Descriptors
Documents disponibles dans cette catégorie (453)
Add the result to your basket Make a suggestion Refine your search Apply to external sources
Extend search on down-posting(s)
Anatomy of the Human Body [electronic document] / Henry Gray, Author . - bartleby.com, 2000.
Languages : English (eng)
Descriptors: Classification
QS 39 Human Anatomy. Handbooks. Resource guides
Indexation
Anatomy ; Electronic books ; HumansAbstract: The Bartleby.com edition of Gray’s Anatomy of the Human Body features 1,247 vibrant engravings—many in color—from the classic 1918 publication, as well as a subject index with 13,000 entries ranging from the Antrum of Highmore to the Zonule of Zinn. Contents note: Introduction -- Anatomical Bibliography -- I. Embryology -- The Animal Cell -- The Ovum -- The Spermatozoön -- Fertilization of the Ovum -- Segmentation of the Fertilized Ovum -- The Neural Groove and Tube -- The Notochord -- The Primitive Segments -- Separation of the Embryo -- The Yolk-sac -- Development of the Fetal Membranes and Placenta -- The Branchial Region -- Development of the Body Cavities -- The Form of the Embryo at Different Stages of Its Growth -- Bibliography -- II. Osteology -- Introduction -- Bone -- The Vertebral Column -- a. General Characteristics of a Vertebra -- The Cervical Vertebræ -- The Thoracic Vertebræ -- The Lumbar Vertebræ -- The Sacral and Coccygeal Vertebræ -- b. The Vertebral Column as a Whole -- The Thorax -- a. The Sternum -- b. The Ribs -- c. The Costal Cartilages -- The Skull -- a. The Cranial Bones -- The Occipital Bone -- The Parietal Bone -- The Frontal Bone -- The Temporal Bone -- The Sphenoid Bone -- Ethmoid bone -- b. The Facial Bones -- The Nasal Bones -- The Maxillæ (Upper Jaw) -- The Lacrimal Bone -- The Zygomatic Bone -- The Palatine Bone -- The Inferior Nasal Concha -- The Vomer -- The Mandible (Lower Jaw) -- The Hyoid Bone -- c. The Exterior of the Skull -- d. The Interior of the Skull -- The Extremities -- a. The Bones of the Upper Extremity -- The Clavicle -- The Scapula -- The Humerus -- The Ulna -- The Radius -- b. The Hand -- The Carpus -- The Metacarpus -- The Phalanges of the Hand -- c. The Bones of the Lower Extremity -- The Hip Bone -- The Pelvis -- The Femur -- The Patella -- The Tibia -- The Fibula -- d. The Foot -- The Tarsus -- The Metatarsus -- The Phalanges of the Foot -- Comparison of the Bones of the Hand and Foot -- The Sesamoid Bones -- III. Syndesmology -- Introduction -- Development of the Joints -- Classification of Joints -- The Kind of Movement Admitted in Joints -- Articulations of the Trunk -- a. Articulations of the Vertebral Column -- b. Articulation of the Atlas with the Epistropheus or Axis -- c. Articulations of the Vertebral Column with the Cranium -- d. Articulation of the Mandible -- e. Costovertebral Articulations -- f. Sternocostal Articulations -- g. Articulation of the Manubrium and Body of the Sternum -- h. Articulation of the Vertebral Column with the Pelvis -- i. Articulations of the Pelvis -- Articulations of the Upper Extremity -- a. Sternoclavicular Articulation -- b. Acromioclavicular Articulation -- c. Humeral Articulation or Shoulder-joint -- d. Elbow-joint -- e. Radioulnar Articulation -- f. Radiocarpal Articulation or Wrist-joint -- g. Intercarpal Articulations -- h. Carpometacarpal Articulations -- i. Intermetacarpal Articulations -- j. Metacarpophalangeal Articulations -- k. Articulations of the Digits -- Articulations of the Lower Extremity -- a. Coxal Articulation or Hip-joint -- b. The Knee-joint -- c. Articulations between the Tibia and Fibula -- d. Talocrural Articulation or Ankle-joint -- e. Intertarsal Articulations -- f. Tarsometatarsal