Abstract：
:Evaluating the incremental cost-effectiveness of a technology is critical to understanding the impact of its adoption. The purpose of this study was to evaluate, using a particular example, how the specific alternatives selected for a cost-effectiveness analysis may influence the results of the analysis. In this example, we analyzed the incremental cost-effectiveness of estriol screening for Down syndrome. Model assumptions of expected costs and effectiveness were based on previously published work involving four clinical strategies, including a "do nothing" (no screening) strategy. When the analysis started with all four strategies, two of the strategies could not be considered cost-effective because of extended dominance. However, when we eliminated the "do nothing" from the strategy set because of its clinical irrelevance, all three remaining strategies might be considered cost-effective from a policy perspective. We concluded that the incremental cost-effectiveness of clinical strategies could be strongly affected by the starting point for the analysis.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Cantor SB,Ganiats TGdoi
10.1016/s0895-4356(99)00021-9subject
Has Abstractpub_date
1999-06-01 00:00:00pages
517-22issue
6eissn
0895-4356issn
1878-5921pii
S0895-4356(99)00021-9journal_volume
52pub_type
杂志文章abstract：:The objective of this study was to identify characteristics of nonrespondents and late respondents in a population-based case-control study on lung cancer conducted in the city of Turin (Italy). Information about demographic and socioeconomic variables of 634 cases and 859 controls who responded to an interview, as we...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(02)00455-9
更新日期：2002-10-01 00:00:00
abstract：OBJECTIVE:Both randomized and observational studies commonly examine composite end points, but the literature on model development and criticism in this setting is limited. STUDY DESIGN AND SETTING:We examined approaches for evaluating heterogeneity in the effects of risk factors for different components of the end po...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2003.02.001
更新日期：2004-02-01 00:00:00
abstract：:Antiretroviral therapy (ART) use was examined in a cohort of homosexual men infected with HIV-1 for long periods. Multivariate logistic regression models, stratified by clinical indication (below and above 500 CD4 cells/microl or prior AIDS), were used to determine predictors of ART naivete. Of the 673 men seen at vis...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00274-2
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to analyze adequacy of judgments about risk of bias (RoB) for blinding of participants and personnel (performance bias) in Cochrane systematic reviews of randomized controlled trials (RCTs). STUDY DESIGN AND SETTING:We extracted judgments and supporting comments for performan...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.05.012
更新日期：2019-09-01 00:00:00
abstract：OBJECTIVES:To determine what criteria researchers use to assess whether the estimates of effect of an intervention on a dichotomous outcome are different when obtained using different study designs. STUDY DESIGN AND SETTING:Scoping review of the literature. We included studies of dichotomous outcomes in which authors ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.02.001
更新日期：2016-07-01 00:00:00
abstract：:The utility of ordinal logistic regression in the prediction of colorectal neoplasia was demonstrated in a group of 461 consecutive patients undergoing colonoscopy in a community practice. One hundred twenty-nine patients had adenomatous polyps and 34 had colorectal adenocarcinoma. An ordinal logistic regression model...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90159-7
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVES:To evaluate meta-analyses with trial sequential analysis (TSA). TSA adjusts for random error risk and provides the required number of participants (information size) in a meta-analysis. Meta-analyses not reaching information size are analyzed with trial sequential monitoring boundaries analogous to interim m...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2007.10.007
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:When contamination is present, randomization on a patient level leads to dilution of the treatment effect. The usual solution is to randomize on a cluster level, but at the cost of efficiency and more importantly, this may introduce selection bias. Furthermore, it may slow down recruitment in ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2005.10.003
更新日期：2006-04-01 00:00:00
abstract：:The present paper analyses the epidemiologic effects of mass breast cancer screening. Mass mammography may possibly achieve a breast cancer mortality reduction in relative risk terms. However, this does not necessarily represent a net benefit. It is argued that the benefits and adverse effects of a screening programme...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(90)90002-7
更新日期：1990-01-01 00:00:00
abstract：:Coronary heart disease (CHD) is an imprecise, inappropriate monitor of atherosclerosis severity and by inapplicable extrapolation CHD risk factors are incorrectly assumed to be causes of atherosclerosis. Taking into account (1) the misuse and substantial diagnostic error of CHD, (2) errors in determining the prevalenc...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(90)90231-d
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.05.014
更新日期：2007-02-01 00:00:00
abstract：:To identify characteristics of certifying physicians and the deceased that are associated with errors in death certificate completion in Taiwan, we retrospectively reviewed 4123 systematically sampled death certificates issued in 1994. Multivariate analyses were used to assess the associations of various characteristi...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00299-7
更新日期：2001-03-01 00:00:00
abstract：:Previous work has suggested that recall bias in case-control studies may be more serious when the overall study quality is lower. This paper summarizes a systematic literature search to examine the question. All relevant studies published between 1966 and 1990 were included if they met the following criteria: (1) they...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00132-a
更新日期：1995-02-01 00:00:00
