“P>According to the Diagnostic and Statistical Manual I


“P>According to the Diagnostic and Statistical Manual IV (DSM IV), conversion disorder is classified as a somatoform illness and defined as an alteration or loss of physical function because of the expression of an underlying psychological ailment. This condition, previously known as hysteria, hysterical neurosis, or conversion hysteria occurs rarely, with an incidence of 11-300 cases per 100 000 people (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edn. Washington, DC: American Psychiatric Association, 1994). Presentation after an anesthetic is exceptional. After thorough review of the literature, fewer than 20 cases have been documented, with only two

instances in patients younger than 18 years of age after general anesthesia; Erastin ic50 both were DNA Damage inhibitor mild in nature. We present a severe case of postoperative conversion disorder that developed upon emergence from anesthesia in a previously healthy 16-year-old girl following direct laryngoscopy with vocal fold injection.”
“Background: Within the framework of economic evaluations, the transferability of utility scores between jurisdictions remains unclear. The EQ-5D is a generic instrument for measuring health-related quality of life in economic evaluations, which can be used for comparing utility scores across countries. At present, the EQ-5D has several

national value sets or tariffs. Nevertheless, utility estimates from foreign studies are often used directly for cost-effectiveness estimates, without adapting by

applying the appropriate national value set. It is unclear if this practice is advisable, due to dissimilarities between the national value sets.

Objective: To examine the effects of differences in national EQ-5D value sets on absolute and marginal utilities of health states, and determine to what degree these differences can be explained by methodological factors.

Methods: First, the relative importance of the EQ-5D domains for the utility estimates was compared across the 15 value sets. Second, two hypothetical health states for a depressed patient and a pain learn more patient (21232 and 33321) were selected for additional analysis, by comparing the utilities as scored by the value sets. The marginal influence of a one-level deterioration in a domain of these health states on the utility estimate was then determined. Third, the differences between the value sets were examined in more detail by using multilevel analysis to examine the role of methodological differences in the valuation studies.

Results: Differences can be perceived between the national value sets of the EQ-5D in the preferences for the domains. The utilities of the two hypothetical health states show that the value sets differ substantially. Furthermore, the differences between the marginal values of the deteriorations are large, which can be explained partly by the type of valuation method.

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