Kari Jorunn Kværner

Tidsskrift for Den norske legeforening (Tidsskriftet) 143(7) s. 1-10 Doi: https://doi.org/10.4045/tidsskr.22.0436

BAKGRUNN Formålet med studien var å undersøke om nedgradering av eksterne henvisninger til pakkeforløp for brystkreft har vært medisinsk forsvarlig og ført til en riktigere prioritering av pasienter inn i spesialisthelsetjenesten. MATERIALE OG METODE Studien inkluderte 214 eksterne henvisninger til pakkeforløp for brystkreft ved Brystdiagnostisk senter, Oslo universitetssykehus som i 2020 ble nedgradert fordi de nasjonale kriteriene ikke var oppfylt. Informasjon som ble innhentet fra elektronisk pasientjournal, var alder, bydel, navn på henvisende lege, resultat etter utredning og behandling samt anbefalt tidspunkt for utredningsstart. Kvalitet på henvisningene ble også vurdert. RESULTATER Andelen pasienter som ble diagnostisert med brystkreft, var 3 % (7/214). Fem var i aldersgruppen 40–50 år (9 %, 5/56), én var over 50 år (1/31) og én var i aldersgruppen 35–40 år (1/38). Ingen var under 35 år. Totalt 95 leger fikk sine henvisninger nedgradert. FORTOLKNING Studien indikerte at nedgradering av henvisninger til pakkeforløp for brystkreft førte til en riktigere prioritering av pasienter til spesialisthelsetjenesten. Resultatene indikerte at nedgraderingen var medisinsk forsvarlig for aldersgruppen under 35 år og over 50 år, men at det må utøves forsiktighet ved nedgradering av henvisninger for aldersgruppen 40–50 år.

Journal of Hand Therapy Doi: https://doi.org/10.1016/j.jht.2023.05.010

Nordic Studies on Alcohol and Drugs (NAD) Doi: https://doi.org/10.1177/14550725221122196

Background: Unemployment rates for individuals in treatment for substance use disorder (SUD) are high, with Norwegian estimates in the range of 81%–89%. Although Individual Placement and Support (IPS) represents a promising method to improved vocational outcome, cross-disciplinary investigations are needed to document implementation benefits and address reimbursements needs. The aim of this study was to model the potential socioeconomic value of employment support integrated in SUD treatment. Methods: Based on scientific publications, an ongoing randomised controlled trial (RCT) on employment support integrated in SUD treatment, and publicly available economy data, we made qualified assumptions about costs and socioeconomic gain for the different interventions targeting employment for patients with SUD: (1) treatment as usual (TAU); (2) TAU and a self-help guide and a workshop; and (3) TAU and IPS. For each intervention, we simulated three different outcome scenarios based on 100 patients. Results: Assuming a 40% employment rate and full-time employment (100%) for 10 years following IPS, we found a 10-year socioeconomic effect of €18,732,146. The corresponding effect for the more conservative TAU + IPS simulation assuming 40% part-time positions (25%) for five years, was €2,519,906. Compared to the two alternative interventions, IPS was cost-effective and more beneficial after six months to two years. Discussion: This concept evaluation study suggests that integrating employment support in the health services is socioeconomically beneficial. Our finding is relevant for decision makers within politics and health. Once employment rates from our ongoing RCT is available, real-life data will be applied to adjust model assumptions and socioeconomic value assumptions.

JMIR Formative Research 5(4) Doi: https://doi.org/10.2196/21357

International Journal of Audiology s. 1-7 Doi: https://doi.org/10.1080/14992027.2021.1939448

