1
|
Griesinger F, Pérol M, Durand-Zaleski I, Bosquet L, Zacharias S, Calleja A, Patel S, Waldenberger D, Reynaud D, Carroll R, Daumont M, Penrod J, Lacoin L, Chouaid C. 109P Treatment patterns in patients with advanced non-small cell lung cancer (aNSCLC) after discontinuing an immune checkpoint inhibitor (ICI) therapy in second-line or later in Germany and France. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.127] [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: 10/19/2022] Open
|
2
|
Damy T, Bourel G, Slama M, Algalarrondo V, Lairez O, Pelcot F, Durand-Zaleski I, Lilliu H, Bartoli M, Fievez S, Granghaud A, Rudant J, De Neuville B, Rault C, Charron P. Identification des patients atteints d’amylose cardiaque à transthyrétine (ATTR-CM) en France : E-PACT, une étude basée sur les données du Système national des données de santé (SNDS). Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.05.040] [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
|
3
|
Gonzalez-Bermejo J, Hajage D, Durand-Zaleski I, Arnal JM, Cuvelier A, Grassion L, Jaffre S, Lamia B, Pontier S, Prigent A, Rabec C, Raherison-Semjen C, Saint Raymond C, Soler J, Trzepizur W, Winck JC, Aguiar M, Chaves H, Conde B, Guimarães MJ, Lopes P, Mineiro A, Moreira S, Pamplona P, Rodrigues CM, Sousa S, Antón A, Córdoba-Izquierdo A, Embid C, Esteban González C, Ezzine F, Garcia P, González M, Guerassimova I, López D, Lujan M, Martí Beltran S, Martinez JM, Masa F, Pascual N, Peñacoba N, Resano P, Rey L, Rodríguez Jerez F, Roncero A, Sancho Chinesta J, Sayas Catalán J. Respiratory support in COPD patients after acute exacerbation with monitoring the quality of support (Rescue2-monitor): an open-label, prospective randomized, controlled, superiority clinical trial comparing hospital- versus home-based acute non-invasive ventilation for patients with hypercapnic chronic obstructive pulmonary disease. Trials 2020; 21:877. [PMID: 33092618 PMCID: PMC7578582 DOI: 10.1186/s13063-020-04672-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is expected to be the 3rd leading cause of death worldwide by 2020. Despite improvements in survival by using acute non-invasive ventilation (NIV) to treat patients with exacerbations of COPD complicated by acute hypercapnic respiratory failure (AHRF), these patients are at high risk of readmission and further life-threatening events, including death. Recent studies suggested that NIV at home can reduce readmissions, but in a small proportion of patients, and with a high level of expertise. Other studies, however, do not show any benefit of home NIV. This could be related to the fact that respiratory failure in patients with stable COPD and their response to mechanical ventilation are influenced by several pathophysiological factors which frequently coexist in the same patient to varying degrees. These pathophysiological factors might influence the success of home NIV in stable COPD, thus long-term NIV specifically adapted to a patient's "phenotype" is likely to improve prognosis, reduce readmission to hospital, and prevent death. In view of this conundrum, Rescue2-monitor (R2M), an open-label, prospective randomized, controlled study performed in patients with hypercapnic COPD post-AHRF, will investigate the impact of the quality of nocturnal NIV on the readmission-free survival. The primary objective is to show that any of 3 home NIV strategies ("rescue," "non-targeted," and "targeted") will improve readmission-free survival in comparison to no-home NIV. The "targeted" group of patients will receive a treatment with personalized (targeted) ventilation settings and extensive monitoring. Furthermore, the influence of comorbidities typical for COPD patients, such as cardiac insufficiency, OSA, or associated asthma, on ventilation outcomes will be taken into consideration and reasons for non-inclusion of patients will be recorded in order to evaluate the percentage of ventilated COPD patients that are screening failures. ClinicalTrials.gov NCT03890224 . Registered on March 26, 2019.
Collapse
|
4
|
Durand-Zaleski I, Deneux-Tharaux C, Seco A, Malki M, Frenkiel J, Sentilhes L. An economic evaluation of tranexamic acid to prevent postpartum haemorrhage in women with vaginal delivery: the randomised controlled TRAAP trial. BJOG 2020; 128:114-120. [PMID: 32770781 DOI: 10.1111/1471-0528.16456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate the cost-effectiveness of tranexamic acid (TXA) use to prevent postpartum haemorrhage. DESIGN A trial-based economic evaluation. SETTING Fifteen French university maternity hospitals. POPULATION Women enrolled in the TRAAP randomised controlled trial comparing TXA versus placebo in women with vaginal delivery. TRAAP failed to show a reduction in postpartum haemorrhage of at least 500 ml in the intervention arm but evidenced significant lower rates of secondary outcomes related to blood loss. METHODS & MAIN OUTCOME MEASURES We estimated direct medical costs from within-trial hospital resources collected prospectively from the study report form. All resources were costed at their value to the hospital. We estimated incremental cost per incremental haemorrhage averted. RESULTS Among the 4079 women in the TRAAP trial, data necessary to calculate costs were available for 3836 (94.0%). The average total costs in the TXA and control groups were €2278 ± 388 and €2288 ± 409 per woman, respectively (P = 0.79). In women with postpartum haemorrhage of at least 500 ml (trial primary endpoint), costs were €2359 ± 354 and €2409 ± 525 (P = 0.14); for provider-assessed clinically significant postpartum haemorrhage and postpartum haemorrhage of at least 1000 ml, costs were respectively €2316 ± 347 versus €2381 ± 521 (P = 0.22) and €2321 ± 318 versus €2411 ± 590 (P = 0.35) in the tranexamic and placebo groups, respectively. The probabilistic sensitivity analysis showed that the use of TXA had a 65-73% probability of saving costs and improving outcome. CONCLUSIONS Our findings support the use of TXA, as both bleeding events and cost may be reduced three out of four times. TWEETABLE ABSTRACT Tranexamic acid at vaginal delivery reduces both costs and bleeding events 3 times out of 4.
Collapse
Affiliation(s)
- I Durand-Zaleski
- AP-HP Health Economics Research Unit, Hotel Dieu Hospital, Paris, France.,INSERM UMR 1153 CRESS, Clinical Epidemiology(Methods) & Obstetrical, Perinatal and Pediatric Epidemiology (Epopé) Research Team, Paris Descartes University, Paris, France
| | - C Deneux-Tharaux
- INSERM UMR 1153 CRESS, Clinical Epidemiology(Methods) & Obstetrical, Perinatal and Pediatric Epidemiology (Epopé) Research Team, Paris Descartes University, Paris, France
| | - A Seco
- INSERM UMR 1153 CRESS, Clinical Epidemiology(Methods) & Obstetrical, Perinatal and Pediatric Epidemiology (Epopé) Research Team, Paris Descartes University, Paris, France.,APHP Paris Centre Clinical Research Unit, Paris, France
| | - M Malki
- AP-HP Health Economics Research Unit, Hotel Dieu Hospital, Paris, France
| | - J Frenkiel
- AP-HP Health Economics Research Unit, Hotel Dieu Hospital, Paris, France
| | - L Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | | |
Collapse
|
5
|
Brunet A, Ayrolles A, Gambotti L, Maatoug R, Estellat C, Descamps M, Girault N, Kalalou K, Abgrall G, Ducrocq F, Vaiva G, Jaafari N, Krebs MO, Castaigne E, Hanafy I, Benoit M, Mouchabac S, Cabié MC, Guillin O, Hodeib F, Durand-Zaleski I, Millet B. Paris MEM: a study protocol for an effectiveness and efficiency trial on the treatment of traumatic stress in France after the 2015-16 terrorist attacks. BMC Psychiatry 2019; 19:351. [PMID: 31703570 PMCID: PMC6842179 DOI: 10.1186/s12888-019-2283-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/07/2018] [Accepted: 09/11/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The Paris and Nice terrorist attacks affected a thousand of trauma victims and first-line responders. Because there were concerns that this might represent the first of several attacks, there was a need to quickly enhance the local capacities to treat a large number of individuals suffering from trauma-related disorders. Since Reconsolidation Therapy (RT) is brief, relatively easy to learn, well tolerated and effective, it appeared as the ideal first-line treatment to teach to clinicians in this context. METHODS This study protocol is a two-arm non-randomized, multicenter controlled trial, comparing RT to treatment as usual for the treatment of trauma-related disorders. RT consists of actively recalling one's traumatic event under the influence of the ß-blocker propranolol, once a week, for 10-25 min with a therapist, over 6 consecutive weeks. This protocol evaluates the feasibility, effectiveness, and cost-utility of implementing RT as part of a large multi-center (N = 400) pragmatic trial with a one-year follow-up. DISCUSSION Paris MEM is the largest trial to date assessing the efficiency of RT in the aftermath of a large-scale man-made disaster. RT could possibly reinforce the therapeutic arsenal for the treatment of patients suffering from trauma-related disorders, not only for communities in western countries but also worldwide for terror- or disaster-stricken communities. TRIAL REGISTRATION Clinical Trials (ClinicalTrials.gov). June 3, 2016. NCT02789982.
