Addo, R, Nonvignon, J & Aikins, M 2013, 'Household costs of mental health care in Ghana.', J Ment Health Policy Econ, vol. 16, no. 4, pp. 151-159.
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BACKGROUND: In Ghana, the prevalence of mental illness is about 13% and most patients are seen on out-patient basis. The economic burden of mental health care to patients and their families is, largely, unknown. AIMS: The aim of this study was to estimate the direct and indirect costs of mental illness to patients and their families and also to describe the intangible costs associated with mental illness. METHODS: Cross-sectional study design was used. Data were collected at the Psychiatric Unit of Ho Municipal Hospital, in the city of Ho, Ghana, from patients with mental illnesses and their households. Direct costs were estimated as medical cost and non-medical cost. Indirect costs were estimated for reported lost time/days by patients and their families. Sensitivity analysis was performed by varying uncertain parameters. Intangible costs was described using the Likert scale to measure the effect of mental illness on patients and their households in the areas of functional limitation, fear, emotional suffering, social relationship, stigmatisation/discrimination and leisure time. RESULTS: The total household cost of mental healthcare for the three month period was estimated as USD34,518.27 (average of USD180.72 per household), with direct and indirect cost making up 26% and 74% respectively. The average monthly household cost was estimated as USD60.24 as compared to the average reported household monthly income of USD184.48. Indirect cost was sensitive to the choice of wage rate used (i.e. local versus national rate). About 64% and 72% of patients and their households respectively were affected emotionally as a result of mental illness. DISCUSSION: Productivity losses due to caregiving and lost employment were the major contributors to the cost of mental illness to patients and households, constituting more than two-thirds of total costs. Cost of drugs was the highest contributor to the direct cost of mental illness. There is the possibility of over (or...
Arora, S, Roxburgh, A, Bruno, R, Nielsen, S & Burns, L 2013, 'A cross‐sectional analysis of over‐the‐counter codeine use among an Australian sample of people who regularly inject drugs', Drug and Alcohol Review, vol. 32, no. 6, pp. 574-581.
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AbstractIntroduction and AimsThe study aims to examine the medical and non‐medical use of over‐the‐counter (OTC) codeine combination drugs in a sample of people who inject drugs; and to examine risk factors associated with exceeding the recommended dose of OTC codeine, including the experience of pain.Design and MethodsThis study analysed annual survey data from a convenience sample of people who inject drugs in Australia who are interviewed for the Illicit Drug Reporting System. People who have injected drugs (n = 902) on at least a monthly basis in the preceding six months across Australia were interviewed. Participants were asked about their use of OTC codeine and their experience of pain.ResultsOne third (35%) of participants had used OTC codeine in the preceding six months and 52% (95% confidence interval 48.7–55.3) of this group had exceeded the recommended dose on their last occasion of use. This clearly places them at increased risk of harms associated with toxicity from the accompanying analgesic found in combination codeine products. Multivariate analyses demonstrated that those exceeding the...
Barnett, AG, Page, K, Campbell, M, Martin, E, Rashleigh-Rolls, R, Halton, K, Paterson, DL, Hall, L, Jimmieson, N, White, K & Graves, N 2013, 'The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: a case–control study', BMJ Open, vol. 3, no. 10, pp. e003587-e003587.
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Bewick, BM, West, RM, Barkham, M, Mulhern, B, Marlow, R, Traviss, G & Hill, AJ 2013, 'The Effectiveness of a Web-Based Personalized Feedback and Social Norms Alcohol Intervention on United Kingdom University Students: Randomized Controlled Trial', Journal of Medical Internet Research, vol. 15, no. 7, pp. e137-e137.
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Background: Alcohol consumption in the student population continues to be cause for concern. Building on the established evidence base for traditional brief interventions, interventions using the Internet as a mode of delivery are being developed. Published evidence of replication of initial findings and ongoing development and modification of Web-based personalized feedback interventions for student alcohol use is relatively rare. The current paper reports on the replication of the initial Unitcheck feasibility trial. Objective: To evaluate the effectiveness of Unitcheck, a Web-based intervention that provides instant personalized feedback on alcohol consumption. It was hypothesized that use of Unitcheck would be associated with a reduction in alcohol consumption. Methods: A randomized control trial with two arms (control=assessment only; intervention=fully automated personalized feedback delivered using a Web-based intervention). The intervention was available week 1 through to week 15. Students at a UK university who were completing a university-wide annual student union electronic survey were invited to participate in the current study. Participants (n=1618) were stratified by sex, age group, year of study, self-reported alcohol consumption, then randomly assigned to one of the two arms, and invited to participate in the current trial. Participants were not blind to allocation. In total, n=1478 (n=723 intervention, n=755 control) participants accepted the invitation. Of these, 70% were female, the age ranged from 17-50 years old, and 88% were white/white British. Data were collected electronically via two websites: one for each treatment arm. Participants completed assessments at weeks 1, 16, and 34. Assessment included CAGE, a 7-day retrospective drinking diary, and drinks consumed per drinking occasion. Results: The regression model predicted a monitoring effect, with participants who completed assessments reducing alcohol consumption over the fin...
Busse, R & Hall, J 2013, 'Gavin Mooney 1943–2012', Health Policy, vol. 109, no. 3, pp. 319-320.
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Comino, EJ, Tran, DT, Haas, M, Flack, J, Jalaludin, B, Jorm, L & Harris, MF 2013, 'Validating self-report of diabetes use by participants in the 45 and up study: a record linkage study', BMC Health Services Research, vol. 13, no. 1, pp. 1-17.
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Background Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information about diabetes in survey and administrative data collections. Methods Baseline questionnaire data at recruitment to the 45 and Up Study was obtained for 266,848 adults aged 45 years and over sampled from New South Wales, Australia in 2006-2009, and linked to administrative data about hospitalisation from the Admitted Patient Data Collection (APDC) for 2000-2009, claims for medical services (MBS) and pharmaceuticals (PBS) from Medicare Australia data for 2004-2009. Diabetes status was determined from response to a question `Has a doctor EVER told you that you have diabetes? (n=23,981) and augmented by examination of free text fields about diagnosis (n=119) or use of insulin (n=58). These data were used to identify the sub-group with type 1 diabetes. We explored the agreement between self-report of diabetes, identification of diabetes diagnostic codes in APDC data, claims for glycosylated haemoglobin (HbA1c) in MBS data, and claims for dispensed medication (oral hyperglycaemic agents and insulin) in PBS data. Results Most participants with diabetes were identified in APDC data if admitted to hospital (79.3%), in MBS data with at least one claim for HbA1c testing (84.7%; 73.4% if 2 tests claimed) or in PBS data through claim for diabetes medication (71.4%). Using these alternate data collections as an imperfect `gold standard? we calculated sensitivities of 83.7% for APDC, 63.9% (80.5% for two tests) for MBS, and 96.6% for PBS data and specificities of 97.7%, 98.4% and 97.1% respectively. The lower sensitivity for HbA1c may reflect the use of this test to screen for diabetes suggesting that it is less useful in identifying people with diabetes without a...
