The incremental net benefit (INB) and the related acceptability curves for public health programs provide valuable tools for decision making. We proposed to apply them to the assessment of mass screening of colorectal cancer. The now standard guaiac fecal occult blood test (FOBT) is already implemented in several countries. We considered the innovative immunological FOBT and computed tomography colonography (CTC) as competing screening technologies. Using biennial guaiac FOBT as the reference strategy, we estimated the cost-effectiveness of the following alternatives: biennial immunological FOBT, CTC every 5 years (strategy CTC5), and CTC every 10 years (strategy CTC10). Over a 30-year horizon and from the perspective of a third-party payer, we developed a Markov model on a hypothetical cohort of 100,000 subjects at average risk of colorectal cancer. Close expected net benefits between immunological FOBT and CTC5 induced uncertainty in the choice of the optimal strategy. Probabilistic sensibility analysis then suggested that below a willingness to pay (WTP) per life-years gained (LYG) of 8,587 €/LYG, CTC10 was optimal, while CTC5 would be preferred beyond a WTP of 8,587 €/LYG.
The amount of published information regarding the exposure-totreatment interval (ETI) and the severity of canine poisoning cases is limited. The ETI is a critical factor in the effectiveness and risk:benefit ratio of decontamination of the upper digestive tract by induction of emesis, gastric lavage and single-dose activated charcoal (Krenzelok et al.Chyka et al., 2005). The efficiency and risk:benefit ratio of upper gastrointestinal (UGI) decontamination following poisoning declines rapidly as the ETI increases, particularly when this interval exceeds 1-2 h (Krenzelok et al.
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