Collapse
Affiliation(s)
- A. Brunet
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Department of Psychiatry, McGill University, Montréal, Canada
| | - A. Ayrolles
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - L. Gambotti
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - R. Maatoug
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - C. Estellat
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - M. Descamps
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Department of Psychiatry, McGill University, Montréal, Canada
| | - N. Girault
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - K. Kalalou
- Unité de recherche clinique, EPS de Ville Evrard, G03, 5 rue du Dr Delafontaine, 93200 Saint-Denis, France
| | - G. Abgrall
- Assistance Publique - Hôpitaux de Paris -, Hôtel-Dieu, 75004 Paris, France
| | - F. Ducrocq
- France CHRU de Lille, Pôle de Psychiatrie Médecine Légale et Santé en milieu Pénitentiaire, SCA-Lab CNRS UMR 9193, 59037 cedex Lille, France
| | - G. Vaiva
- France CHRU de Lille, Pôle de Psychiatrie Médecine Légale et Santé en milieu Pénitentiaire, SCA-Lab CNRS UMR 9193, 59037 cedex Lille, France
| | - N. Jaafari
- CIC INSERM U802, CHU de Poitiers, Unité de recherche clinique intersectorielle en psychiatrie du Centre Hospitalier Henri Laborit, 86022 Poitiers, France
| | - M. O. Krebs
- Centre Hospitalier Sainte Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France
| | - E. Castaigne
- Service de Psychiatrie, CHU de Bicêtre, HUPS, APHP 78, rue du général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - I. Hanafy
- CH Marne La Vallée, Service de Médecine Légale, 77420 Marne-La-Vallée, France
| | - M. Benoit
- Clinical Neuroscience Department Hospital Pasteur 1, France University of Côte d’Azur, 30 avenue de la voie, 06002 NICE cedex 1 Romaine, France
| | - S. Mouchabac
- Département de psychiatrie et de psychologie médicale de l’adulte, Hôpital universitaire Saint-Antoine, Université Pierre et Marie Curie, Paris VI - AP-HP, 184 rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - M. C. Cabié
- Pôle Paris 11 Les Hôpitaux de Saint Maurice, 12-14 rue Val d’Osne, 94410 St Maurice, France
| | - O. Guillin
- Service Hospitalo-universitaire, CH du Rouvray, 4 rue Paul Eluard, 76300 Sotteville-lès-Rouen, France
- unité Inserm U1079 Faculté de médecine et de pharmacie, 76000 Rouen, France
| | - F. Hodeib
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| | - I. Durand-Zaleski
- ECEVE, UMR 1123 URCEco Ile de France Hôtel Dieu, 1 place du Parvis de Notre Dame, 75004 Paris, France
| | - B. Millet
- Département de Psychiatrie adulte, boulevard de l’Hôpital, 75013 Paris, France
- Département de Psychiatrie adulte, Hôpital Universitaire de la Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, boulevard de l’Hôpital, 75013 Paris, France
| |
Collapse
|
6
|
Le Bras A, Salomon LJ, Bussières L, Malan V, Elie C, Mahallati H, Ville Y, Vekemans M, Durand-Zaleski I. Cost-effectiveness of five prenatal screening strategies for trisomies and other unbalanced chromosomal abnormalities: model-based analysis. Ultrasound Obstet Gynecol 2019; 54:596-603. [PMID: 31006923 DOI: 10.1002/uog.20301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the cost-effectiveness of five prenatal screening strategies for trisomies (13/18/21) and other unbalanced chromosomal abnormalities (UBCA), following the introduction of cell-free DNA (cfDNA) analysis. METHODS A model-based cost-effectiveness analysis was performed to estimate prevalence, safety, screening-program costs and healthcare costs of five different prenatal screening strategies, using a virtual cohort of 652 653 pregnant women in France. Data were derived from the French Biomedicine Agency and published articles. Uncertainty was addressed using one-way sensitivity analysis. The five strategies compared were: (i) cfDNA testing for women with a risk following first-trimester screening of ≥ 1/250; (ii) cfDNA testing for women with a risk of ≥ 1/1000 (currently recommended); (iii) cfDNA testing in the general population (regardless of risk); (iv) invasive testing for women with a risk of ≥ 1/250 (historical strategy); and (v) invasive testing for women with a risk of ≥ 1/1000. RESULTS In our virtual population, at similar risk thresholds, cfDNA testing compared with invasive testing was cheaper but less effective. Compared with the historical strategy, cfDNA testing at the ≥ 1/1000 risk threshold was a more expensive strategy that detected 158 additional trisomies, but also 175 fewer other UBCA. Implementation of cfDNA testing in the general population would give an incremental cost-effectiveness ratio of €9 166 689 per additional anomaly detected compared with the historical strategy. CONCLUSION Extending cfDNA to lower risk thresholds or even to all pregnancies would detect more trisomies, but at greater expense and with lower detection rate of other UBCA, compared with the historical strategy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- A Le Bras
- AP-HP, DRCI-URC Eco Ile-de-France, Paris, France
| | - L J Salomon
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- Collège Français d'Echographie Foetale (CFEF), France
| | - L Bussières
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- AP-HP, Hôpital Necker-Enfants Malades, Clinical Unit Research/Clinic Investigation Center, Paris, France
| | - V Malan
- INSERM U1163, Hôpital Necker-Enfants Malades, Paris, France
- AP-HP, Hôpital Necker-Enfants Malades, Department of Histology, Embryology and Cytogenetics, Paris, France
| | - C Elie
- AP-HP, Hôpital Necker-Enfants Malades, Clinical Unit Research/Clinic Investigation Center, Paris, France
| | - H Mahallati
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
| | - Y Ville
- AP-HP, Hôpital Necker-Enfants Malades, Department of Obstetrics and Gynecology, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - M Vekemans
- AP-HP, Hôpital Necker-Enfants Malades, Department of Histology, Embryology and Cytogenetics, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - I Durand-Zaleski
- AP-HP, DRCI-URC Eco Ile-de-France, Paris, France
- Assistance Publique-Hôpitaux de Paris, Service de Santé Publique, Henri Mondor-Albert-Chenevier, Créteil, France
| |
Collapse
|
7
|
Coquerelle S, Darlington M, Durand-Zaleski I. RUBIH2 - Use of NGS in haematological malignancies: From real world data to national recommendations, an innovative program to evaluate the impact of healthcare technology on patient care. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz251.030] [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: 11/12/2022] Open
|
8
|
Li J, Vivot A, Alter L, Durand-Zaleski I. Appraisal of cancer drugs: a comparison of the French health technology assessment with value frameworks of two oncology societies. Expert Rev Pharmacoecon Outcomes Res 2019; 20:405-409. [PMID: 31240965 DOI: 10.1080/14737167.2019.1635458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/26/2022]
Abstract
OBJECTIVES Our primary objective was to compare the grading of the value of cancer drugs ('Amélioration du Service Médical Rendu' [ASMR] level) by the French health technology assessment authority ('Haute Autorité de santé' [HAS]) with that by the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Our secondary objective was to study the drivers of the French grading system. METHODS We included new drugs for solid tumors assessed by the HAS between 2010 and 2016 and compared their ASMR level to scores calculated by the 2016-updated ASCO-VF and 2015 ESMO-MCBS. RESULTS We investigated 27 new cancer drugs assessed by the French HAS between 2010 and 2016. Among the 17 drugs eligible for comparison, the correlation between ASMR levels and ASCO and ESMO scores was weak (r = 0.34 and r = 0.27, respectively). The agreement between the HAS and ESMO regarding the level of meaningful additional benefit was moderate (kappa = 0.43). We found no significant association between 12 potential variables and ASMR level of additional benefit of drugs. CONCLUSION Our findings show inconsistencies in cancer drug appraisals among the three appraisers.
