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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Melville CA, Hatton C, Beer E, Hastings RP, Cooper SA, McMeekin N, Dagnan D, Appleton K, Scott K, Fulton L, Jones RSP, McConnachie A, Zhang R, Knight R, Knowles D, Williams C, Briggs A, Jahoda A. Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self-help therapies. J Intellect Disabil Res 2023; 67:986-1002. [PMID: 37344986 DOI: 10.1111/jir.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self-help. METHODS This study was an exploratory secondary data analysis of data collected during a randomised clinical trial. Participants (n = 161) were randomised to behavioural activation or guided self-help and followed up for 12 months. Pre-treatment variables were included if they have previously been shown to be associated with an increased risk of having depression in adults with IDs or have been reported as a potential predictor or moderator of outcome of treatment for depression with psychological therapies. The primary outcome measure, the Glasgow Depression Scale for Adults with Learning Disabilities (GDS-LD), was used as the dependant variable in mixed effects regression analyses testing for predictors and moderators of outcome, with baseline GDS-LD, treatment group, study centre and antidepressant use as fixed effects, and therapist as a random effect. RESULTS Higher baseline anxiety (mean difference in outcome associated with a 1 point increase in anxiety 0.164, 95% confidence interval [CI] 0.031, 0.297; P = 0.016), lower performance intelligence quotient (IQ) (mean difference in outcome associated with a 1 point increase in IQ 0.145, 95% CI 0.009, 0.280; P = 0.037) and hearing impairment (mean difference 3.449, 95% CI 0.466, 6.432; P = 0.024) were predictors of poorer outcomes, whilst greater severity of depressive symptoms at baseline (mean difference in outcome associated with 1 point increase in depression -0.160, 95% CI -0.806, -0.414; P < 0.001), higher expectation of change (mean difference in outcome associated with a 1 point increase in expectation of change -1.013, 95% CI -1.711, -0.314; p 0.005) and greater percentage of therapy sessions attended (mean difference in outcome with 1 point increase in percentage of sessions attended -0.058, 95% CI -0.099, -0.016; P = 0.007) were predictors of more positive outcomes for treatment after adjusting for randomised group allocation. The final model included severity of depressive and anxiety symptoms, lower WASI performance IQ subscale, hearing impairment, higher expectation of change and percentage of therapy sessions attended and explained 35.3% of the variance in the total GDS-LD score at 12 months (R2 = 0.353, F4, 128 = 17.24, P < 0.001). There is no evidence that baseline variables had a moderating effect on outcome for treatment with behavioural activation or guided self-help. CONCLUSIONS Our results suggest that baseline variables may be useful predictors of outcomes of psychological therapies for adults with IDs. Further research is required to examine the value of these potential predictors. However, our findings suggest that therapists consider how baseline variables may enable them to tailor their therapeutic approach when using psychological therapies to treat depression experienced by adults with IDs.
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Affiliation(s)
- C A Melville
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - E Beer
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - S-A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N McMeekin
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D Dagnan
- Clinical Psychology, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and University of Cumbria, Newcastle upon Tyne Tyne, UK
| | - K Appleton
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - K Scott
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Fulton
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R S P Jones
- School of Psychology, Bangor University, Bangor, UK
| | - A McConnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R Zhang
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R Knight
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - D Knowles
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - C Williams
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A Briggs
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - A Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Chaudhary MA, Edmondson-Jones M, Baio G, Mackay E, Penrod JR, Sharpe DJ, Yates G, Rafiq S, Johannesen K, Siddiqui MK, Vanderpuye-Orgle J, Briggs A. Use of Advanced Flexible Modeling Approaches for Survival Extrapolation from Early Follow-up Data in two Nivolumab Trials in Advanced NSCLC with Extended Follow-up. Med Decis Making 2023; 43:91-109. [PMID: 36259353 DOI: 10.1177/0272989x221132257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Immuno-oncology (IO) therapies are often associated with delayed responses that are deep and durable, manifesting as long-term survival benefits in patients with metastatic cancer. Complex hazard functions arising from IO treatments may limit the accuracy of extrapolations from standard parametric models (SPMs). We evaluated the ability of flexible parametric models (FPMs) to improve survival extrapolations using data from 2 trials involving patients with non-small-cell lung cancer (NSCLC). METHODS Our analyses used consecutive database locks (DBLs) at 2-, 3-, and 5-y minimum follow-up from trials evaluating nivolumab versus docetaxel in patients with pretreated metastatic squamous (CheckMate-017) and nonsquamous (CheckMate-057) NSCLC. For each DBL, SPMs, as well as 3 FPMs-landmark response models (LRMs), mixture cure models (MCMs), and Bayesian multiparameter evidence synthesis (B-MPES)-were estimated on nivolumab overall survival (OS). The performance of each parametric model was assessed by comparing milestone restricted mean survival times (RMSTs) and survival probabilities with results obtained from externally validated SPMs. RESULTS For the 2- and 3-y DBLs of both trials, all models tended to underestimate 5-y OS. Predictions from nonvalidated SPMs fitted to the 2-y DBLs were highly unreliable, whereas extrapolations from FPMs were much more consistent between models fitted to successive DBLs. For CheckMate-017, in which an apparent survival plateau emerges in the 3-y DBL, MCMs fitted to this DBL estimated 5-y OS most accurately (11.6% v. 12.3% observed), and long-term predictions were similar to those from the 5-y validated SPM (20-y RMST: 30.2 v. 30.5 mo). For CheckMate-057, where there is no clear evidence of a survival plateau in the early DBLs, only B-MPES was able to accurately predict 5-y OS (14.1% v. 14.0% observed [3-y DBL]). CONCLUSIONS We demonstrate that the use of FPMs for modeling OS in NSCLC patients from early follow-up data can yield accurate estimates for RMST observed with longer follow-up and provide similar long-term extrapolations to externally validated SPMs based on later data cuts. B-MPES generated reasonable predictions even when fitted to the 2-y DBLs of the studies, whereas MCMs were more reliant on longer-term data to estimate a plateau and therefore performed better from 3 y. Generally, LRM extrapolations were less reliable than those from alternative FPMs and validated SPMs but remained superior to nonvalidated SPMs. Our work demonstrates the potential benefits of using advanced parametric models that incorporate external data sources, such as B-MPES and MCMs, to allow for accurate evaluation of treatment clinical and cost-effectiveness from trial data with limited follow-up. HIGHLIGHTS Flexible advanced parametric modeling methods can provide improved survival extrapolations for immuno-oncology cost-effectiveness in health technology assessments from early clinical trial data that better anticipate extended follow-up.Advantages include leveraging additional observable trial data, the systematic integration of external data, and more detailed modeling of underlying processes.Bayesian multiparameter evidence synthesis performed particularly well, with well-matched external data.Mixture cure models also performed well but may require relatively longer follow-up to identify an emergent plateau, depending on the specific setting.Landmark response models offered marginal benefits in this scenario and may require greater numbers in each response group and/or increased follow-up to support improved extrapolation within each subgroup.
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Affiliation(s)
| | | | - G Baio
- University College London, London, UK
| | | | - J R Penrod
- Bristol-Myers Squibb, Princeton, NJ, USA
| | | | - G Yates
- Parexel International Corp, London, UK
| | - S Rafiq
- Parexel International Corp, London, UK
| | | | | | | | - A Briggs
- London School of Hygiene and Tropical Medicine, London, UK
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Italiano A, Drilon A, Shen L, Hong D, van Tilburg C, Tan D, Lin J, Kummar S, Doz F, Geoerger B, Brose M, Briggs A, Lassen U, Vassal G, Keating K, Norenberg R, Dima L, Brega N, Laetsch T, Garcia-Foncillas J. 464P Intra-patient (Pt) comparison from larotrectinib (Laro) clinical trials in tropomyosin receptor kinase (TRK) fusion cancer: An expanded dataset. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Clarke AE, St-Pierre Y, Paly V, Bruce IN, Malmberg C, Briggs A, Zhang Y, Choi J, Brennan A. POS0734 EXTRAPOLATION OF LONG-TERM OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOSUS: REPLICATING A HOPKINS LUPUS COHORT ANALYSIS WITH THE SYSTEMIC LUPUS INTERNATIONAL COLLABORATING CLINICS (SLICC) INCEPTION COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A disease model of systemic lupus erythematosus (SLE) that predicts short-term outcomes (disease activity and prednisone use) and links them to long-term outcomes (accrual of organ damage and mortality) was previously developed in a single center SLE cohort (Johns Hopkins [JH]) to support health economic analyses (Watson 2015), which has not been comprehensively replicated in other cohorts or contexts.Objectives:As part of an effort to develop and refine this existing disease model, the aim of this study was to replicate the previously estimated network of risk equations for short- and long-term outcomes in the SLICC Inception Cohort, an international cohort of patients (33 centers,11 countries).Methods:The SLICC Inception Cohort enrolled patients fulfilling ACR Classification Criteria for SLE within 15 months of diagnosis from 1999-2011 with annual follow-up through April 2020. The network of risk equations included two linear random effects models to predict (1) change in annual average Systemic Lupus Disease Activity Index (SLEDAI) score based on patient characteristics and the presence of renal, hematological, and immunological involvement in the prior year and (2) average annual prednisone dose based on SLEDAI score in the same year. These equations were then linked to parametric survival models that predicted time to the occurrence of organ damage (system-specific based on the ACR/SLICC Damage Index) and mortality. We compared model performance between the SLICC Cohort and the original analysis from the JH Cohort.Results:In comparison to the JH cohort (N=1354), the SLICC cohort (N=1697) had a smaller fraction of patients of African descent (39% vs 17%) and shorter disease duration at entry (4.8 vs 0.5 years). In the first equation predicting change in annual SLEDAI score, predictors were generally aligned with the same direction and significance, with the exception of renal involvement in the prior period, which had a positive association with change in SLEDAI in the SLICC cohort but was negatively associated in the JH cohort (Table 1). The second equation predicting prednisone dose was also consistent with the original analysis showing a significant positive association between higher disease activity and prednisone use. In all of the parametric survival analyses (individual organ damage and mortality models), coefficients were generally in the same direction and magnitude, though some were no longer significant in the SLICC cohort.Conclusion:The relationships identified in the original analysis were broadly replicated in the SLICC Inception Cohort. Observed differences may reflect differences in the patient populations, structure of the two cohorts (prevalent vs inception), and frequency of visits (quarterly visits in the JH cohort vs annual visits with the SLICC cohort may more closely capture a decrease in SLEDAI associated with treatment specifically related to renal involvement). Additional analyses relaxing the requirement to completely align with the original structure are underway to further assess the predictive accuracy of these models.References:[1]Watson P, et al. Rheumatology (Oxford). 