I will persent my paper for a interview panel, where I invited as a shortlisted candidati for Research Fellow position. They ask me 5-minutes presentation of a quantitative research project I have been involved with.
2. Research interests
• Economic modelling and evaluation of health or social based interventions
• Cost-effectiveness analysis and preference-based outcome assessment in non-
communicable diseases
Experience
• Assistant Professor at ARUMS since 2019
• PI of several local and national level research projects (Attracted several research grants)
• Administrator of data and statistical analysis of PERSIAN cohort (200/000 participants)
Telma Zahirian Moghaddam
PhD
Health Policy & Economics
4. Title Econ. Model Journal Role
The socio-economic inequality in body mass index: a
PERSIAN cohort-based cross-sectional study on 20,000
Iranian adults
Gini Coefficient
BMC Endocrine
Disorders
Corresponding
Author
Kidney stones among Iranian adults: Prevalence and
socioeconomic inequality assessment in a cohort‐based
cross‐sectional study
Decomposing
Health Science
Reports
Corresponding
Author
Socio-economic inequality in prevalence of type 2 diabetes
among adults in north-west of Iran: a Blinder-Oaxaca
decomposition
Blinder-Oaxaca
decomposition
Journal of Diabetes &
Metabolic Disorders
Corresponding
Author
Decomposition of Socioeconomic Inequality in
Cardiovascular Disease Prevalence in the Adult Population: A
Cohort-based Cross-sectional Study in Northwest Iran
Relative
concentration index,
Blinder-Oaxaca
Decomposition
Journal of Preventive
Medicine and Public
Health
Corresponding
Author
Environmental and economics-related factors of smoking
among Iranian adults aged 35–70: a PERSIAN cohort–based
cross-sectional study
Environmental
Science and Pollution
Research
Corresponding
Author
Decomposing environmental and socioeconomic gradient in
alcohol consumption: a cross-sectional analysis of the ArNCD
cohort study
Blinder-Oaxaca
decomposition
Gini
Frontiers in Public
Health
Corresponding
Author
5. Cost-effectiveness analysis of dialysis or comprehensive
conservative care in patients with end-stage kidney disease: A
mixed method decision analytical study
My experiences in
Analysing Data from Randomized Clinical Trials…
The Cost-effectiveness Analysis of Helicobacter pylori
screening to prevent gastric cancer in Ardabil Province
6. Cost-effectiveness analysis of two routine
therapeutic methods for Helicobacter pylori
eradication
PI= Telma Zahirian
Funded by DDRC (No. 923681b)
An evaluation of public-level intervention
7. Objectives
Compare the cost-effectiveness of two therapeutic methods (Clarithromycin and
Furazolidone) in the eradication of H. pylori as first-line treatment in adults.
Service user (patients) perspective
8. Design
• Cross-sectional, Cost-Effectiveness Analysis (CEA) study
Participant
• Residents over 35 years of age in Ardabil city (a population of 7,496)
• Group A) 6,163 participants treated with furazolidone (i.e. amoxicillin 500 +
omeprazole 20 + bismuth 120 + furazolidone 100)
• Group B) 1,333 participants treated with clarithromycin (i.e. amoxicillin 500 +
omeprazole 20 + bismuth 120 + clarithromycin 500)
Tools
• A researcher-made questionnaire (demographic information, and costs)
9. Cost & Effectiveness
• Cost = Direct costs (general practitioner's visits, average prices of medications used
(primary and complementary medications), and necessary tests (e.g., HPsAg)) as well
as indirect costs (absence from work and transportation)
• Effectiveness = successful eradication of Helicobacter infection as a negative
Hepadnaviridae (HPsAg) result (Two months after the end of drug therapy)
Incremental Cost-effectiveness Ratio (ICER) was used to compare the
overall results
𝐼𝐶𝐸𝑅 =
𝑀𝑒𝑎𝑛 𝑐𝑜𝑠𝑡 𝐴 − 𝑀𝑒𝑎𝑛 𝐶𝑜𝑠𝑡 𝐵
𝐸𝑓𝑓𝑒𝑐𝑡 𝐴 − 𝐸𝑓𝑓𝑒𝑐𝑡 𝐵
11. Results
Given the results, the ICER was estimated to be 5,184,392.08 IRR per H. pylori
eradication.
𝐼𝐶𝐸𝑅 =
𝑀𝑒𝑎𝑛 𝑐𝑜𝑠𝑡 𝐴 − 𝑀𝑒𝑎𝑛 𝐶𝑜𝑠𝑡 𝐵
𝐸𝑓𝑓𝑒𝑐𝑡 𝐴 − 𝐸𝑓𝑓𝑒𝑐𝑡 𝐵
=
2570100 − 3120164
85.93 − 96.54
= 𝟓𝟏𝟖𝟒𝟑𝟗𝟐. 𝟎𝟖
Accordingly, each ICER (eradication of H. pylori) by drugs of group B required
5,184,392.08 IRR more than that of group A.
12.
13. Implications for practice
• Therefore, due to the high prevalence of H. pylori and the economic conditions of the
health system in Iran, such as high direct treatment costs, the combination of
furazolidone with amoxicillin 500 + omeprazole 20 + bismuth 120 can be a cost-
effective choice between the two conventional treatment methods and furazolidone
could replace clarithromycin to avoid the economic burden of H. pylori treatment.
• Studies such as this one could help policymakers to make reliable evidence-based
decisions to improve targeted patients’ health and decrease the economic burden of
health care.
14. Strengths and limitations of the study
use of the PERSIAN cohort
study data as a strong, valid,
and approved protocol
among Middle Eastern
countries
The large sample size,
calculation of direct and
indirect costs, and ICER
The region with a high
prevalence of
gastrointestinal cancer
Strengths
Side effects of taking drugs
were not considered in term
of costs and effectiveness
Classification of the costs into
three groups in general (non-
calculation of outpatient
costs and informal payments)
lack of access to more
participant economic data
because of some related
sensitivity and recall bias
Limitations