scholarly journals An Exploration of the Value of Elective Health Checks in UK Zoo-Housed Gibbons

Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2307
Author(s):  
Tawny Kershaw ◽  
Emily J. Hall ◽  
Phillipa Dobbs ◽  
Matyas Liptovszky ◽  
Victoria Strong
Keyword(s):  
Cost Benefit Analysis ◽  
Radiographic Finding ◽  
Cost Benefit ◽  
Binary Logistic Regression ◽  
Clinical Findings ◽  
Health Check ◽  
Health Checks ◽  
Clinically Significant ◽  
Multivariable Modelling ◽  
Preventative Healthcare

Elective health checks form an important part of the preventative healthcare of many zoo-housed animals. These procedures are not without risk or financial expenditure, meaning careful cost–benefit analysis is required when determining the frequency and intensity with which they are implemented. This study evaluated the value of elective health checks (n = 74) carried out on 33 gibbons at a single UK zoological collection from 2011 to 2018. Data were categorised by health check type, animal age, clinical findings and outcome. Univariable binary logistic regression and multivariable modelling were used to identify factors associated with the likelihood of actionable (clinically significant) outcomes. In total, 51.35% of all elective health checks resulted in an actionable outcome. Elderly heath checks had 13.64 times greater odds of an actionable outcome and 34 times greater odds of a significant radiographic finding, when compared to routine (non-elderly) health checks. Our findings suggest that 75% wild longevity is a suitable threshold for identifying elderly captive gibbons and increasing health check frequency. Whilst further work is needed to ascertain whether these findings can be extrapolated to other collections and/or species, this study demonstrates how the analysis of clinical data can aid in the implementation of an effective and evidence-based preventative healthcare plan.

Is perfect the enemy of good? Weighing the evidence for biparametric MRI in prostate cancer

2021 ◽  
Author(s):  
Alexander P Cole ◽  
Bjoern J. Langbein ◽  
Francesco Giganti ◽  
Fiona M. Fennessy ◽  
Clare M. Tempany ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Multiparametric Mri ◽  
Benefit Analysis ◽  
Advantages And Disadvantages ◽  
Contrast Enhanced ◽  
Clinically Significant

The role of multiparametric MRI in diagnosis, staging and treatment planning for prostate cancer is well established. However there remain several challenges to widespread adoption. One such challenge is the duration and cost the examination. Abbreviated exams omitting contrast enhanced sequences may help address this challenge. In this review, we will discuss the rationale for biparametric MRI (bpMRI) for detection and characterization of clinically significant prostate cancer prior to biopsy and synthesize the published literature. We will weigh up the advantages and disadvantages to this approach and lay out a conceptual cost/benefit analysis regarding adoption of bpMRI.

All nasal polyps need histological examination: an audit-based appraisal of clinical practice

2000 ◽  
Vol 114 (10) ◽  
pp. 755-759 ◽  
Author(s):  
Ioannis I. Diamantopoulos ◽  
Nick S. Jones ◽  
James Lowe
Keyword(s):  
Nasal Polyps ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Inverted Papilloma ◽  
Delay In Diagnosis ◽  
Catchment Population ◽  
Significant Pathology ◽  
Pain And Suffering ◽  
Clinically Significant ◽  
The Cost

Case details were reviewed from 2021 patients treated surgically for nasal polyposis between 1991 and 1999, seen by six surgeons serving a catchment population of 805 000. The aim of this study was to determine the incidence of discrepancies between clinical and histological diagnosis. Twenty-two patients (1.1 per cent) were identified as having a lesion that differed histologically from the clinical diagnosis made at the time of surgery and which altered their further management. Amongst them were 11 cases of inverted papilloma, two of Wegener’s granulomatosis, and two of sarcoid. The rest of the cases comprised three of squamous cell carcinoma, one of adenocarcinoma, one of myeloma, one of angiofibroma and one of microcystic papillary adenoma. In this series, the occurrence of malignancy, inverted papilloma, or other clinically significant pathology among the group of patients with otherwise clinically unsuspected histology justifies sending nasal polyps for routine pathologic examination. A cost–benefit analysis showed that, on the basis of 250 cases per year, the cost of laboratory and pathological services would be £12.000, in comparison with the estimated average medicolegal cost of £51.000 per year incurred as a result of a delay in diagnosis together with the pain and suffering which would result given the case mix in this series.