Collapse
Affiliation(s)
- J Li
- Clinical Epidemiology Unit, Greater Paris University Hospitals (AP-HP) , Paris, France.,Judge Business School, University of Cambridge , Cambridge, UK.,Faculty of Medicine, Paris XII University , Créteil, France
| | - A Vivot
- Clinical Epidemiology Unit, Greater Paris University Hospitals (AP-HP) , Paris, France.,UMR1153 Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), INSERM, University Paris Descartes , Paris, France
| | - L Alter
- Department is Oncology Business Unit, LILLY FRANCE , Neuilly-sur-Seine, France
| | - I Durand-Zaleski
- Faculty of Medicine, Paris XII University , Créteil, France.,URC Eco IdF, Greater Paris University Hospitals (AP-HP) , Paris, France
| |
Collapse
|
9
|
Coquerelle S, Darlington M, Mezaour N, Preudhomme C, Mc Intyre E, Durand-Zaleski I. Séquençage Haut Débit (NGS) dans les hémopathies malignes et évaluation médico-économique–PRME RUBIH2. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.049] [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: 10/26/2022] Open
|
10
|
Coquerelle S, Ghardallou M, Rais S, Taupin P, Touzot F, Cavazzana M, Durand-Zaleski I. βeta-thalassémie majeure : analyse coût-efficacité de la thérapie génique versus l’allogreffe de cellules souches hématopoïétique. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.043] [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: 10/27/2022] Open
|
11
|
Bulsei J, Pfister J, Deslee G, Durand-Zaleski I. Justification de l’utilisation de deux questionnaires de qualité de vie, le SGRQ et l’EQ-5D-5L, dans une étude clinique contenant un volet économique. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.089] [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: 10/27/2022] Open
|
12
|
Legendre P, Chahwan D, Mohty M, Hermine O, Kahn J, Lortholary O, Bouscary D, Dougados M, Durand-Zaleski I, Godeau B, Mouthon L. Utilisation des immunoglobulines intraveineuses et sous-cutanées chez des patients atteints de déficits Immunitaires secondaires : analyse rétrospective (ULTIMATE). Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.336] [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: 11/28/2022]
|
13
|
Dibie A, Femery V, Dubois A, Blacher J, Beaunier P, Thorez F, Chabot JM, Isnard-Bagnis C, Benzaqui M, Ohannessian R, Garnier M, Durand-Zaleski I, Ballouk S, Sosner P, Pavy B. [VIVOPTIM: Feedback of an e-Health experimental program of primary prevention of cardiovascular risk on 30 to 70 years old volunteers]. Ann Cardiol Angeiol (Paris) 2018; 67:293-299. [PMID: 30301547 DOI: 10.1016/j.ancard.2018.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 11/26/2022]
Abstract
Today by the e-health and the telemedicine, many people are more and more interested by the improvement of disease knowledge on cardiovascular diseases and associated risk factors, personalized self management support follow-up and e-Health monitoring. MGEN is a not-for-profit complementary health insurance gave itself the ways to use the new digital tools in health. MGEN developed an original and personalized program VIVOPTIM for the primary prevention of the cardiovascular risks for their members. The VIVOPTIM Pilot program is based upon digital services and was experimented by November 2015 to December, 2017 with 8000 members of the MGEN, from 30 to 70 years old and resident in two French areas (Occitanie and Bourgogne Franche-Comté). The assessment of the experiment VIVOPTIM e -health program was positive for the personalized cardiovascular support and for their health. Therefore, the MGEN generalized the VIVOPTIM program of cardiovascular prevention, to the whole France on July 11th, 2018.
Collapse
Affiliation(s)
- A Dibie
- Département de pathologie cardiaque, institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
| | - V Femery
- Mutuelle générale de l'éducation nationale, 3, square Max-Hymans, 75748 Paris cedex 15, France
| | - A Dubois
- Mutuelle générale de l'éducation nationale, 3, square Max-Hymans, 75748 Paris cedex 15, France
| | - J Blacher
- Centre de diagnostic et thérapeutique, Hôtel-Dieu, université Paris Descartes, AP-HP, place du Parvis-Notre-Dame, 75004 Paris, France
| | | | - F Thorez
- 66, 68, rue de la Glacière, 75013 Paris, France
| | - J M Chabot
- Haute Autorité de Santé, 5, avenue du Stade-de-France, 93218 Saint-Denis, France
| | - C Isnard-Bagnis
- Hôpital de La Pitié-Salpêtrière, université Pierre-et-Marie-Curie, AP-HP, Paris, France
| | - M Benzaqui
- 66, 68, rue de la Glacière, 75013 Paris, France
| | | | - M Garnier
- Mutuelle générale de l'éducation nationale, 3, square Max-Hymans, 75748 Paris cedex 15, France
| | - I Durand-Zaleski
- Santé publique hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - S Ballouk
- Mutuelle générale de l'éducation nationale, 3, square Max-Hymans, 75748 Paris cedex 15, France
| | - P Sosner
- Centre de diagnostic et thérapeutique, Hôtel-Dieu, université Paris Descartes, AP-HP, place du Parvis-Notre-Dame, 75004 Paris, France
| | - B Pavy
- Service de réadaptation cardiaque, centre hospitalier Loire Vendée Océan, 44270 Machecoul, France
| |
Collapse
|
14
|
Ferrier C, Dhombres F, Guilbaud L, Durand-Zaleski I, Jouannic JM. [Ultrasound screening for birth defects: A medico-economic review]. ACTA ACUST UNITED AC 2017; 45:408-415. [PMID: 28720225 DOI: 10.1016/j.gofs.2017.06.007] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/14/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The systematic use of ultrasound during pregnancy aims at birth defect detection. Our objective was to assess the economic efficiency of prenatal ultrasound screening for fetal malformations. METHODS We carried out a literature review on Medline via PubMed between 1985 and 2015, from the economic perspective of the prenatal ultrasound screening for fetal malformations. RESULTS The literature on this subject was sparse and we selected only twelve articles presenting relevant economic data, of which only eight were proper medico-economic studies. We found arguments for the economic effectiveness of ultrasound screening for fetal malformation detection, which is largely linked to the terminations of pregnancies and to the cost of the handicaps "avoided". However, none of the reviewed articles could reach medico-economic conclusions. Additionally, we highlighted various elements making economic analyses more complex in this field: the choice of the method, the uncertainty around two essential parameters (the efficiency of ultrasound and the costs of procedures) and the difficulties to compare or to generalize results. We also noticed important methodological heterogeneity among the studies and the absence of French study. CONCLUSIONS Previously published data are insufficient to assess the economic efficiency of prenatal ultrasound screening for fetal malformations.
Collapse
Affiliation(s)
- C Ferrier
- Service de médecine fœtale, pôle de périnatalité, hôpital Armand-Trousseau, AP-HP, UPMC, Paris 6, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Unité de recherche clinique en économie de la santé d'Île-de-France, Hôtel-Dieu de Paris, 1, place du parvis de Notre-Dame, 75004 Paris, France
| | - F Dhombres
- Service de médecine fœtale, pôle de périnatalité, hôpital Armand-Trousseau, AP-HP, UPMC, Paris 6, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
| | - L Guilbaud
- Service de médecine fœtale, pôle de périnatalité, hôpital Armand-Trousseau, AP-HP, UPMC, Paris 6, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France
| | - I Durand-Zaleski
- Unité de recherche clinique en économie de la santé d'Île-de-France, Hôtel-Dieu de Paris, 1, place du parvis de Notre-Dame, 75004 Paris, France
| | - J-M Jouannic
- Service de médecine fœtale, pôle de périnatalité, hôpital Armand-Trousseau, AP-HP, UPMC, Paris 6, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France
| |
Collapse
|
15
|
Blanchard C, Pattou F, Brunaud L, Hamy A, Dahan M, Mathonnet M, Volteau C, Caillard C, Durand-Zaleski I, Mirallié E. Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr). BJS Open 2017; 1:2-10. [PMID: 29951599 PMCID: PMC5989994 DOI: 10.1002/bjs5.2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 03/16/2017] [Indexed: 11/26/2022] Open
Abstract
Background The benefits of single‐use ultrasonic scissors in thyroid surgery are still debated. Although this device has been shown to reduce operating time compared with conventional haemostasis, its cost‐effectiveness has never been demonstrated. The aim of this study was to evaluate the efficacy, cost‐effectiveness and safety of ultrasonic scissors for total thyroidectomy. Methods This was a prospective, randomized, multicentre trial conducted at 13 hospital sites. The primary endpoint was the percentage of patients with hypocalcaemia (serum calcium level below 2 mmol/l) on day 2. Secondary endpoints included postoperative complications and costs, with calculation of incremental cost differences and cost‐effectiveness ratios. Results In total, 1329 patients who underwent total thyroidectomy were included in the analysis: 670 were randomized to treatment with ultrasonic scissors and 659 to conventional haemostasis. There was no difference between groups in the rate of complications, including hypocalcaemia on day 2 (19.7 per cent in ultrasonic scissors group versus 20.3 per cent in conventional haemostasis group; P = 0·743). Median operating times were significantly shorter with ultrasonic scissors (90 versus 100 min with conventional haemostasis; P < 0·001). Total mean(s.d.) direct costs at 6 months were €4311(1547) and €4011(1596) respectively (P < 0·001). Conclusion Ultrasonic scissors were no more clinically effective than conventional haemostasis, but use of these devices was more costly. Registration number: NCT01551914 (http://www.clinicaltrials.gov).
