Download or read book Economic Evaluation of Screening and Treatment for Prostate Cancer in the Midland Cancer Network Region in New Zealand written by Chunhuan Lao and published by . This book was released on 2016 with total page 203 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Prostate cancer is the most frequently diagnosed cancer and the third most common cause of cancer death for men in New Zealand. Aim: This thesis aims to use economic approaches to examine the screening and treatment pathway for prostate cancer in the Midland Cancer Network Region. Methods: This thesis comprises two systematic reviews, and five original studies: 1) the costs of identifying a new case of prostate cancer by screening; 2) survival in a cohort of men with prostate cancer; 3) the cost-effectiveness of active surveillance compared to radical prostatectomy for low risk localised prostate cancer; 4) the cost-effectiveness of active surveillance for intermediate risk prostate cancer; 5) the management and costs of metastatic prostate cancer. Results: The screening costs per cancer detected in New Zealand were NZ$10,777, and varied by subgroups. For men diagnosed with low risk localised prostate cancer at the age of 45-55 years, the life-time costs of active surveillance were higher than the costs of radical prostatectomy. For men diagnosed with low risk or intermediate risk prostate cancer at the age of 60-70 years, the life-time costs of active surveillance were lower than the costs of radical prostatectomy. The cost-effectiveness of active surveillance compared to radical prostatectomy depends on the quality of life under these treatments and the annual probability of having radical prostatectomy in the active surveillance arm. The daily prostate cancer related costs for men with metastatic prostate were highest during the terminal phase (NZ$57) and lowest during the treatment phase (NZ$18). Conclusions: General practice screening costs for prostate cancer could be reduced by better targeting. In terms of the life-time treatment costs, active surveillance is a reasonable option for men diagnosed with low risk or intermediate risk localised prostate cancer at the age of 60-70 years. If active surveillance is to be recommended, better evidence is needed to support of improved quality of life. On current evidence, radical prostatectomy in younger men seems more likely to be cost-effective. The management costs for patients with metastatic prostate cancer varied by phase, with terminal phase being the most expensive.

Download or read book The Epidemiology and Management of Prostate Cancer in New Zealand written by Zuzana Obertová and published by . This book was released on 2015 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Prostate cancer with its high incidence, prevalence and also relatively high mortality represents a major public health issue in New Zealand (NZ). Ethnic and regional disparities in prostate cancer incidence and mortality have been reported in national and international literature. The aim of this study was to identify causes for the observed differences by obtaining currently lacking information on screening, diagnosis, and management of prostate cancer in NZ men. Methods: The study was divided into three section: 1) to describe incidence and survival trends for Māori and non‐Māori men and rural and urban men, men aged 40+ years diagnosed with prostate cancer between 1996 and 2010 were identified from the NZ Cancer Registry and Mortality Collection; 2) computerised records of 31 general practices in the Midland Cancer Network (MCN) region linked to laboratory data were reviewed to assess patterns of PSA screening in primary care in 2010, and to examine follow‐up investigations, including specialist appointment and biopsy for men with an elevated PSA result by ethnicity, and practice characteristics; and 3) to further assess diagnostic and treatment pathways with a special focus on Māori men, clinical records of all Māori men (150) and three frequency age‐matched randomly sampled NZ European men (450) diagnosed with prostate cancer in the MCN region between 2007 and 2010 men were searched retrospectively for information on cancer stage at diagnosis, co‐morbidities, and treatment type for localised disease. Results: Māori men were almost twice as likely to die of prostate cancer compared with non‐ Māori men. Poorer prostate cancer survival for Māori men is likely explained by lower screening rates, less intensive diagnostic investigations, longer wait times, later diagnosis and differences in treatment observed for Māori men compared with non‐Māori men. Although rural men were less likely to be screened, there were little or no differences in diagnostic pathways, incidence and survival of prostate cancer between rural and urban men. Conclusion: Opportunistic screening for prostate cancer is common in New Zealand but its frequency varies by practice, and by ethnicity. Throughout the prostate cancer care pathway minimal differences were found between rural and urban men, presenting a sharp contrast to disparities observed between Māori and non‐Māori men. This study highlighted areas of need for improvement along the prostate cancer care pathway, which will help in guiding policy decisions and resource allocation.

