Cost-effectiveness of antimicrobial resistance point-of-care testing for optimising the treatment of gonorrhoea
|
|
|
- Christine Griffith
- 6 years ago
- Views:
Transcription
1 Cost-effectiveness of antimicrobial resistance point-of-care testing for optimising the treatment of gonorrhoea Emma Harding-Esch, Susie Huntington, Mike Harvey, Claire Broad, Elisabeth Adams, Tariq Sadiq Applied Diagnostic Research & Evaluation Unit (ADREU), St George s, University of London
2 Disclaimer ADREU has received funding from Atlas Genetics, Alere, Cepheid, Phillips, SpeedDx, Mologic, Revolugen and Sekisui. APH reports grants from Cepheid, St George s University of London, Enigma Diagnostics and AstraZeneca. Member of the BD Diagnostics Advisory Panel on UK Provision of Sexual Health Services.
3 Background New diagnoses of selected STIs in men-who-have-sex-with-men (MSM) in England sexual health services, Source: Public Health England (2017) Health Protection Report
4 Background Antimicrobial prescribing practice. GRASP clinics: : Recommendation of cefixime as first line therapy 2011: Recommendation of Ceftriaxone (500mg) & Azithromycin (1g) in combination as first line therapy Source: Adapted from Public Health England (2014) GRASP report
5 Background Strategies to tackle AMR Infection control Research Education Monitoring antimicrobial consumption Rationalise use of antimicrobials in humans and livestock Rapid diagnostic tests for AMR POCT with susceptibility testing Accurate antibiotic treatment Reuse of abandoned antibiotics Reduce selection pressure
6 Aims & objectives Assess the cost-effectiveness of Standard Care (SC) versus six hypothetical AMR-POCT strategies in Sexual Health Clinics (SHCs)
7 AMR-POCT strategies Standard Care (SC): intramuscular ceftriaxone (500mg) and oral azithromycin (1g single dose) Dual therapy optimisation strategies (AMR-POCT determines second agent in addition to ceftriaxone (500mg): 500mg ciprofloxacin or 1g azithromycin): A: AMR-POCT for ciprofloxacin B: Dual AMR-POCT for azithromycin and ciprofloxacin (result used if azithromycin resistant) C: Dual AMR-POCT for ciprofloxacin and azithromycin (result used if ciprofloxacin resistant) Single therapy optimisation strategies (AMR-POCT determines alternative to ceftriaxone: 2g azithromycin, 500mg ciprofloxacin, or penicillin (3g amoxicillin + 1g probenecid)): D: AMR-POCT for azithromycin. If azithromycin resistant, ceftriaxone and ciprofloxacin dual therapy is given E: AMR-POCT for ciprofloxacin. If ciprofloxacin resistant, SC is given F: AMR-POCT for penicillin. If penicillin resistant, SC is given
8 Model Decision tree model Simulated hypothetical cohort: 38,870 SHC attendees diagnosed with NG a 8,488 women 21,915 men who have sex with men (MSM) 8,467 men who have sex with women (MSW) a Public Health England (2016) Sexually transmitted infections (STIs): annual data tables,
9 Inputs and outcome measures Data from published and unpublished sources, and clinician interviews Costs Retail costs AMR-POCT Drugs (ceftriaxone, azithromycin, ciprofloxacin, penicillin) Implementation costs a Management of NG (oral medication/intramuscular injection) Additional cost of performing AMR POCT Test of cure for NG (using POCT for NG) Return visit due to treatment failure a Adapted from Adams et al. BMJ Open 2014; 4(7): e Number of each drug used to treat NG Number of optimal treatments Number of sub-optimal treatments Number of inappropriate treatments Number of treatment failures Measures of effectiveness Ceftriaxone, azithromycin, ciprofloxacin, penicillin Cures the infection and does not contain any drug against which there is resistance Contains drugs against which there is resistance A later drug used when an earlier drug could have been used and would have been optimal Failure to cure an infection due to resistance to a drug given as monotherapy
10 Outcomes & analyses Primary outcomes: Incremental cost-effectiveness ratio (ICER): Cost of AMR-POCT - Cost of SC Effectiveness of AMR-POCT - Effectiveness of SC Cost per additional optimal treatment gained Cost per additional ceftriaxone treatment avoided Secondary outcomes: % people given an inappropriate treatment % people failing treatment due to resistance Sensitivity analyses: Responsiveness of outcomes to changes in parameter inputs & model assumptions 18 analyses per parameter: 6 AMR-POCT strategies, 3 population groups Cost-effectiveness acceptability curves (CEACs): Probability that strategies are cost-effective at different willingness to pay thresholds Monte Carlo simulations
11 AMR-POCT strategies Results 1 = 1.29 USD Comparison Total additional cost Additional cost per patient Number of optimal treatments Dual therapy with ceftriaxone optimisation: A: AMR-POCT for ciprofloxacin (500mg) only B: Dual AMR-POCT for azithromycin (1g) and ciprofloxacin (500mg) C: Dual AMR-POCT for ciprofloxacin (500mg) and azithromycin (1g) Monotherapy optimisation: D: AMR-POCT for azithromycin (2g) E: AMR-POCT for ciprofloxacin (500mg) F: AMR-POCT for penicillin (amoxicillin (3g) + probenecid (1g)) Additional cost per optimal treatment gained Number of ceftriaxone treatments avoided Additional cost per ceftriaxonesparing treatment AMR POC A vs SC 1,286, Dominated 0 Dominated AMR POC B vs SC 1,426, ,532 0 Dominated AMR POC C vs SC 1,398, ,704 0 Dominated AMR POC D vs SC 620, ,890 38, AMR POC E vs SC 805, Dominated 25, AMR POC F vs SC 782, ,981 30, A strategy is dominated if it is more expensive and provides fewer/equivalent benefits.
