The cost-effectiveness of the Argus II retinal prosthesis in Retinitis Pigmentosa patients

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Retinitis Pigmentosa (RP) is a hereditary genetic disease causing bilateral retinal degeneration. RP is a leading cause of blindness resulting in incurable visual impairment and drastic reduction in the Quality of life of the patients. Second Sight Medical Products Inc. developed Argus II, a retinal prosthesis system for treating RP. Argus II is the world's first ever-commercial implant intended to restore some vision in the blind patients. The objective of this study was to assess the cost-effectiveness of the Argus® II Retinal Prosthesis System (Argus II) in Retinitis Pigmentosa (RP) patients. METHOD: A multi -state transition Markov model was developed to determine the cost-effectiveness of Argus II versus usual care in RP from the perspective of healthcare payer. A hypothetical cohort of 1000 RP patients aged 46 years followed up over a (lifetime) 25-year time horizon. Health outcomes were expressed as quality adjusted life years (QALYs) and direct healthcare costs expressed in 2012 €. Results are reported as incremental cost per ratios (ICERs) with outcomes and costs discounted at an annual rate of 3.5%. RESULTS: The ICER for Argus II was €14,603/QALY. Taking into account the uncertainty in model inputs the ICER was €14,482/QALY in the probabilistic analysis. In the scenarios of an assumption of no reduction on cost across model visual acuity states or a model time horizon as short as 10 years the ICER increased to €31,890/QALY and €49,769/QALY respectively. CONCLUSION: This economic evaluation shows that Argus II is a cost-effective intervention compared to usual care of the RP patients. The lifetime analysis ICER for Argus II falls below the published societal willingness to pay of EuroZone countries

LISA test mass charging process due to cosmic ray nuclei and electrons

none10noolar energetic particles and galactic cosmic rays with energies larger than 100 MeV cause progressive charging of the LISA experiment test masses. Consequently, Coulomb forces occur between the test masses and the surrounding conducting surfaces generating spurious signals that might be mistaken for gravitational wave signals. We have parametrized the energy spectra of galactic cosmic-ray nuclei and electrons near the LISA orbit in order to evaluate their role in the test-mass charging relative to the most abundant proton component. This work has been carried out using the FLUKA Monte Carlo program.openC. GRIMANI; H. VOCCA; G. BAGNI; L. MARCONI; R. STANGA; F. VETRANO; A. VICERÉ; P. AMICO; L. GAMMAITONI; F. MARCHESONIGrimani, Catia; H., Vocca; G., Bagni; L., Marconi; R., Stanga; Vetrano, Flavio; Vicere', Andrea; P., Amico; L., Gammaitoni; F., Marcheson

Northern JHK Standard Stars for Array Detectors

We report J, H and K photometry of 86 stars in 40 fields in the northern hemisphere. The fields are smaller than or comparable to a 4x4 arcmin field-of-view, and are roughly uniformly distributed over the sky, making them suitable for a homogeneous broadband calibration network for near-infrared panoramic detectors. K magnitudes range from 8.5 to 14, and J-K colors from -0.1 to 1.2. The photometry is derived from a total of 3899 reduced images; each star has been measured, on average, 26.0 times per filter on 5.5 nights. Typical errors on the photometry are about 0.012.Comment: 10 pages including 3 figures, one separate figure on four pages. The finding chart of the AS-30 field and a few coordinates have been corrected. GIF finding charts can also be found at http://www.arcetri.astro.it/~hunt/std.htm

Testing the performance of a blind burst statistic

In this work we estimate the performance of a method for the detection of burst events in the data produced by interferometric gravitational wave detectors. We compute the receiver operating characteristics in the specific case of a simulated noise having the spectral density expected for Virgo, using test signals taken from a library of possible waveforms emitted during the collapse of the core of Type II Supernovae.Comment: 8 pages, 6 figures, Talk given at the GWDAW2002 worksho

Thermal noise reduction for present and future gravitational wave detectors

Thermal noise in mirror suspension is and will be the most severe fundamental limit to the low-frequency sensitivity of interferometric gravitational wave detectors currently under construction. The technical solutions, adopted in the Virgo detector, optimize the current suspension scheme, but new materials and new designs are needed to further reduce the suspension thermal noise. Silicon fibers are promising candidates both for room temperature advanced detectors and for future cryogenic interferometric detectors

Improvements in vision-related quality of life in blind patients implanted with the Argus II Epiretinal Prosthesis

Background: The purpose of this analysis is to report the change in quality of life (QoL) after treatment with the Argus II Epiretinal Prosthesis in patients with end-stage retinitis pigmentosa. Methods: The Vision and Quality of Life Index (VisQoL) was used to assess changes in QoL dimensions and overall utility score in a prospective 30-patient single-arm clinical study. VisQoL is a multi-attribute instrument consisting of six dimensions (injury, life, roles, assistance, activity and friendship) that may be affected by visual impairment. Within each dimension, patients were divided into two groups based on how much their QoL was affected by their blindness at baseline (moderate/severe or minimal). Outcomes were compared within each dimension sub-group between baseline and the combined follow-up periods using the Friedman test. In addition, data from the six dimensions were combined into a single utility score, with baseline data compared to the combined follow-up periods. Results: Overall, 80 per cent of the patients reported difficulty in one or more dimensions preimplant. Composite VisQoL utility scores at follow-up showed no statistically significant change from baseline; however, in three of the six VisQoL dimensions (injury, life and roles), patients with baseline deficits showed significant and lasting improvement after implantation with Argus II. In two of the three remaining dimensions (assistance and activity), data trended toward an improvement. In the final VisQoL dimension (friendship), none of the patients reported baseline deficits, suggesting that patients had largely adjusted to this attribute. Conclusion: Patients whose vision negatively affected them with respect to three VisQoL dimensions (that is, getting injured, coping with the demands of their life and fulfilling their life roles) reported significant improvement in QoL after implantation of the Argus II retinal prosthesis. Furthermore, the benefit did not deteriorate at any point during the 36-month follow-up, suggesting a long-term, durable improvement

On line power spectra identification and whitening for the noise in interferometric gravitational wave detectors

In this paper we address both to the problem of identifying the noise Power Spectral Density of interferometric detectors by parametric techniques and to the problem of the whitening procedure of the sequence of data. We will concentrate the study on a Power Spectral Density like the one of the Italian-French detector VIRGO and we show that with a reasonable finite number of parameters we succeed in modeling a spectrum like the theoretical one of VIRGO, reproducing all its features. We propose also the use of adaptive techniques to identify and to whiten on line the data of interferometric detectors. We analyze the behavior of the adaptive techniques in the field of stochastic gradient and in the Least Squares ones.Comment: 28 pages, 21 figures, uses iopart.cls accepted for pubblication on Classical and Quantum Gravit

Inertial control of the mirror suspensions of the VIRGO interferometer for gravitational wave detection

In order to achieve full detection sensitivity at low frequencies, the mirrors of interferometric gravitational wave detectors must be isolated from seismic noise. The VIRGO vibration isolator, called 'superattenuator', is fully effective at frequencies above 4 Hz. Nevertheless, the residual motion of the mirror at the mechanical resonant frequencies of the system are too large for the interferometer locking system and must be damped. A multidimensional feedback system, using inertial sensors and digital processing, has been designed for this purpose. An experimental procedure for determining the feedback control of the system has been defined. In this paper a full description of the system is given and experimental results are presented.Comment: 17 pages, 11 figures, accepted for publication on Review of Scientific Instrument