Abstract:
OBJECTIVE:To compare the long-term economic impact of melanoma prevention by sun protection, with the corresponding impact of early detection of melanoma to decrease melanoma deaths. DESIGN:Cost-effectiveness analysis using Markov cohort model. Data were primarily from two population-based randomised controlled trials, epidemiological and costing reports, and included flow-on effects for keratinocyte cancers (previously non-melanoma skin cancers) and actinic keratoses. SETTING:Queensland, Australia. PARTICIPANTS:Men and women with a mean age 50 years modelled for 30 years. INTERVENTIONS:Daily sunscreen use (prevention) compared with annual clinical skin examinations (early detection) and comparing these in turn with the status quo. PRIMARY AND SECONDARY OUTCOMES:Costs, counts of melanoma, melanoma deaths, keratinocyte cancers, life years and quality-adjusted life years. RESULTS:Per 100 000 individuals, for early detection, primary prevention and without intervention, there were 2446, 1364 and 2419 new melanomas, 556, 341 and 567 melanoma deaths, 64 452, 47 682 and 64 659 keratinocyte cancers and £493.5, £386.4 and £406.1 million in economic costs, respectively. There were small differences between prevention and early detection in life years saved (0.09%) and quality-adjusted life years gained (0.10%). CONCLUSIONS:Compared with early detection of melanoma, systematic sunscreen use at a population level will prevent substantial numbers of new skin tumours, melanoma deaths and save healthcare costs. Primary prevention through daily use of sunscreen is a priority for investment in the control of melanoma.
journal_name
BMJ Openjournal_title
BMJ openauthors
Gordon L,Olsen C,Whiteman DC,Elliott TM,Janda M,Green Adoi
10.1136/bmjopen-2019-034388subject
Has Abstractpub_date
2020-02-26 00:00:00pages
e034388issue
2issn
2044-6055pii
bmjopen-2019-034388journal_volume
10pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:The aim is to explore the trends of hypertension incidence and regional variations in China from 1991 to 2015. DESIGN:A dynamic prospective cohort study. SETTING:China Health and Nutrition Survey 1991-2015. PARTICIPANTS:12 952 Chinese adults aged 18+ years. PRIMARY OUTCOME MEASURES:Incident hypertension f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-042053
更新日期:2021-01-13 00:00:00
abstract:INTRODUCTION:Emergency admission risk prediction models are increasingly used to identify patients, typically with one or more chronic conditions, for proactive management in primary care to avoid admissions, save costs and improve patient experience. AIM:To identify and review the published evidence on the costs, eff...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009653
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To determine the validity and reliability of the Spiritual Care Competency Scale (SCCS) among nurses in China. DESIGN:Methodological research. METHODS:After the SCCS was translated into Chinese, the validity and reliability of the Chinese version of the SCCS (C-SCCS) were evaluated using a convenience samp...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030497
更新日期:2019-10-10 00:00:00
abstract:OBJECTIVES:To examine if the estimated glomerular filtration rate (eGFR) slope over a 5-year period is related to incident cardiovascular (CV) events in the following 5 years. DESIGN:Retrospective cohort study. SETTING:Primary care. PARTICIPANTS:All patients aged ≥50 years with at least four eGFR measurements betwee...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023594
更新日期:2018-11-12 00:00:00
abstract:OBJECTIVES:Data linkage combines information from several clinical data sets. The authors examined whether coding inconsistencies for cardiovascular disease between components of linked data sets result in differences in apparent population characteristics. DESIGN:Retrospective cohort study. SETTING:Routine primary c...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000723
更新日期:2012-04-13 00:00:00
abstract:INTRODUCTION:The primary aim of the proposed study is to examine the efficacy of an 8-month supervised, high-intensity progressive resistance training and impact loading programme in comparison with a supervised machine-based isometric exercise training programme using the bioDensity system in older men with low bone m...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2016-014951
更新日期:2017-06-12 00:00:00
abstract:OBJECTIVES:Evidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:A representative s...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009476
更新日期:2015-12-29 00:00:00
abstract:PURPOSE:Limited published data exist on the clinical epidemiology of atrial fibrillation (AF) in South Asia including India. Most of the published data are from the Western countries and the Far East. The Kerala AF registry was initiated to collect systematic, prospective data on clinical characteristics, risk factors,...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025901
