Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
- Messages
- 3,061
- Location
- UK
http://www.nets.nihr.ac.uk/__data/assets/pdf_file/0016/150181/PRO-14-26-08.pdf
"The proposed review will use a broad definition of MUS, which encompasses all of the above definitions, so that the term MUS will be used to refer to any of the following definitions:
i) the occurrence of physical symptoms in the absence of clear physical pathology,
ii) to functional somatic syndromes such as CFS, IBS or fibromyalgia,
iii) the DSM-IV (and more recently V) somatoform disorders and
iv) somatoform disorders that have their own diagnostic criteria e.g. bodily distress syndrome.
The reason for this broad definition is that there is clear overlap between these groups and as yet no consensus as to the validity of one syndrome (i.e. MUS) versus many (i.e. the various FSS). Whether patients are diagnosed with MUS as opposed to a more specific diagnosis can be an artefact of clinician or researcher preference rather a defining feature of the included patients (Fink & Schröder, 2010, Wessley et al., 1999, Shorter et al, 1995)."
(...)
"Given that the term ‘medically unexplained symptoms’ may be used to cover a broad range of health conditions, it is expected that the clinical effectiveness review will identify studies covering a range of populations. As different interventions may work differently depending on the type of symptoms, separate models will be developed for each population identified within the clinical effectiveness review. The population covered by each model will be based on clinical advice regarding the differences and similarities between the populations included within the identified clinical effectiveness studies. If it becomes clear that it is not feasible to conduct a de novo economic evaluation for each separate population then de novo modelling with be prioritised based on the current extent of uncertainty over cost-effectiveness, the likelihood that further economic modelling would reduce that uncertainty and the size of the population likely to receive the intervention. This decision will take into account the evidence identified during the review of published cost-effectiveness analyses, the estimates of effectiveness, and uncertainty surrounding those estimates, based on the clinical effectiveness review, and information from the clinical advisers on the likely impact of the intervention on costs and benefits across the population likely to receive the intervention."
"Where data allows we will estimate cost-effectiveness compared to the current standard of NHS care in that population (usual care). Where there is evidence for more than one type of intervention within a particular population then incremental cost-effectiveness will be estimated to determine the most cost-effective intervention for that population across a range of willingness to pay thresholds."
"The proposed review will use a broad definition of MUS, which encompasses all of the above definitions, so that the term MUS will be used to refer to any of the following definitions:
i) the occurrence of physical symptoms in the absence of clear physical pathology,
ii) to functional somatic syndromes such as CFS, IBS or fibromyalgia,
iii) the DSM-IV (and more recently V) somatoform disorders and
iv) somatoform disorders that have their own diagnostic criteria e.g. bodily distress syndrome.
The reason for this broad definition is that there is clear overlap between these groups and as yet no consensus as to the validity of one syndrome (i.e. MUS) versus many (i.e. the various FSS). Whether patients are diagnosed with MUS as opposed to a more specific diagnosis can be an artefact of clinician or researcher preference rather a defining feature of the included patients (Fink & Schröder, 2010, Wessley et al., 1999, Shorter et al, 1995)."
(...)
"Given that the term ‘medically unexplained symptoms’ may be used to cover a broad range of health conditions, it is expected that the clinical effectiveness review will identify studies covering a range of populations. As different interventions may work differently depending on the type of symptoms, separate models will be developed for each population identified within the clinical effectiveness review. The population covered by each model will be based on clinical advice regarding the differences and similarities between the populations included within the identified clinical effectiveness studies. If it becomes clear that it is not feasible to conduct a de novo economic evaluation for each separate population then de novo modelling with be prioritised based on the current extent of uncertainty over cost-effectiveness, the likelihood that further economic modelling would reduce that uncertainty and the size of the population likely to receive the intervention. This decision will take into account the evidence identified during the review of published cost-effectiveness analyses, the estimates of effectiveness, and uncertainty surrounding those estimates, based on the clinical effectiveness review, and information from the clinical advisers on the likely impact of the intervention on costs and benefits across the population likely to receive the intervention."
"Where data allows we will estimate cost-effectiveness compared to the current standard of NHS care in that population (usual care). Where there is evidence for more than one type of intervention within a particular population then incremental cost-effectiveness will be estimated to determine the most cost-effective intervention for that population across a range of willingness to pay thresholds."
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............cobblers.
