Your browser doesn't support javascript.
loading
Clinical and cost-effectiveness analysis of an open label, single-centre, randomised trial of spinal cord stimulation (SCS) versus percutaneous myocardial laser revascularisation (PMR) in patients with refractory angina pectoris: The SPiRiT trial.
Dyer, M T; Goldsmith, K A; Khan, S N; Sharples, L D; Freeman, C; Hardy, I; Buxton, M J; Schofield, P M.
Afiliación
  • Dyer MT; Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UK. matthew.dyer@brunel.ac.uk
Trials ; 9: 40, 2008 Jun 30.
Article en En | MEDLINE | ID: mdl-18590536
BACKGROUND: Patients with refractory angina have significant morbidity. This study aimed to compare two of the treatment options, Spinal Cord Stimulation (SCS) and Percutaneous Myocardial Laser Revascularisation (PMR) in terms of clinical outcomes and cost-effectiveness. METHODS: Eligible patients were randomised to PMR or SCS and followed up for exercise tolerance time (ETT), Canadian Cardiovascular Society (CCS) classification and the quality of life measures SF-36, Seattle Angina Questionnaire and the EuroQoL at 3, 12 and 24 months. Utilities were calculated using the EQ-5D and these and costs were compared between groups. The incremental cost-effectiveness ratio (ICER) per QALY for SCS compared to PMR was also calculated. RESULTS: At 24 months post-randomisation, patients that had SCS and PMR had similar ETT (mean difference 0.05, 95% CI -2.08, 2.18, p = 0.96) and there was no difference in CCS classification or quality of life outcomes. The difference in overall mean costs when comparing SCS to PMR was GBP5,520 (95% CI GBP1,966 to GBP8,613; p < 0.01) and the ICER of using SCS was GBP46,000 per QALY. CONCLUSION: Outcomes after SCS did not differ appreciably from those after PMR, with the former procedure being less cost-effective as currently applied. Larger studies could clarify which patients would most benefit from SCS, potentially increasing cost-effectiveness. TRIAL REGISTRATION: Current Controlled Trials ISRCTN09648950.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Trials Asunto de la revista: MEDICINA / TERAPEUTICA Año: 2008 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Trials Asunto de la revista: MEDICINA / TERAPEUTICA Año: 2008 Tipo del documento: Article Pais de publicación: Reino Unido