Cronin, P, Goodall, S, Lockett, T, O'Keefe, CM, Norman, R & Church, J 2013, 'COST-EFFECTIVENESS OF AN ADVANCE NOTIFICATION LETTER TO INCREASE COLORECTAL CANCER SCREENING', INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE, vol. 29, no. 3, pp. 261-268.
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Objectives: The aim of this study is to evaluate the cost-effectiveness of a patient-direct mailed advance notification letter on participants of a National Bowel Cancer Screening Program (NBCSP) in Australia, which was launched in August 2006 and offers free fecal occult blood testing to all Australians turning 50, 55, or 65 years of age in any given year. Methods: This study followed a hypothetical cohort of 50-year-old, 55-year-old, and 65-year-old patients undergoing fecal occult blood test (FOBT) screening through a decision analytic Markov model. The intervention compared two strategies: (i) advance letter, NBCSP, and FOBT compared with (ii) NBCSP and FOBT. The main outcome measures were life-years gained (LYG), quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio. Results: An advance notification screening letter would yield an additional 54 per 100,000 colorectal cancer deaths avoided compared with no letter. The estimated cost-effectiveness was $3,976 per LYG and $6,976 per QALY gained. Conclusions: An advance notification letter in the NBCSP may have a significant impact on LYG and cancer deaths avoided. It is cost-effective and offers a feasible strategy that could be rolled out across other screening program at an acceptable cost. © 2013 Cambridge University Press.
Demirkale, F, Donovan, D & Street, DJ 2013, 'Constructing D-optimal symmetric stated preference discrete choice experiments', Journal of Statistical Planning and Inference, vol. 143, no. 8, pp. 1380-1391.
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We give new constructions for DCEs in which all attributes have the same number of levels. These constructions use several combinatorial structures, such as orthogonal arrays, balanced incomplete block designs and Hadamard matrices. If we assume that only the main effects of the attributes are to be used to explain the results and that all attribute level combinations are equally attractive, we show that the constructed DCEs are D-optimal. © 2013 Elsevier B.V.
Gallego, G, van Gool, K, Casey, R & Maddern, G 2013, 'SURGEONS' VIEWS OF HEALTH TECHNOLOGY ASSESSMENT IN AUSTRALIA: ONLINE PILOT SURVEY', INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE, vol. 29, no. 3, pp. 309-314.
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Introduction: Many governments have introduced health technology assessment (HTA) as an important tool to manage the uptake and use of health-related technologies efficiently. Although surgeons play a central role in the uptake and diffusion of new technologies, little is known about their opinion and understanding of the HTA role and process. Methods: A cross-sectional pilot study was conducted using an online questionnaire which was distributed to Fellows of the Royal Australasian College of Surgeons over a 4-week period. Information was sought about knowledge and views of the HTA process. Descriptive statistics were used to summarize the data, frequencies, and proportions were calculated. Results: Sixty-two surgeons completed the survey; of these, 55 percent reported their primary work place as a public hospital. Twenty-four percent of the participants reported that they had never heard of the HTA agency and 60 percent reported that surgical procedures are most likely to be introduced in the Australian healthcare system at the public hospital level (which is beyond the HTAs scope and dealt with at a state level). However, 61 percent considered that decisions about funding and adoption of new technologies should take place at the national level. Conclusions: This survey provides some evidence that many surgeons remain unaware of the federal governments HTA process but still value evidence-based information. In order for HTA to be an effective aid to rational adoption of health-related technologies, there is a need for an evidence-based approach that is integrated and is accepted and understood by the medical professions.
Garcia-Cardenas, V, Sabater-Hernandez, D, Kenny, P, Martinez-Martinez, F, Jose Faus, M & Benrimoj, SI 2013, 'Effect of a pharmacist intervention on asthma control. A cluster randomised trial', RESPIRATORY MEDICINE, vol. 107, no. 9, pp. 1346-1355.
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Introduction Achievement and maintenance of good asthma control is a major objective in asthma management. However, asthma control in many patients is suboptimal, due to improper use of asthma medications and non-adherence. The aim of this study was to evaluate the effect of a pharmacist intervention on asthma control in adult patients. Methods A 6-month cluster randomized controlled trial was undertaken with allocation of community pharmacies to intervention or control group. Adult asthma patients in the intervention group received a protocol-based intervention addressing individual needs related to asthma control, inhaler technique and medication adherence. Patients in the control group received usual care. Main variables were measured at baseline, 3 and 6 months. Results 336 patients completed the study, 150 in the control group and 186 in the intervention group. The intervention resulted in enhanced asthma control: Patients receiving the intervention had an Odds ratio of 3.06 (95% CI:1.63-5.73; p < 0.001) of having controlled asthma six months later. In the intervention group mean ACQ scores significantly improved [0.66 points (SD: 0.78); p < 0.001] and the number of controlled asthma patients increased by 30.1% (p < 0.001) after 6 months. The intervention also resulted in improved medication adherence (by 40.3%, p < 0.001) and inhaler technique (by 56.2%, p < 0.001). No significant changes for any of these variables were observed in the control group. Conclusion The AFasma study focused on the important outcomes of asthma management, and showed that through the designed intervention, community pharmacists can increase controlled asthma patients compared to usual care. Trial registration NCT01085474. © 2013 Elsevier Ltd. All rights reserved.
Graves, N, Halton, K, Page, K & Barnett, A 2013, 'Linking Scientific Evidence and Decision Making A Case Study of Hand Hygiene Interventions', Infection Control & Hospital Epidemiology, vol. 34, no. 4, pp. 424-429.
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Hall, J 2013, 'The Development of Health Economics in Australia and Its Contribution to Policy', AUSTRALIAN ECONOMIC REVIEW, vol. 46, no. 2, pp. 196-201.
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Hall, JP 2013, 'The tale of out-of-pocket spending on health care', MEDICAL JOURNAL OF AUSTRALIA, vol. 199, no. 7, pp. 442-443.
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It is the best of times and the worst of times. Bulk-billing rates for non-referred attendances (principally general practitioners) have reached over 82%.1 Yet there has been renewed attention focused on the growing financial burden that out-of-pocket (OOP) payments impose on patients.2 The apparent contradiction can be reconciled, but to do that we need to get beyond the headline figures. All health care financing, whether provided through government, social agencies or private providers, aims to ensure that individuals are not excluded from receiving costly health care when they need it. When patients face charges, their use of health services is lowered, with OOP expenditures having a greater impact on the use of health care by those with less financial means. So at first glance it seems inconsistent to impose copayments in a system set up to reduce barriers to use.
Hall, L, Halton, K, Bailey, EJ, Page, K, Whitby, M, Paterson, DL & Graves, N 2013, 'Post-discharge surgical site surveillance – where to from here?', Journal of Hospital Infection, vol. 84, no. 3, pp. 268-268.
