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Biomedical subjects

Javier Soto

Publications and source records attributed to Javier Soto.

9 recordsLinked to original sources
PubMed2005

[Linguistic adaptation into Spanish and validation of the Arthritis Treatment Satisfaction Questionnaire].

BACKGROUND AND OBJECTIVE: Linguistic adaptation and validation into Spanish of the ARTS questionnaire, a self reported instrument designed to measure four osteoarthritis treatment satisfaction dimensions: treatment advantages, treatment convenience, apprehension about treatment and satisfaction with medical care. MATERIAL AND METHOD: Adaptation was performed using conceptual equivalence, supervised by a panel of 6 experts and 4 independent translators, who were in charge of performing translation and back-translation of the items. A sample of patients suffering from knee, hip or column osteoarthritis was used to estimate the psychometric properties of feasibility, reliability, validity and sensitivity to change. Three groups were identified: adequate analgesic effect and tolerability, treatment-switch because of a weak analgesic effect, and treatment- switch due to poor tolerability. The ARTS was administered at baseline, 1 week later for retest, and after 4 weeks of treatment with NSAIDs or Cox II-inhibitors. RESULTS: A sample of 163 patients was formed (67.7 [9.2] years old). No floor or ceiling effects were found, items were well understood and non- response rates were below 1%. Cronbach's alpha for the total scales was 0.85, and the intraclass correlation coefficient was 0.81. Exploratory factor analysis yielded 4 dimensions which were coherent with those proposed by the original authors. Concurrent validity was measured with SF-36, a pain VAS instrument, a treatment compliance VAS, and the Morisky-Green compliance questionnaire. The adapted instrument showed a good discriminatory validity, and it was able to distinguish between patients needing a change in treatment and those who did not need it. It was also sensitive to changes in patients' treatment effectiveness after a 30 days follow up. CONCLUSIONS: A psychometrically valid and conceptually equivalent ARTS questionnaire has been produced to explore satisfaction with treatment in patients with osteoarthritis in Spanish speaking countries.

Humans↗
PubMed2005

Pharmacoeconomic evaluation of linezolid versus teicoplanin in bacteremia by Gram-positive microorganisms.

OBJECTIVE: The objective of this study was to compare the efficiency of linezolid versus teicoplanin in the treatment of bacteremia produced by Gram-positive microorganisms through a pharmacoeconomic analysis based on clinical results obtained from a previous clinical trial. METHODS: We applied an analysis of cost-effectiveness elaborated through a pharmacoeconomic model. We defined each unit of effectiveness as 'each successfully cured of infections with bacteremia.' We used the program Pharma-Decision (version Hospital 1.1) that allows to build interactive pharmacoeconomic models. Effectiveness data of both antibiotics were obtained from a published clinical trial, while resources consumed were obtained from the same source and from a consensus provided by a local expert panel. Only direct costs were included in the analysis without taking into consideration indirect costs. The perspective chosen was hospital assistance and the time horizon was set to 28 days. All costs are expressed in Euros. RESULTS: Linezolid demonstrated a better clinical outcome with less associated costs compared to teicoplanin (88.5 versus 56.7% of cured patients and 5,557.04 versus 6,327.43 per treated patient, respectively), thus resulting in a lower cost-effectiveness ratio for linezolid versus teicoplanin (6,279.1 versus 11,159.5 per cured patient with a 95% CI of 5,960.2-6,510.4 and 10,865.2-12,647.3, respectively) which results in a the dominant position for linezolid. The sensitivity analysis showed that linezolid was always the most efficient option even when modifying the value of variables with higher uncertainty. CONCLUSIONS: Linezolid is a more efficient option than teicoplanin because it presents higher rate of effectiveness with lower consumption of resources, thus being a dominant alternative in the treatment of Gram-positive infection with bacteremia.

Acetamides↗
PubMed2004

A novel 4,4'-bispyridyl-5,5'-perfluoroalkyl-2,2'-bisoxazol with antitumoral activity via cell cycle arrest and induction of apoptosis.

