Suchergebnisse

Acknowledgements The authors would like to thank the Thomas Walker and Rebecca Albrow (National Institute for Health and Care Excellence) for comments on earlier versions of the model. We also wish to thank the NICE expert committee members who provided information and data to support the development of the model: Dr Andrew Davenport (Royal Free Hospital, London), Dr Simon Roe (Nottingham University Hospitals NHS Trust), Dr Elizabeth Lindley (St James's University Hospital), Dr Wesley Hayes (Great Ormond Street Hospital), Ms Joanne Prince (Central Manchester University Hospitals NHS Foundation Trust), Mr Nick McAleer (Royal Devon & Exeter NHS Foundation Trust), Dr Kay Tyerman (Leeds General Infirmary), Dr Graham Woodrow (St James's University Hospital) and Mr Paul Taylor (lay specialist committee member). Funding This paper presents independent research funded by the National Institute for Health Research (NIHR), commissioned through the NICE Diagnostic Assessment Programme (Project no 15/17/07). The views expressed are those of the authors and not necessarily those of NICE, the NHS, the NIHR or the Department of Health. The Health Economics Research Unit and the Health Services Research Unit, University of Aberdeen, are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. ; Peer reviewed ; Publisher PDF

This study was funded by the UK Medical Research Council (ref G0701604), and managed by the National Institute for Health Research (NIHR-EME 09-800-26) on behalf of the MRC-NIHR partnership, Efficiency and Mechanism Evaluation Programme. The Health Services Research Unit and the Health Economics Research Unit are both funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no role in the study design; collection, analysis, and interpretation of data; the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily reflect the views of the MRC, National Institute for Health Research, the Department of Health, or the Scottish Government. ; Peer reviewed ; Publisher PDF

This study was funded by the UK Medical Research Council (ref G0701604), and managed by the National Institute for Health Research (NIHR-EME 09-800-26) on behalf of the MRC-NIHR partnership, Efficiency and Mechanism Evaluation Programme. The Health Services Research Unit and the Health Economics Research Unit are both funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. ; Objective To investigate the cost effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed up for 36 months and data on health service utilisation and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5 and 10-year time horizon. Setting: 22 hospital eye services in the United Kingdom. Population: Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions: Lens extraction compared to standard care (i.e. laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures: Costs of primary and secondary health care utilisation (UK NHS perspective), quality adjusted life years (QALYs) and the incremental cost effectiveness ratio (ICER) for lens extraction versus standard care. Results: The mean age of participants was 67.5 (8.42), 57.5% were female, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. Mean health service costs were higher in patients randomized to lens extraction: £2,467 versus £1,486. Mean adjusted QALYs were also higher with early lens extraction: 2.602 versus 2.533. The ICER for lens extraction versus standard care was £14,284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7,090 per QALY gained by 5 years, and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67-89% chance of being cost effective at 3 years, and that it may be cost saving by 10 years. ; Publisher PDF ; Peer reviewed

Date of Acceptance: 07/05/15 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ Acknowledgements The authors would like to thank the investigators who kindly provided additional trials details, the NICE Assessment Subgroup specialist members (Dianna Oxley, Dianne Kitchen, Niall O'Keeffe, Peter Birtles, Peter MacCallum, Rishabh Prasad, and Sue Rhodes) for their assistance with some queries related to the interventions and their use in clinical practice, Charles Boachie for statistical support, and Lara Kemp for secretarial support. Funding This report was commissioned by the NIHR HTA Programme as project number 13/06/2001. The Health Services Research Unit, and Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, are both core-funded by the Chief Scientist Office of the Scottish Government Health Directorates. The views expressed in this report are those of the authors and not necessarily those of the Chief Scientist Office of the Scottish Government Health Directorates, NIHR HTA Programme or the Department of Health. Any errors are the responsibility of the authors. ; Peer reviewed ; Publisher PDF