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Hewitt, J, Refshauge, K, Henwood, T, Goodall, S & Clemson, L 2013, 'Falls prevention research in residential aged care is itself tripped up by medical clearance issues', Australasian Journal on Ageing, vol. 32, no. 4, pp. 247-247.
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Johar, M, Fiebig, DG, Haas, M & Viney, R 2013, 'Using repeated choice experiments to evaluate the impact of policy changes on cervical screening', APPLIED ECONOMICS, vol. 45, no. 14, pp. 1845-1855.
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Australia was one of the first countries to introduce a publicly funded Human Papilloma Virus (HPV) vaccine program, and its introduction coincided with a media campaign to promote regular cervical screening. One issue with HPV vaccination is how it impacts on demand for screening. This study examines changes in women's screening preferences following these two interventions, using a novel approach to policy evaluation based on repeated discrete choice experiments. The study extends our previous analysis of attitudes to screening by taking advantage of the timing of the choice experiments to examine the impact of the two policy changes on determinants of screening. We find that, unexpectedly, willingness to screen is generally lower post-interventions. The reason for this trend appears to be related to HPV vaccination. We also find that interventions have minor impacts on how women value screening attributes. Our approach allows us to examine the impact of provider behaviour. A simulation demonstrates that under certain conditions, participation rates can be increased by 40% to 50% if health providers actively encourage women to undertake a cervical screening test.
Knox, SA, Viney, RC, Gu, Y, Hole, AR, Fiebig, DG, Street, DJ, Haas, MR, Weisberg, E & Bateson, D 2013, 'The effect of adverse information and positive promotion on women's preferences for prescribed contraceptive products', SOCIAL SCIENCE & MEDICINE, vol. 83, pp. 70-80.
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Recent rapid growth in the range of contraceptive products has given women more choice, but also adds complexity to the resultant decision of which product to choose. This paper uses a discrete choice experiment (DCE) to investigate the effect of adverse information and positive promotion on women's stated preferences for prescribed contraceptive products. In November 2007, 527 Australian women aged 18-49 years were recruited from an online panel. Each was randomly allocated to one of three information conditions. The control group only received basic information on contraceptive products. One treatment group also received adverse information on the risks of the combined oral pill. The other group received basic information and promotional material on the vaginal ring, newly introduced into Australia and on the transdermal patch, which is unavailable in Australia. Respondents completed 32 choice sets with 3 product options where each option was described by a product label: either combined pill, minipill, injection, implant, hormonal IUD, hormonal vaginal ring, hormonal transdermal patch or copper IUD; and by the attributes: effect on acne, effect on weight, frequency of administration, contraceptive effectiveness, doctor's recommendation, effect on periods and cost. Women's choices were analysed using a generalized multinomial logit model (G-MNL) and model estimates were used to predict product shares for each information condition. The predictions indicated that adverse information did not affect women's preferences for products relative to only receiving basic information. The promotional material increased women's preferences for the transdermal patch. Women in all groups had a low preference for the vaginal ring which was not improved by promotion. The findings highlight the need for researchers to pay attention to setting the context when conducting DCEs as this can significantly affect results. © 2013 Elsevier Ltd.
Laba, T-L, Bleasel, J, Brien, J-A, Cass, A, Howard, K, Peiris, D, Redfern, J, Salam, A, Usherwood, T & Jan, S 2013, 'Strategies to improve adherence to medications for cardiovascular diseases in socioeconomically disadvantaged populations: A systematic review', International Journal of Cardiology, vol. 167, no. 6, pp. 2430-2440.
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Laba, T-L, Brien, J-A, Fransen, M & Jan, S 2013, 'Patient preferences for adherence to treatment for osteoarthritis: the MEdication Decisions in Osteoarthritis Study (MEDOS)', BMC Musculoskeletal Disorders, vol. 14, no. 1.
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Background: Often affecting knee joints, osteoarthritis (OA) is the most common type of arthritis and by 2020 is predicted to become the fourth leading cause of disability globally. Without cure, medication management is symptomatic, mostly with simple analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), and glucosamine sulfate. Adherence to arthritis medications is generally low. Intentional non-adherence, that is deliberate decision-making about the use of analgesics, occurs in OA patients. To date, a limited number of studies have explored medication-taking decisions in people with OA nor the extent to which individuals' trade off one treatment factor for another in their decision-making using quantitative techniques. This study aimed to estimate the relative influence of medication-related factors and respondent characteristics on decisions to continue medications among people with symptomatic OA. Methods. A discrete choice experiment (DCE) was conducted among participants attending end-of-study visits in the Long-term Evaluation of Glucosamine Sulfate (LEGS) study (ClinicalTrials.gov ID: NCT00513422). The paper-based survey was used to estimate the relative importance of seven medication specific factors (pain efficacy, mode of action, dose frequency, treatment schedule, side effects, prescription, and out-of-pocket costs) and respondent characteristics on decisions to continue medications. Results: 188 (response rate 37%) completed surveys were returned. Four of the seven medication factors (side effects, out-of-pocket costs, mode of action, treatment schedule) had a significant effect on the choice to continue medication; patient characteristics did not. Assuming equivalent pain efficacy and disease-modifying properties for glucosamine, the positive relative likelihood of continuing with sustained-release acetaminophen was equivalent to glucosamine. By contrast, the negative relative likelihood of NSAID continuatio...
Liew, D, De Abreu Lourenço, R, Adena, M, Chim, L & Aylward, P 2013, 'Cost-Effectiveness of 12-Month Treatment With Ticagrelor Compared With Clopidogrel in the Management of Acute Coronary Syndromes', Clinical Therapeutics, vol. 35, no. 8, pp. 1110-1117.e9.
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Background: The PLATO (Platelet Inhibition and Patient Outcomes) randomized trial (NCT00391872) in patients with acute coronary syndromes (ACS) reported that ticagrelor (in addition to aspirin) reduced the rate of the composite end point of myocardial infarction (MI), stroke, or cardiovascular death compared with clopidogrel (in addition to aspirin) by 16% over 12 months (P o 0.001). No significant difference in the incidence of major bleeding was noted, but ticagrelor was associated with a higher rate of major bleeding not related to coronary artery bypass grafting. Objective: By extrapolating the key findings of PLATO, we sought to assess the cost-effectiveness of ticagrelor compared with clopidogrel in the management of ACS in a contemporary Australian setting. Methods: A Markov model with 4 health states (free from further ACS events, MI, stroke, and death) was developed to simulate the long-term costs and outcomes associated with ACS. Event risks were based on data derived directly from PLATO, and costs and utilities were drawn from published sources. A 10- year time horizon was simulated, and future costs and benefits were discounted at a 5% annual rate. However, treatment with ticagrelor and clopidogrel was only assumed for the first 12 months, with no benefits applied beyond drug cessation. Sensitivity analyses were undertaken based on variations to key data inputs. All costs for resource use applied in the analysis were based on published Australian prices (in 2010/2011 dollars [A$]). Results: Over 10 years, the estimated qualityadjusted life-years lived per-patient were 5.74 and 5.68 for ticagrelor and clopidogrel, respectively. Net costs were A$19,132 for ticagrelor and A$18,428 for clopidogrel. These equated to an incremental costeffectiveness ratio of A$9031 per quality-adjusted lifeyear gained for ticagrelor compared with clopidogrel. Sensitivity analyses indicated the result to be robust. Conclusions: When assessed from the perspective of the Austr...