更新日期:2019-07-27 00:00:00
abstract:INTRODUCTION:The large number of treatment modalities for patients diagnosed with Menière's disease (MD) complicates the selection of the best available treatment as the comparative efficacy of these interventions is not clear. We aim to identify the treatment or treatments with the highest efficacy of current pharmaco...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010269
更新日期:2016-06-09 00:00:00
abstract:INTRODUCTION:Musculoskeletal deformities and gait deviations are common features in ambulatory cerebral palsy (CP). Deformity correction through lower limb orthopaedic surgery is the standard form of care aimed at improving or preserving motor function. Current research on CP care does not always take into account indi...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034744
更新日期:2020-03-04 00:00:00
abstract:BACKGROUND:Osteoporosis is an age-related disease with progressive loss of bone, leading to fragile bone. It is one of the major health issues in older adults and causes medical, social and economic impacts globally. Patients with osteoporosis have high risk of osteoporotic fractures. Low-magnitude high-frequency vibra...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038578
更新日期:2020-12-15 00:00:00
abstract:OBJECTIVES:To calculate the prevalence of disabling chronic pain (DCP) and to offer a more representative and accurate estimation by applying different calibration techniques. SETTINGS:2011 Andalusian Health Survey, a cross-sectional population survey based on face-to-face home interviews. PARTICIPANTS:6507 people ag...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014033
更新日期:2017-01-30 00:00:00
abstract:INTRODUCTION:There is no definitive cure for Dupuytren disease (DD), and recurrence of finger contractures after treatment is common. Surgical fasciectomy is considered the standard treatment method for recurrence, although associated with a high incidence of complications. Collagenase injection, a non-surgical treatme...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2018-024424
更新日期:2019-02-25 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of injection-based therapy in base of thumb osteoarthritis. DESIGN:Systematic review and meta-analysis. DATA SOURCES:MEDLINE and EMBASE via OVID, CINAHL and SPORTDiscus via EBSCO were searched from inception to 22 May 2018. STUDY SELECTION:Randomised controlled trials (RCTs) a...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-027507
更新日期:2019-09-11 00:00:00
abstract:INTRODUCTION:Paediatric systematic reviews differ from adult systematic reviews in several key aspects such as considerations of child tailored interventions, justifiable comparators, valid outcomes and child sensitive search strategies. Available guidelines, including PRISMA-P (2015) and PRISMA (2009), do not cover al...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010270
更新日期:2016-04-18 00:00:00
abstract:OBJECTIVES:Low-dose methoxyflurane is a non-opioid, inhaled analgesic administered via the Penthrox inhaler and was recently licensed in Europe for emergency relief of moderate-to-severe trauma-associated pain in conscious adults. This non-interventional study investigated occupational exposure to methoxyflurane in the...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034647
更新日期:2020-02-10 00:00:00
abstract:OBJECTIVE:To determine the housing situation among people seeking psychiatric treatment in relation to morbidity and service utilisation. DESIGN:Cross-sectional patient survey. SETTING:Psychiatric centre with a defined catchment area in Berlin, Germany, March-September 2016. PARTICIPANTS:540 psychiatric inpatients i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032576
更新日期:2019-12-29 00:00:00
abstract:OBJECTIVES:Conduct a feasibility study on the effect of menstrual hygiene on schoolgirls' school and health (reproductive/sexual) outcomes. DESIGN:3-arm single-site open cluster randomised controlled pilot study. SETTING:30 primary schools in rural western Kenya, within a Health and Demographic Surveillance System. ...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2016-013229
更新日期:2016-11-23 00:00:00
abstract:OBJECTIVES:The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents regarding incidence, indications for surgery, surgical methods and the age and gender distributions. SETTING:A retrospective longitudinal population-based cohort study based on regist...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013346
更新日期:2017-01-13 00:00:00
abstract:OBJECTIVES:Cardiovascular disease is an important comorbidity in patients with chronic obstructive pulmonary disease (COPD). We aimed to systematically review the evidence for: (1) risk of myocardial infarction (MI) in people with COPD; (2) risk of MI associated with acute exacerbation of COPD (AECOPD); (3) risk of dea...
