Abstract:
OBJECTIVES:To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). DESIGN:Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. SETTING:English NHS Cervical Cancer Screening Programme. INTERVENTIONS:Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. MAIN OUTCOME MEASURES:Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. RESULTS:Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost £358,222 (€440,426; $574,910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by £9388 per 1000 women treated. CONCLUSIONS:Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Legood R,Smith M,Lew JB,Walker R,Moss S,Kitchener H,Patnick J,Canfell Kdoi
10.1136/bmj.e7086subject
Has Abstractpub_date
2012-10-31 00:00:00pages
e7086eissn
0959-8138issn
1756-1833journal_volume
345pub_type
杂志文章abstract::The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.l4962
更新日期:2019-11-04 00:00:00
abstract::An association between vasectomy and the development of testicular tumors, and the importance of testicular examinations both before and after a vasectomy is discussed. Patients diagnosed with testicular tumors within the last ten years were examined at Bangour General Hospital in Scotland. From 1977-87, 37 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6721.370
更新日期:1990-02-10 00:00:00
abstract:OBJECTIVE:To assess the risk of epileptic seizures in people with and without epilepsy after vaccination with a monovalent AS03 adjuvanted pandemic A/H1N1 influenza vaccine (Pandemrix; Glaxo SmithKline, Sweden). DESIGN:Register based self controlled case series. SETTING:Three Swedish counties (source population 750,0...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e7594
更新日期:2012-12-18 00:00:00
abstract:OBJECTIVES:To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome. DESIGN:Historical cohort study. SETTING:UK district health authority (population 960,000). PART...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7414.526
更新日期:2003-09-06 00:00:00
abstract:OBJECTIVE:To assess the impact of construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission. DESIGN:Four quarterly cycles of malaria incidence surveys, each taking 30 days, undertaken in eight at risk communities close to dams...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7211.663
更新日期:1999-09-11 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
abstract:OBJECTIVE:To examine doctors' perspectives about their experiences with handheld computers in clinical practice. DESIGN:Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. SETTING:Six practice settings across the United States and two additional focus group sessi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.328.7449.1162
更新日期:2004-05-15 00:00:00
abstract::Accumulating data indicate that modifications in diet may reduce the risk of cancer by as much as one third and possibly by as much as two thirds. On the basis of the existing evidence, however, it is not possible to be certain which cancers are causally related to diet and what proportion of them are due to specific ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.308.6944.1610
更新日期:1994-06-18 00:00:00
abstract:OBJECTIVE:To investigate the risk of glioma in adults in relation to mobile phone use. DESIGN:Population based case-control study with collection of personal interview data. SETTING:Five areas of the United Kingdom. PARTICIPANTS:966 people aged 18 to 69 years diagnosed with a glioma from 1 December 2000 to 29 Februa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38720.687975.55
更新日期:2006-04-15 00:00:00
abstract:OBJECTIVES:To report on the country of training and ethnicity of consultants in different specialties in the NHS, on trends in intake to UK medical schools by ethnicity, and on the specialty choices made by UK medical graduates in different ethnic groups. DESIGN:Analysis of official databases of consultants and of stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38202.364271.BE
更新日期:2004-09-11 00:00:00
abstract:OBJECTIVE:To compare direct and indirect costs of day and inpatient treatment of acute psychiatric illness. DESIGN:Randomised controlled trial with outcome and costs assessed over 12 months after the date of admission. SETTING:Teaching hospital in an inner city area. SUBJECTS:179 patients with acute psychiatric illn...
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.314.7091.1381
更新日期:1997-05-10 00:00:00
abstract::Managed care has entered the lexicon of healthcare reform, but confusion and ignorance surround its meaning and purpose. It seeks to cut the costs of health care while maintaining its quality, but the evidence that it is able to achieve these aims is mixed. As well as raising awareness and understanding of the issues ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.314.7097.1823
更新日期:1997-06-21 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:OBJECTIVES:To compare the effectiveness of an early switch to oral antibiotics with the standard 7 day course of intravenous antibiotics in severe community acquired pneumonia. DESIGN:Multicentre randomised controlled trial. SETTING:Five teaching hospitals and 2 university medical centres in the Netherlands. PARTICI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38993.560984.BE
更新日期:2006-12-09 00:00:00
abstract:OBJECTIVE:To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. DESIGN:Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7097.1791
更新日期:1997-06-21 00:00:00
abstract:OBJECTIVE:To determine the contribution of inheritance to the incidence of squamous cell carcinoma of the head and neck. DESIGN:Historical cohort study. First degree relatives of cases with squamous cell carcinoma of the head and neck made up the exposed cohort and first degree relatives of spouses of cases made up th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7059.716
更新日期:1996-09-21 00:00:00
abstract:OBJECTIVE:To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays. DESIGN:Retrospective database study. SETTING:Palliative care unit in Germany. POPULATION:All admissions to palliative care unit between 1 January 1997 and 31 December 2008. MAIN OUTCOM...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7370
更新日期:2014-12-16 00:00:00
abstract:OBJECTIVE:To assess the associations between childhood and adulthood social class and insulin resistance. DESIGN:Cross sectional survey. SETTING:23 towns across England, Scotland, and Wales. PARTICIPANTS:4286 women aged 60-79 years. MAIN OUTCOME MEASURES:Insulin resistance and other cardiovascular disease risk fact...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7368.805
更新日期:2002-10-12 00:00:00
abstract:OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CR...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e7666
更新日期:2012-12-06 00:00:00
abstract::According to a London physician, women with epilepsy taking antiepileptic drugs can take combined oral contraceptives (OCs). It is usual to recommend a combined OC preparation containing at least 50 mcg of estrogen (Ovran) from patients taking enzyme-inducing antiepileptic drugs; this can be increased to 60 mcg by ta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.307.6902.492
更新日期:1993-08-21 00:00:00
abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract::Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in med...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6995.1663a
更新日期:1995-06-24 00:00:00
abstract:OBJECTIVES:To estimate the cost effectiveness of statins in lowering serum cholesterol concentration in people at varying risk of fatal cardiovascular disease and to explore the implications of changing the criteria for intervention on cost and cost effectiveness for a purchasing authority. DESIGN:A life table method ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7044.1443
更新日期:1996-06-08 00:00:00
abstract:OBJECTIVE:To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. DESIGN:Multicentre, three group, randomised, double blind, sham controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k2860
更新日期:2018-07-19 00:00:00
abstract::The opportunities for international public health collaboration through joint business ventures between the USSR and Western nations, an arrangement that would benefit the public, industry, and the medical community, are discussed. Evidence indicates that the state of health of the Soviet population is declining rapi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6777.633
更新日期:1991-03-16 00:00:00
abstract::The introduction in Britain of advance directives--which allow a person to state in advance of becoming incompetent that they wish to take part in treatment decisions when no longer mentally competent--has now been advocated by the medical and legal establishments. The practical application of directives relating to h...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6974.236
更新日期:1995-01-28 00:00:00
abstract:OBJECTIVE:To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN:10 year follow up study based on records of suicide attempters in 1980. SETTING:Poisoning treatment centre at a general hospital. SUBJECTS:974 patients aged 15...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6893.1637
更新日期:1993-06-19 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 potential effectiveness and efficiency of different guidelines for statin treatment to reduce deaths from coronary heart disease in the Canadian population. DESIGN:Modelled outcomes of screening and treatment recommendations of six national or international guidelines--from Canada, Australia, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38849.487546.DE
更新日期:2006-06-17 00:00:00
abstract:OBJECTIVE:To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN:Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelect...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6680.1061
更新日期:1989-04-22 00:00:00