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

More documents

Recommendations

Info

172 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 Smith et al., 1999, 221 Source: RCT Study design: INAD Anaesthetics, drugs Country-specific Costs Belgium, France, and disposables prices converted Propofol TIVA: US $31.9 The Netherlands, Randomisation: Effectiveness data: to US $ UK yes, computer INAD Propofol/sevoflurane: generated US $19.7 Outcome data: Blind: no INAD Sevoflurane/sevoflurane: US $18.8 Power estimate: Cost data: UNACC no Effectiveness Analysis: INAD LMA insertion:TIVA 92.8, Inclusion/ propofol/sevoflurane 87.2, exclusion Sensitivity analysis: sevoflurane/sevoflurane criteria: 4 no 140.3 (p < 0.05) Recruitment Open eyes:TIVA 6.2, rates: no propofol/sevoflurane 7.2, sevoflurane/sevoflurane Representative 6.0 (p < 0.05) sample: no Fit for discharge:TIVA Comparable 195.4, propofol/ groups: no sevoflurane 181.7, sevoflurane/sevoflurane 195.8 (NS) Nausea:TIVA 5.6%, propofol/sevoflurane 11.4%, sevoflurane/ sevoflurane 31.9% (p < 0.05) Vomiting:TIVA 0%, propofol/sevoflurane 8.6%, sevoflurane/sevoflurane 17.4% (p < 0.05) Song et al., 1998, 126 Source: RCT NA NA NA Effectiveness USA No differences between Randomisation: desflurane, sevoflurane CGRNT and propofol in time to transfer to post- Blind: single anaesthesia care unit Power estimate: yes Inclusion/ exclusion criteria: 7 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 Sun et al., 1999, 222 Source: RCT Study design: INAD Anaesthetic and Hospital accounts Costs USA Randomisation: Effectiveness data: drug costs Methohexitone/desflurane: US $68.97 ± 20.74 a CGRNT INAD Nurse time Methohexitone/ Blind: single Outcome data: NA PACU resources sevoflurane: US $75.86 ± 27.63 a Power estimate: Cost data: UNACC NK Propofol/desflurane: Inclusion/ Analysis: INAD US $89.78 ± 20.78 exclusion Sensitivity analysis: Propofol/sevoflurane: criteria: 7 no US $100.66 ± 36.6 a Recruitment p < 0.05 vs propofol rates: NK Effectiveness * Representative No differences sample: NK Comparable groups: no Tang et al., 1999, 129 Source: RCT Study design: INAD Anaesthetics, analgesics Hospital-specific Costs (incremental) USA and anti-emetics prices Drugs: propofol TIVA, Randomisation: Effectiveness data: US $24.8; propofol/ yes, computer INAD Nursing staff sevoflurane, US $25.7; generated sevoflurane/sevoflurane, Outcome data: US $19.64 Blind: single INAD Recovery costs: propofol Power estimate: Cost data: UNACC TIVA, US $21.49; yes, based on propofol/sevoflurane, 80% power and Analysis: INAD US $29.73; sevoflurane/ 25% reduction in sevoflurane, US $30.76 mean total cost Sensitivity analysis: no Perioperative costs: Inclusion/ propofol TIVA, US $46.3; exclusion propofol/sevoflurane, criteria: 3 Recruitment US $55.41;sevoflurane/ sevoflurane, US $50.10 rates: – Effectiveness Patient satisfaction: Representative propofol TIVA, 100%; sample: – propofol/sevoflurane, 88%; sevoflurane/sevoflurane, Comparable groups: – 70% Recovery nausea: propofol TIVA, 3; propofol/ sevoflurane, 18; sevoflurane/sevoflurane, 40 (p < 0.05) Vomiting: propofol TIVA, 0; propofol/sevoflurane, 15; sevoflurane/sevoflurane, 17. (p < 0.05) Cost to achieve complete satisfaction in one patient: propofol TIVA, US $46.3, propofol/sevoflurane, $62.97; sevoflurane/ sevoflurane, $71.57 continued 173
Page 1 and 2:
Which anaesthetic agents are costef
Page 3:
Which anaesthetic agents are costef
Page 6 and 7:
NHS R&D HTA Programme The NHS R&D H
Page 8 and 9:
Contents Appendix 6 Adult patient-b
Page 11 and 12:
Background The aim of the project w
Page 13:
• The incidence of PONV was low d
Page 16 and 17:
2 Introduction dizziness or disorie
Page 18 and 19:
4 Introduction a reduced incidence
Page 20 and 21:
6 Introduction willingness to pay f
Page 22 and 23:
8 Literature review included in the
Page 24 and 25:
10 Literature review TABLE 1 Compar
Page 26 and 27:
12 Literature review intermediate a
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
18 Literature review Patient-based
Page 34 and 35:
20 Literature review TABLE 5 contd
Page 36 and 37:
22 Literature review No studies fol
Page 38 and 39:
24 Literature review (30%) and meth
Page 40 and 41:
26 Literature review • There are
Page 42 and 43:
28 National survey of anaesthetic p
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51:
36 Economic evaluation methods (inc
Page 52 and 53:
38 Economic evaluation methods The
Page 54 and 55:
40 Economic evaluation methods Tabl
Page 56 and 57:
42 Economic evaluation methods simi
Page 58 and 59:
44 Economic evaluation methods Prob
Page 61 and 62:
Recruitment to the CESA RCT The stu
Page 63 and 64:
Clinical outcome data PONV by anaes
Page 65 and 66:
The findings from the logistic regr
Page 67 and 68:
TABLE 29 The length of stay and pri
Page 69 and 70:
140 120 100 80 60 40 20 0 No. of pa
Page 71 and 72:
250 200 150 100 50 0 No. of patient
Page 73 and 74:
TABLE 37 Deterministic sensitivity
Page 75 and 76:
20 15 10 5 0 -5 Difference in varia
Page 77 and 78:
Patient admitted for day surgery an
Page 79 and 80:
500 400 300 200 100 0 -100 -200 -30
Page 81 and 82:
Recruitment to the CESA RCT The stu
Page 83 and 84:
TABLE 49 The occurrence of any PONV
Page 85 and 86:
60 50 40 30 20 10 0 No. of patients
Page 87 and 88:
a scale effect for scenario A, but
Page 89 and 90:
The mean CVs for avoidance of PONV
Page 91 and 92:
1.80 The new variable cost and tota
Page 93 and 94:
100 90 80 70 60 50 40 30 20 10 0 Su
Page 95 and 96:
The structure and content of this d
Page 97 and 98:
nurses to have an in-depth knowledg
Page 99 and 100:
agent used (see appendix 18). It wa
Page 101 and 102:
Furthermore, anaesthetists operate
Page 103 and 104:
The CESA project was designed to as
Page 105:
practice, such as the use of midazo
Page 109 and 110:
1. Royal College of Surgeons of Eng
Page 111 and 112:
60. Cheng KI, Chu KS, Fang YR, Su K
Page 113 and 114:
112. Raeder J, Gupta A, Pedersen FM
Page 115 and 116:
162. Viitanen H, Baer G, Annila P.
Page 117 and 118:
220. Rosenberg KM, Bridge P, Brown
Page 119 and 120:
The range of databases interrogated
Page 121:
24. preferen$.mp. [mp=title, abstra
Page 124 and 125:
110 Appendix 2 TABLE 65 contd Summa
Page 126 and 127:
112 Appendix 3 Quality assessment o
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137: 122 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 and 182: TABLE 71 contd Quality of cost or e
Page 183 and 184: TABLE 71 contd Quality of cost or e
Page 185: 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
Page 209: © Queen’s Printer and Controller
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
Page 233 and 234: 20 15 10 5 0 -5 -10 -15 True weight
Page 235: 15 10 5 0 -5 -10 True weight - Dion
Page 238 and 239:
224 Appendix 19 • patients aged o
Page 241 and 242:
All staff unit costs were for the y
Page 243:
Background Fixed costs account for
Page 246 and 247:
232 Appendix 22 March, Tuesday 15 A
Page 248 and 249:
234 Appendix 23 TABLE 96 Reasons fo
Page 251 and 252:
Patients were coded using the OPCS
Page 253 and 254:
Q03.4 punch biopsy of cervix Q03.5
Page 255 and 256:
This section displays the associati
Page 257 and 258:
given in Table 103 confirm the age
Page 259:
TABLE 107 Occurrence of PONV by dur
Page 262 and 263:
248 Appendix 27 TABLE 113 Frequency
Page 265 and 266:
This section displays the associati
Page 267 and 268:
The adverse events observed in the
Page 269 and 270:
262 Health Technology Assessment Pr
Page 271:
264 Health Technology Assessment Pr
show all

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

Create successful ePaper yourself

Delete template?

Save as template?