Articulations -- g. Intermetatarsal Articulations -- h. Metatarsophalangeal Articulations -- i. Articulations of the Digits -- j. Arches of the Foot -- IV. Myology -- Mechanics of Muscle -- Development of the Muscles -- Tendons, Aponeuroses, and Fasciæ -- The Fasciæ and Muscles of the Head. -- a. The Muscles of the Scalp -- b. The Muscles of the Eyelid -- c. The Muscles of the Nose -- d. The Muscles of the Mouth -- e. The Muscles of Mastication -- The Fasciæ and Muscles of the Anterolateral Region of the Neck -- a. The Superficial Cervical Muscle -- b. The Lateral Cervical Muscles -- c. The Supra- and Infrahyoid Muscles -- d. The Anterior Vertebral Muscles -- e. The Lateral Vertebral Muscles -- The Fasciæ and Muscles of the Trunk -- a. The Deep Muscles of the Back -- b. The Suboccipital Muscles -- c. The Muscles of the Thorax -- d. The Muscles and Fasciæ of the Abdomen -- e. The Muscles and Fasciæ of the Pelvis -- f. The Muscles and Fasciæ of the Perineum -- The Fascia and Muscles of the Upper Extremity -- a. The Muscles Connecting the Upper Extremity to the Vertebral Column -- b. The Muscles Connecting the Upper Extremity to the Anterior and Lateral Thoracic Walls -- c. The Muscles and Fasciæ of the Shoulder -- d. The Muscles and Fasciæ of the Arm -- e. The Muscles and Fasciæ of the Forearm -- f. The Muscles and Fasciæ of the Hand -- The Muscles and Fasciæ of the Lower Extremity. -- a. The Muscles and Fasciæ of the Iliac Region -- b. The Muscles and Fasciæ of the Thigh -- c. The Muscles and Fasciæ of the Leg -- d. The Fasciæ Around the Ankle -- e. The Muscles and Fasciæ of the Foot -- Bibliography -- V. Angiology -- Introduction -- The Blood -- Development of the Vascular System -- The Thoracic Cavity -- a. The Pericardium -- b. The Heart -- c. Peculiarities in the Vascular System in the Fetus -- Bibliography -- VI. The Arteries -- Introduction -- The Aorta -- The Arteries of the Head and Neck -- a. The Common Carotid Artery -- Relations -- The External Carotid Artery -- The Triangles of the Neck -- The Internal Carotid Artery -- b. The Arteries of the Brain -- The Arteries of the Upper Extremity -- a. The Subclavian Artery -- b. The Axilla -- The Axillary Artery -- The Brachial Artery -- The Radial Artery -- The Ulnar Artery -- The Arteries of the Trunk -- a. The Descending Aorta -- The Thoracic Aorta -- The Abdominal Aorta -- b. The Common Iliac Arteries -- The Hypogastric Artery -- The External Iliac Artery -- The Arteries of the Lower Extremity -- a. The Femoral Artery -- b. The Popliteal Fossa -- c. The Popliteal Artery -- d. The Anterior Tibial Artery -- e. The Arteria Dorsalis Pedis -- f. The Posterior Tibial Artery -- Bibliography -- VII. The Veins -- Introduction -- The Pulmonary Veins -- The Systemic Veins -- a. The Veins of the Heart -- b. The Veins of the Head and Neck -- The Veins of the Exterior of the Head and Face -- The Veins of the Neck -- The Diploic Veins -- The Veins of the Brain -- The Sinuses of the Dura Mater. Ophthalmic Veins and Emissary Veins -- c. The Veins of the Upper Extremity and Thorax -- d. The Veins of the Lower Extremity, Abdomen, and Pelvis -- The Portal System of Veins -- VIII. The Lymphatic System -- Introduction -- The Thoractic Duct -- The Lymphatics of the Head, Face, and Neck -- The Lymphatics of the Upper Extremity -- The Lymphatics of the Lower Extremity -- The Lymphatics of the Abdomen and Pelvis -- The Lymphatic Vessels of the Thorax -- Bibliography -- IX. Neurology -- Structure of the Nervous System -- Development of the Nervous System -- The Spinal Cord or Medulla Spinalis -- The Brain or Encephalon -- a. The Hind-brain or Rhombencephalon -- b. The Mid-brain or Mesencephalon -- c. The Fore-brain