Screening for human T cell leukaemia/lymphoma virus among blood donors in Sweden: cost effectiveness analysis.

Abstract:

OBJECTIVE:To analyse the cost effectiveness of a national programme to screen blood donors for infection with the human T cell leukaemia/lymphoma virus. DESIGN:Three models for calculating the costs and benefits of screening were developed. The first model analysed the cost of continuously testing all donations; the second analysed the cost of initially testing new blood donors and then retesting them after five years; the third analysed the cost of testing donors only at the time of their first donation. Patients who had received blood components from donors confirmed to be infected with the virus were offered testing. SETTING:Sweden. MAIN OUTCOME MEASURES:Prevalence of infection with the virus among blood donors, the risk of transmission of the virus, screening costs, and the outcome of infection. RESULTS:648 497 donations were tested for the virus; 1625 samples tested positive by enzyme linked immunosorbent assay. 6 were confirmed positive by western blotting. The prevalence of infection with the virus was 2/100 000 donors. 35 patients who had received blood infected with the virus were tested; 3 were positive. The cost of testing every donation was calculated to be $3.02m (1.88m pounds); this is 18 times higher than the cost of testing new donors only, and only 1 additional positive donor would be discovered in 7 years. Regardless of the model used, screening was estimated to prevent only 1 death every 200 years at a minimum cost of $36m (22.5m pounds). CONCLUSION:Based on these estimates the Swedish National Board of Health and Welfare decided that only new blood donors would be screened for infection with the virus.

journal_name

BMJ

authors

Tynell E,Andersson S,Lithander E,Arneborn M,Blomberg J,Hansson HB,Krook A,Nomberg M,Ramstedt K,Shanwell A,Bjorkman A

doi

10.1136/bmj.316.7142.1417

subject

Has Abstract

pub_date

1998-05-09 00:00:00

pages

1417-22

issue

7142

eissn

0959-8138

issn

1756-1833

journal_volume

316

pub_type

杂志文章
  • Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme: randomised controlled trial.

    abstract:OBJECTIVE:To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. DESIGN:Prospective, operator blinded, randomised controlled trial. SETTING:General dental practice, London. PARTICIPANTS:100 adult smokers...

    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.38621.463900.7C

    authors: Barnfather KD,Cope GF,Chapple IL

    更新日期:2005-10-29 00:00:00

  • Effects of locality based community hospital care on independence in older people needing rehabilitation: randomised controlled trial.

    abstract:OBJECTIVE:To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. DESIGN:Randomised controlled trial. SETTING:Care in a community hospital and district general hospital in Bra...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38498.387569.8F

    authors: Green J,Young J,Forster A,Mallinder K,Bogle S,Lowson K,Small N

    更新日期:2005-08-06 00:00:00

  • Statin use and risk of community acquired pneumonia in older people: population based case-control study.

    abstract:OBJECTIVE:To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia. DESIGN:Population based case-control study. SETTING:Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.b2137

    authors: Dublin S,Jackson ML,Nelson JC,Weiss NS,Larson EB,Jackson LA

    更新日期:2009-06-16 00:00:00

  • Late mortality after sepsis: propensity matched cohort study.

    abstract:OBJECTIVES: To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN: Observational cohort study. SETTING: US Health and Retirement Study. PARTICIPANTS: 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage w...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i2375

    authors: Prescott HC,Osterholzer JJ,Langa KM,Angus DC,Iwashyna TJ

    更新日期:2016-05-17 00:00:00

  • Incidence of malaria among children living near dams in northern Ethiopia: community based incidence survey.

