Search

Your search keyword '"Cortesi, P."' showing total 48 results
Start Over Author "Cortesi, P." Publisher elsevier bv
48 results on '"Cortesi, P."'

3. 51P Phase IB (Ph1b), MESOVAX clinical trial of pembrolizumab (P) and dendritic cell vaccine (DCvax) in advanced pleural and peritoneal mesothelioma (M): Preliminary results

Author

Ridolfi, L., primary, Delmonte, A., additional, De Rosa, F., additional, Azzali, I., additional, Gentili, G., additional, Petrini, M., additional, Pancisi, E., additional, Granato, A.M., additional, Bulgarelli, J., additional, Doglioni, C., additional, Burgio, M.A., additional, Ragonesi, M., additional, Stella, F., additional, Cortesi, P., additional, Casadei, C., additional, Garaffoni, M., additional, Barone, D., additional, and Guidoboni, M., additional

Published
2023
Full Text
View/download PDF

6. Dynamics and costs of patients with appropriate, Уtoo earlyФ and Уtoo lateФ surgery in low-risk Intraductal Papillary Mucinous Neoplasms

Author

Tamburrino, Domenico, primary, Cortesi, P., additional, Facchetti, R., additional, De Pretis, N., additional, Pérez-Cuadrado-Robles, E., additional, Uribarri-Gonzalez, L., additional, Ateeb, Z., additional, Belfiori, G., additional, Arcidiacono, P., additional, Massimo, F., additional, Mantovani, L., additional, Del Chiaro, M., additional, Laukkarinen, J., additional, Crippa, S., additional, and Capurso, G., additional

Published
2022
Full Text
View/download PDF

8. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, FAGIUOLI, STEFANO, Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, and FAGIUOLI, STEFANO

Abstract

Background and aims: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. Methods: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p <.0001). One-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. Lay summary: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities.

Published
2021

9. Liver transplant recipients with Covid-19: results from an Italian multicenter cohort

Author

Mazzarelli, C., primary, Viganò, R., additional, Perricone, G., additional, Merli, M., additional, Pasulo, L., additional, Invernizzi, F., additional, Bhoori, S., additional, Morelli, M.C., additional, Patrono, D., additional, Sandro, S. Di, additional, Cortesi, P., additional, Angrisani, D., additional, De Nicola, S., additional, Vangeli, M., additional, and Belli, L.S., additional

Published
2021
Full Text
View/download PDF

10. Radiotherapy as an Immunological Booster in Patients with Metastatic Melanoma or Renal Cell Carcinoma Treated with High-Dose Interleukin-2: Final Data

Author

Ridolfi, L., primary, Bulgarelli, J., additional, Petracci, E., additional, Pancisi, E., additional, Piccinini, C., additional, Granato, A., additional, Petrini, M., additional, Tazzari, M., additional, Ancarani, V., additional, Turci, L., additional, Gentili, G., additional, Valmorri, L., additional, Romeo, A., additional, De Giorgi, U.F.F., additional, Burgio, S.L., additional, Casadei, C., additional, Cortesi, P., additional, Lolli, C., additional, De Rosa, F., additional, and Guidoboni, M., additional

Published
2019
Full Text
View/download PDF

12. The percentage of patients with HCV infection in need of a liver transplant is rapidly declining while their survival after transplantation is improving: A study based on European liver transplant registry

Author

Perricone, G., primary, Mazzarelli, C., additional, Viganò, R., additional, Duvoux, C., additional, Cortesi, P., additional, Facchetti, R., additional, Vangeli, M., additional, Karam, V., additional, Adam, R., additional, Strazzabosco, M., additional, and Belli, L.S., additional

Published
2018
Full Text
View/download PDF

14. Impact of Direct Anti-Viral Agents on Inactivation/De-Listing of Liver Transplant Candidates Listed for Decompensated C Cirrhosis: A European Study

Author

Belli, L.S., primary, Berenguer, M., additional, Rockenschaub, S.-R., additional, Martini, S., additional, Morelli, C., additional, Donato, F., additional, Volpes, R., additional, Pageaux, G.-P., additional, Coilly, A., additional, Fagiuoli, S., additional, Cortesi, P., additional, and Duvoux, C., additional

Published
2016
Full Text
View/download PDF

32. Italy's health performance, 1990–2017: findings from the Global Burden of Disease Study 2017

Author

Monasta, L, Abbafati, C, Logroscino, G, Remuzzi, G, Perico, N, Bikbov, B, Tamburlini, G, Beghi, E, Traini, E, Boston Redford, S, Ariani, F, Borzì, AM, Bosetti, C, Carreras, G, Caso, V, Castelpietra, G, Cirillo, Massimo, Conti, S, Cortesi, PA, Damiani, G, D’Angiolella, LS, Fanzo, J, Farioli, A, Fornari, C, Gallus, S, Giussani, G, Gorini, G, Grosso, G, Guido, D, La Vecchia, C, Lauriola, P, Leonardi, M, Levi, M, Madotto, F, Mondello, S, Naldi, L, Olgiati, S, Palladino, Raffaele, Piccinelli, C, Piccininni, M, Pupillo, P, Raggi, A, Rubino, S, Santalucia, P, Vacante, M, Vidale, S, Violante, FS, Naghavi, M, and Ronfani, Monasta, L, Abbafati, C, Logroscino, G, Remuzzi, G, Perico, N, Bikbov, B, Tamburlini, G, Beghi, E, Traini, E, Boston Redford, S, Ariani, F, Borzì, Am, Bosetti, C, Carreras, G, Caso, V, Castelpietra, G, Cirillo, Massimo, Conti, S, Cortesi, Pa, Damiani, G, D’Angiolella, L, Fanzo, J, Farioli, A, Fornari, C, Gallus, S, Giussani, G, Gorini, G, Grosso, G, Guido, D, La, Vecchia, Lauriola, P, Leonardi, M, Levi, M, Madotto, F, Mondello, S, Naldi, L, Olgiati, S, Palladino, Raffaele, Piccinelli, C, Piccininni, M, Pupillo, P, Raggi, A, Rubino, S, Santalucia, P, Vacante, M, Vidale, S, Violante, F, Naghavi, M, And, Ronfani, GBD 2017 Italy Collaborators, Andrea Farioli, Francesco S. Violante, Monasta, L., Abbafati, C., Logroscino, G., Remuzzi, G., Perico, N., Bikbov, B., Tamburlini, G., Beghi, E., Traini, E., Redford, S. B., Ariani, F., Borzi, A. M., Bosetti, C., Carreras, G., Caso, V., Castelpietra, G., Cirillo, M., Conti, S., Cortesi, P. A., Damiani, G., D'Angiolella, L. S., Fanzo, J., Fornari, C., Gallus, S., Giussani, G., Gorini, G., Grosso, G., Guido, D., La Vecchia, C., Lauriola, P., Leonardi, M., Levi, M., Madotto, F., Mondello, S., Naldi, L., Olgiati, S., Palladino, R., Piccinelli, C., Piccininni, M., Pupillo, E., Raggi, A., Rubino, S., Santalucia, P., Vacante, M., Vidale, S., Violante, F. S., Naghavi, M., Ronfani, L., Redford, S, Borzì, A, Cirillo, M, Cortesi, P, D'Angiolella, L, La Vecchia, C, Palladino, R, Pupillo, E, and Ronfani, L

Subjects
Male, GBD 2017 Italy Collaborators, Health Status, Demographic transition, Disease, Global Health, 01 natural sciences, Global Burden of Disease, Health Statu, 0302 clinical medicine, Universal Health Insurance, Cause of Death, Health care, Medicine, 030212 general & internal medicine, Public, Environmental & Occupational Health, global burden of disease, Italy, health performance, health-care system, lcsh:Public aspects of medicine, Mortality rate, 1. No poverty, Italian health loss, 3. Good health, Female, TERRITORIES, Life Sciences & Biomedicine, Human, Population ageing, medicine.medical_specialty, Cost Control, Waiting Lists, GBD, 195 COUNTRIES, World Health Organization, Article, 03 medical and health sciences, Life Expectancy, SYSTEMATIC ANALYSIS, Delivery of Health Care, Humans, 0101 mathematics, Science & Technology, SEX-SPECIFIC MORTALITY, health care system, business.industry, DISABILITY, Public health, 010102 general mathematics, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, xxx, Years of potential life lost, Life expectancy, INJURIES, GBD Italy, business, Demography
Abstract

Summary Background Through a comprehensive analysis of Italy's estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we aimed to understand the patterns of health loss and response of the health-care system, and offer evidence-based policy indications in light of the demographic transition and government health spending in the country. Methods Estimates for Italy were extracted from GBD 2017. Data on Italy are presented for 1990 and 2017, on prevalence, causes of death, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth and at age 65 years, healthy life expectancy, and Healthcare Access and Quality (HAQ) Index. We compared the estimates for Italy with those of 15 other western European countries. Findings The quality of the universal health system and healthy behaviours contribute to favourable overall health, even in comparison with other western European countries. In 2017, life expectancy and HAQ Index score in Italy were among the highest globally, with life expectancy at birth reaching 85·3 years for females and 80·8 for males in 2017, ranking Italy eighth globally for females and sixth for males, and an HAQ Index score of 94·9 in 2016 compared with 81·54 in 1990, keeping Italy ranked as ninth globally. Between 1990 and 2017 age-standardised death rates for cardiovascular diseases decreased by 53·7% (95% uncertainty interval −56·1 to −51·4), for neoplasms decreased by 28·2% (−32·3 to −24·6), and for transport injuries decreased by 62·1% (−64·6 to −59·2). However, population ageing is causing an increase in the burden of specific diseases, such as Alzheimer's disease and other dementias (DALYs increased by 77·9% [68·4 to 87·2]) and pancreatic (DALYs increased by 39·7% [28·4 to 51·7]) and uterine cancers (DALYs increased by 164·7% [129·7 to 202·5]). Behavioural risk factors, which are potentially modifiable, still have a strong effect, particularly on cardiovascular diseases and neoplasms. For instance, in 2017, 44 400 (41 200 to 47 800) cancer deaths were attributed to smoking, 12 000 (9600 to 14 800) to alcohol use, and 9500 (5400 to 14 200) to high body-mass index, while 47 000 (31 100 to 65 700) deaths due to cardiovascular diseases could be attributed to high LDL cholesterol, 28 700 (19 700 to 38 500) to diets low in whole grains, and 15 900 (8500 to 24 900) to low physical activity. Interpretation Italy provides an interesting example of the results that can be achieved by a mix of relatively healthy lifestyles and a universal health system. Two main issues require attention, population ageing and gradual decrease of public health financing, which both pose several challenges to the future of Italy's health status. Our findings should be useful to Italy's policy makers and health system experts elsewhere. Funding Bill & Melinda Gates Foundation.

