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González Pedraza Avilés, M.C. Ortiz Zaragoza" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "González Pedraza Avilés" ] 1 => array:2 [ "nombre" => "M.C." "apellidos" => "Ortiz Zaragoza" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0212656700785647?idApp=UINPBA00004N" "url" => "/02126567/0000002500000008/v1_201307091441/S0212656700785647/v1_201307091441/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Análisis coste-efectividad del tratamiento de la hiperplasia prostática benigna de grado moderado" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "546" "paginaFinal" => "551" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C.M. Meseguer Barros, M.L. Fidalgo García, S. Rubio Cebrián" "autores" => array:3 [ 0 => array:3 [ "nombre" => "C.M." "apellidos" => "Meseguer Barros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M.L." "apellidos" => "Fidalgo García" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "cor0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "S." "apellidos" => "Rubio Cebrián" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Epidemiología. Sección Enfermedades no Transmisibles. Consejería de Sanidad de la Comunidad de Madrid." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Farmacéutica Atención Primaria. Servicio de Farmacia Atención Primaria del Área 8. INSALUD. Madrid." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Profesor del Departamento de Planificación y Economía de la Salud. Escuela Nacional de Sanidad. Madrid." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: María Luz Fidalgo García. Dirección-Gerencia de Atención Primaria. Area 8. C/ Alonso Cano, 8. 28933 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cost-effectiveness analysis of the treatment of moderate benign prostatic hyperplasia" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-11-22" "fechaAceptado" => "1999-11-22" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec194431" "palabras" => array:3 [ 0 => "Análisis coste-efectividad" 1 => "Análisis sensibilidad" 2 => "Hiperplasia prostática" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la alternativa más coste-efectiva del tratamiento de la hiperplasia prostática benigna de grado moderado (HPB-GM) y conocer si las conclusiones pueden modificarse al variar el coste o efectividad de las estrategias de tratamiento.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El estudio se modeliza mediante un árbol de decisión para examinar el ratio costeefectividad de 3 estrategias de tratamiento: <span class="elsevierStyleItalic">a</span>) espera vigilada, y si no hay respuesta se administra un fármaco; si tampoco hay respuesta, se procede a resección transuretral de próstata (RUTP); <span class="elsevierStyleItalic">b</span>) tratamiento farmacológico, y si no hay respuesta se realiza RTUP, o <span class="elsevierStyleItalic">c</span>) aplicar inicialmente RTUP.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se simula el tratamiento de 1.000 pacientes con HPB-GM y su trayectoria de episodios y probabilidades a lo largo de 2 años de tratamiento y desde el punto de vista del sistema sanitario como financiador de servicios.