Miguel Negrín

Miguel Negrín
University of Las Palmas de Gran Canaria | ULPGC · Departamento de Métodos Cuantitativos en Economía y Gestión

PhD

About

103
Publications
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Publications

Publications (103)
Article
Full-text available
Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient′s adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average trea...
Article
Rationale: Obesity hypoventilation syndrome (OHS) with concomitant severe obstructive sleep apnea (OSA) is treated with CPAP or noninvasive ventilation (NIV) during sleep. NIV is costlier, but may be advantageous because it provides ventilatory support. However, there are no long-term trials comparing these treatment modalities based on OHS severit...
Article
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.gaceta.2020.05.001 The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
Article
Full-text available
Background Noninvasive ventilation (NIV) is an effective form of treatment in obesity hypoventilation syndrome (OHS) with severe obstructive sleep apnea (OSA). However, there is paucity of evidence in OHS patients without severe OSA phenotype. Research questions Is NIV effective in OHS without severe OSA phenotype? Study design and methods In thi...
Article
Full-text available
Como cada año, presentamos el informe de la actividad realizada por el equipo editorial a lo largo de 2019, así como los datos de desempeño de la revista. El documento permite analizar los avances y las áreas de mejora de la revista, así como los logros más relevantes que fueron alcanzados.
Article
Full-text available
Background: Horizontal equity in access to public general practitioner (GP) services by socioeconomic group has been addressed econometrically by testing the statement "equal probability of using public GP services for equal health care needs, regardless of socioeconomic status". Based on survey data, the conventional approach has been to estimate...
Article
Full-text available
Background: The objective of this research is to analyse trends in horizontal inequity in access to public health services by immigration condition in Spain throughout the period 2006-2017. We focus on "economic immigrants" because they are potentially the most vulnerable group amongst immigrants. Methods: Based on the National Health Surveys of...
Article
Rationale: Despite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomized trials have assessed the impact of long-term noninvasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography. Objectives: We performed a pre-specified secondary analysis of the la...
Article
Full-text available
Introduction Obstructive sleep apnea (OSA) is a prevalent disease associated with significant morbidity and high healthcare costs. Information and communication technology could offer cost-effective management options. Objectives To evaluate an out-of-hospital Virtual Sleep Unit (VSU) based on telemedicine to manage all patients with suspected OSA...
Article
Full-text available
Under national health services (NHS), non-urgent access to specialist doctors is not straightforward and sometimes leads to long waiting times. Consequently, some citizens may decide to pay for private specialist care to complement the services provided publicly, trying to shorten their NHS waiting times. This strategic behaviour may lead to inequi...
Article
Background Obesity hypoventilation syndrome is commonly treated with continuous positive airway pressure or non-invasive ventilation during sleep. Non-invasive ventilation is more complex and costly than continuous positive airway pressure but might be advantageous because it provides ventilatory support. To date there have been no long-term trials...
Article
Full-text available
En los últimos años el consumo de eventos futbolísticos a través de los medios audiovisuales está superando los mercados nacionales para globalizarse. La sostenibilidad económica de los clubes de fútbol depende cada vez más de la difusión masiva en medios audiovisuales y de su capacidad para mantenerse como un producto atractivo, competitivo y soci...
Chapter
In cost–effectiveness analysis (CEA) of medical treatments the optimal treatment is chosen using an statistical model of the cost and effectiveness of the treatments, and data from patients under the treatments. Sometimes these data also include values of certain deterministic covariates of the patients which usually have valuable clinical informat...
Article
Introduction: Fracture Liaison Service (FLS) model for secondary prevention of fractures has demonstrated its cost-effectiveness using decision models. We analyze the impact of a FLS on pharmaceutical expenditures for osteoporosis in real world circumstances. Methods: Expenditures on osteoporosis medications from January 2011 to January 2017 was co...
Article
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In January 2006, the Spanish government enacted a tobacco control law that banned smoking in bars and restaurants, with exceptions depending on the floor space of the premises. In January 2011, further legislation in this area was adopted, removing these exceptions. We analyse the effect produced on cigarette sales by these two bans. We approach th...
Conference Paper
Cost–effectiveness analysis of medical treatments is a statistical decision problem whose aim is to choose an optimal treatment among a finite set of alternative treatments. It is assumed that the treatment selection is to be based on their cost and effectiveness. In this paper we revise this statistical decision problem, discuss two utility functi...
Article
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The Bayesian structural time series model, used in conjunction with a state–space model, is a novel means of exploring the causal impact of a policy intervention. It extends the widely used difference–in–differences approach to the time series setting and enables several control series to be used to construct the counterfactual. This paper highligh...
Article
Background: Peer review in the scientific publication is widely used as a method to identify valuable knowledge. Editors have the task of selecting appropriate reviewers. We assessed the reasons given by potential reviewers for declining a request to review and the factors associated with acceptance, taking into account the difference in the sex of...