Published
2019

33. Real-world costs and dynamics of surveillance in patients who underwent surgery for low-risk branch duct intraductal papillary mucinous neoplasms

Author

Domenico Tamburrino, Paolo Cortesi, Rita Facchetti, Nicolò de Pretis, Enrique Pérez-Cuadrado-Robles, Laura Uribarri-Gonzalez, Zeeshan Ateeb, Giulio Belfiori, Paolo Giorgio Arcidiacono, Lorenzo Giovanni Mantovani, Marco Del Chiaro, Johanna Laukkarinen, Massimo Falconi, Stefano Crippa, Gabriele Capurso, Tamburrino, D, Cortesi, P, Facchetti, R, de Pretis, N, Perez-Cuadrado-Robles, E, Uribarri-Gonzalez, L, Ateeb, Z, Belfiori, G, Arcidiacono, P, Mantovani, L, Del Chiaro, M, Laukkarinen, J, Falconi, M, Crippa, S, and Capurso, G

Subjects
Oncology, Branch-duct IPNM, Cost-effectivene, Intraductal papillary mucinous neoplasm, Pancreatic surgery, Pancrea, Cost-effectiveness, Surgery, General Medicine, Pancreas, EUS, Pancreatic cystic neoplasm
Abstract

Surveillance costs and appropriateness of surgery of "low-risk" BD-IPMNs are relevant issues. In this study we evaluated the rate of correct indication for pancreatectomy defined as high grade dysplasia (HGD) at histology in 961 patients who underwent surveillance for a median of 5.1 years. Undertreatment and overtreatment were defined as invasive cancer and low grade dysplasia (LGD) at histology, respectively. Of the 66 patients (6.9%) who were operated, only 16 (23.8%) had a HGD while 40 (59.7%) had a LGD and 10 (14.9%) an invasive cancer, without differences regarding timing of surgery. The mean surveillance cost was € 194.9 ± 107.6 per patient-year, with a median cost of € 277.1 ± 148.2 in the correct surgery group compared with € 222.7 ± 111.6 and € 197 ± 102.7 in the overtreatment and undertreatment groups. The surveillance mean cost from diagnosis to surgery was € 854.8. Rate of appropriate surgery in BD-IPMNs under surveillance is low.

Published
2023

34. The value of wearable cardioverter defibrillator in adult patients with recent myocardial infarction: Economic and clinical implications from a health technology assessment perspective

Author

Giovanni Luca Botto, Lorenzo Giovanni Mantovani, Paolo Angelo Cortesi, Roberto De Ponti, Antonio D'Onofrio, Mauro Biffi, Alessandro Capucci, Gavino Casu, Pasquale Notarstefano, Marco Scaglione, Gabriele Zanotto, Giuseppe Boriani, Botto, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Biffi, M, Capucci, A, Casu, G, Notarstefano, P, Scaglione, M, Zanotto, G, and Boriani, G

Subjects
Adult, Quality of life, Technology Assessment, Biomedical, MED/42 - IGIENE GENERALE E APPLICATA, Electric Countershock, Defibrillators, Implantable, Wearable Electronic Devices, Myocardial infarction, Sudden cardiac death, Death, Sudden, Cardiac, Cost-effectivene, Humans, Cost-effectiveness, Health technology assessment, Wearable cardioverter defibrillator, Cardiology and Cardiovascular Medicine, Defibrillators
Abstract

Aims: Sudden cardiac death (SCD) causes high mortality and substantial societal burdens for healthcare systems (HSs). The risk of SCD is significantly increased in patients with reduced left ventricular ejection fraction after myocardial infarction (MI). Current guidelines recommend re-evaluation of cardioverter-defibrillator implantation 40 days post-MI, earliest. Medical therapy alone does not provide sufficient protection against SCD, especially in the first month post-MI, and needs time. Consequently, there is a gap in care of high-risk patients upon hospital discharge. The wearable cardioverter defibrillator (WCD) is a proven safe, effective therapy, which temporarily protects from SCD. Little information on WCD cost-effectiveness exists. We conducted this research to demonstrate the medical need of the device in the post-MI setting defining WCD cost-effectiveness. Methods & results: Based on a randomized clinical trials (RCTs) and Italian and international data, we developed a Markov-model comparing costs, patient survival, and quality-of-life, and calculated the Incremental Cost-Effectiveness Ratio (ICER) of a WCD vs. current standard of care in post-MI patients. The rather conservative base case analysis – based on the RCT intention-to-treat results - produced an ICER of €47,709 per Quality Adjusted Life Year (QALY) gained, which is far lower than the accepted threshold of €60,000 in the Italian National HS. The ICER per Life Year (LY) gained was €38,276. Conclusion: WCD utilization in post-MI patients is clinically beneficial and cost-effective. While improving guideline directed patient care, the WCD can also contribute to a more efficient use of resources in the Italian HS, and potentially other HSs as well.

Published
2022

35. Costs and effects of cardiovascular risk reclassification using the ankle-brachial index (ABI) in addition to the Framingham risk scoring in women

Author

Giampiero Mazzaglia, Paolo Cortesi, Lorenzo G. Mantovani, Ippazio Cosimo Antonazzo, Alessandro Maloberti, Mariangela Micale, Cristina Giannattasio, Federica Pagliarin, Cortesi, P, Maloberti, A, Micale, M, Pagliarin, F, Antonazzo, I, Mazzaglia, G, Giannattasio, C, and Mantovani, L

Subjects
0301 basic medicine, medicine.medical_specialty, animal structures, Index (economics), Cost effectiveness, Population, Psychological intervention, Disease, 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Risk groups, Risk Factors, Humans, Medicine, Ankle Brachial Index, education, education.field_of_study, Framingham Risk Score, business.industry, Cardiovascular disease, 030104 developmental biology, medicine.anatomical_structure, Cardiovascular Diseases, Heart Disease Risk Factors, Cost-effectivene, Peripheral vascular disease, Physical therapy, Female, Risk factor, Ankle, Cardiology and Cardiovascular Medicine, business
Abstract

Background and aims Ankle brachial index (ABI) is a simple and cheap parameter to assess the presence of atherosclerosis. It could also help correctly reclassify the cardiovascular risk when added to the Framingham risk score (FRS). Recent evidence has demonstrated improvement in prediction performance of ABI when added to FRS, particularly in women. However, no studies have been published yet evaluating the cost-effectiveness of this approach. This study attempts to fill in this gap by assessing the cost-effectiveness of ABI measurements in primary prevention in women. Methods We developed a Markov model to compare two different strategies for assessing the cardiovascular risk (low, intermediate and high) among women in the general population: 1) FRS strategy, and 2) FRS + ABI strategy; and the relative impact associated with interventions for preventing CV events in intermediate and high-risk categories. Results In the base-case analysis, FRS + ABI reported an additional cost of € 110 and a gain of 0.0039 QALYs per patient, resulting in an ICER of € 27.986/QALY, when compared to FRS alone. The ICER improved to €1.641/QALY when using a lifetime horizon. The effectiveness of preventive CV disease interventions reported also a significant impact. A 32% reduction of CV events was the minimum value estimated to maintain FRS + ABI as a cost-effective strategy. Conclusions The addition of ABI to FRS is a cost-effective approach in women classified at low and intermediate risk with FRS only. This new approach gives the possibility to reclassify and allocate them into the appropriate risk group and treatment.

