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ID:9356208
大小:141.00 KB
页数:17页
时间:2018-04-28
《cost-effectiveness of internal limiting membrane peeling 内界膜剥离的成本效益》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、Cost-effectivenessofinternallimitingmembranepeelingversusnopeelingforpatientswithidiopathicfullthicknessmacularhole:resultsfromarandomisedcontrolledtrial.LauraTernent1LukeVale1CharlesBoachie2JenniferBurr2NoemiLois3fortheFull-thicknessmacularholeandInternalLimitingMembranepeelingStudy(FILMS)Group1Ins
2、tituteofHealth&Society,NewcastleUniversity,UK2HealthServicesResearchUnit,UniversityofAberdeen,UK3OphthalmologyDepartment,GrampianUniversityHospitals-NHSTrust,Aberdeen,UKAddressforcorrespondence:LauraTernent,InstituteofHealth&Society,BaddileyClarkeBuilding,NewcastleUniversityNE24AXTel:01922227083Fax:
3、01912226043E-mail:laura.ternent@ncl.ac.ukWordcount:246817AbstractPurpose:Todeterminewhetherinternallimitingmembrane(ILM)peelingiscost-effectivecomparedwithnopeelingforpatientswithidiopathicstage2or3full-thicknessmacularhole(FTMH).Methods:Acost-effectivenessanalysiswasperformedalongsidearandomisedcon
4、trolledtrial(RCT).141participantswererandomlyallocatedtoreceivemacularholesurgery,witheitherILMpeelingornopeeling.Healthserviceresourceuse,costsandqualityoflifewerecalculatedforeachparticipant.Incrementalcostperquality-adjustedlifeyear(QALY)gainedwascalculatedat6months.Results:At6monthstotalcostswer
5、eonaveragehigher(£424,95%CI-182to1045)intheNoPeelarm;primarilyduetothehigherreoperationrateintheNoPeelarm.ThemeanadditionalQALYsfromILMpeelatsixmonthswere0.002(95%CI0.01to0.013),adjustingforbaselineEQ-5Dandotherminimisationfactors.AmeanincrementalcostperQALYwasnotcomputedasPeelingwasonaveragelesscos
6、tlyandslightlymoreeffective.Astochasticanalysissuggestedthattherewasmorethana90%probabilitythatPeelingwouldbecost-effectiveatawillingnesstopaythresholdof£20,000perQALY.Conclusion:AlthoughthereisnoevidenceofastatisticallysignificantdifferenceineithercostsorQALYsbetweenmacularholesurgerywithorwithoutI
7、LMpeeling,thebalanceofprobabilitiesisthatILMPeelingislikelytobeacost-effectiveoptionforthetreatmentofmacularholes.Furtherlong-termfollow-updataisneededtoconfirmthesefindings.17INTRODUCTIONAfull-thickn
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