Conference Paper
Full-text available
Background In 2012 a Fracture Liaison Service (FLS) was implemented in Hospital Dr Negrin Objectives To analyze the economic impact of the FLS on pharmaceutical expenditure for osteoporosis. Methods Expenditure on osteoporosis medication (government inpunt) was collected from January 1th, 2011 to October 1th, 2016. The data distinguish group I (c...
Article
The random effect approach for meta-analysis was motivated by a lack of consistent assessment of homogeneity of treatment effect before pooling. The random effect model assumes that the distribution of the treatment effect is fully heterogenous across the experiments. However, other models arising by grouping some of the experiments are plausible....
Article
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El objetivo de este trabajo es construir un procedimiento bayesiano, fácil de implementar en la práctica, que soslaye los problemas encontrados en los métodos de meta-análisis para el caso de datos binarios con alta presencia de ceros. Para ello, consideraremos el problema dentro de uno general de selección bayesiana de modelos identificando de for...
Article
The main purpose of this paper is to model time-varying asymmetry information costs. To do this, first, we use two classical reduced-form microstructure models defined in a Bayesian hierarchical framework. In this scenario, we consider adverse selection as a random unobserved state variable and we use the Markov chain Monte Carlo (MCMC) estimator....
Article
Objective: Survival extrapolation using a single, best-fit model ignores 2 sources of model uncertainty: uncertainty in the true underlying distribution and uncertainty about the stability of the model parameters over time. Bayesian model averaging (BMA) has been used to account for the former, but it can also account for the latter. We investigat...
Article
Statistical meta-analysis is mostly carried out with the help of the random effect normal model, including the case of discrete random variables. We argue that the normal approximation is not always able to adequately capture the underlying uncertainty of the original discrete data. Furthermore, when we examine the influence of the prior distributi...
Chapter
We briefly present the advantages and opportunities available to umbrella reviews from the use of Bayesian techniques while taking into account that the concerns commonly arising in Bayesian meta-analysis procedures are also present in umbrella reviews. This is the case, for example, of sparse data, for which the hierarchical logit-normal model can...
Article
Full-text available
Se usó un diseño cuasi-experimental con pre y post-test para estimar el efecto de una capacitación para la prueba de admisión de la Universidad Costa Rica, un test estandarizado que mide habilidades de razonamiento en contextos verbales y matemáticos. Cuatro colegios públicos del área metropolitana central del país participaron en el estudio, asign...
Article
Full-text available
Background Compliance with continuous positive airway pressure (CPAP) therapy is essential in patients with obstructive sleep apnoea (OSA), but adequate control is not always possible. This is clinically important because CPAP can reverse the morbidity and mortality associated with OSA. Telemedicine, with support provided via a web platform and vid...
Article
In most cases, including those of discrete random variables, statistical meta-analysis is carried out using the normal random effect model. The authors argue that normal approximation does not always properly reflect the underlying uncertainty of the original discrete data. Furthermore, in the presence of rare events the results from this approxima...
Article
Full-text available
IntroductionAdult oral health is predicted by oral health in childhood. Prevention improves oral health in childhood and, consequently in adulthood, so substantial cost savings can be derived from prevention. The burden of oral disease is particularly high for disadvantaged and poor population groups in both developing and developed countries. Ther...
Article
The propose of this paper is to develop a Bayesian procedure that adequately account for studies with zero observations in meta-analysis and then we focus the problem in the context of the Bayesian selection models. Also, attention is focused to the link distribution between effectiveness in each study/center and the meta-effectiveness. We present...
Article
This paper presents a Bayesian model for meta‐analysis of sparse discrete binomial data, which are out of the scope of the usual hierarchical normal random‐effect models. Treatment effectiveness data are often of this type. The crucial linking distribution between the effectiveness conditional on the healthcare center and the unconditional effectiv...
Article
Modelling automobile insurance claims is a crucial component in the ratemaking procedure. This paper focuses on the probability that a policyholder reports a claim, where the classical logit link does not provide a right model. This is so because databases related with automobile claims are often unbalanced, containing more non-claims than the pres...
Article
The aim of this paper is to analyse whether there is equity in the access to public health care services by socioeconomic groups. The probability of utilisation of health care services and the respective waiting times are jointly analysed, correcting for the selection bias that would arise if they were analysed separately, as shown in this research...
Article
Home respiratory polygraphy (HRP) may be a cost-effective alternative to polysomnography (PSG) for diagnosis and treatment election in patients with high clinical probability of obstructive sleep apnea (OSA), but there is conflicting evidence on its use for a wider spectrum of patients. To determine the efficacy and cost of OSA management (diagnosi...
Article
In countries with publicly financed health care systems, waiting time-rather than price-is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this p...
Article
In the presence of covariates, the cost-effectiveness analysis of medical treatments shows that the optimal treatment varies across the patient population subgroups, and hence to accurately define the subgroups is a crucial step in the analysis. A patient subgroup definition using only influential covariates within the potential set of patients cov...
