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Tomasz Hermanowski

Other affiliations: Warsaw University of Technology
Bio: Tomasz Hermanowski is an academic researcher from Medical University of Warsaw. The author has contributed to research in topics: Health care & Indirect costs. The author has an hindex of 10, co-authored 60 publications receiving 307 citations. Previous affiliations of Tomasz Hermanowski include Warsaw University of Technology.


Papers
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Journal ArticleDOI
TL;DR: An MCDA approach may lead to different P&R outcomes compared to a standard HTA process, and enrichment of the list of decision making criteria means further scrutiny of a given health technology and as such increases the odds of a negative P &R outcome.
Abstract: The objective of this study was to assess the potential impact of the implementation of multiple-criteria decision analysis (MCDA) on the Polish pricing and reimbursement (P&R) process with regard to orphan drugs. A four step approach was designed. Firstly, a systematic literature review was conducted to select the MCDA criteria. Secondly, a database of orphan drugs was established. Thirdly, health technology appraisals (HTA recommendations) were categorized and an MCDA appraisal was conducted. Finally, a comparison of HTA and MCDA outcomes was carried out. An MCDA outcome was considered positive if more than 50 % of the maximum number of points was reached (base case). In the sensitivity analysis, 25 % and 75 % thresholds were tested as well. Out of 2242 publications, 23 full-text articles were included. The final MCDA tool consisted of ten criteria. In total, 27 distinctive drug-indication pairs regarding 21 drugs were used for the study. Six negative and 21 positive HTA recommendations were issued. In the base case, there were 19 positive MCDA outcomes. Of the 27 cases, there were 12 disagreements between the HTA and MCDA outcomes, the majority of which related to positive HTA guidance for negative MCDA outcomes. All drug-indication pairs with negative HTA recommendations were appraised positively in the MCDA framework. Economic details were available for 12 cases, of which there were 9 positive MCDA outcomes. Amongst the 12 drug-indication pairs, two were negatively appraised in the HTA process, with positive MCDA guidance, and two were appraised in the opposite direction. An MCDA approach may lead to different P&R outcomes compared to a standard HTA process. On the one hand, enrichment of the list of decision making criteria means further scrutiny of a given health technology and as such increases the odds of a negative P&R outcome. On the other hand, it may uncover additional values and as such increase the odds of positive P&R outcomes.

41 citations

Journal ArticleDOI
TL;DR: In this paper, the authors evaluated the health status of a representative sample of the general Polish population using the EQ-5D questionnaire and provided information on age, sex, marital status, education, employment, income, housing conditions, medical history, and smoking habits.
Abstract: INTRODUCTION There are no population norms currently available in Poland for any generic health-related quality of life (HRQoL) questionnaire for adults. OBJECTIVES The aim of the study was to evaluate the health status of a representative sample of the general Polish population using the EQ-5D questionnaire. MATERIAL AND METHODS Adult subjects who were visiting patients in 8 medical centers in Warsaw, Skierniewice, and Pulawy, were inter viewed during the Polish EQ-5D valuation study. Stratified quota sampling was used. The respondents completed the EQ-5D questionnaire and provided information on age, sex, marital status, education, employment, income, housing conditions, medical history, and smoking habits. The interviews were conducted between February and May 2008. RESULTS The final sample (n = 317) was representative of the general Polish population with respect to age and sex. Moderate problems in at least 1 dimension of the HRQoL were reported by 57% of the respondents, while extreme problems by 4.7%. Pain or discomfort was reported by 40% of the respondents, anxiety or depression by 38%. Problems with mobility were reported by 16% of the respondents, with usual activities (work, school) by 13%, and with self-care by 3%. The mean state of health recorded on the visual analogue scale (VAS) was 81.6 +/-14.4 points. The mean VAS value decreased from 87 and 91 points in the youngest age group to 67 and 72 points in the oldest age group, in men and women, respectively. CONCLUSIONS Pain and anxiety are commonly reported problems in the Polish population, especially by young women. EQ-5D is a valuable tool for studying health outcomes and differences in health status within the Polish population.

