Cost-effectiveness of colour duplex sonography compared with angiography of the pelvis and lower limb

1996 ◽  
Vol 6 (4) ◽  
Author(s):  
J.T. Geitung ◽  
T. Wikstr�m ◽  
J. Zeuchner ◽  
J.H. G�thlin
Keyword(s):  
Cost Effectiveness ◽  
Lower Limb ◽  
Duplex Sonography ◽  
Colour Duplex Sonography

PP329 An Australian Cost-Effectiveness Analysis Of The EluviaTM Drug-Eluting Stent For Treatment Of Symptomatic Lower-Limb Peripheral Artery Disease

2020 ◽  
Vol 36 (S1) ◽  
pp. 28-29
Author(s):  
William A. Gray ◽  
Thathya V. Ariyaratne ◽  
Robert I. Griffiths ◽  
Peter W.M. Elroy ◽  
Stacey L. Amorosi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Healthcare System ◽  
Lower Limb ◽  
Sensitivity Analyses ◽  
Public Healthcare ◽  
System Perspective ◽  
Healthcare System Perspective ◽  
Drug Eluting ◽  
Zilver Ptx ◽  
Cost Parameters

IntroductionDespite advances in endovascular interventions, including the introduction of drug-eluting stents (DES), high target lesion revascularization (TLR) rates still burden the treatment of symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a novel, sustained-release, paclitaxel-eluting DES, was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent, in the IMPERIAL randomized controlled trial. This evaluation estimated the cost-effectiveness of Eluvia when compared with Zilver PTX in Australia, based on 12-month clinical outcomes from the IMPERIAL trial.MethodsA state-transition, decision-analytic model with a 12-month time horizon was developed from an Australian public healthcare system perspective. Cost parameters were obtained from the Australian National Hospital Cost Data Collection Cost Report (2016–17). All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020). Complete sets of clinical parameters (primary patency loss, TLR, amputation, and death) and cost parameters from their respective distributions were bootstrapped in samples of 1,000 patients, for each intervention arm of the model. One-way and probabilistic sensitivity analyses were performed.ResultsAt 12 months, modeled TLR rates were 4.5 percent for Eluvia and 8.9 percent for Zilver PTX, and mean total direct costs were AUD 6,537 [USD 4,511] and AUD 6,908 [USD 4,767], respectively (Eluvia average per patient savings; overall cohort=AUD 371 [USD 256]; diabetic cohort=AUD 625 [USD 431]). In probabilistic sensitivity analyses, Eluvia was cost-effective relative to Zilver PTX in 92.0 percent of all simulations at a threshold of $10,000 per TLR avoided. Eluvia was more effective and less costly (dominant) than Zilver PTX in 76.0 percent of simulations.ConclusionsIn the first year after the intervention, Eluvia was more effective and less costly than Zilver PTX, making Eluvia the dominant treatment strategy for treatment of symptomatic lower-limb PAD, from an Australian public healthcare system perspective. These findings should be considered when formulating policy and practice guidelines in the context of priority setting and making evidence-based resource allocation decisions for treatment of PAD in Australia.

scholarly journals Cost-effectiveness of negative-pressure wound therapy in adults with severe open fractures of the lower limb: evidence from the WOLLF randomized controlled trial

2019 ◽  
Vol 101-B (11) ◽  
pp. 1392-1401 ◽  
Author(s):  
S. Petrou ◽  
B. Parker ◽  
J. Masters ◽  
J. Achten ◽  
J. Bruce ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Open Fractures ◽  
Wound Management ◽  
Wound Therapy ◽  
Subgroup Analyses ◽  
The Cost

Aims The aim of this study was to estimate the cost-effectiveness of negative-pressure wound therapy (NPWT) in comparison with standard wound management after initial surgical wound debridement in adults with severe open fractures of the lower limb. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom NHS and Personal Social Services, based on evidence from the 460 participants in the Wound Management of Open Lower Limb Fractures (WOLLF) trial. Economic outcomes were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Bivariate regression of costs (given in £, 2014 to 2015 prices) and quality-adjusted life-years (QALYs), with multiple imputation of missing data, was conducted to estimate the incremental cost per QALY gained associated with NPWT dressings. Sensitivity and subgroup analyses were undertaken to assess the impacts of uncertainty and heterogeneity, respectively, surrounding aspects of the economic evaluation. Results The base case analysis produced an incremental cost-effectiveness ratio of £267 910 per QALY gained, reflecting higher costs on average (£678; 95% confidence interval (CI) -£1082 to £2438) and only marginally higher QALYS (0.002; 95% CI -0.054 to 0.059) in the NPWT group. The probability that NPWT is cost-effective in this patient population did not exceed 27% regardless of the value of the cost-effectiveness threshold. This result remained robust to several sensitivity and subgroup analyses. Conclusion This trial-based economic evaluation suggests that NPWT is unlikely to be a cost-effective strategy for improving outcomes in adult patients with severe open fractures of the lower limb. Cite this article: Bone Joint J 2019;101-B:1392–1401.

scholarly journals Cost effectiveness and impact on quality of life of abobotulinumtoxinA and onabotulinumtoxinA in the treatment of children with lower limb spasticity in Canada

2020 ◽  
Vol 23 (6) ◽  
pp. 631-640
Author(s):  
Karissa Johnston ◽  
Natalya Danchenko ◽  
Ryan Hansen ◽  
Jerome Dinet ◽  
Anna Liovas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Lower Limb ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

scholarly journals Cost-effectiveness of bone-anchored prostheses using osseointegrated fixation: Myth or reality?