</p> <span class="elsevierStyleSectionTitle">Mediciones y resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los datos de efectividad se obtienen a partir de un consenso americano de expertos. Se consideran únicamente los costes tangibles directos derivados del tratamiento, en pesetas constantes de 1998. Se realiza un análisis de sensibilidad simple univariante considerando las variables de costes de la RTUP y de los fármacos en un rango aceptable de ± 20%, y la eficacia de la espera vigilada y del tratamiento farmacológico según los valores incluidos en su intervalo de confianza del 90%. La alternativa con un menor coste por paciente mejorado (PM) es la espera vigilada (77.069 pts./PM) seguido del tratamiento con fármacos (118.656 pts./PM) y, por último, de la RTUP (456.642 pts./PM). Variaciones en los valores de las variables no hacen modificar las posiciones relativas de las estrategias de tratamiento evaluadas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Desde el punto de vista farmacoeconómico, el tratamiento de la HPB-GM debe iniciarse con espera vigilada, procediendo a administrar fármacos sólo si no hay respuesta positiva y recurrir a RTUP cuando los procedimientos farmacológicos no hayan resultado efectivos.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To estimate the most cost-effective alternative of treatment of moderate benign prostatic hyperplasia and to learn whether the outcome can be varied by changing the cost or effectiveness of the alternatives.</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study is made by a decision tree in order to test the cost-effectiveness (CE) rate of three treatment strategies: <span class="elsevierStyleItalic">a</span>) watchful waiting; if there is no response a drug is administered and if there is no response transurethral resection of the prostate (TURP) is done, <span class="elsevierStyleItalic">b</span>) pharmacological treatment, and if there is no response TURP is done, and <span class="elsevierStyleItalic">c</span>) to apply TURP initially.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The treatment is simulated taking 1000 patients with MBPH and testing the outcome of events and probabilities in a two-year treatment and from the point of view of the health system as services supplier.</p> <span class="elsevierStyleSectionTitle">Measurements and results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Effectiveness is obtained from an american experts' consensus. Only the direct tangible costs are taken into account, in constant 1998 pts. An univariant simple sensitivity analysis is made considering the cost variables of TURP and from the drugs in an acceptable range of ± 20%, and the effectiveness of the watchful waiting and the pharmacological treatment. The lower cost alternative per improved patient (IP) is the watchful waiting (77069 pts./IP) followed by the drug treatment (118656 pts./IP) and lastly the TURP (456642 pts./IP). Variations in the variable values make no difference in the relative positions of the tested alternatives.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">From the pharmacoeconomics' point of view the MBPH treatment must be iniciated by watchful waiting, proceeding to drug administration only if there is a positive response and to make use of TURP when the pharmacological procedures have not been effective.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Este trabajo fue presentado en el III Congreso Nacional de Farmacéuticos de Atención Primaria, que se celebró en Barcelona en octubre 1998.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Biblografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of benign prostatic hyperplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.C. Walsh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199608223350809" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1996" "volumen" => "335" "paginaInicial" => "586" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8678937" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Benig prostatic hyperplasia. Current pharmacological treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Jonler" 1 => "M. Riehmann" 2 => "R.C. 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año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 3 | 5 | 8 |
