Economic Impact of Using an Immunostimulating Agent to Prevent Severe Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease
Bibliographic record
Abstract
RATIONALE: OM-85 BV, an immunostimulant made from bacterial extracts, has been shown to reduce the risk of hospitalization for acute exacerbation in patients with chronic obstructive pulmonary disease, as well as to reduce the length of stay for all hospitalizations. METHODS: In conjunction with a placebo controlled, randomized clinical trial, a cost effectiveness analysis was carried out to assess the economic impact of using OM-85 BV. In the analysis, effectiveness was defined as the difference in the number of severe acute exacerbations, assessed by the number of hospitalizations for a respiratory problem, between the placebo and OM-85 BV-treated groups. RESULTS: The median cost to prevent one day of hospitalization for a respiratory condition was CDN$45, with a 95% CI of CDN$18 to CDN$210. Bootstrap of the study population and sensitivity analyses showed that the results were robust and not likely due to random fluctuation; 98.8% of the cost effectiveness and 96.8% of the cost-benefit ratios favoured the use of OM-85 BV. Indirect costs, defined as a need for help, were reduced by 36% in the group treated with OM-85 BV: 779 h of help compared with 1212 h in the placebo group. This trend, while not significant, is consistent with other results and suggests a decrease in the severity of exacerbations in the OM-85 BV-treated group. CONCLUSION: Given the high prevalence of chronic obstructive pulmonary disease worldwide and the high cost of acute exacerbations, immunostimulants may become a key element in the improved control of this condition.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".