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Gromov Y, Gorbunov A, Tyutyunnik V. Intelligent digitalization of cardiovascular risks. CARDIOMETRY 2022. [DOI: 10.18137/cardiometry.2022.22.7794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of the study was to develop a mathematical model of the risks of the cardiovascular system based on the selected factors affecting cardiovascular diseases (CVD) and to test the developed mathematical model on a sample of clinical examples. CVD risk factors was grouped by types: biological indicators (anthropometric, biochemical, morphological, physiological), disease indicators, social indicators. An assessment of the degree of risk for each of the indicators was carried out by calculating the degree of risk using the membership formula, then evaluating the hazard class (according to the degree of risk) using a logical-linguistic model and a training algorithm for the neural fuzzy classifier of the network. The correctness of the risk determination by the developed model was confirmed by the analyzed 60 verified cases of acute cerebrovascular accident (18 men and 42 women). The analysis of the test results of the constructed neuro-fuzzy classifier allows us to conclude that it works satisfactorily even when using incomplete information, which makes it possible to use it for prompt decision-making. The results of testing on clinical examples, with an acceptable level of significance of a type I error of 0.05, showed that the risk was determined correctly. The factors influencing the risk of CVD are identified and designated as the corresponding linguistic variables. A logical-linguistic model was built, from which a transition was made to a hybrid neuro-fuzzy classifier, which allows assessing the influence of the identified factors on the level of risk of CVD. As a result of approbation of the model of intellectual digitalization of risks of the cardiovascular system on real clinical examples, it was confirmed that the risk was determined correctly, which means that it is possible to assert about the prospects for introducing this model into clinical practice and guaranteeing medical specialist more accurate diagnosis and optimization of their activities.
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Kalinina AM, Antonov KA, Gornyi BE, Dubovoj II, Drapkina OM. On the Quality of Medical Examination: Diagnostic Significance of the Survey Method for Detecting the Probability of Cardio-Cerebral Symptoms. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-06-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- A. M. Kalinina
- National Medical Research Center for Therapy and Preventive Medicine
| | - K. A. Antonov
- National Medical Research Center for Therapy and Preventive Medicine
| | - B. E. Gornyi
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. I. Dubovoj
- Bryansk City Outpatient Clinic №5; Bryansk Basic Medical College
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Suvorova EI, Kontsevaya AV, Shalnova SA, Deev AD, Balanova YA. Association of the Level Healthcare Resource Consumption and Frequency of Temporary Disability Cases with Cardiovascular Risk Factors Based on Data of Population Study in Russian Federation. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-02-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To analyze the associations of health care system resources utilization and temporary disability (TD) with the main cardiovascular risk factors (RF) at the population and individual level in working age population based on ESSE-RF study data.Material and methods. The analysis was based on ESSE-RF study data. Standard epidemiological survey methods and evaluation criteria were used. Analysis of probability and number of outpatient visits, hospitalizations, ambulance calls and TD was conducted by using hurdle model. Hypertension, obesity, hypercholesterolemia, hyperglycemia and tobacco consumption were independent variables.Results. A total of 21923 individuals aged 25-64 years were included: men – 8373 (38%) and women – 13550 (62%). The probability of outpatient visits significantly determined in group with tobacco consumption and with hypercholesterolemia for men, and for women – in the smoking group, with obesity and with hyperglycemia. Numbers of outpatient visits has doubled for patient with hyperglycemia. The numbers of outpatient visits were higher among women smokers compared to non-smokers. Chance to be hospitalized significantly associate with smoking, obesity, hypercholesterolemia for men and with obesity, hyperglycemia – for women. Hypercholesterolemia was associated with a smaller number of inpatient treatment cases among men. The probability of ambulance calls increased for smoking men, for male group with hypertension, hypercholesterolemia, obesity and with hyperglycemia, at the same time, the likelihood increased in female group with hypertension, hyperglycemia, smoking and with obesity. In addition, numbers of ambulance calls were higher in 1.55 times for women with obesity (p<0.05).Conclusion. So, there is a significant association of probability of using and consumption level of healthcare recourse with the RF depending on the type of medical care, sex and RF.