2024 Octubre | 11 | 16 | 27 |
2024 Septiembre | 15 | 12 | 27 |
2024 Agosto | 20 | 9 | 29 |
2024 Julio | 23 | 18 | 41 |
2024 Junio | 25 | 19 | 44 |
2024 Mayo | 26 | 13 | 39 |
2024 Abril | 13 | 25 | 38 |
2024 Marzo | 32 | 50 | 82 |
2024 Febrero | 12 | 40 | 52 |
2024 Enero | 30 | 27 | 57 |
2023 Diciembre | 34 | 50 | 84 |
2023 Noviembre | 18 | 56 | 74 |
2023 Octubre | 40 | 54 | 94 |
2023 Septiembre | 18 | 29 | 47 |
2023 Agosto | 10 | 36 | 46 |
2023 Julio | 18 | 51 | 69 |
2023 Junio | 23 | 24 | 47 |
2023 Mayo | 51 | 10 | 61 |
2023 Abril | 37 | 4 | 41 |
2023 Marzo | 28 | 5 | 33 |
2023 Febrero | 22 | 17 | 39 |
2023 Enero | 5 | 4 | 9 |
2022 Diciembre | 9 | 14 | 23 |
2022 Noviembre | 35 | 23 | 58 |
2022 Octubre | 25 | 16 | 41 |
2022 Septiembre | 19 | 20 | 39 |
2022 Agosto | 26 | 39 | 65 |
2022 Julio | 14 | 24 | 38 |
2022 Junio | 10 | 19 | 29 |
2022 Mayo | 19 | 19 | 38 |
2022 Abril | 26 | 29 | 55 |
2022 Marzo | 18 | 26 | 44 |
2022 Febrero | 7 | 9 | 16 |
2022 Enero | 7 | 6 | 13 |
2021 Diciembre | 12 | 24 | 36 |
2021 Noviembre | 21 | 15 | 36 |
2021 Octubre | 8 | 14 | 22 |
2021 Septiembre | 5 | 9 | 14 |
2021 Agosto | 6 | 15 | 21 |
2021 Julio | 12 | 9 | 21 |
2021 Junio | 14 | 5 | 19 |
2021 Mayo | 6 | 26 | 32 |
2021 Abril | 20 | 38 | 58 |
2021 Marzo | 18 | 15 | 33 |
2021 Febrero | 19 | 10 | 29 |
2021 Enero | 9 | 8 | 17 |
2020 Diciembre | 15 | 5 | 20 |
2020 Noviembre | 7 | 12 | 19 |
2020 Octubre | 9 | 6 | 15 |
2020 Septiembre | 21 | 17 | 38 |
2020 Agosto | 8 | 13 | 21 |
2020 Julio | 8 | 11 | 19 |
2020 Junio | 5 | 5 | 10 |
2020 Mayo | 5 | 16 | 21 |
2020 Abril | 6 | 8 | 14 |
2020 Marzo | 12 | 20 | 32 |
2020 Febrero | 5 | 19 | 24 |
2020 Enero | 20 | 39 | 59 |
2019 Diciembre | 28 | 31 | 59 |
2019 Noviembre | 2 | 11 | 13 |
2019 Octubre | 2 | 2 | 4 |
2019 Septiembre | 5 | 7 | 12 |
2019 Agosto | 1 | 2 | 3 |
2019 Julio | 4 | 12 | 16 |
2019 Junio | 47 | 50 | 97 |
2019 Mayo | 84 | 74 | 158 |
2019 Abril | 5 | 2 | 7 |
2019 Marzo | 3 | 4 | 7 |
2019 Febrero | 8 | 6 | 14 |
2019 Enero | 2 | 3 | 5 |
2018 Diciembre | 4 | 2 | 6 |
2018 Noviembre | 7 | 2 | 9 |
2018 Octubre | 4 | 9 | 13 |
2018 Septiembre | 3 | 6 | 9 |
2018 Agosto | 2 | 1 | 3 |
2018 Julio | 1 | 3 | 4 |
2018 Junio | 0 | 0 | 0 |
2018 Mayo | 1 | 3 | 4 |
2018 Abril | 0 | 0 | 0 |
2018 Marzo | 0 | 2 | 2 |
2018 Febrero | 1 | 3 | 4 |
2017 Diciembre | 1 | 0 | 1 |
2017 Noviembre | 2 | 2 | 4 |
2017 Octubre | 2 | 2 | 4 |
2017 Septiembre | 0 | 1 | 1 |
2017 Agosto | 3 | 1 | 4 |
2017 Julio | 4 | 0 | 4 |
2017 Junio | 5 | 11 | 16 |
2017 Mayo | 12 | 2 | 14 |
2017 Abril | 9 | 1 | 10 |
2017 Marzo | 13 | 27 | 40 |
2017 Febrero | 5 | 1 | 6 |
2017 Enero | 4 | 3 | 7 |
2016 Diciembre | 12 | 0 | 12 |
2016 Noviembre | 14 | 0 | 14 |
2016 Octubre | 12 | 0 | 12 |
2016 Septiembre | 8 | 2 | 10 |
2016 Agosto | 13 | 0 | 13 |
2016 Julio | 9 | 2 | 11 |
2016 Junio | 22 | 0 | 22 |
2016 Mayo | 20 | 2 | 22 |
2016 Abril | 11 | 0 | 11 |
2016 Marzo | 10 | 2 | 12 |
2016 Febrero | 11 | 1 | 12 |
2016 Enero | 11 | 0 | 11 |
2015 Diciembre | 18 | 0 | 18 |
2015 Noviembre | 26 | 0 | 26 |
2015 Octubre | 18 | 0 | 18 |
2015 Septiembre | 14 | 0 | 14 |
2015 Agosto | 10 | 0 | 10 |
2015 Julio | 9 | 0 | 9 |
2015 Junio | 4 | 0 | 4 |
2015 Mayo | 7 | 0 | 7 |
2015 Abril | 11 | 0 | 11 |
2015 Marzo | 9 | 0 | 9 |
2015 Febrero | 5 | 0 | 5 |
2015 Enero | 15 | 0 | 15 |
2014 Diciembre | 26 | 0 | 26 |
2014 Noviembre | 5 | 0 | 5 |
2014 Octubre | 17 | 0 | 17 |
2014 Septiembre | 12 | 0 | 12 |
2014 Agosto | 13 | 0 | 13 |
2014 Julio | 14 | 0 | 14 |
2014 Junio | 8 | 0 | 8 |
2014 Mayo | 8 | 0 | 8 |
2014 Abril | 6 | 0 | 6 |
2014 Marzo | 4 | 0 | 4 |
2014 Febrero | 4 | 0 | 4 |
2014 Enero | 5 | 0 | 5 |
2013 Diciembre | 7 | 0 | 7 |
2013 Noviembre | 16 | 0 | 16 |
2013 Octubre | 5 | 0 | 5 |
2013 Septiembre | 5 | 0 | 5 |
2013 Agosto | 6 | 0 | 6 |
2000 Mayo | 721 | 0 | 721 |