Download or read book Costs and effectiveness of prostate cancer screening in elderly men written by and published by DIANE Publishing. This book was released on with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Costs and Effectiveness of Prostate Cancer Screening in Elderly Men written by DIANE Publishing Company and published by DIANE Publishing. This book was released on 1998 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Economic Evaluation of Treatments for Patients with Localized Prostate Cancer written by Virginia Becerra Bachino and published by . This book was released on 2016 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt: L'objectiu global d'aquesta tesi va ser avaluar l'eficiència, des de la perspectiva dels sistemes de salut, dels tractaments més establerts per als pacients diagnosticats amb càncer de pròstata localitzat. El "Estudi multicèntric Espanyol de càncer de pròstata localitzat" és un estudi observacional, prospectiu amb pacients reclutats consecutivament en 10 centres a Espanya entre 2003 i 2005, tractats amb prostatectomia radical retropúbica, braquiteràpia prostàtica o radioteràpia conformacional externa 3D, i seguits intensivament durant els primers dotze mesos i anualment a partir de llavors, fins a 10 anys post-tractament. El que destaca entre els resultats és que, tot i lleugeres diferències entre els costos dels tractaments, qualssevol de les alternatives podria considerar-se econòmicament atractiva per als pacients amb càncer de pròstata localitzat de risc baix i intermedi.

Download or read book Costs and Effectiveness of Prostate Cancer Screening in Elderly Men written by United States. Congress. Office of Technology Assessment and published by U.S. Government Printing Office. This book was released on 1995 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Prostate Cancer Screening in New Zealand written by New Zealand. National Advisory Committee on Health and Disability and published by . This book was released on 2004-01-01 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Screening for Cancer of the Prostate an Evaluation of Benefits Unwanted Health Effects and Costs Report written by Conseil d'évaluation des technologies de la santé du Québec and published by [Montréal] : Le Conseil. This book was released on 1995 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Conseil arrives at two major conclusions: 1) From the perspective of Quebec's public health-care system, the health gains which might result from prostate cancer screening are too uncertain and, if there are any, too slight to justify the adverse health effects and the cost that it would entail. This is equally true for an organized comprehensive screening program as it is for such screening as presently takes place in the context of case findings, i.e. by performing a PSA measurement at the time of medical visits for reasons unrelated to prostate cancer. 2) From the perspective of the individual, every man who considers having his PSA measured should be made fully aware of the potential important consequences of this test and the interventions that ensue therefrom. These conclusions by the Conseil are based on the available evidence, which is extremely deficient and does not enable one to determine with certainty the benefits of a radical prostatectomy within the context of a regular screening program.

Download or read book Prostate Specific Antigen PSA Based Population Screening for Prostate Cancer written by A. Tawfik and published by . This book was released on 2015 with total page 37 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Inquiry Into Early Detection and Treatment of Prostate Cancer written by New Zealand. Parliament. Health Committee and published by . This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Prevalence of Opportunistic Prostate Cancer Screening in New Zealand written by Mary Jane Sneyd and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Midland Cancer Network Strategic Plan 2009 2014 written by Midland Cancer Network and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Screening for Prostate Cancer written by Melissa Low and published by . This book was released on 2001* with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Costs and Effectiveness of Prostate Cancer in Screening in Elderly Men written by and published by . This book was released on 1995 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, the prostate cancer diagnosis rate has increased dramatically, with a slower increase in age-specific mortality. At least in part, the increasing incidence undoubtedly reflects more aggressive efforts at early detection of prostate cancer, particularly through the use of a new blood test, prostate-specific antigen (PSA). This background paper examines the implications of a potential Medicare benefit to cover prostate cancer screening using a combination of the PSA and digital rectal examination (DRE), a time-honored test performed in the physician's office. OTA concludes that the evidence of benefit for prostate cancer screening is substantially weaker than for preventive services already covered by Medicare. Because the scientific knowledge is limited, but the consequences of prostate cancer and its treatment are serious, an informed patient and his physician could equally well decide to receive screening or forgo it. Medicare reimbursement could be one means of insuring that out-of-pocket expenses not impede well-informed decision-making between physician and patient about whether to receive screening.

