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PURPOSE: The present study aimed to systematically collect and synthesize available cost-effectiveness studies of semaglutide in patients with obesity or overweight in comparison with other interventions. METHODS: We comprehensively searched multiple electronic databases to identify relevant literature. Studies were selected based on inclusion and exclusion criteria. The quality of studies was appraised using the "Consolidated Health Economic Evaluation Reporting Standards" (CHEERS) tool. This study is conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Out of a total of 252 items, after review, 32 articles were fully reviewed, and, finally, 7 studies met inclusion and exclusion criteria. The discount rate was in the range of 1.5-3.5%. Studies included showed semaglutide offered more QALYs than anti-obesity drugs but because of higher cost, in some cases, ICER exceeds the willingness to pay threshold. Results show that semaglutide creates higher total cost compared to conventional interventions in patients with class I, II, and III obesities. Results show that in patients with class I obesity (BMI 33) lifestyle intervention (LI), endoscopic sleeve gastroplasty (ESG), Sleeve gastrectomy (SG), and semaglutide create $124,195; $126,732; $139,971; and $370,776, respectively. CONCLUSION: The current systematic review showed that semaglutide provides more QALYs and creates more costs in comparison with phentermine-topiramate, phentermine, and naltrexone-bupropion. Semaglutide may be cost-effective with substantial cost reduction. Semaglutide appears to be cost-effective versus diet and exercise (D&E) and liraglutide but it was not cost-effective versus sleeve gastrectomy, endoscopic sleeve gastroplasty, and gastric bypass.
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Background: Highly necessary to evaluate the effectiveness of preventive interventions to prioritize them at the community level. We aimed to systematically investigate the related studies on the effects of fluoride varnish and fissure sealant on dental caries in 6-12 children. Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library and Scopus databases using Fluoride Varnish, Fissure Sealant, Caries, and Oral Health keywords. The timeframe selected to search for articles is from 2000 to Dec 2020. CMA software: 2 (Comprehensive Meta-Analysis) was used to perform the meta-analysis. The intervention groups in this study were fluoride varnish and fissure sealants, each of them compared to the control groups. Results: We included nine studies. In the intervention group 84,380 and control group 11,254 individuals were studied. Eight of the studies were Randomized Clinical Trial (RCT) and Field RCT, and two was non-RCT. In the overall Fluoride Varnish efficacy study, 4 were fully effective, 1 was ineffective, and all 4 were completely effective for Fissure Sealant. There was a significant difference between decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled primary teeth (dmft) indices in both interventions and comparison groups. Moreover, the mean difference of DMFT for Fluoride Varnish and Fissure Sealant in the intervention and control groups were -0.55 and -0.29, respectively (P=0.00). Conclusion: Due to the efficacy of fissure sealant and fluoride varnish in preventing dental caries in children aged 6-12 yr, these interventions can be considered as health priorities of societies and health systems interventions in countries.
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BACKGROUND: Evidence-based medicine (EBM) plays an important and dominant role in promoting effective decision-making in the health system. This study was aimed to evaluate the EBM performance among health-care workers (HCWs) in hospitals in Iran. METHODS: In this study (a cross-sectional study), participants were 2800 HCWs in hospitals. A researcher-made questionnaire was designed, and judgments of 10 experts were used for the improvement of content validity. The reliability of the questionnaire was assessed by the test-retest method (α = 0.85). Data were analyzed using the descriptive statistics, t-test, and one-way ANOVA, in SPSS.16 software. RESULTS: Eventually, 1524 questionnaires were completed (response rate: 54.4%). The results of the study show that 62%of participants have not accessed scientific journals, 52% of them have difficulties using the Internet at work, guidelines were not reachable for 76% of them, and about 80% have not access to databases. About 39% of participants were not well informed about databases of EBM, and 15.8% of them were immensely knowledgeable about EBM terminology. The most important problems to increase HCWs information about EBM include research methodology- related problems, lack of resources and motivation, and coordination problems. The most prominent facilitators include: providing training courses in EBM and increased facilities. Only work experience showed a significant correlation with barriers and facilitators, and gender revealed a significant correlation with barriers (P < 0.05). CONCLUSION: It seems that prioritizing the increased access to information resources and databases, considering the research skills of the HCWs, extending the opportunities and increasing the facilities such as workforce, equipment, physical environment, and accessibility can have a great impact on the improvement of the activities associated with EBM.