    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

    authors: Ghebreyesus TA,Haile M,Witten KH,Getachew A,Yohannes AM,Yohannes M,Teklehaimanot HD,Lindsay SW,Byass P

    更新日期:1999-09-11 00:00:00

  • Dogs that bite.

    abstract:OBJECTIVE:To study the circumstances of dog bites and identify risk factors. DESIGN:Postal questionnaire survey and case note review of victims of dog bites referred between 1982 and 1989. SETTING:One referral based regional plastic surgery unit. PATIENTS:146 consecutive patients referred for primary treatment of do...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.303.6816.1512

    authors: Shewell PC,Nancarrow JD

    更新日期:1991-12-14 00:00:00

  • Differences in incomes of physicians in the United States by race and sex: observational study.

    abstract:OBJECTIVES: To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices. DESIGN: Cross sectional survey study. SETTING: Nationally representative samples of US physicians. PARTICIPANTS: The 2000-13 American Community Survey (ACS...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i2923

    authors: Ly DP,Seabury SA,Jena AB

    更新日期:2016-06-07 00:00:00

  • Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management.

    abstract:OBJECTIVES:To describe the menstrual experience of women referred for menstrual problems, in particular menorrhagia (excessive menstrual loss), and to assess associations with reasons for referral given by their general practitioners, the women's understanding of the reasons for their attendance at the hospital clinics...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.323.7303.24

    authors: Warner P,Critchley HO,Lumsden MA,Campbell-Brown M,Douglas A,Murray G

    更新日期:2001-07-07 00:00:00

  • Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

    abstract:OBJECTIVE:To assess the risk of cerebral thromboembolism in women using low dose oral contraceptives. DESIGN:A retrospective case-control study. SETTING:All Danish medical, neurological, neurosurgical, and gynaecological departments. SUBJECTS:All 794 women in Denmark aged 15-44 who had suffered a cerebral thromboemb...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6883.956

    authors: Lidegaard O

    更新日期:1993-04-10 00:00:00

  • Safety and effectiveness of first line eflornithine for Trypanosoma brucei gambiense sleeping sickness in Sudan: cohort study.

    abstract:OBJECTIVE:To assess the safety and effectiveness of eflornithine as first line treatment for human African trypanosomiasis. DESIGN:Cohort study. SETTING:Control programme in Ibba, southern Sudan. PARTICIPANTS:1055 adults and children newly diagnosed with second stage disease in a 16 month period. MAIN OUTCOME MEASU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39485.592674.BE

    authors: Priotto G,Pinoges L,Fursa IB,Burke B,Nicolay N,Grillet G,Hewison C,Balasegaram M

    更新日期:2008-03-29 00:00:00

  • Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials.

    abstract:OBJECTIVE: To compare the effectiveness of flexible sigmoidoscopy in screening for colorectal cancer by patient sex and age. DESIGN: Pooled analysis of randomised trials (the US Prostate, Lung, Colorectal and Ovarian cancer screening trial (PLCO), the Italian Screening for Colon and Rectum trial (SCORE), and the Norwe...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.i6673

    authors: Holme Ø,Schoen RE,Senore C,Segnan N,Hoff G,Løberg M,Bretthauer M,Adami HO,Kalager M

    更新日期:2017-01-13 00:00:00

  • Social deprivation and prognostic benefits of cardiac surgery: observational study of 44 902 patients from five hospitals over 10 years.

    abstract:OBJECTIVE:To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. DESIGN:Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end points. SETTING:Birming...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b902

    authors: Pagano D,Freemantle N,Bridgewater B,Howell N,Ray D,Jackson M,Fabri BM,Au J,Keenan D,Kirkup B,Keogh BE,Quality and Outcomes Research Unit (QuORU) UHB Birmingham.,North West Quality Improvement Programme in Cardiac Interventions (U

    更新日期:2009-04-02 00:00:00

  • Cumulative funnel plots for the early detection of interoperator variation: retrospective database analysis of observed versus predicted results of percutaneous coronary intervention.

    abstract:OBJECTIVE:To use funnel plots and cumulative funnel plots to compare in-hospital outcome data for operators undertaking percutaneous coronary interventions with predicted results derived from a validated risk score to allow for early detection of variation in performance. DESIGN:Analysis of prospectively collected dat...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39512.529120.BE

    authors: Kunadian B,Dunning J,Roberts AP,Morley R,Twomey D,Hall JA,Sutton AG,Wright RA,Muir DF,de Belder MA

    更新日期:2008-04-26 00:00:00

  • Comparing health inequality in men and women: prospective study of mortality 1986-96.