Objective This study aimed to explore the short- and long-term effects of a second cochlear implant (CI-2) on the reduction of tinnitus annoyance and tinnitus handicap. Design In a combined retrospective and prospective cohort study, tinnitus annoyance was measured before receiving the CI-2 (Pre), more than two years after (Post1) and more than seven years after (Post2), using the Tinnitus Handicap Inventory (THI), the Visual Analog Scale for the assessment of perceived tinnitus loudness (VAS-L) and annoyance (VAS-A), and a self-report questionnaire. Study sample Twenty sequentially bilaterally implanted adults with bothersome tinnitus. Results CI-2 implantation resulted in a statistically significant reduction of tinnitus handicap from severe at Pre to mild at Post1 (THI mean score reduced from 61.3 [SD = 19.4] to 29.3 [SD = 23.5]). The reduction in tinnitus annoyance was statistically significant from Pre to Post 2 (VAS-A reduced from 7.1 [SD = 1.5] to 3.4 [SD = 2.2]). The reduction in tinnitus loudness was not statistically significant. Conclusions The provision of a CI-2 for severely and profoundly hearing-impaired individuals with bothersome tinnitus is an effective method of providing long-term tinnitus relief.

JMIR Formative Research 4:e14780(1) s. 1-11 Doi: https://doi.org/10.2196/14780

BMJ Innovations 7 Doi: https://doi.org/10.1136/bmjinnov-2020-000432

Objective To describe unmet needs and values in stroke rehabilitation using the Health Value Framework and the associated coassessment tool Health Value Spider, a framework designed to identify and prioritise unmet needs based on health technology assessment (HTA). Setting The study took place at Oslo University Hospital, Norway, from February to April 2019. Participants in three consecutive workshops were recruited from Sunnaas Rehabilitation Hospital, Oslo Municipality, Hospital Procurement Trust and Oslo University Hospital. Twenty-four hospital workers (medical and allied health staff and administrative staff) participated in workshop 1 and 29 patients, user representatives and hospital workers in workshop 2. Twenty-one patients and hospital workers participated in workshop 3. Interventions Stakeholder analysis and scenario building was performed in a coassessment setting where unmet needs were identified applying the Health Value Framework. Two of the authors are also the developers of the Health Value Framework (KJK and LNS). Results In the two first workshops where health workers, patients and next of kin perspectives were elicited, three needs were identified: patient insecurity in patient journey transitions, lack of stroke rehabilitation expertise in primary care and invisible patient problems, such as fatigue and cognitive impairment. In workshop 3, 12 opportunity areas were identified. Four opportunity areas were selected by the stakeholders based on a prioritisation process: early discovery of cognitive impairment, rehabilitation continuity, empowered patients and next of kin and remote monitoring and digital touchpoints. Conclusion Health Value Spider successfully identified and prioritised unmet needs and described associated values.

International Journal of Technology Assessment in Health Care 36(5) s. 481-485 Doi: https://doi.org/10.1017/S0266462320000756

Early health technology assessment (HTA), which includes all methods used to inform industry and other stakeholders about the potential value of new medical products in development, including methods to quantify and manage uncertainty, has seen many applications in recent years. However, it is still unclear how such early value assessments can be integrated into the technology innovation process. This commentary contributes to the discussion on the purposes early HTA can serve. Similarities and differences in the perspectives of five stakeholders (i.e., the hospital, the patient, the assessor, the medical device industry, and the policy maker) on the purpose, value, and potential challenges of early HTA are described. All five stakeholders agreed that integrating early HTA in the innovation process has the possibility to shape and refine an innovation, and inform research and development decisions. The early assessment, using a variety of methodologies, can provide insights that are relevant for all stakeholders but several challenges, for example, feasibility and responsibility, need to be addressed before early HTA can become standard practice. For early evaluations to be successful, all relevant stakeholders including patients need to be involved. Also, nimble, flexible assessment methods are needed that fit the dynamics of medical technology. Best practices should be shared to optimize both the innovation process and the methods to perform an early value assessment.

International Journal of Technology Assessment in Health Care 35(1) s. 17-26 Doi: https://doi.org/10.1017/S0266462318003719

