A preliminary cost-effectiveness analysis of denitrifying bioreactors in the Lower Burdekin

A cost-effectiveness (CE) analysis was undertaken to assess the cost per kilogram of nitrate-nitrogen ($/kg N) removed by denitrifying bioreactor beds in a sugarcane production system in Queensland. The preliminary analysis evaluates the CE of a 34m3 bioreactor bed trialled on a sugarcane farm in the lower Burdekin delta district, conducted as part of the Bioreactors for GBR Project, funded through the Queensland Reef Water Quality Program. The aim of the project was to investigate the nitrate removal performance of bioreactor beds receiving run-off from sugarcane farms in the lower Burdekin. In addition, the CE of a hypothetical 100m3 bioreactor scenario is also explored. The project trialled and monitored three bioreactor beds in the lower Burdekin. Of the three trials, one produced a more comprehensive dataset compared to the others that had experienced significant blockages during the trial period. Data from this trial was therefore utilised in the CE analysis. High-frequency water quality monitoring was undertaken over 12 months (May 2019 - April 2020) with nitrate concentration, woodchip saturation and water flow analysed to enable calculation of the nitrogen removal rate (NRR)

A preliminary cost-effectiveness analysis of denitrifying bioreactors in the Lower Burdekin

A cost-effectiveness (CE) analysis was undertaken to assess the cost per kilogram of nitrate-nitrogen ($/kg N) removed by denitrifying bioreactor beds in a sugarcane production system in Queensland. The preliminary analysis evaluates the CE of a 34m3 bioreactor bed trialled on a sugarcane farm in the lower Burdekin delta district, conducted as part of the Bioreactors for GBR Project, funded through the Queensland Reef Water Quality Program. The aim of the project was to investigate the nitrate removal performance of bioreactor beds receiving run-off from sugarcane farms in the lower Burdekin. In addition, the CE of a hypothetical 100m3 bioreactor scenario is also explored. The project trialled and monitored three bioreactor beds in the lower Burdekin. Of the three trials, one produced a more comprehensive dataset compared to the others that had experienced significant blockages during the trial period. Data from this trial was therefore utilised in the CE analysis. High-frequency water quality monitoring was undertaken over 12 months (May 2019 - April 2020) with nitrate concentration, woodchip saturation and water flow analysed to enable calculation of the nitrogen removal rate (NRR)

Cost-Effectiveness Analysis Terapi Antibiotik Seftriakson Dan Sefotaksim Pada Pasien Tifoid Di RSUD Dr. M.M Dunda Limboto

Tifoid merupakan penyakit infeksi yang disebabkan oleh bakteri Salmonella typhi dan telah banyak menginfeksi masyarakat baik di perkotaan maupun pedesaan. Dengan adanya fenomena multidrug resistance Salmonella typhi maka pemilihan terapi antibiotik yang efektif pada tifoid menjadi faktor yang harus diperhatikan selain kendala biaya. Penelitian ini bertujuan untuk mengetahui efektivitas biaya pada terapi dua antibiotik yaitu seftriakson dan sefotaksim yang digunakan dalam pengobatan demam tifoid di RSUD DR. M.M Dunda Limboto. Penelitian ini dilakukan dengan menggunakan metode survei analitik dengan desain cross sectional. Penelitian ini menggunakan data sekunder pasien demam tifoid periode Januari-Desember 2014. Data yang diambil meliputi, data demografi, lama rawat inap, dan data keuangan pasien. Hasil penelitian menunjukkan bahwa kelompok terapi antibiotik seftriakson lebih cost effective yaitu dengan biaya Rp 3.650.091 dengan lama rawat inap 2,8 hari dibandingkan dengan kelompok terapi antibiotik sefotaksim dengan biaya lebih besar yaitu Rp 4.036.015 dengan lama rawat inap 3,7 hari

Using cost effectiveness analysis; a beginners guide

Objective ‐ This report seeks to describe the key elements of cost effectiveness analysis (CEA) and to demonstrate how such analysis may be used in the library environment. Methods ‐ The paper uses a step‐by‐step approach to walk the non‐economist reader through the basics of conducting a cost effectiveness study. It provides an outline of the key elements of CEA using examples from the library sector, and it presents a case study of a CEA in a hospital library. The case study compares two library services, mediated searching and information skills training, to illustrate the application of CEA and to highlight some of its limitations. Results ‐ CEA is a comparative analysis tool. Its key elements include a study question regarding a particular process or procedure that identifies both costs and effectiveness; a justification of the study’s perspective; evidence of effectiveness; comprehensive identification of all relevant costs, and appropriate measurement of costs and effectiveness. Conclusions ‐ CEA enables comparison of services or interventions regarding particular processes or procedures in terms of their costs, and it measures their effectiveness. The results can be used to aid decision‐making about service provision