or Prosencephalon -- d. Composition and Central Connections of the Spinal Nerves -- e. Composition and Central Connections of the Spinal Nerves -- f. Pathways from the Brain to the Spinal Cord -- g. The Meninges of the Brain and Medulla Spinalis -- h. The Cerebrospinal Fluid -- The Cranial Nerves -- a. The Olfactory Nerves -- b. The Optic Nerve -- c. The Oculomotor Nerve -- d. The Trochlear Nerve -- e. The Trigeminal Nerve -- f. The Abducent Nerve -- g. The Facial Nerve -- h. The Acoustic Nerve -- i. The Glossopharyngeal Nerve -- j. The Vagus Nerve -- k. The Accessory Nerve -- l. The Hypoglossal Nerve -- The Spinal Nerves -- a. The Posterior Divisions -- b. The Anterior Divisions -- c. The Thoracic Nerves -- d. The Lumbosacral Plexus -- e. The Sacral and Coccygeal Nerves -- The Sympathetic Nerves -- a. The Cephalic Portion of the Sympathetic System -- b. The Cervical Portion of the Sympathetic System -- c. The Thoracic Portion of the Sympathetic System -- d. The Abdominal Portion of the Sympathetic System -- e. The Pelvic Portion of the Sympathetic System -- f. The Great Plexuses of the Sympathetic System -- Bibliography -- X. The Organs of the Senses and the Common Integument -- The Peripheral Organs of the Special Senses -- a. The Organs of Taste -- b. The Organ of Smell -- c. The Organ of Sight -- The Tunics of the Eye -- The Refracting Media -- The Accessory Organs of the Eye -- d. The Organ of Hearing -- The External Ear -- The Middle Ear or Tympanic Cavity -- The Auditory Ossicles -- The Internal Ear or Labyrinth -- e. Peripheral Terminations of Nerves of General Sensations -- The Common Integument -- XI. Splanchnology -- The Respiratory Apparatus -- a. The Larynx -- b. The Trachea and Bronchi -- c. The Pleuræ -- d. The Mediastinum -- e. The Lungs -- The Digestive Apparatus -- a. The Mouth -- b. The Fauces -- c. The Pharynx -- d. The Esophagus -- e. The Abdomen -- f. The Stomach -- g. The Small Intestine -- h. The Large Intestine -- i. The Liver -- j. The Pancreas -- The Urogenital Apparatus -- a. Development of the Urinary and Generative Organs -- b. The Urinary Organs -- The Kidneys -- The Ureters -- The Urinary Bladder -- The Male Urethra -- The Female Urethra -- c. The Male Genital Organs -- The Testes and their Coverings -- The Ductus Deferens -- The Vesiculæ Seminales -- The Ejaculatory Ducts -- The Penis -- The Prostate -- The Bulbourethral Glands -- d. The Female Genital Organs -- The Ovaries -- The Uterine Tube -- The Uterus -- The Vagina -- The External Organs -- The Mammæ -- The Ductless Glands -- a. The Thyroid Gland -- b. The Parathyroid Glands -- c. The Thymus -- d. The Hypophysis Cerebri -- e. The Pineal Body -- f. The Chromaphil and Cortical Systems -- g. The Spleen -- XII. Surface Anatomy and Surface Markings -- Surface Anatomy of the Head and Neck -- Surface Markings of Special Regions of the Head and Neck -- Surface Anatomy of the Back -- Surface Markings of the Back -- Surface Anatomy of the Thorax -- Surface Markings of the Thorax -- Surface Anatomy of the Abdomen -- Surface Markings of the Abdomen -- Surface Anatomy of the Perineum -- Surface Markings of the Perineum -- Surface Anatomy of the Upper Extremity -- Surface Markings of the Upper Extremity -- Surface Anatomy of the Lower Extremity -- Surface Markings of the Lower Extremity Link for e-copy: http://www.bartleby.com/107/ Format of e-copy: Webpage Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2733 Anatomy of the Human body / Henry Gray / Philadelphia [United States] : Lea & Febiger (1924)
Anatomy of the Human body [printed text] / Henry Gray, Author . - 21 ed. . - Philadelphia [United States] : Lea & Febiger, 1924 . - 1417 p. : ill. ; 22 cm.
