Ângela Jornada BenAmsterdam Institute for Global Health and Development
Ângela Jornada Ben
PhD in Epidemiology
About
56
Publications
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Introduction
Currently, I am working on a project about the impact of the different EQ-5D-5L utility estimation methods on cost-utility results. I am also working on cost-effectiveness and return-on-investment analyses of healthcare interventions alongside clinical trials developed at the Department of Health Sciences, Health Technology Assessment - Vrije Universiteit Amsterdam
Additional affiliations
January 2018 - present
Publications
Publications (56)
Objectives
This study identifies work trajectories of patients with persistent complaints after a COVID-19 infection receiving allied healthcare and predictors of return work.
Methods
A prospective cohort of 1,333 Dutch working-age patients with persistent complaints after a COVID-19 infection receiving allied healthcare between 2021 and 2022 were...
Objective
To investigate the effectiveness of a Pilates exercise program compared with home-based exercises in individuals with chronic non-specific low back pain.
Design
A randomised controlled trial with a six-month follow-up.
Setting
Rehabilitation clinic.
Participants
One hundred and forty-five individuals (18–50 years of age) with low back...
The EQ-5D-Y-3L is a generic measure of health-related quality of life in children and adolescents. Although the Brazilian-Portuguese EQ-5D-Y-3L version is available, there is no value set for it, hampering its use in economic evaluations. This study aimed to elicit a Brazilian EQ-5D-Y-3L value set based on preferences of the general adult populatio...
Objectives
In many countries, the healthcare sector is dealing with important challenges such as increased demand for healthcare services, capacity problems in hospitals and rising healthcare costs. Therefore, one of the aims of the Dutch government is to move care from in-hospital to out-of-hospital care settings. An example of an innovation where...
Objective
To evaluate the cost-effectiveness of pessary therapy as an initial treatment option compared with surgery for moderate to severe pelvic organ prolapse (POP) symptoms in secondary care from a healthcare and a societal perspective.
Design
Economic evaluation alongside a multicentre randomised controlled non-inferiority trial with a 24-mon...
Objectives: Hospital admission in older adults is associated with unwanted outcomes such as readmission, institutionalization, and functional decline. To reduce these outcomes the Netherlands introduced an alternative to hospital-based care: the Acute Geriatric Community Hospital (AGCH). The AGCH is an acute care unit situated outside of a hospital...
Information on healthcare utilization and costs of general practitioner (GP)-guided care in patients with musculoskeletal complaints is important for keeping healthcare affordable and accessible. A registry-based study was performed to describe healthcare utilization and costs of GP-guided care in patients with musculoskeletal complaints and to pre...
Trial-based economic evaluations are increasingly being conducted to support healthcare decision-making. When analysing trial-based economic evaluation data, different methodological challenges may be encountered, including (i) missing data, (ii) correlated costs and effects, (iii) baseline imbalances and (iv) skewness of costs and/or effects. Desp...
Objectives:
To develop and validate approaches for mapping Oswestry Disability Index (ODI) responses to EQ-5D-3L utility values and to evaluate the impact of using mapped utility values on cost-utility results compared to published regression models.
Methods:
Three response mapping approaches were developed in a random sample of 70% of 18,692 pa...
Introduction
For the analysis of clinical effects, multiple imputation (MI) of missing data was shown to be unnecessary when using longitudinal linear mixed-models (LLM). It remains unclear whether this also applies to cost estimates from trial-based economic evaluations, that are generally right-skewed. Therefore, this study aimed to assess whethe...
Introduction
Patients’ EQ-5D health states are preferably valued using country-specific value sets. If value sets are not available, crosswalks may be used to estimate utility values. However, up until now the impact of using crosswalks instead of value sets on cost-utility outcomes remains unclear.
Methods
Trial-based cost-utility data were simul...
Purpose
Inconsistent results have been found on the impact of using crosswalks versus EQ-5D value sets on reimbursement decisions. We sought to further investigate this issue in a simulation study.
Methods
Trial-based economic evaluation data were simulated for different conditions (depression, low back pain, osteoarthritis, cancer), severity leve...
Introduction
For the analysis of clinical effects, multiple imputation (MI) of missing data were shown to be unnecessary when using longitudinal linear mixed-models (LLM). It remains unclear whether this also applies to trial-based economic evaluations. Therefore, this study aimed to assess whether MI is required prior to LLM when analyzing longitu...
Objective:
Information on the pregnancy rate after successive in-vitro fertilization (IVF) cycles and their associated costs is relevant for couples undergoing assisted reproduction treatments (ARTs). This study, therefore, sought to investigate the effectiveness and the cost-effectiveness of two ARTs, the minimal ovarian stimulation IVF (MS-IVF)...
