Systematic review of economic evaluations and cost analyses of guideline implementation strategies

Objectives To appraise the quality of economic studies undertaken as part of evaluations of guideline implementation strategies; determine their resources use; and recommend methods to improve future studies. Methods Systematic review of economic studies undertaken alongside robust study designs of clinical guideline implementation strategies published (1966-1998). Studies assessed against the BMJ economic evaluations guidelines for each stage of the guideline process (guideline development, implementation and treatment). Results 235 studies were identified, 63 reported some information on cost. Only 3 studies provided evidence that their guideline was effective and efficient. 38 reported the treatment costs only, 12 implementation and treatment costs, 11 implementation costs alone, and two guideline development, implementation and treatment costs. No study gave reasonably complete information on costs. Conclusions Very few satisfactory economic evaluations of guideline implementation strategies have been performed. Current evaluations have numerous methodological defects and rarely consider all relevant costs and benefits. Future evaluations should focus on evaluating the implementation of evidence based guidelines. Keywords: Cost-effectiveness analysis, physician (or health care professional) behaviour, practice guidelines, quality improvement, systematic review.Peer reviewedAuthor versio

Re-using Mini-Sentinel data following rapid assessments of potential safety signals via modular analytic programs

Clinical epidemiolog

Remote Video-to-Video Eye Telemonitoring Use Case for Glaucoma Patients

Part 1: IIVC WorkshopInternational audienceGlaucoma is the second leading cause of blindness globally and the second most common cause of avoidable visual impairment. It also holds a record in noncompliance to therapy from the patients in up to 50% of the subjects treated with anti-glaucoma eye drops. LiveCity e-Health is a European research program, which aims to provide better treatment and follow up of glaucoma patients at their home, through telemonitoring with high definition video-to-video (v2v) communication from the University Hospital. Secondly, it aims to reduce the cost of health and improve the city environment by decreasing the number of visits to the Hospital. For this purpose, a software application has been developed; the latter is easy to use for elderly people at home, and capable of keeping the medical history and digital records of every patient in the Glaucoma Department. In addition, a specific web camera with snapshot ability of high quality photo of the eye has utilised. Two patients have been initially enrolled in the study and the preliminary results are so presented