£ 26,29
Languages : English (eng)
Descriptors: Classification
QS 39 Human Anatomy. Handbooks. Resource guides
Indexation
AnatomyRecord link: https://kce.docressources.info/index.php?lvl=notice_display&id=2745 Hold
Place a hold on this item
Copies(1)
Barcode Call number Media type Location Section Status 10273-02370 QS 39 / GRA Book KCE Library (10.124) Available Readers who borrowed this document also borrowed:
Know your chances Woloshin, Steven Hyperbaric Oxygen 2003 Feldmeier, John Calculated Risks Gigerenzer, Gerd Praktische richtlijnen anesthesiologische pijnbestrijding, gebaseerd op klinische diagnosen Van Zundert, Jan Evidence-based Interventional Pain Medicine Van Zundert, Jan Chronic pain Rashiq, Saifudin UHMS Guidelines for Hyperbaric Facility Operations Workman, W.T. Anticoagulants in non-valvular atrial fibrillation / Hans Van Brabandt / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
Anticoagulants in non-valvular atrial fibrillation [printed text] / Hans Van Brabandt , Author ; Lorena San Miguel , Author ; Nicolas Fairon , Author ; Bert Vaes, Author ; Séverine Henrard, Author ; Anelia Boshnakova, Author ; Rob Cook, Author ; Rob Davies, Author ; Aditi Karnad, Author ; Alan Lovell, Author ; Cécile Dubois , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 195 p. : ill., ; A4. - (KCE Reports. Health Technology Assessment (HTA); 279) .
ISSN : D/2016/10.273/101 : € 0,00
Study 2015-05
Languages : English (eng)
Descriptors: Indexation
2015-05 ; Anticoagulants ; Atrial Fibrillation ; Belgium ; Cost-Benefit Analysis ; Physician's Practice Patterns ; Practice Guidelines as Topic ; R279 ; Secondary Prevention
Classification
QV 193 AnticoagulantsContents note: LIST OF FIGURES 6 -- LIST OF TABLES 8 -- LIST OF ABBREVIATIONS 10 -- SCIENTIFIC REPORT 12 -- 1 AIMS 12 -- 2 INTRODUCTION 13 -- 3 BACKGROUND 13 -- 3 1 ANTITHROMBOTICS13 -- 3 3 STROKE RISK ASSESSMENT IN ATRIAL FIBRILLATION 14 -- 3 4 STROKE PREVENTION IN ATRIAL FIBRILLATION 19 -- 3 4 1 Vitamin K antagonists 19 -- 3 4 2 Antiplatelets 19 -- 3 4 3 Combination therapy of anticoagulants and antiplatelets 20 -- 3 4 4 Novel Oral AntiCoagulants (NOACs) 20 -- 3 5 BLEEDING RISK INDUCED BY VITAMIN K ANTAGONISTS 21 -- 4 EFFICACY AND SAFETY OF NOACS 23 -- 4 1 SEARCH STRATEGY 23 -- 4 2 SYSTEMATIC REVIEWS 25 -- 4 3 PRIMARY STUDIES 26 -- 4 3 1 Ximelagatran 26 -- 4 3 2 Dabigatran 26 -- 4 3 3 Rivaroxaban 27 -- 4 3 4 Apixaban 28 -- 4 3 5 Edoxaban 28 -- 4 3 6 Summary table 28 -- 4 4 SAFETY OF NOACS 30 -- 4 5 RISK OF BIAS IN PIVOTAL RCTS 31 -- 4 6 INTERNATIONAL PRACTICE GUIDELINES 32 -- 5 REIMBURSEMENT OF ANTICOAGULANTS IN BELGIUM 35 -- 6 ADHERENCE TO ANTICOAGULATION GUIDELINES IN PRACTICE 37 -- 6 1 PHYSICIANS’ ADHERENCE TO GUIDELINES 37 -- 6 1 1 Literature search 37 -- 6 1 2 Systematic reviews 38 -- 6 1 3 AF patient registries 38 -- 6 2 PHYSICIANS’ ADHERENCE TO APPROPRIATE DOSE PRESCRIPTION 42 -- 6 2 1 VKA dosing 42 -- 6 2 2 NOAC dosing 42 -- 6 3 PATIENTS’ ADHERENCE TO ANTICOAGULANT PRESCRIPTION 43 -- 7 CLINICAL USE OF ANTICOAGULANTS IN NON-VALVULAR AF: DISCUSSION 45 -- 7 1 STROKE RISK ASSOCIATED WITH AF, VERSUS BLEEDING RISK ASSOCIATED WITH ANTICOAGULANTS 45 -- 7 1 1 Undertreatment in high risk populations with a CHA2DS2-VASc risk score of ≥2 (♂) or ≥3 (♀) 47 -- 7 1 2 Overtreatment in low risk populations with a CHA2DS2-VASc risk score of 0 (or 1 in ♀ with no additional risk factors)47 -- 7 1 3 Anticoagulation in patients with a CHA2DS2-VASc risk score of 1 (♂) or 2 (♀) 47 -- 7 1 4 Patients’ adherence to anticoagulants 47 -- 7 2 NEW ORAL ANTICOAGULANTS VS VITAMIN K ANTAGONISTS 48 -- 7 2 1 Effect of NOACs versus VKAs on stroke 48 -- 7 2 2 Effect of NOACs versus VKAs on bleeding 48 -- 7 2 3 Drug monitoring and compliance to treatment 49 -- 8 COST-EFFECTIVENESS OF NOACS 50 -- 8 1 INTRODUCTION 50 -- 8 2 METHODS 50 -- 8 2 1 Literature review 50 -- 8 2 2 Selection process 50 -- 8 3 RESULTS 53 -- 8 3 1 Overview of economic evaluations 53 -- 8 3 2 Type of economic evaluation 57 -- 8 3 3 Time frame and discounting 58 -- 8 3 4 Perspective 58 -- 8 3 5 Population 58 -- 8 3 6 Intervention and comparator 59 -- 8 3 7 Cost and outcome inputs 59 -- 8 3 8 Industry sponsorship 59 -- 8 3 9 Costs 60 -- 8 3 10 Incremental Cost-effectiveness Ratios (ICERs) 78 -- 8 3 11 Sensitivity Analyses 84 -- 8 3 12 Subgroup Analyses 84 -- 8 3 13 Studies in Belgium 85 -- 8 3 14 NICE Health Technology Assessments 91 -- 8 4 DISCUSSION AND CONCLUSIONS 91 -- 8 4 1 Use of adapted models 91 -- 8 4 2 Assumptions and sources of data 92 -- 8 4 3 Conflict of interests 92 -- 8 4 4 Relevance to Belgian healthcare system 92 -- 8 4 5 Conclusions 92 -- 9 FLEMISH GENERAL PRACTITIONERS’ DATA 94 -- 9 1 INTRODUCTION 94 -- 9 2 METHODOLOGY 95 -- 9 2 1 Description of the Intego database 95 -- 9 2 2 Clinical research questions 95 -- 9 2 3 Patient selection 95 -- 9 2 4 Definition of clinical variables and medications 97 -- 9 2 5 Statistical analysis 100 -- 9 3 RESULTS 101 -- 9 3 1 Prescription of oral anticoagulants in general practice in the general population and validation of proxies for the CHA2DS2-VASc and CHADS2 scores (part 1) 101 -- 9 3 2 Trends in prescriptions of OACs in general practice in people with atrial fibrillation (part 2) 107 -- 9 4 CONCLUSIONS 125 -- 9 4 1 Prescription of oral anticoagulants in general practice in the general population and validation of proxies for the CHA2DS2-VASc and CHADS2 scores (part 1) 125 -- 9 4 2 Trends in prescriptions of oral anticoagulants in general practice in people with atrial fibrillation (part 2) 125 -- 10 ANALYSIS OF BELGIAN DATA 126 -- 