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Cost-effectiveness of human papillomavirus vaccination in Belgium / Nancy Thiry in International Journal of Technology Assessment in Health Care, 25(2009)2 ([04/01/2009])  

[article] Cost-effectiveness of human papillomavirus vaccination in Belgium : do not forget about cervical cancer screening [printed text] / Nancy Thiry, Author ; Chris De Laet , Author ; Frank Hulstaert, Author ; Mattias Neyt , Author ; Huybrechts, Michel, Author ; Irina Cleemput , Author . - 2009 . - 161-170. Languages : English (eng) in International Journal of Technology Assessment in Health Care > 25(2009)2 [04/01/2009] . - 161-170 Descriptors: Classification W 1 Serials. Periodicals Indexation 2007-13 ; Adolescent ; Adult ; Belgium ; Child ; Cohort Studies ; Cost-Benefit Analysis ; Female ; Great Britain ; Health Care Costs ; Humans ; Journal Article ; Markov Chains ; Mass Screening ; Papillomavirus Vaccines ; Peer Review ; Quality-Adjusted Life Years ; R64 ; Uterine Cervical Neoplasms ; Vaccination Abstract: OBJECTIVES: The cost-effectiveness of adding a human papillomavirus (HPV) vaccination program in 12-year-old females to the recommended cervical cancer screening in Belgium is examined. Moreover, the health and economic consequences of a potential decline in screening uptake after initiation of a HPV vaccination program are investigated. METHODS: A static Markov model is developed to estimate the direct effect of vaccination on precancerous lesions and cervical cancers. RESULTS: Vaccination is estimated to avoid 20 percent of the cervical cancers occurring in a 12-year-old girls' cohort and to cost 32,665 euro per quality-adjusted life-year (QALY) gained (95 percent credibility interval [CrI]: 17,447 euro to 68,078 euro), assuming a booster injection after 10 years, a limited duration of protection and discounting costs and effects at 3 percent and 1.5 percent, respectively. Assuming lifelong protection, HPV vaccination is estimated to cost 14,382 euro (95 percent CrI: 9,238 euro to 25,644 euro) per QALY gained, while avoiding 50 percent of the cervical cancer cases. In the base-case, a 10 percent reduction in screening compliance after vaccination obliterates the effect of vaccination on cervical cancer cases avoided, whereas further declines in the level of screening compliance even turned out to be detrimental for the cohort's health, inducing a mean loss in QALYs and life-year gained compared with the situation prevaccination. CONCLUSIONS: An HPV vaccination program should only be considered if the level of screening after vaccination can be maintained. Link for e-copy: http://doi.org/10.1017/S0266462309090217 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2200 [article]

Dental attendance in preschool children / Roos Leroy in International journal of paediatric dentistry, 23(2013)02 ([03/01/2013])  

[article] Dental attendance in preschool children : a prospective study [printed text] / Roos Leroy , Author ; Kris Bogaerts, Author ; K. Hoppenbrouwers, Author ; L. Martens, Author ; Dominique Declerck, Author . - 2013 . - p. 84-93. Languages : English (eng) in International journal of paediatric dentistry > 23(2013)02 [03/01/2013] . - p. 84-93 Descriptors: Classification W 1 Serials. Periodicals Indexation Attitude to Health ; Belgium ; Child, Preschool ; Cohort Studies ; Dental Health Surveys ; Educational Status ; Journal Article ; Logistic Models ; Peer Review ; Prospective Studies ; Socioeconomic Factors Abstract: BACKGROUND: At present, our understanding of the use of dental care services is incomplete, certainly where preschool children are concerned. OBJECTIVES: To investigate what proportion of 3- and 5-year-olds living in Flanders (Belgium) have already visited the dentist, to describe parents' experience about their child's dental visit, and to explore factors that may have an impact on children's early dental visit. DESIGN: Data were collected from 1057 children; validated questionnaires were completed, and children were examined by trained dentist at ages 3 and 5. Logistic regression analyses were performed to explain dental attendance. RESULTS: At the age of 3, 62% and by 5 years, 21% had never visited the dentist. The first dental visit was considered a pleasant experience for the majority of children. Multivariable regression analyses revealed that children who were not first born, whose mothers had a higher educational level and whose parents had recently visited the dentist, had significantly higher odds for having visited the dentist at young age. CONCLUSIONS: Parents of young children need to be informed about and motivated for an early dental visit. Promotion campaigns should focus on firstborn children, children from less educated parents, and parents who do not regularly see a dentist. Link for e-copy: https://doi.org/10.1111/j.1365-263X.2012.01227.x Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4116 [article]

