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3 vs. 1.1; P = 0.04). A secondary hypothesis-generating analysis excluding the cost of BP therapy in the BC group of our retrospective, observational study estimated an 84% (95%CI [27%; 167%]) increment in the costs of resource use among patients receiving PAM versus ZOL (Table 5). Similar to outcomes from the model including BP costs, diagnosis of bone metastasis at or after SRE onset was associated with a significant 180% increase in treatment costs (P Paclitaxel nmr per year in SRE-treatment costs (excluding the cost of BPs). To our Fluconazole knowledge, this study is one of the few estimating SRE treatment costs in patients being treated in day-to-day clinical practice, and applying statistical techniques for SRE cost modeling while controlling for differences in the sample population potentially related to observational retrospective data collection. As with all retrospective studies, however, our study design has certain limitations that might influence the results. Our study was dependent on hospitals' willingness to participate. Therefore, both the hospitals and patients are convenience samples. No formal assessment was made to determine the study sample representativeness because raw statistics were not available from public hospitals in Portugal. If we consider, however, medical oncology visits as proxy for hospital activity (i.e., reflecting the number of oncology patients treated in each hospital), then our sample can be considered reasonably representative. It included two thirds of all oncology and university hospitals, accounting for 52% and 68% of the medical oncology visits in such institutions, respectively. The remaining were a mixture of major urban-area hospitals (central) and smaller size hospitals, far from large metropolitan areas (responsible learn more for 32% of the oncology visits nationwide) [18]. The latter may be underrepresented compared with the former. Nationwide, the nine hospitals participating in our study accounted for approximately 43% of all oncology visits to PNHS hospitals in 2005. The number and characteristics of patients recruited from each hospital were physicians' decisions based on study protocol inclusion and exclusion criteria. Therefore, there might have been some selection bias, which could not be controlled for by researchers. Few hospitals had fully electronic clinical records. Another possible source of bias relates to inter-institution differences in how clinical records were maintained, potentially resulting in imbalanced registration of resource use.