abstract：:The objective of our study was to assess the applicability of using estimates of within-person variance (WPV) from reproducibility studies for a correction of blood pressure values in another study to improve the accuracy of the prevalence estimation of hypertension. Data were collected from two cross-sectional popula...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00228-6
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVES:Previous mathematical analyses of diagnostic tests based on the categorization of a continuous measure have found that test sensitivity and specificity varies significantly by disease prevalence. This study determined if the accuracy of diagnostic codes varied by disease prevalence. STUDY DESIGN AND SETTING...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.05.009
更新日期：2016-11-01 00:00:00
abstract：OBJECTIVE:In some publications, the terms "precision" and "accuracy" are used as if they were synonyms for "reliability" and "validity." METHODS AND RESULTS:This article shows that these terms are neither precise nor accurate when used in this way. Scales can demonstrate high test-retest or interrater reliability (i.e...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2005.09.005
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVES:To revise 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions in systematic reviews produced by the Evidence-based Practice Center (EPC) program, established by the US Agency for Healthcare Research and Quality (AH...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2014.11.023
更新日期：2015-11-01 00:00:00
abstract：:Formulas are derived for determination of the number of patients needed in a prospective comparison of survival curves, when the control group patients have already been followed for some period. Although an explicit formula for the required sample size is not available, the computing is straightforward, and tables of...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章
doi：10.1016/0895-4356(88)90025-x
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:Estimates of minimal clinically important improvements (MCIIs) are larger among patients with higher values at baseline, suggesting that these patients require larger changes to appreciate improvements. We examined if baseline dependency of MCIIs was associated with specific patients across three measures, or...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2013.10.025
更新日期：2014-06-01 00:00:00
abstract：:Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90009-x
更新日期：1991-01-01 00:00:00
abstract：:Both spontaneous reports and single outcome studies may distort the overall safety evaluation of drugs. We identified epidemiologic studies, published from January 1970 to December 1995, that investigated the association of serious adverse effects with aspirin, diclofenac, acetaminophen, and dipyrone to determine and ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(98)00076-6
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVES:In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. STUDY DESIGN AND SETTINGS:We focus on challenges with rating the confidence in effect estima...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2012.04.012
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVES:Findings from nonrandomized studies on safety or efficacy of treatment in patient subgroups may trigger postlaunch randomized clinical trials (RCTs). In the analysis of such RCTs, results from nonrandomized studies are typically ignored. This study explores the trade-off between bias and power of Bayesian RC...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2014.11.015
更新日期：2015-04-01 00:00:00
abstract：:A 110-item food frequency questionnaire was tested among 152 community controls of the Kuopio Breast Cancer Study. They completed the questionnaire twice and kept two 7-day diet records at 3-month intervals. The intraclass correlations for nutrients varied from 0.49 (thiamine with supplements) to 0.81 (lactose), and f...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(95)00551-x
更新日期：1996-04-01 00:00:00
abstract：:The degree of clinical agreement amongst different physicians on the presence or absence of generalized lymphadenopathy was assessed in 32 randomly selected participants from a prospective study of male sexual contacts of men with AIDS or an AIDS-related condition (ARC). Three physicians completed the same standard ex...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(88)90131-x
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:To demonstrate how decision analytic models (DAMs) can be used to quantify impact of using a (diagnostic or prognostic) prediction model in clinical practice and provide general guidance on how to perform such assessments. STUDY DESIGN AND SETTING:A DAM was developed to assess the impact of using the HEART s...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.07.010
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:To test unidimensionality and local independence of a set of shoulder functional status (SFS) items, develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (theta(IRT)...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2005.08.006
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:Regression discontinuity (RD) is a quasi-experimental design that may provide valid estimates of treatment effects in case of continuous outcomes. We aimed to evaluate validity and precision in the RD design for dichotomous outcomes. STUDY DESIGN AND SETTING:We performed validation studies in three large ran...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2018.02.015
更新日期：2018-06-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to develop an index derived from the Medication Appropriateness Index (MAI) items that is suited for clinical studies evaluating appropriateness of psychotropic drug use (PDU) for neuropsychiatric symptoms (NPS) in patients with dementia in nursing homes and to test its reliability ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.03.012
更新日期：2015-08-01 00:00:00
abstract：:Although case-crossover analyses have lately emerged as an alternative to case-control analyses in epidemiological studies, it is not yet known in which situations they give reliable conclusions. In this work, the case-crossover and the case-control designs were first compared on the basis of a dataset from a publishe...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(01)00404-8
更新日期：2001-12-01 00:00:00
