Importance: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.
Objective: To estimate the worldwide burden of SAH.
Barrett's esophagus is the precursor to esophageal adenocarcinoma. Esophageal adenocarcinoma detected from endoscopic surveillance programs accounts for <10% of all cases, suggesting majority of patients with Barrett's esophagus are likely unaccounted for. Previous observational studies have estimated the observed prevalence of Barrett's esophagus to be approximately 1%, but others suggest may be an underestimate.
View Article and Find Full Text PDFObjective: This systematic review aimed to evaluate the effectiveness of alternative exercises within a cardiac rehabilitation (CR) program compared to traditional gym-based exercises or usual care. The focus was on CR completion and outcomes in women.
Introduction: CR programs generally offer traditional gym-based exercises, including treadmill exercises, cycling on ergometers, and conventional resistance training.
Background: A relationship between hospital volume and postoperative mortality following esophagectomy for cancer has been reported in Europe and USA, leading to centralization of surgery for esophageal cancer in some countries. It is unclear if this is replicated in countries with low population density such as Australia and New Zealand (ANZ). This study determined the relationship between hospital volume and mortality following esophagectomy in ANZ to define optimal hospital caseload.
View Article and Find Full Text PDFSwallowing impairment observed in ~ 20% of people with Chronic Obstructive Pulmonary Disease (COPD) may increase the risk of aspiration pneumonia and acute exacerbations. We designed a decision analytic model to assess the cost-effectiveness of the Swallowing and Respiratory Sensation Assessment (SwaRSA) tests and swallowing rehabilitation to reduce COPD exacerbations. We believe that swallowing rehabilitation to improve coordination of swallowing and breathing may reduce exacerbations in people with COPD.
View Article and Find Full Text PDFJ Gastroenterol Hepatol
December 2024
Background And Aim: The first step towards developing a screening strategy for Barrett's esophagus (BE) is the identification of individuals in the community. Currently available tools include endoscopy, less-invasive non-endoscopic devices, and non-invasive risk stratification models. We evaluated the cost of potential strategies for identification of BE as a first step towards screening.
View Article and Find Full Text PDFPurpose: To identify utility-based patient-reported outcome measures (PROMs) for assessing health-related quality of life (HRQoL) in cardiac rehabilitation and secondary prevention programs (CR) and appraise existing evidence on their measurement properties. Secondly, to link their items to the International Classification of Functioning Disability and Health (ICF) and the International Consortium of Health Outcome Measures (ICHOM) domains for cardiovascular disease (CVD).
Methods: Eight databases were searched.
Background: Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business model for primary care providers to implement CR using current Medicare items.
Discussion: Using the chronic disease management plan, general practitioners (GPs) complete four clinical assessments at 1-2 weeks, 8-12 weeks, and 6 and 12 months after discharge.
Objective: To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion.
Design: We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study.
Setting: Economically disadvantaged areas in rural Australia.
Background: Despite the highest levels of evidence on cardiac rehabilitation (CR) effectiveness, its translation into practice is compromised by low participation.
Aim: This study aimed to investigate CR utilisation and effectiveness in South Australia.
Methods: This retrospective cohort study used data linkage of clinical and administrative databases from 2016 to 2021 to assess the association between CR utilisation (no CR received, commenced without completing, or completed) and the composite primary outcome (mortality/cardiovascular re-admissions within 12 months after discharge).
Introduction: Children may find self-reporting health-related quality of life (HRQoL) using patient-reported outcome measures (PROMs) presented in text-based formats difficult, particularly younger children and children with developmental delays or chronic illness. In such cases, pictorial PROMs (where pictorial representations are used alongside or to replace text) may offer a valid alternative.
Aim: This systematic literature review focused on identifying and describing paediatric PROMs that incorporate pictorial approaches, providing children with more effective means to express their HRQoL.
Int J Cardiol Cardiovasc Risk Prev
March 2024
Background: Education to improve medication adherence is one of the core components of cardiac rehabilitation (CR) programs. However, the evidence on the effectiveness of CR programs on medication adherence is conflicting. Therefore, we aimed to summarize the effectiveness of CR programs versus standard care on medication adherence in patients with cardiovascular disease.