12 Additional cost per optimal treatment gained AMR-POCT strategies Results by population group Dual therapy with ceftriaxone optimisation: A: AMR-POCT for ciprofloxacin (500mg) only B: Dual AMR-POCT for azithromycin (1g) and ciprofloxacin (500mg) C: Dual AMR-POCT for ciprofloxacin (500mg) and azithromycin (1g) Monotherapy optimisation: D: AMR-POCT for azithromycin (2g) E: AMR-POCT for ciprofloxacin (500mg) F: AMR-POCT for penicillin (amoxicillin (3g) + probenecid (1g)) 30,000 25,000 20,000 15,000 10,000 Females MSM 5,000 0 A vs SC B vs SC C vs SC D vs SC E vs SC F vs SC Strategy
13 Additional cost per optimal treatment gained AMR-POCT strategies Results by population group 30,000 Dual therapy with ceftriaxone optimisation: A: AMR-POCT for ciprofloxacin (500mg) only B: Dual AMR-POCT for azithromycin (1g) and ciprofloxacin (500mg) C: Dual AMR-POCT for ciprofloxacin (500mg) and azithromycin (1g) Monotherapy optimisation: D: AMR-POCT for azithromycin (2g) E: AMR-POCT for ciprofloxacin (500mg) F: AMR-POCT for penicillin (amoxicillin (3g) + probenecid (1g)) 25,000 20,000 15,000 10,000 Females MSM 5,000 0 * * A vs SC B vs SC C vs SC D vs SC E vs SC F vs SC Strategy * Strategies A and E were dominated by SC for MSM. For MSW, all strategies were dominated by SC.
14 Results Sensitivity analyses: 1. Probability of NG being resistant to azithromycin (18/18) 2. Sensitivity (13/18) 3. Probability of NG being resistant to ciprofloxacin (13/18) 4. Specificity (6/18) 5. Cost of single vs. dual AMR-POCT (5/18)
15 AMR-POCT strategies Overall CEAC for optimal treatment Dual therapy with ceftriaxone optimisation: A: AMR-POCT for ciprofloxacin (500mg) only B: Dual AMR-POCT for azithromycin (1g) and ciprofloxacin (500mg) C: Dual AMR-POCT for ciprofloxacin (500mg) and azithromycin (1g) Monotherapy optimisation: D: AMR-POCT for azithromycin (2g) E: AMR-POCT for ciprofloxacin (500mg) F: AMR-POCT for penicillin (amoxicillin (3g) + probenecid (1g)) Standard care A B C D E F
16 AMR-POCT strategies Key points SC is the cheapest option AMR-POCTs may be cost-effective: Depends on willingness to pay Maximising number of effective agents in treatment regimens Enabling avoidance of ceftriaxone use Most cost-effective strategies: B: for optimal treatment D: for ceftriaxone avoidance Both enable re-use of ciprofloxacin, previously abandoned for the treatment of NG Variation by population group Short-term investment for long-term benefit Dual therapy with ceftriaxone optimisation: A: AMR-POCT for ciprofloxacin (500mg) only B: Dual AMR-POCT for azithromycin (1g) and ciprofloxacin (500mg) C: Dual AMR-POCT for ciprofloxacin (500mg) and azithromycin (1g) Monotherapy optimisation: D: AMR-POCT for azithromycin (2g) E: AMR-POCT for ciprofloxacin (500mg) F: AMR-POCT for penicillin (amoxicillin (3g) + probenecid (1g))
17 S Tariq Sadiq Claire Broad Funding National Institute for Health Research (NIHR) i4i Programme (grant number II-LB ). The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health. Elisabeth Adams Susie Huntington Mike Harvey UK Clinical Research Collaboration (Medical Research Council) Translation Infection Research Initiative Consortium (grant number G )
6. Gonococcal antimicrobial susceptibility
6. Gonococcal antimicrobial susceptibility Key points Gonococcal AMR continues to increase worldwide and could lead to a pandemic of extensively drug-resistant (XDR) N. gonorrhoeae with serious public
The objectives of this presentation are; to increase awareness of the issue of antimicrobial resistant gonorrhea, and to inform primary care and
1 Antimicrobial resistant gonorrhea is an emerging public health threat that needs to be addressed. Neisseria gonorrhoeae is able to develop resistance to antimicrobials quickly. Effective antibiotic stewardship
Harnessing molecular technology to inform our understanding of HIV and STI epidemics
NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections Harnessing molecular technology to inform our understanding of HIV and STI epidemics Katy Town PhD candidate Centre
STI Indicators by STI
STI Indicators by STI Table of Contents pg. 2 Sexual History pg. 3-4 Syphilis pg. 5-6 Gonorrhea pg. 7-9 Chlamydia pg. 10 HIV/PrEP 1 Sexual History Comprehensive Sexual History Elements Percentage of patients
