Showing 9 results for Fit
Maryam Mousavinezhad, Reza Majdzadeh, Ali Akbari Sari, Alireza Delavari, Farideh Mohtasham,
Volume 30, Issue 1 (1-2016)
Abstract
Background: After lung and prostate cancers, colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women after breast cancer worldwide. Every year, more than one million people are diagnosed with colorectal cancer worldwide and half of these patients die from this disease, making it the fourth leading cause of death in the world. This systematic review aimed to assess the effectiveness of the two colorectal diagnostic tests of FOBT (fecal occult blood test) and FIT (fecal immunochemical test)) in terms of technical performance.
Methods: To retrieve the relevant evidence, appropriate medical databases such as Cochrane library, NHSEED, Scopus and Google scholar were searched from February 2013 to July 2014, using free-texts and Mesh. In this study, inclusion/exclusion criteria of the papers, randomized controlled trials, economic evaluations, systematic reviews, meta-analyses and meta-syntheses of the effectiveness of FIT versus FOBT tests in moderate-risk populations (age: 50 to 70 years), which had reported the least of such outcomes as sensitivity, specificity and clinical outcomes were reviewed. The analyses of the effectiveness outcomes were performed in the form of meta-analysis.
Results: Five papers were eligible to be included in the final phase of the study for synthesis. FIT showed a better performance in participation and positivity rate. Moreover, in terms of false positive and negative rate, FIT showed fewer rates compared to FOBT (RR:-4.06; 95% CI (-7.89-0.24), and NN-scope (Number need to scope) (2.2% vs. 1.6%), and NN-screen (Number need to screen) (84% vs. 31-49% in different cut off levels) showed significant differences in FOBT vs. FIT, respectively.
Conclusion: In the five included studies (3, 11-14), the acceptability of FIT was more than FOBT. However, in our meta-analysis, no difference was found between the two tests. FIT was significant in positivity rate and had a better performance in participation rate, and a fewer false negative numbers compared to FOBT.
Ali Mouseli, Mohsen Barouni, Mohammadreza Amiresmaili, Siamak Mirab Samiee, Leila Vali,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Clinical laboratories need to manage resources properly and scientifically to survive in today's highly competitive environment. In this context, scientific-economic principles should be considered to determine the profitability or loss of laboratories. Thus, in this study, the net profit of laboratory services was measured based on scientific-economic principles.
Methods: This was an applied research with descriptive-retrospective approach. A laboratory was selected from 61 laboratories of Kerman, Iran, which performed the highest number of tests among the laboratories of this city. In addition, due to easy access, it was the most visited laboratory by patients. The present study had 2 main phases: (1) measuring the price of services and (2) calculating the net profit of the studied laboratory. Data analysis was performed using activity- based costing (ABC) as an econometric model and Excel software.
Results: The highest charges were related to direct costs (78.28%); consumable goods (47.26%) and professional and logistic human resources (46.31%) had the highest share of these costs. In the test groups, the most expensive tests belonged to the hormones (23.03%) and clinical chemistry (20.84%). Total cost, revenue, and the net profit of the studied laboratory were 641 645, 1 390 942, and 749 297 USD, respectively. After doing sensitivity analysis (50% increase in the frequency of tests), the following values were obtained: 987 071, 2 086 413, and 1 099 342, respectively.
Conclusion: Some test groups in the studied laboratory were not profitable, and this was due to the high cost of these tests and illogical tariffs. One way to overcome this problem is to increase the frequency of laboratory tests.
Aziz Rezapour, Seyran Naghdi, Hesam Ghiasvand, Tayebeh Moradi, Mohammad Javad Kabir, Negar Yousefzadeh,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Chronic Stable Angina (CSA) does not respond to clinical interventions always. Therefore, enhanced external counter pulsation (EECP) has been approved by the Food and Administration Drug (FDA) as an effective technology. This study aimed to synthesize evidence on the economic evaluation of EECP in managing CSA through a systematic approach.