2015;54(4):623-32.JH Cohort(N=1354)SLICC Cohort(N=1697)Female, %92.988.8African descent, %38.816.7Disease duration at entry, mean (SD), years4.8 (6.3)0.5 (0.3)SLEDAI at first visit, mean (SD)3.7 (4.1)5.4 (5.4)Change in average annual SLEDAICoefficientCoefficientConstant1.491*5.762*Annual average SLEDAI in prior period−0.460*−0.755*Male gender−0.080−0.207Log transformation of age−0.241*−1.134*Renal involvement in prior period−0.301*0.627*African descent0.383*0.126Increased DNA binding in prior period0.276*0.939*Low complement in prior period0.484*0.775*Hematological involvement in prior period0.104−0.025Anemia in prior period0.152**0.144Associated annual average prednisone dose (mg/day)Constant3.475*2.738*SLEDAI in same period0.777*0.648**p<0.001; **p<0.05Acknowledgements:We acknowledge the support on this abstract of the following investigators of the Systemic Lupus International Collaborating Clinics:John Hanly - john.hanly@nshealth.caCaroline Gordon - p.c.gordon@bham.ac.ukSang-Cheol Bae - scbae@hanyang.ac.krJuanita Romero-Diaz - juanita.romerodiaz@gmail.comJorge Sanchez-Guerrero - jorge.sanchez-guerrero@uhn.caSasha Bernatsky - sasha.bernatsky@mcgill.caAnn Clarke - aeclarke@ucalgary.caDaniel Wallace - dwallace@ucla.edu/danielwallac@gmail.comDavid Isenberg - d.isenberg@ucl.ac.ukAnisur Rahman - anisur.rahman@ucl.ac.ukJoan Merril - JTMmail@aol.comPaul Fortin - paul.fortin@crchudequebec.ulaval.caDafna Gladman - dafna.gladman@utoronto.caMurray Urowitz - m.urowitz@utoronto.caIan Bruce - ian.bruce@manchester.ac.ukMichelle Petri - mpetri@jhmi.eduEllen Ginzler - ellen.ginzler@downstate.eduMA Dooley - Mary_Dooley@med.unc.eduRosalind Ramsey-Godman - rgramsey@northwestern.eduSusan Manzi - susan.manzi@ahn.org; Susanmanzi@gmail.comAndreas Jonsen - andreas.jonsen@med.lu.seGraciela Alarcon - galarcon@uab.eduRonald van Vollenhoven - r.vanvollenhoven@amsterdamumc.nlCynthia Aranow - CAranow@Northwell.eduMeggan Mackay – mmackay@northwell.eduGuillermo Ruiz-Irastorza - r.irastorza@outlook.esSam Lim - sslim@emory.eduMurat Inanc - drinanc@istanbul.edu.tr; minanc2008@gmail.comKenneth Kalunian - kkalunian@ucsd.eduSoren Jacobsen - sj@dadlnet.dkChristine Peschken - christine.peschken@umanitoba.caDiane Kamen - kamend@musc.eduAnca Askanase - ada20@columbia.eduDisclosure of Interests:Ann E Clarke Consultant of: BMS, AstraZeneca, GSK, and Exagen Diagnostics., Yvan St-Pierre: None declared, Victoria Paly: None declared, Ian N. Bruce Speakers bureau: GSK, UCB, Consultant of: BMS, Eli Lilly, GSK, Astra Zeneca, Merck Serono; UCB, ILTOO, Aurinia, Grant/research support from: Genzyme/Sanofi, GSK, Roche, UCB, Chiara Malmberg: None declared, Andrew Briggs Speakers bureau: Alexion, AstraZeneca, Bayer, BMS, Daiichi Sankyo, Eisai, Gilead, GSK, Kite, Merck, Novartis, Rhythm, Roche, Sanofi, Takeda, Consultant of: Alexion, AstraZeneca, Bayer, BMS, Daiichi Sankyo, Eisai, Gilead, GSK, Kite, Merck, Novartis, Rhythm, Roche, Sanofi, Takeda, Yuanhui Zhang Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Jiyoon Choi Shareholder of: JNJ., Employee of: BMS, Alan Brennan Consultant of: Alan Brennan is a paid consultant on advisory boards regarding cost-effectiveness modelling., Grant/research support from: Alan Brennan received research grants.
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Schneider J, Davies S, Howarth A, GARCIA SANCHEZ J, Rao N, Grandy S, Bhatt P, Parackal A, Wong D, Briggs A. POS-321 TRANSLATING THE FINDINGS OF THE ROXADUSTAT NDD GLOBAL PHASE 3 PROGRAM INTO COST OFFSETS FROM A CANADIAN HEALTHCARE PERSPECTIVE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Italiano A, Hong D, Briggs A, Garcia-Foncillas J, Lassen U, Vassal G, Kummar S, van Tilburg C, Keating K, Reeves J, Fellous M, Nogai H, Laetsch T, Drilon A. 542P Growth modulation index (GMI) of larotrectinib versus prior systemic treatments for TRK fusion cancer patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
This article reports on a survey of recipients of 51 technical assistance projects in 18 states and territories provided by the Teaching Research Assistance to Children Experiencing Sensory Impairments project. On the basis of the respondents’ assessments of factors that result in the most effective provision of technical assistance by consultants in educational settings, the authors present a systematic approach to the achievement of desired individual, programmatic, and systemwide changes through technical assistance.
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Affiliation(s)
- A. Briggs
- South Central Region, TRACES project, P.O. Box 1459, Ocala, FL 34478
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- Project STEPS, Guinnette County Schools, Oakland Center, Lawrenceville, GA 30244
| | - P. Alberto
- Department of Educational Psychology and Special Education, Georgia State University, University Plaza, Atlanta, GA 30303–3083
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Fasching P, Huang M, Cortés J, Zhao J, O’Shaughnessy J, Hu P, Haiderali A, Karantza V, Aktan G, Briggs A, Ramsey S, Qi C, Xie J, Gu C, Qian K, Yuan M, Wu E. Meta-analysis on association of pathological complete response with long-term survival outcomes in triple-negative breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Xin Y, Davies A, McCombie L, Briggs A, Messow CM, Grieve E, Leslie WS, Taylor R, Lean MEJ. Type 2 diabetes remission: economic evaluation of the DiRECT/Counterweight-Plus weight management programme within a primary care randomized controlled trial. Diabet Med 2019; 36:1003-1012. [PMID: 31026353 DOI: 10.1111/dme.13981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2019] [Indexed: 12/21/2022]
Abstract
AIM The Counterweight-Plus weight management programme achieved 46% remission of Type 2 diabetes at 1 year in the DiRECT trial. We estimated the implementation costs of the Counterweight-Plus programme and its 1-year cost-effectiveness in terms of diabetes remission, compared with usual care, from the UK National Health Service (NHS) perspective. METHODS Within-trial total costs included programme set-up and running costs (practitioner appointment visits, low-energy formula diet sachets and training), oral anti-diabetes and anti-hypertensive medications, and healthcare contacts. Total costs were calculated for aggregated resource use for each participant and 95% confidence intervals (CI) were based on 1000 non-parametric bootstrap iterations. RESULTS One-year programme costs under trial conditions were estimated at £1137 per participant (95% CI £1071, £1205). The intervention led to a significant cost-saving of £120 (95% CI £78, £163) for the oral anti-diabetes drugs and £14 (95% CI £7.9, £22) for anti-hypertensive medications compared with the control. Deducting the cost-savings of all healthcare contacts from the intervention cost resulted an incremental cost of £982 (95% CI £732, £1258). Cost per 1 year of diabetes remission was £2359 (95% CI £1668, £3250). CONCLUSIONS Remission of Type 2 diabetes within 1-year can be achieved at a cost below the annual cost of diabetes (including complications). Providing a reasonable proportion of remissions can be maintained over time, with multiple medical gains expected, as well as immediate social benefits, there is a case for shifting resources within diabetes care budgets to offer support for people with Type 2 diabetes to attempt remission. (Clinical Trial Registry No.: ISRCTN03267836).
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Affiliation(s)
- Y Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A Davies
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L McCombie
- Human Nutrition, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - A Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C-M Messow
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - E Grieve
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - W S Leslie
- Human Nutrition, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - R Taylor
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - M E J Lean
- Human Nutrition, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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12
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Huang M, Qi C, Ramsey S, Briggs A, Zhao J, Haiderali A, Karantza V, Xie J, Gu C, Fasching P. Evaluation of pathological complete response as a trial-level surrogate for long-term survival outcomes among triple-negative breast cancer patients receiving neoadjuvant therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz097.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Booth J, Caillet V, Briggs A, Hardcastle N, Jayamanne D, Szymura K, O'Brien R, Harris B, Eade T, Keall P. First-in-Human Clinical Experience with Real-Time Tumor Targeting Via MLC Tracking for Stereotactic Radiation Therapy of Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Hoy DG, Raikoti T, Smith E, Tuzakana A, Gill T, Matikarai K, Tako J, Jorari A, Blyth F, Pitaboe A, Buchbinder R, Kalauma I, Brooks P, Lepers C, Woolf A, Briggs A, March L. Use of The Global Alliance for Musculoskeletal Health survey module for estimating the population prevalence of musculoskeletal pain: findings from the Solomon Islands. BMC Musculoskelet Disord 2018; 19:292. [PMID: 30115055 PMCID: PMC6097436 DOI: 10.1186/s12891-018-2198-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background Musculoskeletal (MSK) conditions are common and the biggest global cause of physical disability. The objective of the current study was to estimate the population prevalence of MSK-related pain using a standardized global MSK survey module for the first time. Methods A MSK survey module was constructed by the Global Alliance for Musculoskeletal Health Surveillance Taskforce and the Global Burden of Disease MSK Expert Group. The MSK module was included in the 2015 Solomon Islands Demographic and Health Survey. The sampling design was a two-stage stratified, nationally representative sample of households. Results A total of 9214 participants aged 15–49 years were included in the analysis. The age-standardized four-week prevalence of activity-limiting low back pain, neck pain, and hip and/or knee pain was 16.8, 8.9, and 10.8%, respectively. Prevalence tended to increase with age, and be higher in those with lower levels of education. Conclusions Prevalence of activity-limited pain was high in all measured MSK sites. This indicates an important public health issue for the Solomon Islands that needs to be addressed. Efforts should be underpinned by integration with strategies for other non-communicable diseases, aging, disability, and rehabilitation, and with other sectors such as social services, education, industry, and agriculture. Primary prevention strategies and strategies aimed at self-management are likely to have the greatest and most cost-effective impact. Electronic supplementary material The online version of this article (10.1186/s12891-018-2198-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D G Hoy
- University of Sydney, Sydney, Australia. .,Global Alliance for Musculoskeletal Health, Truro, UK. .,Pacific Community (SPC), Noumea, New Caledonia.