40 citations

Journal ArticleDOI
TL;DR: Leflunomide monotherapy proved more effective than placebo in relieving symptoms and signs of RA and was superior to sulfasalazine the ACR20 and ACR50 clinical response, quality of life, doctor's and patient's assessment of the disease activity, and reduction in CRP levels.
Abstract: IntroductIon Rheumatoid arthritis (RA) is a chronic systemic disease of the connective tissue that leads to progressive joint destruction, disability, withdrawal from occupational activity, and premature death. objEctIvEs The aim of the paper was to evaluate the efficacy and safety of leflunomide compared with placebo, methotrexate, and sulfasalazine in monotherapy of RA. PAtIEnts And mEthods A systematic search of databases (MEDLINE, EMBASE, Cochrane CENTRAL) was performed. Only randomized blind trials were included into the analysis. The quality of the trials was assessed by the Jadad scale. A quantitative synthesis of the results was performed (meta‑analysis). rEsuL ts The analysis included 7 trials involving 2861 patients (1432 on leflunomide, 312 on placebo, 922 on methotrexate, and 133 on sulfasalazine). Leflunomide, compared with placebo, increased the prob‑ ability of the American College of Rheumatology 20% improvement (ACR20) response 2‑fold (relative risk (RR), 2.02; 95% CI, 1.46-2.80) and the probability of ACR50 response 4‑fold (RR, 4.36; 95% CI, 2.33-8.17), after 1 year of treatment. Efficacy of leflunomide did not differ from that of methotrexate with reference to the majority of endpoints. Leflunomide showed partial superiority over methotrexate in the percentage of patients obtaining ACR50 and ACR70 response, doctor's assessment of the disease activity, reduction in C‑reactive protein (CRP) levels, and improvement of the quality of life (assessed with the modified health assessment questionnaire (HAQ)). Sulfasalazine showed partial superiority in the reduction of erythrocyte sedimentation rate, while leflunomide was superior to sulfasalazine the ACR20 and ACR50 clinical response, quality of life (assessed with the HAQ), doctor's and patient's assessment of the disease activity, and reduction in CRP levels. concL usIons There were no significant differences between the effects of treatment with leflunomide and methotrexate or sulfasalazine, but leflunomide monotherapy proved more effective than placebo in relieving symptoms and signs of RA.

34 citations

Journal ArticleDOI
TL;DR: The newly translated Polish DFS-SF may be used to assess the impact of DFU on HRQoL in Polish patients and demonstrated good construct validity when correlated with the SF-36v2 and showed better psychometric performance than SF- 36v2.
Abstract: Diabetic foot ulcer (DFU) is a common complication of diabetes and not only an important factor of mortality among patients with diabetes but also decreases the quality of life. The short form of Diabetic Foot Ulcer Scale (DFS-SF) provides comprehensive measurement of the impact of diabetic foot ulcers on patients’ health related quality of life (HRQoL). The purpose of this study was to translate DFS-SF into Polish and evaluate its psychometric performance in patients with diabetic foot ulcers. The DFS-SF translation process was performed in line with Principles of Good Practice for the Translation and Cultural Adaptation Process for patient reported outcome measures (PROMs) developed by ISPOR TCA group. Assessment of the reliability and validity of Polish DFS-SF was performed in native Polish patients with current DFU. The DFS-SF validation study involved 212 patients diagnosed with DFU, with 4.4 years of DFU duration on average. The average ulcer size was 5.5 sq. cm, and generally only one limb was affected. Men (72%) and type 2 diabetes patients (86%) prevailed, with 17.8 years representing the mean time since diagnosis. The mean population age was 62.5 years. The internal consistency of all scales of the Polish DFS-SF was high (Cronbach’s alpha ranged from 0.82 to 0.93). Item convergent and discriminant validity was satisfactory (median corrected item-scale correlation ranged from 0.61 to 0.81). The Polish DFS-SF demonstrated good construct validity when correlated with the SF-36v2 and showed better psychometric performance than SF-36v2. The newly translated Polish DFS-SF may be used to assess the impact of DFU on HRQoL in Polish patients.

