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Health Technology Assessment... May 2010This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of sorafenib according to its licensed... (Review)
Review
This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of sorafenib according to its licensed indication for advanced hepatocellular carcinoma (HCC). The ERG report was based on the manufacturer's submission to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The licensed indication for sorafenib specifies advanced HCC patients for whom locoregional intervention and surgery are unsuitable or had been unsuccessful. The clinical evidence came from a multicentre randomised controlled trial (Sorafenib HCC Assessment Randomized Protocol; SHARP) of sorafenib plus best supportive care versus placebo plus best supportive care, with 602 participants of a predominantly European ethnicity broadly comparable to the UK population. The submitted evidence indicated that for advanced HCC patients with Child-Pugh grade A liver function and relatively good Eastern Cooperative Oncology Group performance status, sorafenib on average improves overall survival by 83 days relative to placebo, and also increases time-to-radiological disease progression. Sorafenib therapy had little or no effect on time-to-symptom progression or on quality of life as measured using a disease-specific questionnaire. Sorafenib treatment was associated with increased incidence of hypertension and of gastrointestinal and dermatological problems. However, the therapy was reasonably well tolerated and, in SHARP, withdrawals from treatment due to adverse events were similar in the sorafenib and placebo arms, although more temporary reductions in dose were required in the sorafenib than in the placebo group. In the base case, the manufacturer's submitted economic analysis generated a deterministic incremental cost-effectiveness ratio (ICER) of 64,754 pounds per quality-adjusted life-year (QALY). The ERG extracted individual patient data for overall survival and disease progression, reran the economic model to check the submitted cost-effectiveness results, and performed new analyses which the ERG considered relevant to the decision problem; these analyses delivered ICERs between 76,000 pounds/QALY and 86,000 pounds/QALY. The guidance issued by NICE (7 May 2009) stated that sorafenib, within its licensed indication, is not recommended for the treatment of advanced (Barcelona-Clínic Liver Cancer stage C) HCC patients for whom surgical or locoregional therapies have failed or are not suitable, and people currently receiving sorafenib for the treatment of HCC should have the option to continue treatment until they and their clinician consider it appropriate to stop. Subsequently the manufacturer submitted a patient access scheme to the Department of Health. The base-case ICER submitted by the manufacturer for this scheme was 51,899 pounds/QALY. When the ERG reran the model with inputs considered relevant to the decision problem the ICER estimates ranged between 53,000 pounds to 58,000 pounds/QALY and substantially higher values depending on the nature of the sensitivity analyses. NICE considered the impact of the patient access scheme and determined that it was not sufficient to alter the guidance.
Topics: Antineoplastic Agents; Benzenesulfonates; Carcinoma, Hepatocellular; Cost-Benefit Analysis; Disease Progression; Humans; Liver Neoplasms; Models, Economic; Niacinamide; Phenylurea Compounds; Pyridines; Quality of Life; Sorafenib; Survival Analysis; Treatment Outcome; United Kingdom
PubMed: 20507799
DOI: 10.3310/hta14Suppl1/03 -
Revue Scientifique Et Technique... Dec 2002The authors present estimates of the economic costs to agriculture and industries affected by tourism of the outbreak of foot and mouth disease (FMD) in the United... (Review)
Review
The authors present estimates of the economic costs to agriculture and industries affected by tourism of the outbreak of foot and mouth disease (FMD) in the United Kingdom (UK) in 2001. The losses to agriculture and the food chain amount to about Pound Sterling3.1 billion. The majority of the costs to agriculture have been met by the Government through compensation for slaughter and disposal as well as clean-up costs. Nonetheless, agricultural producers will have suffered losses, estimated at Pound Sterling355 million, which represents about 20% of the estimated total income from farming in 2001. Based on data from surveys of tourism, businesses directly affected by tourist expenditure are estimated to have lost a similar total amount (between Pound Sterling2.7 and Pound Sterling3.2 billion) as a result of reduced numbers of people visiting the countryside. The industries which supply agriculture, the food industries and tourist-related businesses will also have suffered losses. However, the overall costs to the UK economy are substantially less than the sum of these components, as much of the expenditure by tourists was not lost, but merely displaced to other sectors of the economy. Overall, the net effect of FMD is estimated to have reduced the gross domestic product in the UK by less than 0.2% in 2001.