Published
2021

36. 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

37. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Miloud Taki Eddine, Aichour, Amani Nidhal, Aichour, Ibtihel, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bicer, Burcu Kucuk, Bienhoff, Kelly, Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert R A, Brainin, Michael, Brayne, Carol, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair R, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Campos-Nonato, Ismael Ricardo, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castañeda-Orjuela, Carlos A, Castle, Chris D, Catalá-López, Ferrán, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, Cyrus, Cortesi, Paolo Angelo, Cortinovis, Monica, Criqui, Michael H, Cromwell, Elizabeth A, Cross, Marita, Crump, John A, Dadi, Abel Fekadu, Dalal, Koustuv, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, das Neves, José, Davitoiu, Dragos V, Davletov, Kairat, de Courten, Barbora, De Leo, Diego, De Steur, Hans, Defo, Barthelemy Kuate, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Dicker, Daniel, Djalainia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E Ray, dos Santos, Kadine Priscila Bender, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E, Echko, Michelle, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshetie, Setegn, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fanuel, Fanuel Belayneh Bekele, Farag, Tamer, Farinha, Carla Sofia e Sa, Faro, André, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, João C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Franklin, Richard C, Frostad, Joseph J, Fullman, Nancy, Fürst, Thomas, Furtado, Joao M, Futran, Neal D, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M, Geleto, Ayele, Gemechu, Bikila Lencha, Gesesew, Hailay Abrha, Gething, Peter W, Ghajar, Alireza, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W, Goel, Kashish, Goenka, Shifalika, Goldberg, Ellen M, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Goulart, Alessandra Carvalho, Graetz, Nicholas, Gugnani, Harish Chander, Gupta, Prakash C, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Gupta, Rahul, Gutiérrez, Reyna A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Hareri, Habtamu Abera, Haro, Josep Maria, Harun, Kimani M, Harvey, James, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Hay, Simon I, Hay, Roderick J, Hedayati, Mohammad T, Hendrie, Delia, Henry, Nathaniel J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Hoffman, Howard J, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, John J, Huynh, Chantal, Iburg, Kim Moesgaard, Igumbor, Ehimario Uche, Ikeda, Chad, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jassal, Simerjot K, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Kar, Chittaranjan, Karam, Nadim E, Karch, André, Karema, Corine Kakizi, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassa, Getachew Mullu, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Kastor, Anshul, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah T, Khosravi, Ardeshir, Khubchandani, Jagdish, Kiadaliri, Aliasghar Ahmad, Kieling, Christian, Kim, Yun Jin, Kim, Daniel, Kimokoti, Ruth W, Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna A, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krohn, Kristopher J, Kumar, G Anil, Kumar, Pushpendra, Kyu, Hmwe H, Lager, Anton Carl Jonas, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lambert, Nkurunziza, Lan, Qing, Lansingh, Van C, Larsson, Anders, Leasher, Janet L, Lee, Paul H, Leigh, James, Leshargie, Cheru Tesema, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S, Linn, Shai, Liu, Patrick Y, Liu, Angela, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Looker, Katharine J, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Timothy C D, Lunevicius, Raimundas, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Maddison, Emilie R, Magdy Abd El Razek, Hassan Magdy Abd, Magdy Abd El Razek, Mohammed, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Mamun, Abdullah A, Manguerra, Helena, Manhertz, Treh, Mantovani, Lorenzo G, Mapoma, Chabila C, March, Lyn M, Marczak, Laurie B, Martinez-Raga, Jose, Martins, Paulo Henrique Viegas, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, März, Winfried, Mathur, Manu Raj, Mazidi, Mohsen, McAlinden, Colm, McGaughey, Madeline, McGrath, John J, McKee, Martin, Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mengesha, Melkamu Merid, Mengistie, Mubarek Abera, Mengistu, Desalegn Tadese, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Mezgebe, Haftay Berhane, Micha, Renata, Millear, Anoushka, Miller, Ted R, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke, Mishra, Shiva Raj, Mitchell, Philip B, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Muktar Sano Kedir, Mohammed, Kedir Endris, Mohammed, Shafiu, Mohan, Murali B V, Mokdad, Ali H, Mollenkopf, Sarah K, Monasta, Lorenzo, Montañez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Mori, Rintaro, Morrison, Shane D, Moses, Mark, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Mueller, Ulrich O, Muller, Kate, Murdoch, Michele E, Murray, Christopher J L, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Naidoo, Kovin S, Nangia, Vinay, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negasa, Dumessa Edessa, Negoi, Ruxandra Irina, Negoi, Ionut, Newton, Charles R, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Trang Huyen, Nguyen, Grant, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Norheim, Ole F, Norrving, Bo, Noubiap, Jean Jacques N, Nyandwi, Alypio, Obermeyer, Carla Makhlouf, O'Donnell, Martin J, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olagunju, Tinuke Oluwasefunmi, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Osgood-Zimmerman, Aaron, Osman, Majdi, Ota, Erika, Owolabi, Mayowa O, PA, Mahesh, Pacella, Rosana E, Panda, Basant Kumar, Pandian, Jeyaraj Durai, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Parsaeian, Mahboubeh, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pearce, Neil, Pereira, David M, Perez, Krystle Marie, Perico, Norberto, Pesudovs, Konrad, Peterson, Carrie Beth, Petri, William Arthur, Petzold, Max, Phillips, Michael Robert, Phipps, Geoffrey, Pigott, David M, Pillay, Julian David, Pinho, Christine, Piradov, Michael A, Plass, Dietrich, Pletcher, Martin A, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Narayan, Purcell, Carrie, Purwar, Manorama, Qorbani, Mostafa, Quintanilla, Beatriz Paulina Ayala, Rabiee, Rynaz H S, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahman, Mahfuzar, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rankin, Zane, Rao, Paturi Vishnupriya, Rao, Puja C, Rawaf, Salman, Ray, Sarah E, Reiner, Robert C, Reinig, Nikolas, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Satar, Ribeiro, Antonio L, Rivas, Jacqueline Castillo, Roba, Hirbo Shore, Robinson, Stephen R, Rojas-Rueda, David, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Ruhago, George Mugambage, Saadat, Soheil, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salama, Joseph, Saleh, Muhammad Muhammad, Salomon, Joshua A, Salvi, Sundeep Santosh, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolores, Santomauro, Damian, Santos, João Vasco, Santos, Itamar S, Santric Milicevic, Milena M, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Saxena, Sonia, Schelonka, Kathryn, Schmidt, Maria Inês, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shaheen, Amira, Shaikh, Masood Ali, Shamsipour, Mansour, Sharma, Rajesh, Sharma, Jayendra, She, Jun, Shi, Peilin, Shibuya, Kenji, Shields, Chloe, Shifa, Girma Temam, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shirude, Shreya, Shishani, Kawkab, Shoman, Haitham, Siabani, Soraya, Sibai, Abla Mehio, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santos, Silva, João Pedro, Silveira, Dayane Gabriele Alves, Singh, Jasvinder A, Singh, Om Prakash, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Slepak, Erica Leigh, Smith, David L, Smith, Mari, Sobaih, Badr H A, Sobngwi, Eugene, Soljak, Michael, Sorensen, Reed J D, Sousa, Tatiane Cristina Moraes, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steel, Nicholas, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Stovner, Lars Jacob, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Sylte, Dillon, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Taffere, Getachew Redae, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tarekegn, Yihunie L, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Terkawi, Abdullah Sulieman, Tesfaye, Dawit Jember, Tesssema, Belay, Thakur, JS, Thamsuwan, Ornwipa, Theadom, Alice M, Theis, Andrew M, Thomas, Katie E, Thomas, Nihal, Thompson, Robert, Thrift, Amanda G, Tobe-Gai, Ruoyan, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Touvier, Mathilde, Traebert, Jefferson, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thomas, Tsoi, Derrick, Tuzcu, Emin Murat, Tymeson, Hayley, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J, Venkatesh, S, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Violante, Francesco S, Vishnu, Abhishek, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wijeratne, Tissa, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Woolf, Anthony D, Workicho, Abdulhalik, Xavier, Denis, Xu, Gelin, Yadgir, Simon, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Ye, Pengpeng, Yihdego, Mahari Gidey, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zhang, Xueying, Zheng, Yingfeng, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, Viðskiptadeild (HR), School of Business (RU), Háskólinn í Reykjavík, Reykjavik University, Cell biology, Hematology, Neurology, Simon, I, Hay, Amanuel, Alemu, Abajobir, Kalkidan, Hassen, Abate, Cristiana, Abbafati, Kaja, M, Abbas, Foad, Abd Allah, Abdishakur, M, Abdulle, Teshome, Abuka, Abebo, Semaw, Ferede, Abera, Victor, Aboyan, Laith, J, Abu, Raddad, Ilana, N, Ackerman, Isaac, A, Adedeji, Olatunji, Adetokunboh, Ashkan, Afshin, Rakesh, Aggarwal, Sutapa, Agrawal, Anurag, Agrawal, Aliasghar, Ahmad, Kiadaliri, Muktar, Beshir, Ahmed, Amani, Nidhal, Aichour, Ibtihel, Aichour, Miloud, Taki, Eddine, Aichour, Sneha, Aiyar, Tomi, F, Akinyemiju, Nadia, Akseer, Faris, Hasan, Al, Lami, Fares, Alahdab, Ziyad, Al Aly, Khurshid, Alam, Noore, Alam, Tahiya, Alam, Deena, Alasfoor, Kefyalew, Addi, Alene, Raghib, Ali, Reza, Alizadeh Navaei, Juma, M, Alkaabi, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Fatma, Al Maskari, Mohammad, Abdulaziz, Almazroa, Rajaa, Al Raddadi, Ubai, Alsharif, Shirina, Alsowaidi, Benjamin, M, Althouse, Khalid, A, Altirkawi, Nelson, Alvis Guzman, Azmeraw, T, Amare, Erfan, Amini, Walid, Ammar, Yaw, Ampem, Amoako, Mustafa, Geleto, Ansha, Carl, Abelardo, T, Antonio, Palwasha, Anwari, Johan, Ärnlöv, Megha, Arora, Al, Artaman, Krishna, Kumar, Aryal, Solomon, W, Asgedom, Tesfay, Mehari, Atey, Niguse, Tadele, Atnafu, Leticia, Avila Burgo, Euripide, Frinel, G, Arthur, Avokpaho, Ashish, Awasthi, Shally, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Mahmoud, Reza, Azarpazhooh, Peter, Azzopardi, Tesleem, Kayode, Babalola, Umar, Bacha, Alaa, Badawi, Kalpana, Balakrishnan, Marlena, S, Bannick, Aleksandra, Barac, Suzanne, L, Barker, Collo, Till, Bärnighausen, Simon, Barquera, Lope, H, Barrero, Sanjay, Basu, Robert, Battista, Katherine, E, Battle, Bernhard, T, Baune, Shahrzad, Bazargan Hejazi, Justin, Beardsley, Neeraj, Bedi, Yannick, Béjot, Bayu, Begashaw, Bekele, Michelle, L, Bell, Derrick, A, Bennett, Jame, R, Bennett, Isabela, M, Bensenor, Jennifer, Benson, Adugnaw, Berhane, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Balem, Demtsu, Betsu, Mircea, Beuran, Addisu, Shunu, Beyene, Anil, Bhansali, Samir, Bhatt, Zulfiqar, A, Bhutta, Sibhatu, Biadgilign, Kelly, Bienhoff, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Donal, Bisanzio, Habtamu, Mellie, Bizuayehu, Fiona, M, Blyth, Dube, Jara, Boneya, Dipan, Bose, Ibrahim, R, Bou, Orm, Rupert, R, A, Bourne, Michael, Brainin, Carol, E, G, Brayne, Alexandra, Brazinova, Nicholas, J, K, Breitborde, Paul, S, Briant, Gabrielle, Britton, Traolach, S, Brugha, Rachelle, Buchbinder, Lemma, Negesa, Bulto, Bulto, Blair, Bumgarner, Zahid, A, Butt, Lucero, Cahuana Hurtado, Ewan, Cameron, Ismael, Ricardo, Campos, Nonato, Hélène, Carabin, Rosario, Cárdena, David, O, Carpenter, Juan, Jesus, Carrero, Austin, Carter, Felix, Carvalho, Daniel, Casey, Carlos, A, Castañeda, Orjuela, Jacqueline, Castillo, Rivas, Chri, D, Castle, Ferrán, Catalá López, Jung Chen, Chang, Fiona, J, Charlson, Pankaj, Chaturvedi, Honglei, Chen, Mirriam, Chibalabala, Chioma, Ezinne, Chibueze, Vesper, Hichilombwe, Chisumpa, Abdulaal, A, Chitheer, Rajiv, Chowdhury, Devasahayam, Jesuda, Christopher, Liliana, G, Ciobanu, Cirillo, Massimo, Danny, Colombara, Leslie, Trumbull, Cooper, Medical Research Council (MRC), Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Miloud Taki Eddine, Aichour, Amani Nidhal, Aichour, Ibtihel, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fare, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addi, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, Françoi, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bicer, Burcu Kucuk, Bienhoff, Kelly, Bikbov, Bori, Birungi, Charle, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert R A, Brainin, Michael, Brayne, Carol, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair R, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Campos-Nonato, Ismael Ricardo, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesu, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castañeda-Orjuela, Carlos A, Castle, Chris D, Catalá-López, Ferrán, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesuda, Ciobanu, Liliana G, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, Cyru, Cortesi, Paolo Angelo, Cortinovis, Monica, Criqui, Michael H, Cromwell, Elizabeth A, Cross, Marita, Crump, John A, Dadi, Abel Fekadu, Dalal, Koustuv, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, das Neves, José, Davitoiu, Dragos V, Davletov, Kairat, de Courten, Barbora, De Leo, Diego, De Steur, Han, Defo, Barthelemy Kuate, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Dicker, Daniel, Djalainia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E Ray, dos Santos, Kadine Priscila Bender, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E, Echko, Michelle, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshetie, Setegn, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fanuel, Fanuel Belayneh Bekele, Farag, Tamer, Farinha, Carla Sofia e Sa, Faro, André, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, João C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Franklin, Richard C, Frostad, Joseph J, Fullman, Nancy, Fürst, Thoma, Furtado, Joao M, Futran, Neal D, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M, Geleto, Ayele, Gemechu, Bikila Lencha, Gesesew, Hailay Abrha, Gething, Peter W, Ghajar, Alireza, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W, Goel, Kashish, Goenka, Shifalika, Goldberg, Ellen M, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Goulart, Alessandra Carvalho, Graetz, Nichola, Gugnani, Harish Chander, Gupta, Prakash C, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Gupta, Rahul, Gutiérrez, Reyna A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Hareri, Habtamu Abera, Haro, Josep Maria, Harun, Kimani M, Harvey, Jame, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmu, Hay, Simon I, Hay, Roderick J, Hedayati, Mohammad T, Hendrie, Delia, Henry, Nathaniel J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Hoffman, Howard J, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, John J, Huynh, Chantal, Iburg, Kim Moesgaard, Igumbor, Ehimario Uche, Ikeda, Chad, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jassal, Simerjot K, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Kar, Chittaranjan, Karam, Nadim E, Karch, André, Karema, Corine Kakizi, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassa, Getachew Mullu, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Kastor, Anshul, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah T, Khosravi, Ardeshir, Khubchandani, Jagdish, Kiadaliri, Aliasghar Ahmad, Kieling, Christian, Kim, Yun Jin, Kim, Daniel, Kimokoti, Ruth W, Kinfu, Yohanne, Kisa, Adnan, Kissimova-Skarbek, Katarzyna A, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krohn, Kristopher J, Kumar, G Anil, Kumar, Pushpendra, Kyu, Hmwe H, Lager, Anton Carl Jona, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lambert, Nkurunziza, Lan, Qing, Lansingh, Van C, Larsson, Ander, Leasher, Janet L, Lee, Paul H, Leigh, Jame, Leshargie, Cheru Tesema, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S, Linn, Shai, Liu, Patrick Y, Liu, Angela, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Looker, Katharine J, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Timothy C D, Lunevicius, Raimunda, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Maddison, Emilie R, Magdy Abd El Razek, Hassan Magdy Abd, Magdy Abd El Razek, Mohammed, Magis-Rodriguez, Carlo, Mahdavi, Mahdi, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Mamun, Abdullah A, Manguerra, Helena, Manhertz, Treh, Mantovani, Lorenzo G, Mapoma, Chabila C, March, Lyn M, Marczak, Laurie B, Martinez-Raga, Jose, Martins, Paulo Henrique Viega, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, März, Winfried, Mathur, Manu Raj, Mazidi, Mohsen, McAlinden, Colm, McGaughey, Madeline, McGrath, John J, McKee, Martin, Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mengesha, Melkamu Merid, Mengistie, Mubarek Abera, Mengistu, Desalegn Tadese, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Mezgebe, Haftay Berhane, Micha, Renata, Millear, Anoushka, Miller, Ted R, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke, Mishra, Shiva Raj, Mitchell, Philip B, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Muktar Sano Kedir, Mohammed, Kedir Endri, Mohammed, Shafiu, Mohan, Murali B V, Mokdad, Ali H, Mollenkopf, Sarah K, Monasta, Lorenzo, Montañez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Mori, Rintaro, Morrison, Shane D, Moses, Mark, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Mueller, Ulrich O, Muller, Kate, Murdoch, Michele E, Murray, Christopher J L, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Sriniva, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Naidoo, Kovin S, Nangia, Vinay, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negasa, Dumessa Edessa, Negoi, Ruxandra Irina, Negoi, Ionut, Newton, Charles R, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Trang Huyen, Nguyen, Grant, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Norheim, Ole F, Norrving, Bo, Noubiap, Jean Jacques N, Nyandwi, Alypio, Obermeyer, Carla Makhlouf, O'Donnell, Martin J, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olagunju, Tinuke Oluwasefunmi, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Osgood-Zimmerman, Aaron, Osman, Majdi, Ota, Erika, Owolabi, Mayowa O, PA, Mahesh, Pacella, Rosana E, Panda, Basant Kumar, Pandian, Jeyaraj Durai, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Parsaeian, Mahboubeh, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pearce, Neil, Pereira, David M, Perez, Krystle Marie, Perico, Norberto, Pesudovs, Konrad, Peterson, Carrie Beth, Petri, William Arthur, Petzold, Max, Phillips, Michael Robert, Phipps, Geoffrey, Pigott, David M, Pillay, Julian David, Pinho, Christine, Piradov, Michael A, Plass, Dietrich, Pletcher, Martin A, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Narayan, Purcell, Carrie, Purwar, Manorama, Qorbani, Mostafa, Quintanilla, Beatriz Paulina Ayala, Rabiee, Rynaz H S, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahman, Mahfuzar, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rankin, Zane, Rao, Paturi Vishnupriya, Rao, Puja C, Rawaf, Salman, Ray, Sarah E, Reiner, Robert C, Reinig, Nikola, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Satar, Ribeiro, Antonio L, Rivas, Jacqueline Castillo, Roba, Hirbo Shore, Robinson, Stephen R, Rojas-Rueda, David, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Ruhago, George Mugambage, Saadat, Soheil, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salama, Joseph, Saleh, Muhammad Muhammad, Salomon, Joshua A, Salvi, Sundeep Santosh, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, João Vasco, Santos, Itamar S, Santric Milicevic, Milena M, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Saxena, Sonia, Schelonka, Kathryn, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shaheen, Amira, Shaikh, Masood Ali, Shamsipour, Mansour, Sharma, Rajesh, Sharma, Jayendra, She, Jun, Shi, Peilin, Shibuya, Kenji, Shields, Chloe, Shifa, Girma Temam, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shirude, Shreya, Shishani, Kawkab, Shoman, Haitham, Siabani, Soraya, Sibai, Abla Mehio, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santo, Silva, João Pedro, Silveira, Dayane Gabriele Alve, Singh, Jasvinder A, Singh, Om Prakash, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Slepak, Erica Leigh, Smith, David L, Smith, Mari, Sobaih, Badr H A, Sobngwi, Eugene, Soljak, Michael, Sorensen, Reed J D, Sousa, Tatiane Cristina Morae, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steel, Nichola, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Stovner, Lars Jacob, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Sylte, Dillon, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Taffere, Getachew Redae, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tarekegn, Yihunie L, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Terkawi, Abdullah Sulieman, Tesfaye, Dawit Jember, Tesssema, Belay, Thakur, J.S., Thamsuwan, Ornwipa, Theadom, Alice M, Theis, Andrew M, Thomas, Katie E, Thomas, Nihal, Thompson, Robert, Thrift, Amanda G, Tobe-Gai, Ruoyan, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Touvier, Mathilde, Traebert, Jefferson, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thoma, Tsoi, Derrick, Tuzcu, Emin Murat, Tymeson, Hayley, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J, Venkatesh, S., Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Violante, Francesco S, Vishnu, Abhishek, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wijeratne, Tissa, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Woolf, Anthony D, Workicho, Abdulhalik, Xavier, Deni, Xu, Gelin, Yadgir, Simon, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Ye, Pengpeng, Yihdego, Mahari Gidey, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zhang, Xueying, Zheng, Yingfeng, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, Abajobir, A, Abate, K, Abbafati, C, Abbas, K, Abd-Allah, F, Abdulkader, R, Abdulle, A, Abebo, T, Abera, S, Aboyans, V, Abu-Raddad, L, Ackerman, I, Adedeji, I, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, S, Agrawal, A, Ahmed, M, Aichour, M, Aichour, A, Aichour, I, Aiyar, S, Akinyemiju, T, Akseer, N, Al Lami, F, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alam, T, Alasfoor, D, Alene, K, Ali, R, Alizadeh-Navaei, R, Alkaabi, J, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Maskari, F, Almazroa, M, Al-Raddadi, R, Alsharif, U, Alsowaidi, S, Althouse, B, Altirkawi, K, Alvis-Guzman, N, Amare, A, Amini, E, Ammar, W, Amoako, Y, Ansha, M, Antonio, C, Anwari, P, Ärnlöv, J, Arora, M, Artaman, A, Aryal, K, Asgedom, S, Atey, T, Atnafu, N, Avila-Burgos, L, Avokpaho, E, Awasthi, A, Awasthi, S, Azarpazhooh, M, Azzopardi, P, Babalola, T, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, M, Barac, A, Barker-Collo, S, Bärnighausen, T, Barquera, S, Barrero, L, Basu, S, Battista, R, Battle, K, Baune, B, Bazargan-Hejazi, S, Beardsley, J, Bedi, N, Béjot, Y, Bekele, B, Bell, M, Bennett, D, Bennett, J, Bensenor, I, Benson, J, Berhane, A, Berhe, D, Bernabé, E, Betsu, B, Beuran, M, Beyene, A, Bhansali, A, Bhatt, S, Bhutta, Z, Biadgilign, S, Bicer, B, Bienhoff, K, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, H, Blyth, F, Boneya, D, Bose, D, Bou-Orm, I, Bourne, R, Brainin, M, Brayne, C, Brazinova, A, Breitborde, N, Briant, P, Britton, G, Brugha, T, Buchbinder, R, Bulto, L, Bumgarner, B, Butt, Z, Cahuana-Hurtado, L, Cameron, E, Campos-Nonato, I, Carabin, H, Cárdenas, R, Carpenter, D, Carrero, J, Carter, A, Carvalho, F, Casey, D, Castañeda-Orjuela, C, Castle, C, Catalá-López, F, Chang, J, Charlson, F, Chaturvedi, P, Chen, H, Chibalabala, M, Chibueze, C, Chisumpa, V, Chitheer, A, Chowdhury, R, Christopher, D, Ciobanu, L, Cirillo, M, Colombara, D, Cooper, L, Cooper, C, Cortesi, P, Cortinovis, M, Criqui, M, Cromwell, E, Cross, M, Crump, J, Dadi, A, Dalal, K, Damasceno, A, Dandona, L, Dandona, R, das Neves, J, Davitoiu, D, Davletov, K, de Courten, B, De Leo, D, De Steur, H, Defo, B, Degenhardt, L, Deiparine, S, Dellavalle, R, Deribe, K, Deribew, A, Des Jarlais, D, Dey, S, Dharmaratne, S, Dhillon, P, Dicker, D, Djalainia, S, Do, H, Dokova, K, Doku, D, Dorsey, E, dos Santos, K, Driscoll, T, Dubey, M, Duncan, B, Ebel, B, Echko, M, El-Khatib, Z, Enayati, A, Endries, A, Ermakov, S, Erskine, H, Eshetie, S, Eshrati, B, Esteghamati, A, Estep, K, Fanuel, F, Farag, T, Farinha, C, Faro, A, Farzadfar, F, Fazeli, M, Feigin, V, Feigl, A, Fereshtehnejad, S, Fernandes, J, Ferrari, A, Feyissa, T, Filip, I, Fischer, F, Fitzmaurice, C, Flaxman, A, Foigt, N, Foreman, K, Franklin, R, Frostad, J, Fullman, N, Fürst, T, Furtado, J, Futran, N, Gakidou, E, Garcia-Basteiro, A, Gebre, T, Gebregergs, G, Gebrehiwot, T, Geleijnse, J, Geleto, A, Gemechu, B, Gesesew, H, Gething, P, Ghajar, A, Gibney, K, Gillum, R, Ginawi, I, Gishu, M, Giussani, G, Godwin, W, Goel, K, Goenka, S, Goldberg, E, Gona, P, Goodridge, A, Gopalani, S, Gosselin, R, Gotay, C, Goto, A, Goulart, A, Graetz, N, Gugnani, H, Gupta, P, Gupta, R, Gupta, T, Gupta, V, Gutiérrez, R, Hachinski, V, Hafezi-Nejad, N, Hailu, A, Hailu, G, Hamadeh, R, Hamidi, S, Hammami, M, Handal, A, Hankey, G, Hao, Y, Harb, H, Hareri, H, Haro, J, Harun, K, Harvey, J, Hassanvand, M, Havmoeller, R, Hay, S, Hay, R, Hedayati, M, Hendrie, D, Henry, N, Heredia-Pi, I, Heydarpour, P, Hoek, H, Hoffman, H, Horino, M, Horita, N, Hosgood, H, Hostiuc, S, Hotez, P, Hoy, D, Htet, A, Hu, G, Huang, J, Huynh, C, Iburg, K, Igumbor, E, Ikeda, C, Irvine, C, Islam, S, Jacobsen, K, Jahanmehr, N, Jakovljevic, M, James, P, Jassal, S, Javanbakht, M, Jayaraman, S, Jeemon, P, Jensen, P, Jha, V, Jiang, G, John, D, Johnson, C, Johnson, S, Jonas, J, Jürisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kamal, R, Kar, C, Karam, N, Karch, A, Karema, C, Karimi, S, Karimkhani, C, Kasaeian, A, Kassa, G, Kassaw, N, Kassebaum, N, Kastor, A, Katikireddi, S, Kaul, A, Kawakami, N, Keiyoro, P, Kemmer, L, Kengne, A, Keren, A, Kesavachandran, C, Khader, Y, Khalil, I, Khan, E, Khang, Y, Khoja, A, Khosravi, A, Khubchandani, J, Kiadaliri, A, Kieling, C, Kim, Y, Kim, D, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kissoon, N, Kivimaki, M, Knudsen, A, Kokubo, Y, Kolte, D, Kopec, J, Kosen, S, Kotsakis, G, Koul, P, Koyanagi, A, Kravchenko, M, Krohn, K, Kumar, G, Kumar, P, Kyu, H, Lager, A, Lal, D, Lalloo, R, Lallukka, T, Lambert, N, Lan, Q, Lansingh, V, Larsson, A, Leasher, J, Lee, P, Leigh, J, Leshargie, C, Leung, J, Leung, R, Levi, M, Li, Y, Liang, X, Liben, M, Lim, S, Linn, S, Liu, P, Liu, A, Liu, S, Liu, Y, Lodha, R, Logroscino, G, Looker, K, Lopez, A, Lorkowski, S, Lotufo, P, Lozano, R, Lucas, T, Lunevicius, R, Lyons, R, Macarayan, E, Maddison, E, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, D, Mamun, A, Manguerra, H, Manhertz, T, Mantovani, L, Mapoma, C, March, L, Marczak, L, Martinez-Raga, J, Martins, P, Martins-Melo, F, Martopullo, I, März, W, Mathur, M, Mazidi, M, Mcalinden, C, Mcgaughey, M, Mcgrath, J, Mckee, M, Mehata, S, Meier, T, Meles, K, Memiah, P, Memish, Z, Mendoza, W, Mengesha, M, Mengistie, M, Mengistu, D, Mensah, G, Meretoja, T, Meretoja, A, Mezgebe, H, Micha, R, Millear, A, Miller, T, Minnig, S, Mirarefin, M, Mirrakhimov, E, Misganaw, A, Mishra, S, Mitchell, P, Mohammad, K, Mohammadi, A, Mohammed, M, Mohammed, K, Mohammed, S, Mohan, M, Mokdad, A, Mollenkopf, S, Monasta, L, Montañez Hernandez, J, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Morrison, S, Moses, M, Mountjoy-Venning, C, Mruts, K, Mueller, U, Muller, K, Murdoch, M, Murray, C, Murthy, G, Murthy, S, Musa, K, Nachega, J, Nagel, G, Naghavi, M, Naheed, A, Naidoo, K, Nangia, V, Nasher, J, Natarajan, G, Negasa, D, Negoi, R, Negoi, I, Newton, C, Ngunjiri, J, Nguyen, C, Nguyen, Q, Nguyen, T, Nguyen, G, Nguyen, M, Nichols, E, Ningrum, D, Nong, V, Norheim, O, Norrving, B, Noubiap, J, Nyandwi, A, Obermeyer, C, O'Donnell, M, Ogbo, F, Oh, I, Okoro, A, Oladimeji, O, Olagunju, A, Olagunju, T, Olsen, H, Olusanya, B, Olusanya, J, Ong, K, Opio, J, Oren, E, Ortiz, A, Osborne, R, Osgood-Zimmerman, A, Osman, M, Ota, E, Owolabi, M, Pa, M, Pacella, R, Panda, B, Pandian, J, Papachristou, C, Park, E, Parry, C, Parsaeian, M, Patil, S, Patten, S, Patton, G, Paudel, D, Paulson, K, Pearce, N, Pereira, D, Perez, K, Perico, N, Pesudovs, K, Peterson, C, Petri, W, Petzold, M, Phillips, M, Phipps, G, Pigott, D, Pillay, J, Pinho, C, Piradov, M, Plass, D, Pletcher, M, Popova, S, Poulton, R, Pourmalek, F, Prabhakaran, D, Prasad, N, Purcell, C, Purwar, M, Qorbani, M, Quintanilla, B, Rabiee, R, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rai, R, Rajsic, S, Ram, U, Ranabhat, C, Rangaswamy, T, Rankin, Z, Rao, P, Rawaf, S, Ray, S, Reiner, R, Reinig, N, Reitsma, M, Remuzzi, G, Renzaho, A, Resnikoff, S, Rezaei, S, Ribeiro, A, Rivas, J, Roba, H, Robinson, S, Rojas-Rueda, D, Rokni, M, Ronfani, L, Roshandel, G, Roth, G, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, G, Saadat, S, Safdarian, M, Safiri, S, Sagar, R, Sahathevan, R, Sahraian, M, Salama, J, Saleh, M, Salomon, J, Salvi, S, Samy, A, Sanabria, J, Sanchez-Niño, M, Santomauro, D, Santos, J, Santos, I, Santric Milicevic, M, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Schelonka, K, Schmidt, M, Schneider, I, Schöttker, B, Schutte, A, Schwebel, D, Schwendicke, F, Seedat, S, Sepanlou, S, Servan-Mori, E, Shaheen, A, Shaikh, M, Shamsipour, M, Sharma, R, Sharma, J, She, J, Shi, P, Shibuya, K, Shields, C, Shifa, G, Shiferaw, M, Shigematsu, M, Shiri, R, Shirkoohi, R, Shirude, S, Shishani, K, Shoman, H, Siabani, S, Sibai, A, Sigfusdottir, I, Silberberg, D, Silva, D, Silva, J, Silveira, D, Singh, J, Singh, O, Singh, N, Singh, V, Sinha, D, Skiadaresi, E, Slepak, E, Smith, D, Smith, M, Sobaih, B, Sobngwi, E, Soljak, M, Sorensen, R, Sousa, T, Sposato, L, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stathopoulou, V, Steel, N, Stein, D, Steiner, C, Steinke, S, Stokes, M, Stovner, L, Strub, B, Subart, M, Sufiyan, M, Sunguya, B, Sur, P, Swaminathan, S, Sykes, B, Sylte, D, Szoeke, C, Tabarés-Seisdedos, R, Tadakamadla, S, Taffere, G, Takala, J, Tandon, N, Tanne, D, Tarekegn, Y, Tavakkoli, M, Taveira, N, Taylor, H, Tegegne, T, Tehrani-Banihashemi, A, Tekelab, T, Terkawi, A, Tesfaye, D, Tesssema, B, Thakur, J, Thamsuwan, O, Theadom, A, Theis, A, Thomas, K, Thomas, N, Thompson, R, Thrift, A, Tobe-Gai, R, Tobollik, M, Tonelli, M, Topor-Madry, R, Tortajada, M, Touvier, M, Traebert, J, Tran, B, Troeger, C, Truelsen, T, Tsoi, D, Tuzcu, E, Tymeson, H, Tyrovolas, S, Ukwaja, K, Undurraga, E, Uneke, C, Updike, R, Uthman, O, Uzochukwu, B, van Boven, J, Varughese, S, Vasankari, T, Veerman, L, Venkatesh, S, Venketasubramanian, N, Vidavalur, R, Vijayakumar, L, Violante, F, Vishnu, A, Vladimirov, S, Vlassov, V, Vollset, S, Vos, T, Wadilo, F, Wakayo, T, Wallin, M, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, R, Weiss, D, Werdecker, A, Westerman, R, Whiteford, H, Wijeratne, T, Williams, H, Wiysonge, C, Woldeyes, B, Wolfe, C, Woodbrook, R, Woolf, A, Workicho, A, Xavier, D, Xu, G, Yadgir, S, Yaghoubi, M, Yakob, B, Yan, L, Yano, Y, Ye, P, Yihdego, M, Yimam, H, Yip, P, Yonemoto, N, Yoon, S, Yotebieng, M, Younis, M, Yu, C, Zaidi, Z, Zaki, M, Zegeye, E, Zenebe, Z, Zhang, X, Zheng, Y, Zhou, M, Zipkin, B, Zodpey, S, Zoeckler, L, Zuhlke, L, Brayne, Carol [0000-0001-5307-663X], Chowdhury, Rajiv [0000-0003-4881-5690], and Apollo - University of Cambridge Repository

