Abstract：
:Suspected myocardial infarction (MI) is a common reason for emergency hospital attendance and admission. Cardiac biomarker measurement is an essential element of diagnostic assessment of suspected MI. Although the cost of a routinely available biomarker may be small, the large patient population and consequences in terms of hospital admission and investigation mean that the economic impact of cardiac biomarker testing is substantial. Economic evaluation involves comparing the estimated costs and effectiveness (outcomes) of two or more interventions or care alternatives. This process creates some difficulties with respect to cardiac biomarkers. Estimating the effectiveness of cardiac biomarkers involves identifying how they help to improve health and how we can measure this improvement. Comparison to an appropriate alternative is also problematic. New biomarkers may be promoted on the basis of reducing hospital admission or length of stay, but hospital admission for low risk patients may incur significant costs while providing very little benefit, making it an inappropriate comparator. Finally, economic evaluation may conclude that a more sensitive biomarker strategy is more effective but, by detecting and treating more cases, is also more expensive. In these circumstances it is unclear whether we should use the more effective or the cheaper option. This article provides an introduction to health economics and addresses the specific issues relevant to cardiac biomarkers. It describes the key concepts relevant to economic evaluation of cardiac biomarkers in suspected MI and highlights key areas of uncertainty and controversy.
journal_name
Clin Biochemjournal_title
Clinical biochemistryauthors
Goodacre S,Thokala Pdoi
10.1016/j.clinbiochem.2014.08.012subject
Has Abstractpub_date
2015-03-01 00:00:00pages
213-7issue
4-5eissn
0009-9120issn
1873-2933pii
S0009-9120(14)00647-Xjournal_volume
48pub_type
杂志文章,评审abstract：OBJECTIVES:Matrix-assisted laser desorption time-of flight ionization (MALDI)-imaging MS (IMS) with MSMS analysis using on-tissue tryptic digests is a powerful tool for identification of disease-related proteins in formalin-fixed paraffin-embedded (FFPE) tissue sections. We applied this novel IMS technique, not only to...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2013.05.063
更新日期：2013-10-01 00:00:00
abstract：OBJECTIVES:BNP and NT-proBNP are viewed as comparable in their ability to diagnose and monitor HF in clinical guidelines. However, no recent large-scale study has directly established diagnostic concordance between BNP and NT-proBNP. This study sought to assess diagnostic concordance of BNP and NT-proBNP for ruling in ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2018.07.002
更新日期：2018-09-01 00:00:00
abstract：:Fluoride is a potent therapeutic agent that increases spinal bone density in osteoporotic subjects. Based on work with animal cells previously, we proposed fluoride acts by inhibiting phosphotyrosyl protein phosphatase (EC 3.1.3.48) activity in bone cells. The presence of fluoride sensitive acid phosphatase (EC 3.1.3....
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/0009-9120(92)80045-i
更新日期：1992-02-01 00:00:00
abstract：OBJECTIVES:Oxidative stress has a clear pro tumoral effect in myeloproliferative neoplasms (MPDs). In this study, we analyzed oxidative stress in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Design and methods We analyzed serum levels of advanced oxidation protein products (AOPPs) degradatio...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2012.07.100
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Determination of metanephrine (MN), normetanephrine (NMN), and 3-methoxytyramine (3-MT) in saliva may offer potential diagnostic advantages in diagnosing pheochromocytoma. METHODS:In this preliminary study, we determined metanephrine concentrations in saliva of healthy subjects and the relationship with sim...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2016.02.003
更新日期：2016-09-01 00:00:00
abstract：:Congestive heart failure usually features a mild to moderate increase in aspartate aminotransferase (AST) activity. A marked increase in AST may occur rarely and is usually preceded by prolonged shock or hypotensive episodes and is accompanied by hyperbilirubinemia. I report two patients with congestive heart failure ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(83)90366-1
更新日期：1983-04-01 00:00:00
abstract：OBJECTIVE:This study aimed at evaluating Elecsys free triiodothyronine (FT3) assay performed on an Elecsys 2010 system, while paying special attention to age relationship in euthyroid subjects. DESIGN AND METHODS:FT3 levels were measured in 149 euthyroid control subjects aged between 2 and 92 years old, 33 hyperthyroi...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(98)00024-1
更新日期：1998-07-01 00:00:00
abstract：OBJECTIVES:Recently it has been suggested that serum beta-N-acetylhexosaminidase (Hex) could be a joint destruction marker in rheumatoid arthritis (RA) patients. However, a large amount of serum Hex activity has its source from platelets, and the blood platelet-count is often increased in RA, which may have masked the ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(02)00339-9
更新日期：2002-09-01 00:00:00
