Learn More
To address controversies in the applications of cost-effectiveness analysis, we investigate the principles underlying the technique and discuss the implications for the evaluation of medical interventions. Using a standard von Neumann-Morgenstern utility framework, we show how a cost-effectiveness criterion can be derived to guide resource allocation(More)
BACKGROUND Low-molecular-weight heparins may simplify the management of deep venous thrombosis. A critical clinical issue is whether this more convenient therapy is as safe and effective as treatment with unfractionated heparin. PURPOSE To compare the safety and efficacy of low-molecular-weight heparins with those of unfractionated heparin for treatment(More)
BACKGROUND The appropriate roles for several diagnostic tests for coronary disease are uncertain. OBJECTIVE To evaluate the cost-effectiveness of alternative approaches to diagnosis of coronary disease. DESIGN Meta-analysis of the accuracy of alternative diagnostic tests plus decision analysis to assess the health outcomes and costs of alternative(More)
OBJECTIVE Patients who have uncomplicated gastroesophageal-reflux disease (GERD) typically present with heartburn and acid regurgitation. We sought to determine the cost-effectiveness of H2-receptor antagonists (H2RAs) and proton-pump inhibitors (PPIs) as first-line empiric therapy for patients with typical symptoms of GERD. METHODS Decision analysis(More)
CONTEXT Women with inherited BRCA1/2 mutations are at high risk for breast cancer, which mammography often misses. Screening with contrast-enhanced breast magnetic resonance imaging (MRI) detects cancer earlier but increases costs and results in more false-positive scans. OBJECTIVE To evaluate the cost-effectiveness of screening BRCA1/2 mutation carriers(More)
BACKGROUND The choice of antiplatelet therapy after acute coronary syndrome (ACS) is complicated: Ticagrelor and prasugrel are novel alternatives to clopidogrel, patients with some genotypes may not respond to clopidogrel, and low-cost generic formulations of clopidogrel are available. OBJECTIVE To determine the most cost-effective strategy for dual(More)
PURPOSE One-year adjuvant trastuzumab (AT) therapy, with or without anthracyclines, increases disease-free and overall survival in early-stage HER2/neu-positive breast cancer. We sought to evaluate the cost effectiveness of these regimens, which are expensive and potentially toxic. METHODS We used a Markov health-state transition model to simulate three(More)
CONTEXT Installation of automated external defibrillators (AEDs) on passenger aircraft has been shown to improve survival of cardiac arrest in that setting, but the cost-effectiveness of such measures has not been proven. OBJECTIVE To examine the costs and effectiveness of several different options for AED deployment in the US commercial air(More)
CONTEXT ThinPrep, AutoPap, and Papnet are 3 new technologies that increase the sensitivity and cost of cervical cancer screening. OBJECTIVE To estimate the cost-effectiveness of these technological enhancements to Papanicolaou (Pap) tests. DESIGN We estimated the increase in sensitivity from using these technologies by combining results of 8 studies(More)