Objectives Early assessment can assist in allocating resources for innovation effectively and produce the most beneficial technology for an institution. The aim of the present study was to identify methods and discuss the analytical approaches applied for the early assessment of innovation in a healthcare setting. Methods Knowledge synthesis based on a structured search (using the MEDLINE, Embase, and Cochrane databases) and thematic analysis was conducted. An analytical framework based on the stage of innovation (developmental, introduction, or early diffusion) was applied to assess whether methods vary according to stage. Themes (type of innovation, study, analysis, study design, method, and main target audience) were then decided among the authors. Identified methods and analysis were discussed according to the innovation stage. Results A total of 1,064 articles matched the search strategy. Overall, thirty-nine articles matched the inclusion criteria. The use of methods has a tendency to change according to the stage of innovation. Stakeholder analysis was a prominent method in the innovation stages and particularly in the developmental stage, as the introduction and early diffusion stage has more availability of data and may apply more complex methods. Barriers to the identified methods were also discussed as all of the innovation stages suffered from lack of data and substantial uncertainty. Conclusions Although this review has identified applicable approaches for early assessment in different innovation stages, research is required regarding the value of the available data and methods and tools to enhance interactions between different parties at different stages of innovation.

Controversies in Healthcare Innovation. Service, Technology and Organization s. 341-368 Doi: https://doi.org/10.1057/978-1-137-55780-3_13

In Chapter 13, Hoholm et al. discuss controversies in the healthcare sector by studying the nature of innovation projects at the Clinic of Innovation at Oslo University Hospital and its efforts to improve organizational ambidexterity in the area of service innovation. This includes more room for exploration, and improving their capacity to translate and exploit service innovations in use. Using the notions of ‘exploration’ and ‘exploitation’ (March, Organization Science 2:71–87,1991) the authors show how successful innovation requires two different organizational capacities and discuss how a complex knowledge organization like a hospital may increase its ability to handle both, often referred to as ‘organizational ambidexterity’ (Junni et al., The Academy of Management Perspectives 27:299–312, 2013). The authors propose three conditions for driving ambidexterity: organizational responsibilities and roles, provisional evaluation methods, and systematic cross-case learning.

British Journal of General Practice Open 2(2) s. 1-12 Doi: https://doi.org/10.3399/bjgpopen18X101505

Background Most oral antibiotics are prescribed by GPs, and they are therefore the most important influencers with regard to improving antibiotic prescription patterns. Although GPs’ prescription patterns in general are well-studied, little is known about antibiotic prescription patterns in pregnancy. Aim To study GPs’ antibiotic prescriptions in respiratory tract infections (RTIs) during pregnancy, and assess differences, if any, between pregnant and non-pregnant patients. Design & setting Retrospective observational study combining prescription data from the Norwegian Peer Academic Detailing (Rx-PAD) study database, pregnancy data from the Norwegian birth registry, and pharmacy dispension data from the Norwegian Prescription Database (NorPD). Method Records of patient contacts with 458 GPs, between December 2004 and February 2007, were screened for RTI episodes. Similar diagnoses were grouped together, as were similar antibiotics. Episodes were categorised according to whether the patient was pregnant or not, and included women aged 16–46 years. Logistic regression models were used to assess odds ratios (ORs), and calculated relative risks (cRRs) were produced. The authors also adjusted for clustering at various levels. Results Overall prescription rate for RTI episodes was 30.8% (n = 96 830). The cohort was reduced to include only episodes with women pregnant in the study period (n = 18 890). The antibiotic prescription rate in pregnancy was 25.9% versus 34.2% in the time before and after pregnancy (cRR = 0.66 [95% confidence intervals {CI} = 0.68 to 0.81]). During pregnancy, 83.0% of the antibiotic prescriptions were picked up at a pharmacy, compared to an 86.6% filling rate in non-pregnant patients. The difference was not significant when adjusting for clustering at the patient level. Conclusion Norwegian GPs prescribe fewer antibiotics overall when patients are pregnant and, when they do prescribe, choose more narrow spectrum antibiotics for RTIs. This indicates a possible lower target rate for GP prescriptions to females. A low antibiotic dispension rate during pregnancy may represent a discussion topic in the consultation setting, to address possible reasons and avoid under-treatment.

