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BACKGROUND: In pediatric cardiology, the fact that some new biomarkers have assay-specific normal values has to be considered for correct clinical decisions. The current study aimed to provide age-adjusted normative values for NT-proBNP and Galectin-3 using the Abbott immunoassay system from a prospective French pediatric cohort sera collection and to validate our data for NT-proBNP on a second retrospective cohort. METHODS: We analyzed 283 consecutive samples for NT-proBNP and 140 samples for Galectin-3 collected from apparently healthy children (0-18 years) with outpatient treatment at our institution (Hôpital Necker-Enfants malades, Paris, France) during 24 months. RESULTS: For NT-proBNP and Galectin-3, we establish four age partitions, respectively two (<2 years / >2 years) and establish upper reference values and their 90 % CI for each biomarker (Galectin-3 (ng/mL): 56 [44-70] / 26 [23-29]). We evaluated the diagnostic performance of our upper reference values of NT-proBNP on a retrospective cohort (n = 428) with positive predictive value of 0.92. CONCLUSIONS: Using Abbott immunoassay system, we report age-specific reference values for NT-proBNP and for the first time for Galectin-3 in a healthy French pediatric cohort. These data call for larger cohort studies to define more robustly percentiles and diagnostic performance for NT-proBNP.
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INTRODUCTION: Trans-thoracic scan-guided biopsy (TTB) is a crucial examination for exploring thoracic lesions, particularly in the case of tumor pathologies. To make informed decisions in cost-effectiveness analyses, it is important to understand the actual costs of this procedure. AIM: To quantify the cost of performing TTB using a microeconomic approach. METHODS: We used the full cost method, which is the reference method in cost accounting. This method subdivides costs into direct and indirect costs. Direct costs are divided into variable and fixed components. Variable costs include consumables and wages of personnel involved in the "labor" act. Fixed direct costs are those that do not vary during the study period; they include the costs of purchasing, depreciation, maintenance, and repair of the scanner room equipment. Indirect costs include overhead costs that cannot be directly attributed to the TTB procedure. RESULTS: The total direct cost of the TTB procedure amounts to 310.191 TND when using a coaxial and 256.390 TND in the absence of a coaxial, including fixed and variable costs. Indirect costs were not included in this study due to the absence of cost accounting at the hospital. CONCLUSION: Accurate knowledge of the costs of any medical procedure is essential for making informed decisions in cost-effectiveness analyses. This study provides a precise estimate of the direct costs of TTB and can help improve the efficiency of resource allocation for performing this procedure.
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Decision Making , Hospitals , Humans , Biopsy , Costs and Cost Analysis , KnowledgeABSTRACT
Background: The burden of sickle cell disease (SCD) is high in Saudi Arabia, with a significant impact on patients' quality of life (QoL). This study aimed to assess the health-related quality of life (HRQoL) among adults with SCD. Methods: A cross-sectional study was conducted among adults with SCD attending hematology clinics at Qatif Central Hospital in the Eastern Province of Saudi Arabia. The questionnaire included subsections to collect information from participants, including sociodemographic attributes, SCD characteristics, HRQoL based on SF-36, and opinions regarding barriers to service. Results: Among 272 SCD patients, the highest mean score of HRQoL was observed in the social functioning (SF) domain (65.0±23.4), whereas the lowest score was observed in the role limitations due to physical health (RP) domain (47.2±40.4). The mean score for participants' opinions regarding service provision was 19.27±4.68 (min-max:10-30), and only 24.6% had a positive opinion regarding the accessibility of service provision. A total of 38.6% of the respondents acknowledged shortcomings in the services offered by healthcare staff, and 43% identified weaknesses in communication with healthcare staff. Moreover, 40.1% agreed about feeling stigmatized about their condition. SCD patients who were <40 years old, males, had a university degree, had health insurance, waited <15 minutes before receiving health care, and had positive opinions regarding service provision were more likely to have better HRQoL scores. Conclusion: Adults with SCD exhibited low HRQoL in general, and different factors were related to low HRQoL scores. Counselling, empowerment, and improvement of doctor-patient communication are important strategies to improve healthcare provision, and consequently, HRQoL among adults with SCD.