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| 2. |
- Ahmad Kiadaliri, Aliasghar
(författare)
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Gender and Social Disparities in Esophagus Cancer Incidence in Iran, 2003-2009: A Time Trend Province-level Study.
- 2014
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Ingår i: Asian Pacific Journal of Cancer Prevention. - 1513-7368. ; 15:2, s. 623-627
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Tidskriftsartikel (refereegranskat)abstract
- Background: Esophagus cancer (EC) is among the five most common cancers in both sexes in Iran, with an incidence rate well above world average. Social rank (SR) of individuals and regions are well-known independent predictors of EC incidence. The aim of current study was to assess gender and social disparities in EC incidence across Iran's provinces through 2003-2009. Materials and Methods: Data on distribution of population at province level were obtained from the Statistical Centre of Iran. Age-standardized incidence rates of EC were gathered from the National Cancer Registry. The Human Development Index (HDI) was used to assess the province social rank. Rate ratios and Kunst and Mackenbach relative indices of inequality (RIIKM) were used to assess gender and social inequalities, respectively. Annual percentage change (APC) was calculated using joinpoint regression. Results: EC incidence rate increased 4.6% and 6.5% per year among females and males, respectively. There were no gender disparities in EC incidence over the study period. There were substantial social disparities in favor of better-off provinces in Iran. These social disparities were generally the same between males and females and were stable over the study period. Conclusions: The results showed an inverse association between the provinces' social rank and EC incidence rate in Iran. In addition, I found that, in contrast with international trends, women are at the same risk of EC as men in Iran. Further investigations are needed to explain these disparities in EC incidence across the provinces.
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| 3. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Health utilities of type 2 diabetes-related complications: a cross-sectional study in Sweden.
- 2014
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 11:5, s. 4939-52
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Tidskriftsartikel (refereegranskat)abstract
- This study estimates health utilities (HU) in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish) from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR). Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (-0.114) using the UK tariff and stroke (-0.059) using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making.
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| 4. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Overall, gender and social inequalities in suicide mortality in Iran, 2006-2010: a time trend province-level study.
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:8, s. 005227-005227
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Tidskriftsartikel (refereegranskat)abstract
- Suicide is a major global health problem imposing a considerable burden on populations in terms of disability-adjusted life years. There has been an increasing trend in fatal and attempted suicide in Iran over the past few decades. The aim of the current study was to assess overall, gender and social inequalities across Iran's provinces during 2006-2010.
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| 5. |
- Ahmad Kiadaliri, Aliasghar
(författare)
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Towards a Health Economic Simulation Model of Type 2 Diabetes in Sweden
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to provide part of the data required in updating/developing computer simulation models (CSMs) for type 2 diabetes mellitus (T2DM) using data obtained from routine clinical practice in Sweden. In paper I, evolution of five biomarkers (i.e., HbA1c, systolic blood pressure, BMI, LDL and total to HDL cholesterol ratio) over time was estimated using data on 5,043 newly diagnosed T2DM patients from the Swedish National Diabetes Register (NDR) and a dynamic panel data framework. The results indicated that difference between individuals with high and low biomarker values at the baseline was diminishing over time. In paper II, we estimated and validated the risk equations for the first and second major macrovascular events after diagnosis during the five years of follow up using the data on 29,034 T2DM patients from the NDR. We used the Weibull proportional hazard regression to estimate these equations. We found within- and between-event heterogeneities in associations between explanatory variables and the risk of experiencing an event. Validation analysis indicated that all equations had reasonable predictive accuracy in the test sample. In paper III, health utility weights associated with several T2DM-related complications were estimated using survey data on the Swedish version of EuroQol (EQ-5D) instrument among 1,757 T2DM patients collected by the NDR in 2008. The results indicated that history of kidney disorders (–0.114) and stroke (–0.111) had the highest negative effects on the UK EQ-5D index score. Using the UK and Swedish tariffs resulted in discrepant estimates, possibly leading to divergent results from cost–utility analyses. In paper IV, an existing cohort model of T2DM in Sweden was updated using equations from papers II and III, and was used to estimate the lifetime costs and benefits of three second-line treatment alternatives, i.e., GLP-1 agonists, DPP-4 inhibitors, or NPH insulin, as add-on to metformin among T2DM patients in Sweden failing to reach Hba1c ≤ 7% with metformin alone. The results indicated that assuming a willingness to pay of SEK 500,000 per QALY gained in Sweden, treatment strategy with GLP-1 can be considered cost-effective compared to DPP-4 or NPH insulin as second line treatment. The results indicated the importance of developing and refining the equations required in CSMs as new data become available. The data presented in the current thesis are representative of the current clinical practice in Sweden and hence it is suggested that using these data in economic evaluations of T2DM treatment strategies might provide more relevant and accurate results for policy-making in Sweden.
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| 6. |
- Haghparast-Bidgoli, Hassan, et al.
(författare)
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Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature.
- 2014
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Ingår i: Cost Effectiveness and Resource Allocation. - : Springer Science and Business Media LLC. - 1478-7547. ; 12:Jul 11
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Forskningsöversikt (refereegranskat)abstract
- To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data.
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