H status is inherently a multiattribute construct. We examine multiattribute utility decompositions for the quality-adjusted life year (QALY) utility model commonly employed in medical decision and costeffectiveness analyses. We consider several independence conditions on preference, including the classical notions of preferential independence and utility independence, as well as new related no...

The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reducti...

AIMS The efficacy and safety of ticagrelor vs. clopidogrel in patients with acute coronary syndromes (ACS) are well documented in the PLATelet inhibition and patient Outcomes trial (PLATO). The aim of this study was to assess the long-term cost-effectiveness of treating ACS patients for 12 months with ticagrelor compared with generic clopidogrel. METHODS AND RESULTS Event rates, health-care c...

PURPOSE To identify the optimal strategy for staging the mediastinum of patients with known non-small-cell lung cancer (NSCLC), stratified by tumor (T) classification. METHODS We used a decision-analytic model to compare the health outcomes and cost-effectiveness of three staging strategies: (1) chest computed tomography alone, (2) selective mediastinoscopy, and (3) routine mediastinoscopy. T...

A cost-utility analysis was undertaken of enteral tube feeding (ETF) in patients with cerebrovascular accident (CVA). Mortality during ETF was established in nursing homes (n7007) or at home (n2888). Quality of life was measured (EuroQol) on a sub-sample (n25). Quality adjusted life years (QALYs) over 3 years and the cost/QALY were calculated. The cost/QALY (1 pound=1.482 euros; 30/06/05) for p...

The cost-effectiveness analysis of mass screening for Type 2 diabetes mellitus (DM) was performed to elucidate whether, who and how often it should be conducted in Taiwan. A series of Markov process was developed to model the disease natural history of Type 2 DM. A hypothetical cohort with 30,000 residents aged over 30 years in Taiwan was randomly assigned to three arms of screening regimes, bi...

BackgroundWith increasing health care expenditures, knowledge about the benefit and costs of surgical interventions such as total shoulder arthroplasty (TSA) becomes important for orthopedic surgeons, social insurance programs, policy decision makers. We examined impact TSA on quality life (QOL), direct medical costs, productivity losses evaluated cost-utility ratio compared with ongoing nonope...

BACKGROUND Health-state preferences can be combined with willingness-to-pay (WTP) data to calculate WTP per quality-adjusted life year (QALY). The WTP/QALY ratios provide insight into societal valuations of expenditures for medical interventions. METHODS The authors measured preferences for current health in 3 patient populations (N = 391) using standard gamble, time trade-off, visual analog ...

PURPOSE To perform a cost-utility analysis utilizing a cooperative group protocol and constrasting the results with the published quality adjusted survival. METHODS AND MATERIALS A cost-utility analysis was performed on Radiation Therapy Oncology Group (RTOG) protocol 83-02. The quality-adjusted survival has been published previously. Pretreatment tests and chemotherapy costs are not consider...

OBJECTIVE Continuous glucose monitoring (CGM) has been found to improve glucose control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard glucose monitoring in type 1 diabetes. RESEARCH DESIGN AND METHODS This societal cost-effectiveness analysis (CEA) was conducted in trial populations in which CGM has produced a significant glycemic benefit (A1C >or=7.0% ...