Methods of data collection and analysis for the economic evaluation alongside a national, multi-centre trial in the UK: Conventional ventilation or ECMO for Severe Adult Respiratory Failure (CESAR)
| Autor: | Ravindranath Tiruvoipati, Felicity Clemens, Mariamma M. Thalanany, Polly Hardy, Ann Truesdale, Nicola J. Cooper, Giles J. Peek, Diana Elbourne, Miranda Mugford, Clare Hibbert, Andrew M. Wilson, Steven Robinson |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Technology Assessment Biomedical Adolescent Cost effectiveness Cost-Benefit Analysis Severity of Illness Index law.invention Disability Evaluation Extracorporeal Membrane Oxygenation Randomized controlled trial Cost of Illness law Intensive care Correspondence medicine Humans Intensive care medicine health care economics and organizations Aged Cost–utility analysis Respiratory Distress Syndrome Cost–benefit analysis business.industry Data Collection lcsh:Public aspects of medicine Health Policy lcsh:RA1-1270 Cost-effectiveness analysis Health Care Costs Middle Aged medicine.disease Respiration Artificial Survival Analysis United Kingdom Quality-adjusted life year Intensive Care Units Models Economic Economic evaluation Female Medical emergency Quality-Adjusted Life Years business |
| Zdroj: | BMC Health Services Research, Vol 8, Iss 1, p 94 (2008) BMC Health Services Research |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/1472-6963-8-94 |
| Popis: | Background Extracorporeal Membrane Oxygenation (ECMO) is a technology used in treatment of patients with severe but potentially reversible respiratory failure. A multi-centre randomised controlled trial (CESAR) was funded in the UK to compare care including ECMO with conventional intensive care management. The protocol and funding for the CESAR trial included plans for economic data collection and analysis. Given the high cost of treatment, ECMO is considered an expensive technology for many funding systems. However, conventional treatment for severe respiratory failure is also one of the more costly forms of care in any health system. Methods/Design The objectives of the economic evaluation are to compare the costs of a policy of referral for ECMO with those of conventional treatment; to assess cost-effectiveness and the cost-utility at 6 months follow-up; and to assess the cost-utility over a predicted lifetime. Resources used by patients in the trial are identified. Resource use data are collected from clinical report forms and through follow up interviews with patients. Unit costs of hospital intensive care resources are based on parallel research on cost functions in UK NHS intensive care units. Other unit costs are based on published NHS tariffs. Cost effectiveness analysis uses the outcome: survival without severe disability. Cost utility analysis is based on quality adjusted life years gained based on the Euroqol EQ-5D at 6 months. Sensitivity analysis is planned to vary assumptions about transport costs and method of costing intensive care. Uncertainty will also be expressed in analysis of individual patient data. Probabilities of cost effectiveness given different funding thresholds will be estimated. Discussion In our view it is important to record our methods in detail and present them before publication of the results of the trial so that a record of detail not normally found in the final trial reports can be made available in the public domain. Trial Registrations The CESAR trial registration number is ISRCTN47279827. |
| Databáze: | OpenAIRE |
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