Collapse
Affiliation(s)
- C Blanchard
- Clinique de Chirurgie Digestive et Endocrinienne Centre Hospitalier Universitaire (CHU) de Nantes Nantes France
| | - F Pattou
- Chirurgie Générale et Endocrinienne, CHU Lille Université de Lille Lille France
| | - L Brunaud
- Service de Chirurgie Digestive, Hépato-Biliaire et Endocrinienne CHU Nancy - Hôpital de Brabois Nancy France
| | - A Hamy
- Chirurgie Digestive et Endocrinienne CHU Angers Angers France
| | - M Dahan
- Chirurgie Thoracique, Pôle Voies Respiratoires CHU de Toulouse - Hôpital Larrey Toulouse France
| | - M Mathonnet
- Chirurgie Digestive, Générale et Endocrinienne CHU de Limoges - Hôpital Dupuytren Limoges France
| | - C Volteau
- Département Promotion Délégation à la Recherche Clinique et à l'Innovation Nantes France
| | - C Caillard
- Clinique de Chirurgie Digestive et Endocrinienne Centre Hospitalier Universitaire (CHU) de Nantes Nantes France
| | - I Durand-Zaleski
- Assistance Publique - Hôpitaux de Paris Unité de Recherche Clinique en Économie de la Santé d'Île-de-France Hôpital de l'Hôtel-Dieu Paris France
| | - E Mirallié
- Clinique de Chirurgie Digestive et Endocrinienne Centre Hospitalier Universitaire (CHU) de Nantes Nantes France
| | | |
Collapse
|
16
|
Marino P, Touzani R, Borget I, Rouleau E, Durand-Zaleski I, Perrier L, Sika Kossi D, Baffert S. Coût du séquençage NGS à visée diagnostique en génétique somatique et constitutionnelle : estimations issues de 15 laboratoires français de génétique moléculaire des cancers. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.077] [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: 10/19/2022] Open
|
17
|
Azizi M, Pereira H, Hamdidouche I, Gosse P, Monge M, Bobrie G, Delsart P, Mounier-Véhier C, Courand PY, Lantelme P, Denolle T, Dourmap-Collas C, Girerd X, Michel Halimi J, Zannad F, Ormezzano O, Vaïsse B, Herpin D, Ribstein J, Chamontin B, Mourad JJ, Ferrari E, Plouin PF, Jullien V, Sapoval M, Chatellier G, Amar L, Lorthioir A, Pagny JY, Claisse G, Midulla M, Dauphin R, Fauvel J, Rouvière O, Cremer A, Grenier N, Lebras Y, Trillaud H, Heautot J, Larralde A, Paillard F, Cluzel P, Rosenbaum D, Alison D, Claudon M, Popovic B, Rossignol P, Baguet J, Thony F, Bartoli J, Drouineau J, Sosner P, Tasu J, Velasco S, Vernhet-Kovacsik H, Bouhanick B, Rousseau H, Le Jeune S, Lopez-Sublet M, Bellmann L, Esnault V, Baguet J, Vernhet-Kovacsik H, Durand-Zaleski I, Beregi (chair) J, Lièvre M, Persu A. Adherence to Antihypertensive Treatment and the Blood Pressure–Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial. Circulation 2016; 134:847-57. [DOI: 10.1161/circulationaha.116.022922] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/29/2016] [Indexed: 12/20/2022]
Abstract
Background:
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure–lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report the influence of adherence to antihypertensive treatment on blood pressure control.
Methods:
One hundred six patients with hypertension resistant to 4 weeks of treatment with indapamide 1.5 mg/d, ramipril 10 mg/d (or irbesartan 300 mg/d), and amlodipine 10 mg/d were randomly assigned to renal denervation plus standardized stepped-care antihypertensive treatment, or the same antihypertensive treatment alone. For standardized stepped-care antihypertensive treatment, spironolactone 25 mg/d, bisoprolol 10 mg/d, prazosin 5 mg/d, and rilmenidine 1 mg/d were sequentially added at monthly visits if home blood pressure was ≥135/85 mm Hg after randomization. We assessed adherence to antihypertensive treatment at 6 months by drug screening in urine/plasma samples from 85 patients.
Results:
The numbers of fully adherent (20/40 versus 21/45), partially nonadherent (13/40 versus 20/45), or completely nonadherent patients (7/40 versus 4/45) to antihypertensive treatment were not different in the renal denervation and the control groups, respectively (
P
=0.3605). The difference in the change in daytime ambulatory systolic blood pressure from baseline to 6 months between the 2 groups was –6.7 mm Hg (
P
=0.0461) in fully adherent and –7.8 mm Hg (
P
=0.0996) in nonadherent (partially nonadherent plus completely nonadherent) patients. The between-patient variability of daytime ambulatory systolic blood pressure was greater for nonadherent than for fully adherent patients.
Conclusions:
In the DENERHTN trial, the prevalence of nonadherence to antihypertensive drugs at 6 months was high (≈50%) but not different in the renal denervation and control groups. Regardless of adherence to treatment, renal denervation plus standardized stepped-care antihypertensive treatment resulted in a greater decrease in blood pressure than standardized stepped-care antihypertensive treatment alone.
Clinical Trial Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01570777.
Collapse
Affiliation(s)
- Michel Azizi
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Helena Pereira
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Idir Hamdidouche
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Philippe Gosse
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Matthieu Monge
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Guillaume Bobrie
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pascal Delsart
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Claire Mounier-Véhier
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre-Yves Courand
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre Lantelme
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Thierry Denolle
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Caroline Dourmap-Collas
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Xavier Girerd
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean Michel Halimi
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Faiez Zannad
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Olivier Ormezzano
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Bernard Vaïsse
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Daniel Herpin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean Ribstein
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Bernard Chamontin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Jean-Jacques Mourad
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Emile Ferrari
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Pierre-François Plouin
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Vincent Jullien
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Marc Sapoval
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - Gilles Chatellier
- From Paris-Descartes University, France (M.A., P.-F.P., V.J., M.S., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, France (M.A., G.B., P.-F.P.); INSERM, CIC1418, Paris, France (M.A., H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit, France (H.P., G.C.); Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Pharmacology, France (I.H., V.J.); Centre
| | - L. Amar
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | - A. Lorthioir
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | - J.-Y. Pagny
- Hôpital Européen Georges Pompidou, Paris (31/28)
| | | | | | - R. Dauphin
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - J.P. Fauvel
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - O. Rouvière
- Hôpital de la Croix Rousse and Hôpital Edouard Herriot, Lyon (14/13)
| | - A. Cremer
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - N. Grenier
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - Y. Lebras
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - H. Trillaud
- Hôpital Saint André and Hôpital Pellegrin, Bordeaux (14/13)
| | - J.F. Heautot
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - A. Larralde
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - F. Paillard
- Hôpital Arthur Gardiner, Dinard and CHU Rennes (12/12)
| | - P. Cluzel
- Hôpital de la Pitié Salpétrière, Paris (6/5)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Alberti C, Bernard J, Boulkedid R, Guillemin F, Tubach F, Giorgi R, Durand-Zaleski I, Chevreul K, Chêne G, Amiel P. Processus d’expertise des projets de recherche institutionnels, ExPair 2 : revue de la littérature. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.03.042] [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
|
19
|
Aissaoui N, Morshuis M, Maoulida H, Salem J, Brunn M, Varnous S, Gummert J, Durand-Zaleski I, Leprince P, Fagon J. Transplantation versus Ventricular Assist Device for the Management of End-Stage Heart Failure: An Observational Comparison of Clinical and Economic Outcomes. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.822] [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] Open
|
20
|
Marzouk A, Pierucci AF, Durand-Zaleski I. Coûts pré- et post-natal du retard de croissance intra-utérin en France: une étude nationale à partir du PMSI. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.01.024] [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: 10/22/2022] Open
|
21
|
Chouaïd C, Debieuvre D, Durand-Zaleski I, Fernandes J, Scherpereel A, Westeel V, Blein C, Gaudin A, Ozan N, Leblanc S, Vainchtock A, Cotté F, Souquet P. Disparités régionales et socio-économiques dans le cancer du poumon (étude TERRITOIRE). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Deslee G, Mal H, Dutau H, Bourdin A, Vergnon J, Pison C, Kessler R, Jounieaux V, Thiberville L, Leroy S, Marceau A, Laroumagne S, Mallet J, Dukic S, Barbe C, Bulsei J, Jolly D, Durand-Zaleski I, Marquette C. Étude randomisée multicentrique évaluant la réduction volumique par spirales dans l’emphysème (STIC REVOLENS). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.041] [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: 10/22/2022]
|
23
|
Souquet P, Debieuvre D, Westeel V, Durand-Zaleski I, Fernandes J, Scherpereel A, Blein C, Gaudin A, Ozan N, Vainchtock A, Saitta B, Cotté F, Chouaïd C. Délais d’accès à la chimiothérapie adjuvante après une chirurgie curative dans le cancer du poumon (étude TERRITOIRE). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.112] [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: 11/24/2022]
|
24
|
Bahrami S, Lee AS, Harbarth S, Malhotra-Kumar S, Brun-Buisson C, Durand-Zaleski I. Workload associated with mrsa control in surgery: a prospective study alongside a controlled clinical trial. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475084 DOI: 10.1186/2047-2994-4-s1-p188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
25
|
Perlbarg J, Rabetrano H, Soulié M, Salomon L, Durand-Zaleski I. [Economic evaluation of the treatments of non-metastatic prostate cancer]. Prog Urol 2015; 25:1108-15. [PMID: 26519969 DOI: 10.1016/j.purol.2015.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 07/29/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Prostate cancer is the most frequent cancer and the third leading cause of cancer death in men in France. The development of treatment for prostate cancer is fast and sometimes relies on costly innovations. Medico-economic studies are however rare in this area. This literature review aims to summarize available medico-economic data on the initial management of localized prostate cancer and discuss the quality and usability of existing economic studies on the subject. MATERIALS AND METHOD Literature review was done using PubMed and Cochrane databases. Studies and articles were selected based on several criteria: population with initial treatment for localized prostate cancer (without metastasis), comparative studies with surgery as control treatment, studies in countries members of the OECD, articles in English or French published between 2004 and 2014. RESULTS The surgical robot, one of the newest innovations, is more expensive than conventional open surgery or no robotic laparoscopy, even if it is associated with a reduction of the original period of stay. Radiation therapy seems more expensive than surgery as initial therapy of localized prostate cancer. CONCLUSION Conclusions remain limited because of the rarity of reliable health economic studies on the subject.
