Suchergebnisse

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

International audience ; Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.

International audience ; Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.

International audience ; Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.

International audience ; Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.