Cost‐effectiveness analysis of computer‐based assessment

The need for more cost‐effective and pedagogically acceptable combinations of teaching and learning methods to sustain increasing student numbers means that the use of innovative methods, using technology, is accelerating. There is an expectation that economies of scale might provide greater cost‐effectiveness whilst also enhancing student learning. The difficulties and complexities of these expectations are considered in this paper, which explores the challenges faced by those wishing to evaluate the cost‐effectiveness of computer‐based assessment (CBA). The paper outlines the outcomes of a survey which attempted to gather information about the costs and benefits of CBA

A Bayesian approach to stochastic cost-effectiveness analysis

The aim of this paper is to discuss the use of Bayesian methods in cost-effectiveness analysis (CEA) and the common ground between Bayesian and traditional frequentist approaches. A further aim is to explore the use of the net benefit statistic and its advantages over the incremental cost-effectiveness ratio (ICER) statistic. In particular, the use of cost-effectiveness acceptability curves is examined as a device for presenting the implications of uncertainty in a CEA to decision makers. Although it is argued that the interpretation of such curves as the probability that an intervention is cost-effective given the data requires a Bayesian approach, this should generate no misgivings for the frequentist. Furthermore, cost-effectiveness acceptability curves estimated using the net benefit statistic are exactly equivalent to those estimated from an appropriate analysis of ICERs on the cost-effectiveness plane. The principles examined in this paper are illustrated by application to the cost-effectiveness of blood pressure control in the U.K. Prospective Diabetes Study (UKPDS 40). Due to a lack of good-quality prior information on the cost and effectiveness of blood pressure control in diabetes, a Bayesian analysis assuming an uninformative prior is argued to be most appropriate. This generates exactly the same cost-effectiveness results as a standard frequentist analysis

The death of cost-minimization analysis?

Four different types of evaluation methods, cost-benefit analysis (CBA), cost-utility analysis (CUA), cost-effectiveness analysis (CEA) and cost-minimization analysis (CMA), are usually distinguished. In this note, we pronounce the (near) death of CMA by showing the rare circumstances under which CMA is an appropriate method of analysis. We argue that it is inappropriate for separate and sequential hypothesis tests on differences in effects and costs to determine whether incremental cost-effectiveness (or cost-utility) should be estimated. We further argue that the analytic focus should be on the estimation of the joint density of cost and effect differences, the quantification of uncertainty surrounding the incremental cost-effectiveness ratio and the presentation of such data as cost-effectiveness acceptability curves. Two examples from recently published CEA are employed to illustrate the issues. The first shows a situation where analysts might be tempted (inappropriately) to employ CMA rather than CEA. The second illustrates one of the rare circumstances in which CMA may be justified as a legitimate form of analysis

(Correcting) misdiagnoses of asthma: A cost effectiveness analysis

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective.Method: Randomly selected physician-diagnosed-asthmatic subjects from 8 Canadian cities were studied with an extensive diagnostic algorithm to rule-in, or rule-out, a correct diagnosis of asthma. Subjects in whom the diagnosis of asthma was excluded were followed up for 6-months and data on asthma medications and heath care utilization was obtained. Economic analysis was performed to estimate the incremental lifetime costs associated with secondary screening of previously diagnosed asthmatic subjects. Analysis was from the perspective of the Canadian healthcare system and is reported in Canadian dollars.Results: Of 540 randomly selected patients with physician diagnosed asthma 150 (28%; 95%CI 19-37%) did not have asthma when objectively studied. 71% of these misdiagnosed patients were on some asthma medications. Incorporating the incremental cost of secondary-screening for the diagnosis of asthma, we found that the average cost savings per 100 individuals screened was $35,141 (95$4,588-$69,278).Conclusion: Cost savings primarily resulted from lifetime costs of medication use averted in those who had been misdiagnosed.This work was funded by the Canadian Institute of Health Research, Canada and the University Of Ottawa Division Of Respiratory Medicine

Analysis of uncertainty in health care cost-effectiveness studies: an introduction to statistical issues and methods

Cost-effectiveness analysis is now an integral part of health technology assessment and addresses the question of whether a new treatment or other health care program offers good value for money. In this paper we introduce the basic framework for decision making with cost-effectiveness data and then review recent developments in statistical methods for analysis of uncertainty when cost-effectiveness estimates are based on observed data from a clinical trial. Although much research has focused on methods for calculating confidence intervals for cost-effectiveness ratios using bootstrapping or Fieller’s method, these calculations can be problematic with a ratio-based statistic where numerator and=or denominator can be zero. We advocate plotting the joint density of cost and effect differences, together with cumulative density plots known as cost-effectiveness acceptability curves (CEACs) to summarize the overall value-for-money of interventions. We also outline the net-benefit formulation of the cost-effectiveness problem and show that it has particular advantages over the standard incremental cost-effectiveness ratio formulation