Journal of Medical Internet Research (JMIR) 20(5) s. 1-12 Doi: https://doi.org/10.2196/jmir.9751

Background: Noncommunicable diseases (NCDs) account for 70% of all deaths in a year globally. The four main NCDs are cardiovascular diseases, cancers, chronic pulmonary diseases, and diabetes mellitus. Fifty percent of persons with NCD do not adhere to prescribed treatment; in fact, adherence to lifestyle interventions is especially considered as a major challenge. Smartphone apps permit structured monitoring of health parameters, as well as the opportunity to receive feedback. Objective: The aim of this study was to review and assess the effectiveness of app-based interventions, lasting at least 3 months, to promote lifestyle changes in patients with NCDs. Methods: In February 2017, a literature search in five databases (EMBASE, MEDLINE, CINAHL, Academic Research Premier, and Cochrane Reviews and Trials) was conducted. Inclusion criteria was quantitative study designs including randomized and nonrandomized controlled trials that included patients aged 18 years and older diagnosed with any of the four main NCDs. Lifestyle outcomes were physical activity, physical fitness, modification of dietary habits, and quality of life. All included studies were assessed for risk of bias using the Cochrane Collaboration`s risk of bias tool. Meta-analyses were conducted for one of the outcomes (glycated hemoglobin, HbA1c) by using the estimate of effect of mean post treatment with SD or CI. Heterogeneity was tested using the I2 test. All studies included in the meta-analyses were graded. Results: Of the 1588 records examined, 9 met the predefined criteria. Seven studies included diabetes patients only, one study included heart patients only, and another study included both diabetes and heart patients. Statistical significant effect was shown in HbA1c in 5 of 8 studies, as well in body weight in one of 5 studies and in waist circumference in one of 3 studies evaluating these outcomes. Seven of the included studies were included in the meta-analyses and demonstrated significantly overall effect on HbA1c on a short term (3-6 months; P=.02) with low heterogeneity (I2=41%). In the long term (10-12 months), the overall effect on HbA1c was statistical significant (P=.009) and without heterogeneity (I2=0%). The quality of evidence according to Grading of Recommendations Assessment, Development and Evaluation was low for short term and moderate for long term.

Finnish Journal of EHealth and EWelfare (FinJeHeW)

Antibiotics 7(3) Doi: https://doi.org/10.3390/antibiotics7030084

Antibiotics are the most frequent prescription drugs used by pregnant women. Our objective was to investigate if the dispensation of antibiotics and antiasthmatics in children less than 1 year of age is associated with prenatal antibiotic exposure. A secondary aim was to explore the incidence of dispensed antibiotics in pregnancy and dispensed antibiotics and antiasthmatics in children. We conducted an observational study using the Peer Academic Detailing study database to select patients eligible for match in the Medical Birth Registry of Norway, a total of 7747 mother-and-child pairs. Details on antibiotic and antiasthmatic pharmacy dispensations were obtained from the Norwegian Prescription Database. One quarter (1948 of 7747) of the mothers in the study had been dispensed antibiotics during pregnancy. In their first year of life, 17% (1289) of the children had had an antibiotic dispensation, 23% (1747) an antiasthmatic dispensation, and 8% (619) of the children had had both. We found a significant association between dispensed antibiotics in pregnancy and dispensed antibiotics to the child during their first year of life; OR = 1.16 (95% CI: 1.002–1.351). The association was stronger when the mothers were dispensed antibiotics at all, independent of the pregnancy period; OR = 1.60 (95% CI: 1.32–1.94). We conclude that the probability for dispensation of antibiotics was increased in children when mothers were dispensed antibiotics, independent of pregnancy. Diagnostic challenges in the very young and parental doctor-seeking behavior may, at least in part, contribute to the association between dispensations in mothers and children below the age of one year.

Journal of american academy of audiology 29(8) s. 696-705 Doi: https://doi.org/10.3766/jaaa.16184

