Mete Şaylan - Academia.edu (original) (raw)
Papers by Mete Şaylan
Value in Health
This study aimed to review definitions of digital health and understand their relevance for healt... more This study aimed to review definitions of digital health and understand their relevance for health outcomes research. Four umbrella terms (digital health, electronic health, mobile health, and telehealth/telemedicine) were summarized in this article. Methods: PubMed/MEDLINE, Embase, Cochrane Library, and EconLit were searched from January 2015 to May 2020 for systematic reviews containing key Medical Subject Headings terms for digital health (n = 38) and synonyms of "definition." Independent pairs of reviewers performed each stage of the review, with reconciliation by a third reviewer if required. A single reviewer consolidated each definition for consistency. We performed text analysis via word clouds and computed document frequency-and inverse corpus frequency scores. Results: The search retrieved 2610 records with 545 articles (20.9%) taken forward for full-text review. Of these, 39.3% (214 of 545) were eligible for data extraction, of which 134 full-text articles were retained for this analysis containing 142 unique definitions of umbrella terms (digital health [n = 4], electronic health [n = 36], mobile health [n = 50], and telehealth/ telemedicine [n = 52]). Seminal definitions exist but have increasingly been adapted over time and new definitions were created. Nevertheless, the most characteristic words extracted from the definitions via the text analyses still showed considerable overlap between the 4 umbrella terms. Conclusions: To focus evidence summaries for outcomes research purposes, umbrella terms should be accompanied by Medical Subject Headings terms reflecting population, intervention, comparator, outcome, timing, and setting. Ultimately a functional classification system is needed to create standardized terminology for digital health interventions denoting the domains of patient-level effects and outcomes.
Pharmaceutical Market Access in Developed Markets2018, 2018
SUMMARY Introduction: We aimed to quantify patients' and physicians' preferences for ther... more SUMMARY Introduction: We aimed to quantify patients' and physicians' preferences for therapeutic trade-offs involving the efficacy, side-effect risks, and evidence uncertainty in chronic hepatitis B (CHB) treatments. Materials and Methods: Physicians who treat CHB patients and adult patients with a self-reported physician diagnosis of CHB comp- leted a web-enabled, discrete-choice experiment survey in Turkey. Both patients and physicians answered 12 treatment-choice questi- ons. Each question required evaluating a pair of hypothetical CHB medication profiles defined by the years the medicine has been stu- died (weight of evidence), probability that the patient's viral load remains undetectable for five years with possible reversal of disease progression (efficacy), five-year treatment-related risks of a fracture and renal insufficiency, and monthly medication cost. Logit models were used to estimate preference weights for all attribute levels and the profile preference s...
Pharmaceutical Market Access in Developed Markets2018, 2018
Orphanet Journal of Rare Diseases
Background Rare diseases are life-threatening, serious, and chronic conditions that require compl... more Background Rare diseases are life-threatening, serious, and chronic conditions that require complex care and have a low prevalence. An estimated one in 15 people worldwide are affected by rare diseases. This study aims to analyze the accessibility, reimbursement status, licensed status, and Anatomical Therapeutic Chemical (ATC) codes of drugs that the European Medicines Agency (EMA) in Turkey considers to be “orphan” pharmaceuticals. Methods The drugs included in this analysis were obtained from the list of orphan drugs published by the EMA. Orphan drugs’ accessibility and licensing status in Turkey were obtained from the Health Implementation Communiqué published by the Social Security Institution (SGK) and the List of Abroad Active Substance and List of Licensed Products published by the Turkey Pharmaceuticals and Medical Devices Agency (TİTCK). Descriptive analysis was applied to determine the accessibility status of orphan drugs identified by the EMA in Turkey. Results Based on ...
