Papers by Rilana F F Cima
Progress in Brain Research, 2021
People interested in the research are advised to contact the author for the final version of the ... more People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:
Value in Health, 2012
OBJECTIVES: Psoriasis is a chronic disease that impacts significantly on patients' quality of lif... more OBJECTIVES: Psoriasis is a chronic disease that impacts significantly on patients' quality of life (QoL). Biological drugs interfere in the immunologic process that triggers and supports psoriasis and, therefore, prove effective in its treatment. The aim of this study was to perform a cost-utility analysis (CUA) comparing biologic treatments (adalimumab, etanercept, infliximab, and ustekinumab) in Italy. METHODS: A decision tree model previously applied to the UK was adapted for Italy using resource and cost data from the Italian Ministry of Health (Ministero della Salute). Clinical efficacy in the treatment of moderate to severe psoriasis was determined by the Psoriasis Area Criteria and Severity Index (PASI). Relative efficacy of biologic treatments was based on a network meta-analysis of clinical trials. A different level of utility is associated with each level of PASI response. Costs included hospitalization, drug acquisition, administration, and monitoring over a 10-year time horizon. Incremental cost-effectiveness ratios (ICERs) compared with supportive care (no systemic therapy) were expressed as euros/quality-adjusted life year (QALY). One-way sensitivity analyses, where key parameters were changed to alternative plausible values, explored uncertainty in the results. RESULTS: In the base case, adalimumab was found to be the most cost effective compared to supportive care (ICER: €52,583), followed by ustekinumab 90 mg (ICER: €52,846), ustekinumab 45 mg (ICER: €54,997), infliximab (ICER: €56,141), etanercept 50 mg BIW (ICER: €77,611), and etanercept 25 mg BIW (ICER: €78,194). The ICER for ustekinumab 90 mg, ustekinumab 45mg, and infliximab compared to adalimumab were €57,052, €140,445, and €86,794, respectively. Adalimumab remained the most cost-effective over the vast majority of the one-way sensitivity analyses. CONCLUSIONS: The analysis demonstrated that adalimumab is the most costeffective biologic for the treatment of patients affected by moderate to severe psoriasis.
Trials, Jun 1, 2016
There is no evidence-based guidance to facilitate design decisions for confirmatory trials or sys... more There is no evidence-based guidance to facilitate design decisions for confirmatory trials or systematic reviews investigating treatment efficacy for adults with tinnitus. This systematic review therefore seeks to ascertain the current status of trial designs by identifying and evaluating the reporting of outcome domains and instruments in the treatment of adults with tinnitus. Records were identified by searching PubMed, EMBASE CINAHL, EBSCO, and CENTRAL clinical trial registries (ClinicalTrials.gov, ISRCTN, ICTRP) and the Cochrane Database of Systematic Reviews. Eligible records were those published from 1 July 2006 to 12 March 2015. Included studies were those reporting adults aged 18 years or older who reported tinnitus as a primary complaint, and who were enrolled into a randomised controlled trial, a before and after study, a non-randomised controlled trial, a case-controlled study or a cohort study, and written in English. Studies with fewer than 20 participants were excluded...
Objectives: It is well established that catastrophic misinterpretations and fear are involved in ... more Objectives: It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was expected to act as a mediator in reduced quality of life. Design: Sixty-one tinnitus patients from an outpatient ENT department of the University Hospital of Antwerp (Belgium) completed a number of questionnaires about their tinnitus. Hierarchical regression analyses were performed to test hypothesized associations and to assess mediation by tinnitus-related fear. Results: Analyses revealed significant associations between catastro-phizing and fear and between catastrophizing and increased attention toward the tinnitus. Furthermore, both tinnitus-related catastrophizing and fear were negatively associated with quality of life; moreover, tinnitus-related fear fully mediated the association between catastroph-izing about the tinnitus and quality of life. Conclusions: The findings confirm earlier suggestions that tinnitus-related concerns and fears are associated with impaired quality of life, which is in line with a cognitive behavioral account of chronic tinnitus. Future research avenues and clinical applications are discussed.
