agranulocytosis. AIMS OF THE STUDY We sought to determine the cost-effectiveness of allowing clozapine to be a first-line treatment versus the current policy of res...

We show how to use a bedside approximation of life expectancy in quantitative decision-making. This method, the declining exponential approximation of life expectancy (DEALE), enables the physician to collate various survival data with information on morbidity to determine a quality-adjusted expected survival for a potential management plan. The keystone in the DEALE approach is the approximati...

OBJECTIVES To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea. METHODS A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAs...

Objectives: To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea. Methods: A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAs...

BACKGROUND Genotypic antiretroviral resistance testing (GRT) in HIV infection with drug resistant virus is recommended to optimize antiretroviral therapy, in particular in patients with virological failure. We estimated the clinical effect, cost and cost-effectiveness of using GRT as compared to expert opinion in patients with antiretroviral treatment failure. METHODS We developed a mathemati...