28 citations

Journal ArticleDOI
TL;DR: The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a potential role model) in order to establish specific rules on how to share performance feedback with individual physicians.
Abstract: This paper examines the relationship between selected motivation factors that affect the attitude to work among medical doctors at public hospitals and the organizational performance of hospitals. This study was based on World Health Organization questionnaires designed to estimate motivation factors according to Herzberg’s motivation theory and to measure the level of organizational performance of hospitals by using the McKinsey model. A survey was conducted among physicians (n = 249) with either surgical (operative) or nonsurgical (conservative) specialty in 22 departments/units of general public hospitals in Warsaw, Poland. The relationship between the chosen job motivation factors and organizational effectiveness was determined using Spearman’s rank correlation. Furthermore, 95% confidence intervals were calculated. The independent samples t-test was used to confirm statistically significant differences between the independent groups. Normality of the data was tested by the Kolmogorov–Smirnov test. The survey revealed that motivation factors related to “quality and style of supervision” have the highest effect on the organizational performance of hospitals (Spearman’s rank correlation coefficient = 0.490; p < 0.001), whereas “performance feedback” has the lowest effect on organizational performance according to the surveyed healthcare professionals (54% of physicians). The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a potential role model) in order to establish specific rules on how to share performance feedback with individual physicians. The present study contributes to literature on human resource management in the healthcare sector and highlights the importance of nonfinancial aspects in improving the organizational performance of hospitals.

18 citations


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01 Jan 2016

950 citations

Journal ArticleDOI
TL;DR: The zebrafish is a recent addition to animal models of human cancer, and studies using this model are rapidly contributing major insights, with a unique opportunity to functionally characterize the cancer genome.
Abstract: The zebrafish has emerged as an important model system with which to investigate cancer, particularly for validating genomics data and for undertaking screens for oncogenes and drivers of tumour progression and metastasis. This Review outlines what we have learned and could still learn from cancer research using the zebrafish.

356 citations

Journal ArticleDOI
TL;DR: In this paper, an impairment-driven cancer rehabilitation model that includes screening and treating impairments all along the care continuum in order to minimize disability and maximize quality of life is presented.
Abstract: Adult cancer survivors suffer an extremely diverse and complex set of impairments, affecting virtually every organ system. Both physical and psychological impairments may contribute to a decreased health-related quality of life and should be identified throughout the care continuum. Recent evidence suggests that more cancer survivors have a reduced health-related quality of life as a result of physical impairments than due to psychological ones. Research has also demonstrated that the majority of cancer survivors will have significant impairments and that these often go undetected and/or untreated, and consequently may result in disability. Furthermore, physical disability is a leading cause of distress in this population. The scientific literature has shown that rehabilitation improves pain, function, and quality of life in cancer survivors. In fact, rehabilitation efforts can ameliorate physical (including cognitive) impairments at every stage along the course of treatment. This includes prehabilitation before cancer treatment commences and multimodal interdisciplinary rehabilitation during and after acute cancer treatment. Rehabilitation appears to be cost-effective and may reduce both direct and indirect health care costs, thereby reducing the enormous financial burden of cancer. Therefore, it is critical that survivors are screened for both psychological and physical impairments and then referred appropriately to trained rehabilitation health care professionals. This review suggests an impairment-driven cancer rehabilitation model that includes screening and treating impairments all along the care continuum in order to minimize disability and maximize quality of life.

315 citations

01 Jan 2002
TL;DR: It is identified that research should concentrate on both direct but particularly the indirect costs including cost-effective management regimes that encourage an early return to duties.
Abstract: This paper reports the results of a "cost-of-illness" study of low back pain (LBP) in Australian adults. It estimates the direct cost of LBP in 2001 to be AU$1.02 billion. Approximately 71% of this amount is for treatment by chiropractors, general practitioners, massage therapists, physiotherapists and acupuncturists. However, the direct costs are minor compared to the indirect costs of AU$8.15 billion giving a total cost of AU$9.17 billion. LBP in Australian adults represents a massive health problem with a significant economic burden. This burden is so great that it has compelling and urgent ramifications for health policy, planning and research. This study identifies that research should concentrate on both direct but particularly the indirect costs including cost-effective management regimes that encourage an early return to duties.

308 citations

Journal Article
TL;DR: Unless you have either the requisites for this course or written special permission to enroll in it, you may be removed from this course and it will be deleted from your record.
Abstract: Unless you have either the requisites for this course or written special permission to enroll in it, you may be removed from this course and it will be deleted from your record. Graduate students may seek permission from the graduate Chair. This decision may not be appealed. You will receive no adjustment to your fees in the event that you are dropped from a course for failing to have the necessary prerequisites.

261 citations