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Cost-effectiveness model of universal screening for thyroid disorders in pregnancy for the Czech Republic
Tužil, Jan ; Bartáková, Jana (advisor) ; Brennan Kearns, Pavla (referee) ; Babeľa, Róbert (referee)
Model nákladové efektivity plošného screeningu poruchy funkce štítné žlázy v těhotenství pro Českou republiku Cost-effectiveness model of universal screening for thyroid disorders in pregnancy for the Czech Republic Disertační práce English Abstract Introduction: Subclinical hypothyroidism affects approximately 5% of pregnant women in the Czech Republic and is associated with a number of health risks for both mother and child. The negative effects can be prevented by effective and safe hormone replacement therapy. Although subclinical hypothyroidism can be diagnosed solely by blood tests, only 45% of pregnant women in the Czech Republic are currently tested. Thyroid function screening (thyrotropin; TSH) can be accompanied by thyroid autoimmunity testing (anti-thyroid peroxidase antibodies; anti-TPO) to predict increased risk of postpartum thyroiditis. Aims: The aim is to model the cost-effectiveness, budgetary impact and impact on routine practice of the introduction of universal TSH screening (versus the current state of things) and an addition of the universal anti-TPO screening (versus TSH screening alone). Method: The cost-benefit ratio, budget impact, and impact on routine practice were modelled using a decision tree for implementation of the TSH test and a nested decision tree for the addition of the...
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The Financing Evaluation of the Non-Profit Organization
Bartáková, Jana ; Cupal, Martin (referee) ; Lajtkepová, Eva (advisor)
Bachelor thesis is focused on problematics of non-profit sector and financing of non-profit organizations. The thesis contains theoretical backround of this topic. In the practical part is completed evaluation of financing of specific civic organization and then proposal of recommendations, which should improve economy and financial situation of this organisation.
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Correlation of thyroid autoantibodies and sonographical image in pregnant and non-pregnant women with history of spontaneous abortion
Bartáková, Jana ; Potluková, Eliška (advisor) ; Stejskal, Richard (referee)
Introduction: Autoantibodies against thyroperoxidase (TPOAb), thyroid ultrasound (US) and laboratory assessment of thyroid function are crucial in the diagnostics of autoimmune thyroid disorders (AITD). The aim of this project was to analyse the relationship between TPOAb and US findings in pregnant women and in women after spontaneous abortion (SpA). Methods: Using a self-developed classification system for semi-quantitative assessment of thyroid disorders we analysed data of 186 pregnant women screened positive for thyroid disorders during first trimester of pregnancy and 119 women with history of recent early SpA. Statistical analysis was performed using Chi-square, Mann-Whitney and ANOVA tests. Results: Nearly half of the positively screened pregnant women had normal thyroid US (86/186, 46,2 %); thyroid nodules were found in 34 (18,3 %) and US signs of AITD in 66 (35,5 %). More than half of the TPOAb-positive pregnant women had normal thyroid US (71/131, 54,2 %). However, normal thyroid US was found only in 2/12 (16,6 %) of TPOAb-positive women after SpA (p=0,029). Pregnant women with pathological thyroid US had significantly higher serum concentrations of TPOAb compared to women with normal US (1487 kIU/l vs. 354 kIU/l; p<0,001). Furthermore, pregnant TPOAb-positive women with US signs of AITD had a...
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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Correlation of thyroid autoantibodies and sonographical image in pregnant and non-pregnant women with history of spontaneous abortion
Bartáková, Jana ; Stejskal, Richard (referee) ; Potluková, Eliška (advisor)
Introduction: Autoantibodies against thyroperoxidase (TPOAb), thyroid ultrasound (US) and laboratory assessment of thyroid function are crucial in the diagnostics of autoimmune thyroid disorders (AITD). The aim of this project was to analyse the relationship between TPOAb and US findings in pregnant women and in women after spontaneous abortion (SpA). Methods: Using a self-developed classification system for semi-quantitative assessment of thyroid disorders we analysed data of 186 pregnant women screened positive for thyroid disorders during first trimester of pregnancy and 119 women with history of recent early SpA. Statistical analysis was performed using Chi-square, Mann-Whitney and ANOVA tests. Results: Nearly half of the positively screened pregnant women had normal thyroid US (86/186, 46,2 %); thyroid nodules were found in 34 (18,3 %) and US signs of AITD in 66 (35,5 %). More than half of the TPOAb-positive pregnant women had normal thyroid US (71/131, 54,2 %). However, normal thyroid US was found only in 2/12 (16,6 %) of TPOAb-positive women after SpA (p=0,029). Pregnant women with pathological thyroid US had significantly higher serum concentrations of TPOAb compared to women with normal US (1487 kIU/l vs. 354 kIU/l; p<0,001). Furthermore, pregnant TPOAb-positive women with US signs of AITD had a...
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The Financing Evaluation of the Non-Profit Organization
Bartáková, Jana ; Cupal, Martin (referee) ; Lajtkepová, Eva (advisor)
Bachelor thesis is focused on problematics of non-profit sector and financing of non-profit organizations. The thesis contains theoretical backround of this topic. In the practical part is completed evaluation of financing of specific civic organization and then proposal of recommendations, which should improve economy and financial situation of this organisation.
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