| | - T Raikoti
- Pacific Community (SPC), Noumea, New Caledonia
| | - E Smith
- University of Sydney, Sydney, Australia
| | - A Tuzakana
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - T Gill
- University of Adelaide, Adelaide, Australia
| | - K Matikarai
- Pacific Community (SPC), Noumea, New Caledonia
| | - J Tako
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - A Jorari
- Pacific Community (SPC), Noumea, New Caledonia
| | - F Blyth
- University of Sydney, Sydney, Australia
| | - A Pitaboe
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | | | - I Kalauma
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - P Brooks
- University of Melbourne, Melbourne, Australia
| | - C Lepers
- Pacific Community (SPC), Noumea, New Caledonia
| | - A Woolf
- Global Alliance for Musculoskeletal Health, Truro, UK.,Royal Cornwall Hospital, Truro, UK
| | - A Briggs
- Curtin University, Perth, Australia
| | - L March
- University of Sydney, Sydney, Australia.,Global Alliance for Musculoskeletal Health, Truro, UK
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15
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Sanchez R, Nasir K, Klimchak A, Kuznik A, Joulain F, Briggs A. Modeling the population health benefits of LDL-C reduction with alirocumab among cardiovascular disease/heterozygous familial hypercholesterolemia patients with elevated LDL-C. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Sabater J, Baker T, Paly V, Gupte-Singh K, Lorenzi M, Jeffers A, Beyhaghi H, Kotapati S, Rao S, Briggs A. Cost-effectiveness of nivolumab+ipilimumab in first-line treatment of advanced melanoma: Analysis using 28-month overall survival from CheckMate 067. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx375.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Trueman D, Kapetanakis V, Briggs A, Lewis E, Rouleau J, Solomon S, Swedberg K, Zile M, Packer M, McMurray J, Croft D, Haroun R, Gielen V. P3373Better health-related quality of life in patients treated with sacubitril/valsartan compared with enalapril, irrespective of NYHA class: Analysis of EQ-5D in PARADIGM-HF. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Inderjeeth C, Raymond W, Geelhoed E, Briggs A, Briffa K, Oldham D, McQuade J, Mountain D. OP0103 Fracture Liaison Service Implemented in A Metropolitan Tertiary Centre in Western Australia Improved Treatment and Recurrent Fracture Rates by 12 Months. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Inderjeeth C, Sun W, Briggs A, Miller L, Kelly P, Pyper W, Huska A. THU0470 Hospital Utilisation and Mortality of Traumatic Hip and Non-Hip Fractures in Patients with Osteoporosis in Western Australia: A Ten-Year Study Using Linked Administrative Data. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Briggs A, Baker TM, Gilloteau I, Orsini L, Wagner S, Paly V. Partitioned Survival Versus State Transition Modeling in Oncology: a Case Study with Nivolumab in Advanced Melanoma. Value in Health 2015; 18:A338. [PMID: 0 DOI: 10.1016/j.jval.2015.09.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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21
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Wolowacz S, Pearson I, Shannon P, Chubb B, Gundgaard J, Davies M, Briggs A. Development and validation of a cost-utility model for Type 1 diabetes mellitus. Diabet Med 2015; 32:1023-35. [PMID: 25484028 DOI: 10.1111/dme.12663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/28/2022]
Abstract
AIMS To develop a health economic model to evaluate the cost-effectiveness of new interventions for Type 1 diabetes mellitus by their effects on long-term complications (measured through mean HbA1c ) while capturing the impact of treatment on hypoglycaemic events. METHODS Through a systematic review, we identified complications associated with Type 1 diabetes mellitus and data describing the long-term incidence of these complications. An individual patient simulation model was developed and included the following complications: cardiovascular disease, peripheral neuropathy, microalbuminuria, end-stage renal disease, proliferative retinopathy, ketoacidosis, cataract, hypoglycemia and adverse birth outcomes. Risk equations were developed from published cumulative incidence data and hazard ratios for the effect of HbA1c , age and duration of diabetes. We validated the model by comparing model predictions with observed outcomes from studies used to build the model (internal validation) and from other published data (external validation). We performed illustrative analyses for typical patient cohorts and a hypothetical intervention. RESULTS Model predictions were within 2% of expected values in the internal validation and within 8% of observed values in the external validation (percentages represent absolute differences in the cumulative incidence). CONCLUSIONS The model utilized high-quality, recent data specific to people with Type 1 diabetes mellitus. In the model validation, results deviated less than 8% from expected values.
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Affiliation(s)
- S Wolowacz
- Health Economics, RTI Health Solutions, Manchester
| | - I Pearson
- Health Economics, RTI Health Solutions, Manchester
| | - P Shannon
- Patient-Reported Outcomes, RTI Health Solutions, Manchester
| | - B Chubb
- European Health Economics & Outcomes Research, Novo Nordisk Ltd, Gatwick, UK
| | - J Gundgaard
- Health Economics and HTA, Novo Nordisk A/S, Bagsvaerd, Denmark
| | - M Davies
- Diabetes Research Centre, University of Leicester, Leicester
| | - A Briggs
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
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22
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Slater H, Davies S, Milne G, Kelso J, Slattery M, Briggs A. The painHEALTH website: a Western Australian policy-into-practice initiative to deliver holistic, consumer-focused best-evidence pain management for people with musculoskeletal pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Hoogendoorn M, Feenstra T, Asukai Y, Borg S, Hansen RN, Jansson SA, Samyshkin Y, Wacker M, Briggs A, Lloyd A, Sullivan SD, Rutten-van Mölken MP. Cost-Effectiveness Models for Chronic Obstructive Pulmonary Disease (COPD): Cross-Model Comparison of Hypothetical Treatment Scenarios. Value Health 2014; 17:A557-A558. [PMID: 27201829 DOI: 10.1016/j.jval.2014.08.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Hoogendoorn
- Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Y Asukai
- IMS Health, Economics and Outcomes Research, London, UK
| | - S Borg
- The Swedish Institute for Health Economics, Lund, Sweden
| | - R N Hansen
- School of Pharmacy, University of Washington, Seattle, WA, USA
| | | | - Y Samyshkin
- IMS Health, Economics and Outcomes Research, London, UK
| | - M Wacker
- Helmholtz Zentrum Munchen, Neuherberg, Germany
| | - A Briggs
- University of Glasgow, Glasgow, UK
| | - A Lloyd
- IMS Health, Economics and Outcomes Research, London, UK
| | - S D Sullivan
- University of Washington, Pharmaceutical Outcomes Research and Policy Program, Seattle, WA, USA
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24
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Hudgens S, Briggs A, Tremblay G, Forsythe A, Lloyd A. Comparison of Methods to Estimate Health State Utilities in Metastatic Breast Cancer (MBC). Value Health 2014; 17:A557. [PMID: 27201830 DOI: 10.1016/j.jval.2014.08.1835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Hudgens
- Clinical Outcomes Solutions, Tucson, AZ, USA
| | - A Briggs
- University of Glasgow, Glasgow, UK
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25
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Risebrough NA, Briggs A, Baker TM, Exuzides A, Colby C, Rutten van-Molken M, Gonzalez McQuire S, Lomas D, Muellerova H, Tal-Singer R, Ismaila A. Validating A Model To Predict Disease Progression Outcomes In Patients With COPD. Value Health 2014; 17:A560-A561. [PMID: 27201846 DOI: 10.1016/j.jval.2014.08.1852] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- N A Risebrough
- ICON plc (formerly Oxford Outcomes), Toronto, ON, Canada
| | - A Briggs
- University of Glasgow, Glasgow, UK
| | - T M Baker
- ICON plc (formerly Oxford Outcomes), Morristown, NJ, USA
| | | | - C Colby
- ICON plc, San Francisco, CA, USA
| | | | | | - D Lomas
- University College London, London, UK
| | | | | | - A Ismaila
- GlaxoSmithKline, Research Triangle Park, NC, USA
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26
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Hudgens S, Briggs A, Velikova G, Forsythe A, McCutcheon S, Kind P. Impact of Treatment with Eribulin (Eri) or Capecitabine (Cap) for Metastatic Breast Cancer (Mbc) on Eq–5D Utility Derived from Eortc Qlq–C30. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu341.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Bousquet J, Addis A, Adcock I, Agache I, Agusti A, Alonso A, Annesi-Maesano I, Anto JM, Bachert C, Baena-Cagnani CE, Bai C, Baigenzhin A, Barbara C, Barnes PJ, Bateman ED, Beck L, Bedbrook A, Bel EH, Benezet O, Bennoor KS, Benson M, Bernabeu-Wittel M, Bewick M, Bindslev-Jensen C, Blain H, Blasi F, Bonini M, Bonini S, Boulet LP, Bourdin A, Bourret R, Bousquet PJ, Brightling CE, Briggs A, Brozek J, Buhl R, Bush A, Caimmi D, Calderon M, Calverley P, Camargos PA, Camuzat T, Canonica GW, Carlsen KH, Casale TB, Cazzola M, Cepeda Sarabia AM, Cesario A, Chen YZ, Chkhartishvili E, Chavannes NH, Chiron R, Chuchalin A, Chung KF, Cox L, Crooks G, Crooks MG, Cruz AA, Custovic A, Dahl R, Dahlen SE, De Blay F, Dedeu T, Deleanu D, Demoly P, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dubakiene R, Eglin S, Elliot F, Emuzyte R, Fabbri L, Fink Wagner A, Fletcher M, Fokkens WJ, Fonseca J, Franco A, Frith P, Furber A, Gaga M, Garcés J, Garcia-Aymerich J, Gamkrelidze A, Gonzales-Diaz S, Gouzi F, Guzmán MA, Haahtela T, Harrison D, Hayot M, Heaney LG, Heinrich J, Hellings PW, Hooper J, Humbert M, Hyland M, Iaccarino G, Jakovenko D, Jardim JR, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Joos G, Jung KS, Kalayci O, Karunanithi S, Keil T, Khaltaev N, Kolek V, Kowalski ML, Kull I, Kuna P, Kvedariene V, Le LT, Lodrup Carlsen KC, Louis R, MacNee W, Mair A, Majer I, Manning P, de Manuel Keenoy E, Masjedi MR, Melen E, Melo-Gomes E, Menzies-Gow A, Mercier G, Mercier J, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, N'Diaye M, Nafti S, Nekam K, Neou A, Nicod L, O'Hehir R, Ohta K, Paggiaro P, Palkonen S, Palmer S, Papadopoulos NG, Papi A, Passalacqua G, Pavord I, Pigearias B, Plavec D, Postma DS, Price D, Rabe KF, Radier Pontal F, Redon J, Rennard S, Roberts J, Robine JM, Roca J, Roche N, Rodenas F, Roggeri A, Rolland C, Rosado-Pinto J, Ryan D, Samolinski B, Sanchez-Borges M, Schünemann HJ, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Small I, Sola-Morales O, Sooronbaev T, Stelmach R, Sterk PJ, Stiris T, Sud P, Tellier V, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valiulis A, Valovirta E, Van Ganse E, Vandenplas O, Vasankari T, Vestbo J, Vezzani G, Viegi G, Visier L, Vogelmeier C, Vontetsianos T, Wagstaff R, Wahn U, Wallaert B, Whalley B, Wickman M, Williams DM, Wilson N, Yawn BP, Yiallouros PK, Yorgancioglu A, Yusuf OM, Zar HJ, Zhong N, Zidarn M, Zuberbier T. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J 2014; 44:304-23. [PMID: 24925919 DOI: 10.1183/09031936.00014614] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).