journal_title:BMJ open
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmjopen-2015-007824
更新日期:2015-09-11 00:00:00
abstract:OBJECTIVES:To develop a scale to assess infectious disease-specific health literacy (IDSHL) in China and test its initial psychometric properties. METHODS:Item pooling, reduction and assessment of psychometric properties were conducted. The scale was divided into 2 subscales; subscale 1 assessed an individual's skills...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012039
更新日期:2016-08-05 00:00:00
abstract:OBJECTIVES:To introduce multilevel repeated measures (RM) models and compare them with multilevel difference-in-differences (DID) models in assessing the linear relationship between the length of the policy intervention period and healthcare outcomes (dose-response effect) for data from a stepped-wedge design with a hi...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013247
更新日期:2017-02-22 00:00:00
abstract:OBJECTIVES:The primary objective was to describe Ugandan schoolgirls' menstrual hygiene management (MHM) practices and estimate the prevalence of inadequate MHM. Second, to assess the relative contribution of aspects of MHM to health, education and psychosocial outcomes. DESIGN:Secondary analysis of survey data collec...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012596
更新日期:2016-12-30 00:00:00
abstract:INTRODUCTION:Corticosteroid injections (CSI) are a recommended and often-used first-line intervention for shoulder impingement syndrome (SIS) in primary care and orthopaedic settings. Manual physical therapy (MPT) offers a non-invasive approach with negligible risk for managing SIS. There is limited evidence to suggest...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000137
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To validate the performance of a set of risk prediction algorithms developed using the QResearch database, in an independent sample from general practices contributing to the Clinical Research Data Link (CPRD). SETTING:Prospective open cohort study using practices contributing to the CPRD database and pract...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005809
更新日期:2014-08-28 00:00:00
abstract:OBJECTIVE:In this study, we assess the performance of public hospitals in Saudi Arabia. We detect the sources of inefficiency and estimate the optimal levels of the resources that provide the current level of health services. We enrich our analysis by employing locations and capacities of the hospitals. DESIGN:We empl...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031924
更新日期:2020-01-12 00:00:00
abstract:OBJECTIVE:To investigate timely access to palliative medicines/drugs (PMs) from community pharmacies to inform palliative care service delivery. DESIGN:Mixed methods in two sequential phases: (1) prospective audit of prescriptions and concurrent survey of patients/representatives collecting PMs from pharmacy and (2) i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029016
更新日期:2019-11-24 00:00:00
abstract:INTRODUCTION:The association between long-chain omega-3 polyunsaturated fatty acids (PUFAs), brain health, cognitive function and mood has been the subject of intensive research. Marine-derived omega-3 PUFAs, such as docosahexaenoic acid and eicosapentaenoic acid, are highly concentrated in neuronal membranes and affec...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027167
更新日期:2019-06-22 00:00:00
abstract:INTRODUCTION:Women at high inherited risk of ovarian cancer are advised to undergo risk-reducing bilateral salpingo-oophorectomy (RRBSO) at age 40-45 years or when their families are complete. Most women are premenopausal at this age, so RRBSO will induce surgical menopause. Despite the clear benefits of RRBSO for canc...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-018758
更新日期:2017-11-14 00:00:00
abstract:OBJECTIVES:The research aimed to support the effectiveness and necessity of the communication training and methodology introduced in the postgraduate pharmacy training and community pharmacy practice in Hungary. DESIGN:Two cross-sectional questionnaire surveys before and after the introduction of a methodological reco...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039603
更新日期:2020-12-08 00:00:00