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961.
962.
Abstract

Aims: Patients with heart failure are at increased risk of hyperkalemia, particularly when treated with renin-angiotensin-aldosterone system inhibitor (RAASi) agents. This study developed a model to quantify the potential health and economic value associated with sustained potassium management and optimal RAASi therapy in heart failure patients.

Materials and methods: A patient-level, fixed-time increment stochastic simulation model was designed to characterize the progression of heart failure through New York Heart Association functional classes, and predict associations between serum potassium levels, RAASi use, and consequent long-term outcomes. Following internal and external validation exercises, model analyses sought to quantify the health and economic benefits of optimizing both serum potassium levels and RAASi therapy in heart failure patients. Analyses were conducted using a UK payer perspective, independent of costs and utilities related to pharmacological potassium management.

Results: Validation against multiple datasets demonstrated the predictive capability of the model. Compared to those who discontinued RAASi to manage serum potassium, patients with normokalemia and ongoing RAASi therapy benefited from longer life expectancy (+1.38 years), per-patient quality-adjusted life year gains (+0.53 QALYs), cost savings (£110), and associated net monetary benefit (£10,679 at £20,000 per QALY gained) over a lifetime horizon. The predicted value of sustained potassium management and ongoing RAASi treatment was largely driven by reduced mortality and hospitalization risks associated with optimal RAASi therapy.

Limitations: Several modeling assumptions were made to account for a current paucity of published literature; however, ongoing refinement and validation of the model will ensure its continued accuracy as the clinical landscape of hyperkalemia evolves.

Conclusions: Predictions generated by this novel modeling approach highlight the value of sustained potassium management to avoid hyperkalemia, enable RAASi therapy, and improve long-term health economic outcomes in patients with heart failure.  相似文献   
963.
李俊杰 《价值工程》2011,30(10):31-31
现代汽车技术迅猛发展,汽车电子化、智能化趁势越来越明显。特别是桥车的功能和结构越来越复杂,故障的诊断与排除愈来愈依赖高、精、尖的检测仪器与设备。本文主要探讨了汽车怠速不稳故障的诊断与排除方法。  相似文献   
964.
Abstract

Aims: This retrospective chart review examined the six-month migraine-related healthcare resource use (HRU) among European patients who had ≥4 migraine days per month and previously failed at least two prophylactic migraine treatments.

Methods: Neurologists, headache specialists, and pain specialists in France, Germany, Italy, and Spain who treated ≥10 patients with migraine in 2017 were recruited (April–June 2018) to extract anonymized patient-level data. Eligible physicians randomly selected charts of up to five adult patients with clinically-confirmed migraine, ≥4 migraine days in the month prior to the index date, and had previously failed at least two prophylactic migraine treatments. Treatment failure was defined as discontinuation due to lack of efficacy and/or tolerability. Demographic and disease characteristics as of the index date, and migraine-related HRU incurred during the 6-month study period, were recorded.

Results: A total of 104 physicians contributed 168 charts for patients (63% female). On average, patients were 38?years old and failed 2.3 prophylactic treatments as of the index date. During the study period, 83% of patients had ≥1 outpatient visit for migraine in the physician’s office, and 27% went to the ER/A&E. Approximately 5% of patients were hospitalized for migraine, with an average of one hospitalization and an average length of stay of 3 days. Approximately 39% of patients had ≥1 blood test, 22% had ≥1 magnetic resonance imaging, 17% had ≥1 electroencephalogram, and 13% had ≥1 computerized tomography scan. Visits to other healthcare providers were common.

Limitations: This study is subject to the limitations of chart review studies, such as errors in data entry.

Conclusions: Across four European countries, the HRU burden of migraine among patients who previously failed at least two prophylactic treatments was high, indicating a need for more effective prophylactic treatments to appropriately manage migraine and reduce the HRU burden attributable to this common disorder.  相似文献   
965.
以服务为立身之本的民营快递企业的服务质量问题一直以来都备受关注,投递延误、邮件丢失、邮件损坏等服务失误投诉一直居高不下。提升民营快递企业服务质量最为关键的是控制和减少服务失误的发生。通过层次分析法,判定影响民营快递企业服务失误的诸多因素中较为重要的因素是快递员素质、管理手段与方法、服务态度、信息处理技术等。  相似文献   
966.
967.
医疗器械品种多,应用原理与性能各异,给临床使用和日常保养以及维修工作带来很多问题。文章结合工作实践,对心电图机常见故障进行分析,并以ECG-8110K型心电图机为例,解读心电图机在使用维修中的实际问题。  相似文献   
968.
969.
刘志军 《物流技术》2012,(13):162-164
在金融海啸形势下,除了稳定物流企业的日常经营之外,研究易发案件的种类并采取必要的防范措施,也应当成为企业应对危机的必选项。结合相关案例,对于金融海啸下物流企业易发案件做了简要分析。  相似文献   
970.
英汉礼貌的语用与文化价值差异   总被引:1,自引:0,他引:1  
英汉两种语言的礼貌原则具有共性,文化差异使礼貌的语用和文化价值具有差异,易出现语用失误。英语学习者要了解文化差异,注重语用能力的培养,以达到理想的交际效果。  相似文献   
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