Subjects
Male, Dánarmein, AUSTRALIA, GBD, disability-adjusted life-years (DALYs), Heilsufar, Lífslíkur, Epidemiology, Life expectancy, Diseases, Global Health, THERAPY, Global Burden of Disease, Residence Characteristics, Fullorðnir, Cause of Death, Medicine and Health Sciences, Psychology, Konur, Aged, 80 and over, Tölfræði, PLASMODIUM-FALCIPARUM, Aldraðir, Sjúkdómar, Medicine (all), Fatlaðir, Men, Þjóðir, 11 Medical And Health Sciences, ASSOCIATION, Middle Aged, Health policy, PREVALENCE, Sálfræði, disability-adjusted life-years (DALYs), Female, Lýðheilsa, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Global Health Metrics, Adult, AFRICA, Quality of life, People with disabilities, GBD, WEIGHTS, Social ecology, Lífsgæði, Communicable Diseases, World health/statistics, Age Distribution, Life Expectancy, Medicine, General & Internal, SDG 3 - Good Health and Well-being, General & Internal Medicine, Heilbrigðisstefna, Humans, Adults, Disabled Persons, Women, Sex Distribution, Mortality, Noncommunicable Diseases, Aged, Science & Technology, Faraldsfræði, MORTALITY, Wounds and injuries, EPIDEMIOLOGIC TRANSITION, HIV, Áverkar, Karlar, Wounds and Injuries, Félagshagfræði, Older people
Abstract

