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1. The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

Author

Williams, EV, primary, Okeke, Ogwulu CB, additional, Estcourt, CS, additional, Howarth, AR, additional, Copas, A, additional, Low, N, additional, Althaus, C, additional, Mapp, F, additional, Woode, Owusu M, additional, Symonds, M, additional, and Roberts, TE, additional

Published
2021
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3. Cost‐effectiveness of mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage: an economic evaluation based on the MifeMiso trial

Author

Okeke Ogwulu, CB, primary, Williams, EV, additional, Chu, JJ, additional, Devall, AJ, additional, Beeson, LE, additional, Hardy, P, additional, Cheed, V, additional, Yongzhong, S, additional, Jones, LL, additional, La Fontaine Papadopoulos, JH, additional, Bender‐Atik, R, additional, Brewin, J, additional, Hinshaw, K, additional, Choudhary, M, additional, Ahmed, A, additional, Naftalin, J, additional, Nunes, N, additional, Oliver, A, additional, Izzat, F, additional, Bhatia, K, additional, Hassan, I, additional, Jeve, Y, additional, Hamilton, J, additional, Debs, S, additional, Bottomley, C, additional, Ross, J, additional, Watkins, L, additional, Underwood, M, additional, Cheong, Y, additional, Kumar, CS, additional, Gupta, P, additional, Small, R, additional, Pringle, S, additional, Hodge, FS, additional, Shahid, A, additional, Horne, AW, additional, Quenby, S, additional, Gallos, ID, additional, Coomarasamy, A, additional, and Roberts, TE, additional

Published
2021
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4. Diversity and flexibility of algal endosymbionts in globally-distributed large benthic foraminifera

Author

Prazeres Mdf, Marleen Stuhr, Steve S. Doo, Roberts Te, Ramadhani Sf, Willem Renema, and Christiane Schmidt

Subjects
Foraminifera, Flexibility (engineering), biology, Benthic zone, Ecology, Environmental science, biology.organism_classification, Diversity (business)
Abstract

Background Revealing the specificity and flexibility of the algal symbiont-host association is fundamental for understanding how species can occupy a diverse range of habitats. Here we assessed the global distribution of the algal symbiont diversity for three shallow-water species of large benthic foraminifera (LBF) of the genus Amphistegina . Specifically, weinvestigated the role of habitat and host identity on the diversity of algal biome. Results Here we used next-generation sequencing to identify the algal biome in the species A. lobifera , A. lessonii , and A. radiata , collected from shallow habitats in 16 sites, spanning from the Mediterranean Sea to French Polynesia. Results showed the consistent presence of Fragilariales as the main algal taxa associated with all species across sites analysed. However, we uncovered unprecedented diversity of algal phylotypes found in low abundance.We further found high variability in algal biomes both within and between species and sites, indicating a substantial level of flexibility in symbiont associations. The effect of site was significant in all species analysed, and showed that local habitat is the main factor influencing the identity of algal symbionts. Symbiotic associations are also not constrained by the species identity nor the phylogenetic relationship among closely related hosts, suggesting symbiont identity plays a limited role in the evolutionary history of the genus Amphistegina . Conclusions We found that species of Amphistegina form flexible symbiotic relationship with algal taxa, which are primarily shaped by their local habitat. These observations strongly suggest that the capacity of Amphistegina species to utilise a diverse array of available symbionts likely underpins the ecological success of these crucial calcifying organisms across their extensive geographic range.

Published
2020

5. Progesterone to prevent miscarriage in women with early pregnancy bleeding: the PRISM RCT.

Author

Coomarasamy, A, Harb, HM, Devall, AJ, Cheed, V, Roberts, TE, Goranitis, I, Ogwulu, CB, Williams, HM, Gallos, ID, Eapen, A, Daniels, JP, Ahmed, A, Bender-Atik, R, Bhatia, K, Bottomley, C, Brewin, J, Choudhary, M, Crosfill, F, Deb, S, Duncan, WC, Ewer, A, Hinshaw, K, Holland, T, Izzat, F, Johns, J, Lumsden, M-A, Manda, P, Norman, JE, Nunes, N, Overton, CE, Kriedt, K, Quenby, S, Rao, S, Ross, J, Shahid, A, Underwood, M, Vaithilingham, N, Watkins, L, Wykes, C, Horne, AW, Jurkovic, D, Middleton, LJ, Coomarasamy, A, Harb, HM, Devall, AJ, Cheed, V, Roberts, TE, Goranitis, I, Ogwulu, CB, Williams, HM, Gallos, ID, Eapen, A, Daniels, JP, Ahmed, A, Bender-Atik, R, Bhatia, K, Bottomley, C, Brewin, J, Choudhary, M, Crosfill, F, Deb, S, Duncan, WC, Ewer, A, Hinshaw, K, Holland, T, Izzat, F, Johns, J, Lumsden, M-A, Manda, P, Norman, JE, Nunes, N, Overton, CE, Kriedt, K, Quenby, S, Rao, S, Ross, J, Shahid, A, Underwood, M, Vaithilingham, N, Watkins, L, Wykes, C, Horne, AW, Jurkovic, D, and Middleton, LJ

Abstract

BACKGROUND: Progesterone is essential for a healthy pregnancy. Several small trials have suggested that progesterone therapy may rescue a pregnancy in women with early pregnancy bleeding, which is a symptom that is strongly associated with miscarriage. OBJECTIVES: (1) To assess the effects of vaginal micronised progesterone in women with vaginal bleeding in the first 12 weeks of pregnancy. (2) To evaluate the cost-effectiveness of progesterone in women with early pregnancy bleeding. DESIGN: A multicentre, double-blind, placebo-controlled, randomised trial of progesterone in women with early pregnancy vaginal bleeding. SETTING: A total of 48 hospitals in the UK. PARTICIPANTS: Women aged 16-39 years with early pregnancy bleeding. INTERVENTIONS: Women aged 16-39 years were randomly assigned to receive twice-daily vaginal suppositories containing either 400 mg of progesterone or a matched placebo from presentation to 16 weeks of gestation. MAIN OUTCOME MEASURES: The primary outcome was live birth at ≥ 34 weeks. In addition, a within-trial cost-effectiveness analysis was conducted from an NHS and NHS/Personal Social Services perspective. RESULTS: A total of 4153 women from 48 hospitals in the UK received either progesterone (n = 2079) or placebo (n = 2074). The follow-up rate for the primary outcome was 97.2% (4038 out of 4153 participants). The live birth rate was 75% (1513 out of 2025 participants) in the progesterone group and 72% (1459 out of 2013 participants) in the placebo group (relative rate 1.03, 95% confidence interval 1.00 to 1.07; p = 0.08). A significant subgroup effect (interaction test p = 0.007) was identified for prespecified subgroups by the number of previous miscarriages: none (74% in the progesterone group vs. 75% in the placebo group; relative rate 0.99, 95% confidence interval 0.95 to 1.04; p = 0.72); one or two (76% in the progesterone group vs. 72% in the placebo group; relative rate 1.05, 95% confidence interval 1.00 to 1.12; p = 0.07); and thr