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Affiliation(s)
| | | | | | - J Bousquet
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France Fondation Partenariale, France
| | - A Addis
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Regione Emilia-Romagna, Italy
| | - I Adcock
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - I Agache
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases Faculty of Medicine, Transylvania University, Brasov, Romania
| | - A Agusti
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - A Alonso
- Hospital Clínic/FCRB, Barcelona, Spain
| | | | - J M Anto
- MeDALL, Mechanisms of the Development of Allergy Centre for Research in Environmental Epidemiology (CREAL), IMIM (Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - C Bachert
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Dept Respiratory Medicine, Ghent University Hospital, Gent, Belgium ENT Dept, Ghent University Hospital, Gent, Belgium
| | - C E Baena-Cagnani
- ARIA, Allergic Rhinitis and Its Impact on Asthma Research Centre in Respiratory Medicine (CIMER), Faculty of Medicine, Catholic University, Cordoba, Argentina
| | - C Bai
- Shanghai Respiratory Research Institute, Chinese Medical Association, Shanghai, China Chinese Alliance against Lung Cancer
| | - A Baigenzhin
- EuroAsian Respiratory Society, Astana City, Kazakhstan
| | - C Barbara
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases
| | - P J Barnes
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - E D Bateman
- ARIA, Allergic Rhinitis and Its Impact on Asthma Division of Pulmonology, Dept of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - L Beck
- Health Innovation Centre of Southern Denmark, Region of Southern Denmark, Denmark
| | - A Bedbrook
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - E H Bel
- Academic Medical Centre, University of Amsterdam, The Netherlands
| | - O Benezet
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - K S Bennoor
- ARIA, Allergic Rhinitis and Its Impact on Asthma Bangladesh Lung Foundation and National Institute of Diseases of Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualised Medicine, Dept of Clinical and Experimental Sciences, Linköping University, Linköping, Sweden
| | - M Bernabeu-Wittel
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Aura Andalucia, Spain Andalusian Healthcare Service, Spain
| | - M Bewick
- Deputy National Medical Director, NHS England, UK
| | - C Bindslev-Jensen
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, Odense, Denmark
| | - H Blain
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - F Blasi
- ERS, European Respiratory Society, University of Milan, IRCCS Cà Granda, Milan, Italy
| | - M Bonini
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
| | - S Bonini
- ARIA, Allergic Rhinitis and Its Impact on Asthma Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - L P Boulet
- ARIA, Allergic Rhinitis and Its Impact on Asthma Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - A Bourdin
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France INSERM, U1046, Montpellier, France
| | - R Bourret
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - P J Bousquet
- ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - C E Brightling
- National Institute for Health Research, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - A Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J Brozek
- ARIA, Allergic Rhinitis and Its Impact on Asthma Depts of Clinical Epidemiology, and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - R Buhl
- Pulmonary Dept, III, Medical Centre, Mainz University Hospital, Mainz, Germany
| | - A Bush
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Paediatric Respiratory Medicine, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK
| | - D Caimmi
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - M Calderon
- University of Costa Rica, San Jose, Costa Rica Section of Allergy and Clinical Immunology, Imperial College London, Royal Brompton Hospital, London, UK
| | - P Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool and University Hospital Aintree, Liverpool, UK
| | - P A Camargos
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - T Camuzat
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - G W Canonica
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Respiratory Diseases, IRCCS San Martino - IST- University of Genoa, Dept of Internal Medicine, Genoa, Italy
| | - K H Carlsen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma NAH, National Allergy Health Programme, Norway University of Oslo and Oslo University Hospital, Dept of Paediatrics, Oslo, Norway
| | - T B Casale
- ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - M Cazzola
- University of Rome "Tor Vergata" Dept of System Medicine, Rome, Italy
| | - A M Cepeda Sarabia
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia
| | - A Cesario
- IRCCS, San Raffaele Pisana, Rome, Italy
| | - Y Z Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, PR China
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - N H Chavannes
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - R Chiron
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - A Chuchalin
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Pulmonology Research Institute and Russian Respiratory Society, Moscow, Russia
| | - K F Chung
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - L Cox
- ARIA, Allergic Rhinitis and Its Impact on Asthma Nova Southeastern University Osteopathic College of Medicine, Davie, FL, USA
| | - G Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Glasgow, UK
| | - M G Crooks
- Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Hull, UK
| | - A A Cruz
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) ProAR, Nucleo de Excelencia em Asma, Federal University of Bahia and CNPq, Salvador, Brazil
| | - A Custovic
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology University of Manchester, Manchester, UK
| | - R Dahl
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, Odense, Denmark
| | - S E Dahlen
- CfA, The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - F De Blay
- ARIA, Allergic Rhinitis and Its Impact on Asthma SFA, Société française d'Allergologie Strasbourg University, Strasbourg, France
| | - T Dedeu
- EUREGHA, European Regions and Health Authorities, Brussels, Belgium
| | - D Deleanu
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - P Demoly
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France
| | - P Devillier
- ARIA, Allergic Rhinitis and Its Impact on Asthma UPRES, EA 220, Université Versailles Saint Quentin, Hôpital Foch, Suresnes, France
| | - A Didier
- SPLF, Société de Pneumologie de Langue Française Dept of Respiratory Medicine, University of Toulouse, Toulouse, France
| | - A T Dinh-Xuan
- Service de Physiologie, Paris Descartes University EA 2511, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - R Djukanovic
- University Southampton Faculty of Medicine and NIHR Southampton Respiratory Biomedical Research Unit, Southampton, UK
| | - D Dokic
- ARIA, Allergic Rhinitis and Its Impact on Asthma University Clinic of Pulmology and Allergy, University "Ss. Cyril and Methodius", Skopje, Macedonia
| | - H Douagui
- ARIA, Allergic Rhinitis and Its Impact on Asthma Service de pneumo-allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - R Dubakiene
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - S Eglin
- NHS R&D North West, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - F Elliot
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Edinburgh, UK
| | - R Emuzyte
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - L Fabbri
- Dept of Oncology, Haematology and Respiratory Diseases, Policlinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - A Fink Wagner
- GAAPP, Global Allergy and Asthma Patient Platform, Vienna, Austria
| | - M Fletcher
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Education for Health, Warwick, UK
| | - W J Fokkens
- ARIA, Allergic Rhinitis and Its Impact on Asthma Academic Medical Centre, University of Amsterdam, The Netherlands European Rhinology Society
| | - J Fonseca
- ARIA, Allergic Rhinitis and Its Impact on Asthma PNDR, Portuguese National Programme for Respiratory Diseases Porto Age-Up Consortium, Porto, Portugal Dept of Health Information and Decision Sciences and CINTESIS, Porto University Medical School, Allergy, Hospital S. Joao and Instituto and Hospital CUF Porto, Porto, Portugal
| | - A Franco
- Internal and Geriatric Medicine, University of Nice - Sophia Antipolis, Nice, France
| | - P Frith
- Repatriation General Hospital, Adelaide, Australia
| | - A Furber
- Director of Public Health, Wakefield Council, Wakefield, UK
| | - M Gaga
- 7th Respiratory Medicine Dept and Asthma Centre, Athens Chest Hospital, Athens, Greece
| | - J Garcés
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Valencia, Spain Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J Garcia-Aymerich
- MeDALL, Mechanisms of the Development of Allergy Centre for Research in Environmental Epidemiology (CREAL), IMIM (Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - A Gamkrelidze
- ARIA, Allergic Rhinitis and Its Impact on Asthma National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - S Gonzales-Diaz
- ARIA, Allergic Rhinitis and Its Impact on Asthma SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia
| | - F Gouzi
- University Hospital Montpellier, Montpellier, France INSERM, U1046, Montpellier, France
| | - M A Guzmán
- ARIA, Allergic Rhinitis and Its Impact on Asthma Immunology and Allergology Division, Dept of Medicine, Clinical Hospital University of Chile, Santiago, Chile
| | - T Haahtela
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - D Harrison
- Director of Public Health for Blackburn with Darwen, Blackburn, UK
| | - M Hayot
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - L G Heaney
- Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - J Heinrich
- MeDALL, Mechanisms of the Development of Allergy
| | - P W Hellings
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology Dept of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - J Hooper
- Director of Public Health for Kirklees, Huddersfield, UK
| | - M Humbert
- SPLF, Société de Pneumologie de Langue Française
| | - M Hyland
- School of Psychology, University of Plymouth, Plymouth, UK
| | - G Iaccarino
- EIP on AHA Reference Site, Regione-Campania, Italy Dept of Medicine and Surgery, University of Salerno, Salerno, Italy IRCCS Multimedica, Milan, Italy
| | - D Jakovenko
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - J R Jardim
- Respiratory Diseases, Escola Paulista de Medicina of Federal University of Sao Paulo, Sao Paulo, Brazil
| | - C Jeandel
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - C Jenkins
- The George Institute for Global Health and The University of Sydney, Sydney, Australia
| | - S L Johnston
- ARIA, Allergic Rhinitis and Its Impact on Asthma Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - O Jonquet
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - G Joos
- Dept Respiratory Medicine, Ghent University Hospital, Gent, Belgium
| | - K S Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - O Kalayci
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology GARD-Turkey, Global Alliance against Chronic Respiratory Diseases (GARD), Turkey Hacettepe University School of Medicine, Paediatric Allergy and Asthma Unit, Hacettepe, Ankara, Turkey
| | | | - T Keil
- MeDALL, Mechanisms of the Development of Allergy Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - N Khaltaev
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - V Kolek
- CARO, Czech Alliance against Chronic Respiratory Diseases
| | - M L Kowalski
- Dept Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - I Kull
- MeDALL, Mechanisms of the Development of Allergy Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - P Kuna