View Article and Find Full Text PDFDue to limited resources and constant, ever-changing healthcare challenges, health economics is essential to support healthcare decisions while improving health outcomes. Economic evaluation methodology facilitates informed decision-making related to the efficient allocation of resources while positively impacting clinical practice. In this paper, we provide an overview of economic evaluation methods and a real-world example applying one method of economic evaluation (cost-utility analysis) in nursing research.
View Article and Find Full Text PDFPurpose: To compare the sensitivity and discriminant validity of generic and cancer-specific measures for assessing health-related quality of life (HRQoL) for individuals undergoing diagnostic or surveillance colonoscopy for colorectal cancer.
Methods: HRQoL was assessed using EQ-5D-5L (generic), and EORTC QLQ-C30 (cancer-specific) scales, 14 days after (baseline) and one-year following colonoscopy (follow-up). Utility scores were calculated by mapping EORTC-QLQ-C30 onto QLU-C10D.
Purpose: To assess construct validity and responsiveness of the Expanded Prostate Cancer Index Composite Instrument (EPIC-26) relative to the Short-Form Six-Dimension (SF-6D) and Assessment of Quality of Life 6-Dimension (AQoL-6D) in patients following treatment for prostate cancer.
Methods: Retrospective prostate cancer registry data were used. The SF-6D, AQoL-6D, and EPIC-26 were collected at baseline and one year post treatment.
Cancers (Basel)
February 2023
Different wellbeing measures have been used among cancer patients. This study aimed to first investigate the sensitivity of health state utility (HSU), capability, and subjective wellbeing (SWB) instruments in cancer. A cancer-specific instrument (QLQ-C30) was included and transferred onto the cancer-specific HSU scores.
View Article and Find Full Text PDFInt J Environ Res Public Health
September 2021
This study compares the empirical performance of a commonly used functional-status measure, the Barthel Index (BI), to that of a widely used generic preference-based instrument, the EuroQoL-5-Dimensions 3 Level (EQ-5D-3L), in older people. Data from older people receiving rehabilitation services were used to test the validity of the BI and EQ-5D-3L. Convergent validity was investigated using Spearman's correlation, exploratory factor analysis (EFA), scatter plots, Krippendorff's alpha and modified Bland-Altman plots.
View Article and Find Full Text PDFHealth Qual Life Outcomes
October 2021
Aim: This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specific EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy.
Methods: Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy.
Background: Individuals with Barrett's esophagus are believed to be at 30-120× risk of developing esophageal adenocarcinoma (EAC). Early detection and endoscopic treatment of dysplasia/early cancer confers a significant advantage to patients under surveillance; however, most do not progress past the non-dysplastic state of Barrett's esophagus (NDBE), which is potentially an inefficient distribution of health care resources.
Objectives: This article aimed to review the outcomes of cost-effectiveness studies reducing low-value care in the context of endoscopic surveillance for non-dysplastic Barrett's esophagus (NDBE).
Background: The Lyell McEwin Hospital entered into a public-private collaborative agreement in 2019 in order to access Da Vinci® Xi Surgical Systems (Intuitive Surgical, Sunnyvale, CA, USA) in private hospitals. This study aimed to examine the costs associated with usage of robot surgical systems under the agreement, and the potential for acquisition in the public hospital.
Methods: Retrospective data on robotic-assisted and equivalent operations performed between 1 May 2019 and 30 April 2020 were collected and formed subsequent model inputs.
Australas J Ageing
December 2021
Objectives: To assess the impact of a Consumer Directed Care (CDC) model of service delivery on the quality of life of older people receiving home care packages.
Methods: Quality of life was assessed using validated instruments. The relationship between quality of life and length of time exposed to CDC was examined using descriptive statistical and multivariate regression analyses.
Australas J Ageing
March 2020
Objectives: To identify the key categories of consumer expenditures following the introduction of consumer-directed care (CDC) in the Australian community aged care sector.
Methods: Income and expenditure data were extracted from monthly budget statements and categorised. Expenditures by category were examined by home care package level, length of time receiving CDC and socio-demographic characteristics.
World J Surg
June 2019
Background: Research assessing health-related quality of life (HRQoL) which can be applied to economic evaluation in Barrett's esophagus (BE) and esophageal cancer is limited. This study derived health state utilities for various 'stages' of BE and Cancer.
Methods: A cross-sectional survey was conducted, including patients with non-dysplastic BE, low-grade dysplasia, high-grade dysplasia, or esophageal adenocarcinoma.