Outcomes assessed in the review The outcomes assessed in the review and used as model inputs were the incident rates of:
The cost-effectiveness of continuous subcutaneous insulin infusion compared with multiple daily injections for the management of diabetes Scuffham P, Carr L Record Status This is a critical abstract of
Dr Selena Singh. Guy s and St Thomas NHS Foundation Trust, London THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014
THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014 Dr Selena Singh Guy s and St Thomas NHS Foundation Trust, London 1-4 April 2014, Arena and Convention Centre Liverpool Performance of ceftriaxone 500mgcontaining
The cost-effectiveness of a new statin (rosuvastatin) in the UK NHS Palmer S J, Brady A J, Ratcliffe A E
The cost-effectiveness of a new statin (rosuvastatin) in the UK NHS Palmer S J, Brady A J, Ratcliffe A E Record Status This is a critical abstract of an economic evaluation that meets the criteria for
Neisseria gonorrhoeae: The Ontario perspective. Michael Whelan and Dr. Vanessa Allen PHO Grand Rounds, May 5, 2015
Neisseria gonorrhoeae: The Ontario perspective Michael Whelan and Dr. Vanessa Allen PHO Grand Rounds, May 5, 2015 Objectives Participants will be able to: Describe preferred specimen collection for testing
Cost-effective treatment of uncomplicated gonorrhoea including co-infection with Chlamydia trachomatis Genc M, Mardh P A
Cost-effective treatment of uncomplicated gonorrhoea including co-infection with Chlamydia trachomatis Genc M, Mardh P A Record Status This is a critical abstract of an economic evaluation that meets the
Cost-effectiveness of hepatic venous pressure gradient measurements for prophylaxis of variceal re-bleeding Raines D L, Dupont A W, Arguedas M R
Cost-effectiveness of hepatic venous pressure gradient measurements for prophylaxis of variceal re-bleeding Raines D L, Dupont A W, Arguedas M R Record Status This is a critical abstract of an economic
Gonorrhea Antimicrobial Resistance in Alberta. Gonorrhea Antimicrobial Resistance Review
2011 Review in Alberta Alberta Gonorrhea AMR Surveillance Working Group November 2013 2011 Review Background Gonorrhea remains one of the oldest infections known to man. Infections can result in significant
The Emerging Threat of Cephalosporin (& Multidrug) Resistant Gonorrhea
The Emerging Threat of Cephalosporin (& Multidrug) Resistant Gonorrhea Robert D. Kirkcaldy, MD, MPH Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, TB and STD Prevention Centers
The Gonococcal Antimicrobial Surveillance Program (GASP): A snapshot from Southern Africa Dumisile Venessa Maseko
The Gonococcal Antimicrobial Surveillance Program (GASP): A snapshot from Southern Africa Dumisile Venessa Maseko Centre for HIV and STIs Na9onal Ins9tute for Communicable Diseases, Na9onal Health Laboratory
Clopidogrel versus aspirin for secondary prophylaxis of vascular events: a cost-effectiveness analysis Schleinitz M D, Weiss J P, Owens D K
Clopidogrel versus aspirin for secondary prophylaxis of vascular events: a cost-effectiveness analysis Schleinitz M D, Weiss J P, Owens D K Record Status This is a critical abstract of an economic evaluation
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Manual Jan 2018
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Manual Jan 2018 Page 1 Contents 1 Introduction Page 3 2 Contact details Page 4 3 Opening hours Page 4 4 Services provided
Neonatal hearing screening: modelling cost and effectiveness of hospital- and communitybased
Neonatal hearing screening: modelling cost and effectiveness of hospital- and communitybased screening Grill E, Uus K, Hessel F, Davies L, Taylor R S, Wasem J, Bamford J Record Status This is a critical
Treatment resistant STIs relevant to MSM
Treatment resistant STIs relevant to MSM David A. Lewis FRCP (UK) PhD Centre for HIV and STIs National Institute for Communicable Diseases (NHLS) Johannesburg, South Africa Regional Director, IUSTI Africa
HPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 2010
HPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 21 Health Protection Surveillance Centre, www.hpsc.ie Version 1. May 212 Table of Contents Acknowledgements... 5 Key Points... 5 Introduction... 7 Methods...
