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INNOVATION IN GASTROENTEROLOGICAL MANAGEMENT: THE CASE OF CIMETIDINE
Abstract
Gastroenterological medicine has, in recent decades, experienced two major innovations, viz. fibre optic endoscopy (a diagnostic technology) and cimetidine, an innovation in ulcer therapy. This paper is concerned with determining the efficacy of cimetidine in reducing the number of surgical procedures for gastric and duodenal ulcer. It is found that, since the introduction of cimetidine, a statistically significant decline in gastric ulcer operations has occurred. A similar result was not obtained for persons with a diagnosis of duodenal ulcer. The picture of substitution of therapies given by this study is in sharp contrast to that depicted in clinical drug trials. This has significance for technology assessment.
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NOTES AND REFERENCES
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For definitions see Australian Bureau of Statistics, Hospital Morbidity, Queensland, 1979, Australian Bureau of Statistics, Brisbane, 1982, pp. 1–2.
In the period under consideration in this study there were two revisions applicable: the eighth revision from 1969 to 1978 and the ninth revision from 1979. See World Health Organisation, Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, World Health Organisation, Geneva, 1968 and 1977.
Commonwealth Department of Health and Commonwealth Bureau of Census and Statistics, Code of Surgical Operations, Commonwealth Bureau of Census and Statistics, Canberra, 1968; World Health Organisation, International Classification of Procedures in Medicine, World Health Organisation, Geneva, 1978.
Australian Bureau of Statistics, Causes of Death, Australia 1979, Australian Bureau of Statistics, Canberra, 1981, pp. 120–5.
These data have been obtained by computer search of the Queensland Department of Health's copy of the file of unit records for the study period. Given the purpose of this study the aggregated data published by the Australian Bureau of Statistics are inappropriate.
Our attempts to analyse the data by six-month time periods, rather than in years, were unsuccessful. This could have arisen as a result of the smaller numbers that were involved in this shorter time period. Our estimated equations gave relatively poor fits to the six monthly data.
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