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9 results on '"Ideo, G."'

1. Clinical outcome indicators in chronic hepatitis B and C: A primer for value-based medicine in hepatology

Author

Strazzabosco, M, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Cozzolino, P, Fornari, C, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Zavaglia, C, Perricone, G, Munari, L, Mantovani, L, Belli, L, Strazzabosco M., Cortesi P. A., Conti S., Okolicsanyi S., Rota M., Ciaccio A., Cozzolino P., Fornari C., Gemma M., Scalone L., Cesana G., Fabris L., Colledan M., Fagiuoli S., Ideo G., Zavaglia C., Perricone G., Munari L. M., Mantovani L. G., Belli L. S., Strazzabosco, M, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Cozzolino, P, Fornari, C, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Zavaglia, C, Perricone, G, Munari, L, Mantovani, L, Belli, L, Strazzabosco M., Cortesi P. A., Conti S., Okolicsanyi S., Rota M., Ciaccio A., Cozzolino P., Fornari C., Gemma M., Scalone L., Cesana G., Fabris L., Colledan M., Fagiuoli S., Ideo G., Zavaglia C., Perricone G., Munari L. M., Mantovani L. G., and Belli L. S.

Abstract

Background & Aims: Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver-specific clinical outcome indicators (COIs) able to assist both clinicians and administrators in improving the value of care are presently lacking. The Value-Based Medicine in Hepatology (VBMH) study aims to fill this gap, devising and testing a set of COIs for CLD, that could be easily collected during clinical practice. Here we report the COIs generated and recorded for patients with HBV or HCV infection at different stages of the disease. Methods/Results: In the first phase of VBMH study, COIs were identified, based on current international guidelines and literature, using a modified Delphi method and a RAND 9-point appropriateness scale. In the second phase, COIs were tested in an observational, longitudinal, prospective, multicentre study based in Lombardy, Italy. Eighteen COIs were identified for HBV and HCV patients. Patients with CLD secondary to HBV (547) or HCV (1391) were enrolled over an 18-month period and followed for a median of 4 years. The estimation of the proposed COIs was feasible in the real-word clinical practice and COI values compared well with literature data. Further, the COIs were able to capture the impact of new effective treatments like direct-acting antivirals (DAAs) in the clinical practice. Conclusions: The COIs efficiently measured clinical outcomes at different stages of CLDs. While specific clinical practice settings and related healthcare systems may modify their implementation, these indicators will represent an important component of the tools for a value-based approach in hepatology and will positively affect care delivery.

Published
2020

2. Impatto dei farmaci anti virali ad azione diretta sulla cura dei pazienti con epatite C: un approccio di value-based medicine

Author

Conti, S, Cortesi, P, Okolicsanyi, S, Rota, M, Ciaccio, A, Gemma, M, Scalone, L, Cesana, G, Cozzolino, P, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Garcia-Tsao, G, Belli, L, Munari, L, Mantovani, L, Strazzabosco, M, Conti S, Cortesi PA, Okolicsanyi S, Rota M, Ciaccio A, Gemma M, Scalone L, Cesana G, Cozzolino P, Fabris L, Colledan M, Fagiuoli S, Ideo G, Garcia-Tsao G, Belli LS, Munari LM, Mantovani LG, Strazzabosco M, Conti, S, Cortesi, P, Okolicsanyi, S, Rota, M, Ciaccio, A, Gemma, M, Scalone, L, Cesana, G, Cozzolino, P, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Garcia-Tsao, G, Belli, L, Munari, L, Mantovani, L, Strazzabosco, M, Conti S, Cortesi PA, Okolicsanyi S, Rota M, Ciaccio A, Gemma M, Scalone L, Cesana G, Cozzolino P, Fabris L, Colledan M, Fagiuoli S, Ideo G, Garcia-Tsao G, Belli LS, Munari LM, Mantovani LG, and Strazzabosco M

Published
2018

3. Impatto dei farmaci anti virali ad azione diretta sulla cura dei pazienti con epatite C: un approccio di value-based medicine

Author

Conti S, Cortesi PA, Okolicsanyi S, Rota M, Ciaccio A, Gemma M, Scalone L, Cesana G, Cozzolino P, Fabris L, Colledan M, Fagiuoli S, Ideo G, Garcia-Tsao G, Belli LS, Munari LM, Mantovani LG, Strazzabosco M, Conti, S, Cortesi, P, Okolicsanyi, S, Rota, M, Ciaccio, A, Gemma, M, Scalone, L, Cesana, G, Cozzolino, P, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Garcia-Tsao, G, Belli, L, Munari, L, Mantovani, L, and Strazzabosco, M