Methods: In this systematic review study, PubMed/Medline, Cochrane Library, Web of Sciences, Scopus, National Institute for Health Research Journals Library, and the University of York Centre for Review and Dissemination (CRD) were searched. The targeted population was people who suffered from CSA, and the main therapeutic intervention was EECP. The comparators were not limited to any particular ones. Outcomes were changes in the Canadian Cardiovascular Society grading of angina pectoris, quality of life, and any other investigated relevant outcomes in the retrieved studies. The quality of studies was assessed through Philips et al and Joanna Briggs Institute Critical Appraisal tools. We synthesized data through a narrative approach.
Results: We retrieved 7821 studies; among which 3 studies were included in the final phase. Two studies were systematic reviews and the Markov model economic evaluation. Another study was a partial economic evaluation.
Conclusion: All studies only considered direct costs. EECP is a cost-effective technology in managing CSA, however, the sensitivity analysis of the studies showed the cost-effectiveness ratio is varied considerably and further studies are needed to extrapolate its economic value.
Babak Hassanlouei, Afshin Ostovar, Ali Ghanbari Motlagh, Yousef Moradi, Masoud Salehi, Mohsen Asadi Lari,
Volume 36, Issue 1 (1-2022)
Abstract
Background: Colorectal cancer (CRC) accounts for a large proportion of the global burden of cancer and is the fourth leading cause of cancer-related mortality worldwide. Fecal Immunochemical Testing (FIT) can be used for CRC screening programs due to its high accuracy and compliance. The present study reports the preliminary results of the CRC screening program in Iran among all people aged 50 to 69 years.
Methods: This cross-sectional study was carried out on 2,669,625 participants referred to health centers in Iran for CRC screening programs in 2018 and 2019. The data required for this study was taken from the CRC screening program. Relevant information for all individuals aged 50 to 69 referred to the health system that was called for colorectal cancer screening was extracted from the Integrated Electronic Health Records (SIB) database. Finally, the standards indices were calculated for all provinces. Gender, history of inflammatory bowel disease (IBD) (Crohn's disease or ulcerative colitis), history of colon cancer or adenoma in a first-degree family (father, mother, siblings or children), history of colon cancer in a second-degree family if occurred under the age of fifty (aunt, uncle, grandparents), lower gastrointestinal bleeding in a prior month, constipation in the prior month (with or without diarrhea, abdominal pain and feeling of fullness in the colon after defecation), more than ten percent weight loss in the last six months and FIT were assessed.
Results: Among a total number of over 2.6 million, 56.3% were female, and the number of people evaluated by health care providers for CRC screening programs in 2018 and 2019 were 1,365,248 (14.23%) and 1,304,377 (12.89%), respectively. The number of people with positive FIT evaluated for the CRC screening program in 2018 and 2019 was 33,299 (3.09%) and 33,583 (2.57%), respectively. Bushehr province (0.59%) and Isfahan province (7.35%) had the lowest and highest positive FIT rate in 2018, respectively. Also, the correlation between the above-mentioned variables and the number of people with a positive FIT across gender was statistically significant (p<0.05). The study of the relationship between the number of positive FIT cases and the variables examined by Behvarz and community health worker showed that the number of people with a family history of colon cancer in second-degree relatives under the age of 50 and also the number of people with an individual history of inflammatory bowel disease had a significant association with the number of positive FIT cases (p<0.05) (β=-0.718, 95% CI; -2.557-14.992, β=0.388, 95% CI; 0.322-16.737, respectively). The relationship between the number of positive FIT cases and effective variables was not statistically significant (p>0.05).
Conclusion: Positive cases should be referred for further evaluation and colonoscopy. Before performing a screening program, the conditions for performing colonoscopy for these people must be assessed and prepared. The FIT for CRC screening program can be easily promoted in Iran.
Mohsen Falahati, Azam Biabani, Mohadse Nobarani, Avery Beatty, Mahmood Karimy,
Volume 36, Issue 1 (1-2022)
Abstract
Background: To significantly reduce the disease and mortality from the novel Coronavirus Disease (COVID-19), a safe and effective vaccine must be widely delivered to the community. However, the availability of a vaccine for COVID-19 does not ensure that individuals will want to be vaccinated. The present study investigated the attitudes, perceived barriers, and benefits of the COVID-19 vaccine, as well as vaccination intentions, among a sample of Iranian adults.