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Affiliation(s)
- E. I. Suvorova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. D. Deev
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. A. Balanova
- National Medical Research Center for Therapy and Preventive Medicine
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Maksikova TM, Kalyagin AN, Piven DV, Babanskaya E. Complicated Issues of Medical Examination: A Case Study of the Irkutsk Region. Value Health Reg Issues 2019; 21:74-81. [PMID: 31670111 DOI: 10.1016/j.vhri.2019.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/03/2019] [Accepted: 06/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Medical examination of the adult population is aimed at diagnosing chronic noncommunicable diseases and their risk factors. The unreasonable choice of screening methods and information processing can lead to the unjustified waste of resources, with little benefit or even damage to the health of population and to the distortion of the statistic information. OBJECTIVES To evaluate the quality of medical examinations for chronic noncommunicable diseases among the adult population of the Irkutsk region from 2013 to 2017. METHODS We analyzed the Adult Clinical Examination report N 131 using comparative and statistical methods. It was selected for this study because it provides a summary of the findings from the Chronic Non-Communicable Diseases surveys from 2013 to 2017 and thus precluded unnecessary investment of time and labor. The report comprises sections 1000 to 7000, which provided medical examination data, such as demographic information and statistics on various diseases, including neoplasms. RESULTS The years 2016 and 2017 were notable for the emergence of 567 new cancers, which accounted for 12.9% of total diagnoses. In 2017, there were 115 192 patients with cardiovascular diseases, a fivefold increase from 2013. Among the neurological dysfunctions, 0.9% were ischemia attacks and related syndromes. The remaining 99.1% were not highlighted in the report. The respiratory system diseases were pneumonia, bronchitis, chronic obstructive pulmonary disease (COPD), asthma, asthmatic status, and bronchiectasis. These diseases made up 68.3% of all pathologies of the respiratory system. The remaining 11 327 cases were not classified nosologically. CONCLUSION Every section of the N 131 report showed significant inconsistencies among the summary survey results for both the Irkutsk Region and Russia. This could result in a misunderstanding of disease prevalence and, consequently, in improper decision making. At this point, approaches to statistical analysis of health surveys must be reconsidered on a national scale.
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Affiliation(s)
- Tatyana M Maksikova
- Department of Propedeutics of Internal Diseases, Irkutsk State Medical University, Irkutsk, Russia.
| | - Aleksey N Kalyagin
- Department of Propedeutics of Internal Diseases, Irkutsk State Medical University, Irkutsk, Russia
| | - Dmitriy V Piven
- Department of Public Health and Healthcare, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia
| | - Evgeniya Babanskaya
- Department of Family Medicine, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia
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5
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Kalinina AM, Kushunina DV, Gornyi BE, Antonov KA, Betyaeva OV, Sokolov GE. The potential of cardiovascular diseases’ prevention according to the results of dispensary examinations of the adult population. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2019. [DOI: 10.15829/1728-8800-2019-4-69-76] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- A. M. Kalinina
- National Medical Research Center for Preventive Medicine
| | | | - B. E. Gornyi
- National Medical Research Center for Preventive Medicine
| | - K. A. Antonov
- National Medical Research Center for Preventive Medicine
| | - O. V. Betyaeva
- National Medical Research Center for Preventive Medicine
| | - G. E. Sokolov
- National Medical Research Center for Preventive Medicine