Subjects
MED/42 - IGIENE GENERALE E APPLICATA, MED/12 - GASTROENTEROLOGIA, epatite C, farmaci antivirali, value-based medicine, MED/01 - STATISTICA MEDICA
Published
2018

4. Applicazione della value-based medicine nella valutazione della cura dei pazienti affetti da epatite

Author

Fornari, C, Cortesi, PA, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Gemma, M, Scalone, L, Cesana, G, Cozzolino, P, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Garcia-Tsao, G, Belli, LS, Munari, LM, Mantovani, LG, Strazzabosco, M, Fornari, C, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Gemma, M, Scalone, L, Cesana, G, Cozzolino, P, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Garcia-Tsao, G, Belli, L, Munari, L, Mantovani, L, and Strazzabosco, M

Subjects
Value- based medicine, epatite B, epatite C
Published
2018

5. Optimising the clinical strategy for autoimmune liver diseases: Principles of value-based medicine

Author

Carbone, M, Cristoferi, L, Cortesi, P, Rota, M, Ciaccio, A, Okolicsanyi, S, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Belli, L, Munari, L, Mantovani, L, Strazzabosco, M, Cortesi, PA, Belli, LS, Munari, LM, Carbone, M, Cristoferi, L, Cortesi, P, Rota, M, Ciaccio, A, Okolicsanyi, S, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Belli, L, Munari, L, Mantovani, L, Strazzabosco, M, Cortesi, PA, Belli, LS, and Munari, LM

Abstract

Background: Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis represent the three major autoimmune liver diseases (AILDs). Their management is highly specialized, requires a multidisciplinary approach and often relies on expensive, orphan drugs. Unfortunately, their treatment is often unsatisfactory, and the care pathway heterogeneous across different centers. Disease-specific clinical outcome indicators (COIs) able to evaluate the whole cycle of care are needed to assist both clinicians and administrators in improving quality and value of care. Aim of our study was to generate a set of COIs for the three AILDs. We then prospectively validated these indicators based on a series of consecutive patients recruited at three tertiary clinical centers in Lombardy, Italy. Methods: In phase I using a Delphi method and a RAND 9-point appropriateness scale a set of COIs was generated. In phase II the indicators were applied in a real-life dataset. Results: Two-hundred fourteen patients were enrolled and followed-up for a median time of 54. months and the above COIs were recorded using a web-based electronic medical record program. The COIs were easy to collect in the clinical practice environment and their values compared well with the available natural history studies. Conclusions: We have generated a comprehensive set of COIs which sequentially capture different clinical outcome of the three AILDs explored. These indicators represent a critical tool to implement a value-based approach to patients with these conditions, to monitor, compare and improve quality through benchmarking of clinical performance and to assess the significance of novel drugs and technologies. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.

Published
2018

6. Optimising the clinical strategy for autoimmune liver diseases: Principles of value-based medicine

Author

Marta Gemma, Stefano Fagiuoli, Luca Fabris, Gaetano Ideo, Matteo Rota, Marco Carbone, Giancarlo Cesana, S. Okolicsanyi, Luca Maria Munari, Michele Colledan, A. Ciaccio, Paolo Cortesi, Luciana Scalone, Laura Cristoferi, Lorenzo G. Mantovani, Mario Strazzabosco, Luca S. Belli, Carbone, M, Cristoferi, L, Cortesi, P, Rota, M, Ciaccio, A, Okolicsanyi, S, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Belli, L, Munari, L, Mantovani, L, and Strazzabosco, M

Subjects
Male, 0301 basic medicine, Delphi Technique, Delphi method, Autoimmune hepatitis, Tertiary Care Centers, 0302 clinical medicine, MED/12 - GASTROENTEROLOGIA, Multidisciplinary approach, Outcome Assessment, Health Care, Prospective Studies, Incidence, Primary sclerosing cholangitis, Electronic medical record, Clinical performance, Benchmarking, Middle Aged, Primary sclerosing cholangiti, Hepatitis, Autoimmune, Italy, Primary biliary cholangiti, Value-based medicine, Critical Pathways, Molecular Medicine, Female, 030211 gastroenterology & hepatology, Adult, medicine.medical_specialty, Primary biliary cholangitis, Molecular Biology, MED/42 - IGIENE GENERALE E APPLICATA, Cholangitis, Sclerosing, Autoimmune hepatiti, Autoimmune Diseases, Orphan drug, 03 medical and health sciences, medicine, Humans, Intensive care medicine, MED/01 - STATISTICA MEDICA, Aged, Quality Indicators, Health Care, business.industry, medicine.disease, Survival Analysis, 030104 developmental biology, business, Follow-Up Studies
Abstract

