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  1. Article ; Online: A population-based approach for implementing change from opt-out to opt-in research permissions.

    Elizabeth A Marshall / Jim C Oates / Azza Shoaibi / Jihad S Obeid / Melissa L Habrat / Robert W Warren / Kathleen T Brady / Leslie A Lenert

    PLoS ONE, Vol 12, Iss 4, p e

    2017  Volume 0168223

    Abstract: Due to recently proposed changes in the Common Rule regarding the collection of research preferences, there is an increased need for efficient methods to document opt-in research preferences at a population level. Previously, our institution developed an ...

    Abstract Due to recently proposed changes in the Common Rule regarding the collection of research preferences, there is an increased need for efficient methods to document opt-in research preferences at a population level. Previously, our institution developed an opt-out paper-based workflow that could not be utilized for research in a scalable fashion. This project was designed to demonstrate the feasibility of implementing an electronic health record (EHR)-based active opt-in research preferences program. The first phase of implementation required creating and disseminating a patient questionnaire through the EHR portal to populate discreet fields within the EHR indicating patients' preferences for future research study contact (contact) and their willingness to allow anonymised use of excess tissue and fluid specimens (biobank). In the second phase, the questionnaire was presented within a clinic nurse intake workflow in an obstetrical clinic. These permissions were tabulated in registries for use by investigators for feasibility studies and recruitment. The registry was also used for research patient contact management using a new EHR encounter type to differentiate research from clinical encounters. The research permissions questionnaire was sent to 59,670 patients via the EHR portal. Within four months, 21,814 responses (75% willing to participate in biobanking, and 72% willing to be contacted for future research) were received. Each response was recorded within a patient portal encounter to enable longitudinal analysis of responses. We obtained a significantly lower positive response from the 264 females who completed the questionnaire in the obstetrical clinic (55% volunteers for biobank and 52% for contact). We demonstrate that it is possible to establish a research permissions registry using the EHR portal and clinic-based workflows. This patient-centric, population-based, opt-in approach documents preferences in the EHR, allowing linkage of these preferences to health record information.
    Keywords Medicine ; R ; Science ; Q
    Subject code 020
    Language English
    Publishing date 2017-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Contextualising adverse events of special interest to characterise the baseline incidence rates in 24 million patients with COVID-19 across 26 databases

    Erica A. Voss / Azza Shoaibi / Lana Yin Hui Lai / Clair Blacketer / Thamir Alshammari / Rupa Makadia / Kevin Haynes / Anthony G. Sena / Gowtham Rao / Sebastiaan van Sandijk / Clement Fraboulet / Laurent Boyer / Tanguy Le Carrour / Scott Horban / Daniel R. Morales / Jordi Martínez Roldán / Juan Manuel Ramírez-Anguita / Miguel A. Mayer / Marcel de Wilde /
    Luis H. John / Talita Duarte-Salles / Elena Roel / Andrea Pistillo / Raivo Kolde / Filip Maljković / Spiros Denaxas / Vaclav Papez / Michael G. Kahn / Karthik Natarajan / Christian Reich / Alex Secora / Evan P. Minty / Nigam H. Shah / Jose D. Posada / Maria Teresa Garcia Morales / Diego Bosca / Honorio Cadenas Juanino / Antonio Diaz Holgado / Miguel Pedrera Jiménez / Pablo Serrano Balazote / Noelia García Barrio / Selçuk Şen / Ali Yağız Üresin / Baris Erdogan / Luc Belmans / Geert Byttebier / Manu L.N.G. Malbrain / Daniel J. Dedman / Zara Cuccu / Rohit Vashisht / Atul J. Butte / Ayan Patel / Lisa Dahm / Cora Han / Fan Bu / Faaizah Arshad / Anna Ostropolets / Fredrik Nyberg / George Hripcsak / Marc A. Suchard / Dani Prieto-Alhambra / Peter R. Rijnbeek / Martijn J. Schuemie / Patrick B. Ryan

    EClinicalMedicine, Vol 58, Iss , Pp 101932- (2023)

    a multinational retrospective cohort studyResearch in context

    2023  

    Abstract: Summary: Background: Adverse events of special interest (AESIs) were pre-specified to be monitored for the COVID-19 vaccines. Some AESIs are not only associated with the vaccines, but with COVID-19. Our aim was to characterise the incidence rates of ... ...

    Abstract Summary: Background: Adverse events of special interest (AESIs) were pre-specified to be monitored for the COVID-19 vaccines. Some AESIs are not only associated with the vaccines, but with COVID-19. Our aim was to characterise the incidence rates of AESIs following SARS-CoV-2 infection in patients and compare these to historical rates in the general population. Methods: A multi-national cohort study with data from primary care, electronic health records, and insurance claims mapped to a common data model. This study's evidence was collected between Jan 1, 2017 and the conclusion of each database (which ranged from Jul 2020 to May 2022). The 16 pre-specified prevalent AESIs were: acute myocardial infarction, anaphylaxis, appendicitis, Bell's palsy, deep vein thrombosis, disseminated intravascular coagulation, encephalomyelitis, Guillain- Barré syndrome, haemorrhagic stroke, non-haemorrhagic stroke, immune thrombocytopenia, myocarditis/pericarditis, narcolepsy, pulmonary embolism, transverse myelitis, and thrombosis with thrombocytopenia. Age-sex standardised incidence rate ratios (SIR) were estimated to compare post-COVID-19 to pre-pandemic rates in each of the databases. Findings: Substantial heterogeneity by age was seen for AESI rates, with some clearly increasing with age but others following the opposite trend. Similarly, differences were also observed across databases for same health outcome and age-sex strata. All studied AESIs appeared consistently more common in the post-COVID-19 compared to the historical cohorts, with related meta-analytic SIRs ranging from 1.32 (1.05 to 1.66) for narcolepsy to 11.70 (10.10 to 13.70) for pulmonary embolism. Interpretation: Our findings suggest all AESIs are more common after COVID-19 than in the general population. Thromboembolic events were particularly common, and over 10-fold more so. More research is needed to contextualise post-COVID-19 complications in the longer term. Funding: None.
    Keywords COVID-19 ; Observational research ; OMOP CDM ; Adverse events of special interest ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Seek COVER