Différences géographiques de l’incidence du cancer de la thyroïde en Belgique / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

Différences géographiques de l’incidence du cancer de la thyroïde en Belgique : Rôle des stratégies diagnostiques et thérapeutiques dans la prise en charge des pathologies thyroïdiennes [printed text] / Julie Francart, Author ; Annick Van Den Bruel, Author ; Brigitte Decollonne, Author ; Marielle Adam, Author ; Cécile Dubois , Author ; Harlinde De Schutter, Author ; Joan Vlayen , Author ; Sabine Stordeur, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2012 . - VII, 123 p. : Ill. ; A4. - (KCE Reports B. Health Services Research (HSR); 177B) . ISSN : D/2012/10.273/24 : € 0,00 Languages : English (eng) French (fre) Descriptors: Indexation 2010-06 ; Belgium ; Cohort Studies ; Epidemiologic Factors ; Health Services ; R177 ; Thyroid Neoplasms ; Thyroid Nodule ; Thyrotoxicosis ; Utilization Review Classification WK 200 Thyroid Gland. Parathyroid Glands - - Generals works Abstract: L’incidence des cancers de la thyroïde est deux fois plus élevée en Wallonie et à Bruxelles qu’en Flandre. La Ministre de la Santé Publique a demandé à l’Institut Scientifique de Santé Publique (ISP) et au Centre fédéral d’expertise des soins de santé (KCE) d’analyser cette variabilité géographique, en collaboration avec la Fondation Registre du Cancer (BCR). En avril 2012, l’ISP a conclu que vivre aux alentours d’installations nucléaires n’augmentait pas le risque de développer un cancer de la thyroïde. Le KCE a, pour sa part, observé qu’à Bruxelles et plus particulièrement en Wallonie, plus d’examens d’imagerie médicale et d’interventions chirurgicales sont réalisés pour le diagnostic et le traitement des pathologies de la thyroïde. Ce recours intensif augmente les chances de découvrir de manière fortuite un cancer de la thyroïde à un stade de développement précoce. Cela pourrait justifier les différences d’incidence observées entre régions mais une étude approfondie reste nécessaire pour confirmer cette conclusion. Le KCE plaide pour l’amélioration du suivi des recommandations internationales dans la prise en charge des pathologies thyroïdiennes. Cela contribuerait à réduire fortement les différences régionales et conduirait à une utilisation plus fréquente des procédures pré-opératoires recommandées. Contents note: LIST OF FIGURES 5 -- LIST OF TABLES 7 -- LIST OF ABBREVIATIONS 9 -- SYNTHÈSE 10 -- 1. INTRODUCTION 10 -- 2. OBJECTIFS DE L’ÉTUDE 12 -- 3. MÉTHODOLOGIE 13 -- 4. VARIABILITE DES STRATEGIES DE DEPISTAGE ET DE DIAGNOSTIC 13 -- 4.1. INTRODUCTION ET METHODES 13 -- 4.2. ASSOCIATION ENTRE LES PROCEDURES DE DEPISTAGE/DIAGNOSTIQUES ET LA DETECTION FORTUITE D’ANOMALIES SUR LA THYROÏDE 14 -- 5. VARIABILITE DES STRATEGIES THÉRAPEUTIQUES DE LA THYROTOXICOSE 18 -- 5.1. INTRODUCTION ET METHODES 18 -- 5.2. ASSOCIATION ENTRE LA PRISE EN CHARGE DE LA THYROTOXICOSE ET L'INCIDENCE DU CANCER