BMJ Open Doi: https://doi.org/10.1136/bmjopen-2018-021608

AbstrACt Objective The dynamic and interactive mobile application Vett was designed to help change behaviour and is based on cognitive, motivational and visual techniques. Our aim is to investigate the acceptability, usability and utility of Vett as a personalised application for goal achievement. setting The trial took place at the rheumatology clinic at Diakonhjemmet Hospital, Oslo, Norway from January to June 2015. Participants Twelve participants with osteoarthritis were recruited from a 3.5-hour multidisciplinary group-based educational programme (osteoarthritis school). Interventions With the help of a physician, each participant followed a customised 12-week mixed-mode goal achievement plan with digital support based on preset goals, self-monitoring and individual feedback. Acceptability was measured as the perceived degree of goal achievement using a validated habit questionnaire scaled from 0 to 100. Utility and usability were assessed via 10 weekly questions and adherence by fulfilment of predetermined tasks. results Mean goal achievement was 73 (95% CI 68 to 78), an increase of 22 (95% Cl 17 to 26, p<0.01), which equals 48% improvement (95% CI 32% to 59%). Mean user satisfaction was 81 (95% CI 76 to 85), and technical usability was 80 (95% CI 75 to 84), which both increased during the study period. Conclusion The high levels of acceptability, usability and utility support the feasibility of the pers

Journal of Entrepreneurship, Management and Innovation (JEMI) 13(1) s. 89-116 Doi: https://doi.org/10.7341/20171314

In this explorative study, we investigate the relationship between dynamic capabilities and innovation capabilities. Dynamic capabilities are at the core of strategic management in terms of how firms can ensure adaptation to changing environments over time. Our paper follows two paths of argumentation. First, we review and discuss some major contributions to the theories on ordinary capabilities, dynamic capabilities, and innovation capabilities. We seek to identify different understandings of the concepts in question, in order to clarify the distinctions and relationships between dynamic capabilities and innovation capabilities. Second, we present a case study of the ’Innovation Clinic’ at a major university hospital, including four innovation projects. We use this case study to explore and discuss how dynamic capabilities can be extended, as well as to what extent innovation capabilities can be said to be dynamic. In our conclusion, we discuss the conditions for nurturing ‘dynamic innovation capabilities’ in organizations.

The Journal of Headache and Pain 18(35) Doi: https://doi.org/10.1186/s10194-017-0743-0

Background: Some previous studies have postulated an association between migraine and excessive daytime sleepiness (EDS). This study evaluated the association of EDS with migraine and headache frequency in a general population, after adjusting for potential confounding variables. Methods: The study was a postal survey of a random age and gender-stratified sample of 40,000 persons aged 20 to 80 years old drawn by the National Population Register in Norway. The questionnaire included questions about migraine, headache, the Epworth sleepiness scale (ESS) and various comorbidities. EDS was defined as ESS > 10. The association of EDS and migraine/headache were analysed by bivariate and multivariable logistic regression analyses. Results: A total of 21,177 persons responded to the ESS and were included in the analyses. The odds ratio (OR) for EDS was increased for migraineurs (1.42 (95% CI 1.31─1.54), p < 0.001) compared to non-migraineurs; however, this finding was not significant after adjustment for a number of possible confounders. EDS increased with increasing headache frequency, with an OR of 2.74 (95% CI 2.05─3.65), p < 0.001) for those with headache on >179 days per year compared to those without headache in multivariable analysis. Conclusions: In a general population, the odds for EDS increased significantly with the headache frequency, irrespective of migraine status. EDS was not associated with reported migraine in multivariable analysis.

Otolaryngology - Head and Neck Surgery (OTO) 156(4) s. S1-S21 Doi: https://doi.org/10.1177/0194599816643510

Advances in Skin & Wound Care 29(11) s. 511-517 Doi: https://doi.org/10.1097/01.ASW.0000499714.97688.4b

Journal of Multidisciplinary Healthcare 9 s. 481-488 Doi: https://doi.org/10.2147/JMDH.S113689

Background: Rising life expectancy means an increase in the number of elderly people with hearing loss in the population. Many elderly people live in nursing homes, with varying care needs. A substantial proportion of these people will need help with their hearing aids and other hearing devices. Objective: The objective of the study has been to assess the knowledge, experience, skills, competence, and need for information of staff at nursing homes in relation to residents’ hearing loss and hearing aids. Materials and methods: One hundred and ninety-five employees at seven nursing homes participated in the study. The main approach was a descriptive study, using questionnaires. Results: The main findings are that 73% of informants found that many residents need help with their hearing aids. Only one-tenth report that they know enough about the residents’ hearing aids. Almost four out of five informants find that the residents become socially isolated as a result of hearing loss. Seventy-eight percent agree to some extent that more residents would benefit from hearing aids. Conclusion: Staff at nursing homes have insufficient knowledge about hearing loss and hearing aids. Increased focus on the elderly with hearing impairment in nursing homes is needed. Contact between nursing homes and audiological specialists should be improved to best follow-up hearing loss and hearing aids.

