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BACKGROUND The objective of this study was to understand the attitudes and preferences of risk-eligible women regarding use of tamoxifen for breast cancer risk reduction. METHODS A cross-sectional, mixed-methods interview study was conducted at a university medical center and at community sites. Participants were women who had an estimated 5-year breast(More)
Despite the growing literature on economic evaluation of health care programmes, little attention has been paid to the theoretical foundations of cost-effectiveness and cost utility analyses and the validity of the decision rules adopted as methods of achieving the stated goals. We show that although applications of the techniques can be used to pursue some(More)
In this paper we consider whether methods currently used to measure utility of health outcomes are consistent with the equity criteria adopted by researchers. We show that unless the chosen equity criterion is incorporated in the design of the measurement instrument, the derived health state utilities are inconsistent with the equity criterion (except under(More)
Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit)(More)
Despite the central role of the threshold incremental cost-effectiveness ratio (ICER), or lambda (lambda), in the methods and application of cost-effective analysis (CEA), little attention has been given to the determining the value of lambda. In this paper we consider 'what explains the silence of the lambda'? The concept of the threshold ICER is(More)
OBJECTIVE To evaluate trials of acupuncture for osteoarthritis (OA) of the knee, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects, to identify patient or treatment characteristics associated with positive response, and to identify areas of future(More)
This article examines the degree to which relationships between social capital and health are embedded in local geographical contexts and influenced by demographic factors, socio-economic status, health behaviours and coping skills. Using data from a telephone survey of a random sample of adults (N=1504 respondents, response rate=60%), the article(More)
  • S Birch
  • 1988
The analysis in this paper extends the existing research on supplier-inducement by introducing a fixed price constraint on supplier behaviour and analysing output by treatment episode. Testable predictions are generated which distinguish between the inducement and traditional approaches to explaining supplier behaviour. Using data on dental care provision(More)
The application of Sen's notion of capabilities to problems of the allocation of resources to health in the form of an extra-welfarist framework underlies the justification of quality adjusted life years (QALYs) as the method for valuing the benefits of health care. In this paper we critically appraise this application from both conceptual and empirical(More)
In this paper we critically appraise the appropriateness and validity from an economic perspective of alternative preference-based approaches to measuring outcomes in economic evaluations of health care interventions. We describe the properties of an outcome measure for economic evaluation to make it compatible with the principles of economics when applied(More)