Alternative management strategies for patients with suspected peptic ulcer disease Fendrick M A, Chernew M E, Hirth R A, Bloom B S
Alternative management strategies for patients with suspected peptic ulcer disease Fendrick M A, Chernew M E, Hirth R A, Bloom B S Record Status This is a critical abstract of an economic evaluation that
An exploration of the cost-effectiveness of interventions to reduce. differences in the uptake of childhood immunisations in the UK using
An exploration of the cost-effectiveness of interventions to reduce differences in the uptake of childhood immunisations in the UK using threshold analysis National Collaborating Centre for Women s and
REPORT ON THE ENHANCED SURVEILLANCE OF ANTIMICROBIAL-RESISTANT GONORRHEA
i Report on the enhanced surveillance of antimicrobial-resistant gonorrhea REPORT ON THE ENHANCED SURVEILLANCE OF ANTIMICROBIAL-RESISTANT GONORRHEA RESULTS FROM THE 2014 PILOT i TO PROMOTE AND PROTECT
Setting The setting was secondary care. The economic study was carried out in Canada.
Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis Rocchi A, Verma S Record Status This is a critical
The cost effectiveness of opportunistic chlamydia screening in England Adams E J, Turner K M, Edmunds W J
The cost effectiveness of opportunistic chlamydia screening in England Adams E J, Turner K M, Edmunds W J Record Status This is a critical abstract of an economic evaluation that meets the criteria for
Value of an economic analysis on diagnostic tests conducted for the Pneumonia NICE Clinical Guideline
Value of an economic analysis on diagnostic tests conducted for the Pneumonia NICE Clinical Guideline Presenter: Elisabetta Fenu, Health Economics Lead Co-author: Chris Kiff National Clinical Guideline
Faecal DNA testing compared with conventional colorectal cancer screening methods: a decision analysis Song K, Fendrick A M, Ladabaum U
Faecal DNA testing compared with conventional colorectal cancer screening methods: a decision analysis Song K, Fendrick A M, Ladabaum U Record Status This is a critical abstract of an economic evaluation
Management of Gonorrhea in Adolescents and Adults in the United States
SUPPLEMENT ARTICLE Management of Gonorrhea in Adolescents and Adults in the United States Sarah Kidd 1 and Kimberly A. Workowski 1,2 1 Division of STD Prevention, Centers for Disease Control and Prevention,
Sexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2016
Sexually Transmitted Infection surveillance in Northern Ireland 2017 An analysis of data for the calendar year 2016 Contents Page Summary points. 3 Surveillance arrangements and sources of data.. 4 1:
ONLINE SUPPLEMENTARY MATERIALS: FILE 1
ONLINE SUPPLEMENTARY MATERIALS: FILE 1 Clinical care pathways using chlamydia and gonorrhoea tests are evolving: point of care nucleic acid amplification tests may reduce genitourinary medicine service
Linezolid for treatment of ventilator-associated pneumonia: a cost-effective alternative to vancomycin Shorr A F, Susla G M, Kollef M H
Linezolid for treatment of ventilator-associated pneumonia: a cost-effective alternative to vancomycin Shorr A F, Susla G M, Kollef M H Record Status This is a critical abstract of an economic evaluation
Supplementary Online Content
Supplementary Online Content Chahal HS, Marseille EA, Tice JA, et al. Cost-effectiveness of early treatment of hepatitis C virus genotype 1 by stage of liver fibrosis in a US treatment-naive population.