- ARIA, Allergic Rhinitis and Its Impact on Asthma EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Polastma, Poland Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology LSACI, Lithuanian Society of Allergology and Clinical Immunology Pulmonology and Allergology Center, Vilnius University, Vilnius, Lithuania
| | - L T Le
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - K C Lodrup Carlsen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma NAH, National Allergy Health Programme, Norway University of Oslo and Oslo University Hospital, Dept of Paediatrics, Oslo, Norway
| | - R Louis
- CHU Liege, GIGA I Research Center, University of Liege, Liege, Belgium
| | - W MacNee
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - A Mair
- Directorate of Finance, eHealth and Pharmaceuticals, Scottish Government Health Dept, Edinburgh, UK
| | - I Majer
- University of Bratislava, Bratislava, Slovakia
| | - P Manning
- Dept of Medicine, Royal College of Surgeons in Ireland (Medical School) Bon Secours Hospital, Dublin, Ireland
| | - E de Manuel Keenoy
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site Kronikgune, Basque Region, Spain
| | - M R Masjedi
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran
| | - E Melen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - E Melo-Gomes
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases
| | | | - G Mercier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - J Mercier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France
| | - J P Michel
- Geneva Medical School and University Hospitals, Geneva, Switzerland
| | - N Miculinic
- University Hospital for Pulmonary Diseases, Jordanovac, Zagreb, Croatia
| | - F Mihaltan
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases Institute of Pneumology Marius Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia Serbian Alliance against Chronic Respiratory Diseases Association for Asthma and COPD in Serbia
| | | | - I Momas
- Paris Descartes University, Dept of Public Health and Biostatistics, EA 4064 and Paris Municipal, Dept of Social Action, Childhood and Health, Paris, France
| | - A Montilla-Santana
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Aura Andalucia, Spain
| | - M Morais-Almeida
- Immunoallergy Dept, Hospital CUF-Descobertas, Lisbon, Portugal SPAIC, Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
| | - M Morgan
- Respiratory National Clinical Director, NHS England, UK
| | - M N'Diaye
- Service de Médecine Interne et Pathologies Professionnelles, Hôpital Polyclinique de Dakar (IHS), Dakar, Sénégal
| | - S Nafti
- ARIA, Allergic Rhinitis and Its Impact on Asthma Mustapha Hospital, Algiers, Algeria
| | - K Nekam
- ARIA, Allergic Rhinitis and Its Impact on Asthma Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - A Neou
- GALEN, Global Allergy and Asthma European Network Charité University Hospital, Allergy Centre Charité, Berlin, Germany
| | - L Nicod
- Service de Pneumologie, 1011 CHUV-Lausanne, Lausanne, Switerland
| | - R O'Hehir
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Australia
| | - K Ohta
- ARIA, Allergic Rhinitis and Its Impact on Asthma National Hospital Organization, Tokyo National Hospital and Teikyo University School of Medicine, Tokyo, Japan
| | - P Paggiaro
- Cardio-Thoracic and Vascular Dept, University Hospital of Pisa, Pisa, Italy
| | - S Palkonen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma EFA, European Federation of Allergy and Airways Diseases patients' association
| | - S Palmer
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - N G Papadopoulos
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology University of Manchester, Manchester, UK Allergy Dept, 2nd Paediatric Clinic, University of Athens, Athens, Greece
| | - A Papi
- Ferrara University, Ferrara, Italy
| | - G Passalacqua
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Respiratory Diseases, IRCCS San Martino - IST- University of Genoa, Dept of Internal Medicine, Genoa, Italy
| | - I Pavord
- NDM Research Building, University of Oxford, Oxford, UK
| | | | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - D S Postma
- MeDALL, Mechanisms of the Development of Allergy University of Groningen, Dept of Pulmonology, GRIAC Research Institute University Medical Center Groningen, Groningen, The Netherlands
| | - D Price
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - K F Rabe
- Christian Albrechts University Kiel, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Germany
| | - F Radier Pontal
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - J Redon
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site Research Institute INCLIVA, University of Valencia, CIBERObn, Health Institute Carlos III, Madrid, Spain
| | - S Rennard
- University of Nebraska Medical Center, Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha, NE, USA
| | - J Roberts
- Respiratory Nurse Consultant, Salford Royal NHS Foundation Trust, Salford, UK
| | - J M Robine
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France INSERM, U710 and 988, Montpellier, France
| | - J Roca
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - N Roche
- Pneumologie, AP-HP, Hôpital Cochin - Site Val de Grâce, Université Paris Descartes and SPLF, Société de Pneumologie de Langue Française, Paris, France
| | - F Rodenas
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Valencia, Spain Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - A Roggeri
- Arcispedale, S.Maria Nuova Hospital, Reggio Emilia, Italy
| | - C Rolland
- Association Asthme et Allergies, Boulogne-Billancourt, France
| | - J Rosado-Pinto
- ARIA, Allergic Rhinitis and Its Impact on Asthma EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - D Ryan
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Woodbrook Medical Centre, Loughborough, UK Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK
| | - B Samolinski
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland Dept of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - M Sanchez-Borges
- Dept of Allergy and Clinical Immunology, Centro Medico-Docente La Trinidad, Caracas, Venezuela
| | - H J Schünemann
- Depts of Clinical Epidemiology, and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - M Shields
- Child Health, Queen's University Belfast and Royal Belfast Hospital for Sick Children, Belfast, UK
| | - N Siafakas
- Dept of Thoracic Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - Y Sibille
- University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium
| | - T Similowski
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France Fonds de Dotation Recherche en Santé Respiratoire - Fondation du Souffle, Paris, France
| | - I Small
- National Advisory Group, Respiratory Managed Clinical Networks in Scotland
| | - O Sola-Morales
- HITT, Health Institute for Technology Transfer, Barcelona, Spain
| | - T Sooronbaev
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) EuroAsian Respiratory Society, Bishkek, Kyrgyzstan National Centre Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - R Stelmach
- Pulmonary Division, InCor (Heart Institute), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - P J Sterk
- Academic Medical Centre, University of Amsterdam, The Netherlands
| | - T Stiris
- Dept of Neonatal Intensive Care, Oslo University Hospital, Ulleval, Faculty of Medicine, University of Oslo, Oslo, Norway European Academy of Paediatrics (EAP-UEMS)
| | - P Sud
- Regional Medical Manager (North), NHS England, UK
| | - V Tellier
- Observatoire wallon de la santé, Direction générale opérationnelle Pouvoirs locaux, action sociale et Santé, Service public de Wallonie, Belgium
| | - T To
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - A Todo-Bom
- Immunoallergy Dept, Coimbra University Hospital, Coimbra, Portugal
| | - M Triggiani
- Dept of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - R Valenta
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A L Valero
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - A Valiulis
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania European Academy of Paediatrics (EAP-UEMS) LACRD, Lithuanian National Alliance Against Chronic Respiratory Diseases
| | - E Valovirta
- Dept of Lung Diseases and Clinical Allergology, University of Turku, Finland
| | - E Van Ganse
- Pharmacoepidemiology Unit and Respiratory Medicine, CHU-Lyon and UMR CNRS 5558, Claude-Bernard University Lyon, Lyon, France
| | - O Vandenplas
- ARIA, Allergic Rhinitis and Its Impact on Asthma INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France
| | | | - J Vestbo
- Respiratory and Allergy Research Group, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK Dept of Respiratory Medicine J, Odense University Hospital, Odense, Denmark
| | - G Vezzani
- EIP on AHA B3 Action Group (Delivering Integrated Care Models), Regional Agency for Health and Social Care, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy
| | - G Viegi
- CNR, Institutes of Biomedicine and Molecular Immunology (IBIM), Palermo, and of Clinical Physiology (IFC), Pisa, Italy
| | - L Visier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - C Vogelmeier
- German Center for Lung Research (DZL), Dept of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | | | - R Wagstaff
- Acting Director of Public Health, Cumbria County Council, Carlisle, UK
| | - U Wahn
- Charité University Hospital, Allergy Centre Charité, Berlin, Germany
| | - B Wallaert
- SFA, Société française d'Allergologie Hôpital Albert Calmette, CHRU, Lille, France
| | - B Whalley
- School of Psychology, University of Plymouth, Plymouth, UK
| | - M Wickman
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - N Wilson
- North of England EU Health Partnership, UK
| | - B P Yawn
- ARIA, Allergic Rhinitis and Its Impact on Asthma Olmsted Medical Center, Dept of Research and University of Minnesota, Dept of Family and Community Health, Rochester, MN, USA
| | - P K Yiallouros
- ARIA, Allergic Rhinitis and Its Impact on Asthma Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - A Yorgancioglu
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD-Turkey, Global Alliance against Chronic Respiratory Diseases (GARD), Turkey
| | - O M Yusuf
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO) The Allergy and Asthma Institute, Pakistan
| | - H J Zar
- Dept of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - N Zhong
- Guangzhou Institute of Respiratory Diseases and State Key Laboratory of Respiratory Diseases, Guangzhou Medical College, Guangzhou, China
| | - M Zidarn
- ARIA, Allergic Rhinitis and Its Impact on Asthma University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - T Zuberbier
- GALEN, Global Allergy and Asthma European Network Charité University Hospital, Allergy Centre Charité, Berlin, Germany
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Looker HC, Nyangoma SO, Cromie DT, Olson JA, Leese GP, Philip S, Black MW, Doig J, Lee N, Briggs A, Hothersall EJ, Morris AD, Lindsay RS, McKnight JA, Pearson DWM, Sattar NA, Wild SH, McKeigue P, Colhoun HM. Risk stratification for diabetic eye screening. Reply to Stratton I. M. and Aldington S. J. [letter]. Diabetologia 2014; 57:260-1. [PMID: 24201576 DOI: 10.1007/s00125-013-3099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/10/2013] [Indexed: 10/26/2022]
Affiliation(s)
- H C Looker
- Population Health Sciences, University of Dundee, The MacKenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK,
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Looker HC, Nyangoma SO, Cromie DT, Olson JA, Leese GP, Philip S, Black MW, Doig J, Lee N, Briggs A, Hothersall EJ, Morris AD, Lindsay RS, McKnight JA, Pearson DWM, Sattar NA, Wild SH, McKeigue P, Colhoun HM. Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia 2013; 56:1716-25. [PMID: 23689796 PMCID: PMC3699707 DOI: 10.1007/s00125-013-2928-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/12/2013] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS The aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening. METHODS This was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy. RESULTS The study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years. CONCLUSIONS/INTERPRETATION Transition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.