Published
2020

6. The cost-effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM Trial

Author

Ogwulu, CBO, Goranitis, I, Devall, AJ, Cheed, V, Gallos, ID, Middleton, LJ, Harb, HM, Williams, HM, Eapen, A, Daniels, JP, Ahmed, A, Bender-Atik, R, Bhatia, K, Bottomley, C, Brewin, J, Choudhary, M, Deb, S, Duncan, WC, Ewer, AK, Hinshaw, K, Holland, T, Izzat, F, Johns, J, Lumsden, M, Manda, P, Norman, JE, Nunes, N, Overton, CE, Kriedt, K, Quenby, S, Rao, S, Ross, J, Shahid, A, Underwood, M, Vaithilingham, N, Watkins, L, Wykes, C, Horne, AW, Jurkovic, D, Coomarasamy, A, Roberts, TE, Ogwulu, CBO, Goranitis, I, Devall, AJ, Cheed, V, Gallos, ID, Middleton, LJ, Harb, HM, Williams, HM, Eapen, A, Daniels, JP, Ahmed, A, Bender-Atik, R, Bhatia, K, Bottomley, C, Brewin, J, Choudhary, M, Deb, S, Duncan, WC, Ewer, AK, Hinshaw, K, Holland, T, Izzat, F, Johns, J, Lumsden, M, Manda, P, Norman, JE, Nunes, N, Overton, CE, Kriedt, K, Quenby, S, Rao, S, Ross, J, Shahid, A, Underwood, M, Vaithilingham, N, Watkins, L, Wykes, C, Horne, AW, Jurkovic, D, Coomarasamy, A, and Roberts, TE

Abstract

OBJECTIVES: To assess the cost-effectiveness of progesterone compared with placebo in preventing pregnancy loss in women with early pregnancy vaginal bleeding. DESIGN: Economic evaluation alongside a large multi-centre randomised placebo-controlled trial. SETTING: Forty-eight UK NHS early pregnancy units. POPULATION: Four thousand one hundred and fifty-three women aged 16-39 years with bleeding in early pregnancy and ultrasound evidence of an intrauterine sac. METHODS: An incremental cost-effectiveness analysis was performed from National Health Service (NHS) and NHS and Personal Social Services perspectives. Subgroup analyses were carried out on women with one or more and three or more previous miscarriages. MAIN OUTCOME MEASURES: Cost per additional live birth at ≥34 weeks of gestation. RESULTS: Progesterone intervention led to an effect difference of 0.022 (95% CI -0.004 to 0.050) in the trial. The mean cost per woman in the progesterone group was £76 (95% CI -£559 to £711) more than the mean cost in the placebo group. The incremental cost-effectiveness ratio for progesterone compared with placebo was £3305 per additional live birth. For women with at least one previous miscarriage, progesterone was more effective than placebo with an effect difference of 0.055 (95% CI 0.014-0.096) and this was associated with a cost saving of £322 (95% CI -£1318 to £673). CONCLUSIONS: The results suggest that progesterone is associated with a small positive impact and a small additional cost. Both subgroup analyses were more favourable, especially for women who had one or more previous miscarriages. Given available evidence, progesterone is likely to be a cost-effective intervention, particularly for women with previous miscarriage(s). TWEETABLE ABSTRACT: Progesterone treatment is likely to be cost-effective in women with early pregnancy bleeding and a history of miscarriage.

Published
2020

7. The cost‐effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial

Author

Okeke Ogwulu, CB, primary, Goranitis, I, additional, Devall, AJ, additional, Cheed, V, additional, Gallos, ID, additional, Middleton, LJ, additional, Harb, HM, additional, Williams, HM, additional, Eapen, A, additional, Daniels, JP, additional, Ahmed, A, additional, Bender‐Atik, R, additional, Bhatia, K, additional, Bottomley, C, additional, Brewin, J, additional, Choudhary, M, additional, Deb, S, additional, Duncan, WC, additional, Ewer, AK, additional, Hinshaw, K, additional, Holland, T, additional, Izzat, F, additional, Johns, J, additional, Lumsden, M, additional, Manda, P, additional, Norman, JE, additional, Nunes, N, additional, Overton, CE, additional, Kriedt, K, additional, Quenby, S, additional, Rao, S, additional, Ross, J, additional, Shahid, A, additional, Underwood, M, additional, Vaithilingham, N, additional, Watkins, L, additional, Wykes, C, additional, Horne, AW, additional, Jurkovic, D, additional, Coomarasamy, A, additional, and Roberts, TE, additional

Published
2020
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8. Simulation for communication skills training in medical students: Protocol for a systematic scoping review

Author

Bakogiannis, A, Darling, JC, Dimitrova, V, and Roberts, TE

Subjects
education
Abstract

Empirical research has produced inconclusive, and occasionally contradictory, evidence relating to the extent to which improvements in medical communication skills taught through simulation can be measured. This is further limited by the wide range of designs and outcome collection methods that studies employ and does not allow for data comparability or meta-analysis. The proposed scoping review aims to systematically map and comprehensively explore the extent, range and nature of research activity on the use of simulation for communication skills training in medical education. Comprehensive literature searches in MEDLINE, EMBASE, Scopus and Web of Science will be performed and data will be reported using quantitative (simple numeric counts) and qualitative (thematic synthesis) analyses.

Published
2019

9. Valuing the health states associated with breast cancer screening programmes: A systematic review of economic measures

Author

Bromley HL, Petrie D, Mann GB, Nickson C, Rea D, and Roberts TE

Subjects
Cancer Type - Breast Cancer
Abstract

Policy decisions regarding breast cancer screening and treatment programmes may be misplaced unless the decision process includes the appropriate utilities and disutilities of mammography screening and its sequelae. The objectives of this study were to critically review how economic evaluations have valued the health states associated with breast cancer screening, and appraise the primary evidence informing health state utility values (cardinal measures of quality of life). A systematic review was conducted up to September 2018 of studies that elicited or used utilities relevant to mammography screening. The methods used to elicit utilities and the quality of the reported values were tabulated and analysed narratively. 40 economic evaluations of breast cancer screening programmes and 10 primary studies measuring utilities for health states associated with mammography were reviewed in full. The economic evaluations made different assumptions about the measures used, duration applied and the sequalae included in each health state. 22 evaluations referenced utilities based on assumptions or used measures that were not methodologically appropriate. There was significant heterogeneity in the utilities generated by the 10 primary studies, including the methods and population used to derive them. No study asked women to explicitly consider the risk of overdiagnosis when valuing the health states described. Utilities informing breast screening policy are restricted in their ability to reflect the full benefits and harms. Evaluating the true cost-effectiveness of breast cancer screening will remain problematic, unless the methodological challenges associated with valuing the disutilities of screening are adequately addressed.

Published
2019

10. Antibiotic prophylaxis in the surgical management of miscarriage in low-income countries: a cost-effectiveness analysis of the AIMS trial.