Background Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis represent the three major autoimmune liver diseases (AILDs). Their management is highly specialized, requires a multidisciplinary approach and often relies on expensive, orphan drugs. Unfortunately, their treatment is often unsatisfactory, and the care pathway heterogeneous across different centers. Disease-specific clinical outcome indicators (COIs) able to evaluate the whole cycle of care are needed to assist both clinicians and administrators in improving quality and value of care. Aim of our study was to generate a set of COIs for the three AILDs. We then prospectively validated these indicators based on a series of consecutive patients recruited at three tertiary clinical centers in Lombardy, Italy. Methods In phase I using a Delphi method and a RAND 9-point appropriateness scale a set of COIs was generated. In phase II the indicators were applied in a real-life dataset. Results Two-hundred fourteen patients were enrolled and followed-up for a median time of 54 months and the above COIs were recorded using a web-based electronic medical record program. The COIs were easy to collect in the clinical practice environment and their values compared well with the available natural history studies. Conclusions We have generated a comprehensive set of COIs which sequentially capture different clinical outcome of the three AILDs explored. These indicators represent a critical tool to implement a value-based approach to patients with these conditions, to monitor, compare and improve quality through benchmarking of clinical performance and to assess the significance of novel drugs and technologies. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.

Published
2018

7. Clinical outcome indicators in chronic hepatitis B and C: A primer for value-based medicine in hepatology

Author

Carla Fornari, P Cozzolino, Luca Maria Munari, Matteo Rota, Giancarlo Cesana, Gaetano Ideo, Stefano Fagiuoli, Marta Gemma, Paolo Cortesi, Mario Strazzabosco, Claudio Zavaglia, Giovanni Perricone, A. Ciaccio, S. Okolicsanyi, Luciana Scalone, Luca Fabris, Sara Conti, Lorenzo G. Mantovani, Michele Colledan, Luca S. Belli, Strazzabosco, M, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Cozzolino, P, Fornari, C, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Zavaglia, C, Perricone, G, Munari, L, Mantovani, L, and Belli, L

Subjects
Liver Cirrhosis, Male, value-based Medicine, Hepatocellular carcinoma, Modified delphi, Decompensated cirrhosis, Disease, Value Based Medicine, Health problems, 0302 clinical medicine, Longitudinal Studies, Prospective Studies, Value-Based Health Insurance, Liver Neoplasms, Gastroenterology, Middle Aged, Clinical Practice, Treatment Outcome, Cirrhosis, Italy, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, clinical outcome indicator, Healthcare system, medicine.medical_specialty, Carcinoma, Hepatocellular, cirrhosis, clinical outcome indicators, decompensated cirrhosis, hepatocellular carcinoma, hepatology, macromolecular substances, Antiviral Agents, 03 medical and health sciences, Hepatitis B, Chronic, Chronic hepatitis, Internal medicine, parasitic diseases, medicine, Humans, Intensive care medicine, Aged, Quality Indicators, Health Care, Hepatology, business.industry, Clinical Outcome Indicators, decompensated cirrhosi, fungi, Hepatitis C, Chronic, Survival Analysis, Observational study, business, cirrhosi
Abstract

Background & Aims: Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver-specific clinical outcome indicators (COIs) able to assist both clinicians and administrators in improving the value of care are presently lacking. The Value-Based Medicine in Hepatology (VBMH) study aims to fill this gap, devising and testing a set of COIs for CLD, that could be easily collected during clinical practice. Here we report the COIs generated and recorded for patients with HBV or HCV infection at different stages of the disease. Methods/Results: In the first phase of VBMH study, COIs were identified, based on current international guidelines and literature, using a modified Delphi method and a RAND 9-point appropriateness scale. In the second phase, COIs were tested in an observational, longitudinal, prospective, multicentre study based in Lombardy, Italy. Eighteen COIs were identified for HBV and HCV patients. Patients with CLD secondary to HBV (547) or HCV (1391) were enrolled over an 18-month period and followed for a median of 4years. The estimation of the proposed COIs was feasible in the real-word clinical practice and COI values compared well with literature data. Further, the COIs were able to capture the impact of new effective treatments like direct-acting antivirals (DAAs) in the clinical practice. Conclusions: The COIs efficiently measured clinical outcomes at different stages of CLDs. While specific clinical practice settings and related healthcare systems may modify their implementation, these indicators will represent an important component of the tools for a value-based approach in hepatology and will positively affect care delivery.