ACKNOWLEDGEMENTS We would like to thank the Chief Scientist Office of the Scottish Government for funding this study and also all participating community pharmacists for their co-operation in training and recruitment, and all pharmacy customers for taking part in the trial. AUTHOR CONTRIBUTIONS All authors participated in the design of the trial, were members of the project steering group, contributed to and critically commented on draft versions, read and approved the final manuscript. DATA AVAILABILITY The data that support the findings of this study are available from the corresponding author upon reasonable request ; Peer reviewed ; Publisher PDF

Acknowledgements We are grateful to Thomas Walker and Rebecca Albrow at NICE for their thoughtful comments on earlier versions of the economic model and to the NICE Diagnostic Committee for their critical review of our identifed evidence. We are also grateful for the advice and clinical guidance received from the NICE Specialist Advisory Group for DG19 and to Peter S Hall and Alison F Smith (on behalf of the team) for providing early versions of their economic model that was instrumental in the development and structuring of the model used in this study. A big thank goes also to Lara Kemp for her secretarial support and patience throughout the study. The results presented in this paper have not been published previously in any academic journals, nor have they been submitted elsewhere. This work has informed the development of NICE guidance for diagnostic testing for AKI (https://www.nice.org.uk/guidance/dg39) and a full report to the funder describing the totality of this work will be published in the NIHR, HTA mono‑ graph series in due course. Funding The fndings presented in this manuscript are part of a broader research project funded by the National Institute for Health Research (NIHR) and com‑missioned through the NICE Diagnostic Assessment Programme (project no 12/88/97). The views expressed are those of the authors and not necessarily those of NICE, the NHS, the NIHR or the Department of Health. The Health Economics Research Unit and the Health Services Research Unit, University of Aberdeen, are funded by the Chief Scientist Ofce of the Scottish Government Health and Social Care Directorates. ; Peer reviewed ; Publisher PDF

UK National Institute for Health Research Health Technology Assessment Programme. Acknowledgments We thank the women who participated in the HEALTH study. We also thank Angela Hyde (Vice Chair of the Royal College of Obstetricians and Gynaecologists Women's Network until September, 2015, and co-applicant on the original grant application until October, 2016) for her contribution to the design of the participant facing documents and participation in trial meetings from the perspective of a patient, Jonathan Cook (statistician and co-applicant on the original grant application until April, 2014) for his contributions to the study design, Rebecca Bruce for her secretarial support and data management, members of the project management group for their ongoing advice and support of the trial, plus the independent members of the trial steering committee (Henry Kitchener [Chair], Patrick Chien, Barbara Farrell, and Isobel Montgomery) and data monitoring committee (Jane Norman [Chair], Peter O'Donovan, and Andy Vail), and the staff at the recruitment sites who facilitated recruitment, treatment, and follow-up of trial participants. The project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme (project number 12/35/23). The Health Services Research Unit and the Health Economics Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The views expressed herein are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care. ; Peer reviewed ; Publisher PDF

Funding Information: The author(s) have made the following disclosure(s): R.G.: Personal fees ? Heidelberg Engineering.S.S.: Grants and personal fees ? Bayer, during the conduct of the study; Grants and personal fees ? Novartis, Boehringer Ingleheim; Grants ? Allergan, Roche; Personal fees ? Apellis, Oxurion, Heidelberg Engineering, Optos, outside the submitted work; Funded by the Moorfields Biomedical Research Centre and Clinical Research Facility.The project was funded by the National Institute for Health Research Health Technology Assessment Programme (Project Number: 12/142/07) and will be published in full in Health Technology Assessment. The Health Services Research Unit and the Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate. F.G.: Grants ? NIHR, during the conduct of the study; Grants and personal fees ? Novartis, Roche, Bayer; Personal fees ? Allergan, Alimera; Grants ? Chengdu Pharma; Grants and nonfinancial support ? NIHR, outside the submitted work. J.A.C.: Study grant ? NIHR. K.B.: Grants ? NIHR HTA Programme, during the conduct of the study. Obtained funding: Chakravarthy, Ramsay, Sivaprasad, Scotland, Azuara-Blanco, Heiman and Cook Publisher Copyright: © 2021 ; Peer reviewed ; Publisher PDF