Article
This paper deals with the decision problem of choosing an optimal medical treatment, among M possible candidates, when the states of nature are the net benefit of the treatments, and regression models for the treatment cost and effectiveness are assumed. In this setting a crucial step in the analysis is the construction of the population subgroups...
Article
Full-text available
Home respiratory polygraphy (HRP) may be a cost-effective alternative to polysomnography for the diagnosis of sleep apnoea-hypopnoea syndrome (SAHS), but stronger evidence is needed. Normally, patients transport HRP equipment from the hospital to home and back, which may create difficulties for some patients. To determine both the diagnostic effica...
Article
Evaluation of: Oppe M, Al M, Rutten-van Mölken M. Comparing methods of data synthesis. Re-estimating parameters of an existing probabilistic cost-effectiveness model. Pharmacoeconomics 29(3), 239-250 (2011). In the paper by Oppe et al., a cost-effectiveness analysis of alternative treatments for chronic obstructive pulmonary disease (COPD), based o...
Article
This study had two objectives: (1) to design and develop a computer-based tool, called Multi-Objective Evolutionary Algorithm/Hot-Spots (MOEA/HS), to identify and geographically locate highly autocorrelated zones or hot-spots and which merges different methods, and (2) to carry out a demonstration study in a geographical area where previous informa...
Article
This paper deals with medical treatments comparison from the cost-effectiveness viewpoint. A decision theory scheme is considered, where the decision space is the set of treatments involved, the space of states of nature consists of the respective net benefits of the treatments, and the utility function is one of two possible candidates. A first ca...
Article
Full-text available
Cost-effectiveness analysis of a treatment is typically based on specific functions of the expectation of the effectiveness and cost of the treatment, and treatment comparisons are made in the same vein. The mathematical expectation has been the cornerstone for defining the incremental cost-effectiveness ratio and the incremental net benefit, the m...
Article
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Linear regression models are often used to represent the cost and effectiveness of medical treatment. The covariates used may include sociodemographic variables, such as age, gender or race; clinical variables, such as initial health status, years of treatment or the existence of concomitant illnesses; and a binary variable indicating the treatment...
Article
Nosocomial infection is one of the main causes of morbidity and mortality in patients admitted to hospital. One aim of this study is to determine its intrinsic and extrinsic risk factors. Nosocomial infection also increases the duration of hospital stay. We quantify, in relative terms, the increased duration of the hospital stay when a patient has...
Article
Full-text available
The economic literature on cost-effectiveness analysis in the context of decisions by health technology assessment agencies assumes as the quantity of interest a linear combination of the mean of the sampling distribution of the effectiveness and the cost. We argue that this is not always reasonable. Our reasons for this assertion are that (i) trea...
Article
The aim of cost-effectiveness analysis is to maximize health benefits from a given budget, taking a societal perspective. Consequently, the comparison of alternative treatments or technologies is solely based on their expected effectiveness and cost. However, the expectation, or mean, poses important limitations as it might be a poor summary of the...
Article
Full-text available
The Bayesian approach to statistics has been growing rapidly in popularity as an alternative to the classical approach in the economic evaluation of health technologies, due to the significant benefits it affords. One of the most important advantages of Bayesian methods is their incorporation of prior information. Thus, use is made of a greater amo...
Article
This paper focuses on eliciting the willingness to pay (WTP) for policy measures aimed at improving the health care offered to patients suffering from Alzheimer's disease (AD). We utilize a discrete choice experiment (DCE) approach for the elicitation of the preferences of the general population for three alternative policies: home care, day care c...
Book
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The present study aims to estimate the cost-effectiveness of interventions for reducing the burden of depression and schizophrenia in Spain and evaluate their population level impact. The study examines the cost-effectiveness of different types of clinical interventions at the level of the Spanish population. For depression, the interventions consi...
Article
The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning. To determine the existence of geographical hotspots with a high prevalence of schizophrenia in a mental health area in Spain. The study included 774 patients with schizophrenia who were users of the community men...
Article
Recently, several authors have proposed the use of linear regression models in cost-effectiveness analysis. In this paper, by modelling costs and outcomes using patient and Health Centre covariates, we seek to identify the part of the cost or outcome difference that is not attributable to the treatment itself, but to the patients' condition or to c...
Article
Full-text available
The aim of this paper is to analyse if there is horizontal equity in the utilisation of public health care services by región (comunidad autónoma) of residence in Spain. Data from the 2006 National Health Survey were considered to undertake a multilevel analysis, using a binary logistic function for each of the public health care services analysed...
Chapter
Full-text available
The Bayesian approach to statistics has been growing rapidly in popularity as an alterna- tive to the classical approach in the economic evaluation of health technologies, due to the significant benefits it affords. One of the most important advantages of Bayesian meth- ods is their incorporation of prior information. Thus, use is made of a greater...