Abstract:
RATIONALE, AIMS AND OBJECTIVES:Second-generation antipsychotic agents have varying propensities to cause weight gain, elevated lipid levels and associated long-term complications. This study evaluates the cost-effectiveness of four second-generation antipsychotic agents used in Canada for the treatment of schizophrenia (ziprasidone, olanzapine, quetiapine, risperidone) with a focus on their long-term metabolic consequences. METHOD:Using data from the Clinical Antipsychotic Trials of Intervention Effectiveness Study, a semi-Markov model was developed to predict the incidence and associated costs of type 2 diabetes, cardiovascular complications (e.g. angina, myocardial infarction, stroke, cardiovascular disease death), and acute psychiatric hospitalizations in patients with chronic schizophrenia treated over 5 years. Incremental costs per quality-adjusted life year (QALY) gained were calculated from the perspective of the Canadian provincial ministries of health. Scenario and probabilistic sensitivity analyses were performed. RESULTS:The total average cost of treatment with ziprasidone was $25,301 versus $28,563 with olanzapine, $26,233 with quetiapine and $21,831 with risperidone. Ziprasidone had the lowest predicted number of type 2 diabetes cases and cardiovascular disease events, and the highest QALY gains. Patients receiving quetiapine had the highest predicted number of hospitalizations. Ziprasidone was less costly and resulted in more QALYs compared with olanzapine and quetiapine. Compared with risperidone, ziprasidone was more costly and had higher QALYs, with an incremental cost per QALY gained of $218,060. CONCLUSION:Compared with olanzapine and quetiapine, ziprasidone produced savings to the health care system. Although ziprasidone generated incremental expenditures versus risperidone, it resulted in more QALYs. Based on this analysis, ziprasidone treatment possesses cost and therapeutic advantages compared with olanzapine and quetiapine.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
McIntyre RS,Cragin L,Sorensen S,Naci H,Baker T,Roussy JPdoi
10.1111/j.1365-2753.2009.01189.xsubject
Has Abstractpub_date
2010-08-01 00:00:00pages
744-55issue
4eissn
1356-1294issn
1365-2753pii
JEP1189journal_volume
16pub_type
杂志文章abstract:RATIONALE, AIMS AND OBJECTIVES:Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners' (GPs) provision of services to patients. The aim of this study was to investigate the association of experiences of violence and percepti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00864.x
更新日期:2008-04-01 00:00:00
abstract::Randomized trials are undoubtedly different from observational studies, but authors sometimes propose differences between these designs that do not exist. In this article we examine two claims about randomized trials: first, a recent claim that the causal structure of exposure measurement (information) bias in a rando...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01347.x
更新日期:2009-12-01 00:00:00
abstract::Health management programmes are generally evaluated as point treatment studies in which only a baseline and outcome measurement are used in the analysis, even when multiple observations for each individual are available. By summarizing observations into two distinct measurements the evaluator loses any ability to dis...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01361.x
更新日期:2010-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Traditional continuing medical education programmes that offer passive learning have been shown to be poorly effective at changing doctors' clinical behaviour. A multifaceted evidence-based medicine (EBM) intervention was conducted at the largest health maintenance organization (HMO) in I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00859.x
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative sympto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00920.x
更新日期:2008-08-01 00:00:00
abstract::This article draws attention to an absurd feature of contemporary political life that significantly affects health service policy and calls for an urgent explanation. Policies are formed by a process that privileges rhetoric over reality, producing policies that are conceptualized at a later date. Two influential arti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00361.x
更新日期:2002-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To evaluate the variation in prescribing by primary care doctors during the morning and the evening clinics and to determine whether these prescribing patterns are influenced by doctors' training background. METHODS:A retrospective prescription-based study was carried out in 17 out of 20...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00642.x
更新日期:2007-02-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Focusing on the implementation of clinical practice guidelines (CPGs) for the management of adult cancers, the objectives of this study were to (a) describe the intrinsic elements known to influence CPG use; (b) identify the ways in which CPGs are implemented; and (c) explore how CPG cha...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13073
更新日期:2019-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Knowledge in evidence-based medicine (EBM) is increasingly becoming a core competence in medical education. We evaluated the trainee doctors' attitudes and knowledge of EBM to obtain the basis required for developing appropriate teaching and learning opportunities. METHODS:Trainee physic...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01073.x
更新日期:2008-10-01 00:00:00
abstract::The difference between the pth quantiles of 2 survival functions can be used to compare patients' survival between 2 therapies. Setting p = 0.5 yields the median survival time difference. Varying p between 0 and 1 defines the quantile survival time difference curve which can be straightforwardly estimated by the horiz...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12948
更新日期:2018-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Health-care professions have long been considered prone to work-related stress, yet recent research in Bulgaria indicates alarmingly high levels of burnout. Cloninger's inventory is used to analyse and evaluate correlation between personality characteristics and degree of burnout syndrome...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01895.x
更新日期:2012-12-01 00:00:00