Author

Goranitis, I, Lissauer, DM, Coomarasamy, A, Wilson, A, Daniels, J, Middleton, L, Bishop, J, Hewitt, CA, Weeks, AD, Mhango, C, Mataya, R, Ahmed, I, Oladapo, OT, Zamora, J, Roberts, TE, Goranitis, I, Lissauer, DM, Coomarasamy, A, Wilson, A, Daniels, J, Middleton, L, Bishop, J, Hewitt, CA, Weeks, AD, Mhango, C, Mataya, R, Ahmed, I, Oladapo, OT, Zamora, J, and Roberts, TE

Abstract

BACKGROUND: There is ongoing debate on the clinical benefits of antibiotic prophylaxis for reducing pelvic infection after miscarriage surgery. We aimed to study the cost-effectiveness of antibiotic prophylaxis in the surgical management of miscarriage in low-income countries. METHODS: We did an incremental cost-effectiveness analysis using data from 3412 women recruited to the AIMS trial, a randomised, double-blind, placebo-controlled trial designed to evaluate the effectiveness of antibiotic prophylaxis in the surgical management of miscarriage in Malawi, Pakistan, Tanzania, and Uganda. Economic evaluation was done from a health-care-provider perspective on the basis of the outcome of cost per pelvic infection avoided within 2 weeks of surgery. Pelvic infection was broadly defined by the presence of clinical features or the clinically identified need to administer antibiotics. We used non-parametric bootstrapping and multilevel random effects models to estimate incremental mean costs and outcomes. Decision uncertainty was shown via cost-effectiveness acceptability frontiers. The AIMS trial is registered with the ISRCTN registry, number ISRCTN97143849. FINDINGS: Between June 2, 2014, and April 26, 2017, 3412 women were assigned to receive either antibiotic prophylaxis (1705 [50%] of 3412) or placebo (1707 [50%] of 3412) in the AIMS trial. 158 (5%) of 3412 women developed pelvic infection within 2 weeks of surgery, of whom 68 (43%) were in the antibiotic prophylaxis group and 90 (57%) in the placebo group. There is 97-98% probability that antibiotic prophylaxis is a cost-effective intervention at expected thresholds of willingness-to-pay per additional pelvic infection avoided. In terms of post-surgery antibiotics, the antibiotic prophylaxis group was US$0·27 (95% CI -0·49 to -0·05) less expensive per woman than the placebo group. A secondary analysis, a sensitivity analysis, and all subgroup analyses supported these findings. Antibiotic prophylaxis, if implemented

Published
2019

11. Social-environmental drivers inform strategic management of coral reefs in the Anthropocene.

Author

Darling, ES, McClanahan, TR, Maina, J, Gurney, GG, Graham, NAJ, Januchowski-Hartley, F, Cinner, JE, Mora, C, Hicks, CC, Maire, E, Puotinen, M, Skirving, WJ, Adjeroud, M, Ahmadia, G, Arthur, R, Bauman, AG, Beger, M, Berumen, ML, Bigot, L, Bouwmeester, J, Brenier, A, Bridge, TCL, Brown, E, Campbell, SJ, Cannon, S, Cauvin, B, Chen, CA, Claudet, J, Denis, V, Donner, S, Estradivari, Fadli, N, Feary, DA, Fenner, D, Fox, H, Franklin, EC, Friedlander, A, Gilmour, J, Goiran, C, Guest, J, Hobbs, J-PA, Hoey, AS, Houk, P, Johnson, S, Jupiter, SD, Kayal, M, Kuo, C-Y, Lamb, J, Lee, MAC, Low, J, Muthiga, N, Muttaqin, E, Nand, Y, Nash, KL, Nedlic, O, Pandolfi, JM, Pardede, S, Patankar, V, Penin, L, Ribas-Deulofeu, L, Richards, Z, Roberts, TE, Rodgers, KS, Safuan, CDM, Sala, E, Shedrawi, G, Sin, TM, Smallhorn-West, P, Smith, JE, Sommer, B, Steinberg, PD, Sutthacheep, M, Tan, CHJ, Williams, GJ, Wilson, S, Yeemin, T, Bruno, JF, Fortin, M-J, Krkosek, M, Mouillot, D, Darling, ES, McClanahan, TR, Maina, J, Gurney, GG, Graham, NAJ, Januchowski-Hartley, F, Cinner, JE, Mora, C, Hicks, CC, Maire, E, Puotinen, M, Skirving, WJ, Adjeroud, M, Ahmadia, G, Arthur, R, Bauman, AG, Beger, M, Berumen, ML, Bigot, L, Bouwmeester, J, Brenier, A, Bridge, TCL, Brown, E, Campbell, SJ, Cannon, S, Cauvin, B, Chen, CA, Claudet, J, Denis, V, Donner, S, Estradivari, Fadli, N, Feary, DA, Fenner, D, Fox, H, Franklin, EC, Friedlander, A, Gilmour, J, Goiran, C, Guest, J, Hobbs, J-PA, Hoey, AS, Houk, P, Johnson, S, Jupiter, SD, Kayal, M, Kuo, C-Y, Lamb, J, Lee, MAC, Low, J, Muthiga, N, Muttaqin, E, Nand, Y, Nash, KL, Nedlic, O, Pandolfi, JM, Pardede, S, Patankar, V, Penin, L, Ribas-Deulofeu, L, Richards, Z, Roberts, TE, Rodgers, KS, Safuan, CDM, Sala, E, Shedrawi, G, Sin, TM, Smallhorn-West, P, Smith, JE, Sommer, B, Steinberg, PD, Sutthacheep, M, Tan, CHJ, Williams, GJ, Wilson, S, Yeemin, T, Bruno, JF, Fortin, M-J, Krkosek, M, and Mouillot, D

Abstract

Without drastic efforts to reduce carbon emissions and mitigate globalized stressors, tropical coral reefs are in jeopardy. Strategic conservation and management requires identification of the environmental and socioeconomic factors driving the persistence of scleractinian coral assemblages-the foundation species of coral reef ecosystems. Here, we compiled coral abundance data from 2,584 Indo-Pacific reefs to evaluate the influence of 21 climate, social and environmental drivers on the ecology of reef coral assemblages. Higher abundances of framework-building corals were typically associated with: weaker thermal disturbances and longer intervals for potential recovery; slower human population growth; reduced access by human settlements and markets; and less nearby agriculture. We therefore propose a framework of three management strategies (protect, recover or transform) by considering: (1) if reefs were above or below a proposed threshold of >10% cover of the coral taxa important for structural complexity and carbonate production; and (2) reef exposure to severe thermal stress during the 2014-2017 global coral bleaching event. Our findings can guide urgent management efforts for coral reefs, by identifying key threats across multiple scales and strategic policy priorities that might sustain a network of functioning reefs in the Indo-Pacific to avoid ecosystem collapse.

Published
2019

12. The development of a pragmatic, clinically driven ultrasound curriculum in a UK medical school

Author

Wakefield, RJ, Weerasinghe, A, Tung, P, Smith, L, Pickering, J, Msimanga, T, Arora, M, Flood, K, Gupta, P, Bickerdike, S, McLaughlan, J, Uttley, A, Wilson, J, Evans, T, Wolstenhulme, S, and Roberts, TE

Abstract

Whether ultrasound (US) should be incorporated into a medical undergraduate curriculum remains a matter of debate within the medical education arena. There are clear potential benefits to its early introduction particularly with respect to the study of living anatomy and physiology in addition to the learning of clinical skills and procedures required for the graduate clinical practice. However, this needs to be balanced against what is perceived as an added value in addition to financial and time constraints which may potentially lead to the sacrifice of other aspects of the curriculum. Several medical schools have already reported their experiences of teaching US either as a standalone course or as a fully integrated vertical curriculum. This article describes and discusses the initial experience of a UK medical school that has taken the steps to develop its own pragmatic vertical US curriculum based on clinical endpoints with the intent of using US to enhance the learning experience of students and equipping them with the skills required for the safe practice as a junior doctor.

