Abstract:
OBJECTIVE:To evaluate the cost utility of interferon beta-1b in secondary progressive multiple sclerosis. DESIGN:Population based cost utility model (healthcare perspective). Data on use of health services were obtained from case records and routine morbidity data and utility values from a EuroQol survey. Local and published costs were used. Effectiveness was modelled using data on relative risk reductions from a randomised trial of interferon beta-1b. SETTING:Tayside region, 1993-5. SUBJECTS:132 ambulatory people with secondary progressive multiple sclerosis. MAIN OUTCOME MEASURES:Cost per quality adjusted life year (QALY) gained. Rate of relapse and proportion becoming wheelchair dependent over three years. RESULTS:The number needed to treat for 30 months to delay time to wheelchair dependence in one person by nine months was 18 (95% confidence interval 5 to 26). For every 18 people treated for 30 months, six relapses would be prevented, gaining 0.397 discounted QALYs. The cost per QALY gained was 1 024 667 pounds sterling (276 466 pounds sterling to 485 499 pound sterling). If treatment was restricted to patients attending neurology services, the number needed to treat was 14 (cost per QALY gained 833 pounds sterling 514 (161 358 pounds sterling to infinity)). The cost per QALY gained was not sensitive to changes in cost which took account of a societal perspective. CONCLUSIONS:The cost per QALY gained from interferon beta is high because of the high drug cost and modest clinical effect. Resources could be used more efficiently elsewhere.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Forbes RB,Lees A,Waugh N,Swingler RJdoi
10.1136/bmj.319.7224.1529keywords:
subject
Has Abstractpub_date
1999-12-11 00:00:00pages
1529-33issue
7224eissn
0959-8138issn
1756-1833journal_volume
319pub_type
杂志文章abstract::National allocation of resources to regional health authorities and by them to districts is now determined by a weighted capitation formula. The national formula was derived from regression analysis, with hospital utilisation as an index of need for health care--a method which has fundamental limitations. This paper a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6881.835
更新日期:1993-03-27 00:00:00
abstract::Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant scree...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g2253
更新日期:2014-05-27 00:00:00
abstract::I have attempted to adopt the perspective of a patient--albeit one with a rather atypical background--to explore what I want from health research and researchers. This has left me with the impression that health researchers could serve the interests of the public more effectively in a variety of ways, and that they wo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6990.1315
更新日期:1995-05-20 00:00:00
abstract:OBJECTIVES:To identify the extent of HIV infection and injecting drug use among female streetworking prostitutes in Glasgow; to estimate the size of the female streetworking prostitute population in the city; and to estimate the number of HIV positive women working as prostitutes on the streets in Glasgow. DESIGN:Obse...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6857.801
更新日期:1992-10-03 00:00:00
abstract:OBJECTIVE:To determine whether the link suggested between growth in utero and during infancy and death from cardiovascular disease in men is also present in women. DESIGN:Follow up study of women and men whose birth weight and weight at 1 year of age had been recorded. SETTING:Hertfordshire, England. SUBJECTS:5585 w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6918.1519
更新日期:1993-12-11 00:00:00
abstract:OBJECTIVE:To describe the characteristics of patients using non-orthodox health care and their pattern of use of conventional health care with respect to a particular problem. DESIGN:Postal survey of all 2152 practitioners of acupuncture, chiropractic, homeopathy, naturopathy, and osteopathy identified from 11 nationa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6770.207
更新日期:1991-01-26 00:00:00
abstract:OBJECTIVE:To compare the rate of moderate to severe exacerbations between triple therapy and dual therapy or monotherapy in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES:PubMed, Embase, Cochrane databases, and clini...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k4388
更新日期:2018-11-06 00:00:00
abstract:OBJECTIVE:To assess relative efficacy and toxicity of aminoglycosides given by single daily dose compared with multiple daily doses. DESIGN:Meta-analysis of 21 randomised trials identified through MEDLARS (1966 to January 1995). Data were overviewed with fixed effects and random effects models and with meta-regression...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.312.7027.338
更新日期:1996-02-10 00:00:00
abstract:OBJECTIVE:To assess general practitioners' decisions to request lumbar spine radiographs according to the guidelines of the Royal College of Radiologists. DESIGN:Prospective questionnaire survey of outpatients attending for lumbar spine radiography. SETTING:London community hospital. SUBJECTS:100 consecutive adult o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6806.813
更新日期:1991-10-05 00:00:00
abstract:OBJECTIVE:To investigate the results of resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire. DESIGN:Study of all such attempts at resuscitation over 32 months, based on the standard report form for each call made by the ambulance staff and the electrocardiogram tha...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6752.600
更新日期:1990-09-22 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of dietary antioxidants in the primary prevention of age related macular degeneration (AMD). DESIGN:Systematic review and meta-analysis. DATA SOURCES:Search of seven databases without limits on year or language of publication, and retrieval of references in pertinent reviews an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39350.500428.47
更新日期:2007-10-13 00:00:00
abstract:OBJECTIVE: To measure the association between a surgeon's degree of specialization in a specific procedure and patient mortality. DESIGN: Retrospective analysis of Medicare data. SETTING: US patients aged 66 or older enrolled in traditional fee for service Medicare. PARTICIPANTS: 25 152 US surgeons who performed one...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i3571
更新日期:2016-07-21 00:00:00
abstract:OBJECTIVE:To examine period trends in the rate of suicide in the first 28 days after discharge from psychiatric hospital. DESIGN:Cohort study of patients discharged from psychiatric hospital. SETTING:Scotland. SUBJECTS:All patients aged 15-84 who were discharged from Scottish psychiatric hospitals during 1968 to 199...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7001.357
更新日期:1995-08-05 00:00:00
abstract:OBJECTIVE:To determine whether low dose aspirin protects women aged 65 or more against cognitive decline. DESIGN:Cohort study within both arms of the women's health study, a randomised, double blind, placebo controlled trial of low dose aspirin for the primary prevention of cardiovascular disease and cancer, 1992-5. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39166.597836.BE
更新日期:2007-05-12 00:00:00
abstract:OBJECTIVE:To examine variations in teenage pregnancy rates in Trent region and to determine possible associations with local general practice characteristics such as the age and sex of the doctors. DESIGN:Cross sectional survey. SETTING:All 826 general practices in Trent region in existence between 1994 and 1997. SU...