Pharmaceutical Market Access in Developed Markets2018
(Servizio Sanitario Nazionale-SSN)-established with the law 833/1978 [1]-is a network of structur... more (Servizio Sanitario Nazionale-SSN)-established with the law 833/1978 [1]-is a network of structures and facilities to guarantee health services access to all the citizens, as stated by Article 32 of the Italian Constitution [2]. The SSN operates under the direction and responsibility of the Ministry of Health (MH), which determines general healthcare policies, while the "retail sale" is planned, coordinated and managed at regional level, as a consequence of the process of devolution from State to Regions, regulated by the Constitution title V reform in 2001 [3]. The Italian Government as warrantor of health rights (article 32) [2], through MH, determines the essential levels of care (Livelli Essenziali di Assistenza-LEAs) that every region has to be able to provide in the public setting. Every Region autonomously defines its strategic planning, especially in terms of financial resources and distribution on regional territory of Local Health Units (Aziende Sanitarie Locali-ASLs) and Hospital Units (Aziende Ospedaliere-AOs), as well as act as supervisors of granting procedure of private health units. ASLs and AOs operate autonomously to guarantee the organization of local health care and supply of healthcare services. The collaboration between the various governments of SSN, i.e. State, Regions, ASLs and AOs, is a fundamental principle for ensuring uniform health conditions and guarantees throughout the national territory acceptable and appropriate levels of health services for all citizens. The cooperation between the State, on one side, and the nineteen Regions plus the autonomous provinces of Trento and Bolzano, on the other, is promoted through Conferenza Permanente Stato Regioni that represents the policy place in which politic negotiation between central administration and regional autonomies occurs. It was established with the law of 12 October 1983 4]. Long-time planning is a qualifying element of SSN: the MH, as delegate of the central Government, with the cooperation of Regions establishes the National Health Plan (Piano Sanitario Nazionale-PSN). It describes the general targets and elements that must be reached in health matter on the national territory, taking into account the financial, demographical and epidemiological contexts, as well as new scientific and technological innovations. It has three-year validity, but it may be revised in itinere if needed. The PSN defines the line that all health care stakeholders must follow for guaranteeing LEAs, and how funding must be broken down by levels of care.
Orphanet Journal of Rare Diseases
Background Rare diseases are life-threatening, serious, and chronic conditions that require compl... more Background Rare diseases are life-threatening, serious, and chronic conditions that require complex care and have a low prevalence. An estimated one in 15 people worldwide are affected by rare diseases. This study aims to analyze the accessibility, reimbursement status, licensed status, and Anatomical Therapeutic Chemical (ATC) codes of drugs that the European Medicines Agency (EMA) in Turkey considers to be “orphan” pharmaceuticals. Methods The drugs included in this analysis were obtained from the list of orphan drugs published by the EMA. Orphan drugs’ accessibility and licensing status in Turkey were obtained from the Health Implementation Communiqué published by the Social Security Institution (SGK) and the List of Abroad Active Substance and List of Licensed Products published by the Turkey Pharmaceuticals and Medical Devices Agency (TİTCK). Descriptive analysis was applied to determine the accessibility status of orphan drugs identified by the EMA in Turkey. Results Based on ...
Journal of Pharmaceutical Health Services Research
Objectives As one of the most common health problems, the common cold may lead to negative conseq... more Objectives As one of the most common health problems, the common cold may lead to negative consequences such as work or school absenteeism, poor productivity and labour loss. Vitamin C supports immune system defences by supporting the various cellular functions of the immune system, both congenital and adaptive. The purpose of this study is to evaluate the use of vitamin C in white-collar workers and its impact on medical care costs and its impact on the workforce in association with the common cold. Methods For calculation of the effect of 1000 mg vitamin C daily on the workforce and possible healthcare services costs, a Markov-based model was simulated with 6 cycles consistent with the literature that constituted the model input for the 6-month common cold season. The simulated Markov model included parameters for the number of seasonal flu episodes with or without vitamin C use, the duration of the episodes, productivity loss and daily labour costs. The TreeAge Healthcare Pro 202...
Pharmaceutical Market Access in Developed Markets2018
Health, 2016
Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on qual... more Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution-SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the outpatient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.
Bulletin of Clinical Psychopharmacology, 2005
Abstract Selective serotonin reuptake inhibitors are used for the treatment of a wide range of ps... more Abstract Selective serotonin reuptake inhibitors are used for the treatment of a wide range of psychiatric disorders spectrum. Although bleeding attributed to the use of serotonin reuptake inhibitors is reported frequently in the literature, its exact frequency and etiology are ...
Bulletin of Clinical Psychopharmacology, 2004
The emphasis in evaluating drug treatment benefits is shifting from 'efficacy' to 'effectiveness'... more The emphasis in evaluating drug treatment benefits is shifting from 'efficacy' to 'effectiveness'. Efficacy is defined as the desirable effect of an intervention, whereas effectiveness is the extent to which a product works in the patients to whom it has been offered. This meaning is slightly different from 'efficacy', which can be measured in those who have actually been treated. 'Efficacy' relates to explanatory studies and 'effectiveness' to pragmatic studies. 1 Therapeutic efficacy (effectiveness) is often studied using observational surveys of patients whose treatments were selected nonexperimentally. New methodological strategies are being developed that may improve the quality of observational studies. These are, often based on the design principles and patient assembly procedures of the randomized trial. 2 Randomized clinical trials (RCTs) have been considered the 'gold standard' for establishing safety and efficacy due to
Journal of Affective Disorders, 2004
Background: This study aims to investigate whether the risk of recurrence following lithium disco... more Background: This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients. Methods: A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years. Results: The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period. Conclusions: Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.
Journal of Affective Disorders, 2004
This study aims to investigate whether the risk of recurrence following lithium discontinuation i... more This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients. A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years. The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period. Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.