    abstract:OBJECTIVES:To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7245.1303

    authors: Sacker A,Firth D,Fitzpatrick R,Lynch K,Bartley M

    更新日期:2000-05-13 00:00:00

  • Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis.

    abstract:OBJECTIVE:To investigate the association between treatment induced change in high density lipoprotein cholesterol and total death, coronary heart disease death, and coronary heart disease events (coronary heart disease death and non-fatal myocardial infarction) adjusted for changes in low density lipoprotein cholestero...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.b92

    authors: Briel M,Ferreira-Gonzalez I,You JJ,Karanicolas PJ,Akl EA,Wu P,Blechacz B,Bassler D,Wei X,Sharman A,Whitt I,Alves da Silva S,Khalid Z,Nordmann AJ,Zhou Q,Walter SD,Vale N,Bhatnagar N,O'Regan C,Mills EJ,Bucher HC,M

    更新日期:2009-02-16 00:00:00

  • Testing for Helicobacter pylori in dyspeptic patients suspected of peptic ulcer disease in primary care: cross sectional study.

    abstract:OBJECTIVES:To develop an easily applicable diagnostic scoring method to determine the presence of peptic ulcers in dyspeptic patients in a primary care setting; to evaluate whether Helicobacter pylori testing adds value to history taking. DESIGN:Cross sectional study. SETTING:General practitioners' offices in the Utr...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.323.7304.71

    authors: Weijnen CF,Numans ME,de Wit NJ,Smout AJ,Moons KG,Verheij TJ,Hoes AW

    更新日期:2001-07-14 00:00:00

  • Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials.

    abstract:OBJECTIVE:To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. DESIGN:Systematic review with meta-analysis. DATA SOURCES:Medline, PsycINFO, Embase, and the Cochrane Central...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.g2646

    authors: Dombrowski SU,Knittle K,Avenell A,Araújo-Soares V,Sniehotta FF

    更新日期:2014-05-14 00:00:00

  • Acceptability and accuracy of a non-endoscopic screening test for Barrett's oesophagus in primary care: cohort study.

    abstract:OBJECTIVES:To determine the accuracy and acceptability to patients of non-endoscopic screening for Barrett's oesophagus, using an ingestible oesophageal sampling device (Cytosponge) coupled with immunocytochemisty for trefoil factor 3. DESIGN:Prospective cohort study. SETTING:12 UK general practices, with gastroscopi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c4372

    authors: Kadri SR,Lao-Sirieix P,O'Donovan M,Debiram I,Das M,Blazeby JM,Emery J,Boussioutas A,Morris H,Walter FM,Pharoah P,Hardwick RH,Fitzgerald RC

    更新日期:2010-09-10 00:00:00

  • Managing patients with multimorbidity: systematic review of interventions in primary care and community settings.

    abstract:OBJECTIVE:To determine the effectiveness of interventions designed to improve outcomes in patients with multimorbidity in primary care and community settings. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, CINAHL, CAB Health, Cochrane central register of controlled trials, the database of abstracts of review...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.e5205

    authors: Smith SM,Soubhi H,Fortin M,Hudon C,O'Dowd T

    更新日期:2012-09-03 00:00:00

  • HIV prevention in Mexican schools: prospective randomised evaluation of intervention.

    abstract:OBJECTIVE:To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. DESIGN:Cluster randomised controlled trial. SETTING:40 public high schools in the state of Morelos, Mexico. PARTICIPANTS:10 954 firs...

    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.38796.457407.80

    authors: Walker D,Gutierrez JP,Torres P,Bertozzi SM

    更新日期:2006-05-20 00:00:00

  • Improving the preregistration experience: the New Zealand approach.

    abstract::There is currently much debate about how to improve undergraduate medical education, and in particular on how best to prepare students for clinical responsibility. For 20 years a period of trainee internship has formed part of New Zealand medical students' undergraduate training, and the model could have much to offer...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6925.398

    authors: Allen PI,Colls BM

    更新日期:1994-02-05 00:00:00

  • Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial.

    abstract:OBJECTIVE:To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. DESIGN:Randomised controlled trial. SETTING:Home based intervention in heart failure patients. PARTICIPANTS:293 patie...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.39164.568183.AE

    authors: Holland R,Brooksby I,Lenaghan E,Ashton K,Hay L,Smith R,Shepstone L,Lipp A,Daly C,Howe A,Hall R,Harvey I