    Ross D. Williams / Aniek F. Markus / Cynthia Yang / Talita Duarte-Salles / Scott L. DuVall / Thomas Falconer / Jitendra Jonnagaddala / Chungsoo Kim / Yeunsook Rho / Andrew E. Williams / Amanda Alberga Machado / Min Ho An / María Aragón / Carlos Areia / Edward Burn / Young Hwa Choi / Iannis Drakos / Maria Tereza Fernandes Abrahão / Sergio Fernández-Bertolín /
    George Hripcsak / Benjamin Skov Kaas-Hansen / Prasanna L. Kandukuri / Jan A. Kors / Kristin Kostka / Siaw-Teng Liaw / Kristine E. Lynch / Gerardo Machnicki / Michael E. Matheny / Daniel Morales / Fredrik Nyberg / Rae Woong Park / Albert Prats-Uribe / Nicole Pratt / Gowtham Rao / Christian G. Reich / Marcela Rivera / Tom Seinen / Azza Shoaibi / Matthew E. Spotnitz / Ewout W. Steyerberg / Marc A. Suchard / Seng Chan You / Lin Zhang / Lili Zhou / Patrick B. Ryan / Daniel Prieto-Alhambra / Jenna M. Reps / Peter R. Rijnbeek

    BMC Medical Research Methodology, Vol 22, Iss 1, Pp 1-

    using a disease proxy to rapidly develop and validate a personalized risk calculator for COVID-19 outcomes in an international network

    2022  Volume 13

    Abstract: Abstract Background We investigated whether we could use influenza data to develop prediction models for COVID-19 to increase the speed at which prediction models can reliably be developed and validated early in a pandemic. We developed COVID-19 ... ...

    Abstract Abstract Background We investigated whether we could use influenza data to develop prediction models for COVID-19 to increase the speed at which prediction models can reliably be developed and validated early in a pandemic. We developed COVID-19 Estimated Risk (COVER) scores that quantify a patient’s risk of hospital admission with pneumonia (COVER-H), hospitalization with pneumonia requiring intensive services or death (COVER-I), or fatality (COVER-F) in the 30-days following COVID-19 diagnosis using historical data from patients with influenza or flu-like symptoms and tested this in COVID-19 patients. Methods We analyzed a federated network of electronic medical records and administrative claims data from 14 data sources and 6 countries containing data collected on or before 4/27/2020. We used a 2-step process to develop 3 scores using historical data from patients with influenza or flu-like symptoms any time prior to 2020. The first step was to create a data-driven model using LASSO regularized logistic regression, the covariates of which were used to develop aggregate covariates for the second step where the COVER scores were developed using a smaller set of features. These 3 COVER scores were then externally validated on patients with 1) influenza or flu-like symptoms and 2) confirmed or suspected COVID-19 diagnosis across 5 databases from South Korea, Spain, and the United States. Outcomes included i) hospitalization with pneumonia, ii) hospitalization with pneumonia requiring intensive services or death, and iii) death in the 30 days after index date. Results Overall, 44,507 COVID-19 patients were included for model validation. We identified 7 predictors (history of cancer, chronic obstructive pulmonary disease, diabetes, heart disease, hypertension, hyperlipidemia, kidney disease) which combined with age and sex discriminated which patients would experience any of our three outcomes. The models achieved good performance in influenza and COVID-19 cohorts. For COVID-19 the AUC ranges were, COVER-H: ...
    Keywords Patient-level prediction modelling ; COVID-19 ; Risk score ; Medicine (General) ; R5-920
    Subject code 310
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Use of evidence to support healthy public policy

    Sarah Bowman / Nigel Unwin / Julia Critchley / Simon Capewell / Abdullatif Husseini / Wasim Maziak / Shahaduz Zaman / Habiba Ben Romdhane / Fouad Fouad / Peter Phillimore / Belgin Unal / Rana Khatib / Azza Shoaibi / Balsam Ahmad

    Bulletin of the World Health Organization, Vol 90, Iss 11, Pp 847-

    a policy effectiveness-feasibility loop

    2012  Volume 853

    Abstract: Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account ...

    Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a "policy effectiveness-feasibility loop" (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2012-11-01T00:00:00Z
    Publisher World Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

    Helen Mason / Azza Shoaibi / Rula Ghandour / Martin O'Flaherty / Simon Capewell / Rana Khatib / Samer Jabr / Belgin Unal / Kaan Sözmen / Chokri Arfa / Wafa Aissi / Habiba Ben Romdhane / Fouad Fouad / Radwan Al-Ali / Abdullatif Husseini / MedCHAMPS project team

    PLoS ONE, Vol 9, Iss 1, p e

    2014  Volume 84445

    Abstract: Background Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a ... ...

    Abstract Background Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and findings Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives.
    Keywords Medicine ; R ; Science ; Q
    Subject code 333 ; 360
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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