abstract::A system approach termed P4 medicine has recently been proposed in the field of oncology. This approach has been advanced as an extension of what is usually called 'personalized' or 'genomic medicine'. P4 medicine creates effective predictive, personalized, preventive and participatory models to treat patients. In ord...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01709.x
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:The patient-centred medical home (PCMH) is an important part of health care reform. While there is hope, the PCMH model can facilitate the provision of higher quality care, the extent to which organizational climate within the PCMH supports the implementation of evidence-based practices (EBPs) is unknown. ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13050
更新日期:2019-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) for knee osteoarthritis (OA) guide the provision of high-quality healthcare for people with knee OA, which may improve outcomes. Our aim was to evaluate the quality of and content within recently published CPGs for people with knee OA. METHODS:CPGs (2...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13391
更新日期:2020-03-26 00:00:00
abstract:OBJECTIVE:To use structured implicit review following large-scale explicit audit of antipsychotic polyprescribing to: (1) determine the true rate of antipsychotic polytherapy that deviated from best practice for schizophrenia treatment; and (2) assess whether explicit antipsychotic polytherapy criterion was appropriate...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01084.x
更新日期:2009-08-01 00:00:00
abstract::According to Sackett, evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. In this article, clinical reasoning is depicted as multilayered processes of evidence construction by means of social interaction and hum...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00353.x
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilizati...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01277.x
更新日期:2010-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:In the UK fewer than 15% of familial hypercholesterolemia (FH) cases are diagnosed, representing a major gap in coronary heart disease prevention. We wished to support primary care doctors within the Medway Clinical Commissioning Group (CCG) to implement NICE guidance (CG71) and consider ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12481
更新日期:2016-06-01 00:00:00
abstract:RATIONALE:Nurses' work is inextricably linked to the evaluation of the quality of care provision in health care. Within this evaluation, individualized care is a topical theme in western countries. Currently, there is no suitable instrument to measure the level of individualized care from the nurses' point of view. AI...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2009.01168.x
更新日期:2010-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Appropriate indications for colonoscopy (C) are essential for a rational use of resources. The aim of this study is to evaluate the appropriateness of indication for C according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines and to evaluate whether appropriate us...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.00950.x
更新日期:2009-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferenc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01681.x
更新日期:2011-08-01 00:00:00
abstract::Cartwright and Munro argued that extrapolation of findings from randomized controlled trials to other settings can be difficult because information about the underlying causal structure and subgroups is often not available. They advocated the use of 'capacities' - that is fixed causal contributions - in predicting eff...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01909.x
更新日期:2012-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To evaluate asthma management and control in primary care clinics so as to design improvements based on guideline-directed outcomes. METHODS:In this study, all medical records of asthma-diagnosed patients (children as well as adults, entire lifespan, asthma-related visits or not) were re...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01803.x
更新日期:2013-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Heterogeneity is a critical issue in meta-analysis, because it implies the appropriateness of combining the collected studies and impacts the reliability of the synthesized results. The Q test is a traditional method to assess heterogeneity; however, because it does not have an intuitive...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13159
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 mo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01541.x
更新日期:2012-02-01 00:00:00
abstract:RATIONALE:Diagnostic reasoning is a critical aspect of clinical performance, having a high impact on quality and safety of care. Although diagnosis is fundamental in medicine, we still have a poor understanding of the factors that determine its course. According to traditional understanding, all information used in dia...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01771.x
更新日期:2012-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professiona...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01688.x
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:The study aims to obtain the mean relative weights (MRWs) of the cost of care through the retrospective application of the adjusted clinical groups (ACGs) in several primary health care (PHC) centres in Catalonia (Spain) in routine clinical practice. METHODS:This is a retrospective study based on computerize...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01818.x
更新日期:2013-04-01 00:00:00
abstract::It is common for primary care providers (PCPs) to manage complex multimorbidity. When caring for patients with multimorbidity, PCPs face challenges to tackle several issues within a short consultation in order to address patients' complex needs. Furthermore, some PCPs may lack access to a multidisciplinary team and ne...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13163
更新日期:2019-12-01 00:00:00
abstract:RATIONALE:In Canada, Aboriginal people, particularly First Nations experience significant health disparities and a lower health status compared with the non-Aboriginal population. AIMS AND OBJECTIVES:The purpose of this study was to examine the demographic and clinical characteristics of First Nations patients admitte...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12601
更新日期:2017-04-01 00:00:00