Abstract:
OBJECTIVE:Epilepsy surgery is one of the most effective treatments in modern medicine. Yet, it remains largely under-utilized, in spite of its proven efficacy. The referrals for epilepsy surgery are often delayed until it is too late to prevent the detrimental psychosocial effects of refractory seizures. The reluctance towards epilepsy surgery is influenced by the perceived risks of the procedure by practitioners and patients. This review discusses how, in general decision-making processes, one faces a natural tendency towards emphasizing the risks of the most immediate and operational decision (surgery), at times without contrasting these risks with the alternative (uncontrolled epilepsy). METHODS:In the field of economics, this bias is well recognized and can be overcome through marginal analysis, formally defined as focusing on incremental changes as opposed to absolute levels. RESULTS:Regarding epilepsy surgery, the risks and benefits of surgery are considered separately from the risks of uncontrolled epilepsy. For instance, even though surgery carries an ∼0.1-0.5% risk of perioperative mortality, the chance of sudden unexpected death with refractory epilepsy can be as high as 0.6-0.9% per year. It is suggested that the inadequate way of phrasing clinical questions can be a crucial contributing factor for the under-utilization of epilepsy surgery. SIGNIFICANCE:It is proposed that examining decision-making for epilepsy surgery in the context of marginal analysis may enable providers and patients to make more accurate informed decisions.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Edwards JC,Sobel RS,Bonilha Ldoi
10.1080/13696998.2017.1412975subject
Has Abstractpub_date
2018-05-01 00:00:00pages
438-442issue
5eissn
1369-6998issn
1941-837Xjournal_volume
21pub_type
杂志文章,评审abstract:OBJECTIVE:To compare the persistence and costs of brimonidine versus brinzolamide therapy according to data collected by the UK General Practitioner Research Database (GPRD). METHODS:Patients with diagnoses of ocular hypertension or glaucoma, or treated for glaucoma by surgery or laser therapy were identified. Selecte...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990802211107
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To estimate direct medical costs and resource use for commercially-insured patients within two pulmonary hypertension sub-groups: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). RESEARCH DESIGN AND METHODS:Using a retrospective cohort design, subjects (≥18 yea...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.665109
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the cost effectiveness (from a payer's perspective) of adding clostridial collagenase ointment (CCO) to selective debridement compared with selective debridement alone (non-CCO) in the treatment of stage IV pressure ulcers among patients identified from the US Wound ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1252381
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Growing financial pressure on US dialysis providers requires economic efficiency considerations. The objective of this study was to examine short-term economic efficiencies of a cinacalcet-based treatment approach for secondary hyperparathyroidism. METHODS:This study retrospectively assessed cost per bioche...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.3111/13696998.2013.826665
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:This study evaluated the overall burden of illness of chemotherapy-induced nausea and vomiting (CINV) and associated all-cause costs from a hospital's perspective (costs to the hospital) in patients with cancer treated with chemotherapy (CT) in the US hospital outpatient setting. METHODS:Patients with a canc...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.547237
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The ECHELON-1 trial demonstrated efficacy and safety of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline therapy for stage III/IV classical Hodgkin lymphoma. This analysis evaluated the cost-effectiveness o...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/13696998.2018.1542599
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:Non-severe nocturnal hypoglycemic events (NSNHEs) may have a major impact on patients. The objective was to determine how NSNHEs affect diabetes management, sleep quality, functioning, and to assess if these impacts differ by diabetes type or country. METHODS:An internet survey to adults with diabetes in th...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.624144
更新日期:2012-01-01 00:00:00
abstract:AIMS:Hormonal imbalances can affect a woman's physical and mental condition, impacting her daily life and productivity. A mobile application, "Karada-no-kimochi", predicts the menstrual cycle based on recorded data, and provides the information regarding menstruation. This study investigates the effectiveness of the ap...
journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
doi:10.1080/13696998.2018.1515082
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To assess patient characteristics, treatment patterns, and healthcare resource utilization (HRU)/costs of individuals treated for neuroendocrine tumors (NETs) in the US. METHODS:Using a US administrative claims database, this study identified commercially-insured adults newly diagnosed with carcinoid tumors ...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2014.975233
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Many countries have various requirements for local economic analyses to assess the value of a new health technology and/or to secure reimbursement. This study presents a case study of an economic model developed to assess the cost-effectiveness of posaconazole vs standard azole therapy (fluconazole/itraconaz...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.761633
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To investigate adherence to dornase alfa therapy among commercially-insured patients with cystic fibrosis (CF) and to examine the impact of adherence on health and economic outcomes. METHODS:This retrospective cohort analysis included CF patients with ≥1 dornase alfa (Pulmozyme) pharmacy claim between 1 Octo...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2013.787427
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:The spectrum of diseases caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) represents a large burden on healthcare systems around the world. Meningitis, bacteraemia, community-acquired pneumonia (CAP), and acute otitis media (AOM) are vaccine-preventable infectious diseases tha...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.622323
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To compare outcomes between patients with type 2 diabetes mellitus (T2DM) using fixed-dose combination (FDC) and loose-dose combination (LDC) products. METHODS:This retrospective cohort study used MarketScan Commercial and Medicare Supplemental data from January 1, 2009-December 31, 2013. The identified popu...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2015.1109518
更新日期:2016-01-01 00:00:00
abstract:AIM:Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. METHODS:This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy tri...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2016.1207653
更新日期:2016-12-01 00:00:00
abstract::Aims: This study aimed to examine the long-term clinical and economic burden of adults with congenital heart disease (ACHD) in Hong Kong. Methods: It retrospectively analyzed 336 consecutive ACHD patients who attended the Adult Congenital Heart Clinic between January 1, 2009 and December 31, 2014. Direct medical costs...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2019.1613239
更新日期:2019-08-01 00:00:00
abstract:AIMS:This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. MATERIALS AND METHODS:A questionnaire was developed to capture the demographics, disease characteristics, healthc...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2018.1427100
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To estimate the annualized differences in direct medical and indirect costs associated with improvement in fibromyalgia (FM) severity among pregabalin-treated patients. METHODS:Data from three clinical trials of pregabalin in patients with FM were modeled; efficacy results were extrapolated. Mean annual cost...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.727930
更新日期:2013-01-01 00:00:00
abstract:AIMS:Six Delta is a six-dimensional independent platform for outcome-based pricing/contracting. The six dimensions have been described separately: (δ1) cost-effectiveness analysis and cost-utility analysis-based pricing; (δ2) willingness-to-pay-based pricing; (δ3) reference-based pricing; (δ4) safety-based pricing; (δ5...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1815031
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:A new and smaller percutaneous ventricular assist device (pVAD, Impella, Abiomed, Danvers, MA) has been developed to provide circulatory support in hemodynamically unstable patients and to prevent hemodynamic collapse during high-risk percutaneous coronary interventions (PCI). The objective of the study was t...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.762004
更新日期:2013-01-01 00:00:00
abstract::Aims: Nocturia (getting up at night to urinate, where each urination being followed by sleep or intention to sleep) is a bothersome symptom with potentially negative consequences for individual health and daytime functioning. This study assessed the burden of nocturia in the workplace by investigating associations bet...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1767631
更新日期:2020-09-01 00:00:00
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journal_title:Journal of medical economics
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doi:10.1080/13696998.2018.1548355
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Abdominal paracentesis is commonly performed for diagnostic, therapeutic, and palliative indications, but the use of ultrasound guidance for these procedures is relatively recent, variable, and not well documented. A retrospective database analysis of abdominal paracentesis procedures was performed to determi...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.628723
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To critically evaluate published cost-effectiveness studies of novel drug products requiring less-frequent medication dosing compared to conventional formulations of the same drug substance. METHODS:A search was conducted in the Medline and Embase databases for cost-effectiveness studies published before May...
journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.3111/13696991003757500
更新日期:2010-01-01 00:00:00
abstract:AIMS:In this pharmacoeconomic simulation, we: (1) modeled the cost-efficiency of converting patients from reference pegfilgrastim to biosimilar pegfilgrastim-cbqv for prophylaxis of chemotherapy-induced (febrile) neutropenia (CIN/FN) from the US payer perspective, (2) simulated how savings enable, on a budget-neutral b...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1833339
更新日期:2020-10-24 00:00:00
abstract:AIMS:Fast-acting insulin analogues (FAIAs) reduce hypoglycaemia and improve administration flexibility compared with short-acting human insulin (SHI). This analysis examines whether these benefits translate into cost offsets when comparing the total treatment costs for FAIA versus SHI used as basal-bolus therapy for tr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.588892
更新日期:2011-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696991003652248
更新日期:2010-03-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1786392
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the economic burden of herpes zoster (HZ) on the US healthcare system among an immunocompetent population. METHODS:Claims data from the MarketScan Research databases for 2008-2011 were extracted to determine the incremental healthcare resource utilization (RU) and direct medical costs associated...
journal_title:Journal of medical economics
pub_type: 杂志文章
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更新日期:2016-10-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2010.499819
更新日期:2010-01-01 00:00:00
abstract::Objectives: Aging populations are contributing to an increased volume of osteoporotic fractures. The goals of this study were to (1) develop a scorecard on epidemiological burden, policy framework, service provision, and service uptake for osteoporosis in Saudi Arabia and (2) estimate the direct costs of managing oste...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.1080/13696998.2020.1737536
更新日期:2020-07-01 00:00:00