Topics: Agriculture; Animals; Disease Outbreaks; Food Supply; Foot-and-Mouth Disease; Humans; Travel; United Kingdom
PubMed: 12523706
DOI: 10.20506/rst.21.3.1353 -
Journal of Dairy Science May 2022An estimated 40% of food produced in the United States is wasted, which poses a significant barrier to achieving a sustainable future-so much so that the United Nations... (Review)
Review
An estimated 40% of food produced in the United States is wasted, which poses a significant barrier to achieving a sustainable future-so much so that the United Nations Sustainable Development Goal no. 12, to "ensure sustainable consumption and production patterns," includes a goal to "halve per capita global food waste at the retail and consumer level, and reduce food losses along the production and supply chains by 2030." Annually, consumers waste approximately 90 billion pounds of food, equating to roughly 1 pound per person per day. More specifically, consumer waste is the largest contributor to the food waste problem when compared with other steps along the supply chain, such as production, post-harvest handling and storage, processing, and distribution. Furthermore, American families discard approximately 25% of the food and beverages they buy. When considering the type of waste coming from households, fresh fruits and vegetables rank highest at 22%, with dairy products, at 19%, following in close second. A variety of factors contribute to why consumers waste so much food. For dairy, commonly referenced reasons are related to the misunderstanding of date labels, poor planning of purchases, spoilage before consuming products, and improper storage. This wasted food accumulates in landfills and produces methane when decomposing, resulting in environmental consequences related to ozone depletion and climate change. Milk can have negative environmental impacts when disposed of down the drain. This review will discuss the food waste problem, causes, and potential solutions at the consumer level, with particular focus on dairy waste. An individual plus policy, system, and environment approach will also be integrated to provide a well-rounded view of the issue.
Topics: Animals; Fruit; Humans; Milk; Policy; Refuse Disposal; United States; Vegetables
PubMed: 35307180
DOI: 10.3168/jds.2021-20994 -
Nature Communications Oct 2017Low noise stable lasers have far-reaching applications in spectroscopy, communication, metrology and basic science. The Pound-Drever-Hall laser stabilization technique...
Low noise stable lasers have far-reaching applications in spectroscopy, communication, metrology and basic science. The Pound-Drever-Hall laser stabilization technique is widely used to stabilize different types of lasers in these areas. Here we report the demonstration of an integrated Pound-Drever-Hall system that can stabilize a low-cost laser to realize a compact inexpensive light source, which can ultimately impact many fields of science and engineering. We present an integrated architecture utilizing an electronically reconfigurable Mach-Zehnder interferometer as the frequency reference to reduce the frequency noise of semiconductor lasers by more than 25 dB and the relative Allan deviation by more than 12 times at 200 μs averaging time. Compared to the bench-top implementations, the integrated Pound-Drever-Hall system has significantly lower power consumption, less sensitivity to the environmental fluctuations and occupies an area of only 2.38 mm. The photonic and electronic devices are integrated on a standard 180 nm complementary metal-oxide semiconductor silicon-on-insulator process.
PubMed: 29089482
DOI: 10.1038/s41467-017-01303-y -
Health Technology Assessment... Sep 2009To investigate whether it is clinically effective and cost-effective to provide (i) a unilateral cochlear implant for severely to profoundly deaf people (using or not... (Review)
Review
OBJECTIVES
To investigate whether it is clinically effective and cost-effective to provide (i) a unilateral cochlear implant for severely to profoundly deaf people (using or not using hearing aids), and (ii) a bilateral cochlear implant for severely to profoundly deaf people with a single cochlear implant (unilateral or unilateral plus hearing aid).
DATA SOURCES
Main electronic databases [MEDLINE; EMBASE; Cochrane Database of Systematic Reviews; CENTRAL; NHS EED; DARE; HTA (NHS-CRD); EconLit; National Research Register; and ClinicalTrials.gov] searched in October 2006, updated July 2007.
REVIEW METHODS
A systematic review of the literature was undertaken according to standard methods. A state-transition (Markov) model of the main care pathways deaf people might follow and the main complications and device failures was developed.
