ORCID Profile
0000-0003-4923-9410
Current Organisation
Universiti Malaya
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Publisher: BMJ
Date: 08-2016
Publisher: EpiSmart Science Vector Ltd
Date: 2020
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: MDPI AG
Date: 19-02-2019
Abstract: The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adolescents has become a public health concern. The aim of this systematic review was to summarize evidence from observational studies related to diet and physical activity (PA) among Malaysian adolescents (13–18 years) and to recognize the associations between determinants of diet and PA and diet and PA behaviours. A systematic search for observational studies published from August 1990 through August 2017 was conducted via PubMed, Science Direct, Cochrane and Web of Science. A total of 18 studies met the inclusion criteria these were independently extracted by two reviewers. Gender and ethnicity were the most commonly studied correlates of diet and PA males were more physically active and they tended to have poorer diet quality and higher energy and macronutrient intakes in comparison to females Malay adolescents had a lower diet quality and Chinese adolescents spent less time in PA compared to other ethnicities. However, the significance of these associations was often small or inconsistent. This review highlights the lack of longitudinal observational studies but summarizes the best available evidence for policymakers and public health practitioners to improve the diet and the level of PA in Malaysian adolescents.
Publisher: Informa UK Limited
Date: 09-12-2021
DOI: 10.1080/01635581.2021.2013508
Abstract: This study aimed to evaluate the changes in post-diagnosis dietary intake of breast cancer survivors. A total of 112 participants from the Malaysian Breast Cancer Survivorship Cohort study with dietary intake at one-year post-diagnosis (T1) and three-year post-diagnosis (T2) were included. A three-day food record was used to assess the dietary intake of breast cancer survivors. The participants' anthropometrical measurements were measured at both time points (
Publisher: BMJ
Date: 10-2015
Publisher: Springer Science and Business Media LLC
Date: 10-02-2021
DOI: 10.1038/S41467-021-21134-2
Abstract: Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for ex le in low- and middle-income countries.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JAND.2017.05.024
Abstract: Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors. Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis. This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary. Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included. Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured. Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables. About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day interquartile range=7.2 g/day) and calcium (median=458 mg/day interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups. Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an in idualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship care.
Publisher: Springer Science and Business Media LLC
Date: 23-03-2018
DOI: 10.1007/S40258-018-0384-8
Abstract: Previous studies showed that offering BRCA mutation testing to population subgroups at high risk of harbouring the mutation may be cost effective, yet no evidence is available for low- or middle-income countries (LMIC) and in Asia. We estimated the cost effectiveness of BRCA mutation testing in early-stage breast cancer patients with high pre-test probability of harbouring the mutation in Malaysia, an LMIC in Asia. We developed a decision analytic model to estimate the lifetime costs and quality-adjusted life-years (QALYs) accrued through BRCA mutation testing or routine clinical surveillance (RCS) for a hypothetical cohort of 1000 early-stage breast cancer patients aged 40 years. In the model, patients would decide whether to accept testing and to undertake risk-reducing mastectomy, oophorectomy, tamoxifen, combinations or neither. We calculated the incremental cost-effectiveness ratio (ICER) from the health system perspective. A series of sensitivity analyses were performed. In the base case, testing generated 11.2 QALYs over the lifetime and cost US$4815 per patient whereas RCS generated 11.1 QALYs and cost US$4574 per patient. The ICER of US$2725/QALY was below the cost-effective thresholds. The ICER was sensitive to the discounting of cost, cost of BRCA mutation testing and utility of being risk-free, but the ICERs remained below the thresholds. Probabilistic sensitivity analysis showed that at a threshold of US$9500/QALY, 99.9% of simulations favoured BRCA mutation testing over RCS. Offering BRCA mutation testing to early-stage breast cancer patients identified using a locally-validated risk-assessment tool may be cost effective compared to RCS in Malaysia.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2019
Publisher: SAGE Publications
Date: 08-12-2017