Value in Health
This study aimed to review definitions of digital health and understand their relevance for healt... more This study aimed to review definitions of digital health and understand their relevance for health outcomes research. Four umbrella terms (digital health, electronic health, mobile health, and telehealth/telemedicine) were summarized in this article. Methods: PubMed/MEDLINE, Embase, Cochrane Library, and EconLit were searched from January 2015 to May 2020 for systematic reviews containing key Medical Subject Headings terms for digital health (n = 38) and synonyms of "definition." Independent pairs of reviewers performed each stage of the review, with reconciliation by a third reviewer if required. A single reviewer consolidated each definition for consistency. We performed text analysis via word clouds and computed document frequency-and inverse corpus frequency scores. Results: The search retrieved 2610 records with 545 articles (20.9%) taken forward for full-text review. Of these, 39.3% (214 of 545) were eligible for data extraction, of which 134 full-text articles were retained for this analysis containing 142 unique definitions of umbrella terms (digital health [n = 4], electronic health [n = 36], mobile health [n = 50], and telehealth/ telemedicine [n = 52]). Seminal definitions exist but have increasingly been adapted over time and new definitions were created. Nevertheless, the most characteristic words extracted from the definitions via the text analyses still showed considerable overlap between the 4 umbrella terms. Conclusions: To focus evidence summaries for outcomes research purposes, umbrella terms should be accompanied by Medical Subject Headings terms reflecting population, intervention, comparator, outcome, timing, and setting. Ultimately a functional classification system is needed to create standardized terminology for digital health interventions denoting the domains of patient-level effects and outcomes.
Pharmaceutical Market Access in Developed Markets2018, 2018
SUMMARY Introduction: We aimed to quantify patients' and physicians' preferences for ther... more SUMMARY Introduction: We aimed to quantify patients' and physicians' preferences for therapeutic trade-offs involving the efficacy, side-effect risks, and evidence uncertainty in chronic hepatitis B (CHB) treatments. Materials and Methods: Physicians who treat CHB patients and adult patients with a self-reported physician diagnosis of CHB comp- leted a web-enabled, discrete-choice experiment survey in Turkey. Both patients and physicians answered 12 treatment-choice questi- ons. Each question required evaluating a pair of hypothetical CHB medication profiles defined by the years the medicine has been stu- died (weight of evidence), probability that the patient's viral load remains undetectable for five years with possible reversal of disease progression (efficacy), five-year treatment-related risks of a fracture and renal insufficiency, and monthly medication cost. Logit models were used to estimate preference weights for all attribute levels and the profile preference s...
Pharmaceutical Market Access in Developed Markets2018, 2018
Orphanet Journal of Rare Diseases
Background Rare diseases are life-threatening, serious, and chronic conditions that require compl... more Background Rare diseases are life-threatening, serious, and chronic conditions that require complex care and have a low prevalence. An estimated one in 15 people worldwide are affected by rare diseases. This study aims to analyze the accessibility, reimbursement status, licensed status, and Anatomical Therapeutic Chemical (ATC) codes of drugs that the European Medicines Agency (EMA) in Turkey considers to be “orphan” pharmaceuticals. Methods The drugs included in this analysis were obtained from the list of orphan drugs published by the EMA. Orphan drugs’ accessibility and licensing status in Turkey were obtained from the Health Implementation Communiqué published by the Social Security Institution (SGK) and the List of Abroad Active Substance and List of Licensed Products published by the Turkey Pharmaceuticals and Medical Devices Agency (TİTCK). Descriptive analysis was applied to determine the accessibility status of orphan drugs identified by the EMA in Turkey. Results Based on ...
Pharmaceutical Market Access in Developed Markets2018
(Servizio Sanitario Nazionale-SSN)-established with the law 833/1978 [1]-is a network of structur... more (Servizio Sanitario Nazionale-SSN)-established with the law 833/1978 [1]-is a network of structures and facilities to guarantee health services access to all the citizens, as stated by Article 32 of the Italian Constitution [2]. The SSN operates under the direction and responsibility of the Ministry of Health (MH), which determines general healthcare policies, while the "retail sale" is planned, coordinated and managed at regional level, as a consequence of the process of devolution from State to Regions, regulated by the Constitution title V reform in 2001 [3]. The Italian Government as warrantor of health rights (article 32) [2], through MH, determines the essential levels of care (Livelli Essenziali di Assistenza-LEAs) that every region has to be able to provide in the public setting. Every Region autonomously defines its strategic planning, especially in terms of financial resources and distribution on regional territory of Local Health Units (Aziende Sanitarie Locali-ASLs) and Hospital Units (Aziende Ospedaliere-AOs), as well as act as supervisors of granting procedure of private health units. ASLs and AOs operate autonomously to guarantee the organization of local health care and supply of healthcare services. The collaboration between the various governments of SSN, i.e. State, Regions, ASLs and AOs, is a fundamental principle for ensuring uniform health conditions and guarantees throughout the national territory acceptable and appropriate levels of health services for all citizens. The cooperation between the State, on one side, and the nineteen Regions plus the autonomous provinces of Trento and Bolzano, on the other, is promoted through Conferenza Permanente Stato Regioni that represents the policy place in which politic negotiation between central administration and regional autonomies occurs. It was established with the law of 12 October 1983 4]. Long-time planning is a qualifying element of SSN: the MH, as delegate of the central Government, with the cooperation of Regions establishes the National Health Plan (Piano Sanitario Nazionale-PSN). It describes the general targets and elements that must be reached in health matter on the national territory, taking into account the financial, demographical and epidemiological contexts, as well as new scientific and technological innovations. It has three-year validity, but it may be revised in itinere if needed. The PSN defines the line that all health care stakeholders must follow for guaranteeing LEAs, and how funding must be broken down by levels of care.
