Resource utilisation was based on number of days in hospital and administration of high cost drugs for GvHD and related complications. Relevance was determined by expert review. Costs were identified using the local pharmacy database and the unit reference costs database. RESULTS: This audit included 9 patients in the study arm and 7 patients in the comparison arm. The mean reduction in hospitalisation days per patient was 21.3% (74.7-58.7) and spend on high cost drugs per patient was reduced by 48.3% (£28,420-£14,688). The mean net reduction in costs per patient, adjusted for photopheresis treatment costs, was £28,040. Furthermore, all patients died in the comparator arm during the audit period, compared to 10% in the study group. CONCLUSIONS: The additional costs of treating non responders and treatment complications should be considered alongside direct therapy costs. The results of this audit may support the feasibility of economic studies to evaluate the cost effectiveness of treatments for rare life threatening diseases.
4.89; I 2 =0%; 2 studies), complications (RR=0.37; 95%CI: 0.21, 0.65; I 2 = 0%; 2 studies), blood loss (mean difference= -1634.9ml; 95% CI: -2242.2ml, -1027.5ml; I 2 = 0%; 3 studies), and visual analogue scale (mean difference= -0.78; 95% CI: -1.50, -0.03; I 2 = 0%; 3 studies). Infection risk (RR=0.40; 95%CI: 0.09, 1.69; I 2 =0%; 2 studies), favorable change in cobb angle (mean difference= -0.38; 95% CI: -3.19, 2.43; I 2 =90.6%; 3 studies), and Oswestry Disability Index (mean difference= -3.45; 95% CI: -8.35, 1.45; I 2 =0%; 3 studies) were not significantly different between surgery types. Conclusions: Following a comprehensive pooling of the literature, this meta-analysis demonstrated that MIS was associated with better health and safety outcomes in adult patients with adult degenerative scoliosis compared to OS. Further studies are needed to allow for subgroup analyses and identification of specific patient populations who may benefit the most from MIS vs OS.
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