Health economics education in undergraduate medical training : introducing the health economics education (HEe) website

In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula

Emma Frew London Papers - Accession 1695

The Emma Frew London Papers consists of material collected by Winthrop College 1910 alumna, Emma Frew London (1890-1969). The papers consists mostly of scrapbooks and newspaper clippings related to Miss London’s family and her interests as well as to some of the organizations she belonged to. Included in the collection are correspondence, family narratives and histories, obituaries, church programs (weddings and funerals), photographs and negatives, diaries, and other records related to the London Family and extended family. There are also several ledgers of minutes and other records related to the Catawba-Ebenezer Township Tuberculosis Association. Of particular interest is a narrative titled “My Story” written by Emma Frew London’s mother, Emma Dora Frew London (1852-1937), about the origins of her family arriving in Rock Hill, SC just after General Sherman burned the bridge over the Catawba River during the American Civil War.https://digitalcommons.winthrop.edu/manuscriptcollection_findingaids/2686/thumbnail.jp

Willingness to pay for colorectal cancer screening: a comparison of elicitation formats

Willingness to pay is increasingly being used in health technology assessment, although a number of methodological issues remain unresolved. Using data collected from four studies, this thesis presents the findings from a direct comparison between alternative format designs to elicit willingness to pay for two alternative colorectal cancer screening tests; faecal occult blood (FOB) testing and flexible sigmoidoscopy (FS) testing. Along with the willingness to pay values estimated using the open-ended, payment scale, closed-ended and iterative bidding formats, information is collected on household income, attitudes toward health promotion and personal risk perceptions to determine the nature and value of responses. In comparison with the alternative formats, the closed-ended question design produced significantly higher WTP valuations and different justifications for those valuations. It is hypothesised that the yea-saying effect may explain this difference. The payment scale format achieved a higher completion rate compared to the open-ended design and both formats produced broadly similar valuations. Although a subsequent study suggested evidence of range bias within the payment scale design. The iterative bidding format produced higher valuations than the open-ended and payment scale but lower than the closed-ended, it is hypothesised that valuations obtained using different initial bids demonstrate the existence of starting point bias. Across all studies, respondents who have a high health motivation, are well educated, have a high household income and who are particularly worried about the disease have a positive effect on the willingness to pay for colorectal cancer screening

Willingness to pay for colorectal cancer screening: a comparison of elicitation formats

Willingness to pay is increasingly being used in health technology assessment, although a number of methodological issues remain unresolved. Using data collected from four studies, this thesis presents the findings from a direct comparison between alternative format designs to elicit willingness to pay for two alternative colorectal cancer screening tests; faecal occult blood (FOB) testing and flexible sigmoidoscopy (FS) testing. Along with the willingness to pay values estimated using the open-ended, payment scale, closed-ended and iterative bidding formats, information is collected on household income, attitudes toward health promotion and personal risk perceptions to determine the nature and value of responses. In comparison with the alternative formats, the closed-ended question design produced significantly higher WTP valuations and different justifications for those valuations. It is hypothesised that the yea-saying effect may explain this difference. The payment scale format achieved a higher completion rate compared to the open-ended design and both formats produced broadly similar valuations. Although a subsequent study suggested evidence of range bias within the payment scale design. The iterative bidding format produced higher valuations than the open-ended and payment scale but lower than the closed-ended, it is hypothesised that valuations obtained using different initial bids demonstrate the existence of starting point bias. Across all studies, respondents who have a high health motivation, are well educated, have a high household income and who are particularly worried about the disease have a positive effect on the willingness to pay for colorectal cancer screening

How does age affect the relationship between weight and health utility during the middle years of childhood?