Published
2018

13. Erratum to:Methods for evaluating medical tests and biomarkers

Author

Gopalakrishna, G, Langendam, M, Scholten, R, Bossuyt, P, Leeflang, M, Noel-Storr, A, Thomas, J, Marshall, I, Wallace, B, Whiting, P, Davenport, C, GopalaKrishna, G, De Salis, I, Mallett, S, Wolff, R, Riley, R, Westwood, M, Kleinen, J, Collins, G, Reitsma, H, Moons, K, Zapf, A, Hoyer, A, Kramer, K, Kuss, O, Ensor, J, Deeks, JJ, Martin, EC, Riley, RD, Rücker, G, Steinhauser, S, Schumacher, M, Snell, K, Willis, B, Debray, T, Deeks, J, Di Ruffano, LF, Taylor-Phillips, S, Hyde, C, Taylor, SA, Batnagar, G, STREAMLINE COLON Investigators, STREAMLINE LUNG Investigators, METRIC Investigators, Seedat, F, Clarke, A, Byron, S, Nixon, F, Albrow, R, Walker, T, Deakin, C, Zhelev, Z, Hunt, H, Yang, Y, Abel, L, Buchanan, J, Fanshawe, T, Shinkins, B, Wynants, L, Verbakel, J, Van Huffel, S, Timmerman, D, Van Calster, B, Zwinderman, A, Oke, J, O'Sullivan, J, Perera, R, Nicholson, B, Bromley, HL, Roberts, TE, Francis, A, Petrie, D, Mann, GB, Malottki, K, Smith, H, Billingham, L, Sitch, A, Gerke, O, Holm-Vilstrup, M, Segtnan, EA, Halekoh, U, Høilund-Carlsen, PF, Francq, BG, Dinnes, J, Parkes, J, Gregory, W, Hewison, J, Altman, D, Rosenberg, W, Selby, P, Asselineau, J, Perez, P, Paye, A, Bessede, E, Proust-Lima, C, Naaktgeboren, C, De Groot, J, Rutjes, A, Reitsma, J, Ogundimu, E, Cook, J, Le Manach, Y, Vergouwe, Y, Pajouheshnia, R, Groenwold, R, Peelen, L, Nieboer, D, De Cock, B, Pencina, MJ, Steyerberg, EW, Cooper, J, Parsons, N, Stinton, C, Smith, S, Dickens, A, Jordan, R, Enocson, A, Fitzmaurice, D, Adab, P, Boachie, C, Vidmar, G, Freeman, K, Connock, M, Court, R, Moons, C, Harris, J, Mumford, A, Plummer, Z, Lee, K, Reeves, B, Rogers, C, Verheyden, V, Angelini, GD, Murphy, GJ, Huddy, J, Ni, M, Good, K, Cooke, G, Hanna, G, Ma, J, Moons, KGMC, De Groot, JAH, Altman, DG, Reitsma, JB, Collins, GS, Moons, KGM, Kamarudin, AN, Kolamunnage-Dona, R, Cox, T, Borsci, S, Pérez, T, Pardo, MC, Candela-Toha, A, Muriel, A, Zamora, J, Sanghera, S, Mohiuddin, S, Martin, R, Donovan, J, Coast, J, Seo, MK, Cairns, J, Mitchell, E, Smith, A, Wright, J, Hall, P, Messenger, M, Calder, N, Wickramasekera, N, Vinall-Collier, K, Lewington, A, Damen, J, Cairns, D, Hutchinson, M, Sturgeon, C, Mitchel, L, Kift, R, Christakoudi, S, Rungall, M, Mobillo, P, Montero, R, Tsui, T-L, Kon, SP, Tucker, B, Sacks, S, Farmer, C, Strom, T, Chowdhury, P, Rebollo-Mesa, I, Hernandez-Fuentes, M, Damen, JAAG, Debray, TPA, Heus, P, Hooft, L, Scholten, RJPM, Schuit, E, Tzoulaki, I, Lassale, CM, Siontis, GCM, Chiocchia, V, Roberts, C, Schlüssel, MM, Gerry, S, Black, JA, Van der Schouw, YT, Peelen, LM, Spence, G, McCartney, D, Van den Bruel, A, Lasserson, D, Hayward, G, Vach, W, De Jong, A, Burggraaff, C, Hoekstra, O, Zijlstra, J, De Vet, H, Graziadio, S, Allen, J, Johnston, L, O'Leary, R, Power, M, Johnson, L, Waters, R, Simpson, J, Fanshawe, TR, Phillips, P, Plumb, A, Helbren, E, Halligan, S, Gale, A, Sekula, P, Sauerbrei, W, Forman, JR, Dutton, SJ, Takwoingi, Y, Hensor, EM, Nichols, TE, Kempf, E, Porcher, R, De Beyer, J, Hopewell, S, Dennis, J, Shields, B, Jones, A, Henley, W, Pearson, E, Hattersley, A, MASTERMIND consortium, Scheibler, F, Rummer, A, Sturtz, S, Großelfinger, R, Banister, K, Ramsay, C, Azuara-Blanco, A, Burr, J, Kumarasamy, M, Bourne, R, Uchegbu, I, Murphy, J, Carter, A, Marti, J, Eatock, J, Robotham, J, Dudareva, M, Gilchrist, M, Holmes, A, Monaghan, P, Lord, S, StJohn, A, Sandberg, S, Cobbaert, C, Lennartz, L, Verhagen-Kamerbeek, W, Ebert, C, Horvath, A, Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine, Jenniskens, K, Peters, J, Grigore, B, Ukoumunne, O, Levis, B, Benedetti, A, Levis, AW, Ioannidis, JPA, Shrier, I, Cuijpers, P, Gilbody, S, Kloda, LA, McMillan, D, Patten, SB, Steele, RJ, Ziegelstein, RC, Bombardier, CH, Osório, FDL, Fann, JR, Gjerdingen, D, Lamers, F, Lotrakul, M, Loureiro, SR, Löwe, B, Shaaban, J, Stafford, L, Van Weert, HCPM, Whooley, MA, Williams, LS, Wittkampf, KA, Yeung, AS, Thombs, BD, Cooper, C, Nieto, T, Smith, C, Tucker, O, Dretzke, J, Beggs, A, Rai, N, Bayliss, S, Stevens, S, Mallet, S, Sundar, S, Hall, E, Porta, N, Estelles, DL, De Bono, J, CTC-STOP protocol development group, and National Institute for Health Research

Subjects
medicine.medical_specialty, Astrophysics::High Energy Astrophysical Phenomena, MEDLINE, 030204 cardiovascular system & hematology, BTC (Bristol Trials Centre), MASTERMIND consortium, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Intensive care medicine, CTC-STOP protocol development group, lcsh:R5-920, business.industry, Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine, Published Erratum, STREAMLINE COLON Investigators, 3. Good health, STREAMLINE LUNG Investigators, Centre for Surgical Research, Family medicine, METRIC Investigators, High Energy Physics::Experiment, Erratum, business, lcsh:Medicine (General)
Abstract

[This corrects the article DOI: 10.1186/s41512-016-0001-y.].

