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Karlskrona, Sweden

Ferrandis M.-J.,Blekinge County Hospital | Ferrandis M.-J.,Uppsala University | Ryden I.,Uppsala University | Ryden I.,Roche Holding AG | And 2 more authors.
Upsala Journal of Medical Sciences | Year: 2013

Objectives. To estimate the possible economic benefit of a sequential testing strategy with NT-proBNP to reduce the number of echocardiographies. Methods. Retrospective study in a third-party payer perspective. The costs were calculated from three Swedish counties: Blekinge, Östergötland, and Uppland. Two cut-off levels of NT-proBNP were used: 400 and 300 pg/mL. The cost-effectiveness of the testing strategy was estimated through the short-term cost avoidance and reduction in demand for echocardiographies. Results. The estimated costs for NT-proBNP tests and echocardiographies per county were reduced by 33%-36% with the 400 pg/mL cut-off and by 28%-29% with the 300 pg/mL cut-off. This corresponded to a yearly cost reduction of approximately €2-5 million per million inhabitants in these counties. Conclusion. The use of NT-proBNP as a screening test could substantially reduce the number of echocardiographies in the diagnostic work-up of patients with suspected cardiac failure, as well as the associated costs. © 2013 Informa Healthcare.

Rakus-Andersson E.,Blekinge Institute of Technology | Frey J.,Blekinge County Hospital | Rutkowska D.,Czestochowa University of Technology
Lecture Notes in Artificial Intelligence (Subseries of Lecture Notes in Computer Science) | Year: 2015

In the current paper we mathematically try to support the decision concerning the treatment with hyperbaric oxygen for patients, suffering from necrotizing fasciitis. To accomplish the task, we involve the fuzzified model of a quasi-perceptron, which is our modification of the classical artificial simple neuron. By means of the fuzzification of input signals and output decision levels, we wish to distinguish between decisions "treatment without recommended hyperbaric oxygen" versus "treatment with hyperbaric oxygen". The number of decision levels can be arbitrary in order to extend the decision scale. © Springer International Publishing Switzerland 2015.

Zettervall H.,Blekinge Institute of Technology | Rakus-Andersson E.,Blekinge Institute of Technology | Frey J.,Blekinge County Hospital
International Journal on Advances in Life Sciences | Year: 2013

Apart from the probabilistic model and the model of 2-tuple linguistic representations, a new extension of the fuzzy set, known as the hesitant fuzzy linguistic term set can be seen as the third representative of linguistic approaches. In this paper, we focus on multi-expert decision-making problems, in which a group of physicians are independently asked for assessing the effectiveness of a set of treatment therapies. Our goal is to rank the effectiveness of treatment modalities from the most recommended to the contraindicated. Two individual prostate cancer patients have been taken into account in the practical studies. For the first patient, the probabilistic model and the model of 2-tuple linguistic representations have been adopted to accomplish the medical application. Whereas, for the second patient, the approach of hesitant fuzzy linguistic term set has been used to make the medication prognoses. Moreover, the continuous fuzzy numbers in the Left-Right representations are used to mathematically express the experts' judgments and s-parametric membership functions are designed to represent the fuzzy linguistic terms. © 2013 by authors.

Olerud F.,Skane University Hospital | Olsson C.,Blekinge County Hospital | Flivik G.,Skane University Hospital
HIP International | Year: 2014

Previous experience has demonstrated the importance of testing new bone cement in vivo before widespread clinical use. We performed a consecutive, radiostereometric (RSA) study comparing Refobacin Bone Cement (RBC) to the well proven Palacos with Gentamicin (PWG). According to the manufacturer of RBC it has the equivalent characteristics as PWG, and in vitro tests show good results. The purpose of this study was to evaluate whether RBC is safe to use in clinical practice for total hip arthroplasty (THA). Two consecutive series of patients with primary osteoarthritis received a THA using a highly polished, collarless, tapered stem with a hollow centralizer. The study comprises 21 hips with RBC and 30 with PWG. The patients were followed up for two years with repeated RSA examinations and clinical outcome questionnaires SF-12 and WOMAC. There were no statistically significant migratory differences between the groups. The mean subsidence after two years was 1.28 mm and 1.40 mm, and the mean retroversion was 1.03° and 0.99°, for the RBC and the PWG groups respectively. Almost all migration occurred in the interface between the stem and the cement. The WOMAC and SF12 clinical scores did not reveal any clinical differences between the groups. We conclude that, as previous in vitro tests indicate, RBC performs as well as PWG and seems to be safe to use in clinical practice for THA. © 2013 Wichtig Editore.

Rakus-Andersson E.,Blekinge Institute of Technology | Frey J.,Blekinge County Hospital
Advances in Intelligent Systems and Computing | Year: 2015

We modify the classical fuzzy decision making model by adopting the concept of the Choquet integral as a measure of the therapy utility, when proving different treatments in radiation cystitis. The objective is to rank therapies as a sequence, commencing with the most efficacious remedy. © Springer International Publishing Switzerland 2015.

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