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Dorte Gyrd-Hansen

Publications and source records attributed to Dorte Gyrd-Hansen.

27 records · Page 2Linked to original sources
PubMed2002

[General practitioners' perception of disease risks and benefit of prevention].

INTRODUCTION: Uncertainty and risk are central issues in relation to health and health care services. Healthy individuals do not necessarily fall ill, despite the presence of risk factors. Doctors, health service administrators, and patients are more inclined to choose interventions against risk factors, when information about the effects is presented in terms of relative risk reductions rather than absolute risk reductions. The aim of the study was to gain better insight into how general practitioners (GPs) perceive risk of disease, and whether this perception depends on the risk reduction being presented in absolute or relative terms. MATERIAL AND METHODS: Questionnaires with clinical episodes were sent to 1500 Danish GPs. The GPs were randomised into four groups of 375, all of whom received the same case history with information about risk reduction achieved through medical treatment phrased in terms of either relative risk reduction, absolute risk reduction, number needed to treat, or all of the aforementioned terms of risk reduction. The GPs were asked whether they would recommend medical treatment as primary prevention, knowing the case history and expected risk reduction. RESULTS: The GPs' attitude towards recommending medical treatment depended on the phrasing of risk reductions. Of the doctors who received all information on risk reductions, 72% would definitely or probably recommend medication, whereas 91% would recommend medication if only information about relative risk reduction was given, and 63% would recommend medication if information was given in terms of absolute risk reduction or number needed to treat. DISCUSSION: To advise patients rationally, knowledge of the patients' preferences, as well as consideration of all available measures of risk reductions, is needed.

Attitude of Health Personnel↗
PubMed2002

Prenatal screening for cystic fibrosis: an economic analysis.

Cystic fibrosis (CF) is the most common life-shortening genetically transmitted disease in Denmark with a birth prevalence of 1 in 4700, resulting in 12-15 new cases of cystic fibroses annually. The aim of this study is to disclose the societal resource implications of introducing a population wide prenatal screening programme for cystic fibrosis in Denmark. The present analysis is limited to the monetary consequences of introducing a screening programme, where costs of screening are compared to the potential benefits measured in cost savings involved if births of CF patients are avoided. Screening costs in a Danish setting were estimated at DKK 2 771 262 ( pound sterlings 231 438) per aborted affected fetus in the first screening round, stabilising at DKK 1 864 594 ( pound sterlings 155 383) per aborted affected fetus at subsequent screening rounds. Comparing this figure with the estimated benefits of avoiding a CF case (DKK 2.1-4.4 million; pound sterlings 175 000-366 667) suggests that introducing a screening programme for cystic fibrosis will be net cost saving irrespective of the perspective of the analysis, assumptions on replacement children and method of estimating long-term production gains/losses.

Abortion, Legal↗
PubMed2002

Comparing the results of applying different methods of eliciting time preferences for health.

Four methods of eliciting time preferences were tested in a pilot study, with the aim of disclosing individual time preference incorporating and excluding risk, social interpersonal preference incorporating elements of risk and social intertemporal preference. All standard gamble questions resulted in significantly higher individual time preference estimates than elicited through the time-tradeoff method. The social interpersonal preference estimate was significantly higher than the social intertemporal preference. The individual time preference elicited by the time tradeoff was, however, not significantly different from the social intertemporal preference. The analysis proposes that equity and uncertainty have significant and major impacts on the time preference over life time. Hence, applying the social intertemporal preference when estimating the present value of a stream of life-years may seriously overestimate the true present value of health streams by ignoring preferences for equity and uncertainty over life time.

Journal Article↗
PubMed2002

Number needed to treat: easily understood and intuitively meaningful? Theoretical considerations and a randomized trial.

Graphic representation was used to explore to what extent the number needed to treat (NNT) conveys the appropriate notion of benefit for the individual patient in interventions aimed at delaying adverse events. A sample of the Danish population (n = 675) was interviewed face to face, and asked whether they would consent to a hypothetical drug that reduces the risk of heart attack. The benefit of the drug was expressed in terms of NNT and was randomly set at 10, 25, 50, 100, 200, and 400. NNT does not convey information on the proportion of patients being helped by an intervention or the size of the delay of the adverse event intended to be prevented. The proportion of people consenting to the hypothetical drug was about 80%, irrespective of NNT, and some of those who rejected the drug misinterpreted the meaning of NNT. Lay people may have difficulties in understanding the meaning of NNT, and clinicians may do well to use the NNT with caution until more is known about how patients comprehend it.

Adult↗
PubMed2002

The citizen's preferences for financing public health care: a Danish survey.

The Danish public's willingness to forego private consumption in order to obtain improved health care services was investigated using conjoint analysis. The survey was undertaken in the year 1999. 1865 respondents participated in face-to-face interviews and were presented with pair wise choices of different future health care systems. Openness towards the introduction of user charges to a smaller degree demonstrated willingness to compromise relative equity in access to health care in order to avoid a tax increase. Willingness-to-pay for quality attributes lie in the range 780-2350 DKK ($89-$267) if paid by increasing maximum user charges, and in the 0-1220 DKK ($0-$139) bracket, when financed by increased income taxes.

Adult↗
PubMed2002

Danish GPs' perception of disease risk and benefit of prevention.

BACKGROUND: Uncertainty and risk are central issues in relation to health and health care services. Healthy individuals do not necessarily fall ill, despite the presence of risk factors. It has been documented that doctors, health service administrators and patients are more inclined to choose interventions against risk factors when information about the effects is presented in terms of relative risk reductions rather than absolute risk reductions. OBJECTIVES: The objective of the study was to gain better insight into how GPs perceive risk of disease, and how this perception is influenced by the way the risk is presented, e.g. whether changes in risk are presented in absolute or relative terms. METHODS: Questionnaires with clinical episodes were sent to 1500 Danish GPs. The GPs were randomized into four groups of 375, who all received the same case story with information about risk reduction achieved through medical treatment phrased in terms of either relative risk reduction, absolute risk reduction, number needed to treat or all of the aforementioned terms of risk reduction. The GPs were asked whether they would recommend medical treatment as primary prevention, knowing the case story and expected risk reduction. RESULTS: The GPs' attitude towards recommending medical treatment was dependent on the phrasing of risk reductions. Seventy-two per cent of doctors who received all information on risk reductions would definitely or probably recommend medication, while 91% would recommend medication if information only about relative risk reduction was given, and 63% would recommend medication if information was given in terms of absolute risk reduction or number needed to treat. CONCLUSION: In order to advise patients in a rational way, in addition to knowledge of the patients' preferences, doctors need to take into account all available measures of risk reductions.

Attitude of Health Personnel↗
PubMedDate not supplied

Effects of baseline risk information on social and individual choices.

This article analyzes preferences for risk reductions in the context of individual and societal decision making. The effect of information on baseline risk is analyzed in both contexts. The results indicate that if individuals are to imagine that they suffer from 1 low-risk and 1 high-risk ailment, and are offered a specified identical absolute risk reduction, a majority will ceteris paribus opt for treatment of the low-risk ailment. A different preference structure is elicited when priority questions are framed as social choices. Here, a majority will prefer to treat the high-risk group of patients. The preference reversal demonstrates the extent to which baseline risk information can influence preferences in different choice settings. It is argued that presentation of baseline risk information may induce framing effects that lead to nonoptimal resource allocations. A solution to this problem may be to not present group-specific baseline risk information when eliciting preferences.

Adult↗