Correction in: LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017, Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings The highest globally observed HALE at birth for both women and men was in Singapore, at 75.2 years (95% uncertainty interval 71.9-78.6) for females and 72.0 years (68.8-75.1) for males. The lowest for females was in the Central African Republic (45.6 years [42.0-49.5]) and for males was in Lesotho (41.5 years [39.0-44.0]). From 1990 to 2016, global HALE increased by an average of 6.24 years (5.97-6.48) for both sexes combined. Global HALE increased by 6.04 years (5.74-6.27) for males and 6.49 years (6.08-6.77) for females, whereas HALE at age 65 years increased by 1.78 years (1.61-1.93) for males and 1.96 years (1.69-2.13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2.3% [-5.9 to 0.9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16.1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support., Bill & Melinda Gates Foundation

Published
2017

38. Should Sofosbuvir-Based All-Oral Treatment Be Considered In Elderly Chronic Hepatitis C Patients?

Author

PA Cortesi, A Ciaccio, G Belleli, M Rota, S Conti, LG Mantovani, G Annoni, M Strazzabosco, Cortesi, P, Ciaccio, A, Bellelli, G, Rota, M, Conti, S, Mantovani, L, Annoni, G, and Strazzabosco, M

Subjects
Oral treatment, medicine.medical_specialty, Sofosbuvir, MED/42 - IGIENE GENERALE E APPLICATA, business.industry, Health Policy, all-oral treatment, Alternative medicine, Public Health, Environmental and Occupational Health, sofosbuvir, elderly, Chronic hepatitis, hepatitis C, cost-effectiveness, MED/12 - GASTROENTEROLOGIA, Internal medicine, medicine, MED/09 - MEDICINA INTERNA, Nuclear medicine, business, MED/01 - STATISTICA MEDICA, medicine.drug
Abstract

Objectives: A relevant proportion of patients affected by Chronic Hepatitis C(CHC) is older than 65 years. These patients have been undertreated in the past two decades, due to poor eligibility to interferon-containing regimens. New all-oral, interferon-free antivirals may represent a valuable option for this population. Our aim was to assess the cost-effectiveness of sofosbuvir plus ledipasvir(SOF/LDV) therapy in genotype 1(G1) and 4(G4) CHC elderly patients. Methods: A Markov model of CHC natural history was built. The model focuses on CHC patients older than 65 years and assessed the impact of liver fibrosis (METAVIR F3 and F4), age and frailty phenotype, defined by Fried’s (not frail, pre-frail and frail), on the cost-effectiveness of SOF/LDV versus no treatment. The model estimated costs, Life Years and Quality-Adjusted Life Years (QALY) using the lifetime time horizon and the National Health System perspective. Results were presented as incremental cost-effectiveness ratios (ICERs) per QALY gained. Results: The cost-effectiveness of all-oral and IFN-free treatment regimen in HCV elderly patients is influenced by all three parameters assessed in our simulation. ICER was higher in lower fibrosis stages and increased with age and frailty phenotype. In F3 and F4 patients ICER was below 40,000 € /QALY up to age 83.3 and over 85 years in non-frail patients, up to age 79.5 and 82.5 in prefrail and up to age 76.5 and 79.5 in frail, respectively. The ICER was more sensitive to drug price and SVR probability. Further, the mortality rate not-liver related had a higher impact in the not-frail patients. Co nclusions: Age and fibrosis stage are not enough to assess the cost-effectiveness of anti-HCV treatment in elderly subjects. A careful assessment of the patient geriatric status should be mandatory, especially in patients older than 75 years, to better allocate the resources available and to prioritize the access to the treatment

Published
2015
Full Text
View/download PDF

39. Economic Burden Of Stroke: Analysis From An Administrative Database

Author

Carla Fornari, Roberta Ciampichini, V. Chiodini, Lorenzo G. Mantovani, P Cozzolino, Giancarlo Cesana, Fabiana Madotto, Paolo Cortesi, Ciampichini, R, Cozzolino, P, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, and Cesana, G

Subjects
Stroke, business.industry, Administrative database, Health Policy, medicine, Public Health, Environmental and Occupational Health, Medical emergency, medicine.disease, business, Economic Burden
Published
2014
Full Text
View/download PDF

40. Epidemiologic And Economic Burden Attributable To Atrial Fibrillation From Administrative Data

Author

P Cozzolino, Giancarlo Cesana, Paolo Cortesi, Fabiana Madotto, Lorenzo G. Mantovani, V. Chiodini, Carla Fornari, Roberta Ciampichini, Ciampichini, R, Cozzolino, P, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, and Cesana, G

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Health Policy, Atrial Fibrillation, Cardiology, Public Health, Environmental and Occupational Health, Medicine, Atrial fibrillation, business, medicine.disease, Economic Burden
Published
2014
Full Text
View/download PDF

41. Sofosbuvir-based all-oral treatment for elderly chronic hepatitis C patients: A cost-effectiveness analysis

Author

S. Okolicsanyi, Giuseppe Bellelli, Paolo Cortesi, Mario Strazzabosco, Matteo Rota, A. Ciaccio, Lorenzo G. Mantovani, Giorgio Annoni, Ciaccio, A, Cortesi, P, Bellelli, G, Rota, M, Okolicsanyi, S, Mantovani, L, Annoni, G, and Strazzabosco, M

Subjects
medicine.medical_specialty, Oral treatment, Hepatology, Sofosbuvir, MED/42 - IGIENE GENERALE E APPLICATA, business.industry, all-oral treatment, Gastroenterology, Alternative medicine, Cost-effectiveness analysis, sofosbuvir, elderly, Chronic hepatitis, hepatitis C, cost-effectiveness, MED/12 - GASTROENTEROLOGIA, Medicine, business, Intensive care medicine, Nuclear medicine, MED/01 - STATISTICA MEDICA, medicine.drug
Abstract

