M Krahn

..Health-related quality of life is a key issue in prostate cancer (PC) management. The authors summarized published utilities for common health-related quality of life outcomes of PC and determined how methodological factors affect them...

..As a result, age-stratified seroprevalence profiles often differ from what would be expected from constant infection rates...

..We undertook a systematic review of such incidents to evaluate the extent of viral transmission through food contamination and the scope of post-exposure prophylaxis (PEP) interventions...

..To develop a natural history model for chronic hepatitis C virus (HCV) infection to determine allocation of compensatory funds to Canadians who acquired HCV through the blood supply from 1986 through 1990...

..Such analyses should play a role in future clinical policy making. Even modest quit rates attributable to screening spirometry may result in highly favourable cost effectiveness ratios...

..These results provide encouragement to vaccine developers that a vaccine that is moderately effective and reasonably priced should not face economic barriers to implementation and will be attractive to third party payers...

..Utilities can be elicited directly from patients using standard techniques, or indirectly, using questionnaires that incorporate preference weights from community members...

..Preferences (utilities) for health outcomes have an important role in decisions about prostate cancer screening and treatment. The responsiveness of utility instruments has not been evaluated...

..In conjunction with a set of utility weights, it may be used to develop a health status index, to improve utility measurement in patients, and to serve as a short psychometric (nonutility) instrument...

..To evaluate the effects of androgen-deprivation therapy (ADT) on cognitive function in men with nonmetastatic prostate cancer (PC)...

..This prospective longitudinal study evaluated the effect of androgen deprivation therapy (ADT) on objective and self-reported physical function...

..37; P = 0.318) after adjusting for age and type 2 diabetes. Older age and higher prevalence of type 2 diabetes accounted for the increased risk of HCC among immigrant patients with CHC and advanced fibrosis...

..Although cognitive function was not generally related to sex hormone levels in older men, there may be a weak association with working memory. These results may help guide future studies...

..Current hypertension guidelines differ in their recommendations for first-line antihypertensive therapy...

..To evaluate the cost effectiveness of the cyclooxygenase 2 (COX-2) selective nonsteroidal antiinflammatory drug (NSAID) rofecoxib compared with naproxen and the COX-2 NSAID celecoxib compared with ibuprofen and diclofenac...

..In this study we developed and tested these two forms of quality-of-life instruments, both based on a single, validated, health classification system...

..Application of the method supports the hypothesis that rates of fibrosis vary between stages...

..This study evaluated the costs and cost-effectiveness of a school-based grade 6 universal vaccination program against hepatitis B...

..Rates of completion and response are comparable to non-substance abusing populations. Antiviral therapy for HCV infection can be successful within the context of ongoing care for substance abuse for carefully selected patients...

..The present study, however, suggests that the survey respondents appear, in general, to adhere to the HCV treatment guidelines by the Canadian Association for Study of the Liver...

..Elements of adult learning theory are discussed, which may help the instructor to choose which approach to employ. Implementation of the half-cycle correction in commonly used decision-analytic software is also discussed...

..Decision analysis...

..Sudden cardiac death (SCD) is a devastating complication of hypertrophic cardiomyopathy (HCM). The optimal strategy for the primary prevention of SCD in HCM remains controversial...

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..Methodological quality varied across studies. Major methodological flaws included inappropriate model type, comparator, incidence estimate and inclusion/exclusion of costs...

..To determine the prevalence of obesity and investigate factors associated with obesity in a hepatitis C antibody positive clinic population...

..To compare the cost-effectiveness of different imaging strategies in the diagnosis of pediatric appendicitis by using a decision analytic model...

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..Coronary heart disease (CHD) mortality has declined substantially in Canada since 1994...

..Internet-based HRQOL questionnaires are a potential solution, allowing home data collection with immediate storage in a central database...

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..We illustrate the use of decision analysis to compare a hyperbaric oxygen (HBO) chamber to currently available therapy for DCS treatment on the ISS...

..We conclude that motor complications that occur within the first 4 years of treatment of PD do not have a significant negative effect on quality of life as measured by a visual analogue scale for most patients...

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..The effect of communication barriers on outcomes of care in the inpatient setting requires further exploration, particularly for selected conditions in which length of stay is significantly prolonged...

..As a result, they have received much recent attention in the media that has exposed some of the challenges involved in optimally using vaccine technology...

..This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP)...

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..Provincial coverage of these drugs along with physicians' sex, knowledge of ChIs, and perception of the effectiveness of ChIs appear to influence prescribing rates...

..Compared to the respondent generated attributes all three utility-based quality of life instruments have important shortcomings in content validity...

..Prolonged waiting times dramatically decrease the clinical benefits and economic attractiveness of transplantation, suggesting that living donor transplantation may be of particular benefit in this population...

..Zinc supplementation may prevent morbidity and mortality related to diarrheal illnesses, and iron supplementation may improve cognitive development, in children...

..Previous studies have evaluated the influence of age and comorbidity, but to the authors' knowledge not RLE, on actual treatment decisions...

..quot; Life expectancy estimates are strongly associated with treatment choice. The appropriateness of the 10-year rule remains to be determined...

..Many of these patients with at least moderate-grade disease may benefit from potentially curative therapy (radical prostatectomy or radiotherapy)...

..We estimated life expectancy (LE) and quality-adjusted life expectancy (QALE) associated with available treatments for localized prostate cancer in men aged >/= 65 years, adjusting for Gleason score, patient preferences, and comorbidity...

..These findings may have many biases that could not be properly accounted in this retrospective analysis and larger cohort analyses will be required to confirm these findings...

..To explore the preferences of male primary care patients and their spouses for the outcomes of prostate cancer screening and treatment, and quality of life with metastatic prostate cancer...

..5 QALYs), an NNT <or=5 had a specificity of 77%. CONCLUSION: Using NNT thresholds of <or=5 and >15 to rule in and out therapies with large QALY gains may provide general guidance regarding the magnitude of health benefit...

..Further work is required to understand barriers to treatment related to geography, organization of medical care, age, medical provider and patient preferences...

..Although radical prostatectomy (RP) is associated with greater 30-day mortality in older men, the magnitude of the excess risk in older age groups compared with younger ones has not been well characterized...

..Prior studies have suggested an increased risk of short-term complications among older men who underwent radical prostatectomy, but these studies did not adjust for comorbidity...

..Alternative strategies are immediate treatment or observation until disease progression occurs...

..To evaluate the combined effect of marker states and a prompt on the reliability and validity of direct utility assessment...

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..To investigate the association of age with prostate cancer stage and grade, as the latter factors at the time of diagnosis influence management and prognosis, with some studies suggesting that they may change as a function of patient age...

..Comorbidity is an important consideration in oncology practice, particularly among older patients. Although a variety of comorbidity indices have been employed in research studies, it is unclear whether any one index is preferred...

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..To determine the overall direct cost of liver transplantation in Canadian adults and to identify the factors that are associated with high cost...

..Level of Evidence: Economic and Decision Analyses, Level II-1. See the Guidelines for Authors for a complete description of levels of evidence...

..Estimates of progression to cirrhosis from studies conducted in clinical settings were lower than previous estimates...