Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

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168 Appendix 9 TABLE 71 contd Quality of cost or economic comparisons of anaesthetic agents Study Study design Resources measured and costed Source of costs Results Data collection Economic checklist Hsu and Shalansky, Source: Study design: INAD Anaesthetics Not known Costs (anaesthetic 1995, 214 Canada prospective acquisition only) cohort Effectiveness data: Thiopental: US $8079.68 INAD Randomisation: Propofol: US $60331.28 no Outcome data: per year for the institution INAD Blind: no Effectiveness Cost data: UNACC Time to eye opening: Power estimate: 10.9 thiopental and yes. 14 patients Analysis: INAD 7.0 propofol (p = 0.0025) per group estimated to Sensitivity analysis: Time to consciousness: detect a 15% no 13.3 thiopental and difference in time 8.3 propofol (p = 0.0019) to eye opening at 80% power Time spent in recovery room: 142.6 thiopental Inclusion/ and 111.46 propofol exclusion criteria: (p = 0.013) 4 Time to orientation: Recruitment 14.5 thiopental and rates: NK 9.3 propofol (p = 0.0002) Representative Time to tolerate fluid: sample: NK 76.1 thiopental and 53.8 propofol (p = 0.06) Comparable groups: NK Jakobsson et al., Source: RCT Study design: INAD Anaesthetics and drugs Official list price Costs 1997, 84 Sweden Desflurane: SEK 40.5 ± 18 Randomisation: Effectiveness data: NK INAD Propofol: SEK 114 ± 34 Blind: NK Outcome data: NA p < 0.01 Power estimate: Cost data: UNACC Effectiveness * NK No differences Analysis: INAD Inclusion/ exclusion Sensitivity analysis: criteria: 5 no Recruitment rates: NK Representative sample: NK Comparable groups: yes continued
TABLE 71 contd Quality of cost or economic comparisons of anaesthetic agents © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Health Technology Assessment 2002; Vol. 6: No. 30 Study Study design Resources measured and costed Source of costs Results Data collection Economic checklist Kain et al., 1994, 215 Source: RCT Study design: INAD Anaesthetics, time Hospital accounts Costs USA to recovery Propofol net saving: Randomisation: Effectiveness data: US $3228 NK INAD Effectiveness * Blind: single Outcome data: NA Propofol superior Power estimate: Cost data: UNACC NK Analysis: INAD Inclusion/exclusion criteria: NK Sensitivity analysis: no Recruitment rates: NK Representative sample: NK Comparable groups: NK Killian et al., 1992, 86 Source: RCT Study design: INAD Anaesthetics and Not known Costs Canada anti-emetics Propofol TIVA: total cost Randomisation: Effectiveness data: US $16.41 per patient yes INAD Thiopental/isoflurane: total Blind: no Outcome data: INAD cost US $5.45 per patient Power estimate: Effectiveness no Cost data: UNACC No difference in terms of time to open eyes Inclusion/exclusion Analysis: INAD (immediate recovery), criteria: 9 Aldrete score, time to Sensitivity analysis: orientation, PONV. Recruitment no Propofol TIVA was rates: NK superior in terms of intermediate and late Representative recovery, psychomotor sample: NK tests and overall recovery Comparable groups: yes Kurpiers et al., Source: RCT Study design: INAD Drug Hospital-specific Costs 1996, 216 USA prices Propofol TIVA: average Randomisation: Effectiveness data: cost US $31.77 ± 14.44; yes INAD drug costs US $57.97 ± 20.22 Blind: no Outcome data: INAD Propofol/desflurane: Power estimate: average cost US $12.99 no Cost data: UNACC ± 7.61; drug costs US $34.86 ± 14.13 Inclusion/exclusion Analysis: INAD criteria: 8 Effectiveness Sensitivity analysis: PONV: propofol 12% and Recruitment no desflurane 41% (p < 0.05) rates: NK Representative sample: NK Comparable groups: yes continued 169
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Which anaesthetic agents are costef
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Which anaesthetic agents are costef
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NHS R&D HTA Programme The NHS R&D H
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Contents Appendix 6 Adult patient-b
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Background The aim of the project w
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• The incidence of PONV was low d
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2 Introduction dizziness or disorie
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4 Introduction a reduced incidence
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6 Introduction willingness to pay f
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8 Literature review included in the
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10 Literature review TABLE 1 Compar
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12 Literature review intermediate a
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18 Literature review Patient-based
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20 Literature review TABLE 5 contd
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22 Literature review No studies fol
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24 Literature review (30%) and meth
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26 Literature review • There are
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28 National survey of anaesthetic p
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36 Economic evaluation methods (inc
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38 Economic evaluation methods The
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40 Economic evaluation methods Tabl
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42 Economic evaluation methods simi
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44 Economic evaluation methods Prob