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Govan L, Maietti E, Torsney B, Wu O, Briggs A, Colhoun HM, Fischbacher CM, Leese GP, McKnight JA, Morris AD, Sattar N, Wild SH, Lindsay RS. The effect of deprivation and HbA1c on admission to hospital for diabetic ketoacidosis in type 1 diabetes. Diabetologia 2012; 55:2356-60. [PMID: 22733482 PMCID: PMC4209851 DOI: 10.1007/s00125-012-2601-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 05/08/2012] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS Diabetic ketoacidosis is a potentially life-threatening complication of diabetes and has a strong relationship with HbA(1c). We examined how socioeconomic group affects the likelihood of admission to hospital for diabetic ketoacidosis. METHODS The Scottish Care Information - Diabetes Collaboration (SCI-DC), a dynamic national register of all cases of diagnosed diabetes in Scotland, was linked to national data on hospital admissions. We identified 24,750 people with type 1 diabetes between January 2005 and December 2007. We assessed the relationship between HbA(1c) and quintiles of deprivation with hospital admissions for diabetic ketoacidosis in people with type 1 diabetes adjusting for patient characteristics. RESULTS We identified 23,479 people with type 1 diabetes who had complete recording of covariates. Deprivation had a substantial effect on odds of admission to hospital for diabetic ketoacidosis (OR 4.51, 95% CI 3.73, 5.46 in the most deprived quintile compared with the least deprived). This effect persisted after the inclusion of HbA(1c) and other risk factors (OR 2.81, 95% CI 2.32, 3.39). Men had a reduced risk of admission to hospital for diabetic ketoacidosis (OR 0.71, 95% CI 0.63, 0.79) and those with a history of smoking had increased odds of admission to hospital for diabetic ketoacidosis by a factor of 1.55 (95% CI 1.36, 1.78). CONCLUSIONS/INTERPRETATION Women, smokers, those with high HbA(1c) and those living in more deprived areas have an increased risk of admission to hospital for diabetic ketoacidosis. The effect of deprivation was present even after inclusion of other risk factors. This work highlights that those in poorer areas of the community with high HbA(1c) represent a group who might be usefully supported to try to reduce hospital admissions.
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Affiliation(s)
- L Govan
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
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Briggs A, Partridge DG, Bates S. HIV testing in colposcopy and termination of pregnancy services: a missed opportunity? Journal of Family Planning and Reproductive Health Care 2011; 37:201-3. [DOI: 10.1136/jfprhc-2011-100106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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32
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Govan L, Wu O, Briggs A, Colhoun HM, McKnight JA, Morris AD, Pearson DWM, Petrie JR, Sattar N, Wild SH, Lindsay RS. Inpatient costs for people with type 1 and type 2 diabetes in Scotland: a study from the Scottish Diabetes Research Network Epidemiology Group. Diabetologia 2011; 54:2000-8. [PMID: 21607632 PMCID: PMC4209853 DOI: 10.1007/s00125-011-2176-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 03/07/2011] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS The rising prevalence of diabetes worldwide has increased interest in the cost of diabetes. Inpatient costs for all people with diabetes in Scotland were investigated. METHODS The Scottish Care Information-Diabetes Collaboration (SCI-DC), a real-time clinical information system of almost all diagnosed cases of diabetes in Scotland, UK, was linked to data on all hospital admissions for people with diabetes. Inpatient stay costs were estimated using the 2007-2008 Scottish National Tariff. The probability of hospital admission and total annual cost of admissions were estimated in relation to age, sex, type of diabetes, history of vascular admission, HbA(1c), creatinine, body mass index and diabetes duration. RESULTS In Scotland during 2005-2007, 24,750 people with type 1 and 195,433 people with type 2 diabetes were identified, accounting for approximately 4.3% of the total Scottish population (5.1 million). The estimated total annual cost of admissions for all people diagnosed with type 1 and type 2 diabetes was £26 million and £275 million, respectively, approximately 12% of the total Scottish inpatient expenditure (£2.4 billion). Sex, increasing age, serum creatinine, previous vascular history and HbA(1c) (the latter differentially in type 1 and type 2) were all associated with likelihood and total annual cost of admission. CONCLUSIONS/INTERPRETATION Diabetes inpatient expenditure accounted for 12% of the total Scottish inpatient expenditure, whilst people with diabetes account for 4.3% of the population. Of the modifiable risk factors, HbA(1c) was the most important driver of cost in type 1 diabetes.
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Affiliation(s)
- L Govan
- Centre for Population & Health Sciences, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
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Gillies M, Lewsey J, Starkie H, Briggs A, Shepherd M, MacIntyre K. P2-99 Time trends in first and subsequent hospitalisation for COPD in Scotland, 1991-2009. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
We aimed to establish current practice regarding the testing of children of HIV-positive women in two centres in the South Yorkshire HIV Network, UK. Notes were reviewed from 59 women who attended clinic over a three-month period from 01 September 2009 to 30 November 2009. In our sample, only 29 of 52 (56%) children living in the UK who required testing had been HIV tested. Testing rates were high in preschool children (15/15) and fell with age to 2/11 (18%) in the 16-20 years age group. Uptake of testing for children of HIV-positive parents could potentially be improved if testing was incorporated into routine clinic practice as part of the package of care offered to a newly diagnosed individual.
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Affiliation(s)
- A Briggs
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK.
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Paul J, Briggs A, Harkin A, Haydon AM, Iveson T, Masterson M, Midgley RA, Cassidy J. SCOT: Short Course Oncology Therapy—A comparison of 12 and 24 weeks of adjuvant chemotherapy in colorectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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O'Byrne L, Roberts NJ, Boyd K, Briggs A, Partridge MR. S12 Pre-clinic telephone consultations: a costing study. Thorax 2010. [DOI: 10.1136/thx.2010.150912.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Roberts NJ, Boyd K, Briggs A, Caress AL, Partridge MR. S10 Is it cost-effective to replace nurses with lay asthma educators in primary care? Thorax 2010. [DOI: 10.1136/thx.2010.150912.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Geue C, Lorgelly P, Lewsey J, Briggs A, Hart C. 063 Population ageing in Scotland: an analysis of the implications for healthcare expenditure using the Renfrew/Paisley study. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Briggs A, Kinghorn GR. Nodular herpes simplex virus-1-positive oral lesions as a manifestation of immune reconstitution inflammatory syndrome. Int J STD AIDS 2010; 21:377-8. [DOI: 10.1258/ijsa.2010.010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a case of nodular oral herpes simplex virus-1-positive lesions consistent with immune reconstitution inflammatory syndrome in a patient recently commenced on treatment for tuberculosis and HIV co-infection.
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Affiliation(s)
- A Briggs
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
| | - G R Kinghorn
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
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Salati R, Shorey M, Briggs A, Calderon J, Rojas MR, Chen LF, Gilbertson RL, Palmieri M. First Report of Tomato yellow leaf curl virus Infecting Tomato, Tomatillo, and Peppers in Guatemala. Plant Dis 2010; 94:482. [PMID: 30754504 DOI: 10.1094/pdis-94-4-0482c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In Guatemala and other Central American countries, whitefly-transmitted geminiviruses (begomoviruses) cause economically important diseases of tomato (Solanum lycopersicum) and pepper (Capsicum annuum). Disease symptoms include stunted and distorted growth and leaf curling, crumpling, light green to yellow mosaic, purpling, and vein swelling. In Guatemala, at least eight bipartite begomovirus species infect tomato or peppers (1), but their role and relative importance is unclear. As part of an Integrated Pest Management strategy to manage these diseases, surveys for begomovirus symptoms in pepper and tomato have been conducted in the Salama Valley, Sanarate, and other locations since 2003, and begomoviruses were identified by squash blot hybridization, PCR and DNA sequencing. Beginning in 2006, a new type of symptom, stunted upright growth and upcurled leaves with yellowing of the margins and interveinal areas, was observed in tomato and tomatillo plants in the Salama Valley and Sanarate. These symptoms were similar to those induced by the exotic monopartite begomovirus Tomato yellow leaf curl virus (TYLCV). Evidence that TYLCV caused these symptoms came from positive results in high stringency squash blot hybridization tests with a TYLCV probe, and amplification of the expected size of ~0.3- and 2.8-kb fragments in PCR tests with TYLCV capsid protein (CP) gene and full-length component primer pairs, respectively (3). Sequence analyses of PCR-amplified CP fragments and portions of full-length fragments revealed 97 to 99% identity with isolates of TYLCV-Israel (TYLCV-IL). The complete nucleotide sequence of an isolate from the Salama Valley (GenBank Accession No. GU355941) was >99% identical to those of TYLCV-IL isolates from the Dominican Republic, Florida, and Cuba and ~97% identical to those of isolates from Mexico and California. Thus, this TYLCV-IL isolate (TYLCV-IL[GT:06]) was probably introduced from the Caribbean Region. To further characterize begomoviruses in the Salama Valley, leaf samples were collected from 44 and 118 tomato plants showing symptoms of begomovirus infection in March 2006 and 2007, respectively, and from 106 symptomatic pepper plants in March 2007. Begomovirus infection was confirmed in 42 of 44 and 93 of 118 of the tomato samples and 100 of 106 of the pepper samples based on PCR amplification of the expected size of ~0.6- and 1.1-kb DNA fragments with the begomovirus degenerate primers pairs AV494/AC1048 and PAL1v1978/PAR1c496, respectively (2,4). Sequence analyses of cloned PCR-amplified fragments revealed that 3 of the 44 and 16 of the 118 tomato samples collected in 2006 and 2007, respectively, and 9 of the 106 pepper samples were infected with TYLCV based on >97% identity with TYLCV-IL. In all samples, TYLCV was present in mixed infections with other begomoviruses. The introduction of TYLCV adds to the already high level of genetic complexity of bipartite begomovirus infection of tomatoes and peppers in Guatemala and will undoubtedly complicate disease management efforts. References: (1) M. K. Nakhla et al. Acta Hortic. 695:277, 2005. (2) M. R. Rojas et al. Plant Dis. 77:340, 1993. (3) R. Salati et al. Phytopathology 92:487, 2002. (4) S. D. Wyatt and J. Brown. Phytopathology 86:1288, 1996.