Download or read book Comparison of Efficacy and Frequency of Screening and Selected Treatment Modalities for Prostate Cancer in African American and White Men written by and published by . This book was released on 1999 with total page 107 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prostate cancer mortality among African-American is twice than for whites. The aim of the present research concept development proposal was to determine the feasibility of conducting a study to evaluate differences in prostate cancer screening and treatment practices between African-American and White men. A case-control study where New Jersey residents dying of prostate cancer between the ages of 55 and 79 years during the period July 1, 1997 through June 30, 2000 are being enrolled as cases. Controls are a representative group of New Jersey male residents ascertained from HCFA files, matched to the cases on age and race. Till December 15, 1999, 198 cases and 126 controls have been recruited into the study. The majority of patients were Whites (85.9% of cases and 86.5% of controls) and the response rate was 70%. The frequency of PSA screening among cases was 15.9% as compared to 38.9% among controls. Only 12 patients with localized prostate cancer were recruited into the study and four (33.3%) of them had prostatectomy. Because of small numbers, we were unable to assess screening and treatment differences by race. In conclusion, although the number of patients recruited were too small for valid conclusion, we have demonstrated the feasibility of conducting a case-control study to evaluate racial differences in the frequency of screening and early treatment for prostate cancer. Based on the pilot data, a grant proposal for a major study is under preparation.

Download or read book Value of Expanding First line Treatment Choices written by Boshen Jiao and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare payers often implement coverage policies to restrict the usage of high-cost, novel first-line treatments. Step therapy policy is a typical example, requiring patients to fail a less costly medication before accessing a more costly treatment, even if both have been approved for first-line use. A cost-effectiveness analysis (CEA) can be carried out to inform the restriction policy by comparing a new first-line treatment versus the existing one. However, the traditional approach fails to recognize treatment effect heterogeneity, real-world treatment selection, and the resources used to implement policies. To overcome these limitations, this study aimed to develop a general framework to better evaluate the cost-effectiveness of expanding versus restricting first-line treatment choices. I illustrated this framework using the case of abiraterone acetate plus prednisone (AAP) for metastatic hormone-sensitive prostate cancer (mHSPC). In Aim 1, I formulated mathematical expressions for the new cost-effectiveness metrics under the proposed framework. Aim 2 assessed whether clinical evidence of age-related treatment effect heterogeneity of AAP was associated with its differential utilization among men with mHSPC. Finally, Aim 3 applied the proposed framework to the empirical case study of AAP combined with androgen deprivation therapy (ADT) as a first-line treatment for mHSPC. In Aim 1, I formulated an incremental cost-effectiveness ratio (ICER) metric to compare an expanded versus a restricted choice set (CS) of first-line treatments, accounting for clinical evidence-driven treatment selection and policy implementation costs. I also developed the metrics of expected value of expanding choices (EVEC) and expected value of perfect information (EVPI) to quantify the value resulting from an expansion policy and future studies to eliminate uncertainties around treatment effect heterogeneity, respectively. In Aim 2, A retrospective difference-in-differences (DID) event study was conducted among newly diagnosed mHSPC men using TriNetX electronic medical records data. I analyzed the change in the uptake rate of AAP before versus after the publication of clinical trial evidence among mHSPC men aged

Download or read book Statistics and Probability in Forensic Anthropology written by Zuzana Obertová and published by Academic Press. This book was released on 2020-07-28 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: Statistics and Probability in Forensic Anthropology provides a practical guide for forensic scientists, primarily anthropologists and pathologists, on how to design studies, how to choose and apply statistical approaches, and how to interpret statistical outcomes in the forensic practice. As with other forensic, medical and biological disciplines, statistics have become increasingly important in forensic anthropology and legal medicine, but there is not a single book, which specifically addresses the needs of forensic anthropologists in relation to the research undertaken in the field and the interpretation of research outcomes and case findings within the setting of legal proceedings. The book includes the application of both frequentist and Bayesian statistics in relation to topics relevant for the research and the interpretation of findings in forensic anthropology, as well as general chapters on study design and statistical approaches addressing measurement errors and reliability. Scientific terminology understandable to students and advanced practitioners of forensic anthropology, pathology and related disciplines is used throughout. Additionally, Statistics and Probability in Forensic Anthropology facilitates sufficient understanding of the statistical procedures and data interpretation based on statistical outcomes and models, which helps the reader confidently present their work within the forensic context, either in the form of case reports for legal purposes or as research publications for the scientific community. Contains the application of both frequentist and Bayesian statistics in relation to topics relevant for forensic anthropology research and the interpretation of findings Provides examples of study designs and their statistical solutions, partly following the layout of scientific manuscripts on common topics in the field Includes scientific terminology understandable to students and advanced practitioners of forensic anthropology, legal medicine and related disciplines