Published
2017

14. The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

Author

Estcourt, C, Sutcliffe, L, Mercer, CH, Copas, A, Saunders, J, Roberts, TE, Fuller, SS, Jackson, LJ, Sutton, AJ, White, PJ, Birger, R, Rait, G, Johnson, A, Hart, G, Muniina, P, and Cassell, J

Abstract

Background: Sexually transmitted infection (STI) diagnoses are increasing and efforts to reduce transmission have failed. There are major uncertainties in the evidence base surrounding the delivery of STI care for men. Aim: To improve the sexual health of young men in the UK by determining optimal strategies for STI testing and care. Objectives: To develop an evidence-based clinical algorithm for STI testing in asymptomatic men; model mathematically the epidemiological and economic impact of removing microscopy from routine STI testing in asymptomatic men; conduct a pilot randomised controlled trial (RCT) of accelerated partner therapy (APT; new models of partner notification to rapidly treat male sex partners of people with STIs) in primary care; explore the acceptability of diverse venues for STI screening in men; and determine optimal models for the delivery of screening. Design: Systematic review of the clinical consequences of asymptomatic non-chlamydial, non-gonococcal urethritis (NCNGU); case–control study of factors associated with NCNGU; mathematical modelling of the epidemiological and economic impact of removing microscopy from asymptomatic screening and cost-effectiveness analysis; pilot RCT of APT for male sex partners of women diagnosed with Chlamydia trachomatis infection in primary care; stratified random probability sample survey of UK young men; qualitative study of men’s views on accessing STI testing; SPORTSMART pilot cluster RCT of two STI screening interventions in amateur football clubs; and anonymous questionnaire survey of STI risk and previous testing behaviour in men in football clubs. Settings: General population, genitourinary medicine clinic attenders, general practice and community contraception and sexual health clinic attenders and amateur football clubs. Participants: Men and women. Interventions: Partner notification interventions: APTHotline [telephone assessment of partner(s)] and APTPharmacy [community pharmacist assessment of partner(s)]. SPORTSMART interventions: football captain-led and health adviser-led promotion of urine-based STI screening. Main outcome measures: For the APT pilot RCT, the primary outcome, determined for each contactable partner, was whether or not they were considered to have been treated within 6 weeks of index diagnosis. For the SPORTSMART pilot RCT, the primary outcome was the proportion of eligible men accepting screening. Results: Non-chlamydial, non-gonococcal urethritis is not associated with significant clinical consequences for men or their sexual partners but study quality is poor (systematic review). Men with symptomatic and asymptomatic NCNGU and healthy men share similar demographic, behavioural and clinical variables (case–control study). Removal of urethral microscopy from routine asymptomatic screening is likely to lead to a small rise in pelvic inflammatory disease (PID) but could save > £5M over 20 years (mathematical modelling and health economics analysis). In the APT pilot RCT the proportion of partners treated by the APTHotline [39/111 (35%)], APTPharmacy [46/100 (46%)] and standard patient referral [46/102 (45%)] did not meet national standards but exceeded previously reported outcomes in community settings. Men’s reported willingness to access self-sampling kits for STIs and human immunodeficiency virus infection was high. Traditional health-care settings were preferred but sports venues were acceptable to half of men who played sport (random probability sample survey). Men appear to prefer a ‘straightforward’ approach to STI screening, accessible as part of their daily activities (qualitative study). Uptake of STI screening in the SPORTSMART RCT was high, irrespective of arm [captain led 28/56 (50%); health-care professional led 31/46 (67%); poster only 31/51 (61%)], and costs were similar. Men were at risk of STIs but previous testing was common. Conclusions: Men find traditional health-care settings the most acceptable places to access STI screening. Self-sampling kits in football clubs could widen access to screening and offer a public health impact for men with limited local sexual health services. Available evidence does not support an association between asymptomatic NCNGU and significant adverse clinical outcomes for men or their sexual partners but the literature is of poor quality. Similarities in characteristics of men with and without NCNGU precluded development of a meaningful clinical algorithm to guide STI testing in asymptomatic men. The mathematical modelling and cost-effectiveness analysis of removing all asymptomatic urethral microscopy screening suggests that this would result in a small rise in adverse outcomes such as PID but that it would be highly cost-effective. APT appears to improve outcomes of partner notification in community settings but outcomes still fail to meet national standards. Priorities for future work include improving understanding of men’s collective behaviours and how these can be harnessed to improve health outcomes; exploring barriers to and facilitators of opportunistic STI screening for men attending general practice, with development of evidence-based interventions to increase the offer and uptake of screening; further development of APT for community settings; and studies to improve knowledge of factors specific to screening men who have sex with men (MSM) and, in particular, how, with the different epidemiology of STIs in MSM and the current narrow focus on chlamydia, this could negatively impact MSM’s sexual health. Funding: The National Institute for Health Research Programme Grants for Applied Research programme.