1. Comparative effectiveness of liraglutide
Cost-effectiveness of liraglutide (Victoza ) for the treatment of adults with insufficiently controlled type 2 diabetes as an adjunct to diet and exercise. The NCPE has issued a recommendation regarding
The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women Haddix A C, Hillis S D, Kassler W J
The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women Haddix A C, Hillis S D, Kassler W J Record Status This is a critical abstract of an economic evaluation that meets the
EHIVQUAL. For use with ehivqual, an electronic web based program for quality of care data collection and review REVIEW PERIOD:
NEW YORK STATE DEPARTMENT OF HEALTH AIDS INSTITUTE EHIVQUAL QUALITY OF CARE INDICATOR DEFINITIONS* * For use with ehivqual, an electronic web based program for quality of care data collection and review
The HIV Prevention England programme: what s next? Cary James May 2016
The HIV Prevention England programme: what s next? Cary James May 2016 Summary Programme objectives Campaign evolution Sector development Structure and governance Support for HIV prevention system Communication
Health technology The study compared three strategies for diagnosing and treating obstructive sleep apnoea syndrome (OSAS).
Cost-effectiveness of split-night polysomnography and home studies in the evaluation of obstructive sleep apnea syndrome Deutsch P A, Simmons M S, Wallace J M Record Status This is a critical abstract
STD UPDATE Patrick Loose, Chief HIV, STD & Hepatitis Branch February 15, 2018
Patrick Loose, Chief HIV, STD & Hepatitis Branch February 15, 2018 MISSION Improve health outcomes in communities disproportionately impacted by HIV and STDs Collect, study and publish data Diagnose and
5/1/2017. Sexually Transmitted Diseases Burning Questions
Sexually Transmitted Diseases Burning Questions Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles Los Angeles, California FORMATTED: 04-03-17 Financial
6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.?
BACTERIAL STDs IN A POST- HIV WORLD Tracey Graney, PhD, MT(ASCP) Monroe Community College Learning Objectives Describe the epidemiology and incidence of bacterial STDs in the U.S. Describe current detection
Setting The setting was secondary care. The economic study was conducted in the USA.
HER-2 testing and trastuzumab therapy for metastatic breast cancer: a cost-effectiveness analysis Elkin E B, Weinstein K C, Winer E P, Kuntz K M, Schnitt S J, Weeks J C Record Status This is a critical
Setting The setting was primary care. The economic study was carried out in the USA.
"Shotgun" versus sequential testing: cost-effectiveness of diagnostic strategies for vaginitis Carr P L, Rothberg M B, Friedman R H, Felsenstein D, Pliskin J S Record Status This is a critical abstract
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Report for the period January - December 2011
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Report for the period January - ember 211 Kirstine Eastick PhD FRCPath (Director) SBSTIRL, Microbiology Edinburgh
Pharmacoeconomic comparison of treatments for the eradication of Helicobacter pylori Taylor J L, Zagari M, Murphy K, Freston J W
Pharmacoeconomic comparison of treatments for the eradication of Helicobacter pylori Taylor J L, Zagari M, Murphy K, Freston J W Record Status This is a critical abstract of an economic evaluation that
Estimating gonorrhoea prevalence
Estimating gonorrhoea prevalence in young heterosexual men and women attending community-based sexual health services to inform decisions on gonorrhoea testing K. Town 1, M. Furegato 1, N. Field 1,2 and
REPRODUCTIVE TRACT INFECTIONS
REPRODUCTIVE TRACT INFECTIONS State-of-the-Art 02.10.1998 Dr Saloney Nazeer Department of Gynaecology & Obstetrics Geneva University Hospital CLASSIFICATION OF RTIs STDs Non-STDs - infections which result
Disclosures. STD Screening for Women. Chlamydia & Gonorrhea. I have no disclosures or conflicts of interest to report.
Disclosures Management of STIs: Challenges in Practice I have no disclosures or conflicts of interest to report. Alison O. Marshall, MSN, FNP-C Associate Professor of Practice & Director of the Family
Addendum DAP39 ADDENDUM. This Diagnostics Assessment Report was commissioned by the NIHR HTA Programme as project number 16/30/05
25 The clinical and cost effectiveness of lead-i electrocardiogram (ECG) devices for detecting atrial fibrillation using single-time point testing in primary care [DAP39] DAP39 ADDENDUM Addendum This Diagnostics
Setting The study setting was the community. The economic analysis was conducted in the USA.
