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ISCB2014_abstract_book

ISCB 2014 Vienna, Austria • Abstracts - Poster Presentations 121Wednesday, 27th August 2014 • 11:00-11:30 Monday25thAugustTuesday26thAugustThursday28thAugustAuthorIndexPostersWednesday27thAugustSunday24thAugust in the UK elderly population using data from a large national Primary Care database. This method is not contingent on the identification of the con- founders, and can be applied, where outcomes are recorded in the data before and after intervention. Extensions to the method were explored to address the potential for bias from informative censoring due to sub- sequent vaccination of the controls. This prompted the authors to further develop the method for wider applicability. This has important conse- quences for interventions, such as vaccination, where an entire popula- tion is targeted, leaving few untreated controls for comparison, or where outcomes are not observed before an intervention.   P3.4 Comparative effectiveness and outcomes research P3.4.25a Short- versus long-term outcomes after treatment for tuberculosis LJ Bonnett1 , G Davies1 1 University of Liverpool, Liverpool, United Kingdom Background: TB remains a major killer amongst infectious diseases and current treatment involves a four-drug regimen for at least six months. Clinical development of a single novel TB drug is expected to take at least six years. A completely novel combination regimen would require twenty years or more. New drugs and regimens are required to shorten treatment duration, reduce toxicity and combat drug resistance. We reviewed the ability of short-term outcomes from phase II trials to predict longer-term outcomes from phase III trials and hence improve se- lection of optimum combinations of new and existing drugs for develop- ment in pivotal trials. Methods: Phase II or phase III trials of combinations of eight agents for drug sensitive individuals with tuberculosis were included in our system- atic review. Definitive clinical endpoints included treatment failure and treatment relapse. Early clinical endpoints incorporated positive or nega- tive culture at various time points, time to sputum culture conversion and serial viable colony counts. For categorical data, the odds ratio will be calculated using the Mantel- Haenszel method, and for continuous data, such as colony counts, the mean difference will be calculated. Time to event outcomes will be sum- marised via the generic inverse-variance method. Additionally, early end- points will be evaluated as surrogate outcomes for poor outcome via the generalised R2 statistic. Results: 2865 trials were identified for potential inclusion in the review. Of these, 49 phase II and 478 phase III trials were included. Data is currently being extracted and results will be presented. P3.4.34 The association of inhaled bronchodilators with the risk of acute myocardial infarction S Choi1 , EJ Jang1,2 , Y Kim1 , JM Kim1 , C-H Lee1,3 , J-J Yim3 , HI Yoon4 , DK Kim5 1 National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea, 2 Andong National University, Andong, Republic of Korea, 3 Seoul National University Hospital, Seoul, Republic of Korea, 4 Seoul National University Bundang Hospital, Seongnam, Republic of Korea, 5 SMG-SNU Boramae Medical Center, Seoul, Republic of Korea   Background: Among cardiovascular adverse events, acute myocardial in- farction (AMI) has been regarded as one of the most important issues on drug safety. The objective of this study is to investigate whether inhaled bronchodilators affect the risk of AMI. Methods: A nested case-control study based on the Korean national claims database included new adult users of inhaled medications be- tween January 1, 2009 and December 31, 2011. Patients diagnosed with AMI after enrollment were identified as cases and up to five control indi- viduals matched for age, sex, initiation date, diagnosis of hypertension, diabetes mellitus, chronic obstructive pulmonary disease(COPD), ischemic heart disease, other heart disease, and Charlson Comorbidity Index were selected. The association between the use of inhaled bronchodilators and AMI were investigated by conditional logistic regression. Results: From the eligible cohort, 11,054 patients with AMI and matched 47,815 controls were selected. Mean age was 67 years old and the pro- portion of males was 53.6%. In unadjusted analysis, short acting beta agonists(SABA) [OR=1.2, 95% CI=(1.1, 1.3), p-value<0.001] and long acting beta agonists(LABA) [OR=1.3, 95% CI=(1.1, 1.6), p-value=0.013] significant- ly increased the risk of AMI. After adjusting with other inhaled medicines, age, respiratory disease, comorbidities, concomitant medication, and health care utilization, SABA [OR=1.2, 95% CI=(1.1, 1.3), p-value<0.001] and LABA [OR=1.3, 95% CI=(1.1, 1.6), p-value=0.011] increased the risk of AMI. Conclusions: Our population based nested case-control showed that the use of SABA and LABA increased risk of clinically significant AMI. P3.4.83 Economic evaluation of cervical cancer screening strategy J Kim1 , Y Kim1 , M-J Ko1 , S Choi1 , J Shim1 , Y Lee1 1 National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea   National Cervical Screening Programme in Korea recommends that a biannual cervical pap smear test interval is appropriate for women over 30 years. Conventional cytology is relatively simple and cheap method . However, several studies in abroad have shown the relatively high false negative rate and reported that HPV testing is more sensitive than cytol- ogy. We assessed the cost-effectiveness of incorporate human papillomavi- rus (HPV) DNA testing into existing cervical cancer screening program in South Korea. The model compared two management of screening methods: (1) Pap smear, (2) Triage with HPV DNA testing(HPV DNA screen- ing test after atypical or abnormal pap results at routine cervical cancer screening). To compared current screening policy with new strategy: (1) screening interval, (2) screening start age, (3) screening period . We con- sidered these kind of strategies combination.We conducted cost-utility analysis applying QALYs to which takes into account life span expansion and the quality of life. Markov model was used with one year cycle and life time analysis period.Sensitivity analysis was conducted to reflect the uncertainty of variables. As a result, pap smear test with 5 year interval was most inexpensive strat- egy, pap smear test with 1 year interval was most effectiveness strategy.

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