Published
2016

15. Erratum to: Methods for evaluating medical tests and biomarkers.

Author

Gopalakrishna, G, Langendam, M, Scholten, R, Bossuyt, P, Leeflang, M, Noel-Storr, A, Thomas, J, Marshall, I, Wallace, B, Whiting, P, Davenport, C, GopalaKrishna, G, de Salis, I, Mallett, S, Wolff, R, Riley, R, Westwood, M, Kleinen, J, Collins, G, Reitsma, H, Moons, K, Zapf, A, Hoyer, A, Kramer, K, Kuss, O, Ensor, J, Deeks, JJ, Martin, EC, Riley, RD, Rücker, G, Steinhauser, S, Schumacher, M, Snell, K, Willis, B, Debray, T, Deeks, J, di Ruffano, LF, Taylor-Phillips, S, Hyde, C, Taylor, SA, Batnagar, G, STREAMLINE COLON Investigators, STREAMLINE LUNG Investigators, METRIC Investigators, Di Ruffano, LF, Seedat, F, Clarke, A, Byron, S, Nixon, F, Albrow, R, Walker, T, Deakin, C, Zhelev, Z, Hunt, H, Yang, Y, Abel, L, Buchanan, J, Fanshawe, T, Shinkins, B, Wynants, L, Verbakel, J, Van Huffel, S, Timmerman, D, Van Calster, B, Zwinderman, A, Oke, J, O'Sullivan, J, Perera, R, Nicholson, B, Bromley, HL, Roberts, TE, Francis, A, Petrie, D, Mann, GB, Malottki, K, Smith, H, Billingham, L, Sitch, A, Gerke, O, Holm-Vilstrup, M, Segtnan, EA, Halekoh, U, Høilund-Carlsen, PF, Francq, BG, Dinnes, J, Parkes, J, Gregory, W, Hewison, J, Altman, D, Rosenberg, W, Selby, P, Asselineau, J, Perez, P, Paye, A, Bessede, E, Proust-Lima, C, Naaktgeboren, C, de Groot, J, Rutjes, A, Reitsma, J, Ogundimu, E, Cook, J, Le Manach, Y, Vergouwe, Y, Pajouheshnia, R, Groenwold, R, Peelen, L, Nieboer, D, De Cock, B, Pencina, MJ, Steyerberg, EW, Cooper, J, Parsons, N, Stinton, C, Smith, S, Dickens, A, Jordan, R, Enocson, A, Fitzmaurice, D, Adab, P, Boachie, C, Vidmar, G, Freeman, K, Connock, M, Court, R, Moons, C, Harris, J, Mumford, A, Plummer, Z, Lee, K, Reeves, B, Rogers, C, Verheyden, V, Angelini, GD, Murphy, GJ, Huddy, J, Ni, M, Good, K, Cooke, G, Hanna, G, Ma, J, Moons, KGMC, de Groot, JAH, Altman, DG, Reitsma, JB, Collins, GS, Moons, KGM, Kamarudin, AN, Kolamunnage-Dona, R, Cox, T, Borsci, S, Pérez, T, Pardo, MC, Candela-Toha, A, Muriel, A, Zamora, J, Sanghera, S, Mohiuddin, S, Martin, R, Donovan, J, Coast, J, Seo, MK, Cairns, J, Mitchell, E, Smith, A, Wright, J, Hall, P, Messenger, M, Calder, N, Wickramasekera, N, Vinall-Collier, K, Lewington, A, Damen, J, Cairns, D, Hutchinson, M, Sturgeon, C, Mitchel, L, Kift, R, Christakoudi, S, Rungall, M, Mobillo, P, Montero, R, Tsui, T-L, Kon, SP, Tucker, B, Sacks, S, Farmer, C, Strom, T, Chowdhury, P, Rebollo-Mesa, I, Hernandez-Fuentes, M, Damen, JAAG, Debray, TPA, Heus, P, Hooft, L, Scholten, RJPM, Schuit, E, Tzoulaki, I, Lassale, CM, Siontis, GCM, Chiocchia, V, Roberts, C, Schlüssel, MM, Gerry, S, Black, JA, van der Schouw, YT, Peelen, LM, Spence, G, McCartney, D, van den Bruel, A, Lasserson, D, Hayward, G, Vach, W, de Jong, A, Burggraaff, C, Hoekstra, O, Zijlstra, J, de Vet, H, Graziadio, S, Allen, J, Johnston, L, O'Leary, R, Power, M, Johnson, L, Waters, R, Simpson, J, Fanshawe, TR, Phillips, P, Plumb, A, Helbren, E, Halligan, S, Gale, A, Sekula, P, Sauerbrei, W, Forman, JR, Dutton, SJ, Takwoingi, Y, Hensor, EM, Nichols, TE, Kempf, E, Porcher, R, de Beyer, J, Hopewell, S, Dennis, J, Shields, B, Jones, A, Henley, W, Pearson, E, Hattersley, A, MASTERMIND consortium, Scheibler, F, Rummer, A, Sturtz, S, Großelfinger, R, Banister, K, Ramsay, C, Azuara-Blanco, A, Burr, J, Kumarasamy, M, Bourne, R, Uchegbu, I, Murphy, J, Carter, A, Marti, J, Eatock, J, Robotham, J, Dudareva, M, Gilchrist, M, Holmes, A, Monaghan, P, Lord, S, StJohn, A, Sandberg, S, Cobbaert, C, Lennartz, L, Verhagen-Kamerbeek, W, Ebert, C, Horvath, A, Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine, Jenniskens, K, Peters, J, Grigore, B, Ukoumunne, O, Levis, B, Benedetti, A, Levis, AW, Ioannidis, JPA, Shrier, I, Cuijpers, P, Gilbody, S, Kloda, LA, McMillan, D, Patten, SB, Steele, RJ, Ziegelstein, RC, Bombardier, CH, Osório, FDL, Fann, JR, Gjerdingen, D, Lamers, F, Lotrakul, M, Loureiro, SR, Löwe, B, Shaaban, J, Stafford, L, van Weert, HCPM, Whooley, MA, Williams, LS, Wittkampf, KA, Yeung, AS, Thombs, BD, Cooper, C, Nieto, T, Smith, C, Tucker, O, Dretzke, J, Beggs, A, Rai, N, Bayliss, S, Stevens, S, Mallet, S, Sundar, S, Hall, E, Porta, N, Estelles, DL, de Bono, J, CTC-STOP protocol development group, Gopalakrishna, G, Langendam, M, Scholten, R, Bossuyt, P, Leeflang, M, Noel-Storr, A, Thomas, J, Marshall, I, Wallace, B, Whiting, P, Davenport, C, GopalaKrishna, G, de Salis, I, Mallett, S, Wolff, R, Riley, R, Westwood, M, Kleinen, J, Collins, G, Reitsma, H, Moons, K, Zapf, A, Hoyer, A, Kramer, K, Kuss, O, Ensor, J, Deeks, JJ, Martin, EC, Riley, RD, Rücker, G, Steinhauser, S, Schumacher, M, Snell, K, Willis, B, Debray, T, Deeks, J, di Ruffano, LF, Taylor-Phillips, S, Hyde, C, Taylor, SA, Batnagar, G, STREAMLINE COLON Investigators, STREAMLINE LUNG Investigators, METRIC Investigators, Di Ruffano, LF, Seedat, F, Clarke, A, Byron, S, Nixon, F, Albrow, R, Walker, T, Deakin, C, Zhelev, Z, Hunt, H, Yang, Y, Abel, L, Buchanan, J, Fanshawe, T, Shinkins, B, Wynants, L, Verbakel, J, Van Huffel, S, Timmerman, D, Van Calster, B, Zwinderman, A, Oke, J, O'Sullivan, J, Perera, R, Nicholson, B, Bromley, HL, Roberts, TE, Francis, A, Petrie, D, Mann, GB, Malottki, K, Smith, H, Billingham, L, Sitch, A, Gerke, O, Holm-Vilstrup, M, Segtnan, EA, Halekoh, U, Høilund-Carlsen, PF, Francq, BG, Dinnes, J, Parkes, J, Gregory, W, Hewison, J, Altman, D, Rosenberg, W, Selby, P, Asselineau, J, Perez, P, Paye, A, Bessede, E, Proust-Lima, C, Naaktgeboren, C, de Groot, J, Rutjes, A, Reitsma, J, Ogundimu, E, Cook, J, Le Manach, Y, Vergouwe, Y, Pajouheshnia, R, Groenwold, R, Peelen, L, Nieboer, D, De Cock, B, Pencina, MJ, Steyerberg, EW, Cooper, J, Parsons, N, Stinton, C, Smith, S, Dickens, A, Jordan, R, Enocson, A, Fitzmaurice, D, Adab, P, Boachie, C, Vidmar, G, Freeman, K, Connock, M, Court, R, Moons, C, Harris, J, Mumford, A, Plummer, Z, Lee, K, Reeves, B, Rogers, C, Verheyden, V, Angelini, GD, Murphy, GJ, Huddy, J, Ni, M, Good, K, Cooke, G, Hanna, G, Ma, J, Moons, KGMC, de Groot, JAH, Altman, DG, Reitsma, JB, Collins, GS, Moons, KGM, Kamarudin, AN, Kolamunnage-Dona, R, Cox, T, Borsci, S, Pérez, T, Pardo, MC, Candela-Toha, A, Muriel, A, Zamora, J, Sanghera, S, Mohiuddin, S, Martin, R, Donovan, J, Coast, J, Seo, MK, Cairns, J, Mitchell, E, Smith, A, Wright, J, Hall, P, Messenger, M, Calder, N, Wickramasekera, N, Vinall-Collier, K, Lewington, A, Damen, J, Cairns, D, Hutchinson, M, Sturgeon, C, Mitchel, L, Kift, R, Christakoudi, S, Rungall, M, Mobillo, P, Montero, R, Tsui, T-L, Kon, SP, Tucker, B, Sacks, S, Farmer, C, Strom, T, Chowdhury, P, Rebollo-Mesa, I, Hernandez-Fuentes, M, Damen, JAAG, Debray, TPA, Heus, P, Hooft, L, Scholten, RJPM, Schuit, E, Tzoulaki, I, Lassale, CM, Siontis, GCM, Chiocchia, V, Roberts, C, Schlüssel, MM, Gerry, S, Black, JA, van der Schouw, YT, Peelen, LM, Spence, G, McCartney, D, van den Bruel, A, Lasserson, D, Hayward, G, Vach, W, de Jong, A, Burggraaff, C, Hoekstra, O, Zijlstra, J, de Vet, H, Graziadio, S, Allen, J, Johnston, L, O'Leary, R, Power, M, Johnson, L, Waters, R, Simpson, J, Fanshawe, TR, Phillips, P, Plumb, A, Helbren, E, Halligan, S, Gale, A, Sekula, P, Sauerbrei, W, Forman, JR, Dutton, SJ, Takwoingi, Y, Hensor, EM, Nichols, TE, Kempf, E, Porcher, R, de Beyer, J, Hopewell, S, Dennis, J, Shields, B, Jones, A, Henley, W, Pearson, E, Hattersley, A, MASTERMIND consortium, Scheibler, F, Rummer, A, Sturtz, S, Großelfinger, R, Banister, K, Ramsay, C, Azuara-Blanco, A, Burr, J, Kumarasamy, M, Bourne, R, Uchegbu, I, Murphy, J, Carter, A, Marti, J, Eatock, J, Robotham, J, Dudareva, M, Gilchrist, M, Holmes, A, Monaghan, P, Lord, S, StJohn, A, Sandberg, S, Cobbaert, C, Lennartz, L, Verhagen-Kamerbeek, W, Ebert, C, Horvath, A, Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine, Jenniskens, K, Peters, J, Grigore, B, Ukoumunne, O, Levis, B, Benedetti, A, Levis, AW, Ioannidis, JPA, Shrier, I, Cuijpers, P, Gilbody, S, Kloda, LA, McMillan, D, Patten, SB, Steele, RJ, Ziegelstein, RC, Bombardier, CH, Osório, FDL, Fann, JR, Gjerdingen, D, Lamers, F, Lotrakul, M, Loureiro, SR, Löwe, B, Shaaban, J, Stafford, L, van Weert, HCPM, Whooley, MA, Williams, LS, Wittkampf, KA, Yeung, AS, Thombs, BD, Cooper, C, Nieto, T, Smith, C, Tucker, O, Dretzke, J, Beggs, A, Rai, N, Bayliss, S, Stevens, S, Mallet, S, Sundar, S, Hall, E, Porta, N, Estelles, DL, de Bono, J, and CTC-STOP protocol development group