DE LA THYROÏDE 18 -- 6. VARIABILITE DES STRATÉGIES THÉRAPEUTIQUES DES NODULES THYROIDIENS 21 -- 6.1. INTRODUCTION ET METHODES 21 -- 6.2. ASSOCIATION ENTRE LA PRISE EN CHARGE DE LA PATHOLOGIE NODULAIRE ET L'INCIDENCE DU CANCER DE LA THYROÏDE 21 -- 7. CONCLUSION 25 -- 8. RÉFÉRENCES 27 -- SCIENTIFIC SUMMARY 29 -- 1. INTRODUCTION 29 -- 2. RESEARCH QUESTIONS 30 -- 3. GEOGRAPHICAL DISTRIBUTION OF THYROID CANCER INCIDENCE IN BELGIUM (2004-2006) 30 -- 3.1. INTRODUCTION 30 -- 3.2. METHODOLOGY 30 -- 3.2.1. Data selection 30 -- 3.2.2. Data collection of BCR database 31 -- 3.2.3. Dataset 31 -- 3.2.4. Calculation of incidence rates 32 -- 3.3. INCIDENCE OF THYROID CANCER IN BELGIUM 32 -- 3.3.1. General 32 -- 3.3.2. Comparison with other European countries 33 -- 3.3.3. Incidence by sex 34 -- 3.3.4. Incidence by age 35 -- 3.3.5. Incidence by histological type 35 -- 3.3.6. Incidence by T category (and size) 36 -- 3.4. INCIDENCE OF THYROID CANCER BY REGION 37 -- 3.4.1. General 37 -- 3.4.2. Incidence by histological type 37 -- 3.4.3. Incidence by T category and size 38 -- 3.4.4. Incidence by T category and histological type 39 -- 3.5. INCIDENCE BY DISTRICT 40 -- 3.5.1. General 40 -- 3.5.2. Incidence by histological type 42 -- 3.5.3. Incidence by T category 44 -- 3.6. INCIDENCE BY MUNICIPALITY 46 -- 4. VARIABILITY OF SCREENING AND DIAGNOSTIC STRATEGIES 46 -- 4.1. INTRODUCTION AND DEFINITIONS 46 -- 4.2. DATA SOURCE 47 -- 4.3. METHODOLOGY 47 -- 4.4. RESULTS 49 -- 4.4.1. TSH testing 49 -- 4.4.2. Neck Ultrasound 54 -- 4.4.3. Duplex Carotid US 58 -- 4.4.4. High-tech imaging test (CT scan, PET scan and MRI) 61 -- 4.5. DISCUSSION 64 -- 5. VARIABILITY OF TREATMENT STRATEGIES FOR THYROTOXICOSIS 66 -- 5.1. INTRODUCTION 66 -- 5.2. METHODOLOGY 67 -- 5.2.1. Definition of thyrotoxic patients 68 -- 5.2.2. Definition of surgery 68 -- 5.3. RESULTS 69 -- 5.3.1. Main outcome measures 70 -- 5.3.2. Secondary outcome measures 77 -- 5.3.3. Summary of results 80 -- 5.4. DISCUSSION 82 -- 6. VARIABILITY OF TREATMENT STRATEGIES FOR NODULAR DISEASE 84 -- 6.1. INTRODUCTION 84 -- 6.2. METHODOLOGY 85 -- 6.2.1. Definition of patients with nodular disease 86 -- 6.2.2. Definition of surgery 86 -- 6.3. RESULTS 86 -- 6.3.1. Outcomes measures 87 -- 6.3.2. Summary of results 102 -- 6.4. DISCUSSION 105 -- 7. INTERNATIONAL TRENDS IN THYROID CANCER INCIDENCE 107 -- 7.1. INTRODUCTION 107 -- 7.2. METHODOLOGY 107 -- 7.3. OVERVIEW OF INTERNATIONAL DATA AND EPIDEMIOLOGICAL SURVEYS 107 -- 7.3.1. World adjusted incidence rates 107 -- 7.3.2. Increasing trends 107 -- 7.3.3. Spatial disparities in thyroid cancer incidence rates in countries 110 -- 7.3.4. Explanatory hypotheses 112 -- 7.3.5. Mortality rates 115 -- 7.4. DISCUSSION 116 -- 8. CONCLUSION 117 -- 9. REFERENCES 119 Link for e-copy: https://kce.fgov.be/sites/default/files/page_documents/KCE_177B_cancer_de_la_thy [...] Format of e-copy: PDF (5 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2986

