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1.
Philip S. Wells Anthonie W. A. Lensing Lloyd Haskell Bennett Levitan François Laliberté Michael Durkin 《Journal of medical economics》2018,21(6):587-594
Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment. 相似文献
2.
Emi Watanabe-Fujinuma Benjamin F. Banderas Yukihiro Koretsune Koichiro Kumagai Shinichiro Uchiyama Takeshi Yamashita 《Journal of medical economics》2019,22(8):798-805
Aims: The Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) are validated treatment satisfaction patient-reported outcome (PRO) instruments. The ACTS includes two domains: Burdens and Benefits; the TSQM-II includes four: Effectiveness, Side Effects, Convenience, and Global Satisfaction. Japanese-language versions of the ACTS and TSQM-II have been developed and linguistically validated. This study aimed to assess their psychometric properties in Japanese patients with atrial fibrillation (AF).Materials and methods: ACTS and TSQM-II data from 534 patients with AF were collected in a Japanese post-marketing surveillance study of a direct oral-anticoagulant, rivaroxaban. Four key psychometric properties, in line with best practice guidelines from the US Food and Drug Administration, were examined using traditional psychometric methods: acceptability, scaling assumptions, reliability (i.e. internal consistency reliability, test-retest reliability), and construct validity (i.e. convergent validity and known groups).Results: ACTS Burdens and Benefits and TSQM-II Effectiveness, Convenience, and Global Satisfaction scales were found to be acceptable (e.g. item-level missing data at baseline <4%), with all scales having good internal consistency (Cronbach’s alpha > 0.80). test-retest reproducibility intraclass correlation coefficients for the ACTS Burdens and Benefits were 0.59 and 0.65, respectively, and between 0.54–0.61 for the TSQM-II scales. Known-groups validity for the ACTS and TSQM-II was supported by differences in scale scores by positive and negative impact (p?<?0.05). Correlations between the ACTS and TSQM-II (convergent validity) were lower than expected (range r?=?0.09–0.48), but in line with the original ACTS development study.Limitations: Evaluation of test-retest reproducibility was limited by assessment period, which was longer (3 months) than recommended guidelines (usually up to 2 weeks).Conclusions: Overall, Japanese versions of ACTS and TSQM-II scales satisfied internal consistency reliability and traditional validity criteria. Our study supports the ACTS and TSQM-II as appropriate PRO instruments to measure satisfaction with anticoagulant treatment in Japanese patients with AF.Trial registration: NCT01598051, clinicaltrials.gov; registered April 20, 2012. 相似文献
3.
采油污水处理工艺探讨 总被引:3,自引:0,他引:3
针对采油污水的水质特点,以及其中有机污染物的组成,结合现有处理工艺,确定了以生化法降解有机污染物为核心的处理工艺,实现了达标排放,并对处理工艺适用性进行了分析。 相似文献
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An approach is presented to satisfy the demand for simple criteria, guidelines and models for the preliminary sizing of horizontal subsurface flow (SF) constructed wetland systems. This approach eliminates time-consuming calculations and iterations by providing graphical solutions for wetland system sizing. Therefore, it can be used for the preliminary assessment of new or performance evaluation of existing subsurface flow constructed wetland systems. The validity of this methodology is checked with data from existing systems and is found to be quite satisfactory. This methodology is combined with simple equations predicting the maximum wetland capacity in summer, so as to assist designers in sizing installations in tourist areas with increased summer populations. Furthermore, based on this methodology, a sensitivity analysis is performed of the area requirements for wastewaters of various strengths and various design conditions and performance criteria. The results provide a useful overview to engineers and further simplify the design methodology of new subsurface flow constructed wetland systems. 相似文献
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牛头山水电站大坝为抛物线形混凝土双曲拱坝,最大坝高108.0 m,采用坝顶5孔开敞式溢洪道泄洪,挑流消能。为提前发挥水电站效益,在拱坝尚未完全封拱的情况下,通过计算分析,得出了水库可以下闸蓄水的结论。 相似文献
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抽水蓄能电站运行方式和电网经济效益分析 总被引:1,自引:1,他引:0
用计算机模拟法建立模拟模型,对选定的系统进行生产模拟,统计计算出电网系统投入不同抽水蓄能容量时所发生的系统运行总燃料费用(包括抽水蓄能电站的抽水费)和系统的负荷缺电力时间概率(LOLP)等指标。通过对计算结果的分析,得出不同系统在投入不同容量抽水蓄能机组和采取不同运行方式的情况下,其运行总燃料费用的边际成本和LOLP的边际值的变化规律,并且对电网的经济效益进行合理分析。从而为抽水蓄能电站的规划和投资建设提供理论依据,推动抽水蓄能电站的发展,促使我国电源结构趋向合理。 相似文献
10.
小浪底水库投入运用后,黄河下游水沙条件的变化,使游荡性河道整治出现了新情况,新问题。下一步治理应注意积极修建新布点工程,完成具有关键性导流作用的续建工程,确定适应新情况的设计治导线,积极开展新结构试验和观测研究。 相似文献