Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy
Identifieur interne : 001D24 ( Main/Corpus ); précédent : 001D23; suivant : 001D25Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy
Auteurs : Angelo Antonini ; Patrizia Berto ; Stefania Lopatriello ; Filippo Tamma ; Lieven Annemans ; Mike ChambersSource :
- Movement Disorders [ 0885-3185 ] ; 2008-11-15.
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Abstract
Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22278
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A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Angelo Antonini MD, PhD</name><affiliations><json:string>Parkinson Institute, Milan, Italy</json:string></affiliations></json:item><json:item><name>Patrizia Berto MSc</name><affiliations><json:string>PBE Consulting, Verona, Italy</json:string></affiliations></json:item><json:item><name>Stefania Lopatriello MSc</name><affiliations><json:string>PBE Consulting, Verona, Italy</json:string></affiliations></json:item><json:item><name>Filippo Tamma MD</name><affiliations><json:string>Department of Neurology, San Paolo Hospital, Milan, Italy</json:string></affiliations></json:item><json:item><name>Lieven Annemans PhD</name><affiliations><json:string>Department of Public Health, University of Ghent, Belgium</json:string></affiliations></json:item><json:item><name>Mike Chambers MSc</name><affiliations><json:string>GE Healthcare, Chalfont St. Giles, England</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinsonism</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>essential tremor</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DaTSCAN®</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>single photon emission computed tomography (SPECT)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>123I‐FP‐CIT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cost‐effectiveness</value></json:item></subject><articleId><json:string>MDS22278</json:string></articleId><language><json:string>eng</json:string></language><abstract>Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</abstract><qualityIndicators><score>6.301</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>7</keywordCount><abstractCharCount>1363</abstractCharCount><pdfWordCount>3925</pdfWordCount><pdfCharCount>26371</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>198</abstractWordCount></qualityIndicators><title>Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy</title><genre><json:string>article</json:string></genre><host><volume>23</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>8</total><last>2209</last><first>2202</first></pages><issn><json:string>0885-3185</json:string></issn><issue>15</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1002/mds.22278</json:string></doi><id>C9F93480604AF95B462D61550F1DC0EDBF1BA469</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/C9F93480604AF95B462D61550F1DC0EDBF1BA469/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/C9F93480604AF95B462D61550F1DC0EDBF1BA469/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/C9F93480604AF95B462D61550F1DC0EDBF1BA469/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2008</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: The study was funded by an unrestricted grant from GE Healthcare (formerly Amersham Health) to PBE consulting, Verona, Italy (Berto and Lopatriello). At the time of the study Michael Chambers was an employee of GE Healthcare. Lieven Annemans received an unrestricted grant from GE healthcare for the development of the original model. Angelo Antonini and Filippo Tamma have received consultancy fees from GE Healthcare.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy</title><author><persName><forename type="first">Angelo</forename><surname>Antonini</surname></persName><roleName type="degree">MD, PhD</roleName><note type="correspondence"><p>Correspondence: Parkinson Institute, Via Bignami,1, 20126 Milan, Italy</p></note><affiliation>Parkinson Institute, Milan, Italy</affiliation></author><author><persName><forename type="first">Patrizia</forename><surname>Berto</surname></persName><roleName type="degree">MSc</roleName><affiliation>PBE Consulting, Verona, Italy</affiliation></author><author><persName><forename type="first">Stefania</forename><surname>Lopatriello</surname></persName><roleName type="degree">MSc</roleName><affiliation>PBE Consulting, Verona, Italy</affiliation></author><author><persName><forename type="first">Filippo</forename><surname>Tamma</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, San Paolo Hospital, Milan, Italy</affiliation></author><author><persName><forename type="first">Lieven</forename><surname>Annemans</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Public Health, University of Ghent, Belgium</affiliation></author><author><persName><forename type="first">Mike</forename><surname>Chambers</surname></persName><roleName type="degree">MSc</roleName><affiliation>GE Healthcare, Chalfont St. Giles, England</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-11-15"></date><biblScope unit="volume">23</biblScope><biblScope unit="issue">15</biblScope><biblScope unit="page" from="2202">2202</biblScope><biblScope unit="page" to="2209">2209</biblScope></imprint></monogr><idno type="istex">C9F93480604AF95B462D61550F1DC0EDBF1BA469</idno><idno type="DOI">10.1002/mds.22278</idno><idno type="ArticleID">MDS22278</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="fr"><p>Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinsonism</term></item><item><term>Parkinson's