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Biomedical subjects

L M Davies

Publications and source records attributed to L M Davies.

12 recordsLinked to original sources
PubMed1992

Assessing the costs and benefits of medical research: the diabetic retinopathy study.

Significant amounts of scarce resources are devoted to medical research, but there have been few attempts to assess whether the benefits to society of these investments exceed the costs. A method for undertaking such an assessment has been developed and applied retrospectively to the Diabetic Retinopathy Study, a major clinical trial funded by the National Eye Institute from 1972-1981. It was estimated that the trial, which cost $10.5 million, generated a net saving of $2816 million to society ($231 million when the costs of lost production are excluded) (1982 prices) and a gain to patients of 279,000 vision years. This approach could be applied prospectively in considering priorities for medical research, in conjunction with traditional criteria such as the scientific merit of the proposal and the capabilities of the investigators. The key factors affecting the economic returns from medical research are the prevalence, incidence and economic burden of the disease in question, the costs and effectiveness of the medical intervention concerned, the likely impact of the clinical trial on clinical practice and the likely timespan of benefits from knowledge obtained during the trial.

Clinical Trials as Topic↗
PubMed1991

Evaluation of the costs and benefits of reducing hospital infection.

The techniques of economic evaluation have now been widely applied in health care. These techniques assess the value for money from interventions by comparing their costs and consequences. Since measures to reduce hospital infection normally result in costs they should, in principle, be subjected to economic evaluation. This paper outlines the essential elements of economic evaluation and distinguishes between different forms of analysis. It also discusses a number of evaluations of infection control measures undertaken to date. The recurring methodological weaknesses in current studies are identified and improvements suggested. Finally, the practical relevance of such studies in the current cost-conscious health care environment is discussed.

Communicable Disease Control↗
PubMed1986

Prophylactic efficacy of intranasal alpha 2-interferon against rhinovirus infections in the family setting.

In a double-blind evaluation of alpha 2-interferon as prophylaxis against naturally acquired respiratory infections, 120 adult members of 46 Australian families used 325 courses of intranasal spray during a six-month period, applying 5 million IU to the anterior nasal mucosa daily for seven days when respiratory symptoms developed in another member of the family. Used in this way, the alpha 2-interferon was well tolerated, and the rate of minor nasal bleeding (12 percent) did not increase with repeated courses. By comparison with the control group of 109 members of 49 families who used 319 seven-day courses of placebo spray, the users of alpha 2-interferon experienced 33 percent fewer days with nasal symptoms and 41 percent fewer episodes of "definite" respiratory illness. The users of alpha 2-interferon who were exposed to rhinovirus infections experienced 76 percent fewer days with symptoms and 86 percent fewer "definite" illnesses than their counterparts who used placebo. All of the observed clinical benefits, which suggested prevention of 6.8 "definite" respiratory illnesses per 100 courses of medication used, could be explained by a protective effect against illness associated with rhinoviruses that was not demonstrated for influenza A or B or coronavirus 229E.

Administration, Intranasal↗
PubMed1986

A cost-effectiveness comparison of the intraocular lens and the contact lens in aphakia.

There is currently interest in the effectiveness and cost of the intraocular lens as compared with other methods of correcting aphakia following cataract extraction. We have undertaken a retrospective review of patients undergoing cataract surgery by the extracapsular method at Moorfields Eye Hospital during the period January 1982 to July 1983. From the total population we selected at random two groups of patients, having their aphakia corrected either by means of a contact lens or an intraocular implant. Patients under the age of 60 years and those with complicating illnesses were excluded from the study. Using case notes, we followed the sample patients from the time of referral until one year after the operation, and recorded a number of clinical and economic variables such as waiting time for operation, length of inpatient stay, incidence of per- and post-operative complications, number of follow-up visits, final visual acuity and (for the contact lens patients) waiting time for lens issue and average daily wearing time. We found that the visual acuities obtained, and the total costs to society, were similar for the two groups.

Aged↗
PubMed1976

Drug induced interstitial nephritis, hepatitis and exfoliative dermatitis.

Acute interstitial nephritis associated with hepatitis, exfoliative dermatitis, fever and eosinophilia is uncommon. The syndrome has been described previously in association with phenindione administration, leptospirosis and heavy metal poisoning. Four cases are described, two of which were due to phenindione sensitivity. The other two patients had been exposed to a number of toxins including allopurinol, frusemide, chlorothiazide and methyldopa so that the exact aetiological agent is unclear. Interstitial nephritis should be considered as a cause of acute renal failure in patients with other features of drug hypersensitivity.

Acute Disease↗