Estimated effectiveness and cost-effectiveness of federally funded prevention efforts on gonorrhoea rates in the United States, 1971-2003, under various assumptions about the impact of prevention funding
SYNDROMIC CASE MANAGEMENT OF RTIs Advantages, Limitations, Optimization
WHO COLLABORATING CENTRE FOR RESEARCH IN HUMAN REPRODUCTION Hôpitaux Universitaires de Genève SYNDROMIC CASE MANAGEMENT OF RTIs Advantages, Limitations, Optimization Dr SALONEY NAZEER Department of Gynaecology
Summary of the Health Needs in Rugby Borough
Rugby Borough Summary of the Health Needs in Rugby Borough Domain Indicator Rugby Borough 2010 Trend Warwickshire England Data Communities Children's and young people Adult's health and lifestyle Disease
Assessment of cost-effectiveness of universal hepatitis B immunization in a low-income country with intermediate endemicity using a Markov model
Assessment of cost-effectiveness of universal hepatitis B immunization in a low-income country with intermediate endemicity using a Markov model Aggarwal R, Ghoshal U C, Naik S R Record Status This is
HIV in London: A Complexity Challenge
HIV in London: A Complexity Challenge Professor Jane Anderson (Homerton University Hospital) and Dr David Asboe (Chelsea and Westminster Hospital) NHS England Clinical Reference Group for HIV Representatives
APPENDIX A SERVICE SPECIFICATION
Service Specification No. Service Authority Lead Provider Lead 2013/14 APPENDIX A SERVICE SPECIFICATION Participation in the Ruclear chlamydia and gonorrhoea screening programme (General practices) Period
TRANSITIONS TO PALLIATIVE CARE FOR OLDER PEOPLE IN ACUTE HOSPITALS
TRANSITIONS TO PALLIATIVE CARE FOR OLDER PEOPLE IN ACUTE HOSPITALS TRANSITIONS TO PALLIATIVE CARE FOR OLDER PEOPLE IN ACUTE HOSPITALS Foreword 03 Background 04 AIms 04 Method 05 Results 6-9 Conclusions
STI Treatment Guidelines. Teodora Wi. Training Course in Sexual and Reproductive Health Research
Teodora Wi Geneva, 28 August 2017 STI Treatment Guidelines Teodora Wi Training Course in Sexual and Reproductive Health Research 2017 Twitter @HRPresearch 1 STI treatment guidelines Neisseria gonorrhoeae
Improving outcomes The UK s achievements in managing and preventing the HIV epidemic and how we should approach public health priorities
Improving outcomes The UK s achievements in managing and preventing the HIV epidemic and how we should approach public health priorities Professor Kevin Fenton Senior Advisor, Public Health England Director,
Real-world observational data in costeffectiveness analyses: Herceptin as a case study
Real-world observational data in costeffectiveness analyses: Herceptin as a case study DR BONNY PARKINSON, PROFESSOR ROSALIE VINEY, ASSOCIATE PROFESSOR STEPHEN GOODALL AND PROFESSOR MARION HAAS ISPOR AUSTRALIA
Strategic overview of sexual health procurement Haringey and London
Strategic overview of sexual health procurement Haringey and London Sarah Hart : March 2017 2 Context for redesign of sexual health services in Haringey and London From July 2017 there will be a new offer
Setting The setting was unclear. The economic study was conducted in Switzerland.
Health-economic comparison of continuous subcutaneous insulin infusion with multiple daily injection for the treatment of Type 1 diabetes in the UK Roze S, Valentine W J, Zakrzewska K E, Palmer A J Record
Cost-effectiveness of abandoning microscopy of urethral smears for asymptomatic nonchlamydial non-gonococcal urethritis in men in the UK
Cost-effectiveness of abandoning microscopy of urethral smears for asymptomatic nonchlamydial non-gonococcal urethritis in men in the UK Appendix 1 Model Assumptions All assumptions were confirmed and
The cost-effectiveness of expanded testing for primary HIV infection Coco A
The cost-effectiveness of expanded testing for primary HIV infection Coco A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract
The Clinical Need for Antibiotic Resistance Related Diagnostics Professor Mark H. Wilcox
The Clinical Need for Antibiotic Resistance Related Diagnostics Professor Mark H. Wilcox Leeds Teaching Hospitals, University of Leeds, & Public Health England, UK Facts (i) IVDs will be the world s largest
Update on Sexually Transmitted Infections Jeanne Marrazzo, MD, MPH
Update on Sexually Transmitted Infections Jeanne Marrazzo, MD, MPH Division of Infectious Diseases University of Alabama at Birmingham School of Medicine Birmingham, Alabama Outline Syphilis in all its
Sexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2011
Sexually Transmitted Infection surveillance in Northern Ireland 2012 An analysis of data for the calendar year 2011 Contents Page Summary points. 3 Surveillance arrangements and sources of data.. 4 1:
Internationell utblick STI/HIV i världen
Internationell utblick STI/HIV i världen Magnus Unemo, PhD, Assoc. Professor, Director Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology Örebro University
Cost-effectiveness considerations in the treatment of essential thrombocythemia Golub R, Adams J, Dave S, Bennett C L