abstract：:The biosynthesis of prostate specific antigen (PSA) was studied in human epidermoid carcinoma, (KB) cells and in normal human embryonic lung (WI-38)cells. The prostate carcinoma cell line, PC-35F12 was used as a control. PSA specific antibodies were used to precipitate the immunologically reactive peptides from cell e...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(01)00280-6
更新日期：2001-11-01 00:00:00
abstract：OBJECTIVES:To investigate the association of parental hyperhomocysteinemia, C677T Methylene tetrahydrofolate reductase (MTHFR) polymorphism and DNA damage with recurrent pregnancy loss (RPL). DESIGN AND METHODS:A case-control study. Reverse phase HPLC, PCR-RFLP and Cytokinesis blocked micronuclei assay were used to as...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2008.12.003
更新日期：2009-03-01 00:00:00
abstract：UNLABELLED:Frozen biospecimens are crucial for translational research and contain well-preserved nucleic acids and protein. However, the risks of freezer failure as well as space, cost, and environmental concerns of frozen biospecimens are substantial. OBJECTIVE:The purpose of the study was to review the current statu...
journal_title：Clinical biochemistry
pub_type： 杂志文章,评审
doi：10.1016/j.clinbiochem.2013.12.011
更新日期：2014-03-01 00:00:00
abstract：:Lipoprotein lipase (LPL) of adipose cells is present only in membrane compartments, mainly in the Golgi apparatus. LPL is a typical secretory protein which appears to be active as a homodimer. The process of LPL synthesis and maturation requires multiple steps. LPL is synthesized in the endoplasmic reticulum as an ina...
journal_title：Clinical biochemistry
pub_type： 杂志文章,评审
doi：10.1016/0009-9120(90)90034-r
更新日期：1990-10-01 00:00:00
abstract：OBJECTIVES:Bisphenol A (BPA) exposure may promote obesity, but its effect on bone mineral density (BMD) has not been reported in humans. We aimed to examine the relationships between BPA exposure, body composition, serum estradiol, leptin, osteocalcin levels and BMDs in healthy premenopausal women. DESIGN AND METHODS:...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2012.08.024
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVES:To study the usefulness of combined cardiac Troponin T (cTnT) and CK-MB mass determinations in risk stratification of acute coronary syndromes. DESIGN AND METHODS:Blood samples for cTnT and CK-MB mass were collected at arrival and 4, 8, and 12-24 later in 301 consecutive patients with recent acute chest pai...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2003.12.003
更新日期：2004-04-01 00:00:00
abstract：:Immunoturbidimetric assays for specific proteins are available on "open system" clinical chemistry analyzers. The analytical performance of nine immunoturbidimetric specific protein assays (C3, C4, CRP, Haptoglobin, IgA, IgG, IgM, RF, and Transferrin) was compared to immunonephelometry. Testing was performed on the Ab...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2009.06.016
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVES:To establish whether normal human subjects excrete glycine betaine at a constant rate. DESIGN AND METHODS:Urine was collected from ten normal healthy male subjects for 14 days, during which fluid intake was systematically varied from <800 mL to >3 L per day. Glycine betaine, sorbitol and creatinine excretio...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2006.10.029
更新日期：2007-04-01 00:00:00
abstract：:Preparation of (14C) Pro labeled protocollagen and requirements for its hydroxylation by PPH was investigated. Protocollagen can be prepared by centrifugation of the biological material at 15.000 X g. Substances in current use, viz catalase, bovine serum albumin and dithiothreitol were found unnecessary under the hydr...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(76)80072-0
更新日期：1976-12-01 00:00:00
abstract：OBJECTIVES:Superoxide dismutase (SOD) is a key antioxidant enzyme, responsible for scavenging of superoxide anion - a precursor of all reactive oxygen species (ROS). ROS are implicated in many pathologies, particularly in tumor disease. The aim of our work was to evaluate SOD isoforms' activity and protein level change...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2007.09.014
更新日期：2008-01-01 00:00:00
abstract：OBJECTIVE:To review biochemical literature and determine the significance of non-covalent bonding in plasma. RESULTS:Many non-covalent bonds exist in plasma. Relatively strong self-associations are found for serum albumin, several gamma-globulins, apolipoproteins and fibrin(ogen). Here, fibrinogen and fibrin, consider...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(96)00159-2
更新日期：1997-03-01 00:00:00
abstract：:We describe a patient who received intravenous dimethyl sulphoxide (DMSO) (as part of an experimental protocol) to control increased intracranial pressure. The patient died of a brain abscess. She developed extreme serum hyperosmolality from the DMSO with the osmolality peaking at 717 mosmol/kg. DMSO may induce extrem...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(83)90168-6
更新日期：1983-08-01 00:00:00
abstract：:We assessed the diagnostic value of four commercially available methods for determining pancreatic lipase (LPS) in serum (the turbidimetric procedure from Boehringer, two enzymatic approaches from Kodak and Poli, and an immunochemical assay) in a population of 46 hospitalized patients with acute abdominal pain. In 31 ...