10 1 INTRODUCTION 126 -- 10 2 METHODS 126 -- 10 2 1 General Methodology 126 -- 10 3 DATA LIMITATIONS 128 -- 10 4 RESULTS 128 -- 10 4 1 Evolution over time 128 -- 10 4 2 Profile of the anticoagulant users 132 -- 10 5 DISCUSSION 145 -- 11 FINAL CONCLUSION147 -- 11 1 TO ANTICOAGULATE OR NOT? 147 -- 11 1 1 Risk of stroke risk associated with non-valvular AF 147 -- 11 1 2 Net clinical benefit of anticoagulants 147 -- 11 1 3 Overdiagnosis and oveartreatment 148 -- 11 1 4 Undertreatment 148 -- 11 2 VKA OR NOAC? 149 -- 11 2 1 Advantages of NOACs versus VKAs 149 -- 11 2 2 Disadvantages of NOACs versus VKAs 149 -- 11 2 3 VKA or NOAC: KCE’s conclusion 150 -- 11 3 TRENDS IN ANTICOAGULANT PRESCRIPTION 151 -- APPENDICES 152 -- APPENDIX 1 RCTS COMPARING NOACS WITH VKA IN NON-VALVULAR AF 152 -- APPENDIX 2 LITERATURE SEARCH FOR EFFICACY OF NOAC 153 -- APPENDIX 3 SUMMARY OF FINDINGS TABLES 157 -- APPENDIX 4 META-ANALYSES OF ISCHEMIC STROKE RISK BY CHA2DS2-VASC SCORE 164 -- APPENDIX 5 SYSTEMATIC REVIEWS ON INAPPROPRIATE USE OF ORAL ANTICOAGULANTS 166 -- APPENDIX 6 SEARCH STRATEGIES FOR C-E CHAPTER 172 -- APPENDIX 7 APPENDICES TO FLEMISH GPS’ DATA 174 -- APPENDIX 8 APPENDICES TO BELGIAN IMA DATA 184 -- REFERENCES 186 Link for e-copy: https://doi.org/10.57598/R279C Format of e-copy: PDF (4,8 MB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3966 Anticoagulants in non-valvular atrial fibrillation / Hans Van Brabandt / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
Anticoagulants in non-valvular atrial fibrillation : Synthesis [printed text] / Hans Van Brabandt , Author ; Lorena San Miguel , Author ; Nicolas Fairon , Author ; Bert Vaes, Author ; Séverine Henrard, Author ; Anelia Boshnakova, Author ; Rob Cook, Author ; Rob Davies, Author ; Aditi Karnad, Author ; Alan Lovell, Author ; Cécile Dubois , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 22 p. : ill., ; A4. - (KCE Reports. Health Technology Assessment (HTA); 279Cs) .
ISSN : D/2016/10.273/100 : € 0,00
Study 2015-05
Languages : English (eng)
Descriptors: Indexation
2015-05 ; Anticoagulants ; Atrial Fibrillation ; Belgium ; Cost-Benefit Analysis ; Physician's Practice Patterns ; Practice Guidelines as Topic ; R279 ; Secondary Prevention
Classification
QV 193 AnticoagulantsContents note: FOREWORD -- KEY MESSAGES 2 -- SYNTHESE 4 -- 1. OBJECTIVES OF THIS STUDY 6 -- 2. ATRIAL FIBRILLATION 6 -- 2.1. A SILENT DISORDER WITH POTENTIALLY SERIOUS CONSEQUENCES 6 -- 2.2. ASSESSMENT OF THE THROMBOEMBOLIC RISK 7 -- 3. EFFICACY OF ORAL ANTICOAGULANTS IN ATRIAL FIBRILLATION 8 -- 3.1. VITAMIN K ANTAGONISTS 8 -- 3.2. NOVEL ORAL ANTICOAGULANTS (NOACS) 8 -- 3.3. COMPARISON OF THE EFFICACY OF VKAS AND NOACS 9 -- 4. PRACTICAL: PRESCRIBE ANTICOAGULANTS OR NOT? 11 -- 4.1. FINDING THE BALANCE BETWEEN THE RISK OF ISCHEMIC