Orphanet Journal of Rare Diseases
Background Rare diseases are life-threatening, serious, and chronic conditions that require compl... more Background Rare diseases are life-threatening, serious, and chronic conditions that require complex care and have a low prevalence. An estimated one in 15 people worldwide are affected by rare diseases. This study aims to analyze the accessibility, reimbursement status, licensed status, and Anatomical Therapeutic Chemical (ATC) codes of drugs that the European Medicines Agency (EMA) in Turkey considers to be “orphan” pharmaceuticals. Methods The drugs included in this analysis were obtained from the list of orphan drugs published by the EMA. Orphan drugs’ accessibility and licensing status in Turkey were obtained from the Health Implementation Communiqué published by the Social Security Institution (SGK) and the List of Abroad Active Substance and List of Licensed Products published by the Turkey Pharmaceuticals and Medical Devices Agency (TİTCK). Descriptive analysis was applied to determine the accessibility status of orphan drugs identified by the EMA in Turkey. Results Based on ...
Journal of Pharmaceutical Health Services Research
Objectives As one of the most common health problems, the common cold may lead to negative conseq... more Objectives As one of the most common health problems, the common cold may lead to negative consequences such as work or school absenteeism, poor productivity and labour loss. Vitamin C supports immune system defences by supporting the various cellular functions of the immune system, both congenital and adaptive. The purpose of this study is to evaluate the use of vitamin C in white-collar workers and its impact on medical care costs and its impact on the workforce in association with the common cold. Methods For calculation of the effect of 1000 mg vitamin C daily on the workforce and possible healthcare services costs, a Markov-based model was simulated with 6 cycles consistent with the literature that constituted the model input for the 6-month common cold season. The simulated Markov model included parameters for the number of seasonal flu episodes with or without vitamin C use, the duration of the episodes, productivity loss and daily labour costs. The TreeAge Healthcare Pro 202...
Pharmaceutical Market Access in Developed Markets2018
Health, 2016
Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on qual... more Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution-SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the outpatient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.
Bulletin of Clinical Psychopharmacology, 2005
Abstract Selective serotonin reuptake inhibitors are used for the treatment of a wide range of ps... more Abstract Selective serotonin reuptake inhibitors are used for the treatment of a wide range of psychiatric disorders spectrum. Although bleeding attributed to the use of serotonin reuptake inhibitors is reported frequently in the literature, its exact frequency and etiology are ...
Bulletin of Clinical Psychopharmacology, 2004
The emphasis in evaluating drug treatment benefits is shifting from 'efficacy' to 'effectiveness'... more The emphasis in evaluating drug treatment benefits is shifting from 'efficacy' to 'effectiveness'. Efficacy is defined as the desirable effect of an intervention, whereas effectiveness is the extent to which a product works in the patients to whom it has been offered. This meaning is slightly different from 'efficacy', which can be measured in those who have actually been treated. 'Efficacy' relates to explanatory studies and 'effectiveness' to pragmatic studies. 1 Therapeutic efficacy (effectiveness) is often studied using observational surveys of patients whose treatments were selected nonexperimentally. New methodological strategies are being developed that may improve the quality of observational studies. These are, often based on the design principles and patient assembly procedures of the randomized trial. 2 Randomized clinical trials (RCTs) have been considered the 'gold standard' for establishing safety and efficacy due to
Journal of Affective Disorders, 2004
Background: This study aims to investigate whether the risk of recurrence following lithium disco... more Background: This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients. Methods: A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years. Results: The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period. Conclusions: Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.
Journal of Affective Disorders, 2004
This study aims to investigate whether the risk of recurrence following lithium discontinuation i... more This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients. A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years. The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period. Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.