The compound 6a is a novel bisoxazol derivative with high cytotoxic properties in vitro against different human tumor-derived cell lines and with similar efficiency against epithelial, haematopoietic and mesenchymal tumor cells. Although the molecular mechanism is not yet fully defined, cell cycle analysis revealed that 6a induces efficiently G0/G1 phase arrest in colon adenocarcinoma HT-29 cells in a dose- and time-dependent manner. Induction of cell death is observed, a possible explanation for the antiproliferative profile of the molecule. The compound was well tolerated at doses that allowed to examine its antitumor activity against human xenografts of the HT-29 cell line implanted s.c. in nude mice. Treatment of mice with 4 mg/kg of the compound resulted in a 60% inhibition of tumor growth. These observations support the use of 6a for the generation of more potent derivatives that could be used as new anticancer agents.

Animals↗
PubMed2003

[Adaptation and validation of the Health Utilities Index Mark 3 into Spanish and correction norms for Spanish population].

BACKGROUND AND OBJECTIVE: The Health Utilities Index Mark III (HUI-3) is a psychometric instrument developed to assign utilities to patients' health states. We present its Spanish adaptation and validation. Moreover, we estimate its utility in the Spanish population and compare it to Canadian patients. PATIENTS AND METHOD: The Adaptation process has been carried out following the original protocol by Furlong. A panel of experts was selected in order to warrant the process, the questionnaire translation and the training of interviewers. Two different samples were used: a modelling sample to develop the Multi Attribute Utility function (MAUF) and a directed measure sample to validate the MAUF. Both samples are representative of the Spanish population according to gender and age quota. In order to estimate the utilities associated with each health state, Visual Analogue Scale (VAS) and Standard Gamble (SG) procedures were used. The instrument's dimensionality was assessed by means of Factor Analysis, and the convergent validity was checked against EuroQoL. RESULTS: The HUI-3 Spanish version is feasible (< 2% missing values and 7.34 1.27 minutes completion time) and reliable (Cronbach's (= 0.792 in modelling sample, 0.707 in direct measure sample, and 0.760 as a whole), showing a good test-retest correlation (0.909, p < 0.001). Convergent validity is good (correlation with EuroQoL: within 0.788 and 0.793). Factor solution met 5 factors: Speech & Dexterity, Ambulation & Pain, Vision, Emotion & Cognition, and Hearing. The Spanish and Canadian utility function differed significantly; 0.07 pts, p < 0.001). CONCLUSIONS: This questionnaire can be applied to individuals or collectively, either self-administered or through an interview. Psychometric indexes are good. Differences between Spanish and Canadian utility functions suggest the need of using the specific function for each population.

Adolescent↗
PubMed2002

Health economic evaluations using decision analytic modeling. Principles and practices--utilization of a checklist to their development and appraisal.

OBJECTIVES: Decision analytic modeling allows a rational, feasible, scientific, and timely approach to measure the efficiency of new medical technologies in health care by using the best available evidence of different sources to produce detailed estimates of the clinical and economic consequences of different healthcare interventions. The aim of this article has been twofold: first, to state the benefit, usefulness, and limitations of decision analytic modeling; and second, to propose a list of steps that should be considered when carrying out this sort of analysis in order to increase its credibility and validity for medical decision making. METHODS: After having read the published literature about decision analytic models, a checklist was created, listing the paramount items and points that should always be followed when carrying out disease modeling. RESULTS: A checklist with 3 items and steps to be taken was drawn up to ensure that all important methodologic aspects are considered when performing and assessing decision analytic modeling, thereby constituting a standard guide to good modeling practices. In addition, a set of limitations inherent to the use of decision analytic models is also contemplated, along with a list of recommendations increasing their validity and utility. CONCLUSIONS: Health economic assessments will continue to be an important tool for the correct allocation of resources, and disease analytic modeling will be a potentially invaluable tool in assisting decision makers in this task.

Cost-Benefit Analysis↗