AND HAEMORRHAGIC STROKE.11 -- 4.2. OVERTREATMENT 12 -- 4.3. UNDERTREATMENT 12 -- 4.4. SPECIAL CASE: PATIENTS WITH A CHA2DS2-VASC SCORE = 1 (FOR MEN) AND = 2 (FOR WOMEN) 13 -- 4.5. ADDITIONAL OBSERVATIONS 14 -- 5. MONITORING A PATIENT ON ANTICOAGULANTS 15 -- 5.1. MONITORING COAGULATION 15 -- 5.2. MONITORING COMPLIANCE 15 -- 5.3. A NEW FORM OF UNDERTREATMENT WITH NOACS 16 -- 5.4. REVERSIBILITY OF THE ANTICOAGULANT EFFECT AND ANTIDOTES 16 -- 6. ECONOMIC ASPECTS 17 -- 6.1. REIMBURSEMENT OF NOACS IN BELGIUM 17 -- 6.2. ECONOMIC EVALUATIONS 18 -- 7. CONCLUSIONS 19 -- 7.1. ANTICOAGULANTS OR NOT? 19 -- 7.2. VKA OR NOAC 19 -- 7.2.1. Advantages of NOACs compared to VKAs 19 -- 7.2.2. Disadvantages of NOACs compared to VKAs 19 -- 7.2.3. Conclusion 20 Link for e-copy: https://doi.org/10.57598/R279CS Format of e-copy: PDF (847 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3967 Anticoagulation et fibrillation auriculaire / Hans Van Brabandt / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
Anticoagulation et fibrillation auriculaire : Synthèse [printed text] / Hans Van Brabandt , Author ; Lorena San Miguel , Author ; Nicolas Fairon , Author ; Bert Vaes, Author ; Séverine Henrard, Author ; Anelia Boshnakova, Author ; Rob Cook, Author ; Rob Davies, Author ; Aditi Karnad, Author ; Alan Lovell, Author ; Cécile Dubois , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2016 . - 22 p. : ill., ; A4. - (KCE Reports B. Health Technology Assessment (HTA); 279Bs) .
ISSN : D/2016/10.273/98 : € 0,00
Studie 2015-05
Languages : French (fre)
Descriptors: Indexation
2015-05 ; Anticoagulants ; Atrial Fibrillation ; Belgium ; Cost-Benefit Analysis ; Physician's Practice Patterns ; Practice Guidelines as Topic ; R279 ; Secondary Prevention
Classification
QV 193 AnticoagulantsAbstract: Les anticoagulants sont des médicaments qui sont prescrits, entre autres, aux personnes atteintes d’un trouble du rythme cardiaque appelé fibrillation auriculaire, pour diminuer leur risque d’accident vasculaire cérébral (AVC). Depuis quelques années, de « nouveaux anticoagulants oraux » ou NOAC sont arrivés sur le marché. Leur usage est plus pratique que celui des « anciens » puisqu’ils ne nécessitent plus de prises de sang de contrôle tous les mois. Mais leur prix est aussi nettement plus élevé : ils représentent pour notre assurance maladie un coût annuel supplémentaire qui avoisine les 100 millions d’euros. Le Centre fédéral d’Expertise des Soins de santé (KCE) a mené une analyse critique des données existantes sur ces médicaments et a découvert que leurs avantages ne sont pas aussi évidents qu’il y paraît. En effet, si leur efficacité est supérieure à celle des anciens médicaments… ce n’est que de quelques dixièmes de pourcents, et à condition qu’ils soient bien utilisés.
