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

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Members Chair, Professor Kent Woods, Director, NHS HTA Programme, & Professor of Therapeutics University of Leicester Professor Bruce Campbell, Consultant Vascular & General Surgeon, Royal Devon & Exeter Hospital Members Programme Director, Professor Kent Woods, Director, NHS HTA Programme, & Professor of Therapeutics University of Leicester Chair, Professor Shah Ebrahim, Professor in Epidemiology of Ageing, University of Bristol Deputy Chair, Professor Jon Nicholl, Director, Medical Care Research Unit, University of Sheffield Professor Douglas Altman, Director, ICRF Medical Statistics Group, University of Oxford Professor John Bond, Director, Centre for Health Services Research, University of Newcastle-upon-Tyne © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Health Technology Assessment 2002; Vol. 6: No. 30 Health Technology Assessment Programme Prioritisation Strategy Group Professor Shah Ebrahim, Professor in Epidemiology of Ageing, University of Bristol Dr John Reynolds, Clinical Director, Acute General Medicine SDU, Oxford Radcliffe Hospital Dr Ron Zimmern, Director, Public Health Genetics Unit, Strangeways Research Laboratories, Cambridge HTA Commissioning Board Professor John Brazier, Director of Health Economics, University of Sheffield Dr Andrew Briggs, Research Fellow, Institute of Health Sciences, University of Oxford Ms Christine Clark, Freelance Medical Writer, Bury, Lancs Professor Martin Eccles, Professor of Clinical Effectiveness, University of Newcastleupon-Tyne Dr Andrew Farmer, General Practitioner & NHS R&D Clinical Scientist, Institute of Health Sciences, University of Oxford Professor Adrian Grant, Director, Health Services Research Unit, University of Aberdeen Dr Alastair Gray, Director, Health Economics Research Centre, Institute of Health Sciences, University of Oxford Professor Mark Haggard, Director, MRC Institute of Hearing Research, University of Nottingham Professor Jenny Hewison, Academic Unit of Psychiatry & Behavioural Sciences, University of Leeds Professor Peter Jones, University Department of Psychiatry, University of Cambridge Professor Alison Kitson, Director, Royal College of Nursing Institute, London Professor Sarah Lamb, Research Professor in Physiotherapy, University of Coventry Dr Donna Lamping, Head, Health Services Research Unit, London School of Hygiene & Tropical Medicine Professor David Neal, Department of Surgery, University of Newcastleupon-Tyne Professor Tim Peters, Social Medicine, University of Bristol Professor Martin Severs, Professor in Elderly Health Care, University of Portsmouth Dr Jonathan Shapiro, Senior Fellow, Health Services Management Centre, Birmingham Dr Sarah Stewart-Brown, Director, Health Services Research Unit, University of Oxford Dr Gillian Vivian, Consultant in Nuclear Medicine & Radiology, Royal Cornwall Hospitals Trust, Truro Current and past membership details of all HTA ‘committees’ are available from the HTA website (see inside front cover for details) continued 261
262 Health Technology Assessment Programme continued Members Chair, Dr Ron Zimmern, Director, Public Health Genetics Unit, Strangeways Research Laboratories, Cambridge Mrs Stella Burnside, Chief Executive, Altnagelvin Hospitals Health & Social Services Trust, Londonderry Dr Paul O Collinson, Consultant Chemical Pathologist & Senior Lecturer, St George's Hospital, London Dr Barry Cookson, Director, Laboratory of Hospital Infection, Public Health Laboratory Service, London Members Chair, Dr John Reynolds, Clinical Director, Acute General Medicine SDU, Oxford Radcliffe Hospital Professor Tony Avery, Professor of Primary Health Care, University of Nottingham Professor Iain T Cameron, Professor of Obstetrics & Gynaecology, University of Southampton Mr Peter Cardy, Chief Executive, Macmillan Cancer Relief, London Diagnostic Technologies & Screening Panel Professor Howard Cuckle, Professor of Reproductive Epidemiology, University of Leeds Professor Adrian K Dixon, Professor of Radiology, Addenbrooke's Hospital, Cambridge Dr David Elliman, Consultant in Community Child Health, St. George's Hospital, London Dr Tom Fahey, Senior Lecturer in General Practice, University of Bristol Dr Andrew Farmer, General Practitioner & NHS R&D Clinical Scientist, Institute of Health Sciences, University of Oxford Professor Jane Franklyn, Professor of Medicine, University of Birmingham Dr Christopher Cates, GP & Cochrane Editor, Bushey Health Centre, Bushey, Herts Dr Karen A Fitzgerald, Pharmaceutical Adviser, Bro Taf Health Authority, Cardiff Dr Felicity J Gabbay, Managing Director, Transcrip Ltd, Milford-on-Sea, Hants Mr Peter Golightly, Director, Trent Medicines Information Services, Leicester Royal Infirmary Dr Antony J Franks, Deputy Medical Director, The Leeds Teaching Hospitals NHS Trust Dr J A Muir Gray, Programmes Director, National Screening Committee, NHS Executive, Oxford Dr Peter Howlett, Executive Director – Planning, Portsmouth Hospitals NHS Trust Dr S M Ludgate, Medical Director, Medical Devices Agency, London Professor Jennie Popay, Professor of Sociology & Public Health, Institute for Health Research, University of Lancaster Pharmaceuticals Panel Dr Alastair Gray, Director, Health Economics Research Centre, Institute of Health Sciences, University of Oxford Mrs Sharon Hart, Managing Editor, Drug & Therapeutics Bulletin, London Dr Christine Hine, Consultant in Public Health Medicine, Bristol South & West Primary Care Trust Mrs Jeannette Howe, Deputy Chief Pharmacist, Department of Health, London Professor Robert Peveler, Professor of Liaison Psychiatry, Royal South Hants Hospital, Southampton Dr Frances Rotblat, CPMP Delegate, Medicines Control Agency, London Dr Susan Schonfield, CPHM Specialist Commissioning, Public Health Directorate, Croydon Primary Care Trust Mrs Kathlyn Slack, Professional Support, Diagnostic Imaging & Radiation Protection Team, Department of Health, London Mr Tony Tester, Chief Officer, South Bedfordshire Community Health Council, Luton Dr Andrew Walker, Senior Lecturer in Health Economics, University of Glasgow Professor Martin J Whittle, Head of Division of Reproductive & Child Health, University of Birmingham Dr Eamonn Sheridan, Consultant in Clinical Genetics, St James's University Hospital, Leeds Mrs Katrina Simister, New Products Manager, National Prescribing Centre, Liverpool Professor Terence Stephenson, Professor of Child Health, University of Nottingham Dr Richard Tiner, Medical Director, Association of the British Pharmaceutical Industry, London Professor Jenifer Wilson- Barnett, Head of Florence Nightingale School of Nursing & Midwifery, King's College, London Current and past membership details of all HTA ‘committees’ are available from the HTA website (see inside front cover for details)
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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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TABLE 69 Summary of paediatric pati
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TABLE 69 contd Summary of paediatri
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TABLE 70 Characteristics of cost or
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TABLE 71 Quality of cost or economi
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TABLE 71 contd Quality of cost or e
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Abbott J, Abbott P. Psychological a
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Hall JE, Stewart JIM, Harmer M. Sin
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Struys M, Versichelen L, Thas O, He
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182 Appendix 11
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184 Appendix 11
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186 Appendix 11
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188 Appendix 11
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The aim of this study was to develo
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anaesthetics in day surgery, using
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© Queen’s Printer and Controller
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Background The empirical study quan
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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: The adverse events observed in the
Page 271: 264 Health Technology Assessment Pr
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