Ear and Hearing, 2011
Objectives: Tinnitus Disability Index (TDI) is presented as a novel and brief self-report measure... more Objectives: Tinnitus Disability Index (TDI) is presented as a novel and brief self-report measure for the assessment of the interference of tinnitus with performance in specific daily life activities. We hypothesized that the TDI is a reliable and valid measure and that tinnitus disability is strongly associated with tinnitus severity, subjective tinnitus intensity ratings, and ratings of general health.
Background Up to 21% of adults will develop tinnitus, which is one of the most distressing and de... more Background Up to 21% of adults will develop tinnitus, which is one of the most distressing and debilitating audiological problems. The absence of medical cures and standardised practice can lead to costly and prolonged treatment. We aimed to assess effectiveness of a stepped-care approach, based on cognitive behaviour therapy, compared with usual care in patients with varying tinnitus severity.
Journal of the American Academy of Audiology, 2014
Tinnitus can be defined as the perception of an auditory sensation, perceivable without the prese... more Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound. The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches. Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch. A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was establishe...
Ear and Hearing, 2011
Objectives: Expressing the outcomes of treatment in quality-adjusted life years is increasingly i... more Objectives: Expressing the outcomes of treatment in quality-adjusted life years is increasingly important as a tool to aid decision makers concerning the allocation of scarce resources within the health care sector. A quality-adjusted life year is a measure of life expectancy that is weighted by health-related quality of life. These weights are referred to as utility scores and are usually measured by multiattribute utility measures. Several studies found that different utility measures provide different estimates of the same person's level of utility. The aim of this study was to investigate which of two widely used utility measures, the EQ-5D and the HUI mark III, is preferred in a tinnitus population.
Ear and Hearing, 2013
The aim of this study was to examine the costs of tinnitus in The Netherlands from a health care ... more The aim of this study was to examine the costs of tinnitus in The Netherlands from a health care and a societal perspective. Furthermore, the impact of disease characteristics and demographic characteristics on these costs were examined. A bottom-up cost of illness study was performed, using the baseline data on a cost questionnaire of a randomized controlled trial investigating the (cost) effectiveness of an integral multidisciplinary treatment for tinnitus versus care as usual. Mean yearly costs were multiplied by the prevalence figure of tinnitus for the adult general population to estimate the total cost of illness of tinnitus to society. Because cost data usually are not normally distributed, a nonparametric bootstrap resampling procedure with 1000 simulations was performed to determine statistical uncertainty of the cost estimates per category. Several questionnaires measuring disease and demographic characteristics were administered. The impact of disease characteristics and demographics on costs was investigated using a multivariate regression analysis. Total mean societal cost of illness was €6.8 billion (95% confidence interval: €3.9 billion-€10.8 billion). The larger part of total cost of illness was not related to health care. Total mean health care costs were €1.9 billion (95% confidence interval: €1.4 billion-€2.5 billion). Significant predictors of both health care costs and societal costs were tinnitus severity, age, shorter duration of tinnitus, and more severe depression. The economical burden of tinnitus to society is substantial, and severity of tinnitus is an important predictor of the costs made by patients.
BMC Health Services Research, 2009
Background: Tinnitus is a common chronic health condition that affects 10% to 20% of the general ... more Background: Tinnitus is a common chronic health condition that affects 10% to 20% of the general population. Among severe sufferers it causes disability in various areas. As a result of the tinnitus, quality of life is often impaired. At present there is no cure or uniformly effective treatment, leading to fragmentized and costly tinnitus care. Evidence suggests that a comprehensive multidisciplinary approach in treating tinnitus is effective. The main objective of this study is to examine the effectiveness, costs, and cost-effectiveness of a comprehensive treatment provided by a specialized tinnitus center versus usual care. This paper describes the study protocol.
Otology & Neurotology, 2014
Background Up to 21% of adults will develop tinnitus, which is one of the most distressing and de... more Background Up to 21% of adults will develop tinnitus, which is one of the most distressing and debilitating audiological problems. The absence of medical cures and standardised practice can lead to costly and prolonged treatment. We aimed to assess eff ectiveness of a stepped-care approach, based on cognitive behaviour therapy, compared with usual care in patients with varying tinnitus severity.
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Papers by Rilana F F Cima