A361spirometry, BDR and FeNO testing. Where diagnostic uncertainty remained, individuals would then undergo PEF and finally MCT testing. This strategy dominated other strategies that did not utilise MCT, producing higher health outcomes at a lower cost to the health service. Two strategies that made more individuals undergo MCT were not cost-effective at the threshold with incremental cost-effectiveness ratios of £20,276 and £32,565 per/QALY respectively. Although assumptions were made relating to conditional dependence and the consequences of false diagnoses, the model's results were found to be robust to significant changes in these and other uncertain parameters. ConClusions: These findings highlight the need for thorough objective testing for diagnosing asthma as doing so has the potential to improve health outcomes whilst reducing costs to the health service.
Introduction Screening, brief intervention and referral to treatment (SBIRT) programmes have been advocated as having a preventive effect in non dependent drinkers and can provide a pathway to access specialist treatment for alcohol use disorders (AUD) for hospitalised patients who are contemplating changing their drinking behaviour. Little research into the effect of referral methods in hospitalised people treated for AUDs has been carried out. Methods Patient data for 2007-2009 were retrospectively reviewed in order to compare two referral to treatment methods namely, referral to treatment by a specialist nurse (RTT group) or self referral supported by a specialist nurse (SSR). Attendances at offered appointments were compared to identify each referral methods efficacy in eliciting attendance at a community alcohol treatment service following a request for further treatment for AUD elicited during hospitalisation in an acute setting. Results The sample size was 76; the most common reason for hospitalisation was deliberate overdose with alcohol (17.3%) followed by fall or collapse with alcohol (11.8%) Alcoholic Liver Disease with alcohol withdrawal (7.3%).Of 76 Patients referred to treatment by both methods, 36 were in the SSR group and 40 in the RTT group, no significant difference in response to referral modality between the RTT and SSR group was detected. Conclusion This study found no evidence of a difference in effectiveness of referral methods. This suggests that both referral methods were as effective as each other in eliciting attendance at a specialist alcohol treatment service after an offer of treatment had been made during acute hospitalisation. Further studies, with a larger population, are required to validate this finding Disclosure of Interest None Declared.
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