Methods: Demographic data were categorized in this study based on whether or not participants received the vaccine. Drawn from a multistage sampling protocol in 2021, a descriptive-analytical study was conducted on 1350 adults in Saveh, Iran. A survey with 5 different sections inquired about eligible participants’ sociodemographic information, their attitudes, perceived benefits, and barriers, as well as their intentions to get vaccinated for COVID-19. Multiple logistic regression analysis (enter method) was performed to assess factors related to vaccination intent.
Results: The mean age of those who intended to receive the COVID-19 vaccine (57.9±19.2) was significantly higher than those who did not intend to receive the vaccine (43.4±16.8) (p=0.00). Additionally, married individuals were significantly more likely to receive the vaccine than individuals who were single and/or widowed. Additionally, (n=663) substantially more homemakers and retirees received vaccinations than workers and self-employed individuals (n=481) (p=0.001). Findings revealed that 78% of participants intended to receive the COVID-19 vaccine. Multiple unconditional logistic regression analyses showed that age and marital status, as well as the behavioral variables (attitude odds ratio [OR]=1.73, benefits OR=1.78, and perceived Barriers OR=0.52), had a significant relationship with vaccination intentions (p=0.001).
Conclusion: This study demonstrated that to increase intentions to receive the COVID-19 vaccine, public health campaigns and interventions should focus on promoting the benefits of the vaccine, improving the attitudes toward the vaccine, as well as reducing the perceived barriers.
Salar Ghorbani, Aziz Rezapour, Mahmoud Eisavi, Maedeh Barahman, Saeed Bagheri Faradonbeh,
Volume 37, Issue 1 (2-2023)
Abstract
Background: Breast cancer is a non-communicable and common disease that accounts for a high percentage of deaths. Early diagnosis of this disease reduces the death rate. Screening methods such as digital mammography can help prevent or identify the disease earlier. Therefore, this study aims to analyze the cost-benefit of breast cancer using digital mammography.
Methods: This systematic review was conducted based on PRISMA 2020 checklist. PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, and Google Scholar were searched without any time limitation on June 2022. The quality of the studies was evaluated with the CHEERS checklist. After data extraction, the results were synthesized by thematic content analysis.
Results: During the search, 3468 records were identified, of which 1061 were duplicates. 2407 titles and abstracts screened in terms of inclusion criteria. Finally, after studying 20 fulltexts, three of them were included in the study. The quality of these articles was scored between 10 and 16. These studies were from Spain, Denmark, and the United States from 2000 to 2019. Two studies showed that digital mammography is not as effective as other screening methods.
Conclusion: The results of this study showed that digital mammography is not very cost-benefit for the health care system. An increase in its repetition frequency imposes more costs on the health system and doesn’t have more benefits for it.
Majid Abedinejad, Mohammad Hadian, Soudabe Behrooj, Saeed Bagheri Faradonbeh, Nadia Saniee,
Volume 38, Issue 1 (1-2024)
Abstract
Background: One of the most important causes of mortality in the world is acute myocardial infarction. There are two general treatments including thrombolytic drugs and percutaneous coronary interventions. But, monitoring outpatient AMI treatment from a remote or rural location has emerged as a successful telemedicine technique. So, the present study aimed to review the economic evaluation studies of telemedicine in patients with acute myocardial infarction.
Methods: This study was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist (PRISMA is a 27-item checklist used to improve transparency in systematic reviews) guidelines in 2022. PubMed, Scopus, Web of Science, Proquest, Iranian databases (SID, Magiran), and Google Scholar were searched with the keywords of telemedicine and myocardial infarction from 2000 to 2022. After eliminating duplicates, titles and abstracts were screened based on inclusion and exclusion criteria, details, and the most important results of eligible studies were recorded in the data collection form.
Results: 904 records were identified in this search, of which 147 were duplicates. Finally, 6 records were included in this study. Among these studies, 4 were cost-effectiveness, one was cost analysis, and one was cost-utility. The willingness to pay threshold was between 20,000 and 100,000, and the outcomes were measured with QALY (Quality-adjusted life-years). The reviewed studies showed that telemedicine can improve outcomes such as quality of life and reduce disease costs.
Conclusions: The results showed that telemedicine interventions for acute myocardial infarction can be helpful, and cost-effective. However in some cases, it can cause increased costs and may not have a significant difference in effectiveness with other methods because of the condition and stage of the disease.
