Ulcus Cruris – Frühe venöse Ablation erhöht Lebensqualität bei Kosteneffizienz

2019 ◽  
Vol 24 (05) ◽  
pp. 220-220
Author(s):  
Gabriele Dobler
Keyword(s):  
Clinical Trial ◽  
Cost Effectiveness ◽  
Randomized Clinical Trial ◽  
Ulcus Cruris ◽  
Cost Effectiveness Analysis ◽  
Venous Reflux ◽  
Venous Ulceration ◽  
Effectiveness Analysis ◽  
Endovenous Ablation

Epstein DM. et al. Cost-effectiveness analysis of a randomized clinical trial of early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration. Br J Surg 2019; 106: 555–562 Aktuelle Richtlinien empfehlen bei venösen Beingeschwüren die Behandlung des venösen Refluxes mit endovenösen Ablationstechniken. Viele Praktiker warten jedoch mit der Intervention bis das Ulcus abgeheilt ist. Die EVRA (Early Venous Reflux Ablation) Studie ergab, dass eine frühe endovenöse Ablation zu signifikant schnellerer Abheilung der Ulcera führte. Epstein et al. verglichen die Kosteneffektivität früher und später Intervention.

scholarly journals Single versus double embryo transfer: cost-effectiveness analysis alongside a randomized clinical trial

2006 ◽  
Vol 21 (8) ◽  
pp. 2090-2097 ◽  
Author(s):  
Audrey A.A. Fiddelers ◽  
Aafke P.A. van Montfoort ◽  
Carmen D. Dirksen ◽  
John C.M. Dumoulin ◽  
Jolande A. Land ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cost Effectiveness ◽  
Randomized Clinical Trial ◽  
Embryo Transfer ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Transfer Cost ◽  
Single Versus ◽  
Double Embryo Transfer

scholarly journals Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis

2021 ◽  
Author(s):  
Modou Diop ◽  
David Epstein
Keyword(s):  
Cost Effectiveness ◽  
Repeated Measures ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Venous Ulceration ◽  
Time Horizons ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Significant Difference ◽  
Endovenous Ablation

Abstract OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study.METHODS: Patients in the Early Endovenous Ablation in Venous Ulceration (EVRA) trial had between 1 year and 5.5 years (median 3 years) of follow-up under early or deferred endovenous ablation. This study compares Complete-Case-Analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM), Bayesian parametric approach using the R package missingHE (BPA) and repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life years (QALYs) at different time horizons (1 year, 3 years and 5 years). RESULTS: All methods found no statistically significant difference in cost at the 5% level in all time horizons, and all methods found statistically significantly greater mean QALY at year 1. By year 3, only BPA showed a statistically significant difference in QALY. Standard errors differed substantially between the methods employed. CONCLUSION: CCA can be biased if data are MAR, and is wasteful of the data. Hence the results for CCA are likely to be inaccurate. Other methods coincide in suggesting that early intervention is cost-effective at a threshold of £20,000 per QALY over all time horizons. However, the variation in the results across the methods does generate some additional methodological uncertainty, underlining the importance of conducting sensitivity analyses using alternative approaches.

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