Abstract: Background. The use of complementary and alternative medicine (CAM) has increased and little is known on CAM use during the initial period. Therefore, the aim was to determine prevalence of CAM use among newly diagnosed breast cancer patients prior to seeking conventional treatment. Methods. This is a cross-sectional study involved interviewing newly diagnosed breast cancer patients in the University Malaya Medical Centre (UMMC) using a structured questionnaire. Eligible respondents were interviewedduring a routine clinical visit. Results. A total of 400 patients were interviewed, of whom 139 (34.8%) were CAM users. Dietary supplementation (n = 107, 77.0%) was the most frequently used type of CAM, followed by spiritual healing (n = 40, 28.8%) and traditional Chinese medicine (n = 32, 23.0%). Malay ethnic group (n = 61, 43.9%) was the largest group of CAM users, followed by Chinese (n = 57, 41.0%) and Indian (n = 20, 14.4%). Majority of these CAM users (n = 87, 73.1%) did not disclose the use of CAM to their doctors. Most of them used remedies based on the recommendation of family and friends. Malay ethnicity and patients with 3 or more comorbidities were more likely to use CAM. Conclusion. There is substantial use of CAM among breast cancer patients in UMMC prior to seeking hospital treatment, and the most popular CAM modality is dietary supplements. Since, the majority of CAM users do not disclose the use of CAM to their physicians, therefore health care providers should ensure that those patients who are likely to use CAM are appropriately counseled and advised.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 12-2019
DOI: 10.1200/JGO.19.00011
Abstract: The main objective of this systematic review was to identify whether mass and small media interventions improve knowledge and attitudes about cancer, cancer screening rates, and early detection of cancer in Asia. The review was conducted according to a predefined protocol. Medline, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar were searched in September 2017, and data extraction and rating of methodologic study quality (according to Joanna Briggs Institute rating procedures) were performed independently by reviewers. Twenty-two studies (reported across 24 papers) met the inclusion criteria. Most studies (n = 21) were conducted in high or upper-middle income countries targeted breast (n = 11), cervical (n = 7), colorectal (n = 3), or oral (n = 2) cancer and used small media either alone (n = 15) or in combination with mass media and other components (n = 5). Studies regarding cancer screening uptake were of medium to high quality and mainly reported positive outcomes for cervical cancer and mixed results for breast and colorectal cancer. The methodologic strength of research that investigated change in cancer-related knowledge and the cost effectiveness of interventions, respectively, were weak and inconclusive. Evidence indicated that small media c aigns seemed to be effective in terms of increasing screening uptake in Asia, in particular cervical cancer screening. Because of the limited number of studies in Asia, it was not possible to be certain about the effectiveness of mass media in improving screening uptake and the effectiveness of c aigns in improving cancer-related knowledge.
Publisher: MDPI AG
Date: 22-11-2019
Abstract: Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13–17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3) however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health.
Publisher: SAGE Publications
Date: 05-2020
Abstract: Good nutrition in the first “1000 days,” including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
Publisher: Public Library of Science (PLoS)
Date: 07-02-2018
Publisher: Frontiers Media SA
Date: 22-09-2020
Publisher: Cambridge University Press (CUP)
Date: 03-08-2020
DOI: 10.1017/S1368980020002293
Abstract: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents. A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data. Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia. Focus groups were conducted with seventy-six adolescents aged 13–14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators. Stakeholders thought that adolescents’ misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers’ commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA. These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-06-2013
DOI: 10.7314/APJCP.2013.14.6.3799
Abstract: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage s ling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.
Publisher: Cambridge University Press (CUP)
Date: 22-06-2020
DOI: 10.1017/S0007114520002202
Abstract: The longitudinal relationship between muscle strength, dietary intake and physical activity among adolescents is not well understood. We investigated the trend and longitudinal effects of dietary intakes and physical activity scores on muscle strength in adolescents. This prospective cohort study consisted of 436 adolescents (134 males 302 females) aged 13 years at baseline (2012) who were followed up at the ages of 15 (2014) and 17 (2016) years, respectively. We measured muscle strength using a calibrated hand dynamometer, estimated dietary intake with a 7-d dietary history and physical activity scores with a validated physical activity questionnaire for older children. A generalised estimating equation was used to examine the effect of dietary intakes and physical activity on muscle strength changes. The analysis was performed separately by sex. The muscle strength for males and females had increased within the 5-year period. The dietary intakes (energy and macronutrients) also increased initially but plateaued after the age of 15 years for both sexes. Females recorded a significant declining trend in physical activity scores compared with males as they grew older. A significant positive longitudinal relationship was found between protein ( β = 0·035 P = 0·016), carbohydrate intake ( β = 0·002 P = 0·013) and muscle strength among males. However, no longitudinal relationship was found between dietary intake, physical activity and muscle strength among females. Higher protein and carbohydrate intake among males was associated with higher muscle strength but was not observed in females. Nutrition and physical activity focusing on strength building are required in early adolescence and need to be tailored to males and females accordingly.
