This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Cost‐effectiveness analysis of a randomized clinical trial of early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration. BJS 2019; 106: 555-562.
Published: 11th February 2019
Authors: D. M. Epstein, M. S. Gohel, F. Heatley, X. Liu, A. Bradbury, R. Bulbulia et al.
Background
Treatment of superficial venous reflux in addition to compression therapy accelerates venous leg ulcer healing and reduces ulcer recurrence. The aim of this study was to evaluate the costs and cost‐effectiveness of early versus delayed endovenous treatment of patients with venous leg ulcers.
Method
This was a within‐trial cost‐utility analysis with a 1‐year time horizon using data from the EVRA (Early Venous Reflux Ablation) trial. The study compared early versus deferred endovenous ablation for superficial venous truncal reflux in patients with a venous leg ulcer. The outcome measure was the cost per quality‐adjusted life‐year (QALY) over 1 year. Sensitivity analyses were conducted with alternative methods of handling missing data, alternative preference weights for health‐related quality of life, and per protocol.
Results
After early intervention, the mean(s.e.m.) cost was higher (difference in cost per patient £163(318) (€184(358))) and early intervention was associated with more QALYs at 1 year (mean(s.e.m.) difference 0·041(0·017)). The incremental cost‐effectiveness ratio (ICER) was £3976 (€4482) per QALY. There was an 89 per cent probability that early venous intervention is cost‐effective at a threshold of £20 000 (€22 546)/QALY. Sensitivity analyses produced similar results, confirming that early treatment of superficial reflux is highly likely to be cost‐effective.
Conclusion
Early treatment of superficial reflux is highly likely to be cost‐effective in patients with venous leg ulcers over 1 year. Registration number: ISRCTN02335796 (
You may also be interested in
Original article
Authors: S. Zommorodi, M. Bottai, R. Hultgren
Original article
Authors: A. Saratzis, N. E. M. Jaspers, B. Gwilym, O. Thomas, A. Tsui, R. Lefroy et al.
Original article
Authors: J. M. Czerniecki, M. L. Thompson, A. J. Littman, E. J. Boyko, G. J. Landry, W. G. Henderson et al.
Original article
Authors: N. Nair, G. Kvizhinadze, G. T. Jones, R. Rush, M. Khashram, J. Roake et al.
Original article
Authors: D. C. Bosanquet, A. J. Sanders, F. Ruge, J. Lane, C. A. Morris, W. G. Jiang et al.
Randomized clinical trial
Authors: S. A. S. Hamann, L. Timmer‐de Mik, W. M. Fritschy, G. R. R. Kuiters, T. E. C. Nijsten, R. R. Bos et al.
Systematic review
Authors: A. J. A. Meershoek, E. E. Vries, D. Veen, H. M. Ruijter, G. J. Borst, A. Garcia‐Pastor et al.
Original article
Authors: S. F. Cheng, M. M. Brown, R. J. Simister, T. Richards
Original article
Authors: J. S. Lindholt, L. M. Rasmussen, R. Søgaard, J. Lambrechtsen, F. H. Steffensen, L. Frost et al.
Randomized clinical trial
Authors: S. Vähäaho, O. Mahmoud, K. Halmesmäki, A. Albäck, K. Noronen, P. Vikatmaa et al.
Systematic review
Authors: R. M. A. Bulder, E. Bastiaannet, J. F. Hamming, J. H. N. Lindeman
Original article
Authors: D. C. Norvell, M. L. Thompson, E. J. Boyko, G. Landry, A. J. Littman, W. G. Henderson et al.