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From the early days of its recognized occurrence, AIDS has been per
ceived as posing tremendous threats, burdens and challenges to
human beings. Individuals, societies and, in a global point of
view, mankind are affected by the effects of the HN infection, the
nature and extent of which is still unclear in many ways. In the
beginning only biomedical and epidemiological analyses of the
problem were the top research priori ties, the former laden with
great hopes that it may soon be possible to stop the spread of the
disease and to overcome its physical impact. Yet it soon became
clear that AIDS would be something to be reckoned and coped with on
a long-term basis, making a thorough investigation of its impact
absolutely mandatory. AIDS has serious economic consequences. Taken
seriously, they can not be confined to predictions of costs
intended to support the AIDS issue in the struggle for resources.
Besides cost calculations - a method ologically tricky and
wide-ranging topic in itself -and their application to
cost-effectiveness and other analyses, economic issues include
identify ing and assessing patterns of care, analyzing problems of
financing, exploring impacts on markets other than health care, and
modelling scenarios for future developments and strategies. At
present, the eco nomic aspects of AIDS still constitute a very
recent topic in European health economics and health systems
research. Many projects are just about to start, and there must be
a better exchange of information between research groups.
The purpose of economic evaluation is to inform decisions intended
to improve healthcare. The new edition of Methods for the Economic
Evaluation of Health Care Programmes equips the reader with the
necessary tools and understanding required to undertake evaluations
by providing an outline of key principles and a 'tool kit' based on
the authors' own experiences of undertaking economic evaluations.
Building on the strength of the previous edition, the accessible
writing style ensures the text is key reading for the non-expert
reader, as no prior knowledge of economics is required. The book
employs a critical appraisal framework, which is useful both to
researchers conducting studies and to decision-makers assessing
them. Practical examples are provided throughout to aid learning
and understanding. The book discusses the analytical and policy
challenges that face health systems in seeking to allocate
resources efficiently and fairly. New chapters include 'Principles
of economic evaluation' and 'Making decisions in healthcare' which
introduces the reader to core issues and questions about resource
allocation, and provides an understanding of the fundamental
principles which guide decision making. A key part of
evidence-based decision making is the analysis of all the relevant
evidence to make informed decisions and policy. The new chapter
'Identifying, synthesising and analysing evidence' highlights the
importance of systematic review, and how and why these methods are
used. As methods of analysis continue to develop, the chapter on
'Characterising, reporting and interpreting uncertainty' introduces
the reader to recent methods of analysis and why characterizing
uncertainty matters for health care decisions. The fourth edition
of Methods for the Economic Evaluation of Health Care Programmes
has been thoroughly revised and updated, making it essential
reading for anyone commissioning, undertaking, or using economic
evaluations in health care, including health service professionals,
health economists, and health care decision makers.
Decision making in health care involves consideration of a complex
set of diagnostic, therapeutic and prognostic uncertainties.
Medical therapies have side effects, surgical interventions may
lead to complications, and diagnostic tests can produce misleading
results. Furthermore, patient values and service costs must be
considered. Decisions in clinical and health policy require careful
weighing of risks and benefits and are commonly a trade-off of
competing objectives: maximizing quality of life vs maximizing life
expectancy vs minimizing the resources required. This text takes a
proactive, systematic and rational approach to medical decision
making. It covers decision trees, Bayesian revision, receiver
operating characteristic curves, and cost-effectiveness analysis;
as well as advanced topics such as Markov models, microsimulation,
probabilistic sensitivity analysis and value of information
analysis. It provides an essential resource for trainees and
researchers involved in medical decision modelling, evidence-based
medicine, clinical epidemiology, comparative effectiveness, public
health, health economics, and health technology assessment.
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