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Myasoedova EI, Voronina LP, Polunina OS, Shvarts YG. [Indicators of the left ventricular-arterial coupling interaction in chronic forms of ischemic heart disease: relationships of the protradenomedullin and N-terminal probrain natriuretic peptide]. KARDIOLOGIIA 2019; 59:41-50. [PMID: 31340748 DOI: 10.18087/cardio.2627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE OF THE STUDY Analyze the parameters of the interaction between the left ventricle and the arterial system in patients with chronic forms of coronary heart disease and to identify relationships with levels of proadrenomedullin (MR‑proADM) and N‑terminal precursor of the brain natriuretic peptide B (NT‑proBNP). MATERIALS AND METHODS 240 patients with chronic forms of coronary heart disease (median - 55,9 [43; 63] years) and Q‑forming myocardial infarction in the past were examined. Of these, 110 patients with myocardial infarction and preserved lef ventricular ejection fraction and 130 patients with ischemic cardiomyopathy. All patients were calculated parameters of lef ventricular‑arterial interaction and the determination in blood serum levels of MR‑proADM and NT‑proBNP. RESULTS In patients with ischemic cardiomyopathy, an increase in the lef ventricular‑arterial interaction index was detected (2,51 [1,18; 5,00]), which reflects a decrease in the functional abilities and efficiency of the heart. In patients with myocardial infarction and a preserved left ventricular ejection fraction, this indicator was in the range of normal values (0,78 [0,55; 1,07]), which indicates an effective cardiac work. A study of MR‑proADM and NT‑proBNP levels demonstrated an increase in both groups (1,72 [1,56; 1,98] nmol/l and 779,3 [473; 2193] pg/ml in the group of patients with ischemic cardiomyopathy; 0,89 [0,51; 1,35] nmol/l and 246 [118; 430] pg/ml in the group of patients with myocardial infarction and preserved left ventricular ejection fraction), and the correlation analysis with left ventricular‑arterial coupling interaction parameters allowed identify statistically significant connections (in the group of patients with ischemic cardiomyopathy: with the level of MR‑proADM ‑ r=0,67, p=0,006, with the level of NT‑proBNP ‑ r=0,78, p<0,001; in the group of patients with myocardial infarction and preserved left ventricular ejection fraction: with MR‑proADM level ‑ r=‑0,52, p=0,024, with NT‑proBNP level ‑ r =‑0,38, p=0,037). CONCLUSION The findings suggest a pathogenetic association between the biomarkers under study and the parameters of left ventricular‑arterial coupling interaction.
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Affiliation(s)
| | | | | | - Yu G Shvarts
- V. I. Razumovsky Saratov State Medical University
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Persiyanova-Dubrova AL, Badalov NG, Marfina TV, Rachin AP. [Balneotherapy and modification of risk factors in cardiovascular disease prevention programs]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2019; 96:49-57. [PMID: 31513168 DOI: 10.17116/kurort20199604149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the Russian Federation, as in many other countries. Taking into consideration the observed increase in the spread of risk factors, modern demographic trends (an increase in the proportion of elderly people), and a high economic burden of circulatory system diseases, the search for new forms and effective strategies of prevention is becoming relevant. OBJECTIVE: To provide the data available in the scientific literature on the effectiveness of the measures to modify risk factors and lifestyle, which are implemented during balneotherapy under both resort and in non-resort conditions, and to define areas for further investigators in this field. Investigations evaluating the effectiveness of these measures were sought in the Embase, PubMed, PEDro, Web of Science, eLIBRARY databases in January 2012 to August 2018. The analysis included seven trials that showed an improvement of estimated endpoints (blood pressure, body mass index, lipid profile, physical activity, and morbidity and mortality rates). The generalization of results of the analyzed trials was limited by the high heterogeneity of their protocols and methodological quality, which does not allow for a final conclusion on the effectiveness of preventive measures implemented during balneotherapy. Future research should provide more evidence of the benefits of this approach. The analysis will be able to take into account the existing experience and to develop a strategy to enhance the effectiveness of cardiovascular disease prevention programs based on high-quality randomized clinical trials.