RESULTS
The clinical effectiveness review included 33 papers, of which only two were RCTs. They used 62 different outcome measures and overall were of moderate to poor quality. All studies in children comparing one cochlear implant with non-technological support or an acoustic hearing aid reported gains on all outcome measures, some demonstrating greater gain from earlier implantation. The strongest evidence for an advantage from bilateral over unilateral implantation was for understanding speech in noisy conditions (mean improvement 13.2%, p < 0.0001); those receiving their second implant earlier made greater gains. Comparison of bilateral with unilateral cochlear implants plus an acoustic hearing aid was compromised by small sample sizes and poor reporting, but benefits were seen with bilateral implants. Cochlear implants improved children's quality of life, and those who were implanted before attending school were more likely to do well academically and attend mainstream education than those implanted later. In adults, there was a greater benefit from cochlear implants than from non-technological support in terms of speech perception. Increased age at implantation may reduce effectiveness and there is a negative correlation between duration of deafness and effectiveness. Speech perception measures all showed benefits for cochlear implants over acoustic hearing aids [e.g. mean increase in score of 37 points in noisy conditions (p < 0.001) with BKB sentences]; however, prelingually deafened adults benefited less than those postlingually deafened (mean change scores 20% versus 62%). For unilateral versus bilateral implantation, benefits in speech perception were significant in noisy conditions on all measures [e.g. 76% for HINT sentences (p < 0.0001)]. Quality of life measured with generic and disease-specific instruments or by interview mostly showed significant gains or positive trends from using cochlear implants. The Markov model base-case analysis estimated that, for prelingually profoundly deaf children, the incremental cost-effectiveness ratio (ICER) for unilateral implantation compared with no implantation was 13,413 pounds per quality-adjusted life-year (QALY). Assuming the utility gain for bilateral implantation is the same for adults and children, the ICERs for simultaneous and sequential bilateral implantation versus unilateral implantation were 40,410 pounds and 54,098 pounds per QALY respectively. For postlingually sensorineurally profoundly deaf adults, the corresponding ICERs were 14,163 pounds, 49,559 pounds and 60,301 pounds per QALY respectively. Probabilistic threshold analyses suggest that unilateral implants are highly likely to be cost-effective for adults and children at willingness to pay thresholds of 20,000 pounds or 30,000 pounds per QALY. There are likely to be overall additional benefits from bilateral implantation, enabling children and adults to hold conversations more easily in social situations.
CONCLUSIONS
Unilateral cochlear implantation is safe and effective for adults and children and likely to be cost-effective in profoundly deaf adults and profoundly and prelingually deaf children. However, decisions on the cost-effectiveness of bilateral cochlear implants should take into account the high degree of uncertainty within the model regarding the probable utility gain.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cochlear Implantation; Cost-Benefit Analysis; Deafness; Female; Humans; Infant; Male; Middle Aged; Models, Economic; United Kingdom; Young Adult
PubMed: 19799825
DOI: 10.3310/hta13440 -
Pain Physician 2014Although there are several studies of systemic corticosteroid therapies in various doses and various durations in complex regional pain syndrome (CRPS), the outcome...
BACKGROUND
Although there are several studies of systemic corticosteroid therapies in various doses and various durations in complex regional pain syndrome (CRPS), the outcome measurement parameters are limited to the range of motion measurements, edema, and symptoms of CRPS.
OBJECTIVE
To investigate the effects of prednisolone on clinical symptoms, pain, hand grip strength, range of motion, as well as on functional ability and quality of life in patients who developed CRPS after traumatic upper extremity injury.
STUDY DESIGN
Retrospective evaluation.
METHODS
Forty-five patients who used prednisolone for CRPS of the upper extremity were retrospectively studied. Prednisolone was started with a dose of 30 mg and tapered by 5 mg every 3 days until discontinuation after 3 weeks. Clinical symptoms (morning stiffness, cold intolerance, shoulder pain, numbness of fingers, hyperesthesia, abnormal sweating, and cyanosis that is exacerbated by exposure to cold temperature), pain (Visual Analogue Scale-Rest [VAS-R] and VAS-Activity [VAS-A]) were reviewed. The muscle strength with grip strength (GS) (kg), lateral pinch (LP) (pound), tip-to-tip pinch (TP) (pound), and chuck pinch (CP) (pound) measurements; the joint range of motion with using third finger tip-distal crease distance (FT-DC) (cm); functional ability with Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) score; and quality of life with Short Form-36 (SF-36) score were evaluated.