Published
2019

8. Clinical outcome indicators in chronic hepatitis B and C: A primer for value-based medicine in hepatology.

Author

Strazzabosco M, Cortesi PA, Conti S, Okolicsanyi S, Rota M, Ciaccio A, Cozzolino P, Fornari C, Gemma M, Scalone L, Cesana G, Fabris L, Colledan M, Fagiuoli S, Ideo G, Zavaglia C, Perricone G, Munari LM, Mantovani LG, and Belli LS

Subjects
Aged, Carcinoma, Hepatocellular epidemiology, Female, Gastroenterology standards, Hepatitis B, Chronic complications, Hepatitis C, Chronic complications, Humans, Italy epidemiology, Liver Cirrhosis epidemiology, Liver Neoplasms epidemiology, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Survival Analysis, Treatment Outcome, Value-Based Health Insurance, Antiviral Agents therapeutic use, Hepatitis B, Chronic drug therapy, Hepatitis C, Chronic drug therapy, Quality Indicators, Health Care
Abstract

Background & Aims: Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver-specific clinical outcome indicators (COIs) able to assist both clinicians and administrators in improving the value of care are presently lacking. The Value-Based Medicine in Hepatology (VBMH) study aims to fill this gap, devising and testing a set of COIs for CLD, that could be easily collected during clinical practice. Here we report the COIs generated and recorded for patients with HBV or HCV infection at different stages of the disease., Methods/results: In the first phase of VBMH study, COIs were identified, based on current international guidelines and literature, using a modified Delphi method and a RAND 9-point appropriateness scale. In the second phase, COIs were tested in an observational, longitudinal, prospective, multicentre study based in Lombardy, Italy. Eighteen COIs were identified for HBV and HCV patients. Patients with CLD secondary to HBV (547) or HCV (1391) were enrolled over an 18-month period and followed for a median of 4 years. The estimation of the proposed COIs was feasible in the real-word clinical practice and COI values compared well with literature data. Further, the COIs were able to capture the impact of new effective treatments like direct-acting antivirals (DAAs) in the clinical practice., Conclusions: The COIs efficiently measured clinical outcomes at different stages of CLDs. While specific clinical practice settings and related healthcare systems may modify their implementation, these indicators will represent an important component of the tools for a value-based approach in hepatology and will positively affect care delivery., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2020
Full Text
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9. Optimising the clinical strategy for autoimmune liver diseases: Principles of value-based medicine.

Author

Carbone M, Cristoferi L, Cortesi PA, Rota M, Ciaccio A, Okolicsanyi S, Gemma M, Scalone L, Cesana G, Fabris L, Colledan M, Fagiuoli S, Ideo G, Belli LS, Munari LM, Mantovani L, and Strazzabosco M

Subjects
Adult, Aged, Autoimmune Diseases epidemiology, Cholangitis, Sclerosing epidemiology, Critical Pathways organization & administration, Delphi Technique, Female, Follow-Up Studies, Hepatitis, Autoimmune epidemiology, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Prospective Studies, Survival Analysis, Tertiary Care Centers statistics & numerical data, Autoimmune Diseases therapy, Cholangitis, Sclerosing therapy, Hepatitis, Autoimmune therapy, Outcome Assessment, Health Care methods, Quality Indicators, Health Care
Abstract

Background: Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis represent the three major autoimmune liver diseases (AILDs). Their management is highly specialized, requires a multidisciplinary approach and often relies on expensive, orphan drugs. Unfortunately, their treatment is often unsatisfactory, and the care pathway heterogeneous across different centers. Disease-specific clinical outcome indicators (COIs) able to evaluate the whole cycle of care are needed to assist both clinicians and administrators in improving quality and value of care. Aim of our study was to generate a set of COIs for the three AILDs. We then prospectively validated these indicators based on a series of consecutive patients recruited at three tertiary clinical centers in Lombardy, Italy., Methods: In phase I using a Delphi method and a RAND 9-point appropriateness scale a set of COIs was generated. In phase II the indicators were applied in a real-life dataset., Results: Two-hundred fourteen patients were enrolled and followed-up for a median time of 54months and the above COIs were recorded using a web-based electronic medical record program. The COIs were easy to collect in the clinical practice environment and their values compared well with the available natural history studies., Conclusions: We have generated a comprehensive set of COIs which sequentially capture different clinical outcome of the three AILDs explored. These indicators represent a critical tool to implement a value-based approach to patients with these conditions, to monitor, compare and improve quality through benchmarking of clinical performance and to assess the significance of novel drugs and technologies. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen., (Copyright © 2017. Published by Elsevier B.V.)

Published
2018
Full Text
View/download PDF

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