BackgroundThe purpose of this study was to investigate the epidemiological, humanistic, and economic burden of illness associated with adult lower limb spasticity (LLS) and its complications.MethodsA systematic search of MEDLINE and EMBASE identified 23 studies published between January 2002 and October 2012 that assessed the epidemiology, impact, and resource use associated with LLS. A hand-search of four neurology conferences identified abstracts published between 2010 and 2012.ResultsLLS was found to occur in one third of adults after stroke, half to two thirds with multiple sclerosis, and three quarters with cerebral palsy. LLS limits mobility and reduces quality of life. No clear association was found between LLS and occurrence of pain, development of contractures, or risk of falls.ConclusionThe evidence on the burden of LLS and its complications is surprisingly limited given the condition’s high prevalence among adults with common disorders, such as stroke. Further research is needed to clarify the impact of LLS, including the likelihood of thrombosis in spastic lower limbs. The dearth of high-quality evidence for LLS suggests a lack of awareness of, and interest in, the problem, and therefore, the unmet need among patients and their carers.
Intra class correlation coefficients between the countries were high: from 0.89 (England vs. US) through 0.99 (Canada vs. US). ConClusions: This proof of concept study indicates that computer-based choice tasks for the EQ-5D-5L in the general population are feasible and parameter of the choice tasks estimates are generally consistent and logical, and the estimated values are largely consistent between the 4 countries. PP3 Can the Use of soCial Media and Mobile aPPs iMProve Patient Knowledge of disease and health oUtCoMes? a systeMatiC review
Breast-feeding initiation rates are satisfactorily high in Berlin. Rates of early first suckling and (exclusive) initial breast-feeding are highest in birth centres. No consistent association was found between hospitals' breast-feeding policy and initial breast-feeding variables. The questionnaire was well accepted and is deemed suitable for monitoring purposes.
Objectives: Encompassing a group of cancers originating from the upper aerodigestive tract, head and neck cancers are ranked in the top ten for both incidence and mortality among all malignancies globally. This study aimed to estimate trends in total secondary care costs associated with the treatment of head and neck cancers in England from 2006/2007 to 2010/2011. MethOds: Data on inpatient and outpatient activity associated with oropharyngeal, oral cavity and laryngeal cancer was extracted from the Hospital Episode Statistics (HES) database. After grouping inpatient episodes into spells, a single Healthcare Resource Group (HRG) was derived for each and then cross-referenced with the National Tariff 2010/11 to estimate the associated cost. For specific types of therapy, including chemotherapy and radiotherapy, HRG definitions were cross-referenced with the National Reference Costs for the latest available year and inflated using the PCI index. Outpatient costs were estimated by grouping consultations by treatment speciality. Results: The total cost of treatment for all cancers over the entire period was estimated to be around £309 million, at 2011 prices. Inpatient care covered by bundled HRGs accounted for over 90% of this cost, at £280 million. Total costs due to oropharyngeal cancer were slightly higher than those estimated for laryngeal and oral cancer, costing £115 million (37.06%), £96 million (31.15%) and £98 million (31.79%) respectively. There was, generally, an increasing trend in the secondary care burden of all three cancers. Annual costs and patient numbers increased the most for oropharyngeal cancer, with annual inpatient costs increasing from £16,576,046 in 2006/07 to £28,467,016 in 2010/11. cOnclusiOns: This study indicates that there is a significant, and increasing, health and economic burden associated with head and neck cancers in England, highlighting the need for preventative programmes.
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