Collapse
Affiliation(s)
- J Perlbarg
- URC-Eco (unité de recherche clinique spécialisée en économie de la santé), Hôtel-Dieu, AP-HP, 1, place du Parvis-Notre-Dame, 75004 Paris, France
| | - H Rabetrano
- URC-Eco (unité de recherche clinique spécialisée en économie de la santé), Hôtel-Dieu, AP-HP, 1, place du Parvis-Notre-Dame, 75004 Paris, France
| | - M Soulié
- Département d'urologie-andrologie-transplantation rénale, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France
| | - L Salomon
- Service d'urologie et de transplantation rénale et pancréatique, CHU Mondor, 51, avenue Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
| | - I Durand-Zaleski
- URC-Eco (unité de recherche clinique spécialisée en économie de la santé), Hôtel-Dieu, AP-HP, 1, place du Parvis-Notre-Dame, 75004 Paris, France
| |
Collapse
|
26
|
Durand-Zaleski I, Rabetrano H, Devonec M, Mandron E, Soulie M, De la Taille A, Benoit G, Mottet N, Gasman D, Dore B, Zerbib M, Vaessen C, Irani J, Lebret T, Colombel M, Lechevallier E, Bastuji-Garin S, Allory Y, Abbou C, Rischmann P, Salomon L. Résultats économiques de Propenlap, étude prospective multicentrique comparant les voies ouvertes et mini-invasives de la prostatectomie totale. Prog Urol 2015; 25:742. [DOI: 10.1016/j.purol.2015.08.054] [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: 10/22/2022]
|
27
|
Rigoard P, Roulaud M, Monlezun O, Lorgeoux B, Guetarni F, Ingrand P, Durand-Zaleski I, ESTIMET Study G. Multicolumn spinal cord stimulation in failed back surgery syndrome: design of a national, multicentre, randomized, controlled health economics trial (Estimet Study). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1287] [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: 10/22/2022]
|
28
|
Michel M, Becquemin JP, Clément MC, Marzelle J, Quelen C, Durand-Zaleski I. Thirty day Outcomes and Costs of Fenestrated and Branched Stent Grafts versus Open Repair for Complex Aortic Aneurysms. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.06.209] [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: 11/26/2022]
|
29
|
Abstract
The increasing pressure on healthcare resources affects blood donation and transfusion. We attempted a survey of the efficiency of different strategies, actual or proposed to improve the management of blood products. We found an important disconnect between the cost effectiveness ratio of strategies and their uptake by policy makers. In other words, the least efficient strategies are those which increase transfusion safety by increasing the number of biological markers and are those preferred by health authorities in developed countries. Other more efficient strategies are more slowly implemented and included a systematic use of transfusion guidelines, reducing blood losses or increasing pre operative blood levels in elective surgeries.
Collapse
Affiliation(s)
- I Durand-Zaleski
- ECEVE, UMRS 1123, URCEco Île-de-France, hôpital de l'Hôtel-Dieu, place du parvis de Notre-Dame, 75004 Paris, France; Santé publique, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| |
Collapse
|
30
|
Michel M, Becquemin JP, Clément MC, Marzelle J, Quelen C, Durand-Zaleski I. Editor's choice - thirty day outcomes and costs of fenestrated and branched stent grafts versus open repair for complex aortic aneurysms. Eur J Vasc Endovasc Surg 2015; 50:189-96. [PMID: 26100447 DOI: 10.1016/j.ejvs.2015.04.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 04/08/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To compare 30 day outcomes and costs of fenestrated and branched stent grafts (f/b EVAR) and open surgery (OSR) for the treatment of complex abdominal aortic aneurysms (AAA) and thoraco-abdominal aortic aneurysms (TAAA). METHODS The multicenter prospective registry WINDOW was set up to evaluate f/b EVAR in high risk patients with para/juxtarenal AAA, and infradiaphragmatic and supradiaphragmatic TAAA. A control group of patients treated by OSR was extracted from the national hospital discharge database. The primary endpoint was 30 day mortality. Secondary endpoints included severe complications, length of stay, and costs. Mortality was assessed by survival analysis and uni/multivariate Cox regression analyses using pre- and post-operative characteristics. Bootstrap methods were used to estimate the cost-effectiveness of f/b EVAR versus OSR. RESULTS Two hundred and sixty eight cases and 1,678 controls were included. There was no difference in 30 day mortality (6.7% vs. 5.4%, p = 0.40), but costs were higher with f/b EVAR (€38,212 vs. €16,497, p < .001). After group stratification, mortality was similar with both treatments for para/juxtarenal AAA (4.3% vs. 5.8%, p = .26) and supradiaphragmatic TAAA (11.9% vs. 19.7%, p = .70), and higher with f/b EVAR for infradiaphragmatic TAAA (11.9% vs. 4.0%, p = .010). Costs were higher with f/b EVAR for para/juxtarenal AAA (€34,425 vs. €14,907, p < .0001) and infradiaphragmatic TAAA (€37,927 vs. €17,530, p < .0001), but not different for supradiaphragmatic TAAA (€54,710 vs. €44,163, p = .18). CONCLUSION f/b EVAR does not appear justified for patients with para/juxtarenal AAA and infradiaphragmatic TAAA fit for OSR but may be an attractive option for patients with para/juxtarenal AAA not eligible for surgery and patients with supradiaphragmatic TAAA. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov/ct2/show/NCT01168037; identifier: NCT01168037 (WINDOW registry).
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Aortic Aneurysm, Abdominal/diagnosis
- Aortic Aneurysm, Abdominal/economics
- Aortic Aneurysm, Abdominal/mortality
- Aortic Aneurysm, Abdominal/surgery
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/economics
- Aortic Aneurysm, Thoracic/mortality
- Aortic Aneurysm, Thoracic/surgery
- Blood Vessel Prosthesis/economics
- Blood Vessel Prosthesis Implantation/adverse effects
- Blood Vessel Prosthesis Implantation/economics
- Blood Vessel Prosthesis Implantation/instrumentation
- Blood Vessel Prosthesis Implantation/mortality
- Case-Control Studies
- Chi-Square Distribution
- Cost-Benefit Analysis
- Endovascular Procedures/adverse effects
- Endovascular Procedures/economics
- Endovascular Procedures/instrumentation
- Endovascular Procedures/mortality
- Female
- France
- Hospital Costs
- Humans
- Kaplan-Meier Estimate
- Length of Stay/economics
- Male
- Middle Aged
- Models, Economic
- Multivariate Analysis
- Proportional Hazards Models
- Prospective Studies
- Prosthesis Design
- Registries
- Stents/economics
- Time Factors
- Treatment Outcome
Collapse
Affiliation(s)
- M Michel
- URC Eco Ile de France, DRCD, AP-HP, Hôtel Dieu, Paris, France.
