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- Andersson, F, et al.
(author)
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Adding formoterol to budesonide in moderate asthma--health economic results from the FACET study
- 2001
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In: Respiratory Medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 95:6, s. 505-512
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Journal article (peer-reviewed)abstract
- The FACET (Formoterol and Corticosteroid Establishing Therapy) study established that there is a clear clinical benefit in adding formoterol to budesonide therapy in patients who have persistent symptoms of asthma despite treatment with low to moderate doses of an inhaled corticosteroid. We combined the clinical results from the FACET study with an expert survey on average resource use in connection with mild and severe asthma exacerbations in the U.K., Sweden and Spain. The primary objective of this study was to assess the health economics of adding the inhaled long-acting beta2-agonist formoterol to the inhaled corticosteroid budesonide in the treatment of asthma. The extra costs of adding the inhaled beta2-agonist formoterol to the corticosteroid budesonide in asthmatic patients in Sweden were offset by savings from reduced use of resources for exacerbations. For Spain the picture was mixed. Adding formoterol to low dose budesonide generated savings, whereas for moderate doses of budesonide about 75% of the extra formoterol costs could be recouped. In the U.K., other savings offset about half of the extra cost of formoterol. All cost-effectiveness ratios are within accepted cost-effectiveness ranges reported from previous studies. If productivity losses were included, there were net savings in all three countries, ranging from Euro 267-1183 per patient per year. In conclusion, adding the inhaled, long-acting beta2-agonist formoterol to low-moderate doses of the inhaled corticosteroid budesonide generated significant gains in all outcome measures with partial or complete offset of costs. Adding formoterol to budesonide can thus be considered to be cost-effective.
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- Ullman, Gustav, et al.
(author)
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On the extent of quantum noise limitation in digital chest radiography
- 2004
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Reports (other academic/artistic)abstract
- The aim for this work was to study to what extent the detection of nodules is quantum noise limited, based on the combined results from a nodule-detection clinical trial and a Monte Carlo computational model of a digital chest imaging system. The Monte Carlo computer program computes measures of physical image quality such as image contrast, C and signalto-noise ratio, SNR for nodules of any size. A computed radiography (CR) imaging system used simulated. The patient anterior-posterior thickness was 25 cm and nodules with diameters between 1-40 mm were included. The image contrast and SNR was calculated for 1600 (40x40) positions in the chest image and averaged over five anatomical regions of interest (lateral pulmonary, retrocardial, hilar, lower- and upper mediastinal regions). Threshold contrasts for each region, Cth, corresponding to Az=0.80 for detecting a 10 mm nodule, were deduced from the clinical trial. A threshold is also used for the quantum noise signal-to-noise ratio, SNRth. The model computes the diameter of a disk-shaped object that is required to comply with the two criteria: SNR≥SNRth and C≥Cth. A system is said to be quantum noise limited when the nodule size required to fulfil both criteria is not limited by the contrast but by the SNR. The required nodule diameter is largest in the hilar region (25 mm) and smallest in the lateral pulmonary region (11 mm). When the threshold SNRth=25 is used, the lower mediastinal region is quantum noise limited already at low speed classes (S>100). The hilar region is never quantum noise limited at realistic speed classes (S<1000). The accuracy of this model will be tested in the future by more sophisticated modelling of anatomical background and noise in the SNR-expression.
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