BACKGROUND Genotypic antiretroviral resistance testing (GRT) in HIV infection with drug resistant virus is recommended to optimize antiretroviral therapy, in particular in patients with virological failure. We estimated the clinical effect, cost and cost-effectiveness of using GRT as compared to expert opinion in patients with antiretroviral treatment failure. METHODS We developed a mathemati...

CONTEXT Homosexual and bisexual men infected with human immunodeficiency virus (HIV) are at increased risk for human papillomavirus-related anal neoplasia and anal squamous cell carcinoma (SCC). OBJECTIVE To estimate the clinical benefits and cost-effectiveness of screening HIV-positive homosexual and bisexual men foranal squamous intraepithelial lesions (ASIL) and anal SCC. DESIGN Cost-eff...

BACKGROUND AND PURPOSE Few studies have evaluated the long-term health impact of stroke as categorized into different subtypes. The aim of this study is to quantify the loss of quality-adjusted life expectancy related to ischemic stroke and intracerebral hemorrhage. METHODS The hospital-based cohort, which consisted of 13,194 patients with first-ever stroke onset dates between 1995 and 2007, ...

PURPOSE We assessed the effect of age, health status and patient preferences on outcomes of surgery vs active surveillance for low risk prostate cancer. MATERIALS AND METHODS We used Monte Carlo simulation of Markov models of the life courses of 200,000 men diagnosed with low risk prostate cancer and treated with surveillance or radical prostatectomy to calculate quality adjusted life expecta...

conclusions this study demonstrates that the mental states associated with specific diseases should not be ignored in evaluating health states. although there are benefits to relying on expert panels and the general population in evaluating various health states, attention to the particular health states of the patients (taking into account their associated mental well-being) should also be uti...