RESULTS
Mean age was 43.53 ± 11.43 years. After 3 weeks of therapy, patients showed significant improvements in clinical symptoms compared to the basal assessments (P < 0.05). The comparison of pre- and post-treatment results revealed that VAS-R, VAS-A, GS, LP, TP, CP, FT-DC, Q-DASH scores, and all SF-36 subscores were significantly improved (P < 0.05).
LIMITATIONS
The retrospective design and data collection procedure was limited to the medical records of patients.
CONCLUSION
A short-term oral prednisolone therapy significantly reduced the symptoms and signs of CRPS, and improved the functional abilities and quality of life.
Topics: Adult; Anti-Inflammatory Agents; Complex Regional Pain Syndromes; Disability Evaluation; Female; Follow-Up Studies; Hand Strength; Humans; Male; Middle Aged; Pain Measurement; Prednisolone; Quality of Life; Retrospective Studies; Treatment Outcome
PubMed: 24658479
DOI: No ID Found -
Animals : An Open Access Journal From... May 2023Access to comprehensive municipal pound, animal welfare shelters, and rescue group data for admissions and outcomes for stray and owner-relinquished cats in Australia is...
Access to comprehensive municipal pound, animal welfare shelters, and rescue group data for admissions and outcomes for stray and owner-relinquished cats in Australia is currently lacking. This hinders effective assessment of existing management strategies for domestic cats by animal management agencies. Our study aimed to estimate the numbers of cat admissions and intakes to Australian municipal council pounds, animal welfare organizations (excluding smaller animal welfare organizations thought to have annual cat intakes of less than 500), and animal rescue groups and their respective outcomes for 2018-2019 (pre-COVID). Unavailable municipal council data were imputed based on known data and council human populations. Only Victoria and New South Wales had publicly available municipal data, and only RSPCA had publicly available data in all states. We estimated a total of 179,615 (7.2/1000 human residents) admissions to pounds, shelters, and rescue groups in 2018-2019, with an estimated 5% reclaimed, 65% rehomed, and 28% euthanized. Reclaim rates were low across all the agencies. Councils operating their own pound had nearly double the euthanasia rate (estimated at 46%) compared to animal welfare organizations (25%). Rescue groups rehomed an estimated 35% of the total number of cats rehomed by all agencies. The upper quartiles of councils with intakes of >50 cats in Victoria and New South Wales had estimated euthanasia rates from 73% to 98%, and 67% to 100%, respectively. We recommend that comprehensive municipal pound, shelter, and rescue statistics be routinely calculated using standardized methods and made available publicly in a timely fashion. This would inform management strategies to optimize live outcomes and therefore reduce the negative mental health impacts on staff tasked with euthanizing healthy and treatable cats and kittens.
PubMed: 37889641
DOI: 10.3390/ani13111771 -
BMJ (Clinical Research Ed.) Dec 2009To evaluate the cost effectiveness of routine screening for postnatal depression in primary care. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the cost effectiveness of routine screening for postnatal depression in primary care.
DESIGN
Cost effectiveness analysis with a decision model of alternative methods of screening for depression, including standardised postnatal depression and generic depression instruments. The performance of screening instruments was derived from a systematic review and bivariate meta-analysis at a range of instrument cut points; estimates of other relevant parameters were derived from literature sources and relevant databases. A decision tree considered the full treatment pathway from the possible onset of postnatal depression through identification, treatment, and possible relapse.
SETTING
Primary care.
PARTICIPANTS
A hypothetical population of women assessed for postnatal depression either via routine care only or supplemented by use of formal identification methods six weeks postnatally, as recommended in recent guidelines.
MAIN OUTCOME MEASURES
Costs expressed in 2006-7 prices and impact on health outcomes expressed in terms of quality adjusted life years (QALYs). The time horizon of the analysis was one year.
RESULTS
The routine application of either postnatal or general depression questionnaires did not seem to be cost effective compared with routine care only. The Edinburgh postnatal depression scale (at a cut point of 16) had an incremental cost effectiveness ratio (ICER) of pound 41,103 (euro 45,398, $67,130) per QALY compared with routine care only. The ICER for all other strategies ranged from pound 49,928 to pound 272,463 per QALY versus routine care only, while the probability that no formal identification strategy was cost effective was 88% (59%) at a cost effectiveness threshold of pound 20,000 ( pound 30,000) per QALY. While sensitivity analysis indicated that the cost of managing incorrectly identified depression (false positive result) was an important driver of the model, formal identification approaches did not seem to be cost effective at any feasible estimate of this cost.