Louviere, JJ, Carson, RT, Burgess, L, Street, D & Marley, AAJ 2013, 'Sequential preference questions factors influencing completion rates and response times using an online panel', Journal of Choice Modelling, vol. 8, pp. 19-31.
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How many choice sets respondents will answer is a critical issue in how much data a researcher has for analysis. We used 66 separate surveys that ask respondents, from an opt-in web panel, sequences of preference questions about consumer products to study design factors that influence the rate of completing the entire sequence of questions comprising a discrete choice experiment. We do this by systematically varying the number of choice sets, the number of alternatives respondents were asked to consider, the nature of the list of attributes of each alternative and the type of statistical design. Completion rates systematically varied with the factors explored, but perhaps the key finding is that completion rates are reasonably high in all cases.We found that completion rates are relatively unaffected by asking more questions (choice sets), but they decline as one includes more alternatives. Expected time to complete a survey often plays a key role in the cost of web-based panels, so we also look at how the preceding factors impact completion times. Practical implications for applied research using opt-in web panels are discussed.© 2013 Elsevier Ltd.
McCluskey, A, Ada, L, Middleton, S, Kelly, PJ, Goodall, S, Grimshaw, JM, Logan, P, Longworth, M & Karageorge, A 2013, 'Improving Quality of Life by Increasing Outings after Stroke: Study Protocol for the Out-and-About Trial', International Journal of Stroke, vol. 8, no. 1, pp. 54-58.
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Rationale Almost one-third of Australians need help to travel outdoors after a stroke. Ambulation training and escorted outings are recommended as best practice in Australian clinical guidelines for stroke. Yet fewer than 20% of people with stroke receive enough of these sessions in their local community to change outcomes. Aims The Out-and-About trial aims to determine the efficacy and cost effectiveness of an implementation program to change team behavior and increase outings by people with stroke. Design A two-group cluster-randomized trial will be conducted using concealed allocation, blinded assessors, and intention-to-treat analysis. Twenty community teams and their stroke clients ( n = 300) will be recruited. Teams will be randomized to receive either the Out-and-About program or written guidelines only. Study Outcomes The primary outcome is the proportion of people with stroke receiving multiple escorted outings during therapy sessions, measured at baseline and 13 months postintervention. Secondary outcomes include number of outings and distance traveled, measured using a self-report diary at baseline and six months postbaseline, and a global positioning system after six months. Cost effectiveness will measure quality-adjusted life years and health service use, measured at baseline and six months postbaseline. Discussion A potential outcome of this study will be evidence for a costed, transferable implementation program. If successful, the program will have international relevance and transferability. Another potential outcome will be validation of a novel and objective method of measuring outdoor travel (global positioning system) to supplement self-repor...
Mulhern, B & Meadows, K 2013, 'Investigating the minimally important difference of the Diabetes Health Profile (DHP-18) and the EQ-5D and SF-6D in a UK diabetes mellitus population', Health, vol. 05, no. 06, pp. 1045-1054.
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Objectives: It is important to know what patient
reported outcome measure (PROM) scores relate
to a meaningful change in health status
across time. The aim of this study was to investigate
the minimally important difference (MID)
of the Diabetes Health Profile (DHP-18), EQ-5D
and SF-6D in a Type 1 and Type 2 diabetes patient
sample. Methods: A longitudinal dataset
including a UK community sample of people
with Type 1 and Type 2 diabetes was used for the
analysis. A combination of anchor and distribution
methods was used to investigate the MID.
For the anchor based method, a global health
change indicator was used if it correlated with
the PROM scores at baseline and follow up. To
calculate the anchor based MID, the change in
PROM score for those reporting no change on
the anchor was subtracted from those reporting
small change. For the distribution based estimation,
the 1 Standard Error of Measurement,
0.5 and 0.33 standard deviation methods were
used. Results: The anchor was not correlated
with the DHP-18 dimensions so was only used to
estimate MID values for the EQ-5D and SF-6D.
For the DHP-18, MID estimates for the Psychological
Distress domain range from 6.99 to 10.59,
the Barriers to Activity domain range from 6.48
to 9.89, and the Disinhibited Eating domain
range from 7.52 to 11.39. The EQ-5D estimations
range from 0.058 to 0.158, and the SF-6D estimations
range from 0.038 to 0.081. The 0.5 SD
and 1SEM estimations are of a similar magnitude
across the three measures. Conclusions:
This study has derived a range of values for
each measure that may correspond to an important
change in health status. The MID values
may guide researchers who are using the
measures as part of their assessment of both
Type 1 and Type 2 patients with diabetes mellitus.
Mulhern, B, Longworth, L, Brazier, J, Rowen, D, Bansback, N, Devlin, N & Tsuchiya, A 2013, 'Binary Choice Health State Valuation and Mode of Administration: Head-to-Head Comparison of Online and CAPI', Value in Health, vol. 16, no. 1, pp. 104-113.
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Background: Health state valuation exercises can be conducted online, but the quality of data generated is unclear. Objective: To investigate whether responses to binary choice health state valuation questions differ by administration mode: online versus face to face. Methods: Identical surveys including demographic, self-reported health status, and seven types of binary choice valuation questions were administered in online and computer-assisted personal interview (CAPI) settings. Samples were recruited following procedures employed in typical online or CAPI studies. Analysis included descriptive comparisons of the distribution of responses across the binary options and probit regression to explain the propensity to choose one option across modes of administration, controlling for background characteristics. Results: Overall, 422 (221 online; 201 CAPI) respondents completed a survey. There were no overall age or sex differences. Online respondents were educated to a higher level than were the CAPI sample and general population, and employment status differed. CAPI respondents reported significantly better general health and health/life satisfaction. CAPI took significantly longer to complete. There was no effect of the mode of administration on responses to the valuation questions, and this was replicated when demographic differences were controlled. Conclusions: The findings suggest that both modes may be equally valid for health state valuation studies using binary choice methods (e.g., discrete choice experiments). There are some differences between the observable characteristics of the samples, and the groups may differ further in terms of unobservable characteristics. When designing health state valuation studies, the advantages and disadvantages of both approaches must be considered. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.
Mulhern, B, Meadows, K & Churchman, D 2013, 'Assessing the Relationship Between the Diabetes Health Profile and Diabetes Specific Clinical Indicators: Case for Tailored Therapeutics', Value in Health, vol. 16, no. 7, pp. A448-A448.
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Mulhern, B, Rowen, D, Brazier, J, Smith, S, Romeo, R, Tait, R, Watchurst, C, Chua, K-C, Loftus, V, Young, T, Lamping, D, Knapp, M, Howard, R & Banerjee, S 2013, 'Development of DEMQOL-U and DEMQOL-PROXY-U: generation of preference-based indices from DEMQOL and DEMQOL-PROXY for use in economic evaluation', Health Technology Assessment, vol. 17, no. 5, pp. 1-140.
