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首页> 外文期刊>BMJ: British medical journal >Cost effectiveness analysis of larval therapy for leg ulcers
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Cost effectiveness analysis of larval therapy for leg ulcers

机译：幼虫治疗的成本效益分析小腿溃疡

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Objective To assess the cost effectiveness of larval therapy compared with hydrogel in the management of leg ulcers.Design Cost effectiveness and cost utility analyses carriedout alongside a pragmatic multicentre, randomised, open trial with equal randomisation.Population Intention to treat population comprising 267patients with a venous or mixed venous and arterial ulcers with at least 25% coverage of slough or necrotic tissue.Interventions Patients were randomly allocated to debridement with bagged larvae, loose larvae, or hydrogel.Main outcome measure The time horizon was 12 months and costs were estimated from the UK National Health Service perspective. Cost effectiveness outcomes are expressed in terms of incremental costs per ulcer-free day (cost effectiveness analysis) and incremental costs per quality adjusted life years (cost utility analysis).Results The larvae arms were pooled for the main analysis. Treatment with larval therapy cost, on average, ?.70 (?109.61; Dollars 140.57) more per participant peryear (95% confidence interval -?1.9 to ?5.8) than treatment with hydrogel. Participants treated with larval therapy healed, on average, 2.42 days before those in the hydrogel arm (95% confidence interval -0.95 to 31. 91 days) and had a slightly better health related quality of life, as the annual difference in QALYs was 0.011 (95% confidence interval -0.067 to 0.071). However, none of these differences was statistically significant. The incremental cost effectiveness ratio for the base case analysis was estimated at ?26 per QALY gained and. ? per ulcer-free day. Considerable uncertainty surrounds the outcome estimates. Conclusions Debridement of sloughy or necrotic leg ulcers with larval therapy is likely to produce similar health benefits and have similar costs to treatment with hydrogel.
机译：摘要目的评估的成本效益幼虫疗法相比,水凝胶小腿溃疡的管理。有效性和成本效用分析carriedout与务实的多中心、随机、开放试验与平等随机。人口由267患者静脉至少或混合静脉和动脉溃疡25%的覆盖率的泥沼或坏死组织。分配给清创术袋装幼虫,宽松的幼虫,或水凝胶。时间是12个月和成本估计从英国国家卫生服务视角。表达的增量成本(成本效益分析)和ulcer-free天增量成本每质量调整生命年(成本效用分析)。汇集了主要的分析。幼虫治疗成本、平均吗? 2每个参与者每年140.57美元)更多(95%置信区间,1.9 ? 5.8)比治疗水凝胶。治疗愈合,平均2.42天水凝胶的手臂(95%的信心区间-0.95 - 31所示。更好的健康相关生活质量的在提升为0.011(95%的年度差异置信区间-0.067 - 0.071)。这些差异在统计学上有很重要的意义。基本情况分析估计比率每QALY ? 26了。结果则有相当的不确定性估计。坏死与幼虫小腿溃疡治疗是可能的产生类似的健康益处,类似的成本与水凝胶治疗。

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