Purpose
To assess whether regression modeling can be used to predict EQ-5D-3L utility values from the Oswestry Disability Index (ODI) in low back pain (LBP) patients for use in cost-effectiveness analysis.
Methods
EQ-5D-3L utility values of LBP patients were estimated using their ODI scores as independent variables using regression analyses, while...
Introdução: Porto Alegre está há 12 anos no ranking nacional dos maus indicadores de morbimortalidade do HIV. Assim, explorar as características dos grupos prioritários é fundamental para o controle da epidemia, como as pessoas em Situação de Rua(SR). A vigilância epidemiológica nas pessoas em SR é possível apenas no SICLOM. Entretanto, o serviço d...
Purpose
To examine the cost effectiveness of dietary advice to increase protein intake on 6-month change in physical functioning among older adults.
Methods
In this multicenter randomized controlled trial, 276 community-dwelling older adults with a habitual protein intake < 1.0 g/kg adjusted body weight (aBW)/d were randomly assigned to either Int...
Objective
To evaluate the cost-effectiveness of double-layer compared with single-layer uterine closure after a first caesarean section (CS) from a societal and healthcare perspective.
Design
Economic evaluation alongside a multicentre, double-blind, randomised controlled trial.
Setting
32 hospitals in the Netherlands, 2016–2018.
Participants
22...
Background
As resources for healthcare are scarce, decision-makers increasingly rely on economic evaluations when making reimbursement decisions about new health technologies, such as drugs, procedures, devices, and equipment. Economic evaluations compare the costs and effects of two or more interventions. Musculoskeletal disorders have a high prev...
Purpose:
To assess the impact of EQ-5D country-specific value sets on cost-utility outcomes.
Methods:
Data from 2 randomized controlled trials on low back pain (LBP) and depression were used. 3L value sets were identified from the EuroQol Web site. A nonparametric crosswalk was employed for each tariff to obtain the likely 5L values. Differences...
Introdução: O enfrentamento ao vírus da imunodeficiência humana está para completar 40 anos e calcula-se que haja cerca de 36,7 milhões de pessoas vivendo com o vírus da imunodeficiência humana/aids no mundo. No Brasil, estima-se que existam atualmente 718 mil casos diagnosticados. Muitos avanços já foram conquistados, como o direito à terapia anti...
Objective To evaluate whether double-layer uterine closure after a first caesarean section (CS) is superior compared with single-layer uterine closure in terms of postmenstrual spotting and niche development in the uterine caesarean scar. Design Multicentre, double-blind, randomised controlled superiority trial. Setting Thirty-two hospitals in the...
Objective:
To evaluate if double-layer uterine closure after a first caesarean section (CS) is superior compared to single-layer uterine closure in terms of postmenstrual spotting and niche development in the uterine caesarean scar.
Design:
Multicentre, double-blind, randomised controlled superiority trial SETTING: 32 hospitals in the Netherland...
Objective:
To assess the cost-effectiveness and return-on-investment (ROI) of the Dynamic Work (DW) Intervention, a worksite intervention aimed at reducing sitting time among office workers.
Methods:
In total, 244 workers were randomized to the intervention or control group. Overall sitting time, standing time, step counts, quality-adjusted life...
Objective
This study aimed to establish the utility values of different health states associated with diabetic retinopathy in a Brazilian sample to provide input to model-based economic evaluations.
Subjects and methods
This cross-sectional study was performed in a sample of patients with type 2 diabetes mellitus (T2D) who underwent teleophthalmol...
This study compares the five‐level EuroQol five‐dimension questionnaire (EQ‐5D‐5L) crosswalks and the 5L value sets for England, the Netherlands, and Spain and explores the implication of using one or the other for the results of cost–utility analyses. Data from two randomized controlled trials in depression and diabetes were used. Utility value di...
Digital health technological initiatives have been sprouting during the last years in most countries. The implementation of such technologies is thought to have the potential to transform the organization of healthcare while promoting a healthy workforce and ensuring access to affordable quality care for all. Nevertheless, evidence on the effective...
Introduction: The statistical quality of many trial-based economic evaluations is poor. When conducting trial-based economic evaluations, researchers often turn to national pharmacoeconomic guidelines for guidance. Therefore, this study reviewed which recommendations are currently given by national pharmacoeconomic guidelines on the statistical ana...
Objective
To perform a cost-utility analysis of diabetic retinopathy (DR) screening strategies from the perspective of the Brazilian Public Healthcare System.
