Browsing by Author "Sanhueza, Enrique"
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- ItemApplication of cost-effectiveness analysis to demonstrate the potential value of companion diagnostics in chronic myeloid leukemia(FUTURE MEDICINE LTD, 2011) Gaultney, Jennifer G.; Sanhueza, Enrique; Janssen, Jeroen J.; Redekop, William K.; Uyl de Groot, Carin A.Aim: A cost effectiveness analysis was performed to assess the potential value of companion diagnostics in supporting treatment decisions for dasatinib and nilotinib in chronic myeloid leukemia. Materials & methods: A decision model was developed, and model inputs were taken from the literature and publicly available sources. The perspective of the healthcare sector in the Netherlands was used. Sensitivity and scenario analyses were performed to assess uncertainty in the results. Results: Companion diagnostics could improve health and reduce costs, despite the estimates being uncertain owing to limited evidence for comparative effectiveness between dasatinib and nilotinib. The results were sensitive to the cost of treatment, utility of progression and progression-free survival. Conclusion: This case demonstrates the use of cost effectiveness analysis at an early stage of health technology assessment to generate economic evidence for the use of companion diagnostics in treatment decisions and to support decision-making for their development.
- ItemHigh-Frequency, Low-Intensity Vibrations Increase Bone Mass and Muscle Strength in Upper Limbs, Improving Autonomy in Disabled Children(WILEY, 2011) Reyes, M. Loreto; Hernandez, Marta; Holmgren, Luz J.; Sanhueza, Enrique; Escobar, Raul G.Disuse osteoporosis in children is a progressive disease that can affect quality of life. High-frequency, low-magnitude vibration (HFLMV) acts as an anabolic signal for bone and muscle. We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of regional HFLMV in disabled children. Sixty-five children 6 to 9 year of age were randomized into three groups: placebo, 60 Hz, and 90 Hz. In the two active groups, a 0.3-g mechanical vibration was delivered to the radii and femurs for 5 minutes each day. After 6 months, the main endpoint was bone mineral density (BMD) at the ultradistal radius (UDR), 33% radii (33% R), and femoral necks (FN). Secondary endpoints were area and bone mineral content (BMC) at the UDR, 33% R, and FN; grip force of the upper and lower limbs; motor function; and PedsQL evaluation. An intention-to-treat analysis was used. Fifty-seven children (88%) completed the protocol. A significant increase was observed in the 60-Hz group relative to the other groups in BMD at the UDR (p=.011), in grip force of the upper limbs (p=.035), and in the "daily activities item" (p=.035). A mixed model to evaluate the response to intervention showed a stronger effect of 60 Hz on patients with cerebral palsy on the UDR and that between-subject variability significantly affected the response. There were no reported side effects of the intervention. This work provides evidence that regional HFLMV is an effective and safe strategy to improve bone mass, muscle strength, and possibly independence in children with motor disabilities. (C) 2011 American Society for Bone and Mineral Research.