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Recruitment to the CESA RCT The stu
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Clinical outcome data PONV by anaes
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The findings from the logistic regr
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TABLE 29 The length of stay and pri
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140 120 100 80 60 40 20 0 No. of pa
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250 200 150 100 50 0 No. of patient
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TABLE 37 Deterministic sensitivity
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20 15 10 5 0 -5 Difference in varia
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Patient admitted for day surgery an
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500 400 300 200 100 0 -100 -200 -30
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Recruitment to the CESA RCT The stu
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TABLE 49 The occurrence of any PONV
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60 50 40 30 20 10 0 No. of patients
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a scale effect for scenario A, but
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The mean CVs for avoidance of PONV
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1.80 The new variable cost and tota
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100 90 80 70 60 50 40 30 20 10 0 Su
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The structure and content of this d
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nurses to have an in-depth knowledg
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agent used (see appendix 18). It wa
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Furthermore, anaesthetists operate
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The CESA project was designed to as
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practice, such as the use of midazo
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1. Royal College of Surgeons of Eng
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60. Cheng KI, Chu KS, Fang YR, Su K
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112. Raeder J, Gupta A, Pedersen FM
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162. Viitanen H, Baer G, Annila P.
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220. Rosenberg KM, Bridge P, Brown
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The range of databases interrogated
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24. preferen$.mp. [mp=title, abstra
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110 Appendix 2 TABLE 65 contd Summa
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112 Appendix 3 Quality assessment o
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Page 132 and 133: 118 Appendix 4 TABLE 66 contd Summa
Page 173 and 174: TABLE 69 Summary of paediatric pati
Page 175 and 176: TABLE 69 contd Summary of paediatri
Page 177 and 178: TABLE 70 Characteristics of cost or
Page 179 and 180: TABLE 71 Quality of cost or economi
Page 181: TABLE 71 contd Quality of cost or e
Page 185 and 186: TABLE 71 contd Quality of cost or e
Page 187 and 188: TABLE 71 contd Quality of cost or e
Page 189 and 190: Abbott J, Abbott P. Psychological a
Page 191 and 192: Hall JE, Stewart JIM, Harmer M. Sin
Page 193: Struys M, Versichelen L, Thas O, He
Page 196 and 197: 182 Appendix 11
Page 205 and 206: The aim of this study was to develo
Page 207 and 208: anaesthetics in day surgery, using
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Page 213 and 214: Background The empirical study quan
Page 215 and 216: Satisfaction with care Nearly all (
Page 217 and 218: TABLE 76 Reason given for preferenc
Page 219 and 220: TABLE 79 Comparisons with previous
Page 221 and 222: TABLE 80 Reason given for preferenc
Page 223 and 224: TABLE 81 Reason given for willingne
Page 225 and 226: Background Variable costs account f
Page 227 and 228: TABLE 85 Unit costs for the purchas
Page 229 and 230: Background The empirical study requ
Page 231 and 232: Ethical approval This was covered b
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20 15 10 5 0 -5 -10 -15 True weight
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15 10 5 0 -5 -10 True weight - Dion
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224 Appendix 19 • patients aged o
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All staff unit costs were for the y
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Background Fixed costs account for
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232 Appendix 22 March, Tuesday 15 A
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234 Appendix 23 TABLE 96 Reasons fo
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Patients were coded using the OPCS
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Q03.4 punch biopsy of cervix Q03.5
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This section displays the associati
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given in Table 103 confirm the age
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TABLE 107 Occurrence of PONV by dur
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248 Appendix 27 TABLE 113 Frequency
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This section displays the associati
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The adverse events observed in the
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262 Health Technology Assessment Pr
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264 Health Technology Assessment Pr
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