2017 ◽  
Vol 42 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Laurent Alain Frossard ◽  
Gregory Merlo ◽  
Brendan Burkett ◽  
Tanya Quincey ◽  
Debra Berg
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Lower Limb ◽  
Quality Adjusted Life Year ◽  
Incremental Cost Effectiveness Ratio ◽  
Decision Makers ◽  
Evidence Based ◽  
Cost Effectiveness Ratio ◽  
Limb Bone ◽  
Quality Adjusted Life

Background: In principle, lower limb bone-anchored prostheses could alleviate expenditure associated with typical socket manufacturing and residuum treatments due to socket-suspended prostheses. Objective: This study reports (a) the incremental costs and (b) heath gain as well as (c) cost-effectiveness of bone-anchored prostheses compared to socket-suspended prostheses. Study design: Retrospective individual case-controlled observations and systematic review. Methods: Actual costs were extracted from financial records and completed by typical costs when needed over 6-year time horizon for a cohort of 16 individuals. Health gains corresponding to quality-adjusted life-year were calculated using health-related quality-of-life data presented in the literature. Results: The provision of bone-anchored prostheses costed 21% ± 41% more but increased quality-adjusted life-years by 17% ± 5% compared to socket-suspended prostheses. The incremental cost-effectiveness ratio ranged between –$25,700 per quality-adjusted life-year and $53,500 per quality-adjusted life-year with indicative incremental cost-effectiveness ratio of approximately $17,000 per quality-adjusted life-year. Bone-anchored prosthesis was cost-saving and cost-effective for 19% and 88% of the participants, respectively. Conclusion: This study indicated that bone-anchored prostheses might be an acceptable alternative to socket-suspended prostheses at least from a prosthetic care perspective in Australian context. Altogether, this initial evidence-based economic evaluation provided a working approach for decision makers responsible for policies around care of individuals with lower limb amputation worldwide. Clinical relevance For the first time, this study provided evidence-based health economic benefits of lower limb bone-anchored prostheses compared to typical socket-suspended prostheses from a prosthetic care perspective that is essential to clinicians and decision makers responsible for policies.

The role of colour duplex sonography in preoperative perforator mapping of the anterolateral thigh flap

2013 ◽  
Vol 271 (5) ◽  
pp. 1241-1247 ◽  
Author(s):  
Paweł Golusiński ◽  
Łukasz Łuczewski ◽  
Jakub Pazdrowski ◽  
Tomasz Synowiec ◽  
Piotr Pieńkowski ◽  
...  
Keyword(s):  
Duplex Sonography ◽  
Anterolateral Thigh Flap ◽  
Anterolateral Thigh ◽  
Colour Duplex Sonography

scholarly journals INFLUENCE OF FALLS REDUCTION ON THE COST-EFFECTIVENESS OF ADVANCED HYDRAULIC MICROPROCESSOR CONTROLLED KNEE PROTHESES IN ELDERLY PATIENTS WITH LOWER LIMB AMPUTATIONS

2018 ◽  
Author(s):  
Henning Krüger ◽  
Andreas Hahn ◽  
Alexander Kuhlmann
Keyword(s):  
Cost Effectiveness ◽  
Elderly Patients ◽  
Lower Limb ◽  
National Assembly ◽  
Improve Cost Effectiveness ◽  
Concomitant Factors ◽  
The Cost ◽  
New Generation ◽  
The Impact ◽  
Improve Cost

INTRODUCTION The assessment of cost-effectiveness and the use of health economical methods becomes of increasing importance when evaluating the impact of modern medical technology. The cost effectiveness of advanced hydraulic microprocessor controlled knees (MPKs) had recently by shown by RAND 1. A new generation of advanced hydraulic microprocessor controlled knee (MPK) components became available to address specifically the needs of elderly individuals The reduction of concomitant factors such as falls may significantly improve cost-effectiveness. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32041/24455 How to cite: Krüger H, Hahn A, Kuhlmann A. INFLUENCE OF FALLS REDUCTION ON THE COST-EFFECTIVENESS OF ADVANCED HYDRAULIC MICROPROCESSOR CONTROLLED KNEE PROTHESES IN ELDERLY PATIENTS WITH LOWER LIMB AMPUTATIONS. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32041                                                                           Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee.  http://www.aopanet.org/

Duplex sonography phlebologically accentuated

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 139-151
Author(s):  
M. Marshall
Keyword(s):  
Medical Education ◽  
Deep Vein Thrombosis ◽  
Doppler Sonography ◽  
Duplex Sonography ◽  
Disease Course ◽  
Foam Sclerotherapy ◽  
Optimal Position ◽  
Vein Thrombosis ◽  
Colour Duplex Sonography ◽  
Deep Vein

SummaryWithout any doubt colour duplex sonography was an enormous progress in angiological and/or phlebological diagnostics. Starting with the directional Doppler sonography, the large spectrum of phlebological diagnostics by colour duplex sonography is presented. Colour duplex sonography is used for a) the fundamental, morphologically and haemodynamically based diagnostics of deep vein thrombosis, of the insufficiency of subfascial and epifascial veins and for differential diagnostic delimitations (of arterial disorders, lip- and lymphedema, Baker-cysts, haematomas and so on), b) intrainterventional controls (steering of endovenous catheters and of foam sclerotherapy), c) the postinterventional assessment of results and disease course (definitively successful elimination of refluxes, relapses, complications as deep vein thrombosis and so on). Finally, the optimal position of the patient for duplex examination – supine or standing – is discussed, and methodical developments of the angiologic-phlebological diagnostics with ultrasound devices are described. Conclusion: In many cases duplexsonography avoids invasive examinations. It is part of the obligatory medical education in the field of phlebology.

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