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Affiliation(s)
- R Salati
- Seminis Vegetable Seeds, Inc., 500 Lucy Brown Lane, San Juan Bautista, CA 95045
| | - M Shorey
- Seminis Vegetable Seeds, Inc., 500 Lucy Brown Lane, San Juan Bautista, CA 95045
| | - A Briggs
- Seminis Vegetable Seeds, Inc., 500 Lucy Brown Lane, San Juan Bautista, CA 95045
| | - J Calderon
- Seminis Vegetable Seeds, Inc., 6a Avenida 6-26 zona 2, Barrio Agua Caliente, Salama, Guatemala
| | - M R Rojas
- Department of Plant Pathology, University of California, 1 Shields Ave, Davis 95616
| | - L F Chen
- Department of Plant Pathology, University of California, 1 Shields Ave, Davis 95616
| | - R L Gilbertson
- Department of Plant Pathology, University of California, 1 Shields Ave, Davis 95616
| | - M Palmieri
- Department of Plant Protection-Virology, Universidad del Valle de Guatemala, Apartado Postal No. 82, Guatemala, Guatemala, C.A
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Hirst A, Dutton S, Wu O, Briggs A, Edwards C, Waldenmaier L, Maresh M, Nicholson A, McPherson K. A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. The HOPEFUL study. Health Technol Assess 2008; 12:1-248, iii. [DOI: 10.3310/hta12050] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - K McPherson
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK
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Aljitawi O, Nakamura R, Palmer J, Senitzer D, Pullarkat V, Briggs A, Cai JL, Rosenthal J, Schriber J, Snyder D, Nademanee A, Parker P, Forman S. 378: Tacrolimus, Sirolimus and Antithymocyte Globulin (rATG) for Graft Versus Host Disease Prophylaxis for Unrelated Donor Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wu O, Briggs A, Dutton S, Hirst A, Maresh M, Nicholson A, McPherson K. Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost-utility analysis of the HOPEFUL study. BJOG 2007; 114:1352-62. [PMID: 17949377 DOI: 10.1111/j.1471-0528.2007.01525.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the relative cost-effectiveness of uterine artery embolisation (UAE) and hysterectomy in women with symptomatic uterine fibroids from the perspective of the UK NHS. DESIGN Cost-utility analysis. SETTING Eighteen UK NHS hospital trusts. POPULATION OR SAMPLE Women who underwent UAE (n= 649; average follow up of 8.6 years) or hysterectomy (n= 459; average follow up of 4.6 years) for the treatments of symptomatic fibroids. METHODS A probabilistic decision model was carried out based on data from a large comparative cohort and the literature. The two interventions were evaluated over the time horizon from the initial procedure to menopause. Extensive sensitivity analysis was carried out to test model assumptions and parameter uncertainties. MAIN OUTCOME MEASURES Costs of procedures and complications and quality of life expressed as quality-adjusted life years (QALYs). RESULTS Overall, UAE was associated with lower mean cost (2536 pounds sterling versus 3282 pounds sterling) and a small reduction in quality of life (8.203 versus 8.241 QALYs) when compared with hysterectomy. However, when the quality of life associated with the conservation of the uterus was incorporated in the model, UAE was shown to be the dominant strategy--lower costs and greater QALYs. CONCLUSIONS UAE is a less expensive option to the health service compared with hysterectomy, even when the costs of repeat procedures and associated complications are factored in. The quality of life implications in the short term are also predicted to favour UAE; however, this advantage may be eroded over time as women undergo additional procedures to deal with recurrent fibroids. Given the hysterectomy is the current standard treatment for symptomatic fibroids, offering women UAE as an alternative treatment for fibroids is likely to be highly cost-effective for those women who prefer uterus-conserving treatment.
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Affiliation(s)
- O Wu
- Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow, UK.
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Flowers CR, Sambrook JC, Briggs A, Osenenko K, Wang H, Dalal MR. Cost-effectiveness of tositumomab and iodine I-131 tositumomab (Bexxar therapeutic regimen (BTR)), in treatment of non- Hodgkin lymphoma (NHL). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8089 Background: BTR has demonstrated efficacy in NHL patients and it has potential to prolong time to progression (TTP) in relapsed/refractory, low grade, follicular, or transformed NHL. This study assessed effectiveness and cost-effectiveness of BTR compared to alternative therapies in first, second, and third line NHL therapy. Methods: Time-to-event models were constructed with 2 events: progression and death. Patient data from 8 BTR clinical trials were combined to fit Weibull models for TTP and overall survival (OS) by including FLIPI covariates. Estimates for BTR were compared with estimates for alternatives from Weibull models fitted to published TTP and BTR OS data by lines of therapy and measured in life-years (LY). Estimated pre-progression costs included drug costs, lab tests, monitoring, and adverse events; post progression costs included NHL costs until death, all valued in 2006 $US and discounted at 3%. Indirect comparisons yielded incremental cost-effectiveness ratios (ICER=Δ cost/Δ LYs) in each line of therapy. Results: As observed in the table , cost of care estimates in BTR were often comparable with alternative therapies, but typically LY gain favored BTR. Mostly in first and third line, a BTR strategy had an ICER less than the cost-effectiveness threshold of $50,000 per LY gained. Conclusion: Overall, a BTR strategy has a favorable cost-effectiveness profile to alternative strategies including rituximab maintenance (RXM) in first, second, and third line NHL therapy. Results imply both a possible survival gain with early BTR use, and the cost-effectiveness of BTR. This modeling approach can aid in clinical decision making regarding the sequence and timing of therapy for patients with follicular NHL. No significant financial relationships to disclose. [Table: see text]
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Affiliation(s)
- C. R. Flowers
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
| | - J. C. Sambrook
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
| | - A. Briggs
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
| | - K. Osenenko
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
| | - H. Wang
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
| | - M. R. Dalal
- Winship Cancer Institute, Atlanta, GA; Oxford Outcomes Ltd., Vancouver, BC, Canada; GlaxoSmithKline, Collegeville, PA
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Williams C, Brunskill S, Altman D, Briggs A, Campbell H, Clarke M, Glanville J, Gray A, Harris A, Johnston K, Lodge M. Cost-effectiveness of using prognostic information to select women with breast cancer for adjuvant systemic therapy. Health Technol Assess 2007; 10:iii-iv, ix-xi, 1-204. [PMID: 16959170 DOI: 10.3310/hta10340] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the cost-effectiveness of using prognostic information to identify patients with breast cancer who should receive adjuvant therapy. DATA SOURCES Electronic databases from 1980 through to February 2002. A survey of clinical practice in UK cancer centres and units. Large retrospective dataset containing data on prognostic factors, treatments and outcomes for women with early breast cancer treated in Oxford. REVIEW METHODS Between six and nine databases were searched by an information expert. Evidence-based methods were used to review and select those studies and the quality of each included paper was assessed using standard assessment tools reported in the literature or piloted and developed for this study. A survey of clinical practice in UK cancer centres and units was carried out to ensure that conclusions drawn from the report could be implemented. These data, along with the information gathered in the systematic reviews, informed the methodological approach adopted for the health economic modelling. An illustrative framework was developed for incorporating patient-level prediction within a health economic decision model. This framework was applied to a large retrospective dataset containing data on prognostic factors, treatments and outcomes for women with early breast cancer treated in Oxford. The data were used to estimate directly a parametric regression-based risk equation, from which a prognostic index was developed, and prognosis-specific estimates of the baseline breast cancer hazard could be observed. Published estimates of treatment effects, health service treatment costs and utilities were used to construct a decision analytic framework around this risk equation, thus enabling simulation of the effectiveness and cost-effectiveness of adjuvant therapy for all possible combinations of prognostic factors included in the model. RESULTS The lack of good-quality systematic reviews and well-conducted studies of prognostic factors in breast cancer is a striking finding. There are no registers of studies of prognostic factors or of reviews of prognostic studies. Many of the reviews used weak methods, primary studies are similar with poor methodology and reporting of results. In addition, there is much variation in patient populations, assay methods, analysis of results, definitions used and reporting of results. Most studies appear to be retrospective and some use inappropriate methods likely to inflate outcomes such as optimising cut points and failing to test the results in an independent population. Very few reviews used meta-analysis to conduct a pooled analysis and to provide an estimate of the average size of any association. Instead, most reviews relied on vote counting. Although many prognostic models for breast cancer have been published, remarkably few have been re-examined by independent groups in independent settings. The few validation studies have been carried out on ill-defined samples, sometimes of smaller size and short follow-up, and sometimes using different patient outcomes when validating a model. The evidence from the validation studies shows support for the prognostic value of the Nottingham Prognostic Index (NPI). No new prognostic factors have been shown to add substantially to those identified in the 1980s. Improvement of this index depends on finding factors that are as important as, but independent of, lymph node, stage and pathological grade. The NPI remains a useful clinical tool, although additional factors may enhance its use. We accepted that hormone receptor status (ER) for hormonal therapy such as tamoxifen and prediction of response to trastuzumab by HER2 did not require systematic review, as the mechanism of action of these drugs requires intact receptors. There was no clear evidence that other factors were useful predictors of response and survival. The survey confirmed pathological nodal status, tumour grade, tumour size and ER status as the most clinically important factors for consideration when selecting women with early breast cancer for adjuvant systemic therapy in the UK. The protocols revealed that although UK cancer centres appear to be using the same prognostic and predictive factors when selecting women to receive adjuvant therapy, much variation in clinical practice exists. Some centres use protocols based upon the NPI whereas others do not use a single index score. Within NPI and non-NPI users, between-centre variability exists in guidelines for women for whom the benefits are uncertain. Consensus amongst units appears to be greatest when selecting women for adjuvant hormone therapy with the decision based primarily upon ER or progesterone receptor status rather than combinations of a number of factors. Guidelines as to who should receive adjuvant chemotherapy, however, were found to be much less uniform. Searches of the literature revealed only five published papers that had previously examined the cost-effectiveness of using prognostic information for clinical decision-making. These studies were of varying quality and highlight the fact that economic evaluation in this area appears still to be in its infancy. By combining methodologies used in determining prognosis with those used in health economic evaluation, it was possible to illustrate an approach for simulating the effectiveness (survival and quality-adjusted survival) and the cost-effectiveness associated with the decision to treat individual women or groups of women with different prognostic characteristics. The model showed that effectiveness and cost-effectiveness of adjuvant systemic therapy have the potential to vary substantially depending upon prognosis. For some women therapy may prove very effective and cost-effective, whereas for others it may actually prove detrimental (i.e. the reductions in health-related quality of life outweigh any survival benefit). CONCLUSIONS Outputs from the framework constructed using the methods described here have the potential to be useful for clinicians, attempting to determine whether net benefits can be obtained from administering adjuvant therapy for any presenting woman; and also for policy makers, who must be able to determine the total costs and outcomes associated with different prognosis based treatment protocols as compared with more conventional treat all or treat none policies. A risk table format enabling clinicians to look up a patient's prognostic factors to determine the likely benefits (survival and quality-adjusted survival) from administering therapy may be helpful. For policy makers, it was demonstrated that the model's output could be used to evaluate the cost-effectiveness of different treatment protocols based upon prognostic information. The framework should also be valuable in evaluating the likely impact and cost-effectiveness of new potential prognostic factors and adjuvant therapies.