Abstract

[This corrects the article DOI: 10.1186/s41512-016-0001-y.].

Published
2017

16. Testing and Treating Women after Unsuccessful Conservative Treatments for Overactive Bladder or Mixed Urinary Incontinence: A Model-Based Economic Evaluation Based on the BUS Study

Author

Shimosawa, T, Goranitis, I, Barton, P, Middleton, LJ, Deeks, JJ, Daniels, JP, Latthe, P, Coomarasamy, A, Rachaneni, S, McCooty, S, Verghese, TS, Roberts, TE, Shimosawa, T, Goranitis, I, Barton, P, Middleton, LJ, Deeks, JJ, Daniels, JP, Latthe, P, Coomarasamy, A, Rachaneni, S, McCooty, S, Verghese, TS, and Roberts, TE

Abstract

OBJECTIVE: To compare the cost-effectiveness of bladder ultrasonography, clinical history, and urodynamic testing in guiding treatment decisions in a secondary care setting for women failing first line conservative treatment for overactive bladder or urgency-predominant mixed urinary incontinence. DESIGN: Model-based economic evaluation from a UK National Health Service (NHS) perspective using data from the Bladder Ultrasound Study (BUS) and secondary sources. METHODS: Cost-effectiveness analysis using a decision tree and a 5-year time horizon based on the outcomes of cost per woman successfully treated and cost per Quality-Adjusted Life-Year (QALY). Deterministic and probabilistic sensitivity analyses, and a value of information analysis are also undertaken. RESULTS: Bladder ultrasonography is more costly and less effective test-treat strategy than clinical history and urodynamics. Treatment on the basis of clinical history alone has an incremental cost-effectiveness ratio (ICER) of £491,100 per woman successfully treated and an ICER of £60,200 per QALY compared with the treatment of all women on the basis of urodynamics. Restricting the use of urodynamics to women with a clinical history of mixed urinary incontinence only is the optimal test-treat strategy on cost-effectiveness grounds with ICERs of £19,500 per woman successfully treated and £12,700 per QALY compared with the treatment of all women based upon urodynamics. Conclusions remained robust to sensitivity analyses, but subject to large uncertainties. CONCLUSIONS: Treatment based upon urodynamics can be seen as a cost-effective strategy, and particularly when targeted at women with clinical history of mixed urinary incontinence only. Further research is needed to resolve current decision uncertainty.

Published
2016

17. The validity and responsiveness of the ICECAP-A capability-well-being measure in women with irritative lower urinary tract symptoms

Author

Goranitis, I, Coast, J, Al-Janabi, H, Latthe, P, Roberts, TE, Goranitis, I, Coast, J, Al-Janabi, H, Latthe, P, and Roberts, TE

Abstract

PURPOSE: A desire to incorporate broader aspects of well-being in health economic evaluations has led to the development of the ICEpop CAPability measure for Adults (ICECAP-A). The ICECAP-A draws upon Amartya Sen's capability approach and conceptualises well-being as the capability to achieve Stability, Attachment, Autonomy, Achievement, and Enjoyment. The aim of this study was to assess the psychometric performance of the ICECAP-A in a context where patient outcomes can extend beyond health-related quality of life. METHODS: Longitudinal data were collected for 478 women with symptoms of urinary frequency and urgency, with or without incontinence. Women were recruited across 22 hospitals in the UK and had a mean age of 55 (SD 14). The psychometric performance of the measure was evaluated in relation to the EuroQol Five-Dimension Questionnaire (EQ-5D-3L) and the International Consultation on Incontinence Questionnaire for Overactive Bladder (ICIQ-OAB) and involved an assessment of acceptability, construct validity, and responsiveness using parametric and nonparametric methods. RESULTS: ICECAP-A showed good convergence with the ICIQ-OAB with 20 out of 22 expected patterns of relationship confirmed. Findings suggested that the ICECAP-A has better discriminative properties than EQ-5D-3L and as good as those of the ICIQ-OAB, confirming expected associations with clinical and demographic factors. The ICECAP-A was more responsive than EQ-5D-3L and ICIQ-OAB to deteriorations of clinical symptoms. Improvements in symptoms were not valued as highly as deteriorations by either ICECAP-A or EQ-5D-3L. CONCLUSIONS: The ICECAP-A is a valid and responsive measure capturing broad emotional and practical impacts of urinary symptoms on women's well-being and could be considered for use in economic evaluations in this context.

Published
2016

19. The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction

Author

Morris, RK, primary, Malin, GL, additional, Quinlan-Jones, E, additional, Middleton, LJ, additional, Diwakar, L, additional, Hemming, K, additional, Burke, D, additional, Daniels, J, additional, Denny, E, additional, Barton, P, additional, Roberts, TE, additional, Khan, KS, additional, Deeks, JJ, additional, and Kilby, MD, additional

Published
2013
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23. An economic evaluation of outpatient versus inpatient polyp treatment for abnormal uterine bleeding.