    更新日期:2007-05-26 00:00:00

  • Personal use of permanent hair dyes and cancer risk and mortality in US women: prospective cohort study.

    abstract:OBJECTIVE:To evaluate the associations between personal use of permanent hair dyes and cancer risk and mortality. DESIGN:Prospective cohort study. SETTING AND PARTICIPANTS:117 200 women enrolled in the Nurses' Health Study, an ongoing prospective cohort study of female nurses in the United States. The women were free...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m2942

    authors: Zhang Y,Birmann BM,Han J,Giovannucci EL,Speizer FE,Stampfer MJ,Rosner BA,Schernhammer ES

    更新日期:2020-09-02 00:00:00

  • Resting energy expenditure, substrate use, and video tapes.

    abstract:OBJECTIVE:To investigate the effect of watching different types of video on energy expenditure. DESIGN:Randomised study assessing a "pleasant," an "amusing," an "exciting," and no video film clips. SUBJECTS:12 volunteers who did not know the purpose of the study. MAIN OUTCOME MEASURES:Changes in energy expenditure, ...

    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.311.7021.1664

    authors: Cooper BG,Matthews JN,Alberti KG

    更新日期:1995-12-23 00:00:00

  • Consequences of fetomaternal haemorrhage after intrauterine transfusion.

    abstract::Fetomaternal haemorrhage was studied after 68 consecutive fetal intravascular transfusions performed in 20 patients with Rh isoimmunisation. alpha Fetoprotein concentration was assayed in maternal blood taken before, and immediately after each transfusion and three and 24 hours later. An increase of 50% or more in the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6660.1379

    authors: Nicolini U,Kochenour NK,Greco P,Letsky EA,Johnson RD,Contreras M,Rodeck CH

    更新日期:1988-11-26 00:00:00

  • Widening access to UK medical education for under-represented socioeconomic groups: modelling the impact of the UKCAT in the 2009 cohort.

    abstract:OBJECTIVE:To determine whether the use of the UK clinical aptitude test (UKCAT) in the medical schools admissions process reduces the relative disadvantage encountered by certain sociodemographic groups. DESIGN:Prospective cohort study. SETTING:Applicants to 22 UK medical schools in 2009 that were members of the cons...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e1805

    authors: Tiffin PA,Dowell JS,McLachlan JC

    更新日期:2012-04-17 00:00:00

  • Graphical aid for determining power of clinical trials involving two groups.

    abstract::Physicians need to evaluate clinical research critically, and determining the power of a study is an essential component of research evaluation. This report presents a graphical aid that permits rapid power determination for clinical trials with two groups. Power curves were developed for dichotomous outcomes by setti...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6649.672

    authors: Miller DK,Homan SM

    更新日期:1988-09-10 00:00:00

  • High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts.

    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

    authors: Nordentoft M,Breum L,Munck LK,Nordestgaard AG,Hunding A,Laursen Bjaeldager PA

    更新日期:1993-06-19 00:00:00

  • Risk factors for HIV infection in people attending clinics for sexually transmitted diseases in India.

    abstract:OBJECTIVE:To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India. DESIGN:Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS:2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7000.283

    authors: Rodrigues JJ,Mehendale SM,Shepherd ME,Divekar AD,Gangakhedkar RR,Quinn TC,Paranjape RS,Risbud AR,Brookmeyer RS,Gadkari DA

    更新日期:1995-07-29 00:00:00

  • A multifaceted strategy for implementation of the Ottawa ankle rules in two emergency departments.

    abstract:PROBLEM:Despite widespread acceptance of the Ottawa ankle rules for assessment of acute ankle injuries, their application varies considerably. DESIGN:Before and after study. BACKGROUND AND SETTING:Emergency departments of a tertiary teaching hospital and a community hospital in Australia. KEY MEASURES FOR IMPROVEMEN...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b3056

    authors: Bessen T,Clark R,Shakib S,Hughes G

    更新日期:2009-08-12 00:00:00