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Biomedical subjects

Simon Dixon

Publications and source records attributed to Simon Dixon.

23 records · Page 2Linked to original sources
PubMed2003

The use of willingness to pay to assess public preferences towards the fortification of foodstuffs with folic acid.

OBJECTIVES: To assess public attitudes towards the fortification of flour with folic acid, and quantify their intensity of preference towards the proposed policy. DESIGN: Structured interviews describing the proposed policy of fortification followed by questions about the respondent's preferences towards fortification. SETTING AND PARTICIPANTS: A United Kingdom community sample of 76 people interviewed at home. MAIN VARIABLES STUDIED: Direction of preference towards fortification, willingness to pay (WTP) for the preferred course of action, and the reasons behind their preferences. RESULTS: Responses showed that 51 (67%) were in favour of fortification, 15 (20%) were opposed, while the remaining 10 (13%) were either indifferent or were unsure. Those in favour of fortification tended to be younger and poorer than those opposed to it. Willingness to pay estimates show that those in favour of food fortification had more intense preferences, with mean and median WTP around twice as great. Reasons for being willing to pay were centred on the health benefits, with particular reference being made to the intervention saving lives and it being preventative. Those opposed tended to believe that there was insufficient evidence. CONCLUSIONS: The combination of a policy vote, WTP and qualitative data, allow us to assess the direction, intensity and motivations behind people's preferences. Further work needs to be undertaken to gather more robust estimates of public preferences for fortification, and to better understand attitudes towards public health interventions more generally.

Adolescent↗
PubMed2003

Evaluation of the impact of a technology appraisal process in England: the South and West Development and Evaluation Committee.

OBJECTIVES: To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process. METHODS: Two postal questionnaires examining issues of awareness, influence and quality of the DEC reports were sent to samples of clinical and managerial health service staff in S&W NHS region, the North West NHS region, and three other randomly selected health authorities elsewhere. Supplementary telephone interviews were undertaken with a subsample of staff. Trends in utilisation before and after the publication of four S&W DEC reports were examined using routine health service data. RESULTS: Survey response rates ranged between 73% and 85%. Within health authorities in the S&W, agreement about the impact of the DEC in informing policy and purchasing decisions was consistently high, although responses from clinicians were more equivocal. In the topic areas examined, the impact of the DEC reports could not be separated from wider influences on practice. The cost of each DEC report is estimated to have been pounds sterling 24659. CONCLUSIONS: Health service staff perceived that the S&W DEC process had had an impact on policy decisions and clinical practice locally; however, any actual impact on practice could not be identified with routine data. The approach used in this study would be valuable in evaluating the impact of the English NHS National Institute for Clinical Excellence.

Attitude of Health Personnel↗
PubMed2003

Psychological treatment for insomnia in the management of long-term hypnotic drug use: a pragmatic randomised controlled trial.

OBJECTIVE: To evaluate the clinical and cost impact of providing cognitive behaviour therapy (CBT) for insomnia (comprising sleep hygiene, stimulus control, relaxation and cognitive therapy components) to long-term hypnotic drug users in general practice. DESIGN: A pragmatic randomised controlled trial with two treatment arms (a CBT treated 'sleep clinic' group, and a 'no additional treatment' control group), with post-treatment assessments commencing at 3 and 6 months. SETTING: Twenty-three general practices in Sheffield, UK. PARTICIPANTS: Two hundred and nine serially referred patients aged 31-92 years with chronic sleep problems who had been using hypnotic drugs for at least 1 month (mean duration = 13.4 years). RESULTS: At 3- and 6-month follow-ups patients treated with CBT reported significant reductions in sleep latency, significant improvements in sleep efficiency, and significant reductions in the frequency of hypnotic drug use (all P<0.01). Among CBT treated patients SF-36 scores showed significant improvements in vitality at 3 months (P<0.01). Older age presented no barrier to successful treatment outcomes. The total cost of service provision was 154.40 per patient, with a mean incremental cost per quality-adjusted life-year of 3416 (at 6 months). However, there was evidence of longer term cost offsets owing to reductions in sleeping tablet use and reduced utilisation of primary care services. CONCLUSIONS: In routine general practice settings, psychological treatments for insomnia can improve sleep quality and reduce hypnotic consumption at a favourable cost among long-term hypnotic users with chronic sleep difficulties.

Adult↗
PubMedDate not supplied

The routine collation of health outcomes data from hospital treated subjects in the Health Outcomes Data Repository (HODaR): descriptive analysis from the first 20,000 subjects.

OBJECTIVES: Health technology assessment requires data covering many different facets of treatment. A new resource, the Health Outcomes Data Repository (HODaR), is described and evaluated for its use in the pharmaceutical research and development process. METHODS: Data were collated for subjects treated at Cardiff and Vale National Health Service (NHS) Hospitals Trust, United Kingdom. Inpatients are surveyed 6 weeks postdischarge by postal survey, whilst outpatients are handed a survey pack when they attend. Survey data cover sociodemographics, resource use, production losses, and quality of life. Electronic hospital data are available for all responders, and linked with survey returns. Sample characteristics, coverage of disease areas, and a more detailed description of data values for diabetes are described. RESULTS: Survey responses relating to 16,188 admissions and 4476 outpatient attendances were available relating to around 2000 different diagnoses. Over 5000 pharmacy items and 400,000 biochemistry test results were available. Analysis of utility data showed a broad coverage of diseases. For patients with diabetes the pattern of EQ-5D scores across subgroups is not clear. Health service resource use showed a linear relationship with respect to number of comorbidities. CONCLUSIONS: HODaR represents a new approach to accessing patient data, and gathers both routine and survey-based data. Although linking survey data to routine hospital systems is a complex task, which produces some limitations, it can produce health outcomes data at relatively low cost. Its performance within the pharmaceutical research and development process needs to be further evaluated in order to assess its most appropriate role.

Adult↗