Basics of qualitative research: Grounded theory procedures and techniques

Health literacy has been associated with health-related knowledge and patient comprehension. This systematic review updates a 2004 review and found 96 eligible studies that suggest that low health ...

Low Health Literacy and Health Outcomes: An Updated Systematic Review

Importance Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. Objective To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. Design In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. Findings The concept of a “reference case” and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an “impact inventory,” which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses. Conclusions and Relevance The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.

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Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine

《Ｏｘｆｏｒｄ Ａｄｖａｎｃｅｄ Ｌｅａｒｎｅｒ’ｓ Ｄｉｃｔｉｏｎａｒｙ ｏｆ Ｃｕｒｒｅｎｔ Ｅｎｇｌｉｓｈ》（ 以下简称ＯＡＬＤ） 是英语学习词典的先驱。它是第一部既重视词语释义，又重视词法、句法，配有大量例证的词典。我国英语学习者对其第二、三、四版（ 英汉双解版） 都十分熟悉。１９９５ 年，ＯＡＬＤ 第五次修订再版，又有了新的特色，但仍有不足

评《Oxford Advanced Learner’s Dictionary of Current English》第五版

https://www.niph.go.jp/journal/data/62-6/201362060009.pdf

Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force.

Challenges and Opportunities in the Malaysian Health Care System.

Background

Risperidone has been used in Singapore for schizophrenia since 1996. However, little information is available on its utilization pattern.



Objective

To examine the risperidone utilization pattern in the Psychiatric Outpatient Clinic of the National University Hospital.



Method

Medical records of all outpatients with schizophrenia prescribed with risperidone from 1 September1999 to 31 August 2000 were reviewed.



Results

A total of 417 risperidone prescriptions were dispensed for 130 outpatients (50 male, 80 female) during the study period. The mean ± SD daily doses for prescriptions and for patients were 2.3 ± 1.3 mg and 2.1 ± 1.1 mg, respectively. Among these patients, 28 (21.5%) received at least one concomitant conventional antipsychotic and 71 (54.6%) received a concomitant anti-Parkinsonian agent. Logistic regression analysis suggested that a higher risperidone dose was associated with the greater probability of anti-Parkinsonian agent usage.



Conclusions

The mean risperidone dose during the study period was towards the lower end of recommendation for schizophrenia. Further study is warranted to confirm and explain the pattern of low-dose risperidone, and the high use of concomitant conventional antipsychotics and anti-Parkinsonian agents in Singapore. Elucidation of these would provide a valuable insight for the management of Asian patients with schizophrenia using risperidone. However, the current data indicate that the practice of using a lower dose of risperidone could represent better affordability and an improved cost-effectiveness ratio of risperidone compared with conventional antipsychotics in Asian patients. Copyright © 2004 John Wiley & Sons, Ltd.

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore.

Objective: This systematic review aimed to evaluate the cost-effectiveness of medication adherence-improving interventions in patients with asthma.Data source: Search engines including PubMed, Scopus and EBSCOhost were used to locate relevant studies from the inception of the databases to 19 October 2018. Drummond's checklist was used to appraise the quality of the economic evaluation.Study selection: Economic studies evaluating the cost-effectiveness of medication adherence enhancing interventions for asthmatic patients were selected. Relevant information including study characteristics, quality assessment, health outcomes and costs of intervention were narratively summarized. The primary outcome of interest was cost-effectiveness (CE) values and the secondary outcomes were costs, medication adherence and clinical consequences.Results: Twenty studies including 11 randomized controlled trials, 6 comparative studies and 3 modeled studies using Markov models were included in the review. Among these, 15 studies evaluated an educational intervention with 13 showing cost-effectiveness in improving health outcomes. The CE of an internet-based intervention showed similar results between groups, while 3 studies of simplified drug regimens and adding a technology-based training program achieved the desirable cost-effectiveness outcome.Conclusion: Overall, our results would support that all of the identified medication adherence-enhancing interventions were cost-effective considering the increased adherence rate, improved clinical effectiveness and the reduced costs of asthma care. However, it was not possible to identify the most cost-effective intervention. More economic studies with sound methodological conduct will be needed to provide stronger evidence in deciding the best approach to improve medication adherence.

A systematic review of the cost-effectiveness of medicationadherence-enhancing intervention for asthma.

Objective:To assess the difference in resource utilisation between lithium and valproate treatment groups from the VALID study.Methods:A modelled economic study was conducted as an appendage to the VALID study, an international, randomised, open-label, parallel-group, 12-week, equivalence study in patients with bipolar I disorder experiencing a manic/mixed episode, compared the efficacy and safety of valproate against that of lithium. The difference in health resource utilisation between the treatment groups was analysed based on information collected from a standardised questionnaire.Results:Efficacy and tolerability of valproate and lithium were shown to be comparable in the management of bipolar disorder in the VALID study. Cost analysis was based on information for 138 (35.5% male, mean age: 37.73 years) and 131 (45.8% male, mean age: 38.98 years) patients from lithium and valproate treatment groups, respectively. The groups differed in the number of hospital visits (503 vs. 421), outpatient v...

Estimation of resource utilisation difference between lithium and valproate treatment groups from the VALID study.

Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piec-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

Shu-Chuen Li

Papers

Challenges and Opportunities in the Malaysian Health Care System.

Drug utilization review of risperidone for outpatients in a tertiary referral hospital in Singapore.

A systematic review of the cost-effectiveness of medicationadherence-enhancing intervention for asthma.

Estimation of resource utilisation difference between lithium and valproate treatment groups from the VALID study.

Challenges and opportunities in integrating complementary and alternative medicine into mainstream of the Malaysian healthcare system