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Affiliation(s)
- A L Persiyanova-Dubrova
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - N G Badalov
- National Medical Research Center for Rehabilitation and Balneology, Ministry of Health of Russia, Moscow, Russia
| | - T V Marfina
- National Medical Research Center for Rehabilitation and Balneology, Ministry of Health of Russia, Moscow, Russia
| | - A P Rachin
- National Medical Research Center for Rehabilitation and Balneology, Ministry of Health of Russia, Moscow, Russia
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Kontsevaya AV, Balanova YA, Imaeva AE, Khudyakov MB, Karpov OI, Drapkina OM. ECONOMIC BURDEN OF HYPERCHOLESTEROLEMIA IN THE RUSSIAN FEDERATION. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2018. [DOI: 10.20996/1819-6446-2018-14-3-393-401] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background. The prevalence of hypercholesterolemia (HCE) is quite high in the Russian Federation (RF), and it is associated with clinical consequences and with potential economic impact. Impact includes not only cost of its correction, but also the cost of treatment of diseases and complications, as well as the deficiency of the gross domestic product (GDP).Aim. Evaluation of economic impact due to HCE in the Russian population, including direct expenditures of the Health Care System as well as nondirect impact in common economy.Material and methods. Prevalence of HCE in the RF was identified based on local published studies. Local statistical data (2016) on cardio-vascular diseases (CVDs), including Ischemic Heart Disease (IHD), Myocardial Infarction and cerebral-vascular disease were included in the analysis. Population Attributive Risk (PAR) of HCE in CVDs has been extrapolated on all Russian population. Official statistics, parameters of Govern Guarantees Program of Free Medical Aid were used for modelling of direct and non-direct components of economic impact. Total amount of premature deaths with calculation of years of potential life lost until life expectation at 72 years was calculated. Economic impact due to premature CVDs mortality in economic activity age with consideration on ratio of employment have included GDP lost. Calculation of GDP lost also included monetary impact based on number of disability CVDs patients multiplied on GDP per capita in disability group.Results.Visits to policlinics of patients with CVDs and HCE had a first place among all calls for medical aid. In the same time, hospitalization required in higher expenditures (outpatients cost treatment expenditures were 2.43 billion RUR, in-patients treatment – 18.21 billion RUR). IHD with HCE was most expensive for direct expenditures in comparison with other CVD groups: more than 28.9 billion RUR per year, and with direct non-medical expenditures of 29.3 billion RUR in total. Years of potential life lost in economic active age were one million in total, 1.29 trillion RUR per year mostly due to indirect expenditures due to premature deaths in economy activity age (99% of impact). Total Economic impact due to HCE in the Russian population for all HCE are estimated as 1.295 trillion RUR.Conclusion. Total economic impact due to HCE in the RF is 1.5% of GDP (2016), 1.295 trillion RUR. Direct expenditures included Health Care System expenses; disability covering had 2.3% only. Main part of impact is economic lost due to premature mortality and decrease of labor productivity. HCE patients control at target levels with help of healthy lifestyle and adequate pharmaceutical therapy can decrease economic impact.
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Aleksandrov AA, Rozanov VB, Zvolinskaya ЕY, Pugoeva KS. RISK FACTOR PREVALENCE AND PROBABILITY OF FATAL CARDIOVASCULAR EVENTS IN MEN 42-44 YEARS OLD. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2016. [DOI: 10.15829/1728-8800-2016-4-38-43] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- A. A. Aleksandrov
- National Research Center for Preventive Medicine of the Ministry of Health, Moscow
| | - V. B. Rozanov
- National Research Center for Preventive Medicine of the Ministry of Health, Moscow; I.M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow
| | - Е. Yu. Zvolinskaya
- National Research Center for Preventive Medicine of the Ministry of Health, Moscow
| | - Kh. S. Pugoeva
- National Research Center for Preventive Medicine of the Ministry of Health, Moscow
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10
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Efanov AY, Storozhok МA, Sholomov IF, Medvedeva IV, Shalaev SV. PREVALENCE OF CARDIOVASCULAR RISK FACTORS IN NON-ORGANIZED POPULATION OF 25-64 YEAR OLDS IN TYUMEN REGION. RESULTS OF ESSE-RF STUDY IN TYUMEN REGION. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2016. [DOI: 10.15829/1728-8800-2016-4-60-65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- A. Yu. Efanov
- Tyumen State Medical University of the Ministry of Health, Tyumen; Scientific-Practical Medical Center, Tyumen
| | - М. A. Storozhok
- Tyumen State Medical University of the Ministry of Health, Tyumen
| | - I. F. Sholomov
- Tyumen State Medical University of the Ministry of Health, Tyumen; Scientific-Practical Medical Center, Tyumen
| | - I. V. Medvedeva
- Tyumen State Medical University of the Ministry of Health, Tyumen; Scientific-Practical Medical Center, Tyumen
| | - S. V. Shalaev
- Tyumen State Medical University of the Ministry of Health, Tyumen