scholarly journals Histopathological Examination of Intervertebral Disc Specimens: A Cost-Benefit Analysis

2007 ◽  
Vol 34 (4) ◽  
pp. 451-455 ◽  
Author(s):  
Adam S. Wu ◽  
Daryl R. Fourney
Keyword(s):  
Intervertebral Disc ◽  
Cost Benefit Analysis ◽  
Histopathological Examination ◽  
Pathological Finding ◽  
Cost Benefit ◽  
Histopathological Finding ◽  
Pathological Examination ◽  
Indications For Surgery ◽  
Benefit Analysis ◽  
Clinically Significant

Object:Routine histopathological examination of intervertebral disc specimens is commonly performed in North American hospitals, but recent studies have questioned the utility of this practice in cases where the indication for surgery is a benign process such as degenerative disc disease. In this study, we have performed a cost-benefit analysis of this practice.Methods:We performed a cost-benefit analysis of routine histopathological examination of 1775 routine (non-neoplastic and non-infectious indications for surgery) and 70 non-routine (suspected neoplastic or infectious indications for surgery) discectomy specimens obtained over an eight-year period (1996 and 2004). Chart reviews were used to determine if any histopathology findings were clinically significant (i.e., affected subsequent patient care). Total costs were calculated. A literature review was conducted to compare our results with other published series.Results:We found four unexpected histopathology results among 1775 specimens obtained from routine cases, one of which was clinically significant. We calculated costs of $42,165.25 per unexpected histopathological finding and $168,625 per clinically significant histopathological finding. For non-routine surgeries, the cost per abnormal pathological finding was $116.67.Conclusions:In routine cases, histopathological examination of disc specimens is not justified. The decision to send specimens for pathological examination should be based on the surgeon's judgment.

The Use of Cost-Benefit Analysis for Evaluating Efficiency of Public Investment Projects (The Case of Sochi-2014 Winter Olympic Games)

2011 ◽  
pp. 57-78
Author(s):  
I. Pilipenko
Keyword(s):  
Net Present Value ◽  
Olympic Games ◽  
Cost Benefit Analysis ◽  
Public Investment ◽  
Cost Benefit ◽  
Investment Efficiency ◽  
Benefit Analysis ◽  
Step Method ◽  
Investment Projects ◽  
The Usa

The paper analyzes shortcomings of economic impact studies based mainly on input- output models that are often employed in Russia as well as abroad. Using studies about sport events in the USA and Olympic Games that took place during the last 30 years we reveal advantages of the cost-benefit analysis approach in obtaining unbiased assessments of public investments efficiency; the step-by-step method of cost-benefit analysis is presented in the paper as well. We employ the project of Sochi-2014 Winter Olympic and Paralympic Games in Russia to evaluate its efficiency using cost-benefit analysis for five accounts (areas of impact), namely government, households, environment, economic development, and social development, and calculate the net present value of the project taking into account its possible alternatives. In conclusion we suggest several policy directions that would enhance public investment efficiency within the Sochi-2014 Olympics.

Hostile Takeovers and Anti-takeover Defenses in the Russian Corporate Market

2007 ◽  
pp. 70-84 ◽  
Author(s):  
E. Demidova
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Hostile Takeovers ◽  
Russian Market ◽  
Takeover Defenses ◽  
The Cost ◽  
European Markets

This article analyzes definitions and the role of hostile takeovers at the Russian and European markets for corporate control. It develops the methodology of assessing the efficiency of anti-takeover defenses adapted to the conditions of the Russian market. The paper uses the cost-benefit analysis, where the costs and benefits of the pre-bid and post-bid defenses are compared.

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