| | - J-P Becquemin
- Department of Vascular Surgery, CHU Henri Mondor, Créteil, France
| | - M-C Clément
- URC Eco Ile de France, DRCD, AP-HP, Hôtel Dieu, Paris, France
| | - J Marzelle
- Department of Vascular Surgery, CHU Henri Mondor, Créteil, France
| | - C Quelen
- URC Eco Ile de France, DRCD, AP-HP, Hôtel Dieu, Paris, France
| | - I Durand-Zaleski
- URC Eco Ile de France, DRCD, AP-HP, Hôtel Dieu, Paris, France; UPEC, CHU Henri Mondor, Créteil, France
| |
Collapse
|
31
|
Thomas C, Mirallié S, Pierres C, Dert C, Clément MC, Mahlaoui N, Durand-Zaleski I, Fischer A, Audrain M. Projet de mise en place du dépistage néonatal systématique des déficits immunitaires combinés sévères : présentation de l’étude DEPISTREC. Arch Pediatr 2015; 22:646-52. [DOI: 10.1016/j.arcped.2015.03.001] [Citation(s) in RCA: 5] [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] [Received: 06/24/2014] [Revised: 10/11/2014] [Accepted: 03/03/2015] [Indexed: 11/28/2022]
|
32
|
Roulaud M, Durand-Zaleski I, Ingrand P, Serrie A, Diallo B, Peruzzi P, Hieu PD, Voirin J, Raoul S, Page P, Fontaine D, Lantéri-Minet M, Blond S, Buisset N, Cuny E, Cadenne M, Caire F, Ranoux D, Mertens P, Naous H, Simon E, Emery E, Gadan B, Regis J, Sol JC, Béraud G, Debiais F, Durand G, Guetarni Ging F, Prévost A, Brandet C, Monlezun O, Delmotte A, d'Houtaud S, Bataille B, Rigoard P. Multicolumn spinal cord stimulation for significant low back pain in failed back surgery syndrome: design of a national, multicentre, randomized, controlled health economics trial (ESTIMET Study). Neurochirurgie 2014; 61 Suppl 1:S109-16. [PMID: 25456442 DOI: 10.1016/j.neuchi.2014.10.105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 09/24/2014] [Accepted: 10/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Many studies have demonstrated the efficacy of spinal cord stimulation (SCS) for chronic neuropathic radicular pain over recent decades, but despite global favourable outcomes in failed back surgery syndrome (FBSS) with leg pain, the back pain component remains poorly controlled by neurostimulation. Technological and scientific progress has led to the development of new SCS leads, comprising a multicolumn design and a greater number of contacts. The efficacy of multicolumn SCS lead configurations for the treatment of the back pain component of FBSS has recently been suggested by pilot studies. However, a randomized controlled trial must be conducted to confirm the efficacy of new generation multicolumn SCS. Évaluation médico-économique de la STImulation MEdullaire mulTi-colonnes (ESTIMET) is a multicentre, randomized study designed to compare the clinical efficacy and health economics aspects of mono- vs. multicolumn SCS lead programming in FBSS patients with radicular pain and significant back pain. MATERIALS AND METHODS FBSS patients with a radicular pain VAS score≥50mm, associated with a significant back pain component were recruited in 14 centres in France and implanted with multicolumn SCS. Before the lead implantation procedure, they were 1:1 randomized to monocolumn SCS (group 1) or multicolumn SCS (group 2). Programming was performed using only one column for group 1 and full use of the 3 columns for group 2. Outcome assessment was performed at baseline (pre-implantation), and 1, 3, 6 and 12months post-implantation. The primary outcome measure was a reduction of the severity of low back pain (bVAS reduction≥50%) at the 6-month visit. Additional outcome measures were changes in global pain, leg pain, paraesthesia coverage mapping, functional capacities, quality of life, neuropsychological aspects, patient satisfaction and healthcare resource consumption. TRIAL STATUS Trial recruitment started in May 2012. As of September 2013, all 14 study centres have been initiated and 112/115 patients have been enrolled. Preliminary results are expected to be published in 2015. TRIAL REGISTRATION Clinical trial registration information-URL: www.clinicaltrials.gov. Unique identifier NCT01628237.
Collapse
Affiliation(s)
- M Roulaud
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France.
| | - I Durand-Zaleski
- Clinical Research Unit in Economics, Hôtel Dieu, 75004 Paris, France
| | - P Ingrand
- Faculty of medicine and pharmacy, Poitiers University Hospital, 86000 Poitiers, France
| | - A Serrie
- Pain Evaluation and Treatment Centre, Lariboisière Hospital, 75010 Paris, France
| | - B Diallo
- Pain Evaluation and Treatment Centre, Poitiers University Hospital, 86000 Poitiers, France
| | - P Peruzzi
- Department of Neurosurgery, Reims University Hospital, 51092 Reims, France
| | - P D Hieu
- Pain Evaluation and Treatment Centre, Brest University Hospital, 29200 Brest, France
| | - J Voirin
- Department of Neurosurgery, Colmar Hospital, 68024 Colmar, France
| | - S Raoul
- Department of Neurosurgery, Nantes University Hospital, 44093 Nantes, France
| | - P Page
- Department of Neurosurgery, Sainte-Anne Hospital, AP-HP, 75014 Paris, France
| | - D Fontaine
- Department of Neurosurgery, Nice University Hospital, 06003 Nice, France
| | - M Lantéri-Minet
- Department of Neurosurgery, Nice University Hospital, 06003 Nice, France
| | - S Blond
- Department of Neurosurgery, Lille University Hospital, 59037 Lille, France
| | - N Buisset
- Department of Neurosurgery, Lille University Hospital, 59037 Lille, France
| | - E Cuny
- Department of Neurosurgery, Bordeaux University Hospital, 33076 Bordeaux, France
| | - M Cadenne
- Department of Neurosurgery, Bordeaux University Hospital, 33076 Bordeaux, France
| | - F Caire
- Department of Neurosurgery, Limoges University Hospital, 87042 Limoges, France
| | - D Ranoux
- Department of Neurosurgery, Limoges University Hospital, 87042 Limoges, France
| | - P Mertens
- Department of Neurosurgery, Lyon University Hospital, 69677 Lyon, France
| | - H Naous
- Department of Neurosurgery, Lyon University Hospital, 69677 Lyon, France
| | - E Simon
- Department of Neurosurgery, Lyon University Hospital, 69677 Lyon, France
| | - E Emery
- Department of Neurosurgery, Caen University Hospital, 14000 Caen, France
| | - B Gadan
- Department of Neurosurgery, Caen University Hospital, 14000 Caen, France
| | - J Regis
- Department of Neurosurgery, AP-HM, Timone Hospital, 13385 Marseille, France
| | - J-C Sol
- Department of Neurosurgery, Toulouse University Hospital, 31000 Toulouse, France
| | - G Béraud
- Internal Medicine/Infectious and Tropical Diseases Department, Poitiers University Hospital, 86000 Poitiers, France
| | - F Debiais
- Department of Rheumatology, Poitiers University Hospital, 86000 Poitiers, France
| | - G Durand
- Department of Rheumatology, Poitiers University Hospital, 86000 Poitiers, France
| | - F Guetarni Ging
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France
| | - A Prévost
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France
| | - C Brandet
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France
| | - O Monlezun
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France
| | - A Delmotte
- Department of Neurosurgery, Spine-Neurostimulation Unit, Poitiers University Hospital, 86000 Poitiers, France
| | - S d'Houtaud
- Department of Neurosurgery, Spine-Neurostimulation Unit, Poitiers University Hospital, 86000 Poitiers, France
| | - B Bataille
- Department of Neurosurgery, Spine-Neurostimulation Unit, Poitiers University Hospital, 86000 Poitiers, France
| | - P Rigoard
- N(3)lab (Neuromodulation and Neural Networks), Inserm CIC 802, Poitiers University Hospital, 86000 Poitiers, France; Department of Neurosurgery, Spine-Neurostimulation Unit, Poitiers University Hospital, 86000 Poitiers, France
| |
Collapse
|
33
|
Cadier B, Chevreul K, Brunn M, Durand-Zaleski I. Évaluation des expérimentations de nouveaux modes de prise en charge : l’apport du calage sur les marges pour évaluer l’opportunité de la généralisation. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.040] [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: 11/28/2022] Open
|
34
|
Bulsei J, Darlington M, Durand-Zaleski I. Stratégie DENER-HTN, étude médico-économique de type coût-efficacité. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.090] [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: 10/25/2022] Open
|
35
|
Lanitis T, Cotté FE, Gaudin AF, Kachaner I, Kongnakorn T, Durand-Zaleski I. Stroke prevention in patients with atrial fibrillation in France: comparative cost-effectiveness of new oral anticoagulants (apixaban, dabigatran, and rivaroxaban), warfarin, and aspirin. J Med Econ 2014; 17:587-98. [PMID: 24831811 DOI: 10.3111/13696998.2014.923891] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To conduct an economic evaluation of the currently prescribed treatments for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) including warfarin, aspirin, and novel oral anticoagulants (NOACs) from a French payer perspective. METHODS A previously published Markov model was adapted in accordance to the new French guidelines of the Commission for Economic Evaluation and Public Health (CEESP), to adopt the recommended efficiency frontier approach. A cohort of patients with NVAF eligible for stroke preventive treatment was simulated over lifetime. Clinical events modeled included strokes, systemic embolism, intracranial hemorrhage, other major bleeds, clinically relevant non-major bleeds, and myocardial infarction. Efficacy and bleeding data for warfarin, apixaban, and aspirin were obtained from ARISTOTLE and AVERROES trials, whilst efficacy data for other NOACs were from published indirect comparisons. Acute medical costs were obtained from a dedicated analysis of the French national hospitalization database (PMSI). Long-term medical costs and utility data were derived from the literature. Univariate and probabilistic sensitivity analyses were performed to assess the robustness of the model projections. RESULTS Warfarin and apixaban were the two optimal treatment choices, as the other five treatment strategies including aspirin, dabigatran 110 mg, dabigatran in sequential dosages, dabigatran 150 mg, and rivaroxaban were strictly dominated on the efficiency frontier. Further, apixaban was a cost-effective alternative vs warfarin with an incremental cost of €2314 and an incremental quality-adjusted life year (QALY) of 0.189, corresponding to an incremental cost-effectiveness ratio (ICER) of €12,227/QALY. CONCLUSIONS Apixaban may be the most economically efficient alternative to warfarin in NVAF patients eligible for stroke prevention in France. All other strategies were dominated, yielding apixaban as a less costly yet more effective treatment alternative. As formally requested by the CEESP, these results need to be verified in a French clinical setting using stroke reduction and bleeding safety observed in real-life patient cohorts using these anticoagulants.