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Bolotova EV, Komissarova IM. UNHEALTHY DIET AS CARDIOVASCULAR RISK FACTOR IN RURAL POPULATION OF KRASNODARSKI KRAI. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2016. [DOI: 10.15829/1728-8800-2016-4-50-54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- E. V. Bolotova
- Kuban State Medical University, of the Ministry of Health, Krasnodar
| | - I. M. Komissarova
- Kuban State Medical University, of the Ministry of Health, Krasnodar; Central District Hospital “Severskaya”. St. Severskaya, Krasnodarski Krai
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12
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Kalinina AM, Ipatov PV, Kaminskaya AK, Kushunina DV. [Identification of circulatory diseases and their risk during medical examination of an adult population: methodological aspects]. TERAPEVT ARKH 2015; 87:31-37. [PMID: 25823267 DOI: 10.17116/terarkh201587131-37] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study the efficiency of a methodology for the active detection of coronary heart disease (CHD) and cerebrovascular diseases (CVD) during medical examination and to determine the need and possible ways of its improvement. SUBJECTS AND METHODS The medical examinations of 19.4 million people (94.6% of all the citizens who had undergone medical examinations in all the regions of Russia in 2013) were analyzed and the methodological aspects of identification of the circulatory diseases (CDs) that were induced by coronary and cerebral vessel atherosclerosis and had common risk factors, primarily CHD and CVD, were assessed. RESULTS The medical examinations revealed 2,915,445 cases of CDs and their suspicions, during which its clinical diagnosis was established in 57.2%. The suspected disease requiring that its diagnosis should be further specified; off-medical examinations revealed hypertension in more than 770,000 cases, CHD in 232,000, and CVD in 146,000. The proportion of stable angina pectoris of all angina cases was much higher at a young age (25.6%) than at middle (15.6%) and elderly (11.3%) ages. Brachiocephalic artery stenoses were detected in almost 13,000 cases. According to the official health statistics, within the years preceding the introduction of large-scale medical examinations, there was a slight rise in new CD cases among the adult population of Russia, which was more significant in 2013 (according to the preliminary data) than in 2012. CONCLUSION The methodology for the active detection of CDs through a two-step medical examination, which is used during a follow-up, makes it possible to substantially increase detection rates for CDs. There has been shown to be a need for the better quality and completeness of diagnostic examination in real practice.
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Affiliation(s)
- A M Kalinina
- National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - P V Ipatov
- National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - A K Kaminskaya
- National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - D V Kushunina
- National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
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13
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Kontsevaya AV, Kalinina AM, Boytsov SA, Ipatov PV. SOCIO-ECONOMIC EFFECTIVENESS OF HEALTH SCREENING ACTIVITY IN 2013 IN RUSSIAN FEDERATION. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2014. [DOI: 10.15829/1728-8800-2014-3-4-10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To estimate long-term socio-economic effectiveness of broad health screening activity of adults by the results in the year 2013.Material and methods. The study is performed with the method of mathematic modelling using the results of completed in the year 2013 health screening and with an estimate for adult productive and economically active age (up to 72) for 10-year perspective of potentially prevented deaths from the main chronic non-infectious diseases (CHID), saved years of life and economic expenses by 1 year of saved life.Results. Through analyzed malignant tumours (MT) maximum deaths are to be prevented from breast cancer. The most significant effect of the performed screening is decrease of cardiovascular (CV) deaths — quantity of potentially saved lifes at productive age during 10 years would be 10 times higher than from MT. Screening for the studied CHID is characteristic for certain economic expediency, because expenses on 1 year of potentially saved life appeared lower than gross domestic product by one inhabitant. The most economic expediency of screening was found at the matter of CV diseases: expenses on 1 year of saved productve life (15,5th RUR) and economically active age (11th RUR), that is significantly lower than domestic gross product by inhabitant. Return of investments into health improvement thank to earlier diagnostics of CHID and further treatment would reach 10 RUR per each invested 1 RUR by 10 years.Conclusion. The analysis and calculations showed a significant positive effect of health screening in 2013, most of all due to earlier diagnostics and complex action against CV diseases and MT, which are included into screening and observation. Expenses on 1 year of saved life were lower than domestic gross product by inhabitant (in prices of the 2013) and return of investment by maintaining labour potential of economically active population was 10 RUR by 1 invested RUR during 10 years. Economic efficiency of health screening as a strategy to prevent premature death, preventable death and to keep health is clear.