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pub_type: 杂志文章
doi:10.1136/bmj.320.7238.842
更新日期:2000-03-25 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of rectal artemether with intravenous quinine in the treatment of cerebral malaria in children. DESIGN:Randomised, single blind, clinical trial. SETTING:Acute care unit at Mulago Hospital, Uganda's national referral and teaching hospital in Kampala. PARTICIPANTS:103 child...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.330.7487.334
更新日期:2005-02-12 00:00:00
abstract:OBJECTIVE:To examine the predictors of long term outcome for patients with the chronic fatigue syndrome. DESIGN:Cohort study. SUBJECTS:139 subjects previously enrolled in two treatment trials; 103 (74%) were reassessed a mean of 3.2 years after start of the trials. SETTING:University hospital referral centre. MAIN ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6931.756
更新日期:1994-03-19 00:00:00
abstract:OBJECTIVE:To investigate estimation of calorie (energy) content of meals from fast food restaurants in adults, adolescents, and school age children. DESIGN:Cross sectional study of repeated visits to fast food restaurant chains. SETTING:89 fast food restaurants in four cities in New England, United States: McDonald's...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f2907
更新日期:2013-05-23 00:00:00
abstract:OBJECTIVE:To define the benefit of rice oral rehydration salts solution in relation to the glucose based World Health Organisation oral rehydration salts solution for treating and preventing dehydration in patients with severe dehydrating diarrhoea. DESIGN:Meta-analysis using data from 13 available randomised trials t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.304.6822.287
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN:Cross sectional. SETTING:Denmark. SUBJECTS:323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE:Bias in dietary reporting of energy and pr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7011.986
更新日期:1995-10-14 00:00:00
abstract::Objectives To estimate the short term effect of particulate air pollution (particle diameter <10 μm, or PM10) on mortality and explore the heterogeneity of particulate air pollution effects in major cities in China.Design Generalised linear models with different lag structures using time series data.Setting 38 of the ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j667
更新日期:2017-03-14 00:00:00
abstract:OBJECTIVES:To determine clinical correlates and outcome of hypoxaemia in children admitted to hospital with an acute lower respiratory tract infection. DESIGN:Prospective cohort study. SETTING:Paediatric wards of the Royal Victoria Hospital and the hospital of the Medical Research Council's hospital in Banjul, the Ga...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.318.7176.86
更新日期:1999-01-09 00:00:00
abstract::The aim of the study was to assess whether increased energy expenditure causes the negative energy balance (tissue catabolism) commonly seen in children with insulin dependent (type I) diabetes. Resting metabolic rate and thermogenesis induced by adrenaline were measured in five healthy children and 14 children with t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6697.487
更新日期:1989-08-19 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN:Matched cohort study. SETTING:Population based, electronic primary healthcare databases before 31 December 2015 from four European coun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l5367
更新日期:2019-10-08 00:00:00
abstract:OBJECTIVE:To determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis and transplantation) and conservative kidney management. DESIGN:International cross sectional survey. SETTING:International Society of Nephrology (ISN) survey of 182 cou...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l5873
更新日期:2019-10-31 00:00:00
abstract::Care in the community for insane people today is more a matter of expert provision than communal support. In consequence, although they are no longer confined to hospital, mentally ill people largely remain marginalised in a society that does not have the resources, nor often the inclination, to take responsibility fo...
journal_title:BMJ (Clinical research ed.)
pub_type: 历史文章,杂志文章
doi:10.1136/bmj.311.7021.1708
更新日期:1995-12-23 00:00:00
abstract:OBJECTIVES:To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index. DESIGN:Mendelian randomisation analysis, using variation at specific genes (SLC2A9 (rs7442295) as an instrument fo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f4262
更新日期:2013-07-18 00:00:00
abstract:OBJECTIVE:To systematically determine the impact of growth hormone therapy on adult height of children with idiopathic short stature. DESIGN:Systematic review. DATA SOURCES:Cochrane Central Register of Controlled Trials, Medline, and the bibliographic references from retrieved articles of randomised and non-randomise...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.c7157
更新日期:2011-03-11 00:00:00
abstract:OBJECTIVE:To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia. DESIGN:Population based case-control study. SETTING:Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.b2137
更新日期:2009-06-16 00:00:00
abstract:OBJECTIVE:To investigate the association between long term intake of dietary and supplemental calcium and death from all causes and cardiovascular disease. DESIGN:Prospective longitudinal cohort study. SETTING:Swedish mammography cohort, a population based cohort established in 1987-90. PARTICIPANTS:61 433 women (bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f228
更新日期:2013-02-12 00:00:00