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Différences géographiques de l’incidence du cancer de la thyroïde en Belgique / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

Différences géographiques de l’incidence du cancer de la thyroïde en Belgique : Rôle des stratégies diagnostiques et thérapeutiques dans la prise en charge des pathologies thyroïdiennes - Synthèse [printed text] / Julie Francart, Author ; Annick Van Den Bruel, Author ; Brigitte Decollonne, Author ; Marielle Adam, Author ; Cécile Dubois , Author ; Harlinde De Schutter, Author ; Joan Vlayen , Author ; Sabine Stordeur, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2012 . - 26 p. : Ill. ; A4. - (KCE Reports B. Health Services Research (HSR); 177Bs) . ISSN : D/2012/10.273/28 : € 0,00 Languages : French (fre) Descriptors: Indexation 2010-06 ; Belgium ; Cohort Studies ; Epidemiologic Factors ; Health Services ; R177 ; Thyroid Neoplasms ; Thyroid Nodule ; Thyrotoxicosis ; Utilization Review Classification WK 200 Thyroid Gland. Parathyroid Glands - - Generals works Abstract: L’incidence des cancers de la thyroïde est deux fois plus élevée en Wallonie et à Bruxelles qu’en Flandre. La Ministre de la Santé Publique a demandé à l’Institut Scientifique de Santé Publique (ISP) et au Centre fédéral d’expertise des soins de santé (KCE) d’analyser cette variabilité géographique, en collaboration avec la Fondation Registre du Cancer (BCR). En avril 2012, l’ISP a conclu que vivre aux alentours d’installations nucléaires n’augmentait pas le risque de développer un cancer de la thyroïde. Le KCE a, pour sa part, observé qu’à Bruxelles et plus particulièrement en Wallonie, plus d’examens d’imagerie médicale et d’interventions chirurgicales sont réalisés pour le diagnostic et le traitement des pathologies de la thyroïde. Ce recours intensif augmente les chances de découvrir de manière fortuite un cancer de la thyroïde à un stade de développement précoce. Cela pourrait justifier les différences d’incidence observées entre régions mais une étude approfondie reste nécessaire pour confirmer cette conclusion. Le KCE plaide pour l’amélioration du suivi des recommandations internationales dans la prise en charge des pathologies thyroïdiennes. Cela contribuerait à réduire fortement les différences régionales et conduirait à une utilisation plus fréquente des procédures pré-opératoires recommandées. Link for e-copy: https://kce.fgov.be/sites/default/files/page_documents/KCE_177B_cancer_de_la_thy [...] Format of e-copy: PDF (357 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2987

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Hospital-acquired, laboratory-confirmed bloodstream infections / France Vrijens in Journal of Hospital Infection, 75(2010)03 ([04/01/2010])  

[article] Hospital-acquired, laboratory-confirmed bloodstream infections : linking national surveillance data to clinical and financial hospital data to estimate increased length of stay and healthcare costs [printed text] / France Vrijens , Author ; Frank Hulstaert, Author ; Stefaan Van de Sande , Author ; Stephan Devriese , Author ; I. Morales, Author ; Yves Parmentier, Author . - 2010 . - p. 158-162. Languages : English (eng) in Journal of Hospital Infection > 75(2010)03 [04/01/2010] . - p. 158-162 Descriptors: Classification W 1 Serials. Periodicals Indexation Adolescent ; Adult ; Aged ; Aged, 80 and over ; Belgium ; Case studies ; Child ; Cohort Studies ; Cross Infection ; Epidemiology ; Health Care Costs ; Infant ; Infant, Newborn ; Journal Article ; Length of Stay ; Peer Review ; statistics and numerical data [Subheading] Abstract: This matched cohort study estimates the effect of hospital-acquired bloodstream infection (HA-BSI) on length of stay (LOS) and costs during hospitalisation of 1839 patients (age range <1 to >80 years) gathered from 19 acute hospitals in Belgium. A second objective was to evaluate the impact of the choice of matching criteria. Data from national surveillance of HA-BSI were linked to hospital administrative discharge data, with respect for the patients' right to confidentiality of their health record. Controls were identified based on a set of matching factors: hospital, All-Patient Refined Diagnosis Related Groups, age, principal diagnosis, Charlson Comorbidity Index and time to infection. The results showed that, depending on the choice of matching factors, the estimation of additional LOS decreased from 26 to 10 days, with the most critical factor being the time to infection. The additional LOS attributable to HA-BSI was 9.9 days [95% confidence interval (CI): 7.8, 11.9]. The additional cost per infection was euro4900 [95% CI: euro4035, euro5750]; 58% of those costs were due to LOS, 10% were due to antibiotics, 10% due to other pharmaceutical products and 15% were due to billed medical acts. The main conclusion is that laboratory-confirmed HA-BSIs increase the LOS by 10 days for patients surviving the infection, and that the time to infection plays a crucial role in this estimation. Link for e-copy: https://doi.org/10.1016/j.jhin.2009.12.006 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4123 [article]

Oral health care utilization in children with disabilities / Roos Leroy in Clinical oral investigations, 17(2013)08 ([11/01/2013])  

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Primary prevention of cardiovascular disease / O.H. Franco in International Journal of Technology Assessment in Health Care, 23(2007)1 ([04/01/2007])  

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Regional differences in thyroid cancer incidence in Belgium / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Regional differences in thyroid cancer incidence in Belgium / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Regionale verschillen in de incidentie van schildklierkanker in België / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Regionale verschillen in de incidentie van schildklierkanker in België / Julie Francart / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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The health and economic burden of rotavirus disease in Belgium / J Bilcke in European journal of pediatrics, 167(2008)12 ([12/01/2008])  

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The polypill / O.H. Franco in Journal of Epidemiology & Community Health, 60(2006)03 ([04/07/2006])  

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