Publisher: MDPI AG
Date: 03-09-2021
Abstract: Breast cancer (BC) is the most common cancer among women globally, including in Malaysia. There is a need to assess women’s beliefs about BC and screening in different cultural settings. This study aimed to translate and validate an adapted version of the United States (US) Ch ion Health Belief Model Scale (CHBMS) for an investigation of predictors of BC screening in Malaysia. The CHBMS was adapted, and forward and backward translated into the Malay language. The validity and reliability of the CHBMS-BC-M (M for Malay language) was investigated in a community s le of 251 multi-ethnic Malay-speaking women. Principal component analysis with varimax rotation indicated that the structure of the adapted CHBMS-BC-M comprised three subscales with 21 items, and an Item-Content Validity Index (I-CVI) of 0.83 and above for all items. The explanatory factor analysis (EFA) showed acceptable to high factor loadings on items. Cronbach’s alpha for the subscales ranged from 0.59 to 0.87. The reproducibility of the scale was fair to high, with an Intraclass Correlation Coefficient (ICC) of 0.53 to 0.80 for the subscales. Overall, the analysis indicated that the translated CHBMS-BC-M is a valid and reliable scale to measure beliefs about BC and screening in the Malay-speaking ethnic population of Malaysia.
Publisher: MDPI AG
Date: 30-06-2022
DOI: 10.3390/NU14132733
Abstract: A healthy eating environment in the school setting is crucial to nurture the healthy eating pattern for youth. Thus, it helps to combat the obesity issue. However, the impact of healthy school environment on healthy eating habits among Asian adolescents is scarce and less clear. This clustered randomised-control study has two objectives. The first objective was to evaluate the changes in adolescents’ dietary intake after the interventions for all arms (control healthy cooking training only subsidization with healthy cooking training). The second objective was to compare the effect of subsidization with healthy cooking training and healthy cooking training only with the control arm on adolescents’ dietary intakes. This study consisted of 340 secondary school students aged 14 years in rural and urban Malaysia. A total of two arms of intervention and one arm of control were included. Intervention one focused on healthy cooking preparation for the canteen and convenience shop operators. Intervention two included subsidization for fruits and vegetables with a healthy cooking preparation training for the canteen and suggestions on providing healthy options to the convenience shop operators. The outcome measured was changes to dietary intake. It was measured using a three-day dietary history pre- and post-intervention. A paired-t test was used to evaluate the outcome of intervention programmes on dietary changes for all arms (control, intervention one and two). An ANCOVA test was used to investigate the effect of providing subsidization and healthy cooking preparation training to the canteen and convenience shop operators on adolescents’ dietary intakes as compared to the control arm. Overall, the reduction in energy and carbohydrates for all arms were observed. Interestingly, fat intake was significantly increased after the four-week intervention programme under healthy cooking intervention but not in the food subsidization group. When comparing between control, healthy cooking training only and subsidization with the healthy cooking training arm, there was no significant changes between arms. A robust intervention to include subsidization of healthy foods for intervention programmes at schools in a larger scale study is needed to confirm this finding.
Publisher: SAGE Publications
Date: 11-2018
Abstract: Good nutrition for infants, during the first 1000 days from conception, is one of the most important determinants of a healthy long life. Breastfeeding is the most important component of infant nutrition and reduces morbidity and mortality. With the changes to the climate currently occurring, issues of nutrition and food supply are only going to increase in importance. The Sustainable Development Goals of the United Nations, place nutrition at the forefront of world development and a sustainable planet. The vision of Asia-Pacific Academic Consortium for Public Health (APACPH) is to “achieve the highest possible level of health of all the people of the nations of the Asia-Pacific region.” Much of the burden of disease, early deaths, and disability in the Asia Pacific region could be reduced with public health efforts to address the major risk factors, including nutrition-related causes and smoking. The United Nations Decade of Action on Nutrition 2016-2025 has recently been launched with the aim of reducing the global burden of inappropriate nutrition. The goals include increasing rates of exclusive breastfeeding to 6 months, reducing wasting and stunting, and reducing the rates of low birthweight. This is the position endorsed in these guidelines along with the principles of the Baby Friendly Hospital Initiative. These guidelines expand the information on infants that was included in the 2016 APACPH Dietary Guidelines. APACPH covers many different environments, geographical areas, cultures, and socioeconomic groups. These guidelines are generally applicable to all infants in our region, specific local advice may sometimes be needed.
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/174821
Abstract: Objectives . This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. Methods . A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-s ling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results . Altogether, 882 in iduals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions . The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2018
Publisher: Oxford University Press (OUP)
Date: 04-10-2019
DOI: 10.1093/TBM/IBZ134
Abstract: We used a cultural adaptation framework and local partnership working in Malaysia to translate and implement an established cancer awareness-raising mass media c aign.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2013.01.006
Abstract: To determine the predictors of death in Malaysian HIV-infected patients undergoing antiretroviral therapy (ART). Data from 845 HIV-infected patients aged ≥ 20 years on ART in a large teaching hospital in Malaysia from 1989 to 2009 were analyzed using Kaplan-Meier and Cox regression analyses. 72.7% of the patients survived. Multivariate Cox regression showed that significant predictors of death were age ≥ 50 years (HR 1.76 95% CI 1.18-2.64), secondary education (HR 3.57 95% CI 1.12-11.37), tertiary education (HR 3.57 95% CI 1.09-11.70), being unemployed (HR 1.49 95% CI 1.07-2.09), AIDS on initial presentation (HR 5.75 95% CI 3.29-10.07), single-drug ART (HR 1.84 95% CI 1.27, 2.66), double-drug ART (HR 1.63 95% CI 1.19-2.25) and inability to achieve viral load ≤ 50 copies/ml (HR 10.22 95% CI 7.26-14.37). Every effort needs to be made to ensure that all HIV patients have access to triple drug ART, to lower viral load to ≤ 50 copies/ml and to treat HIV patients before they progress to AIDS as these are significant modifiable predictors of death in Malaysian HIV patients.