CONCLUSIONS
Formal identification methods for postnatal depression do not seem to represent value for money for the NHS. The major determinant of cost effectiveness seems to be the potential additional costs of managing women incorrectly diagnosed as depressed. Formal identification methods for postnatal depression do not currently satisfy the National Screening Committee's criteria for the adoption of a screening strategy as part of national health policy.
Topics: Cost-Benefit Analysis; Depression, Postpartum; Female; Humans; Models, Economic; Postnatal Care; Primary Health Care; Quality-Adjusted Life Years
PubMed: 20028779
DOI: 10.1136/bmj.b5203 -
Health Technology Assessment... Mar 2007To assess the clinical effectiveness and cost-effectiveness of pegylated interferon alpha (PEG) and non-pegylated interferon alpha (IFN) and ribavirin (RBV) for the... (Review)
Review
OBJECTIVES
To assess the clinical effectiveness and cost-effectiveness of pegylated interferon alpha (PEG) and non-pegylated interferon alpha (IFN) and ribavirin (RBV) for the treatment of adults with histologically mild chronic hepatitis C (HCV) infection.
DATA SOURCES
Electronic bibliographic databases were searched up to July 2005.
REVIEW METHODS
A systematic review and an economic evaluation were carried out. A Markov state transition model was developed to estimate the cost-effectiveness of treatment strategies for adults with mild chronic HCV.
RESULTS
Among the included studies, eight randomised controlled trials (RCTs) of antiviral treatment in mild HCV were identified and included. In general these RCTs were of good quality. The results suggested that effectiveness, particularly with respect to sustained virological response was similar in patients with mild disease to the results obtained in patients with moderate/severe disease. This finding was supported by RCTs reporting the results for mild HCV sub-groups. The authors' cost-effectiveness analysis showed that early treatment compared with watchful waiting is associated with quality-adjusted life-year (QALY) gains but with increased treatment costs. The base-case incremental costs per QALY for 48 weeks of treatment are: watchful waiting with IFN + RBV versus best supportive care = pound 3097-6585; early treatment with IFN + RBV versus watchful waiting with IFN + RBV = pound 5043-8092; watchful waiting with PEG 2a + RBV versus best supportive care = pound 3052; early treatment with PEG 2a + RBV versus watchful waiting with PEG 2a + RBV = pound 5900; watchful waiting with PEG 2b + RBV versus best supportive care = pound 2534; and early treatment with PEG 2b + RBV versus watchful waiting with PEG 2b + RBV = pound 5774. These results were consistent with previous assessments of cost-effectiveness.
CONCLUSION
This systematic review and economic evaluation show that patients with histologically mild HCV can be successfully treated with both pegylated and non-pegylated interferon alpha. Early treatment and watchful waiting strategies are associated with acceptable cost-per-QALY estimates. Research needs to be directed towards newer, potentially more effective interventions, particularly those that improve treatment response in patients with genotype 1, with minimal adverse effects. Further research is required into the natural history of HCV to estimate better the rate of liver disease progression, and also into the effectiveness of non-invasive biochemical markers of liver disease, as an alternative to liver biopsy.
Topics: Antiviral Agents; Cost-Benefit Analysis; Drug Therapy, Combination; Female; Hepatitis C, Chronic; Humans; Interferon alpha-2; Interferon-alpha; Male; Markov Chains; Multicenter Studies as Topic; Polyethylene Glycols; Randomized Controlled Trials as Topic; Recombinant Proteins; Ribavirin
PubMed: 17346498
DOI: 10.3310/hta11110 -
Health Technology Assessment... Nov 2006To assess the clinical and cost-effectiveness of oxaliplatin in combination with 5-fluorouracil/leucovorin (5-FU/LV), and capecitabine monotherapy (within their licensed... (Review)
Review
OBJECTIVES
To assess the clinical and cost-effectiveness of oxaliplatin in combination with 5-fluorouracil/leucovorin (5-FU/LV), and capecitabine monotherapy (within their licensed indications), as adjuvant therapies in the treatment of patients with Stage III (Dukes' C) colon cancer after complete surgical resection of the primary tumour, as compared with adjuvant chemotherapy with an established fluorouracil-containing regimen.
