METHODS: Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food-drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score.
RESULTS: Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher scores on the clinical endpoints resulting in a higher TUS for atorvastatin. Fluvastatin recorded the lowest TUS.
CONCLUSION: The multiattribute scoring tool was successfully applied to organize decision variables in reviewing statins for the formulary. Based on the TUS, atorvastatin is recommended to remain in the formulary and be considered as first-line in the treatment of hypercholesterolemia.
METHODS: A total of 28 employees participated in a six-month-long obesity health programme, which consisted of two weekly unsupervised exercise sessions and monthly dietary/health education sessions. The physical fitness and body fat percentages of participants were assessed at the baseline and after six months, using SPSS version 20.0.
RESULTS: The participants were 31.6 years (SD 8.2) of age, and had a BMI of 27.6 kg/m(2) (SD 3.2). The Wilcoxon test showed significant differences in body fat percentage (P = 0.010), gross maximum oxygen uptake (VO2max, P = 0.014), partial curl up repetition (P = 0.001) and sit and reach distance (P = 0.005). However, no significant effects were observed on body mass (P = 0.193), self-perceived level of physical activity (P = 0.145) or behaviour toward exercise (P = 0.393).
CONCLUSION: The worksite health programme successfully improved the physical fitness and body fat percentages of subjects, despite not improving the subjects' self-perceptions with regard to physical activity.