Methods
A model-based economic evaluation was performed to estimate the incremental costs per quality-adjusted life-year (QALY) gained between three DR screening strategies: (1) the opportun...
Objective:
To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP).
Design:
Randomized controlled trial with three months follow-up.
Setting:
Rehabilitation clinic.
Participants:
Seventy-two individuals (be...
Patient no-show is a prevalent problem in health care services leading to inefficient resources allocation and limited access to care. This study aims to develop and validate a patient no-show predictive model based on empirical data. A retrospective study was performed using scheduled appointments between 2011 and 2014 from a Brazilian public prim...
Types of appointment: Definition based on the primary care service database.
(DOCX)
No-show predictive model calculator.
Practical application of the predictive patient no-show model.
(XLSX)
Aspectos-chave
• Episódios de infecção das vias aéreas superiores são causas frequentes de demanda espontânea na atenção primária à saúde
• Em geral, os episódios de IVAS são de etiologia viral, apresentam boa evolução e são autolimitados
• As IVAS representam um dos principais motivos de prescrição desnecessária de medicamentos
• Uma abordagem cen...
Aspectos-chave
• Episódios de dor de garganta são motivos frequentes de atendimento na atenção primária
• Em geral, os episódios de dor de garganta apresentam boa evolução e são autolimitados em populações não vulneráveis
• Apesar do conhecimento de que a maior parte das dores de garganta são de etiologia viral, antibióticos ainda são prescritos in...
Aspectos-chave
• Na atenção primária à saúde, o Tremor Fisiológico Exacerbado, o Tremor Essencial e as Síndromes Parkinsonianas são os diagnósticos diferenciais mais prevalentes de tremor
• O Tremor Fisiológico Exacerbado é um tipo de tremor postural ou cinético, simétrico e bilateral na ausência de outros sintomas ou sinais neurológicos e está ass...
Objetivo: Elaborar a matriz de competências a serem desenvolvidas pelos estudantes durante os três meses de estágio no internato em Medicina de Família e Comunidade na Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA). Métodos: Foi realizada revisão de literatura sobre o referencial teórico do ensino baseado em competências sobre e...
Introduction.
We must study alternatives to structure an effective diabetic retinopathy screening program for Brazilian public health system.
Objectives.
Evaluate the diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care, accuracy of the family physician in diabetic retinopathy identification compa...
Clinical decision-making is performed by health professionals and it is currently connected to the need for manual query for these professionals for clinical guidelines, which are generally formed by large text files, which makes this process very slow and laborious. The development of mobility-based systems, which has the objective of helping the...
INTRODUCTION: Tuberculosis deserves special attention from health professionals and society. However, health services are not organized to attend these patients, and the prevalence of the disease remains high in the country. The objective of this paper is to demonstrate the role of primary care in improving tuberculosis indicators with structured p...
The decision making process conducted by health professionals is strongly linked to the consultations of clinical guidelines, generally available in large text files, making the access to the information very laborious and time consuming. The health area is very fertile for the emergence of solutions based on mobility. Among others, there are solut...
To analyze the reliability and performance of the Portuguese version of questionnaires used to evaluate adherence to hypertensive treatment.
Hypertensive patients attending a primary healthcare unit in Porto Alegre, Southern Brazil, from January to September 2010, were randomly selected (n = 206). To evaluate adherence, Portuguese versions of the M...
Introdução: um dos passos importantes no processo de avaliação dos serviços de saúde, propostos por Donabedian, é a avaliação das características sócio-demográficas e de saúde da população atendida, utilizando estas informações no planejamento. Objetivo: determinar a prevalência dos fatores e comportamentos de risco cardiovascular numa área adscrit...
Introdução: a regionalização do controle da tuberculose (TB) é uma das metas da Vigilância (CGVS) buscando reduzir os casos de abandono do tratamento e aumentar a taxa de diagnóstico. A análise dos resultados prévios das áreas a serem regionalizadas é importante para manter e ampliar a qualidade do controle da tuberculose, além de ser uma das etapa...
Introdução: a regionalização do controle da tuberculose (TB) é uma das metas da Vigilância (CGVS) buscando reduzir os casos de abandono do tratamento e aumentar a taxa de diagnóstico. A análise dos resultados prévios das áreas a serem regionalizadas é importante para manter e ampliar a qualidade do controle da tuberculose, além de ser uma das etapa...
Small-for-size livers are associated with graft dysfunction, probably due to portal hyperperfusion. Modulation of the recipient portal inflow is a new option in these cases. This article sought to analyze the effect of portocaval shunt in small-for-size liver grafts in pigs. Twelve liver transplants were performed in white pigs. The donors' mean we...