PROTECT - trial: a multicentre prospective pragmatic RCT and health economic analysis of the effect of tailored repositioning to prevent pressure ulcers - study protocol

2016 ◽  
Vol 73 (2) ◽  
pp. 495-503 ◽  
Author(s):  
Dorien De Meyer ◽  
Nele Van Damme ◽  
Karen Van den Bussche ◽  
Ann Van Hecke ◽  
Sofie Verhaeghe ◽  
...  
Keyword(s):  
Health Economic ◽  
Economic Analysis ◽  
Study Protocol ◽  
Pressure Ulcers ◽  
Health Economic Analysis

scholarly journals Evaluating the clinical and cost-effectiveness of permissive hypotension in critically ill patients aged 65 years or over with vasodilatory hypotension: Statistical and health economic analysis plan for the 65 trial in article

2020 ◽  
Vol 21 (3) ◽  
pp. 230-231
Author(s):  
Karen Thomas ◽  
Akshay Patel ◽  
M Zia Sadique ◽  
Richard D Grieve ◽  
Alexina J Mason ◽  
...  
Keyword(s):  
Health Economic ◽  
Economic Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Randomised Clinical Trial ◽  
Open Label ◽  
Health Economic Analysis ◽  
Permissive Hypotension ◽  
Critical Care Units ◽  
Parallel Group

The 65 trial is a pragmatic, multicentre, parallel-group, open-label, randomised clinical trial of permissive hypotension (targeting a mean arterial pressure target of 60–65 mmHg during vasopressor therapy) versus usual care in critically ill patients aged 65 years or over with vasodilatory hypotension. The trial will recruit 2600 patients from 65 United Kingdom adult general critical care units. The primary outcome is all-cause mortality at 90 days. An economic evaluation is embedded. This paper describes the proposed statistical and health economic analysis for the 65 trial.

scholarly journals P105: Transforming emergency stroke care through innovation: Canadas first stroke ambulance

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S94-S94
Author(s):  
L. Morrison ◽  
S. Amlani ◽  
T. Jeerakathil ◽  
A. Shuaib ◽  
H. Kalashyan
Keyword(s):  
Health Economic ◽  
Economic Analysis ◽  
Patient Care ◽  
Tertiary Care ◽  
Added Value ◽  
Rural Setting ◽  
Stroke Patients ◽  
Health Economic Analysis ◽  
Economic Implications ◽  
Suspected Stroke

Introduction: A two-year Stroke Ambulance (SA) pilot project was implemented at the University of Alberta Hospital (UAH) in February, 2017, the first in the world to utilize this specialized technology in a rural setting. The primary objective is to evaluate clinical and economic implications of timely SA assessment and treatment of hyperacute stroke patients who present to non-stroke centres in rural Alberta and might otherwise have received delayed treatment, or not at all, due to prolonged transfer times. Methods: A steering committee and seven working groups were established, with representation from Alberta Health Services (AHS) programs impacted, to ensure comprehensive project development and implementation. The SA portable CT scanner, point of care laboratory, and videoconference system facilitate diagnosis of stroke in the field. The multidisciplinary team includes a stroke fellow, advanced & primary care paramedics, registered nurse, CT technologist, and telestroke physician. When not dispatched, the team provides stroke expertise and patient care in the emergency department (ED) and diagnostic imaging. The service model includes suspected stroke patients presenting to non-stroke centres within a 250 Km radius of Edmonton (Phase I); patients presenting to Edmonton Zone (EZ) hospitals without CT capability and/or tPA protocols (Phase 2); and expedited transport from EZ hospitals to the UAH for urgent endovascular therapy (EVT) (Phase 3). A health economic analysis will compare stroke ambulance care with standard care. Results: The SA has responded to 54 dispatches, 13 patients thrombolyzed and 3 patients receiving EVT. Median rendezvous to CT time was 10 minutes, median rendezvous to tPA time was 21 minutes, and mean time from symptom onset to tPA was 180 minutes. There were no complications. After SA imaging and assessment, 18 patients were repatriated back to their local community hospital, avoiding unnecessary admission to tertiary care. Conclusion: Our preliminary experience demonstrates that the SA offers a novel approach to performing timely evaluation and treatment of suspected stroke from non-stroke centres and may serve as an excellent triage mechanism, reducing avoidable admissions to overcapacity tertiary care EDs. The SA team provides added value to the ED with stroke expertise and patient care. A comprehensive health economic analysis will determine cost-effectiveness and whether spread is feasible.

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