DATA SOURCES
Ten electronic bibliographic databases were searched from inception to January 2005. Searches were supplemented by hand searching relevant articles, sponsor and other submissions of evidence to the National Institute of Health and Clinical Excellence and conference proceedings.
REVIEW METHODS
A systematic review and meta-analysis (where appropriate) of clinical efficacy evidence and a cost-effectiveness review and economic modelling were carried out. Marginal costs, life years gained and cost-effectiveness acceptability curves were estimated. Probabilistic sensitivity analysis was used to generate information on the likelihood that each of the interventions was optimal.
RESULTS
Three randomised active-controlled trials, of varying methodological quality, were included in the review. The MOSAIC trial and NSABP C-07 study considered the addition of oxaliplatin to adjuvant treatment (albeit administered in different 5-FU/LV regimens) and the X-ACT study compared oral capecitabine with bolus 5-FU/LV alone. A review of the available evidence indicated that in patients with Stage III colon cancer, oxaliplatin in combination with an infusional de Gramont schedule of 5-FU/LV (FOLFOX4) was more effective in preventing and delaying disease recurrence than infusional 5-FU/LV alone (de Gramont regimen). Serious adverse events and treatment discontinuations due to toxicity were more evident with oxaliplatin-based regimens (FOLFOX4 and FLOX regimen) than infusional or bolus 5-FU/LV alone (de Gramont and Roswell Park regimen). Oral capecitabine was at least equivalent in disease-free survival to the bolus Mayo Clinic 5-FU/LV regimen for patients with resected Stage III colon cancer. Although, the safety and tolerability profile of capecitabine was superior to that of the Mayo Clinic 5-FU/LV regimen, it has not been evaluated in comparison with other less toxic 5-FU/LV regimens currently in common use in the UK. Based on the assumptions and survival analysis methods used, the cost-effectiveness analysis using economic modelling estimated that capecitabine was a dominating strategy and resulted in a cost-saving of approximately pound 3320 per patient in comparison with the Mayo Clinic 5-FU/LV regimen, while also providing an additional 0.98 quality-adjusted life-years (QALYs) over a 50-year model time horizon. Oxaliplatin in combination with 5-FU/LV (FOLFOX4 regimen) is estimated to cost an additional pound 2970 per QALY gained when compared with the de Gramont 5-FU/LV regimen and demonstrated superior survival outcomes with marginal costs. The uncertainty analysis suggests that both interventions have a high probability of being cost-effective at a threshold of both pound 20,000 and pound 30,000. An indirect comparison of the FOLFOX4 and Mayo Clinic 5-FU/LV regimens suggests that the use of FOLFOX4 in place of the Mayo Clinic 5-FU/LV regimen would cost an additional pound 5777 per QALY gained. An incremental cost-effectiveness ratio (ICER) is estimated to be approximately pound 13,000 per QALY gained from treatment with FOLFOX4 compared with capecitabine. However, if the Mayo Clinic and the de Gramont 5-FU/LV regimens are assumed to be equivalent in terms of effectiveness, the ICER of FOLFOX4 in comparison with capecitabine may be greater than pound 30,000 per QALY.
CONCLUSIONS
The evidence suggests that both capecitabine and FOLFOX4 are clinically effective and cost-effective in comparison with 5-FU/LV regimens (Mayo Clinic and de Gramont schedules). Further research is suggested into the effectiveness, tolerability, patient acceptability and costs of different oxaliplatin/fluoropyrimidine schedules in the adjuvant setting; the effects of treatment duration on efficacy; adverse events; resource data collection strategies and reporting of summary statistics; subgroups benefiting most from adjuvant chemotherapy; and methods for estimating mean survival.
Topics: Antimetabolites, Antineoplastic; Antineoplastic Agents; Capecitabine; Colonic Neoplasms; Cost-Benefit Analysis; Deoxycytidine; Drug Therapy, Combination; Fluorouracil; Organoplatinum Compounds; Oxaliplatin; Treatment Outcome; United Kingdom
PubMed: 17049138
DOI: 10.3310/hta10410