Asma Rashki Kemmak, Leila Etemad, Atoosa Haghighizadeh, Nadia Saniee, Omid Rajabi,
Volume 38, Issue 1 (1-2024)
Abstract
Background: Cardiovascular diseases (CVDs) are one of the chronic diseases and the leading cause of death worldwide. More people die from CVDs worldwide than from any other cause each year. The effects of CVDs are not limited to mortality and morbidity but also have important health and economic outcomes.
Methods: This was a systematic review that evaluated the economic evaluation of rivaroxaban plus aspirin compared with aspirin alone for the treatment of CVDs. The present study reviewed articles that performed a complete economic evaluation, including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis related to the economic evaluation of rivaroxaban compared to enoxaparin for knee replacement patients during the years 2007 and 2023. In order to find relevant studies, databases including Pubmed, Web of Science, Embase, Scopus, Economic Evaluations Database, and Proquest were searched. Inclusion criteria included Studies that carried out a complete economic evaluation including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis in relation to the economic evaluation of rivaroxaban plus aspirin compared to aspirin alone for CVD patients, economic evaluation studies carried out using decision analysis models based on the economic evaluation approach, full-text studies, English studies, and were studies published between 2007 and 2023. Exclusion criteria also included partial economic evaluation (such as effectiveness evaluation, cost evaluation, and quality of life evaluation), studies of low methodological quality based on the CHEERS checklist, non-English studies and all protocols, conference abstracts, and letters-to-the-editor.
Results: After searching various databases, all retrieved articles were entered into EndNote software, and duplicates were removed. The remaining studies were reviewed independently by two relevant researchers. At this stage, preferred reporting items for systematic reviews (PRISMA) were used to retrieve the final articles. Out of 1048 studies, nine studies met the inclusion criteria. The economic evaluation studies included in the present study were conducted between 2018 and 2023. Cost-effectiveness analysis (CEA) was used in all studies.
Conclusion: The findings of the present study showed that rivaroxaban plus aspirin is more cost-effective than aspirin alone in the patient with CVDs, But to generalize the results to other countries of the world, more studies are needed.
Alireza Hejrati, Reza Maddah, Sadaf Parvin, Abbas Gholami, Lina Hejrati, Bahareh Shateri Amiri, Anousheh Haghighi,
Volume 38, Issue 1 (1-2024)
Abstract
Background: Diffuse large B-cell lymphoma (DLBL) and systemic lupus erythematosus (SLE) are complex autoimmune disorders that present unique clinical challenges. These conditions may share underlying genetic and signaling pathways despite their distinct manifestations. Uncovering these commonalities could offer invaluable insights into disease pathogenesis, paving the way for more targeted and effective therapeutic interventions. This study embarks on a comprehensive investigation of the common genes and signaling pathways between SLE and DLBL.
Methods: The researchers scoured the Gene Expression Omnibus database, meticulously gathering microarray datasets for SLE (GSE61635) and DLBL (GSE56315). Differential expression analysis was performed, allowing the team to identify the genes that were commonly dysregulated across these 2 autoimmune conditions. To delve deeper into the biological significance of these shared genes, the researchers conducted functional enrichment analysis, network analysis, and core gene identification. Notably, the diagnostic potential of the identified hub genes was assessed using a cutting-edge neural network model.
Results: The data analysis revealed a remarkable 146 genes that were shared between SLE and DLBL, of which 111 were upregulated and 45 downregulated. Functional enrichment analysis unveiled the involvement of these shared genes in vital immune system-related processes—such as defense response to viruses, interferon signaling, and broader immune system pathways. Network analysis pinpointed 5 hub genes (IFIT3, IFIT1, DDX58, CCL2, and OASL) that emerged as central players, exhibiting a high degree of centrality and predicted to hold crucial roles in the underlying molecular mechanisms. Remarkably, the neural network model demonstrated exceptional diagnostic accuracy in distinguishing between the disease states (DLBL and SLE) based solely on the expression patterns of these hub genes.
Conclusion: The identified hub genes and their associated pathways hold immense potential as diagnostic biomarkers and may serve as valuable targets for future therapeutic explorations.
