Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial
| Autor: | Tracey Sach, A Zaman, Francis Osborn, Alexander J E Foss, Rowan H. Harwood, Richard M. Gregson, Tahir Masud |
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| Rok vydání: | 2009 |
| Předmět: |
Pediatrics
medicine.medical_specialty genetic structures Cost-Benefit Analysis Eye disease medicine.medical_treatment Cataract Extraction Cataract law.invention Quality of life Randomized controlled trial law Outcome Assessment Health Care medicine Humans Aged Aged 80 and over Cost–utility analysis Cost–benefit analysis business.industry Health Care Costs Cataract surgery medicine.disease eye diseases Confidence interval Surgery Clinical trial Ophthalmology Models Economic Female Quality-Adjusted Life Years sense organs business |
| Zdroj: | Eye. 24:276-283 |
| ISSN: | 1476-5454 0950-222X |
| DOI: | 10.1038/eye.2009.112 |
| Popis: | The aim of this study was to evaluate the cost-effectiveness of second-eye cataract surgery for older women with minimal visual dysfunction in the eye to be operated on from a Health and Personal Social Services perspective, compared to waiting list controls who had already undergone first-eye cataract surgery.A cost-utility analysis was undertaken alongside a randomized controlled trial of second-eye cataract surgery in secondary care ophthalmology clinics. A total of 239 women over 70 years old with one unoperated cataract were randomized to cataract surgery (expedited, approximately 4 weeks) or control (routine surgery, 12 months wait). Outcomes were measured in terms of quality-adjusted life years (QALYs), with health-related quality of life estimated using the EuroQol EQ-5D.The operated group had costs which were, on average, pound646 more than the control group (95% confidence interval, pound16-1276, P0.04) and had a mean QALY gain of 0.015 (95% confidence interval, -0.039 to 0.068, P=0.59) per patient over 1 year. Therefore, the incremental cost-utility ratio was pound44,263 over the 1-year trial period. In an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pound17,299, under conservative assumptions.Second-eye cataract surgery is not likely to be cost-effective in the short term for those with mild visual dysfunction pre-operation. In the long term, second-eye cataract surgery appears to be cost-effective unless carer costs are included. |
| Databáze: | OpenAIRE |
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