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Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease
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Macafee, D. A. L., Humes, D. J., Bouliotis, G., Beckingham, I. J., Whynes, D. K. and Lobo, D. N. (2009) Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease. British Journal of Surgery, 96 (9). pp. 1031-1040. doi:10.1002/bjs.6685 ISSN 0007-1323.
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Official URL: https://doi.org/10.1002/bjs.6685
Abstract
Background:
This randomized controlled trial compared the cost–utility of early laparoscopic cholecystectomy with that for conventional management of newly diagnosed acute gallbladder disease.
Methods:
Adults admitted to hospital with a first episode of biliary colic or acute cholecystitis were randomized to an early intervention group (36 patients, operation within 72 h of admission) or a conventional group (36, elective cholecystectomy 3 months later). Costs were measured from a National Health Service and societal perspective. Quality‐adjusted life year (QALY) gains were calculated 1 month after surgery.
Results:
The mean(s.d.) total costs of care were £5911(2445) for the early group and £6132(3244) for the conventional group (P = 0·928), Mean(s.d.) societal costs were £1322(1402) and £1461(1532) for the early and conventional groups respectively (P = 0·732). Visual analogue scale scores of health were 72·94 versus 84·63 (P = 0·012) and the mean(s.d.) QALY gain was 0·85(0·26) versus 0·93(0·13) respectively (P = 0·262). The incremental cost per additional QALY gained favoured conventional management at a cost of £3810 per QALY gained.
Conclusion:
In this pragmatic trial, the cost–utilities of both the early and conventional approaches were similar, but the incremental cost per additional QALY gained favoured conventional management. Registration number: ISRCTN81663421 (http://www.controlled‐trials.com).
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | British Journal of Surgery | ||||||||
Publisher: | John Wiley & Sons Ltd. | ||||||||
ISSN: | 0007-1323 | ||||||||
Official Date: | September 2009 | ||||||||
Dates: |
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Volume: | 96 | ||||||||
Number: | 9 | ||||||||
Page Range: | pp. 1031-1040 | ||||||||
DOI: | 10.1002/bjs.6685 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access |
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