Collapse
Affiliation(s)
- T Lanitis
- Evidera, Modeling and Simulation, Health Economics , London , UK
| | | | | | | | | | | |
Collapse
|
36
|
Zarca K, Durand-Zaleski I, Roux C, Souberbielle JC, Schott AM, Thomas T, Fardellone P, Benhamou CL. Cost-effectiveness analysis of hip fracture prevention with vitamin D supplementation: a Markov micro-simulation model applied to the French population over 65 years old without previous hip fracture. Osteoporos Int 2014; 25:1797-806. [PMID: 24691648 DOI: 10.1007/s00198-014-2698-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 12/03/2013] [Accepted: 03/18/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED We performed a cost-effectiveness analysis of four vitamin D supplementation strategies for primary prevention of hip fracture among the elderly population and found that the most cost-effective strategy was screening for vitamin D insufficiency followed by adequate treatment to attain a minimum 25(OH) serum level. INTRODUCTION Vitamin D supplementation has a demonstrated ability to reduce the incidence of hip fractures. The efficiency of lifetime supplementation has not yet been assessed in the population over 65 years without previous hip fracture. The objective was to analyze the efficiency of various vitamin D supplementation strategies for that population. METHODS A Markov micro-simulation model was built with data extracted from published studies and from the French reimbursement schedule. Four vitamin D supplementation strategies were evaluated on our study population: (1) no treatment, (2) supplementation without any serum level check; (3) supplementation with a serum level check 3 months after initiation and subsequent treatment adaptation; (4) population screening for vitamin D insufficiency followed by treatment based on the vitamin D serum level. RESULTS "Treat, then check" and "screen and treat" were two cost-effective strategies and dominated "treat without check" with incremental cost-effectiveness ratios of €5,219/quality-adjusted life-years (QALY) and €9,104/QALY, respectively. The acceptability curves showed that over €6,000/QALY, the "screen and treat" strategy had the greatest probability of being cost-effective, and the "no treatment" strategy would never be cost-effective if society were willing to spend over €8,000/QALY. The sensitivity analysis showed that among all parameters varying within realistic ranges, the cost of vitamin D treatment had the greatest effect and yet remained below the WHO cost-effectiveness thresholds. CONCLUSIONS Population screening for vitamin D insufficiency followed by treatment based on the vitamin D serum level is the most cost-effective strategy for preventing hip fracture occurrence in the population over 65 years old.
Collapse
Affiliation(s)
- K Zarca
- Hôpital Hôtel Dieu, URC Eco Ile-de-France (AP-HP), 1 Place du Parvis Notre Dame, 75004, Paris, France,
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Michel M, Clément MC, Quélen C, Marzelle J, Becquemein JP, Durand-Zaleski I. Analyse de la concordance entre données CRF et PMSI lors de l’utilisation du PMSI-MCO en recherche clinique. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.021] [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: 10/25/2022] Open
|
38
|
Michel M, Clément MC, Quélen C, Marzelle J, Becquemin JP, Durand-Zaleski I. Évaluation médico-économique des endoprothèses fenêtrées dans le traitement des anévrismes complexes de l’aorte abdominale utilisant le PMSI pour le groupe non-exposé. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.050] [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: 11/25/2022] Open
|
39
|
Clément MC, Le Bihan C, Mignot C, Mahlaoui N, Fischer A, Durand-Zaleski I. Évaluation médico-économique de la prise en charge hospitalière des déficits immunitaires combinés sévères (DICS) selon l’âge au moment de la greffe de moelle osseuse. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.084] [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: 10/25/2022] Open
|
40
|
Cadier B, Durand-Zaleski I, Thoams D, Chevreul K. Arguments médico-économiques sur le remboursement intégral du traitement tabagique en France : évaluation coût–efficacité et impact budgétaire. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.12.033] [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: 10/25/2022] Open
|
41
|
Zarca K, Durand-Zaleski I, Roux C, Schott-Pethelaz AM, Souberbielle JC, Fardelonne P, Thomas T, Benhamou CL. Modélisation coût–efficacité de plusieurs stratégies de supplémentation en vitamine D dans la population des plus de 65ans. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.12.030] [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: 10/25/2022] Open
|
42
|
Le Jeannic A, Quelen C, Durand-Zaleski I, Alberti C. CompaRec : comparaison de deux modes de recueil des données individuelles des patients, les cahiers d’observation papier et électronique des études cliniques. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.12.064] [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: 10/25/2022] Open
|
43
|
Legardeur H, Girard G, Journy N, Ressencourt V, Durand-Zaleski I, Mandelbrot L. Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: Importance of fasting plasma glucose. Diabetes & Metabolism 2014; 40:43-48. [DOI: 10.1016/j.diabet.2013.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 01/06/2013] [Accepted: 01/11/2013] [Indexed: 11/29/2022]
|
44
|
Elissen AMJ, Nolte E, Knai C, Brunn M, Chevreul K, Conklin A, Durand-Zaleski I, Erler A, Flamm M, Frølich A, Fullerton B, Jacobsen R, Saz-Parkinson Z, Sarria-Santamera A, Sönnichsen A, Vrijhoef HJM. Is Europe putting theory into practice? A study of the level of self-management support in coordinated care approaches for chronically ill. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.234] [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: 11/13/2022] Open
|
45
|
Chevreul K, Durand-Zaleski I, Gouépo A, Fery-Lemonnier E, Hommel M, Woimant F. Cost of stroke in France. Eur J Neurol 2013; 20:1094-100. [PMID: 23560508 DOI: 10.1111/ene.12143] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 02/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE A cost of illness study was undertaken on behalf of the French Ministry of Health to estimate the annual cost of stroke in France with the goal of better understanding the current economic burden so that improved strategies for care may be developed. METHODS Using primary data from exhaustive national databases and both top-down and bottom-up approaches, the stroke-related costs for healthcare, nursing care and lost productivity were estimated. RESULTS The total healthcare cost of stroke patients in France in 2007 was €5.3 billion, 92% of which was borne by statutory health insurance. The average cost of incident cases was €16 686 per patient in the first year, while the annual cost of prevalent cases was a little less than half that amount (€8099). Nursing care costs were estimated at €2.4 billion. Lost productivity reached €255.9 million and that income loss for stroke patients was partially compensated by €63.3 million in social benefit payments. CONCLUSIONS With healthcare costs representing 3% of total health expenditure in France, stroke constitutes an ongoing burden for the health system and overall economy. Nursing care added nearly half again the amount spent on healthcare, while productivity losses were more limited because nearly 80% of acute incident strokes were in patients over age 65. The high cost of illness underscores the need for improved prevention and interventions to limit the disabling effects of stroke.