Background and aim: A relevant proportion of patients affected by chronic hepatitis C (CHC) is older than 65 years. Comorbidities and a higher susceptibility to drugs toxicity have historically limited treatment in these patients. Recent approval of interferon-free regimens, characterized by high efficacy and limited toxicity, provides unprecedented chances for these patients to be cured. The aim of this study is to assess cost-effectiveness, taking into account the severity of liver disease, age, and the geriatric (frailty) status. Methods: A semi-Markov model of CHC natural history was built. The study focuses on CHC patients older than 65 years, stratified according to liver fibrosis (METAVIR F3 and F4), age (65–85 years old) and Fried’s frailty phenotype (not frail, pre-frail and frail) generating 30 simulated cohorts. Treatment with sofosbuvir plus simeprevir (SOF/SMV) versus no treatment was assessed for each cohort. The model estimated costs, Life Years and Quality Adjusted Life Years (QALY), with a lifetime time horizon and the Health System perspective. Results are presented as incremental costeffectiveness ratios (ICERs) per QALY gained. Cost-effectiveness was defined as an ICER under the 37,000D threshold. Results: At each fibrosis score, ICER increased with age and frailty index. Among F3 patients, ICER ranged from D13,934 in notfrail 65-years-old andD79,354 in frail 85-years-old patients. Among F4 patients ICER ranged from D13,873 in not frail 65-years-old and D115,965 in frail 85-years-old patients. In both F3 and F4 cohorts ICER was below D37,000/QALY up to age 80 in non-frail patients, up to age 75 in pre-frail patients, up to age 70 in frail patients. Conclusion: SOF/SMV treatment is cost-effective in most CHC patients older than 65 years, however a careful assessment of the patient geriatric status is mandatory. This cost-effectiveness analysis should promote a prospective clinical study to verify efficacy and side effects in elderly HCV patients.

Published
2015

42. The Cost-Effectiveness Of Sofosbuvir And Ribavirin Treatment In Hcv-Infected Patients Listed For Liver Transplantation

Author

Matteo Rota, A. Ciaccio, Giancarlo Cesana, Mario Strazzabosco, Lorenzo G. Mantovani, Paolo Cortesi, Luca S. Belli, Cortesi, P, Mantovani, L, Ciaccio, A, Rota, M, Cesana, G, Strazzabosco, M, and Belli, L

Subjects
medicine.medical_specialty, Sofosbuvir, MED/42 - IGIENE GENERALE E APPLICATA, Sofosbuvir and Ribavirin, Cost effectiveness, business.industry, Ribavirin, medicine.medical_treatment, Health Policy, Public Health, Environmental and Occupational Health, Liver transplantation, Cost-Effectiveness analysis, Gastroenterology, chemistry.chemical_compound, chemistry, MED/12 - GASTROENTEROLOGIA, Cost-Effectiveness analysi, Internal medicine, medicine, business, MED/01 - STATISTICA MEDICA, health care economics and organizations, Hepatitis C patients listed for liver transplant, medicine.drug
Abstract

Objectives: Sofosbuvir in combination with ribavirin (SOF/RBV) is a novel treatment able to suppress HCV viremia when applied to HCV patients listed for transplant, preventing HCV recurrence. Aim of this study was to assess the costeffectiveness of this regimen in HCV patients listed for transplant for cirrhosis (HCVcirrhosis) or for hepatocellular carcinoma (HCV-HCC). Methods: a semi-Markov model was developed. The model simulates the progression of HCV-cirrhosis or HCV-HCC patients from the time of listing until death considering the risk of HCV recurrence post-transplant. The model compared 2 different strategies: 1) SOF/RBV up to a maximum of 24 weeks or until OLT if performed before the 24th week, 2) No antiviral treatment. The model estimated the costs related to the treatment with SOF/RBV, the costs associated to each health state, the life-years (LYSs), the quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) expressed as € per QALY gained. The analysis was performed from the Italian National Health System perspective with a lifetime time horizon and one-month Markov cycles. Future costs and clinical benefits, expressed as QALYs, were discounted at 3% per year. Results: in the base-case analysis the ICER for 24 weeks of SOF/RBVR was € 30,518 per QALY gained in HCV-cirrhosis patients and € 41,610 in HCV-HCC patients. The reliability of our results was confirmed by the one way sensitivity-analysis and by the cost-effectiveness acceptability curve. Further, SOF/RBV cost-effectiveness was clearly sensitive to the duration of treatment; assuming 12 weeks SOF/RBV treatment duration, the ICER decreased to € 19,317 in HCVCirrhosis and € 29,540 in HCV-HCC. Conclusions: our study shows that treating patients with HCV-cirrhosis or HCV-HCC listed for transplant with SOF/RBV is costeffective and may become the new standard of care for these patients. However a well-defined prospective study is needed to confirm the value of the parameters assumed in the model and the results

Published
2014
Full Text
View/download PDF

43. Models of The Impact of Major Liver Diseases on Eq-5d Visual Analogue Scale and Utility-Index: Convergences and Divergences

Author

Mario Strazzabosco, Giancarlo Cesana, Luciana Scalone, Lorenzo G. Mantovani, Sara Conti, Paolo Cortesi, Conti, S, Cortesi, P, Scalone, L, Strazzabosco, M, Cesana, G, and Mantovani, L

Subjects
Index (economics), business.industry, Visual analogue scale, Health Policy, Public Health, Environmental and Occupational Health, computer.software_genre, EQ-5D, Medicine, Data mining, Artificial intelligence, business, computer, HCC, liver diseases, Natural language processing
Abstract

Objectives Liver diseases (LDs) can reduce health-related quality-of-life (HRQoL), with an important impact on the burden of LDs. Our aim was to analyze the impact of the major LDs on EQ-5D Visual Analogue Scale (VAS) and utility-index (UI) through different regression models, using HRQoL of the general population as a reference. Methods HRQoL data were measured using the EQ-5D-3L in a sample of patients with 9 major LDs enrolled during 2011-2012 in a multicenter study conducted in the most populated region of Italy, Lombardy. Such data were added to those recorded in 2013 on a representative sample of Lombardy general population. Relationships between the outcomes of interest (VAS and UI) and LDs were explored through ordinary least squares (OLS) and Tobit regression, that accounts for ceiling effect, adjusting for age and gender. Goodness-of-fit was assessed through R2 (OLS) and pseudo-R2(Tobit). Results The sample included 9,817 subjects (3,017 with LDs). OLS and Tobit regressions performed similarly on VAS (R2:0.13,pseudo-R2:0.12) and estimated the largest and significant HRQoL reduction in patients with decompensated cirrhosis (DC), followed by those with autoimmune hepatitis (AIH) and hepatocellular carcinoma (HCC). As for UI, the Tobit model performed better than OLS regression (R2:0.11,pseudo-R2:0.15), with the highest decrease estimated in patients with DC, followed by those with HCC and compensated cirrhosis. Conclusions The Tobit model performed slightly better than OLS regression on the UI, but not on VAS, maybe due to a stronger ceiling effect in UI. This distributional difference mirrors different data-generation mechanisms: UI is derived from the EQ-5D-3L domains, while VAS is reported by patients. Therefore, VAS and UI might capture different aspects of HRQoL, as supported by our results, that show how the same LD can be differently associated with VAS and UI (e.g.: AIH seemed to have an impact on VAS only, while HCC on UI only).

Published
2015

44. P1169 : Outcome indicators in primary sclerosing cholangitis: Interim analysis of the value-based medicine in hepatology study

Author

S. Okolicsanyi, Luca Fabris, P. Giani, A. Ciaccio, Luciana Scalone, Marco Gemma, Mario Strazzabosco, Lorenzo G. Mantovani, Paolo Cortesi, Maria Grazia Valsecchi, M.R. Buonocore, M. Rota, Stefano Fagiuoli, Luca S. Belli, Fabris, L, Ciaccio, A, Okolicsanyi, S, Rota, M, Cortesi, P, Buonocore, M, Gemma, M, Giani, P, Belli, L, Fagiuoli, S, Scalone, L, Valsecchi, M, Mantovani, L, and Strazzabosco, M

Subjects
medicine.medical_specialty, outcome indicators, MED/42 - IGIENE GENERALE E APPLICATA, outcome indicator, Clinical epidemiology, Gastroenterology, Primary sclerosing cholangitis, primary sclerosing cholangitis, value-based medicine, health care, MED/12 - GASTROENTEROLOGIA, Internal medicine, Medicine, MED/01 - STATISTICA MEDICA, Hepatology, business.industry, Public health, Translational medicine, medicine.disease, Interim analysis, Research centre, Family medicine, primary sclerosing cholangiti, Biostatistics, business
Abstract

Background and Aims: Primary sclerosing cholangitis (PSC) is an enigmatic disease with scarce therapeutic options, potentially evolving to severe and life-threatening complications, including malignancies like cholangiocarcinoma (CCA) or colon cancer. The clinical management of PSC remains challenging and may benefit from identification of outcome indicators to assess the quality of care. This study aims to: (A) identify Outcome Indicators (OIs) for PSC, and (B) validate OIs in a clinical context with a preliminary interim analysis. Methods: (A) A panel of experts generated a list of OIs using a modified version of the Delphi method. (B) OIs with the highest RAND/UCLA score were tested in an ongoing multicentric and prospective study (Value-based Medicine in Hepatology, VBMH). Results: Five OIs were identified on the basis of the highest rating values and disagreement indexes next to 0. They include: annual rate of acute cholangitis episodes (OI#1); mortality rate for patients not yet listed for liver transplantation (OI#2); rate of quality of life improvement, measured by EQ-VAS (a visual assessment scale ranging from 0 to 100 where the patient points out his present-day health status) and EQ-5D (assessment of 5 domains that measure daily performance according to 3 levels of severity) (OI#3); number of patients died for CCA and CRC (OI#4); incidence and/or worsening of osteoporosis, expressed as T-score differential over a 2-year interval (OI#5). In the validation study, 63 consecutive patients with PSC enrolled in 3 tertiary liver centres in Northern Italy were evaluated for a 24-month follow-up period. For each OI, the following values were reported: OI#1: cumulative incidence of 5.2%, resulting in 0.029 cholangitis/patient; OI#2, OI#4: no patients died without being listed for transplantation or because of cancer during study time; OI#3: 38.9% and 19.4% of patients showed an improvement in EQ-VAS and EQ-5D parameters, respectively; OI#5: 3% of patients developed or worsened osteoporosis. Conclusions: Five OIs for PSC were identified on a highly shared consensus. Albeit the study population is small (as in the case of rare diseases) and the follow-up time is short as compared to the long natural history of the disease, these OIs have proven to be easy to collect and to work appropriately. Therefore, they are suitable to be extended to specialized centres involved in PSC management to further validate their clinical usefulness.