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Affiliation(s)
- A. V. Kontsevaya
- FSBH State Research Centre for Preventive Medicine of the Ministry of Health. Moscow, Russia
| | - A. M. Kalinina
- FSBH State Research Centre for Preventive Medicine of the Ministry of Health. Moscow, Russia
| | - S. A. Boytsov
- FSBH State Research Centre for Preventive Medicine of the Ministry of Health. Moscow, Russia
| | - P. V. Ipatov
- FSBH State Research Centre for Preventive Medicine of the Ministry of Health. Moscow, Russia
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Martsevich SY, Tolpygina SN, Malysheva AM, Polyanskaya YN, Gofman EA, Lerman OV, Mazaev VP, Deev AD. VALUE OF SPECIFIC PARAMETERS AND INTEGRATIVE INDICES OF TREADMILL TEST FOR THE ASSESSMENT OF CORONARY STENOSIS SEVERITY. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2013. [DOI: 10.15829/1728-8800-2013-5-22-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim.To assess the value of specific parameters and integrated indices (II; such as Duke Index (DI), Centre for Preventive Medicine Index (CPMI), and modified CPMI) of the treadmill test in the diagnostics of coronary stenosis severity among patients with stable coronary heart disease (CHD).Material and methods.The study included all patients (260 permanent residents of Moscow City or Moscow Region) who were admitted to the State Research Centre for Preventive Medicine with the CHD diagnosis and who underwent coronary angiography (CAG) and treadmill test in the period between January 1st 2004 and December 31st 2007.Results.There were statistically significant associations between the main treadmill test parameters and the severity of coronary artery (CA) atherosclerosis. The larger number of stenosis-affected CA was associated with a higher prevalence of chest pain and treadmill tests with positive results and ST segment depression >1 mm, as well as with a decreased total duration of treadmill test. Similarly, the increased risk, as assessed by treadmill test indices (DI, CPMI, and modified CPMI), was linked to an increased number of stenosis-affected CA. Modified CPMI demonstrated the highest diagnostic value for the assessment of coronary atherosclerosis severity.Conclusion.The treadmill test parameters which demonstrated their diagnostic value for the assessment of CHD severity included the following: positive test results, retrosternal chest pain as the reason for test discontinuation, ST segment depression >1mm, and short total duration of the test. Overall, all II demonstrated their high value in CHD diagnostics. Modified CPMI was the most effective II in the assessment of CA atherosclerosis severity.
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Affiliation(s)
- S. Yu. Martsevich
- State Research Centre for Preventive Medicine; I.M. Sechenov First Moscow State Medical University, Moscow
| | | | | | | | | | | | | | - A. D. Deev
- State Research Centre for Preventive Medicine
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Kalinina AM, Kontsevaya AV, Deev AD. LONG-TERM ECONOMIC EFFECTIVENESS OF THE MULTIFACTORIAL CARDIOVASCULAR PREVENTION PROGRAMME IN THE CONTEXT OF PRIMARY HEALTH CARE. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2013. [DOI: 10.15829/1728-8800-2013-1-60-66] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Economic effects of the multifactorial cardiovascular prevention programme are analysed in the context of prevention-associated preserved work potential. The programme of multifactorial prevention of cardiovascular disease (CVD) is one of the few Russian controlled studies, which was performed in the primary health care settings, in the population-based middle-aged cohort, and included both the active preventive intervention (5 years) and the end-point follow-up (10 years). This study is a post-hoc analysis employing modern parameters of integrated assessment, such as life-years saved (LYS) and estimated cost-effectiveness of the programme. In the active prevention population, the 5-year intervention saved 52,5 life-years per 1000 participants, with the cumulative 10-year LYS number of 147,4. The programme costs per 1 LYS (85512,4 roubles for 5 years and 41679,3 roubles for 10 years) were significantly lower than the gross domestic product per one worker per year (290000 roubles). The payback of the CVD prevention investment (per 1 rouble invested) reached 2,3 roubles for 5 years and 5,8 roubles for 10 years. Multifactorial medical prevention of CVD is economically effective and justifiable when integrated into the routine practice of primary health care.
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Affiliation(s)
| | | | - A. D. Deev
- State Research Centre for Preventive Medicine, Moscow
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