Collapse
Affiliation(s)
- K Chevreul
- Department of Public Health, Henri Mondor-Albert Chenevier Hospitals (AP-HP), Creteil, France.
| | | | | | | | | | | |
Collapse
|
46
|
Ingen-Housz-Oro S, Durand-Zaleski I, Cosnes A, Valeyrie-Allanore L, Moreno JC, Chosidow O, Wolkenstein P. [Dermatology day-care: between official rules and reality]. Ann Dermatol Venereol 2012. [PMID: 23199765 DOI: 10.1016/j.annder.2012.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/19/2022]
Abstract
BACKGROUND Official rules published in 2006 and 2010 concerning ambulatory care rates in France led to artificial redistribution of this activity from day-care hospitalization to consultations. In our dermatological day-care establishment, we compared the financial costs engendered for patients admitted for day-care hospitalization and those seen at consultations. PATIENTS AND METHODS From 2011/01/10 to 2011/02/04, for each patient, we prospectively analyzed the following data: day-care hospitalization or consultation, age, sex, diagnosis, laboratory and radiological examination, non-dermatological consultations, time spent with the patient by doctors (interns, senior doctors) and nurses, with timing by a stop-watch. The hospital cost was the total for medical examinations (official nomenclature), non-dermatological consultations, physicians' and nurses' salaries and establishment overheads (216 €). The hospital revenue regarding the consultation group consisted of the sum of reimbursement for medical examination, dermatological and non-dermatological consultations, and regarding the day-care hospitalization group, the dermatology rate (670 €) or chemotherapy sessions (380 €). Results were compared using a Chi(2) test and a Student's t-test (P ≤ 0.05). RESULTS One hundred and twenty-seven patients were included: 67 in the day-care hospitalization group and 60 in the consultation group. Patients in the day-care hospitalization group were older and had significantly more radiological examinations and non-dermatological consultations, but the number of laboratory examinations and skin biopsies did not differ between the two groups. The mean time spent by doctors was similar in both groups but the time spent by senior doctors without the help of interns was significantly greater and longer than the time for a standard consultation. Nurses spent a mean 72 minutes with each hospitalized patient and 35 minutes with consultation patients (P = 0.007). Hospital costs were identical in both groups at around 415 €. The hospital showed a profit for day-care hospitalization patients (252 €) and a loss (244 €) for consultation patients. DISCUSSION Half of the patients studied were in day-care hospitalization and half were seen in consultations. The high number of bed-ridden patients with bullous pemphigoid accounts for the fact that day-care patients were older. The reasons for the significantly longer time spent by nurses with day-care hospitalized patients were administration and supervision of chemotherapy, skin care and nursing of bed-ridden patients. However, nurses spent 35 min with each consultation patient, justifying the need to maintain the posts of these staff in such day-care units. The availability of physicians for patients with severe dermatoses and the organization of medical examinations in the same place in the same day underscore the need for medical structures like day-care hospitalization. At present, time spent on intellectual work involving reflection is regrettably not taken into account, which is detrimental to this specialty. The hospital was in profit for day hospitalizations while consultations resulted in losses, in particular because of the absence of social security reimbursement of the establishment's overheads. CONCLUSION Rules are in need of modification in order to allow the treatment of patients with more complicated conditions.
Collapse
Affiliation(s)
- S Ingen-Housz-Oro
- Service de dermatologie, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | | | | | | | | | | | | |
Collapse
|
47
|
Deslee G, Barbe C, Bourdin A, Durand-Zaleski I, Dutau H, Jolly D, Jounieaux V, Kessler R, Mal H, Pison C, Thiberville L, Vergnon JM, Marquette CH. [Cost-effectiveness of lung volume reduction coil treatment in emphysema. STIC REVOLENS]. Rev Mal Respir 2012. [PMID: 23200592 DOI: 10.1016/j.rmr.2012.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Medical therapeutic options for the treatment of emphysema remain limited. Lung volume reduction surgery is infrequently used because of its high morbi-mortality. Endobronchial lung volume reduction coil (LVRC(®), PneumRx, Mountain View, CA) treatment has been recently developed and has been shown to be feasible and associated with an acceptable safety profile, while resulting in improvements in dyspnea, exercise capacity and lung function. The objective of this study is to analyze the cost effectiveness of LVRC treatment in severe emphysema. METHODS This prospective, multicenter study, randomized with a 1:1 ratio (LVRC vs conventional treatment) will include 100 patients who will be followed up for 1year. The primary outcome measure is the 6-month improvement of the 6-minute walk test: the percentage of patients showing an improvement of at least 54m will be compared between groups. A cost-effectiveness study will estimate the cost of LVRC treatment, the global cost of this therapeutic option and will compare the cost between patients treated by LVRC and by medical treatment alone. EXPECTED RESULTS This study should allow validating the clinical efficacy of LVRC in severe emphysema. The cost-effectiveness study will assess the medical-economic impact of the LVRC therapeutic option.
Collapse
Affiliation(s)
- G Deslee
- Service de pneumologie, hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, Reims, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Loubière S, Rotily M, Durand-Zaleski I, Costagliola D, Moatti JP. L'introduction de la PCR dans le dépistage du virus de l'hépatite C dans les dons de sang : du mésusage du principe de précaution. Med Sci (Paris) 2012. [DOI: 10.4267/10608/1922] [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: 11/30/2022] Open
|
49
|
Roche N, Aguilaniu B, Burgel PR, Durand-Zaleski I, Dusser D, Escamilla R, Perez T, Raherison C, Similowski T. [Prevention of COPD exacerbation: a fundamental challenge]. Rev Mal Respir 2012; 29:756-74. [PMID: 22742463 DOI: 10.1016/j.rmr.2012.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 10/25/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a cause of suffering for patients and a burden for healthcare systems and society. Their prevention represents individual and collective challenge. The present article is based on the work of a group of experts who met on 5th and 6th May 2011 and seeks to highlight the importance of AECOPD. STATE OF THE ART In the absence of easily quantifiable criteria, the definition of AECOPD varies in the literature, making identification difficult and affecting interpretation of study results. Exacerbations increase mortality and risk of cardiovascular disease. They also increase the risk of developing further exacerbations, accelerate the decline in lung function and contribute to reduction in muscle mass. By limiting physical activity and affecting mental state (anxiety, depression), AECOPD are disabling and impair quality of life. They increase work absenteeism and are responsible for about 60% of the global cost of COPD. PERSPECTIVES Earlier identification with simple criteria, possibly associated to patient phenotyping, could be helpful in preventing hospitalization. CONCLUSIONS Given their immediate and delayed impact, AECOPD should not be trivialized or neglected. Their prevention is a fundamental issue.
Collapse
Affiliation(s)
- N Roche
- Service de pneumologie et réanimation, pôle Arcole, Hôtel-Dieu, 1, place du Parvis-Notre-Dame, Assistance publique-Hôpitaux de Paris, université Paris Descartes, 75181 Paris cedex 04, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Benjamin L, Cotté FE, Mercier F, Vainchtock A, Vidal-Trécan G, Durand-Zaleski I. Burden of breast cancer with brain metastasis: a French national hospital database analysis. J Med Econ 2012; 15:493-9. [PMID: 22304337 DOI: 10.3111/13696998.2012.662924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 11/09/2022]
Abstract
OBJECTIVE Incidence of breast cancer with brain metastases (BCBM) is increasing, especially among patients over-expressing HER2. Epidemiology on this sub-type of cancer is scarce, since cancer registries carry no information on the HER2 status. A retrospective database analysis was conducted to estimate the burden of BCBM, especially among HER2-positive patients in a secondary objective. METHODS Patients with a new diagnosis of BCBM carried out between January and December 2008 were identified from the national hospital database using the International Disease Classification. Patients receiving a targeted anti-HER2 therapy were identified from the national pharmacy database. Hospital and pharmacy claims were linked to estimate the burden of HER2-positive patients. Data on hospitalizations were extracted to describe treatment patterns and healthcare costs during a 1-year follow-up. Predictors of treatment cost were analyzed through multi-linear regression analysis. RESULTS Two thousand and ninety-nine BCBM patients were identified (mean age (SD) = 57.8 (13.6)), of whom 12.2% received a targeted anti-HER2 therapy; 79% of patients had brain metastases associated with extracranial metastases, and the attrition rate reached 82%. Patients received mostly palliative care (47.4%), general medical care (40.6%), and chemotherapy (35.0%). The total annual hospital cost of treatment was 8,426,392€, representing a mean cost of 22,591€ (±14,726) per patient, mainly influenced by extracranial metastases, surgical acts, and HER2-overexpression (p < 0.0001). CONCLUSIONS The database linkage of hospital and pharmacy claims is a relevant approach to identify sub-type of cancer. Chemotherapy was widely used as a systemic treatment for breast cancer rather than for local treatment of brain metastases whose morbi-mortality remains high. The variability of treatment costs suggests clinical heterogeneity and, thus, extensive individualization of protocols.
Collapse
Affiliation(s)
- L Benjamin
- Epidémiologie, Evaluation et Politiques de santé (EA 4069), Université Paris Descartes, Sorbonne Paris Cité, France.
| | | | | | | | | | | |
Collapse
|