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BackgroundDementia is one of the most common and serious disorders in later life and the economic and personal cost of caring for people with dementia is immense. There is a need to be able to evaluate interventions in dementia using cost-effectiveness analyses, but the generic preference-based measures typically used to measure effectiveness do not work well in dementia. Existing dementia-specific measures can effectively measure health-related quality of life but in their current form cannot be used directly to inform cost-effectiveness analysis using quality-adjusted life-years as the measure of effectiveness.ObjectivesThe aim was to develop two brief health-state classifications, one from DEMQOL and one from DEMQOL-Proxy, to generate health states amenable to valuation. These classification systems consisted of items taken from DEMQOL and DEMQOL-Proxy so they can be derived from any study that has used these instruments.Data sourcesIn the first stage of the study we used a large, clinically representative sample aggregated from two sources: a sample of patients and carers attending a memory service in south London and a sample of patients and carers from other community services in south London. This included 644 people with a diagnosis of mild/moderate dementia and 689 carers of those with mild/moderate dementia. For the valuation study, the general population sample of 600 respondents was drawn to be representative of the UK general population. Households were sampled in urban and rural areas in northern England and balanced to the UK population according to geodemographic profiles. In the patient/carer valuation study we interviewed a sample of 71 people with mild dementia and 71 family carers drawn from a memory service in south London. Finally...
Norman, R, Church, J, van den Berg, B & Goodall, S 2013, 'Australian health-related quality of life population norms derived from the SF-6D', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, vol. 37, no. 1, pp. 17-23.
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Objective: To investigate population health-related quality of life norms in an Australian general sample by age, gender, BMI, education and socioeconomic status. Method: The SF-36 was included in the 2009/10 wave of the Household, Income and Labour Dynamics in Australia (HILDA) survey (n=17,630 individuals across 7,234 households), and converted into SF-6D utility scores. Trends across the various population subgroups were investigated employing population weights to ensure a balanced panel, and were all sub-stratified by gender. Results: SF-6D scores decline with age beyond 40 years, with decreasing education and by higher levels of socioeconomic disadvantage. Scores were also lower at very low and very high BMI levels. Males reported higher SF-6D scores than females across most analyses. Conclusions: This study reports Australian population utility data measured using the SF-6D, based on a national representative sample. These results can be used in a range of policy settings such as cost-utility analysis or exploration of health-related inequality. In general, the patterns are similar to those reported using other multi-Attribute utility instruments and in different countries. © 2013 The Authors.
Norman, R, Cronin, P & Viney, R 2013, 'A Pilot Discrete Choice Experiment to Explore Preferences for EQ-5D-5L Health States', Applied Health Economics and Health Policy, vol. 11, no. 3, pp. 287-298.
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Background: The EQ-5D-5L has recently been developed to improve the sensitivity of the widely used three-level version. Valuation studies are required before the use of this new instrument can be adopted. The use of discrete choice experiments (DCEs) in this area is a promising area of research. Purpose: To test the plausibility and acceptability of estimating an Australian algorithm for the newly developed five-level version of the EQ-5D using a DCE. Methods: A choice experiment was designed, consisting of 200 choice sets blocked such that each respondent answered 10 choice sets. Each choice set presented two health state-duration combinations, and an immediate death option. The experiment was implemented in an online Australian-representative sample. A random-effects probit model was estimated. To explore the feasibility of the approach, an indicative algorithm was developed. The algorithm is transformed to a 0 to 1 scale suitable for use to estimate quality-adjusted life-year weights for use in economic evaluation. Results: A total of 973 respondents undertook the choice experiment. Respondents were slightly younger and better educated than the general Australian population. Of the 973 respondents, 932 (95.8 %) completed all ten choice sets, and a further 12 completed some of the choice sets. In choice sets in which one health state-duration combination dominated another, the dominant option was selected on 89.5 % of occasions. The mean and median completion times were 17.9 and 9.4 min, respectively, exhibiting a highly skewed distribution. The estimation results are broadly consistent with the monotonic nature of the EQ-5D-5L. Utility is increasing in life expectancy (i.e., respondents tend to prefer health profiles with longer life expectancy), and mainly decreases in higher levels in each dimension of the instrument. A high proportion of respondents found the task clear and relatively easy to complete. Conclusions: DCEs are a feasible approach to ...
Norman, R, Hall, J, Street, D & Viney, R 2013, 'EFFICIENCY AND EQUITY: A STATED PREFERENCE APPROACH', HEALTH ECONOMICS, vol. 22, no. 5, pp. 568-581.
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Outcome measurement in the economic evaluation of health care considers outcomes independent of to whom they accrue. This article reports on a discrete choice experiment designed to elicit population preferences regarding the allocation of health gain between hypothetical groups of potential patients. A random-effects probit model is estimated, and a technique for converting these results into equity weights for use in economic evaluation is adopted. On average, the modelling predicts a relatively high social value on health gains accruing to nonsmokers, carers, those with a low income and those with an expected age of death less than 45 years. Respondents tend to favour individuals with similar characteristics to themselves. These results challenge the conventional practice of assuming constant equity weighting. For decision makers, whether a formal equity weighting system represents an improvement on more informal approaches to weighing up equity and efficiency concerns remains uncertain. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.
O’Hara, BJ, Bauman, AE, Eakin, EG, King, L, Haas, M, Allman-Farinelli, M, Owen, N, Cardona-Morell, M, Farrell, L, Milat, AJ & Phongsavan, P 2013, 'Evaluation Framework for Translational Research', Health Promotion Practice, vol. 14, no. 3, pp. 380-389.
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The Get Healthy Information and Coaching Service® (GHS), a free government-funded telephone-delivered information and coaching service was launched in February 2009 by the Australian New South Wales state government. It represents the translation of research evidence applied in the real world (T4 or Phase 4 translation), aimed at addressing the modifiable risk factors associated with the overweight and obesity. In controlled settings, it has been established that telephone-based lifestyle counseling programs are efficacious in reducing anthropometric and behavioral risk factors. This article presents the GHS case study as a population-wide intervention and describes the quasi-experimental evaluation framework used to evaluate both the process (statewide implementation) and impact (effectiveness) of the GHS in a real-world environment. It details the data collection, measures, and statistical analysis required in assessing the process of implementation—reach and recruitment, marketing and promotion, service satisfaction, intervention fidelity, and GHS setting up and operations costs—and in assessing the impact of GHS—increasing physical activity, improving dietary practices, and reducing body weight and waist circumference. The comprehensive evaluation framework designed for the GHS provides a method for building effectiveness evidence of a rare translation of efficacy trial evidence into population-wide practice.
Page, K, Graves, N, Halton, K & Barnett, AG 2013, 'Humans, ‘things’ and space: costing hospital infection control interventions', Journal of Hospital Infection, vol. 84, no. 3, pp. 200-205.