International Journal of Pediatric Otorhinolaryngology 78(7) s. 1026-1029 Doi: https://doi.org/10.1016/j.ijporl.2014.03.030

Cephalalgia 34(10) s. 752-755 Doi: https://doi.org/10.1177/0333102414538551

The Pediatric Infectious Disease Journal 32(9) s. 946-949 Doi: https://doi.org/10.1097/INF.0b013e318297c436

International Journal of Pediatric Otorhinolaryngology 77(8) s. 1329-1332 Doi: https://doi.org/10.1016/j.ijporl.2013.05.027

Otolaryngology - Head and Neck Surgery (OTO) 148 s. E1-E25 Doi: https://doi.org/10.1177/0194599812460984

Research in Developmental Disabilities 34(7) Doi: https://doi.org/10.1016/j.ridd.2013.04.006

BMJ Open 3(1) Doi: https://doi.org/10.1136/bmjopen-2012-002285

Cephalalgia 32(6) s. 451-458 Doi: https://doi.org/10.1177/0333102411431900

Scandinavian Journal of Disability Research 14(4) s. 300-312 Doi: https://doi.org/10.1080/15017419.2011.640411

Journal of Pediatrics 160(3) s. 526-526

The Journal of Headache and Pain 12(1) s. 55-61 Doi: https://doi.org/10.1007/s10194-010-0268-2

Objective is to investigate the relationship between migraine and obstructive sleep apnea in the general population. A cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway, were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. 376 persons with high risk and 157 persons with low risk of sleep apnea aged 30–65 years were included for further investigations. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Migraine without aura (MO) and migraine with aura (MA) was diagnosed according to the International Classification of Headache Disorders. MO and MA occurred in 12.5 and 6.8% of the participants with obstructive sleep apnea. The logistic regression analyses showed no relationship between the two types of migraine and obstructive sleep apnea, with adjusted odds ratios for MO 1.15 (0.65–2.06) and MA 1.15 (0.95–2.39). Further, estimates using cutoff of moderate (AHI ≥ 15) and severe (AHI ≥ 30) obstructive sleep apnea, did not reveal any significant relationship between migraine and the AHI. Migraine and obstructive sleep apnea are unrelated in the general population. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution and reproduction in any medium, provided the original author(s) and source are credited.

The Journal of Headache and Pain 12(1) s. 63-69 Doi: https://doi.org/10.1007/s10194-010-0265-5

The main objective of this study is to investigate the relationship between tension-type headache and obstructive sleep apnea in the general population. The method involves a cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. Included in this study were 297 persons with high risk and 134 persons with low risk of sleep apnea, aged 30–65 years. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Tension-type headache was diagnosed according to the International Classification of Headache Disorders. Results showed the prevalence of frequent and chronic tension-type headache was 18.7 and 2.1% in the participants with obstructive sleep apnea. The logistic regression analyses showed no significant relationship between tension-type headache and obstructive sleep apnea, with adjusted odds ratios for frequent tension-type headache of 0.95 (0.55–1.62) and chronic tension-type headache of 1.91 (0.37–9.85). The results did not change when using cut-off of moderate (AHI ≥15) and severe (AHI ≥30) obstructive sleep apnea. Thus, we did not find any significant relationship between tension-type headache and the AHI. The presence and severity of sleep apneas seem not to influence presence and attack-frequency of tension-type headache in the general population. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Journal of Sleep Research 20(1) s. 162-170 Doi: https://doi.org/10.1111/j.1365-2869.2010.00861.x

Disability and Rehabilitation 33(23.24) s. 2179-2185 Doi: https://doi.org/10.3109/09638288.2011.563815