disease</term></item><item><term>essential tremor</term></item><item><term>DaTSCAN®</term></item><item><term>single photon emission computed tomography (SPECT)</term></item><item><term>123I‐FP‐CIT</term></item><item><term>cost‐effectiveness</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-11-14">Received</change><change when="2008-07-20">Registration</change><change when="2008-11-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/C9F93480604AF95B462D61550F1DC0EDBF1BA469/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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type="organization"><unparsedAffiliation>Parkinson Institute, Milan, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="IT" type="organization"><unparsedAffiliation>PBE Consulting, Verona, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="IT" type="organization"><unparsedAffiliation>Department of Neurology, San Paolo Hospital, Milan, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="BE" type="organization"><unparsedAffiliation>Department of Public Health, University of Ghent, Belgium</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="GB" type="organization"><unparsedAffiliation>GE Healthcare, Chalfont St. Giles, England</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinsonism</keyword><keyword xml:id="kwd2">Parkinson's disease</keyword><keyword xml:id="kwd3">essential tremor</keyword><keyword xml:id="kwd4">DaTSCAN®</keyword><keyword xml:id="kwd5">single photon emission computed tomography (SPECT)</keyword><keyword xml:id="kwd6"><sup>123</sup>I‐FP‐CIT</keyword><keyword xml:id="kwd7">cost‐effectiveness</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="fr"><title type="main">Abstract</title><p>Economic evaluation (Italian NHS perspective) modeling <sup>123</sup>I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of <sup>123</sup>I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. <sup>123</sup>I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of <sup>123</sup>I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. <sup>123</sup>I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn3"><p>Potential conflict of interest: The study was funded by an unrestricted grant from GE Healthcare (formerly Amersham Health) to PBE consulting, Verona, Italy (Berto and Lopatriello). At the time of the study Michael Chambers was an employee of GE Healthcare. Lieven Annemans received an unrestricted grant from GE healthcare for the development of the original model. Angelo Antonini and Filippo Tamma have received consultancy fees from GE Healthcare.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Cost‐Effectiveness of 123I‐FP‐CIT SPECT in Parkinsonism</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Cost‐effectiveness of</title></titleInfo><name type="personal"><namePart type="given">Angelo</namePart><namePart type="family">Antonini</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Parkinson Institute, Milan, Italy</affiliation><description>Correspondence: Parkinson Institute, Via Bignami,1, 20126 Milan, Italy</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Patrizia</namePart><namePart type="family">Berto</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>PBE Consulting, Verona, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefania</namePart><namePart type="family">Lopatriello</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>PBE Consulting, Verona, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Filippo</namePart><namePart type="family">Tamma</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, San Paolo Hospital, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lieven</namePart><namePart type="family">Annemans</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Public Health, University of Ghent, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mike</namePart><namePart type="family">Chambers</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>GE Healthcare, Chalfont St. Giles, England</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2008-11-15</dateIssued><dateCaptured encoding="w3cdtf">2007-11-14</dateCaptured><dateValid encoding="w3cdtf">2008-07-20</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">4</extent><extent unit="references">23</extent><extent unit="words">5481</extent></physicalDescription><abstract lang="fr">Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: The study was funded by an unrestricted grant from GE Healthcare (formerly Amersham Health) to PBE consulting, Verona, Italy (Berto and Lopatriello). At the time of the study Michael Chambers was an employee of GE Healthcare. Lieven Annemans received an unrestricted grant from GE healthcare for the development of the original model. Angelo Antonini and Filippo Tamma have received consultancy fees from GE Healthcare.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinsonism</topic><topic>Parkinson's disease</topic><topic>essential tremor</topic><topic>DaTSCAN®</topic><topic>single photon emission computed tomography (SPECT)</topic><topic>123I‐FP‐CIT</topic><topic>cost‐effectiveness</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>15</number></detail><extent unit="pages"><start>2202</start><end>2209</end><total>8</total></extent></part></relatedItem><identifier type="istex">C9F93480604AF95B462D61550F1DC0EDBF1BA469</identifier><identifier type="DOI">10.1002/mds.22278</identifier><identifier type="ArticleID">MDS22278</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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