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Affiliation(s)
- C Williams
- Bristol Haematology and Oncology Centre, UK
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Affiliation(s)
- J. P. Spriet
- a Laboratoire de Spectroscopie Hertzienne, C.N.R.S. , Université de Lille I , F 59655 , Villeneuve, d'Ascq Cédex , France
| | - G. Biskupski
- a Laboratoire de Spectroscopie Hertzienne, C.N.R.S. , Université de Lille I , F 59655 , Villeneuve, d'Ascq Cédex , France
| | - H. Dubois
- a Laboratoire de Spectroscopie Hertzienne, C.N.R.S. , Université de Lille I , F 59655 , Villeneuve, d'Ascq Cédex , France
| | - A. Briggs
- b C.R.T.B.T., S.N.C.I. (C.N.R.S.) , 25 avenue des Martyrs, F 38042 , Grenoble Cédex , France
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Clarke PM, Gray AM, Briggs A, Stevens RJ, Matthews DR, Holman RR. Cost-utility analyses of intensive blood glucose and tight blood pressure control in type 2 diabetes (UKPDS 72). Diabetologia 2005; 48:868-77. [PMID: 15834550 DOI: 10.1007/s00125-005-1717-3] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2004] [Accepted: 12/03/2004] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS This study estimated the economic efficiency (1) of intensive blood glucose control and tight blood pressure control in patients with type 2 diabetes who also had hypertension, and (2) of metformin therapy in type 2 diabetic patients who were overweight. METHODS We conducted cost-utility analysis based on patient-level data from a randomised clinical controlled trial involving 4,209 patients with newly diagnosed type 2 diabetes conducted in 23 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study (UKPDS). Three different policies were evaluated: intensive blood glucose control with sulphonylurea/insulin; intensive blood glucose control with metformin for overweight patients; and tight blood pressure control of hypertensive patients. Incremental cost : effectiveness ratios were calculated based on the net cost of healthcare resources associated with these policies and on effectiveness in terms of quality-adjusted life years gained, estimated over a lifetime from within-trial effects using the UKPDS Outcomes Model. RESULTS The incremental cost per quality-adjusted life years gained (in year 2004 UK prices) for intensive blood glucose control was 6,028 UK pounds, and for blood pressure control was 369 UK pounds. Metformin therapy was cost-saving and increased quality-adjusted life expectancy. CONCLUSIONS/INTERPRETATION Each of the three policies evaluated has a lower cost per quality-adjusted life year gained than that of many other accepted uses of healthcare resources. The results provide an economic rationale for ensuring that care of patients with type 2 diabetes corresponds at least to the levels of these interventions.
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Affiliation(s)
- P M Clarke
- Health Economics Research Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
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48
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Clarke PM, Gray AM, Briggs A, Farmer AJ, Fenn P, Stevens RJ, Matthews DR, Stratton IM, Holman RR. A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68). Diabetologia 2004; 47:1747-59. [PMID: 15517152 DOI: 10.1007/s00125-004-1527-z] [Citation(s) in RCA: 424] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Accepted: 06/01/2004] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to develop a simulation model for type 2 diabetes that can be used to estimate the likely occurrence of major diabetes-related complications over a lifetime, in order to calculate health economic outcomes such as quality-adjusted life expectancy. METHODS Equations for forecasting the occurrence of seven diabetes-related complications and death were estimated using data on 3642 patients from the United Kingdom Prospective Diabetes Study (UKPDS). After examining the internal validity, the UKPDS Outcomes Model was used to simulate the mean difference in expected quality-adjusted life years between the UKPDS regimens of intensive and conventional blood glucose control. RESULTS The model's forecasts fell within the 95% confidence interval for the occurrence of observed events during the UKPDS follow-up period. When the model was used to simulate event history over patients' lifetimes, those treated with a regimen of conventional glucose control could expect 16.35 undiscounted quality-adjusted life years, and those receiving treatment with intensive glucose control could expect 16.62 quality-adjusted life years, a difference of 0.27 (95% CI: -0.48 to 1.03). CONCLUSIONS/INTERPRETATIONS The UKPDS Outcomes Model is able to simulate event histories that closely match observed outcomes in the UKPDS and that can be extrapolated over patients' lifetimes. Its validity in estimating outcomes in other groups of patients, however, remains to be evaluated. The model allows simulation of a range of long-term outcomes, which should assist in informing future economic evaluations of interventions in type 2 diabetes.
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Affiliation(s)
- P M Clarke
- Health Economics Research Centre, Department of Public Health, University of Oxford, Headington, Oxford, UK.
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Tytgat GN, Heading RC, Müller-Lissner S, Kamm MA, Schölmerich J, Berstad A, Fried M, Chaussade S, Jewell D, Briggs A. Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting. Aliment Pharmacol Ther 2003; 18:291-301. [PMID: 12895213 DOI: 10.1046/j.1365-2036.2003.01679.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Gastro-oesophageal reflux disease (GERD) and constipation have a major impact on public health; however, the wide variety of treatment options presents difficulties for recommending therapy. Lack of definitive guidelines in pharmacy and general practice medicine further exacerbates the decision dilemma. AIMS To address these issues, a panel of experts discussed the principles and practice of treating GERD and constipation in the general population and in pregnancy, with the aim of developing respective treatment guidelines. RESULTS The panel recommended antacids 'on-demand' as the first-line over-the-counter treatment in reflux, and as rescue medication for immediate relief when reflux breaks through with proton pump inhibitors. Calcium/magnesium-based antacids were recommended as the treatment of choice for pregnant women because of their good safety profile. In constipation, current data do not distinguish a hierarchy between polyethylene glycol (PEG)-based laxatives and other first-line treatments, although limitations are associated with stimulant- and bulk-forming laxatives. Where data are available, PEG is superior to lactulose in terms of efficacy. In pregnancy, PEG-based laxatives meet the criteria for the ideal treatment. CONCLUSIONS The experts developed algorithms that present healthcare professionals with clear treatment options and management strategies for GERD and constipation in pharmacy and general practice medicine.
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Affiliation(s)
- G N Tytgat
- Academisch Medisch Centrum, Amsterdam, The Netherlands.
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50
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Clarke P, Gray A, Legood R, Briggs A, Holman R. The impact of diabetes-related complications on healthcare costs: results from the United Kingdom Prospective Diabetes Study (UKPDS Study No. 65). Diabet Med 2003; 20:442-50. [PMID: 12786677 DOI: 10.1046/j.1464-5491.2003.00972.x] [Citation(s) in RCA: 197] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To develop a model for estimating the immediate and long-term healthcare costs associated with seven diabetes-related complications in patients with Type 2 diabetes participating in the UK Prospective Diabetes Study (UKPDS). METHODS The costs associated with some major complications were estimated using data on 5102 UKPDS patients (mean age 52.4 years at diagnosis). In-patient and out-patient costs were estimated using multiple regression analysis based on costs calculated from the length of admission multiplied by the average specialty cost and a survey of 3488 UKPDS patients' healthcare usage conducted in 1996-1997. RESULTS Using the model, the estimate of the cost of first complications were as follows: amputation pound 8459 (95% confidence interval pound 5295, pound 13 200); non-fatal myocardial infarction pound 4070 ( pound 3580, pound 4722); fatal myocardial infarction pound 1152 ( pound 941, pound 1396); fatal stroke pound 3383 ( pound 1935, pound 5431); non-fatal stroke pound 2367 ( pound 1599, pound 3274); ischaemic heart disease pound 1959 ( pound 1467, pound 2541); heart failure pound 2221 ( pound 1690, pound 2896); cataract extraction pound 1553 ( pound 1320, pound 1855); and blindness in one eye pound 872 ( pound 526, pound 1299). The annual average in-patient cost of events in subsequent years ranged from pound 631 ( pound 403, pound 896) for heart failure to pound 105 ( pound 80, pound 142) for cataract extraction. Non-in-patient costs for macrovascular complications were pound 315 ( pound 247, pound 394) and for microvascular complications were pound 273 ( pound 215, pound 343) in the year of the event. In each subsequent year the costs were, respectively, pound 258 ( pound 228, pound 297) and pound 204 ( pound 181, pound 255). CONCLUSIONS These results provide estimates of the immediate and long-term healthcare costs associated with seven diabetes-related complications.
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Affiliation(s)
- P Clarke
- Health Economics Research Centre and Diabetes Trials Unit, University of Oxford, Oxford, UK.
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