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Biomedical subjects

Matthew Dyer

Publications and source records attributed to Matthew Dyer.

5 recordsLinked to original sources
PubMed2006

A pilot Internet "value of health" panel: recruitment, participation and compliance.

OBJECTIVES: To pilot using a panel of members of the public to provide preference data via the Internet METHODS: A stratified random sample of members of the general public was recruited and familiarized with the standard gamble procedure using an Internet based tool. Health states were periodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained); Participation (a) the proportion of people trained who provided any preferences and (b) the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed). The influence of covariates on these outcomes was investigated using univariate and multivariate analyses. RESULTS: A panel of 112 people was recruited. 23% of those approached (n = 5,320) responded to the invitation, and 24% of respondents (n = 1,215) were willing to participate (net = 5.5%). However, eventual recruitment rates, following training, were low (2.1% of those approached). Recruitment from areas of high socioeconomic deprivation and among ethnic minority communities was low. Eighteen sets of health state descriptions were considered over 14 months. 74% of panel members carried out at least one valuation task. People from areas of higher socioeconomic deprivation and unmarried people were less likely to participate. An average of 41% of panel members expressed preferences on each set of descriptions. Compliance ranged from 3% to 100%. CONCLUSION: It is feasible to establish a panel of members of the general public to express preferences on a wide range of health state descriptions using the Internet, although differential recruitment and attrition are important challenges. Particular attention to recruitment and retention in areas of high socioeconomic deprivation and among ethnic minority communities is necessary. Nevertheless, the panel approach to preference measurement using the Internet offers the potential to provide specific utility data in a responsive manner for use in economic evaluations and to address some of the outstanding methodological uncertainties in this field.

Adolescent↗
PubMed2006

Human genomic deletions mediated by recombination between Alu elements.

Recombination between Alu elements results in genomic deletions associated with many human genetic disorders. Here, we compare the reference human and chimpanzee genomes to determine the magnitude of this recombination process in the human lineage since the human-chimpanzee divergence approximately 6 million years ago. Combining computational data mining and wet-bench experimental verification, we identified 492 human-specific deletions (for a total of approximately 400 kb) attributable to this process, a significant component of the insertion/deletion spectrum of the human genome. The majority of the deletions (295 of 492) coincide with known or predicted genes (including 3 that deleted functional exons, as compared with orthologous chimpanzee genes), which implicates this process in creating a substantial portion of the genomic differences between humans and chimpanzees. Overall, we found that Alu recombination-mediated genomic deletion has had a much higher impact than was inferred from previously identified isolated events and that it continues to contribute to the dynamic nature of the human genome.

Animals↗
PubMed2006

Cost-effectiveness of ventricular assist device use in the United Kingdom: results from the evaluation of ventricular assist device programme in the UK (EVAD-UK).

BACKGROUND: The UK Department of Health funds ventricular assist device (VAD) implantation as a bridge to transplantation (BTT) at three centers. The cost-effectiveness of this program has not been established. METHODS: All 70 VAD implants for BTT and a consecutive cohort of 71 inotrope-dependent transplant candidates, between April 2002 and December 2004, were prospectively monitored for survival, transplantation, quality of life and resource use. Costs and quality-adjusted life-years were estimated for these groups, and for a hypothetical scenario in which VAD patients would die within 30 days in the absence of the program. RESULTS: Mean quality-adjusted life-years for a VAD patient was 3.27 at a lifetime cost of 173,841 pounds (316,078 US dollars). The majority of the cost was attributable to the VAD implant (63,830 pounds, 116,056 US dollars) and the initial hospital stay in the ITU and ward (14,500 pounds, 26,364 US dollars). Inotrope-dependent transplant candidates had mean quality-adjusted life-years of 4.99 at a lifetime cost of 130,905 pounds (238,011 US dollars). The worst clinical scenario resulted in a lifetime cost of 14,400 pounds (26,182 US dollars), based on 1 month in the ICU (mean 15 days). These figures were robust to a range of plausible assumptions. CONCLUSIONS: A lifetime model based on current UK practice demonstrates that BTT VAD patients had significant quality-adjusted life-years, but treatment was expensive when compared with the worst clinical scenario. If device technology improves, costs are reduced, or referral practice changes, results should be re-assessed.

Cohort Studies↗
PubMed2005

Quantum delocalization of hydrogen in the Li2NH crystal.

By mapping out potential energy surfaces from density-functional theory (DFT) and solving a protonic Schrödinger equation, we find that the H atom in a unit cell of the Li2NH crystal shows remarkably strong quantum behavior, leading to the delocalization of H over six octahedral sites around each N. This can be rationalized in terms of rapid coherent tunneling among these equivalent octahedral sites. Structural and dynamical consequences of our finding are discussed. Since the Li-N-H compounds are considered promising candidates for H-storage, understanding of these fundamental properties will be useful toward improving the performance of the material.

Journal Article↗