Cost-effectiveness of single-photon emission computed tomography for diagnosis of coronary artery disease: A systematic review of the key drivers and quality of published literature

Background: Single-photon-emission computed tomography (SPECT) being one of the most commonly used methods that significantly improved the detection of coronary artery disease. The objective of this study was to perform a systematic review of the cost-effectiveness of SPECT in diagnosis of coronary artery disease. Methods: Electronic databases including PubMed, Scopus and Web of Science were searched from 1997 through 2017. The full economic evaluations of SPECT as the first and only test in diagnosis of coronary artery disease were included in this study. Non-English studies, conference abstracts and letters/editorials were excluded. The Consolidated Health Economic Evaluation Reporting Standards checklist was used to review the methodological quality of included studies. Results: Eight studies met the systematic review inclusion criteria. In general, the quality of the included studies was high. The abstract of studies had the least degree of compliance with the Consolidated Health Economic Evaluation Reporting Standards checklist. The majority of the papers used decision tree model and estimated cost from a payer's perspective. This study revealed wide heterogeneity in the methodology particularly in setting, comparators, time horizon, and perspective. Conclusion: By conducting this systematic review on 8 valid studies, it was found that the cost-effectiveness of an imaging test strongly depends on the pretest likelihood of disease. The included studies on cost-effectiveness provide conflicting evidence in support of the use of SPECT in diagnosis of coronary artery disease. This study showed that the cost-effectiveness of an imaging test varied between subgroups of patients. © 201

Impact of the economic crisis on healthcare resources: A panel data analysis in Eastern Mediterranean countries during 2005 to 2013

Background: Studying the impact of economic crisis on healthcare resources is important because the economic crisis is an important socio-economic determinant of healthcare resources and is strongly linked to a number of health outcomes. We aimed to examine the impact of the economic crisis on healthcare resources in the Eastern Mediterranean countries of World Health Organization (WHO). Methods: In this study, health expenditure per capita was considered as the indicator of healthcare resources and the unemployment rate was assumed as a proxy of economic crisis. Hausman test showed that to perform the analysis it is required to use a random effect panel data model from 2005 to 2013. The data were taken from the World Bank database and the calculations were performed using the statistical software STATA 12. Results: The results showed that the unemployment rate and out-of-pocket payment (OOP) had a strong relationship with healthcare resources. So, a 1 increase in unemployment rate leads a 138 decrease in health expenditure per capita and a 1 increase in OOP is accompanied with a 12 decrease in health expenditure per capita (p-value < 0.01). In this regard, countries having an unemployment rate more than 5 and OOP more than 25 indicate 260 health expenditure per capita less than countries with OOP less than 25 and an unemployment rate less than 5. Conclusions: The findings imply that during the economic crisis there is a decrease in healthcare resources for Eastern Mediterranean countries. In this connection, the unemployment rate and OPP are important predictors of healthcare resources. © 201

Men�s willingness to pay for prostate cancer screening: a systematic review

Background: This study aimed to review studies on willingness to pay (WTP) for prostate cancer screening. Methods: This systematic-review was conducted based on the Preferred Reporting Items for Systematic Reviews guidelines. By searching six-health-database, WTP studies on prostate cancer screening using contingent valuation method published in English until March 2020 were included and those with unavailable full-text and inadequate quality-assessment scores were excluded. Smith checklist was used for the quality assessment. Extracted WTPs were converted to US dollar in 2018 using exchange rate parity and net present value formula to make comparison. Factors� effect was assessed by vote counting. Results: Six final studies published after 2006 reported above 70 Smith checklist items needed to be considered in contingent valuation study reports. Seven factors have positive effects on WTP. The reported WTP value varied from 11 to 588 in Japan and Germany, respectively. Conclusion: WTP for prostate cancer screening was positive among all studied men. The results of factors� effect assessment showed that better understanding prostate cancer risks or screening tests and factors such as age, income, family history of cancer, hospitalization history, and educational level have positive effects. Moreover, prostate-specific antigen history, health insurance, employment, and subject�s health assessment received less attention. The results� generalization to all countries is not applicable because there are no studies for low- and middle-income countries. Systematic review registration: PROSPERO 2020 CRD42020172789 © 2020, The Author(s)