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Pearce, A, Haas, M & Viney, R 2013, 'Are the True Impacts of Adverse Events Considered in Economic Models of Antineoplastic Drugs? A Systematic Review', Applied Health Economics and Health Policy, vol. 11, no. 6, pp. 619-637.
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Background: Antineoplastic drugs for cancer are often associated with adverse events, which influence patients' physical health, quality of life and survival. However, the modelling of adverse events in cost-effectiveness analyses of antineoplastic drugs has not been examined. Aims: This article reviews published economic evaluations that include a calculated cost for adverse events of antineoplastic drugs. The aim is to identify how existing models manage four issues specific to antineoplastic drug adverse events: the selection of adverse events for inclusion in models, the influence of dose modifications on drug quantity and survival outcomes, the influence of adverse events on quality of life and the consideration of multiple simultaneous or recurring adverse events. Methods: A systematic literature search was conducted using MESH headings and key words in multiple electronic databases, covering the years 1999-2009. Inclusion criteria for eligibility were papers covering a population of adults with solid tumour cancers, the inclusion of at least one adverse event and the resource use and/or costs of adverse event treatment. Results: From 4,985 citations, 26 eligible articles were identified. Studies were generally of moderate quality and addressed a range of cancers and treatment types. While the four issues specific to antineoplastic drug adverse events were addressed by some studies, no study addressed all of the issues in the same model. Conclusion: This review indicates that current modelling assumptions may restrict our understanding of the true impact of adverse events on cost effectiveness of antineoplastic drugs. This understanding could be improved through consideration of the selection of adverse events, dose modifications, multiple events and quality of life in cost-effectiveness studies. © 2013 Springer International Publishing Switzerland.
Pearce, AM, Haas, M & Viney, R 2013, 'AUSTRALIAN STANDARD COSTS AND CONSEQUENCES OF FOUR CHEMOTHERAPY ADVERSE EVENTS', VALUE IN HEALTH, vol. 16, no. 7, pp. A404-A404.
Pearce, AM, Haas, M & Viney, R 2013, 'CAN ADMINISTRATIVE DATA PREDICT CHEMOTHERAPY ADVERSE EVENTS?', VALUE IN HEALTH, vol. 16, no. 7, pp. A392-A392.
Rabovskaja, V, Parkinson, B & Goodall, S 2013, 'The Cost-Effectiveness of Mandatory Folic Acid Fortification in Australia', The Journal of Nutrition, vol. 143, no. 1, pp. 59-66.
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The Australian government recently introduced mandatory folic acid fortification of bread to reduce the incidence of neural tube defects (NTDs). The economic evaluation of this policy contained a number of limitations. This study aimed to address the limitations and to reconsider the findings. Cost-effectiveness analysis was used to assess the cost and benefits of mandatory versus voluntary folic acid fortification. Outcomes measures were quality-adjusted life-years (QALYs), life-years gained (LYG), avoided NTD cases, and additional severe neuropathy cases. Costs considered included industry costs and regulatory costs to the government. It was estimated that mandatory fortification would prevent 31 NTDs, whereas an additional 14 cases of severe neuropathy would be incurred. Overall, 539 LYG and 503 QALYs would be gained per year of mandatory compared with voluntary fortification. Mandatory fortification was cost-effective at A$10,723 per LYG and at A$11,485 per QALY. Probabilistic sensitivity analysis showed that at A$60,000 and A$151,000 per QALY, the probability that mandatory fortification was the most cost-effective strategy was 79% and 85%, respectively. Threshold analysis of loss of consumer choice indicated that with a compensation value above A$1.21 [assuming a willingness to pay (WTP) threshold of A$60,000 per QALY] or A$3.19 (assuming a WTP threshold of A$151,000 per statistical life-year) per capita per year mandatory fortification would not be cost-effective. Mandatory fortification was found to be cost-effective; however, inclusion of the loss of consumer choice can change this result. Even with mandatory fortification, mean folate intake will remain below the recommended NTD preventive level.
Reeve, R & van Gool, K 2013, 'Modelling the Relationship between Child Abuse and Long-Term Health Care Costs and Wellbeing: Results from an Australian Community-Based Survey', ECONOMIC RECORD, vol. 89, no. 286, pp. 300-318.
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Childhood abuse is a serious social and economic problem. In Australia, there are 17,000 substantiated cases of physical and sexual child abuse each year. We model the relationship between childhood abuse and long-term health, health care costs and well being using data from the 2007 National Survey of Mental Health and Wellbeing. We find that adults with a history of childhood abuse suffer from significantly more health conditions, incur higher annual health care costs and are more likely to harm themselves. Our results suggest that child abuse has long-lasting economic and welfare costs. The costs are greatest for those who experienced both physical and sexual abuse. © 2013 Economic Society of Australia.
Roche, M, Duffield, C, Wise, S, Baldwin, R, Fry, M & Solman, A 2013, 'Domains of practice and Advanced Practice Nursing in Australia', NURSING & HEALTH SCIENCES, vol. 15, no. 4, pp. 497-503.
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A key component of workforce reform is the international growth in Advanced Practice Nursing (APN) roles. This study evaluated one APN role in Australia, the Clinical Nurse Consultant (CNC). All 56 CNCs employed in a tertiary hospital in New South Wales took part in the study. Demographic and work activity data were collected by an online questionnaire. Face-to-face interviews included the administration of a 50-point tool to score the level of practice of each CNC against five domains.The domains of practice did not appear to have played a central role in the design of these CNC roles despite being defined in the industrial legislation and linked to a pay structure.There was widespread variability in the level of practice both within and between the CNC grades as well as significant differences in job content. Few CNCs managed to achieve a moderate level of practice across all five domains. The findings suggest that the distinctive features of the CNC roles as articulated in the domains of practice are often not realized in practice.
Salam, A, Stewart, F, Singh, K, Thom, S, Williams, HJ, Patel, A, Jan, S, Laba, T, Prabhakaran, D, Maulik, P, Day, S & Ward, H 2013, 'INterpreting the Processes of the UMPIRE Trial (INPUT): protocol for a qualitative process evaluation study of a fixed-dose combination (FDC) strategy to improve adherence to cardiovascular medications', BMJ Open, vol. 3, no. 5, pp. e002313-e002313.
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Introduction: This paper describes a planned process evaluation of the Use of a Multidrug Pill In Reducing Cardiovascular Events (UMPIRE) trial, one of several randomised clinical trials taking place globally to assess the potential of cardiovascular drugs as a fixeddose combination ( polypill) in cardiovascular disease prevention. A fixed-dose combination may be a promising strategy for promoting adherence to medication; alleviating pill burden through simplifying regimens and reducing cost. This process evaluation will complement the UMPIRE trial by using qualitative research methods to inform understanding of the complex interplay of factors that underpin trial outcomes. Methods: A series of semistructured, in-depth interviews with local health professionals and UMPIRE trial participants in India and the UK will be undertaken. The aim is to understand their views and experiences of the trial context and of day-to-day use of medications more generally. The grounded theory approach will be used to analyse data and help inform the processes of the UMPIRE trial. Ethics and dissemination: The study has received ethical approval for all sites in the UK and India where trial participant interviews will be undertaken. The process evaluation will help inform and enhance the understanding of the UMPIRE trial results and its applicability to clinical practice as well as shaping policy regarding strategies for improving cardiovascular medication adherence.