Author

Diwakar, L, Roberts, TE, Cooper, NAM, Middleton, L, Jowett, S, Daniels, J, Smith, P, and Clark, TJ

Subjects
*POLYPS, *UTERINE hemorrhage treatment, *ENDOMETRIAL diseases, *HYSTEROSCOPY, *OUTPATIENT medical care research, *COST effectiveness, *THERAPEUTICS, *COMPARATIVE studies, *OUTPATIENT medical care, *GYNECOLOGIC surgery, *HOSPITAL care, *RESEARCH methodology, *MEDICAL care research, *MEDICAL care costs, *MEDICAL cooperation, *PATIENT satisfaction, *RESEARCH, *UTERINE hemorrhage, *COST analysis, *EVALUATION research, *RANDOMIZED controlled trials, *TREATMENT effectiveness, *DISEASE complications, *SURGERY, *ECONOMICS
Abstract

Objectives: To undertake a cost-effectiveness analysis of outpatient uterine polypectomy compared with standard inpatient treatment under general anaesthesia.Design: Economic evaluation carried out alongside the multi-centre, pragmatic, non-inferiority, randomised controlled Outpatient Polyp Treatment (OPT) trial. The UK National Health Service (NHS) perspective was used in the estimation of costs and the interpretation of results.Setting: Thirty-one secondary care UK NHS hospitals between April 2008 and July 2011.Participants: Five hundred and seven women with abnormal uterine bleeding and hysteroscopically diagnosed endometrial polyps.Interventions: Outpatient uterine polypectomy versus standard inpatient treatment. Clinicians were free to choose the technique for polypectomy within the allocated setting.Main Outcome Measures: Patient-reported effectiveness of the procedure determined by the women's self-assessment of bleeding at 6 months, and QALY gains at 6 and 12 months.Results: Inpatient treatment was slightly more effective but more expensive than outpatient treatment, resulting in relatively high incremental cost-effectiveness ratios. Intention-to-treat analysis of the base case at 6 months revealed that it cost an additional £9421 per successfully treated patient in the inpatient group and £ 1,099,167 per additional QALY gained, when compared with outpatient treatment. At 12 months, these costs were £22,293 per additional effectively treated patient and £445,867 per additional QALY gained, respectively.Conclusions: Outpatient treatment of uterine polyps associated with abnormal uterine bleeding appears to be more cost-effective than inpatient treatment at willingness-to-pay thresholds acceptable to the NHS.Tweetable Abstract: HTA-funded OPT trial concluded that outpatient uterine polypectomy is cost-effective compared with inpatient polypectomy. [ABSTRACT FROM AUTHOR]

Published
2016
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24. Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness.

Author

Ewer, AK, primary, Furmston, AT, additional, Middleton, LJ, additional, Deeks, JJ, additional, Daniels, JP, additional, Pattison, HM, additional, Powell, R, additional, Roberts, TE, additional, Barton, P, additional, Auguste, P, additional, Bhoyar, A, additional, Thangaratinam, S, additional, Tonks, AM, additional, Satodia, P, additional, Deshpande, S, additional, Kumararatne, B, additional, Sivakumar, S, additional, Mupanemunda, R, additional, and Khan, KS, additional

Published
2012
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27. Antenatal screening for haemoglobinopathies in primary care: a cohort study and cluster randomised trial to inform a simulation model. The Screening for Haemoglobinopathies in First Trimester (SHIFT) trial

Author

Dormandy, E, primary, Bryan, S, additional, Gulliford, MC, additional, Roberts, TE, additional, Ades, AE, additional, Calnan, M, additional, Atkin, K, additional, Karnon, J, additional, Barton, PM, additional, Logan, J, additional, Kavalier, F, additional, Harris, HJ, additional, Johnston, TA, additional, Anionwu, EN, additional, Davis, V, additional, Brown, K, additional, Juarez-Garcia, A, additional, Tsianakas, V, additional, and Marteau, TM, additional

Published
2010
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30. Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost-consequence analysis of an exploratory trial.

Author

Roberts TE, Tsourapas A, Sutcliffe L, Cassell J, Estcourt C, Roberts, Tracy E, Tsourapas, Angelos, Sutcliffe, Lorna, Cassell, Jackie, and Estcourt, Claudia

Abstract

Objectives: To undertake a cost-consequence analysis to assess two new models of partner notification (PN), known as Accelerated Partner Therapy (APT Hotline and APT Pharmacy), as compared with routine patient referral PN, for sex partners of people with chlamydia, gonorrhoea and non-gonococcal urethritis.Methods: Comparison of costs and outcomes alongside an exploratory trial involving two genitourinary medicine clinics and six community pharmacies. Index patients selected the PN method (APT Hotline, APT Pharmacy or routine PN) for their partners. Clinics and pharmacies recorded cost and resource use data including duration of consultation and uptake of treatment pack. Cost data were collected prospectively for two out of three interventions, and data were synthesised and compared in terms of effectiveness and costs.Results: Routine PN had the lowest average cost per partner treated (approximately £46) compared with either APT Hotline (approximately £54) or APT Pharmacy (approximately £53) strategies. The cost-consequence analysis revealed that APT strategies were more costly but also more effective at treating partners compared to routine PN.Conclusion: The hotline strategy costs more than both the alternative PN strategies. If we accept that strategies which identify and treat partners the fastest are likely to be the most effective in reducing reinfection and onward transmission, then APT Hotline appears an effective PN strategy by treating the highest number of partners in the shortest duration. Whether the additional benefit is worth the additional cost cannot be determined in this preliminary analysis. These data will be useful for informing development of future randomised controlled trials of APT. [ABSTRACT FROM AUTHOR]

Published
2012
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32. Health practices and expectations of Brazilians in the United States.

Author

Roberts TE

Abstract

This ethnographic examination of Brazilian immigrant perspectives regarding healthcare in the U.S. included participant observation and interviews with 42 Brazilian transnational. Data were analyzed using Agar's approach. Findings show that Brazilians accessed allopathic care only as a last resort after self-treatment strategies failed, that they tended to feel that diagnostic testing, referrals, and symptom-relieving prescriptions were imperative to good care, and that they expected more personal warmth, continuity of care, and more affectionate verbal and nonverbal cues than their U.S. clinicians provided. Recommendations to improve quality of healthcare to Brazilian transnational in the USA are discussed. [ABSTRACT FROM AUTHOR]

Published
2007

33. Parenteral dihydroergotamine for acute migraine headache: a systematic review of the literature.

Author

Colman I, Brown MD, Innes GD, Grafstein E, Roberts TE, and Rowe BH

Abstract

STUDY OBJECTIVE: Many therapies are used in the treatment of acute migraine headache, with little agreement on effectiveness. This systematic review is designed to determine the effectiveness of parenteral dihydroergotamine in reducing pain, nausea, and relapse for episodes of acute migraine in adults. METHODS: Randomized controlled trials were identified using MEDLINE, EMBASE, other computerized databases, hand searching, bibliographies, and contacts with industry and authors. Studies in which dihydroergotamine (alone or in combination with an antiemetic) was compared with placebo or any other common migraine therapy were considered. Relevance, inclusion, and study quality were assessed independently by 2 reviewers. RESULTS: From 281 potentially relevant abstracts, 11 studies met the inclusion criteria. Solitary dihydroergotamine use was compared to sumatriptan and phenothiazines in 3 studies; results failed to demonstrate a significant benefit of dihydroergotamine over these therapies. In 8 combination treatment studies, heterogeneity in study methodology prevented statistical pooling. However, dihydroergotamine administered with an antiemetic was as effective as or more effective than meperidine, valproate, or ketorolac across all pain, nausea, and relapse outcomes reported in all studies. CONCLUSION: This evidence suggests that dihydroergotamine is not as effective as sumatriptan or phenothiazines as a single agent for treatment of acute migraine headache; however, when administered with an antiemetic, dihydroergotamine appears to be as effective as opiates, ketorolac, or valproate. Given its nonnarcotic properties, parenteral dihydroergotamine combined with an antiemetic should be considered as effective initial therapy in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2005
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41. Foreword

Author

Roberts, Terrance

Published
2013

43. Contents

Author

Roberts, Terrance

Published
2013

49. Afterword

Author

Roberts, Terrance

Published
2013

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