journal_title：Clinical biochemistry
pub_type： 临床试验,杂志文章
doi：10.1016/s0009-9120(05)80009-8
更新日期：1991-12-01 00:00:00
abstract：BACKGROUND:Vitamin B12 insufficiency/deficiency is common in mixed patient populations. However there is no single marker which can reliably diagnose B12 insufficiency/deficiency. Elevated concentrations of methylmalonic acid (MMA) are considered the most representative marker of metabolic vitamin B12 insufficiency, bu...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2013.08.006
更新日期：2014-01-01 00:00:00
abstract：OBJECTIVES:Glycosylation analysis provides many opportunities for diagnostics, but its complexity hampers its routine application. Aiming to alleviate this problem, we developed a simple assay that can measure sialylation of transferrin directly from serum. DESIGN AND METHODS:Transferrin samples with different levels ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2007.01.010
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVES:Pediatric serum samples collected from healthy children in the CALIPER (Canadian Laboratory Initiative in Pediatric Reference Interval) project are stored at -80 °C for various periods of time. This study aimed to determine the stability of chemistry, protein, and hormone analytes under these conditions. DE...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2012.03.029
更新日期：2012-07-01 00:00:00
abstract：:1. A CK(BB) fraction was observed in sera of a patient with prostatic carcinoma. The fraction accounted for 59% of the total enzyme activity. A metastatic tumor of a prostatic carcinoma was observed to contain solely the CK(BB) isozyme. An embryonal testicular carcinoma was observed to have a higher percentage of the ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(78)90641-0
更新日期：1978-04-01 00:00:00
abstract：:Although a multitude of hepatitis B markers are available to discriminate different states of hepatitis B virus (HBV) infection, there remains a need to detect the HBV DNA itself. The HBV DNA test is the only test that can quantify the number of complete virions. As shown in this review, the diagnostic value of testin...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/0009-9120(93)90127-r
更新日期：1993-08-01 00:00:00
abstract：OBJECTIVES:To investigate the predictive value of cystatin C among patients diagnosed with non-ST-elevation acute coronary syndrome (nSTE-ACS). DESIGN AND METHODS:Admission serum samples from 245 nSTE-ACS patients were measured with a novel cystatin C immunoassay based on a dry-reagent, double monoclonal design. Creat...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2012.02.012
更新日期：2012-05-01 00:00:00
abstract：OBJECTIVE:We compared leukocyte counts obtained by cytometric analysis and Fuchs-Rosenthal (FR) chamber counting in different proportions of lymphocytes (Lym%) suspensions and cerebrospinal fluid (CSF). DESIGN AND METHODS:UF-100 (UF) was evaluated. For preparation of cell suspensions, gradient density centrifugation m...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2006.05.003
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND:In several studies, it was shown that there was a marked decrease in serum levels of HDL-C during infection and inflammation in general. In particular, a decrease in the level of serum HDL-C was also shown in pneumonia. Correlations between inflammatory markers such as acute phase proteins, cytokines and ser...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2006.01.015
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:To confirm that the naproxen metabolite O-desmethylnaproxen interferes with the Jendrassik and Grof method for total bilirubin and was a possible cause of spurious hyperbilirubinemia in a case of naproxen overdose. DESIGN AND METHODS:Plasma was spiked with naproxen or O-desmethylnaproxen before total and dir...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2008.09.119
更新日期：2009-01-01 00:00:00
