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1、Volume13•Number5•2010VALUEINHEALTHACost-UtilityAnalysisofMicrowaveEndometrialAblationversusThermalBalloonEndometrialAblationvhe_704528..534123MaryM.Kilonzo,MSc,AlisonM.Sambrook,MSc,MRCOG,JonathanA.Cook,PhD,32MarionK.Campbell,PhD,KevinG.Cooper,MD,MRCOG1HealthEconomicsResearchUnit,
2、UniversityofAberdeen,UK;2DepartmentofGynaecology,AberdeenRoyalInfirmary,UK;3HealthServicesResearchUnit,UniversityofAberdeen,UKABSTRACTObjective:Toevaluatethecost-effectivenessofmicrowaveendometrialResults:ThemeancostofTBALL(10yearsequipmentlife,100usesablation(MEA)andthermalballoo
3、nendometrialablation(TBALL)forannually)ofreusableequipmentwas£181(95%confidenceinterval[CI]heavymenstrualbleeding.£70–434)greaterthanMEA.Therewerenostatisticallysignificantdiffer-Methods:Acost-utilityanalysisperformedalongsideapragmaticRCTinencesbetweenthetotalnonhealthcostsandheal
4、thbenefitsofthetwoasinglehospitalwithinScotlandonwomenundergoingMEAandTBALL.arms.Onaverage,MEAprovidedmoreQALYsafteradjustingforbaselineResourceusedatacollectedfromall314trialparticipantswerecombinedEQ-5Dscore(0.017;95%CI0.017–0.051).Intermsofmeanincrementalwithstudyspecificandpubl
5、ishedunitcostdatatoestimateacostpercostperQALY,MEAwas,onaverage,dominant(lesscostlyandatleastpatient.Quality-adjustedlife-years(QALYs)werebasedonEQ-5Daseffective)andtherewasovera90%chancethatMEAwouldberesponsesatbaseline,2weeks,6and12months.Theincrementalcostperconsideredcost-eff
6、ectiveata£20,000thresholdofacostperQALY.QALYofTBALLversusMEAwascalculatedandbootstrappingwasConclusions:MEAislikelytobemorecost-effectivethanTBALLatperformedtodeterminethelikelihoodthatatreatmentwouldbecost-1year.Furtherlonger-termfollow-upis,however,needed.effectiveatdifferentth
7、resholdvaluesforsociety’swillingnesstopayforaKeywords:cost-utilityanalysis,health-relatedqualityoflife,quality-QALY.adjustedlife-year,randomizedcontrolledtrial.IntroductionJanuary2003andJanuary2005.WomenwererandomizedtoeitherMEAorTBALLunderlocalorgeneralanesthesiadepend-Womenwith
8、heavymenstrualbleedingrepresentasignifica
