Cost-utility analysis of the newly recommended adjuvant chemotherapy for resectable gastric cancer patients in the 2011 Chinese National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Gastric Cancer.

BACKGROUND: Postoperative adjuvant chemotherapy with capecitabine and oxaliplatin was first recommended for resectable gastric cancer patients in the 2011 Chinese National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Gastric Cancer, but the economic influence of this therapy in China is unknown. OBJECTIVE: The aim of the present study was to determine the cost-effectiveness of adjuvant chemotherapy with capecitabine and oxaliplatin after a gastrectomy with extended (D2) lymph-node dissection, compared with a D2 gastrectomy alone, for patients with stage II-IIIB gastric cancer. METHODS: On the basis of data from the CLASSIC trial, a Markov model was created to determine economic and clinical data for patients in the chemotherapy and surgery group (CSG) and the surgery-only group (SOG). The costs, presented in 2010 US dollars and estimated from the perspective of the Chinese health-care system, were obtained from the published literature and the local health system. The utilities were based on published literature. Costs, life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were estimated. A lifetime horizon and a 3 % annual discount rate were used. One-way and probabilistic sensitivity analyses were performed. RESULTS: For the base case, the CSG compared with SOG would increase LYs and QALYs in a 3-, 5-, 10- or 30-year time horizon (except the QALYs at 3 or 5 years). In the short run (such as in 3 or 5 years), the medical costs would increase owing to adjuvant chemotherapy of capecitabine plus oxaliplatin after D2 gastrectomy, but in the long run the costs would decline. The ICERs suggested that the SOG was dominant at 3 or 5 years and the CSG was dominant at 10 or 30 years. The one-way sensitivity analysis showed that the utility of disease-free survival for 1-10 years for the SOG and the cost of oxaliplatin were the most influential parameters. The probabilistic sensitivity analysis predicted a 98.6 % likelihood that the ICER for the CSG would be less than US$13,527/QALY (three times the per capita gross domestic product of China). CONCLUSION: For patients in China with resectable disease, our results suggest that adjuvant chemotherapy with capecitabine plus oxaliplatin after a D2 gastrectomy is cost-saving and dominant in the long run on the basis of a current clinical trial, compared with treatment with a D2 gastrectomy alone.

Design and application of a digital thermometer for channels and acupoints based on SPCE061A / 医疗卫生装备

In this paper, a digital phonetic thermometer for channels and acupoints is designed with the SPCE061A SCM (Single Chip Microprocessor). Such of the thermometer are introduced as its design principle, hardware connection, software design flow, main characteristics and application.

Development of Nursing Station Infusion Monitoring System / 医疗卫生装备

Objective To design a more rapid and convenient infusion monitoring system.Methods Pentium series were used as its master and the MCU as its slaves.The management was based on RS232 standard.Results In the nursing station,nurses can monitor the fusion state of all patient rooms in the hospital.Conclusion It is proved that this system is simple,cheap and practical.[Chinese Medical Equipment Journal,2008,29(3):61-62,65]

Improvement of Field Liquid Transfusion Control System / 医疗卫生装备

Objective To improve the stability and practicability of field liquid transfusion control system.Methods SPCE062A 's high accurate AD was used to acquire the dropping speed,and a new method for weight sensor 's self proofread was applied.Results The infrared photoelectric sensor was removed,so the monitoring part could work with any appropriate sensor.Conclusion The system cost is decreased and its stability and availability are enhanced.[Chinese Medical Equipment Journal,2008,29(2):66-67]

Application of data acquisition card / 医疗卫生装备

This paper develops a multiport hyperfunctional data acquisition card. Its ports are controlled through programming, and then precise locating and real- time feedback of medical instruments can be fulfilled.