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

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62 Results of the adult economic evaluation TABLE 39 RRRs for PONV in the adult study Variable Assigned distribution * Propofol/ Propofol/ Propofol/ Sevoflurane/ propofol isoflurane sevoflurane sevoflurane Probability of PONV with no 0.14 0.18 0.17 0.30 ondansetron (path 1) Triangular: Triangular: Triangular: Triangular: 0.10–0.18 0.13–0.23 0.13–0.21 0.24–0.23 Probability of PONV with ondansetron 0.05 0.07 0.07 0.11 (path 3) Triangular: Triangular: Triangular: Triangular: 0.03–0.07 0.04–0.10 0.04–0.09 0.07–0.16 Mean cost of PONV with no 21.55 † 9.60 16.34 18.21 ondansetron (path 1) Beta subjective: Beta subjective: Beta subjective: Beta subjective: 10.8, 10.9, 3.8, 3.9, 7.4, 7.4, 7.1, 7.2, 21.55, 51.16 9.60, 17.61 16.34, 33.78 18.21, 45.84 Mean cost of no PONV with no 21.07 6.91 13.24 14.10 ondansetron (path 2) Beta subjective: Beta subjective: Beta subjective: Beta subjective: 2.3, 10.9, 1.2, 1.3, 3.7, 3.8, 4.7, 4.8, 21.07, 147.69 6.91, 38.76 13.24, 135.91 14.10, 44.47 Mean cost of PONV with 25.44 13.52 20.27 22.17 ondansetron (path 3) Beta subjective: Beta subjective: Beta subjective: Beta subjective: 10.8, 10.9, 3.8, 3.9, 7.4, 7.4, 7.1, 7.2, 21.55, 51.16 9.60, 17.61 16.34, 33.78 18.21,45.84 Mean cost of no PONV with 24.96 10.83 17.17 18.06 ondansetron (path 4) Beta subjective: Beta subjective: Beta subjective: Beta subjective: 2.3, 10.9, 1.2, 1.3, 3.7, 3.8, 4.7, 4.8, 21.07, 147.69 6.91, 38.76 13.24, 135.91 14.10, 44.47 * Triangular distribution parameters required for simulation: minimum, maximum. Beta-subjective distribution parameters required for simulation: minimum, mode, distribution-defined mean, maximum † The mean returned by the simulation on the beta-subjective distribution, utilising the given distribution parameters Patient admitted for day surgery and anaesthesised with propofol/propofol No anti-emetic prophylaxis Anti-emetic prophylaxis PONV 0.14 No PONV PONV 0.86 0.05 No PONV FIGURE 12 The decision tree for simulating the effect of prophylactic ondansetron with the propofol/propofol regimen in the adult study 0.95 21.55 21.07 25.44 24.96
Patient admitted for day surgery and anaesthesised with propofol/isoflurane No anti-emetic prophylaxis Anti-emetic prophylaxis © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Health Technology Assessment 2002; Vol. 6: No. 30 PONV No PONV PONV 0.18 0.82 No PONV FIGURE 13 The decision tree for simulating the effect of prophylactic ondansetron with the propofol/isoflurane regimen in the adult study Patient admitted for day surgery and anaesthesised with propofol/sevoflurane No anti-emetic prophylaxis Anti-emetic prophylaxis PONV 0.07 0.93 No PONV PONV 0.17 0.83 No PONV FIGURE 14 The decision tree for simulating the effect of prophylactic ondansetron with the propofol/sevoflurane regimen in the adult study Patient admitted for day surgery and anaesthesised with sevoflurane/sevoflurane No anti-emetic prophylaxis Anti-emetic prophylaxis 0.07 0.93 PONV No PONV PONV 0.30 0.70 No PONV FIGURE 15 The decision tree for simulating the effect of prophylactic ondansetron with the sevoflurane/sevoflurane regimen in the adult study 0.11 0.89 9.60 6.91 13.52 10.83 16.34 13.24 20.27 17.17 18.21 14.10 22.17 18.06 63
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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
Page 26 and 27: 12 Literature review intermediate a
Page 28 and 29: 14 Literature review TABLE 3 Compar
Page 30 and 31: 16 Literature review TABLE 4 Compar
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 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: 20 15 10 5 0 -5 Difference in varia
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
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112 Appendix 3 Quality assessment o
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114 Appendix 4 TABLE 66 contd Summa
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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 (
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TABLE 76 Reason given for preferenc
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TABLE 79 Comparisons with previous
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TABLE 80 Reason given for preferenc
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TABLE 81 Reason given for willingne
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Background Variable costs account f
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TABLE 85 Unit costs for the purchas
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Background The empirical study requ
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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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