Cost-effectiveness considerations in the treatment of essential thrombocythemia Golub R, Adams J, Dave S, Bennett C L Record Status This is a critical abstract of an economic evaluation that meets the
Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C. Part review of NICE technology appraisal guidance 75 and 106
Issue date: September 2010 Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C Part review of NICE technology appraisal guidance 75 and 106 National Institute for Health and Clinical
Self Testing Models within Community Based Organisations GMI Partnership and Positive East Community Self Testing Models
Self Testing Models within Community Based Organisations GMI Partnership and Positive East Community Self Testing Models Phillip Wragg, Yasmin Dunkley The Projects GMI Community Coaching Model (MSM) Positive
The health economics of calcium and vitamin D3 for the prevention of osteoporotic hip fractures in Sweden Willis M S
The health economics of calcium and vitamin D3 for the prevention of osteoporotic hip fractures in Sweden Willis M S Record Status This is a critical abstract of an economic evaluation that meets the criteria
Mental Health Intelligence Network
Mental Health Intelligence Network Consultation for Public Health England with mental health service users, families and others interested in mental health and wellbeing. Executive Summary June 2014 1
PROGRESS REPORT OF THE IMPLEMENTATION OF THE GLOBAL STRATEGY FOR PREVENTION AND CONTROL OF SEXUALLY TRANSMITTED INFECTIONS:
PROGRESS REPORT OF THE IMPLEMENTATION OF THE GLOBAL STRATEGY FOR PREVENTION AND CONTROL OF SEXUALLY TRANSMITTED INFECTIONS: 2006 2015 Document for the World Health Assembly 27 April 2015 ii Contents Acronyms
Orchestrated Efforts to Optimize Antibiotic Prescriptions in a Medical Department
Orchestrated Efforts to Optimize Antibiotic Prescriptions in a Medical Department Dr. Eugene Tso Division of Infectious Diseases Department of Medicine & Geriatrics United Christian Hospital 11 May 2010
A cost effectiveness analysis of treatment options for methotrexate-naive rheumatoid arthritis Choi H K, Seeger J D, Kuntz K M
A cost effectiveness analysis of treatment options for methotrexate-naive rheumatoid arthritis Choi H K, Seeger J D, Kuntz K M Record Status This is a critical abstract of an economic evaluation that meets
National Guidelines for the Prevention and Control of Gonorrhoea and for minimising the impact of Antimicrobial Resistance in Neisseria Gonorrhoea
National Guidelines for the Prevention and Control of Gonorrhoea and for minimising the impact of Antimicrobial Resistance in Neisseria Gonorrhoea Table of Contents Membership of the Antimicrobial Resistance
Clinical Practice Objectives
STD Essentials for the Busy Clinician Susan S. Philip, MD, MPH Assistant Professor, Division of Infectious Diseases, UCSF Director, STD Prevention and Control Services San Francisco Department of Public
Cost-effectiveness of uterine artery embolization and hysterectomy for uterine fibroids Beinfeld M T, Bosch J L, Isaacson K B, Gazelle G S
Cost-effectiveness of uterine artery embolization and hysterectomy for uterine fibroids Beinfeld M T, Bosch J L, Isaacson K B, Gazelle G S Record Status This is a critical abstract of an economic evaluation
NICE decisions on health care provisions in England
NICE decisions on health care provisions in England Matt Stevenson, Professor of Health Technology Assessment (HTA), ScHARR, University of Sheffield, UK A quick introduction I am Technical Director of
Antimicrobial resistance and molecular epidemiology of Neisseria gonorrhoeae in New Zealand,
Antimicrobial resistance and molecular epidemiology of Neisseria gonorrhoeae in New Zealand, 2014-15 December 2015 PREPARED FOR: CLIENT REPORT No: PREPARED BY: Ministry of Health FW15061 Helen Heffernan,
Cost-effectiveness analysis of biological treatments for rheumatoid arthritis Chiou C F, Choi J, Reyes C M
Cost-effectiveness analysis of biological treatments for rheumatoid arthritis Chiou C F, Choi J, Reyes C M Record Status This is a critical abstract of an economic evaluation that meets the criteria for
Technical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, May 2008 Vienna International Centre
Technical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, 5-95 9 May 2008 Vienna International Centre Evidence-based Nuclear Cardiology: Imaging of CAD The
STIs in Primary Care. Dr Eleanor Draeger 19 th January 2016
STIs in Primary Care Dr Eleanor Draeger 19 th January 2016 Poli=cs! 2012! Health and Social Care act! Sexual Health commissioning moved to local authority! 2015! 200 million cuts to public health! 40%
Clinical Guidelines Update (aka Know Your NAATs)
Clinical Guidelines Update (aka Know Your NAATs) WARNING: contains adult themes, sexual references and pictures that may be disturbing! Dr Heather Young Christchurch Sexual Health Centre heather.young@cdhb.health.nz
Study population The study population comprised a hypothetical cohort of patients with severe sepsis and septic shock.