Published
2015

45. Characteristics of patients with Chronic Hepatitis C who have failed past treatment or who have never been treated: How much room left for Interferon?

Author

Marco Gemma, Luca S. Belli, Lorenzo G. Mantovani, S. Okolicsanyi, Paolo Cortesi, A. Ciaccio, Maria Cristina Vinci, S. De Salvia, Matteo Rota, Mario Strazzabosco, Ciaccio, A, Okolicsanyi, S, Rota, M, Cortesi, P, De Salvia, S, Gemma, M, Vinci, M, Mantovani, L, Belli, L, and Strazzabosco, M

Subjects
medicine.medical_specialty, Hepatology, MED/42 - IGIENE GENERALE E APPLICATA, business.industry, Gastroenterology, interferon, hepatitis C, treatment failure, Surgery, Chronic hepatitis, MED/12 - GASTROENTEROLOGIA, Interferon, Internal medicine, medicine, business, MED/01 - STATISTICA MEDICA, medicine.drug
Abstract

Background/aims: According to current guidelines on management of Chronic Hepatitis C (CHC), both interferon (IFN)-containing and IFN-free treatment combinations may be offered to patients, depending on viral genotype, previous treatment and contraindications to IFN. The past two decades of treatment have selected a large population of patients ineligible to IFN. Our aim is to characterize the current CHC population in order to best drive resource allocation. Patients and methods: we retrospectively retrieved the characteristics and outcomes of a cohort of 801 consecutive CHC outpatients followed-up at two tertiary Centers in Northern Italy. Baseline characteristics of never treated and treated CHC patients were compared by means of Chi-Square test for categorical and t-test for continuous variables. Results: fifty-three percent (426 out of 801) of patients had previously received treatment. Among them, 103 (24%) had achieved SVR; 323 (76%) had failed, of whom 74 (23%) did not complete and 249 (77%) did not respond to treatment. Adverse events were the main cause of treatment withdrawal (90%). Forty-seven percent (n = 375) of all participants had never received any treatment, mostly because of contraindications (27% overall, hematologic 11%, psychiatric 24%, cardiovascular 15%, autoimmune 7%, others 43%), advanced age (27%), personal choice (15%) or no fibrosis (10%). Never treated patients differed significantly (p < 0.01) from treated ones by age (61 vs 56 years) and gender (male 49 vs 65%). Six-hundred and ninety-eight patients (323 failed plus 375 never treated) are awaiting new antiviral therapy, of which 442 (63%) are candidate to all-oral combinations because of contraindications or past intolerance to IFN, while the remaining 256 (37%) may still receive an IFN-containing regimen. Conclusions: 37% of the CHC patients being followed in our clinics may receive IFN-containing protocols with newer DAAs, while about the two thirds of these patients are obligated candidates for the more costly, IFN-free regimens.

Published
2015

46. The Burden of Severe Hypoglicaemias and Diabetes Ketoacidosis: A Population-Based Study

Author

Carla Fornari, Roberta Ciampichini, Paolo Cortesi, Lorenzo G. Mantovani, V. Chiodini, Giancarlo Cesana, Fabiana Madotto, P Cozzolino, Ciampichini, R, Cozzolino, P, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, and Cesana, G

Subjects
medicine.medical_specialty, Diabetes Ketoacidosis, business.industry, Health Policy, Public Health, Environmental and Occupational Health, MEDLINE, Economic burden, medicine.disease, Ketoacidosis, Population based study, Diabetes mellitus, medicine, Intensive care medicine, business, Severe Hypoglicaemia
Published
2014

47. Measurement of clinical outcomes and quality of life indicators as a new value-based approach to liver cirrhosis management

Author

Luciana Scalone, Mario Strazzabosco, Stefano Fagiuoli, Marco Gemma, A. Ciaccio, Luca S. Belli, Maria Grazia Valsecchi, Matteo Rota, S. Okolicsanyi, Paolo Cortesi, Giancarlo Cesana, P. Giani, Lorenzo G. Mantovani, Okolicsanyi, S, Ciaccio, A, Cortesi, P, Rota, M, Gemma, M, Giani, P, Scalone, L, Mantovani, L, Fagiuoli, S, Valsecchi, M, Cesana, G, Belli, L, and Strazzabosco, M

Subjects
Quality of life, Health care indicators, Clinical outcomes, Liver cirrhosis, Delphi method, Prospective study, Value-based Medicine in Hepatology, medicine.medical_specialty, Pathology, Cirrhosis, Hepatology, Clinical outcome, MED/42 - IGIENE GENERALE E APPLICATA, business.industry, Gastroenterology, medicine.disease, Liver cirrhosi, MED/12 - GASTROENTEROLOGIA, medicine, Intensive care medicine, business, Value (mathematics), Health care indicator, MED/01 - STATISTICA MEDICA
Abstract

Complications in liver cirrhosis (LC) are associated with increased mortality and costs. Management of LC complications is well established in clinical practice, but their real effectiveness is difficult to measure. Assessment of outcome indicators (OIs) together with patients-health related quality of life (p-HRQoL) could help decision-making process for clinicians and administrators. Aim: The aim of our study was to identify a set of OIs, and apply them in the clinical assessment of compensated (CC) and decompensated cirrhosis (DC), together with p-HRQoL scales. Specific OIs chosen by a panel of hepatologists with a modified Delphi method, were tested in a prospective multicenter observational study. P-HRQoL collected using the EQ-5D questionnaire, generated an health profile with five utility domains (mobility, self care, anxiety/depression,usualactivitiesandpain),and a visual analogue scale, which measured overall p-HRQoL in a range from 0 to 100. We enrolled 1772 patients with LC in 18 months: 1015 CC and 757 DC; median follow-up time was 2 years. Results: Variceal bleeding had an annual incidence of 3.1% with 1-year survival of 76%. Hepatocellular carcinoma occurred in a rate of 3.5%peryear,and 83%CC patients were diagnosed at earlystage. The strongest OIs according to the experts were decompensation rate in CC, which was 6.6% per year, and overall survival in DC patients.The1 yearsurvival aftert he first decompensation episode (ascites in 73% of cases) was 96% for CPT-A, 82% CPT-B, 56% CPT-C, whereas it was 94% and 57% for MELD score respectively below or above 15. Interestingly,no significant changes in p-HRQoL between baseline and after 2 years were found in CC and CPT-A patients, while p-HRQoL progressively decreased in DC and CPT B-C. Conclusions: Systematic measurement and comparison of objective OIs and p-HRQoL scales could increase value-based care in liver cirrhosis patients.

Published
2014

48. PGI31 Health Care Indicators to Measure Quality of Care in Patients with Liver Diseases

Author

A. Ciaccio, Lorenzo G. Mantovani, Luciana Scalone, G. Ideo, S. Okolicsanyi, Mario Strazzabosco, M. Rota, P.A. Cortesi, Maria Grazia Valsecchi, Giancarlo Cesana, Cortesi, P, Scalone, L, Okolicsanyi, S, Rota, M, Ciaccio, A, Ideo, G, Valsecchi, M, Mantovani, L, Cesana, G, and Strazzabosco, M

Subjects
medicine.medical_specialty, MED/42 - IGIENE GENERALE E APPLICATA, business.industry, Health Policy, Quality of care, Delphi method, Public Health, Environmental and Occupational Health, Measure (physics), Alternative medicine, Health care indicators, MED/12 - GASTROENTEROLOGIA, Family medicine, Liver diseases, Health care, medicine, In patient, business, Psychiatry, Liver disease, Health care indicator, MED/01 - STATISTICA MEDICA
Abstract

Objective: Liver Diseases (LDs) are prevalent and generate high human and economic costs to the society. Efficient strategies of diagnosis and treatment are necessary to improve patients’ health and reduce costs. Our aim was to identify healthcare quality indicators (HCQIs) to measure quality of care provided to LD patients. Methods: This work was conducted using a modified Delphi methodology based on a two-stage rating process. We organized 7 expert panels, involving 8-10 hepatologists each. Each panel focused on one/few condition(s): hepatitis B, hepatitis C, cirrhosis, hepatocellular carcinoma, autoimmune hepatopathies and cholangiopathies, metabolic hepatopathies, liver transplant. For each condition a preliminary set of HCQIs was identified and discussed by the panel, according to evidence and experience. Then, each panel member performed a first independent rating of all HCQIs using the RAND 9-point agreement scale (RAS; 1=totally disagree to 9=totally agree). Median scores of each HCQI were calculated and then used to rate again the HCQIs in the light of these results. After this second rating, a disagreement index (DI) was calculated to identify and accept (if DI≤1) indicators with median RAS≥7. The final set of HCQIs was selected. Results: The final list included 8 valid HCQIs for hepatitis B, 7 for hepatitis C, 4 for compensated cirrhosis, 8 for decompensated cirrhosis, 10 for hepatocellular carcinoma, 12 for autoimmune hepatopathies and cholangiopathies, 11 for metabolic hepatopathies and 15 for liver transplant. Health-Related Quality-of-Life was included as a further HCQI in all conditions. Discussion: We identified and proposed a set of indicators as a tool to assess the quality of care provided to patients affected with LDs. After a validation process, which is being performed, their use could help clinicians and budget holders in understanding and improving the efficiency of the healthcare provided

Published
2012

Catalog

Books, media, physical & digital resources
See catalog results