Vaccine 29(47) s. 8564-8574 Doi: https://doi.org/10.1016/j.vaccine.2011.09.025

Background: A seven valent pneumococcal conjugate vaccine (PCV7) was introduced in the Norwegian childhood immunization programme in 2006, and since then the incidence of invasive pneumococcal disease has declined substantially. Recently, two new second generation pneumococcal conjugate vaccines have become available, and an update of the economic evidence is needed. The aim of this study was to estimate incremental costs, health effects and cost-effectiveness of the pneumococcal conjugate vaccines PCV7, PCV13 and PHiD-CV in Norway. Methods: We used a Markov model to estimate costs and epidemiological burden of pneumococcal- and NTHi-related diseases (invasive pneumococcal disease (IPD), Community Acquired Pneumonia (CAP) and acute otitis media (AOM)) for a specific birth cohort. Using the most relevant evidence and assumptions for a Norwegian setting, we calculated incremental costs, health effects and cost-effectiveness for different vaccination strategies. In addition we performed sensitivity analyses for key parameters, tested key assumptions in scenario analyses and explored overall model uncertainty using probabilistic sensitivity analysis. Results: The model predicts that both PCV13 and PHiD-CV provide more health gains at a lower cost than PCV7. Differences in health gains between the two second generation vaccines are small for invasive pneumococcal disease but larger for acute otitis media and myringotomy procedures. Consequently, PHiD-CV saves more disease treatment costs and indirect costs than PCV13. Conclusion: This study predicts that, compared to PVC13, PHiD-CV entails lower costs and greater benefits if the latter is measured in terms of quality adjusted life years. PVC13 entails more life years gained than PHiD-CV, but those come at a cost of NOK 3.1 million (∼D 0.4 million) per life year. The results indicate that PHiD-CV is cost-effective compared to PCV13 in the Norwegian setting.

The Journal of Headache and Pain Doi: https://doi.org/10.1007/s10194-010-0268-2

The Journal of Headache and Pain Doi: https://doi.org/10.1007/s10194-010-0265-5

Cephalalgia 30(2) s. 152-160 Doi: https://doi.org/10.1111/j.1468-2982.2009.01877.x

International Journal of Pediatric Otorhinolaryngology 74(12) s. 1419-1424 Doi: https://doi.org/10.1016/j.ijporl.2010.09.022

International Journal of Pediatric Otorhinolaryngology 74(12) s. 1356-1360 Doi: https://doi.org/10.1016/j.ijporl.2010.09.002

Journal of Sleep Research Doi: https://doi.org/10.1111/j.1365-2869.2010.00861.x

Acta Paediatrica 99(1) s. 99-105 Doi: https://doi.org/10.1111/j.1651-2227.2009.01506.x

International Journal of Pediatric Otorhinolaryngology 74(3) s. 231-240 Doi: https://doi.org/10.1016/j.ijporl.2009.09.006

International Journal of Pediatric Otorhinolaryngology 74(2) s. 168-172 Doi: https://doi.org/10.1016/j.ijporl.2009.11.001

Cephalalgia 29 s. 155-155

Acta Oto-Laryngologica 129(2) s. 195-198 Doi: https://doi.org/10.1080/00016480802078101

Cephalalgia 29 s. 153-153

Cephalalgia 29 s. 159-159

Cephalalgia 29 s. 62-62

Cephalalgia Doi: https://doi.org/10.1111/j.1468-2982.2009.01877.x

International Journal of Pediatric Otorhinolaryngology 73(4) s. 603-606 Doi: https://doi.org/10.1016/j.ijporl.2008.12.007

European Archives of Oto-Rhino-Laryngology 266(5) s. 653-656 Doi: https://doi.org/10.1007/s00405-008-0799-1

(Posten ble rapportert i 2008. Rapporteres ikke i 2009.)