CPS: 3D Compositional Part Segmentation through Grasping

Abstract—Most objects are composed of parts which have a semantic meaning. A handle can have many different shapes and can be present in quite different objects, but there is only one semantic meaning to a handle, which is “a part that is designed especially to be grasped by the hand”. We introduce here a novel 3D algorithm named CPS for the decomposition of objects into their semantically meaningful parts. These meaningful parts are learned from experiments where a robot grasps different objects. Objects are represented in a compositional graph hierarchy where their parts are represented as the relationship between subparts, which are in turn represented based on the relationships between small adjacent regions. Unlike other compositional approaches, our method relies on learning semantically meaningful parts which are learned from grasping experience. This compositional part representation provides generalization for part segmentation. We evaluated our method in this respect, by training it on one dataset and evaluating it on another. We achieved on average 78 % part overlap accuracy for segmentation of novel part instances. Keywords-Compositional model, 3D object representation, object part segmentation, graspability I

Quality of life in breast cancer patients using neoadjuvant ac (Doxorubicin and cyclophosphamide) in comparison with pg (paclitaxel and gemcitabine) therapy

Background: Quality of life has become a part of the evaluation criteria for cancer therapy. The aim of this study was to evaluate the quality of life in breast cancer patients under chemotherapy regimens that contained doxorubicin and cyclophosphamide (AC) compared to paclitaxel and gemcitabine (PG). Methods: This cohort study evaluated 100 women with breast cancer treated by doxorubicin and cyclophosphamide or gemcitabine and paclitaxel regimens. We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 to assess health related quality of life at the beginning and end of chemotherapy. Data were analyzed by the independent t-test at a significance level of 0.05. Results: Most of the 100 patients were married (68), aged 41-50 years (36), non-college educated (76), and had insurance (97). The mean quality of life scores at the first session of chemotherapy and prior to the onset of treatment-related adverse events were 71.33 for the doxorubicin and cyclophosphamide groups and 71.15 for the gemcitabine and paclitaxel groups. Analysis of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at the last chemotherapy session showed that the quality of life in both groups deteriorated as a result of side effects. The mean of quality of life scores at the first session of chemotherapy were 66.49 for the doxorubicin and cyclophosphamide group and 59.99 for the gemcitabine and paclitaxel group. Conclusion: Strategies to improve the emotional and role functions of the patients who undergo treatment should be given priority. Financial difficulties faced by breast cancer patients should be addressed from a policy making level at the initiating health financing system. © 2018, Shiraz University of Medical Sciences. All rights reserved

Quality of life in breast cancer patients using neoadjuvant ac (Doxorubicin and cyclophosphamide) in comparison with pg (paclitaxel and gemcitabine) therapy

Background: Quality of life has become a part of the evaluation criteria for cancer therapy. The aim of this study was to evaluate the quality of life in breast cancer patients under chemotherapy regimens that contained doxorubicin and cyclophosphamide (AC) compared to paclitaxel and gemcitabine (PG). Methods: This cohort study evaluated 100 women with breast cancer treated by doxorubicin and cyclophosphamide or gemcitabine and paclitaxel regimens. We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 to assess health related quality of life at the beginning and end of chemotherapy. Data were analyzed by the independent t-test at a significance level of 0.05. Results: Most of the 100 patients were married (68), aged 41-50 years (36), non-college educated (76), and had insurance (97). The mean quality of life scores at the first session of chemotherapy and prior to the onset of treatment-related adverse events were 71.33 for the doxorubicin and cyclophosphamide groups and 71.15 for the gemcitabine and paclitaxel groups. Analysis of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at the last chemotherapy session showed that the quality of life in both groups deteriorated as a result of side effects. The mean of quality of life scores at the first session of chemotherapy were 66.49 for the doxorubicin and cyclophosphamide group and 59.99 for the gemcitabine and paclitaxel group. Conclusion: Strategies to improve the emotional and role functions of the patients who undergo treatment should be given priority. Financial difficulties faced by breast cancer patients should be addressed from a policy making level at the initiating health financing system. © 2018, Shiraz University of Medical Sciences. All rights reserved

