HRQL measures provide not only important information on the improvements offered by new therapies but also an outcome measure for economic evaluations. Recently developed HRQL measures and applications that include the direct assessments of children are important contributions. By the age of 7 or 8 years, children can generally provide reliable responses. Furthermore, children often provide information that is not available from parental reports (e.g., in the more subjective areas of pain and emotion). However, the use of multiple viewpoints, such as the patient, parent, and health professional perspectives, can provide valid and important complementary information. Expertise in HRQL measurement should be included in the design of most future trials. Funds for HRQL research should be made available to enhance the scope of HRQL activities by organizations such as the Children's Oncology Group. In the near future, further work to generate evidence of validity for available HRQL measures for use in children with ALL will be a high priority. Continuation of inquiries into the methods for HRQL assessment of younger children (i.e., preschoolers) is also a priority.
FDG-PET demonstrated 95.9% accuracy in restaging for patients with HL with CRu/PR after first-line therapy. Given the observed probabilities, FDG-PET is highly cost effective and would reduce costs for the public health care program in Brazil.
Biomedical databases are an important source of information for health
technology assessment. However, there is considerable variation in the costs
of accessing commercial databases. We sought to measure the quality, amount of
overlap, and costs of information retrieved from two of the main database
sources — MEDLINE and EMBASE. Librarians at two health technology
assessment agencies ran a total of eight literature searches on various
medical technologies, using both databases. All search results were
independently reviewed by two researchers. The researchers were asked to
identify relevant references and to rank each of these according to a level of
evidence scale. The results were tabulated to show the number of references
identified by each database, the number of relevant references ranked by level
of evidence, and the number of these references that were unique to one or the
other database. The cost of retrieving references from each source was also
calculated. Each database contained relevant references not available in the
other. Because of the longer time lag for indexing in MEDLINE, many of the
references that originally appeared to be unique to EMBASE were subsequently
available in MEDLINE as well. Since our study was conducted, MEDLINE has been
made available worldwide, free of charge, via the Internet. Hence, the cost
difference between the databases is now even greater. However, notwithstanding
the costs, it appears that literature searches that rely on only one or the
other database will inevitably miss pertinent information.
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