Tyson, JY, Pearce, MM, Vargas, P, Bagchi, S, Mulhern, BJ & Cianciotto, NP 2013, 'Multiple Legionella pneumophila Type II Secretion Substrates, Including a Novel Protein, Contribute to Differential Infection of the Amoebae Acanthamoeba castellanii, Hartmannella vermiformis, and Naegleria lovaniensis', Infection and Immunity, vol. 81, no. 5, pp. 1399-1410.
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ABSTRACT Type II protein secretion (T2S) by Legionella pneumophila is required for intracellular infection of host cells, including macrophages and the amoebae Acanthamoeba castellanii and Hartmannella vermiformis . Previous proteomic analysis revealed that T2S by L. pneumophila 130b mediates the export of >25 proteins, including several that appeared to be novel. Following confirmation that they are unlike known proteins, T2S substrates NttA, NttB, and LegP were targeted for mutation. nttA mutants were impaired for intracellular multiplication in A. castellanii but not H. vermiformis or macrophages, suggesting that novel exoproteins which are specific to Legionella are especially important for infection. Because the importance of NttA was host cell dependent, we exam...
van Gool, K, Norman, R, Delatycki, MB, Hall, J & Massie, J 2013, 'Understanding the Costs of Care for Cystic Fibrosis: An Analysis by Age and Health State', VALUE IN HEALTH, vol. 16, no. 2, pp. 345-355.
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Objectives: Cystic fibrosis (CF) is an inherited disease that requires more intensive treatments as the disease progresses. Recent medical advancements have improved survival but have also increased costs. Our lack of understanding on the relationship between disease severity and lifetime health care costs is a major impediment to the timely economic assessment of new treatments. Methods: Using data from three waves of the Australian Cystic Fibrosis Australia Data Registry, we estimate the annual costs of CF care by age and health state. We define health states on the basis of annual lung-function scores and patient's organ transplant status. We exploit the longitudinal nature of the data to model disease progression, and we use this to estimate lifetime health care costs. Results: The mean annual health care cost for treating CF is US $15,571. Costs for patients with mild, moderate, and severe disease are US $10,151, US $25,647, and US $33,691, respectively. Lifetime health care costs are approximately US $306,332 (3.5% discount rate). The majority of costs are accounted for by hospital inpatients (58%), followed by pharmaceuticals (29%), medical services (10%), complications (2%), and diagnostic tests (1%). Conclusions: Our study is the first of its kind using the Australian Cystic Fibrosis Data Registry, and demonstrates the utility of longitudinal registry data for the purpose of economic analysis. Our results can be used as an input to future economic evaluations by providing analysts with a better understanding of the long-term cost impact when new treatments are developed. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
Weisberg, E, Bateson, D, Knox, S, Haas, M, Viney, R, Street, D & Fiebig, D 2013, 'Do women and providers value the same features of contraceptive products? Results of a best-worst stated preference experiment', EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE, vol. 18, no. 3, pp. 181-190.
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Objectives To determine how women and physicians rate individual characteristics of contraceptives. Methods Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors influence choice. Women and general practitioners (GPs) were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features. Results Two hundred women, mean age 36, 71% using contraception, were presented with descriptions of 16 possible methods and asked to indicate their preference for individual characteristics. One hundred and sixty-two GPs, mostly women, also completed 16 descriptions. Longer duration of action was most favoured by both, followed by lighter periods with less pain or amenorrhoea. The least attractive features for women were heavier and more painful periods, high cost, irregular periods, low efficacy (10% failure) and weight gain of 3 kg. GPs ranked a 10% pregnancy rate as least attractive followed by heavy painful periods and a 5% failure rate. Conclusion Women and GPs differed in their ranking of contraceptive characteristics. Long duration of use, high efficacy, minimal or no bleeding without pain, were preferred by both. Very undesirable were heavy periods especially with pain, and low efficacy. © 2013 The European Society of Contraception and Reproductive Health.
Wong, CKH, Lam, CLK, Mulhern, B, Law, W-L, Poon, JTC, Kwong, DLW & Tsang, J 2013, 'Measurement invariance of the Functional Assessment of Cancer Therapy—Colorectal quality-of-life instrument among modes of administration', Quality of Life Research, vol. 22, no. 6, pp. 1415-1426.
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Objectives: To test for the measurement invariance of the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) in patients with colorectal neoplasms between two modes of administration (self- and interviewer administrations). It is important to establish the measurement invariance of the FACT-C across different modes of administration to ascertain whether it is valid to pool FACT-C data collected by different modes or to assess each group separately. Methods: A cross-sectional sample of 391 Chinese patients with colorectal neoplasms was recruited from specialist outpatient clinics between September 2009 and July 2010. Confirmatory factor analysis (CFA) was used to test the original five-factor model of the FACT-C on data collected by self- and interviewer administrations in single-group analysis. Multiple-group CFA was then used to compare the factor structure between the two modes of administration using chi-square tests and other goodness-of-fit statistics. Results: The hypothesized five-factor model of FACT-C demonstrated good fit in each group. Configural invariance and metric invariance were fully supported in multiple-group CFA. Some item intercepts and their corresponding error variances were not identical between administration groups, suggesting evidence of partial strict factorial invariance. Conclusions: Our results confirmed that the five-factor structure of FACT-C was invariant in Chinese patients using both self- and interviewer administrations. It is appropriate to pool or compare data in the emotional well-being and colorectal cancer subscale scores collected by both administrations. Measurement invariance in three items, one from each of the other subscales, may be contaminated by response bias between modes of administration. © 2012 The Author(s).
Wong, CKH, Mulhern, B, Wan, YF & Lam, CLK 2013, 'Comparative Responsiveness of Direct and Mapped SF-6D Preference-Based Measures in Colorectal Cancer', Value in Health, vol. 16, no. 7, pp. A420-A420.
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Arora, S, Kecmanovic, M, Hall, JP & Goodall, S 1970, 'The impact of financial incentives on primary care in Australia', iHEA 9th World Congress on Health Economics, Sydney.
Bonney, M, Rose, J, De Abreu Lourenco, R, Taylor, C & Frenzel, C 1970, 'A preference study investigating choices for different forms of an inhaled antibiotic in patients with cystic fibrosis or their carergivers', 10th Australasian Cystic Fibrosis Conference, Auckland, New Zealand.
Church, J, Goodall, S, Gurgacz, S, Whiteman, D & Lord, R 1970, 'Cost-effectiveness of radiofrequency ablation compared to endoscopic surveillance for patients with Barrett's esophagus with low grade dysplasia', ISPOR 18th Annual International Meeting, New Orleans, USA.