The Journal of Headache and Pain 9(6) s. 339-347 Doi: https://doi.org/10.1007/s10194-008-0077-z

The objective was to investigate the prevalence and interrelation of migraine and headache in the general population. Forty thousand men and women aged 20–80 years from the Norwegian general population received a mailed questionnaire with questions about migraine and headache. The questionnaire response rate was 54.5%. The lifetime prevalence of migraine was 26.5% (95% CI 25.9–27.1%), i.e., 18.1% (95% CI 17.3–18.9%) in men and 34.1% (95% CI 33.2–35.0%) in women. The prevalence of migraine decreased slightly in both men and women after an age of 45. The 1 year prevalence of headache was 77.2%, i.e., 69.6% (95% CI 68.7–70.6%) in men and 84.0% (95% CI 83.3–84.7%) in women. The frequency of headache decreased with age, but some of the elders aged 70 or above experienced more frequent headache. The prevalence of being headache free increased from 19.1% (95% CI 14.2–25.6%) to 74.7% (95% CI 70.0–78.8%) in 20 and 80 years old men without co-occurrence of migraine, and from 5.1% (95% CI 2.9–8.8%) to 61.4% (95% CI 54.9–67.6%) in 20 and 80 years old women without co-occurrence of migraine. Co-occurrence of migraine significantly increased the frequency of headache and decreased the prevalence of being headache free. Published Open Access with SpringerOpen

European Archives of Oto-Rhino-Laryngology

European Journal of Neurology 15 s. 326-326

International Journal of Pediatric Otorhinolaryngology 72 s. 1207-1213 Doi: https://doi.org/10.1016/j.ijporl.2008.04.012

Cephalalgia 28 Doi: https://doi.org/10.1111/j.1468-2982.2008.01577.x

European Journal of Neurology 15 s. 348-348

European Journal of Neurology 15 s. 326-327

European Journal of Neurology 15 s. 349-349

Nasjonale faglige retningslinjer for antibiotikabruk i primærhelsetjenesten (Helsedirektoratet bestillingsnummer IS-1593) s. 38-50

International Journal of Pediatric Otorhinolaryngology 71(8) s. 1251-1259 Doi: https://doi.org/10.1016/j.ijporl.2007.04.017

Acta Oto-Laryngologica 127 s. 29-33 Doi: https://doi.org/10.1080/00016480600606756

International Journal of Pediatric Otorhinolaryngology 71 Doi: https://doi.org/10.1016/j.ijporl.2007.04.012

Acta Oto-Laryngologica 127(5) s. 480-485 Doi: https://doi.org/10.1080/00016480600895128

International Journal of Pediatric Otorhinolaryngology 71(10) s. 1579-1583 Doi: https://doi.org/10.1016/j.ijporl.2007.06.022

International Journal of Pediatric Otorhinolaryngology 71 s. 1035-1039 Doi: https://doi.org/10.1016/j.ijporl.2007.03.010

International Journal of Pediatric Otorhinolaryngology 70 s. 1569-1573

International Journal of Pediatric Otorhinolaryngology 70(9) s. 1561-1568 Doi: https://doi.org/10.1016/j.ijporl.2006.04.004

Archives of Disease in Childhood 91(5) s. 391-395 Doi: https://doi.org/10.1136/adc.2005.083881

International Journal of Pediatric Otorhinolaryngology 70(4) s. 597-602 Doi: https://doi.org/10.1016/j.ijporl.2005.08.005

Archives of Otolaryngology - Head & Neck Surgery 131 s. 383-387

Tidsskrift for Den norske legeforening (Tidsskriftet)

Tidsskrift for Den norske legeforening (Tidsskriftet)

Tidsskrift for Den norske legeforening (Tidsskriftet) 125 s. 1016-1017

Annals of Otology, Rhinology and Laryngology 194 s. 8-15

Archives of Otolaryngology - Head & Neck Surgery s. 383-387

Tidsskrift for Den norske legeforening (Tidsskriftet) s. 2242-2243-2242-2243

Ørebetennelse er den vanligste årsak til legebesøk og forskrivning av antibiotika. Akutt otitis media hos ellers friske barn skal ikke behandles med slike medikamenter, men barn med residiverende otitt skal få antibiotika på liberal indikasjon. Slike «ørebarn» trenger spesiell oppfølging. Hvis barnet har hatt sekretorisk otitt i mer enn tre måneder, skal det henvises til øre-nese-hals-spesialist.

Twin research 7(3) s. 239-244

Twin research 7 s. 239-244

European Archives of Oto-Rhino-Laryngology

Tidsskrift for Den norske legeforening (Tidsskriftet) s. 2743-2745 : ill.-2743-2745 : ill.

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