Prevalence of depression and anxiety among participants with glaucoma in a population-based cohort study : the Gutenberg Health Study

Background To investigate the prevalence of depression and anxiety among subjects with self-reported glaucoma and the association between self-reported glaucoma and depression respectively anxiety in a European cohort. Methods A study sample of 14,657 participants aged 35 to 74 years was investigated in a population-based cohort study. All participants reported presence or absence of glaucoma. Ophthalmological examinations were carried out in all participants and demographic and disease related information were obtained by interview. Depression was assessed with the Patient Health Questionnaire (PHQ-9), and generalized anxiety with the two screening items (GAD-2) of the short form of the GAD-7 (Generalized Anxiety Disorder-7 Scale). Prevalence of depression and generalized anxiety were investigated for subjects with and without self-reported glaucoma. Logistic regression analyses with depression, respectively anxiety as dependent variable and self-reported glaucoma as independent variable were conducted and adjusted for socio-demographic factors, systemic comorbidities (arterial hypertension, myocardial infarction, stroke, diabetes mellitus, chronic obstructive pulmonary disease, cancer), ocular diseases (cataract, macular degeneration, corneal diseases, diabetic retinopathy), visual acuity, intraocular pressure, antiglaucoma eye drops (sympathomimetics, parasympathomimetics, carbonic anhydrase inhibitors, beta-blockers, prostaglandins) and general health status. Results 293 participants (49.5% female) reported having glaucoma. Prevalence of depression among participants with and without self-reported glaucoma was 6.6% (95%-CI 4.1–10.3) respectively 7.7% (95%-CI 7.3–8.2), and for anxiety 5.3% (95%-CI 3.1–8.7) respectively 6.6% (95%-CI 6.2–7.1). Glaucoma was not associated with depression (Odds ratio 1.10, 95%-CI 0.50–2.38, p = 0.80) or anxiety (1.48, 95%-CI 0.63–3.30, p = 0.35) after adjustment for socio-demographic factors, ocular/systemic diseases, ocular parameters, antiglaucoma drugs and general health status. A restriction to self-reported glaucoma cases either taking topical antiglaucoma medications or having a history of glaucoma surgery did not alter the result. Conclusions This is the first study analyzing both depression and anxiety among glaucoma patients in a European cohort. Subjects with and without self-reported glaucoma had a similar prevalence of depression and anxiety in our population-based sample. Self-reported glaucoma was not associated with depression or anxiety. A lack of a burden of depressive symptoms may result from recruitment from a population-based sample as compared to previous study groups predominantly recruited from tertiary care hospitals

Decomposition of Socioeconomic Inequality in Catastrophic Health Expenditure: An Evidence from Iran

Background: Evidences showed that the incidence of catastrophic health expenditure is unequally distributed among disadvantaged populations. The present study has tried to explain the contributors of this unfair inequality in Hamadan, Iran. Methods: The target population was households that utilized inpatient services in hospitals of Hamadan. A proportional stratified random sampling method was used to determine study sample (N = 770). The associated factors of catastrophic health expenditure were estimated using logistic regression analysis. The inequality of catastrophic health expenditure was measured by concentration index and explained by decomposition analysis. The data were analyzed by using STATA version 12. Results: The key determinants of catastrophic health expenditure were poor economic status, lower household size, lack of supplementary insurance and the number of hospitalizations. The overall concentration index of catastrophic health expenditure in Hamadan was �0.163 (95 CI: �0.242 to �0.083). Household economic status (63.60) and household size (39.90) were considered as the first and the second largest contributors of catastrophic health expenditure inequality, respectively. Conclusion: It is demonstrated that catastrophic health expenditure inequality in Iran could be explained by the factors beyond the health sector scope. Hence, future policy efforts need to consider both health system factors and the factors beyond the health system to eliminate catastrophic health spending burden and its inequality. © 2019 INDIACLE

Neuroscience-informed classification of prevention interventions in substance use disorders : an RDoC-based approach

Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.Peer reviewe