Church, J, Goodall, S, Gurgacz, S, Whiteman, D & Lord, R 1970, 'PGI19 Cost-effectiveness of radiofrequency ablation compared to endoscopic surveillance for patients with Barrett's esophagus with low grade dysplasia [conference abstract]', Value in Health, Elsevier, New Orleans, USA, pp. 1-1.
Church, J, Reeve, RD, Goodall, S & Haas, MR 1970, 'Deconstructing the positive feedback loop between depression and obesity: can stressful life events be used as an instrument?', iHEA 9th World Congress on Health Economics, Sydney.
Cronin, PA, Goodall, S, Lockett, T, O'Keefe, R, Norman, R & Church, J 1970, 'Cost-effectiveness of a mailed advance notification letter to increase colorectal cancer screening', ISPOR 18th Annual International Meeting, New Orleans, USA.
De Abreu Lourenco, R 1970, 'Paying primary care providers [invited speaker]', National Primary Health Care Conference 2013.
De Abreu Lourenco, R, Kenny, PM & Hall, JP 1970, 'Factors linked to patient GP payments: results of a survey of Australian patients', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Goodall, S, Hou, C, Church, J & High, H 1970, 'Cost-effectiveness of genetic screening for Multiple Endocrine Neoplasia type 2b to prevent childhood medullary thyroid cancer', ISPOR 18th Annual International Meeting, New Orleans, USA.
Goodall, S, Kenny, PM, De Abreu Lourenco, R & Haas, MR 1970, 'Understanding patients' preferences for primary care services: Have Discrete Choice Experiments helped?', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Haas, MR, Goodall, S & De Abreu Lourenco, R 1970, 'Awareness and uptake among Australians of innovations in the delivery of primary care', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Hall, JP 1970, 'Primary health care in Australia: how can research support health system development? [Plenary]', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Hall, JP 1970, 'The health economics perspective on end of life care', End of Life Issues and Decision Making Forum, Canberra.
Hall, JP 1970, 'Uptake of government incentive schemes and grants in Australian primary care', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Hall, JP & De Abreu Lourenco, R 1970, 'A (rural) health system for the 21st century: Financing our health care system - the place and pace of reform', 12th National Rural Health Conference, Adelaide.
Hou, C, Goodall, S, Church, J & High, H 1970, 'Cost-effectiveness of genetic screening for Multiple Endocrine Neoplasia Type2B to prevent childhood medullary thyroid cancer', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Hou, C, Haas, MR, Viney, RC, Van Gool, K, Gu, Y & Brodaty, H 1970, 'Understanding the cost of dementia in Australia', iHEA 9th World Congress on Health Economics, Sydney.
Kalff, A, Kennedy, N, Smiley, A, Prince, HM, Roberts, AW, Bradstock, KF, De Abreu Lourenco, R & Spencer, A 1970, 'Thalidomide Consolidation Post Autologous Stem Cell Transplant (ASCT) For Multiple Myeloma (MM) Is Cost-Effective With Durable Survival Benefit At 5 Years Post Randomisation: Final Analysis Of The ALLG MM6 Study', Blood, American Society of Hematology, pp. 537-537.
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Abstract Background Studies investigating thalidomide consolidation/maintenance strategies post ASCT in patients with MM have consistently demonstrated improvement in duration of myeloma control, however not consistently shown improvements in overall survival. Cost effectiveness of thalidomide in the post-ASCT consolidation/maintenance setting in Australian clinical practice has not been previously established Aim To determine whether progression free survival (PFS) and overall survival (OS) advantages for thalidomide consolidation post ASCT at 3 years post randomisation in the ALLG MM6 study are durable at later follow-up. To compare overall response rate (ORR) to salvage therapy and incidence of second primary malignancy (SPM). To investigate the cost-effectiveness of thalidomide in the post-ASCT consolidation setting. Methods Phase III, randomised, multi-centre, open label study. 243 newly diagnosed MM patients 6 weeks following a single MEL200 ASCT as part of their first-line therapy were randomly assigned to receive indefinite prednisolone maintenance (50mg alternate days) alone (CA = 129 patients, 1 patient withdrew consent) or in combination with 12 months of thalidomide consolidation (100mg/d increasing to 200mg/d after 2/52) (TA = 114 patients). This was a post hoc analysis, PFS and OS were measured from date of randomization; these endpoints were compared using intention-to-treat analyses. Data for ORR to salvage therapy was collected retrospectively for 96 of 187 relapsed/progressed patients only (TA = 42/81 relapsed, CA = 54/109 relapsed), as was data for SPM (207/23...
Kecmanovic, M, Arora, S, Hall, JP & Goodall, S 1970, 'The impact of financial incentives on primary care in Australia', 2013 Primary Health Care Research Conference, Sydney.
Kenny, PM, Haas, MR & Goodall, S 1970, 'Patient preferences in general practice: Important factors for choosing a GP', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Norman, R, Viney, RC, Street, D, Cronin, PA & Ratcliffe, J 1970, 'Using choice experiments to explore preferences for health profiles with different survival durations: experience from Australia', iHEA 9th World Congress on Health Economics, Sydney.
Parkinson, B, Goodall, S & Norman, R 1970, 'Measuring the Loss of Consumer Choice in Mandatory Health Programmes Using Discrete Choice Experiments', APPLIED HEALTH ECONOMICS AND HEALTH POLICY, 32nd Conference of Australian Health Economists, SPRINGER INTERNATIONAL PUBLISHING AG, Sydney, pp. 139-150.
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Parkinson, B, Viney, R, Goodall, S & Haas, M 1970, 'Drivers of Clinician Prescribing Decisions and the Economics of Information', Value in Health, 35th Australian Conference of Health Economists, Elsevier BV, Canberra, pp. A471-A471.
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Parkinson, BT, Viney, RC, Goodall, S & Haas, MR 1970, 'Clinician prescribing decisions and the economics of information', iHEA 9th World Congress on Health Economics, Sydney.
Parkinson, BT, Viney, RC, Goodall, S & Haas, MR 1970, 'Drivers of clinician prescribing decisions and the economics of information (PHP105)', ISPOR 16th Annual European Congress, Dublin, Ireland.
Pearce, AM, Haas, M & Viney, R 1970, 'The incidence and costs of chemotherapy side effects', 10th Summer Workshop in Health Economics, 10th Summer Workshop in Health Economics, Sydney.
Reeve, RD, Church, J, Haas, MR, Bradford, W & Viney, RC 1970, 'What factors drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote New South Wales?', World Diabetes Congress 2013, Melbourne.
Reeve, RD, Church, J, Haas, MR, Bradford, W & Viney, RC 1970, 'What factors underpin the diabetes gap in non-remote NSW?', iHEA 9th World Congress on Health Economics, Sydney.
Reeve, RD, Srasuebkul, P, Pearson, S, Haas, MR & Viney, RC 1970, 'Resource use and costs of cancer care at the end of life', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