Trois problèmes se posent en effet : (1) Parmi les patients sous anticoagulants, certains n’en retirent aucun bénéfice parce que le risque d’AVC que l’on cherche à éviter est à peu près équivalent, chez eux, au risque d’hémorragie dû au traitement. (2) De nombreux patients reçoivent des doses de NOAC réduites, dont nous ne savons pas si elles sont efficaces. (3) Comme les NOAC ne nécessitent plus de prises de sang de contrôle tous les mois, les médecins ne sont plus en mesure de vérifier si leurs patients ont une anticoagulation suffisante. Le KCE appelle donc à la vigilance : il se peut que bon nombre de patients sous NOAC ne soient en réalité pas correctement protégés.Contents note: PRÉFACE 1 -- MESSAGES CLÉS 2 -- SYNTHÈSE 4 -- 1OBJECTIFS DE CETTE ÉTUDE 6 -- 2LA FIBRILLATION AURICULAIRE 6 -- 2.1UN TROUBLE DISCRET AUX CONSÉQUENCES POTENTIELLEMENT GRAVES 6 -- 2.2ESTIMATION DU RISQUE THROMBO-EMBOLIQUE 7 -- 3EFFICACITÉ DES ANTICOAGULANTS ORAUX DANS LA FIBRILLATION AURICULAIRE 8 -- 3.1LES ANTAGONISTES DE LA VITAMINE K 8 -- 3.2NOUVEAUX ANTICOAGULANTS ORAUX (NOAC) 8 -- 3.3EFFICACITÉ COMPARÉE DES AVK ET DES NOAC 9 -- 4EN PRATIQUE: ANTICOAGULER OU NON ? 11 -- 4.1TROUVER L’ÉQUILIBRE ENTRE LE RISQUE D’AVC ISCHÉMIQUE ET LE RISQUE D’AVC HÉMORRAGIQUE 11 -- 4.2SUR-TRAITEMENT.12 -- 4.3SOUS-TRAITEMENT 12 -- 4.4CAS PARTICULIER : LES PATIENTS AVEC UN SCORE CHA2DS2-VASC = 1 (POUR LES HOMMES) ET = 2 (POUR LES FEMMES) 13 -- 4.5REMARQUES COMPLÉMENTAIRES 14 -- 5LA SURVEILLANCE DU PATIENT SOUS ANTICOAGULANTS 15 -- 5.1SURVEILLANCE DE L’HÉMOSTASE DU PATIENT 15 -- 5.2SURVEILLANCE DE L’OBSERVANCE THÉRAPEUTIQUE 15 -- 5.3VERS UN NOUVEAU RISQUE DE SOUS-TRAITEMENT ? 16 -- 5.4RÉVERSIBILITÉ DE L’ACTION ANTICOAGULANTE ET ANTIDOTES 16 -- 6ASPECTS ÉCONOMIQUES 17 -- 6.1REMBOURSEMENT DES NOAC EN BELGIQUE17 -- 6.2ÉVALUATIONS ÉCONOMIQUES.18 -- 7CONCLUSIONS.19 -- 7.11E QUESTION : ANTICOAGULER OU PAS ? 19 -- 7.22E QUESTION : AVK OU NOAC? 19 -- 7.2.1Avantages des NOAC sur les AVK 19 -- 7.2.2Désavantages des NOAC par rapport aux AVK 19 -- 7.2.3Conclusion 20 -- RECOMMANDATIONS 21 -- RÉFÉRENCES22 Link for e-copy: https://doi.org/10.57598/R279Bs Format of e-copy: PDF (847 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3969 Antimicrobial Stewardship / Céline Pulcini / Amsterdam : Elsevier/Academic Press (2017)
PermalinkAntistolling en voorkamerfibrillatie / Hans Van Brabandt / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2016)
PermalinkAntiviral agents in seasonal and pandemic influenza / N Van de Vyver ; W Janssens ; An De Sutter ; B Michiels ; Frans Govaerts ; Frank Hulstaert ; Marie-Laurence Lambert ; R Peleman ; Dirk Ramaekers / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2006)
PermalinkAntivirale middelen bij seizoensgriep en grieppandemie. / N Van de Vyver ; W Janssens ; An De Sutter ; B Michiels ; Frans Govaerts ; Frank Hulstaert ; Marie-Laurence Lambert ; R Peleman ; Dirk Ramaekers / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2006)
PermalinkApplied Linear Statistical Models / Michael Kutner / McGraw-Hill/Irwin (2004)
PermalinkApplied logistic regression / David W. Hosmer / New York ; Hoboken : J. Wiley (2000)
PermalinkApplied nonparametric statistical methods / Peter Sprent / London : Chapman & Hall (2000)
PermalinkApplied regression analysis and other multivariable methods / David G. Kleinbaum / Pacific Grove : Duxbury press (1998)
PermalinkPermalinkAssessing the economic value of anti-cancer therapies / Niels Neymark / New York ; Berlin ; Tokyo : Springer (1998)
Permalink