Purpose: The limited literature examining weight status and preference-based health-related quality of life (HRQL) in young children is equivocal. This study aims to examine how the association between weight status and preference-based HRQL changes as children develop between the ages of 6 and 10 years old. Methods: The Child Health Utility 9D (CHU-9D) was used to determine preference-based HRQL. Height and weight data were also collected and used to calculate z-BMI adjusted for age and gender. 1467 children were recruited from 54 schools across the West Midlands. Data were collected at four time points over 5 years. Impact of weight on dimensions of HRQL was assessed via the distribution of responses to CHU-9D dimensions by weight status. Multi-level regression analysis controlling for ethnicity, deprivation and other relevant co-variates was conducted to examine the relationship between weight and HRQL. Results: There was no evidence to suggest that the weight status impacted upon the distribution of responses to CHU-9D dimensions. Correspondingly, the multi-level regression analysis found no statistically significant differences in CHU-9D scores between underweight, healthy weight, overweight and obese children. Conclusions: The evidence surrounding the link between preference-based HRQL and weight status in children is limited. This study found no association between weight status and HRQL as measured by the CHU-9D in children between the ages of 5 and 10 years in the UK. Given this, it is recommended that future studies aiming to prevent obesity in children in their middle years do not rely solely on preference-based measures for economic evaluation, and instead focus on capturing clinical or wellbeing outcomes

Is utility-based quality of life associated with overweight in children? Evidence from the UK WAVES randomised controlled study

BACKGROUND: Quality-Adjusted Life Years (QALYs) are often used to make judgements about the relative cost-effectiveness of competing interventions and require an understanding of the relationship between health and health-related quality of life (HRQOL) when measured in utility terms. There is a dearth of information in the literature concerning how childhood overweight is associated with quality of life when this is measured using utilities. This study explores how weight is associated with utility-based HRQOL in 5–6 year olds and examines the psychometric properties of a newly developed pediatric utility measure – the CHU9D instrument. METHODS: Weight and HRQOL were examined using data collected from 1334 children recruited within a UK randomised controlled trial (WAVES) (ISRCTN97000586). Utility-based HRQOL was measured using the CHU9D, and general HRQOL measured using the PedsQL instrument. The association between weight and HRQOL was examined through a series of descriptive and multivariate analysis. The construct validity of the CHU9D was further assessed in relation to weight status, in direct comparison to the PedsQL instrument. RESULTS: The HRQOL of children who were either overweight or obese was not statistically different from children who were healthy or underweight. This result was the same for when HRQOL was measured in utility terms using the CHU9D instrument, and in general terms using the PedsQL instrument. Furthermore, the results support the construct validity of the newly developed CHU9D as the PedsQL total HRQOL scores corresponded well with the individual CHU9D dimensions. CONCLUSION: At age 5–6 years, the inverse association between overweight and HRQOL is not being captured by either the utility-based CHU9D instrument nor the PedsQL instrument. This result has implications for how the cost-effectiveness of childhood obesity interventions is measured in children aged 5–6 years. TRIAL REGISTRATION: ISRCTN Registry: ISRCTN97000586 19(th) May 2010

Willingness to pay for colorectal cancer screening: a comparison of elicitation formats

Willingness to pay is increasingly being used in health technology assessment, although a number of methodological issues remain unresolved. Using data collected from four studies, this thesis presents the findings from a direct comparison between alternative format designs to elicit willingness to pay for two alternative colorectal cancer screening tests; faecal occult blood (FOB) testing and flexible sigmoidoscopy (FS) testing. Along with the willingness to pay values estimated using the open-ended, payment scale, closed-ended and iterative bidding formats, information is collected on household income, attitudes toward health promotion and personal risk perceptions to determine the nature and value of responses. In comparison with the alternative formats, the closed-ended question design produced significantly higher WTP valuations and different justifications for those valuations. It is hypothesised that the yea-saying effect may explain this difference. The payment scale format achieved a higher completion rate compared to the open-ended design and both formats produced broadly similar valuations. Although a subsequent study suggested evidence of range bias within the payment scale design. The iterative bidding format produced higher valuations than the open-ended and payment scale but lower than the closed-ended, it is hypothesised that valuations obtained using different initial bids demonstrate the existence of starting point bias. Across all studies, respondents who have a high health motivation, are well educated, have a high household income and who are particularly worried about the disease have a positive effect on the willingness to pay for colorectal cancer screening