Cost-effectiveness of immunoglobulin M-enriched immunoglobulin (Pentaglobin) in the treatment of severe sepsis and septic shock Neilson A R, Burchardi H, Schneider H Record Status This is a critical abstract
COMMUNITY HEALTH DIVISION NEWSLETTER. Then...
MOTIVATION TO PREVENT STIS When we STI staff call people who have been diagnosed with a sexually transmitted infection, we want to make sure they and their partners have been treated. We also want to help
Cost-effectiveness of endovascular abdominal aortic aneurysm repair Michaels J A, Drury D, Thomas S M
Cost-effectiveness of endovascular abdominal aortic aneurysm repair Michaels J A, Drury D, Thomas S M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion
The barriers and facilitators of supporting self care in Mental Health NHS Trusts
The barriers and facilitators of supporting self care in Mental Health NHS Trusts Executive Summary for the National Institute for Health Research Service Delivery and Organisation programme April 2010
Setting The setting was institutional and tertiary care in London, Essex and Hertfordshire in the UK.
Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis Knapp M, Thorgrimsen L, Patel A, Spector A, Hallam A, Woods B, Orrell M Record Status This is a critical abstract of
Technology appraisal guidance Published: 22 September 2010 nice.org.uk/guidance/ta200
Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C Technology appraisal guidance Published: 22 September 2010 nice.org.uk/guidance/ta200 NICE 2018. All rights reserved. Subject to
Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management. William M. Geisler M.D., M.P.H. University of Alabama at Birmingham
Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management William M. Geisler M.D., M.P.H. University of Alabama at Birmingham Chlamydia and Gonorrhea Current Epidemiology Chlamydia Epidemiology
Summary A LOOK AT ELAGOLIX FOR ENDOMETRIOSIS JULY 2018
JULY 2018 WHAT IS ENDOMETRIOSIS? Endometriosis is a chronic gynecological condition with symptoms that include painful menstrual periods, nonmenstrual pelvic pain, and pain during intercourse, as well
Sexually Transmitted Disease Surveillance 1998 Supplement
Sexually Transmitted Disease Surveillance 1998 Supplement Division of STD Prevention November 1999 Gonococcal Isolate Surveillance Project (GISP) Annual Report - 1998 DEPARTMENT OF HEALTH AND HUMAN SERVICES
In vitro assessment of dual drug combinations to inhibit growth of Neisseria gonorrhoeae
AAC Accepted Manuscript Posted Online 26 January 2015 Antimicrob. Agents Chemother. doi:10.1128/aac.04127-14 Copyright 2015, American Society for Microbiology. All Rights Reserved. 1 2 In vitro assessment
Reporting blood culture results to clinicians: MIC, resistance mechanisms, both?
Reporting blood culture results to clinicians: MIC, resistance mechanisms, both? Christian G. Giske, MD, PhD Senior Consultant Physician/Associate Professor Department of Clinical Microbiology Karolinska
And new, additional, challenges are developing RISING EXPECTATIONS INCREASING NEED FINANCIAL CONSTRAINTS CLIMATE CHANGE
However, all health services, everywhere, still face 5 major problems one of which is unwarranted variation which is variation in utilization of health care services that cannot be explained by variation
Economic evaluation of antibacterials in the treatment of acute sinusitis Laurier C, Lachaine J, Ducharme M
Economic evaluation of antibacterials in the treatment of acute sinusitis Laurier C, Lachaine J, Ducharme M Record Status This is a critical abstract of an economic evaluation that meets the criteria for
Sexually Transmitted Diseases. Summary of CDC Treatment Guidelines
DC 2015 Sexually Transmitted Diseases Summary of CDC Treatment Guidelines These summary guidelines reflect the June 2015 update to the 2010 CDC Guidelines for Treatment of Sexually Transmitted Diseases.
Cost-effectiveness of influenza vaccination in high-risk children in Argentina Dayan G H, Nguyen V H, Debbag R, Gomez R, Wood S C
Cost-effectiveness of influenza vaccination in high-risk children in Argentina Dayan G H, Nguyen V H, Debbag R, Gomez R, Wood S C Record Status This is a critical abstract of an economic evaluation that
RETURN OF THE CLAP: Emerging Issues in Gonorrhea Management and Antibiotic Resistance
RETURN OF THE CLAP: Emerging Issues in Gonorrhea Management and Antibiotic Resistance Ina Park, MD, MS University of California San Francisco California Prevention Training Center DISCLOSURE No Relevant