Publisher: MDPI AG
Date: 09-2021
DOI: 10.3390/NU13093078
Abstract: This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student’s perception of healthy food and their eating habits, which also affect the food vendors’ profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: MDPI AG
Date: 30-01-2022
Abstract: This study evaluated the impact of the ‘Be Cancer Alert’ mass media c aign for breast cancer (BCAC-BC) in terms of changes to women’s health beliefs regarding BC susceptibility and the benefits and barriers of breast cancer screening in Malaysia. Pre- and post-c aign surveys evaluated changes in health beliefs among women aged 40 years and above (n = 676). The perceived susceptibility to breast cancer was significantly higher at follow-up (mean ± SD: 7.30 ± 2.77 vs. 7.63 ± 2.58, p = 0.008) whereas the mean score for the perceived benefits of undertaking screening was high at baseline and follow-up (16.34 ± 2.36 vs. 15.95 ± 2.07, p = 0.001). The perceptions or beliefs about barriers to screening did not change significantly (31.70 ± 8.26 vs. 31.77 ± 7.63, p = 0.841). Regression analyses indicated that mean scores for the barriers subscale were significantly lower among Chinese women (−2.61, 95% CI −4.67, −0.55, p = 0.013) compared to Malay, and among single compared to married women (−2.40, 95% CI −4.60, −0.21, p = 0.032) after adjustment for other demographic variables and past screening history. Malaysian women appeared to already have positive perceptions before the BCAC-BC mass media c aign about the benefits of BC screening. However, the c aign appeared to be linked to both an increased awareness of the susceptibility to breast cancer and to positive beliefs that countered emotional barriers to screening, particularly among single women and Chinese-Malay women.
Publisher: Wiley
Date: 12-07-2023
DOI: 10.1111/BCP.15818
Abstract: Despite the availability of newer antiseizure medications, carbamazepine (CBZ) remains the gold standard. However, patients of Asian ancestry are susceptible to CBZ‐related severe cutaneous adverse reactions. Universal HLA‐B*15:02 screening is a promising intervention to address this. With the increasing recognition of integrating real‐world evidence in economic evaluations, the cost‐effectiveness of universal HLA‐B*15:02 screening was assessed using available real‐world data in Malaysia. A hybrid model of a decision tree and Markov model was developed to evaluate 3 strategies for treating newly diagnosed epilepsy among adults: (i) CBZ initiation without HLA‐B*15:02 screening (current practice) (ii) universal HLA‐B*15:02 screening prior to CBZ initiation and (iii) alternative prescribing without HLA‐B*15:02 screening. The model was populated with real‐world inputs derived from the Malaysian population. From a societal perspective, base‐case analysis and sensitivity analyses estimated the costs and outcomes over a lifetime. Incremental cost‐effectiveness ratios were calculated. In the base‐cases analysis, universal HLA‐B*15:02 screening yielded the lowest total costs and the highest total quality‐adjusted life years (QALYs) gained. Compared with current practice, universal screening was less costly by USD100 and more effective by QALYs increase of 0.1306, while alternative prescribing resulted in 0.1383 QALYs loss at additional costs of USD332. The highest seizure remission rate (56%) was estimated for universal HLA‐B*15:02 screening vs . current practice (54%) and alternative prescribing (48%). Our study suggests that universal HLA‐B*15:02 screening is a cost‐effective intervention in Malaysia. With the demonstrated value of real‐world evidence in economic evaluations, more relevant standardization efforts should be emphasized to better inform decision‐making.
Publisher: Springer Science and Business Media LLC
Date: 12-09-2016
Publisher: Public Library of Science (PLoS)
Date: 11-06-2015
Publisher: Springer Science and Business Media LLC
Date: 05-03-2021
DOI: 10.1038/S41467-021-22038-X
Abstract: A Correction to this paper has been published: 0.1038/s41467-021-22038-x.
No related grants have been discovered for Maznah Dahlui.