Jan R. BoehnkeJul 29

This #CostUtilityAnalysis of 'academic detailing' to enhance naloxone distribution for opioid users (i) shows it potentially cost-effective at WTP of US$50,000 per #QALY and (ii) it used #UtilityScores developed from #NIDA shared data*
https://link.springer.com/article/10.1007/s40258-025-00991-8

#HealthEconomics #HRQL #HRQoL

* To develop these we used National Institute on Drug Abuse-published #RCT data
https://link.springer.com/article/10.1007/s11136-024-03729-6

To me an example how #DataSharing supports research for community infrastructure

#NIDA #Psychometrics

Enhancing Naloxone Distribution for Opioid Users in the USA: A Cost-Utility Analysis of Academic Detailing to Clinicians - Applied Health Economics and Health Policy

Background Opioid overdose remains a leading cause of mortality in the USA. Although distributing naloxone to laypersons for use during witnessed opioid overdoses has been shown to effectively reduce overdose deaths, clinician awareness of naloxone prescribing remains low. Academic detailing (AD) has been reported to be an effective strategy to increase naloxone distribution to individuals at risk of opioid-related overdose/death. Objective This study evaluated the cost effectiveness of an academic detailing program aimed at promoting naloxone prescribing for adults at risk of opioid-related overdose compared to no intervention (non-AD program). Methods A Markov model with an integrated decision tree was developed to estimate the costs and outcomes associated with the AD program over a lifetime horizon from the US payer perspective. Model robustness was tested using sensitivity and scenario analyses. Results The results indicated that the AD program incurred a total direct cost of US$6280 and achieved 16.52 quality-adjusted life years (QALYs). In comparison, the non-AD program incurred a total direct cost of US$5971 and achieved 15.92 QALYs. The incremental cost-effectiveness ratio for the AD program was US$514 per QALY gained with an incremental net monetary benefit of US$29,739. Sensitivity and scenario analyses confirmed the robustness of these findings, which suggest that AD is a cost-effective strategy for improving survival and quality of life in individuals at risk of opioid overdose. Conclusions For decision makers seeking to address the opioid crisis, implementing an academic detailing program represents a cost-effective option at a willingness-to-pay threshold of US$50,000 per QALY gained.

SpringerLink
AuscandocFeb 28, 2024
Impact of community mask mandates on SARS-CoV-2 transmission in Ontario after adjustment for differential testing by age and sex | PNAS Nexus | Oxford Academic https://academic.oup.com/pnasnexus/article/3/2/pgae065/7606553 “The prevented fraction associated with #MaskMandates was 46% (95% CI 41–51%), with 290,000 clinical #cases, 3,008 #deaths, and loss of 29,038 quality-adjusted life years (#QALY) averted from 2020 June to December, representing $CDN 610 million in economic wealth. (1/2)
Impact of community mask mandates on SARS-CoV-2 transmission in Ontario after adjustment for differential testing by age and sex

Abstract. Mask use for prevention of respiratory infectious disease transmission is not new but has proven controversial during the SARS-CoV-2 pandemic. In

OUP Academic
Stuart D NeilsonNov 20, 2023

The #neoliberals are winning over all parties. If [UK] #Labour see “#health and #workinprogress as two sides of the same coin" they are valuing people only by #economic activity. As inhumane as the #Conservative party.

Valuing people as economic input, and #disabled people as worth less, opens up greater abuse when health and social resources are determined by #QALY and #DALY (quality / disability adjusted life years) measures.

People are not economic property.

https://www.theguardian.com/politics/2023/nov/20/labour-would-treat-health-and-work-as-two-sides-of-same-coin-says-liz-kendall

Labour would treat health and work as ‘two sides of same coin’, says Liz Kendall

Exclusive: Shadow work and pensions secretary gives first interview in new role

The Guardian
Jan R. BoehnkeOct 10, 2023

October issue of Quality of Life Research #ISOQOL
https://link.springer.com/journal/11136/volumes-and-issues/32-10

Opens w a #ScopingReview of the use of the visual analogue scale for valuing #HealthStates, arguing that inconsistent design makes comparisons across studies challenging:
https://link.springer.com/article/10.1007/s11136-023-03411-3
#Psychometrics #HealthEconomics #QALY

Or read about the #EvidenceGap map for interventions for improving clinical outcomes and #HRQL for people living with skeletal dysplasias
https://link.springer.com/article/10.1007/s11136-023-03431-z

Quality of Life Research | Volume 32, issue 10

Volume 32, issue 10 articles listing for Quality of Life Research

SpringerLink
Jan R. BoehnkeJun 19, 2023

Last week "Quality of Life Research" published 4 articles, for example:

#QALY estimation in #MentalHealth trials w #PHQ9, #GAD7 to #ReQoL, EQ5D:
https://link.springer.com/article/10.1007/s11136-023-03443-9
#HTA #HealthEconomics

Experiences of adults after late repair of tetralogy of fallot in a low-middle income country (Pakistan):
https://rdcu.be/deQ1y
#HRQL #LMIC

Online first articles:
https://link.springer.com/journal/11136/online-first
#ISOQOL

Enabling QALY estimation in mental health trials and care settings: mapping from the PHQ-9 and GAD-7 to the ReQoL-UI or EQ-5D-5L using mixture models - Quality of Life Research

Purpose Patient-reported outcome measures (PROMs) are commonly collected in trials and some care settings, but preference-based PROMs required for economic evaluation are often missing. For these situations, mapping models are needed to predict preference-based (aka utility) scores. Our objective is to develop a series of mapping models to predict preference-based scores from two mental health PROMs: Patient Health Questionnaire-9 (PHQ-9; depression) and Generalised Anxiety Questionnaire-7 (GAD-7; anxiety). We focus on preference-based scores for the more physical-health-focussed EQ-5D (five-level England and US value set, and three-level UK cross-walk) and more mental-health-focussed Recovering Quality-of-Life Utility Index (ReQoL-UI). Methods We used trial data from the Improving Access to Psychological Therapies (IAPT) mental health services (now called NHS Talking Therapies), England, with a focus on people with depression and/or anxiety caseness. We estimated adjusted limited dependent variable or beta mixture models (ALDVMMs or Betamix, respectively) using GAD-7, PHQ-9, age, and sex as covariates. We followed ISPOR mapping guidance, including assessing model fit using statistical and graphical techniques. Results Over six data collection time-points between baseline and 12-months, 1340 observed values (N ≤ 353) were available for analysis. The best fitting ALDVMMs had 4-components with covariates of PHQ-9, GAD-7, sex, and age; age was not a probability variable for the final ReQoL-UI mapping model. Betamix had practical benefits over ALDVMMs only when mapping to the US value set. Conclusion Our mapping functions can predict EQ-5D-5L or ReQoL-UI related utility scores for QALY estimation as a function of variables routinely collected within mental health services or trials, such as the PHQ-9 and/or GAD-7.

SpringerLink
aztecladyMar 23, 2023

Via Matthew Cortland (@mattbc) , lawyer and health care advocate, on the proposed ban of Quality Adjusted Life Years (QALY):
Representative Cathy McMorris Rodgers has a good bill that would address a potentially significant source of ableism in medicine. House Democrats need to get on board.

#USPolitics #USHealthcare #QALY

https://www.patreon.com/posts/house-gop-on-77924727

Show threadChuck DarwinJan 14, 2023

@ff6600 @pvonhellermannn

#EffectiveAltruism

During #EA’s brief history, self-avowed effective altruists have tended to take as the objects of moral assessment particular actions, while also taking as their core #value the sort of well-being capturable by the metrics of welfare economics.

One instrument that some have recommended for assessing actions in terms of well-being is the quality-adjusted-life-year or #QALY, an economic metric for health programmes, which integrates measures of the value of extending individuals’ lives with measures of the quality of life over the relevant period, with one QALY standing for one year of life in perfect health

tripuJul 6, 2022

It feels great to stumble upon an #ACX post validating your own idea:

“I’m disappointed that no one has ever tried expanding the #QALY concept to things outside health care before. It’s not that I think it will work. It’s that I think it will fail to work in a different way than our naive opinions fail to work, and we might learn something from it.”

https://slatestarcodex.com/2013/05/02/if-its-worth-doing-its-worth-doing-with-made-up-statistics/

#ScottAlexander #SSC

If It’s Worth Doing, It’s Worth Doing With Made-Up Statistics

I do not believe that the utility weights I worked on last week – the ones that say living in North Korea is 37% as good as living in the First World – are objectively correct or corres…

Slate Star Codex
Show threadtripuJun 22, 2022

Ultimately, everything you do, don’t do, consume, use, avoid or covet should work towards that goal of maximising your #wellbeing or the well-being of others, right? What better unit than “QALY” for that?

“Currency” carries too much psychological and ideological baggage, and it keeps the spotlight in one very specific dimension (ie, money).

“Time” is better, but it ignores the vital distinction between time spent and time well spent (remember: it’s “live long and prosper” not just “live long”).

I know it sounds far-fetched right now, but a much more refined definition of #QALY could be used to estimate the expected value of all products, habits and public policies — and to measure their impact in hindsight.