Q-TWiST and Cost-Effectiveness Analysis of Endovascular versus Open Repair for Ruptured Abdominal Aortic Aneurysms in a High Deliberate Practice Volume Center

Canning, Patrick; Tawfick, Wael; Kamel, Khaled Mahmoud; Hynes, Niamh; Sultan, Sherif

doi:10.1016/j.avsg.2018.08.091

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…According to the results, all studies met the checklist items. One study showed an average quality (26), while other studies were found to have excellent quality.…”

Section: Quality Assessment Of Studiesmentioning

confidence: 97%

“…Studies were performed in European countries, including the United Kingdom, the Netherlands, and Ireland. Three of the studies were conducted in the UK (22)(23)(24), one was performed in the Netherlands (25), and one was carried out in Ireland (26). In most studies, the populations were slightly different, and in all studies, the diameter of AAAs was larger than 5.5 cm.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…The perspective of the selected studies was not significantly different, as in all of the studies, it was a third-party payer's perspective. The time horizon was three years in nearly all of the studies (23,24,26). Nevertheless, one study had a time horizon of 30 years (22), and one study had a time horizon of two years (25).…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…The effectiveness of the intervention was evaluated by QALYs in all studies. With the exception of two studies (23,26), other studies performed a sensitivity analysis to determine the effect of ICER on the input variables. One of these studies conducted one-way and multivariate sensitivity analyses (22); one study used one-way and probabilistic sensitivity analyses (25); and one study only performed a probabilistic sensitivity analysis (24).…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Although EVAR was not introduced as a cost-effective approach in one of the studies ( 23), the rest of the studies found it to be cost-effective (22,23,26). The findings of our study showed that all selected studies had considered the direct medical costs, including hospital admission, follow-up (outpatient appointments), cost of surgery, operating room equipment, blood products, diagnostic procedures (e.g., pathology), consultation, dialysis, physiotherapy, imaging procedures (e.g., duplex CT imaging), and Intensive Care Unit (ICU) or Ward Stay.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

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Cost-Effectiveness of Endovascular Aneurysm Repair Versus Open Surgical Repair for Ruptured Abdominal Aortic Aneurysms: A Systematic Review

et al. 2021

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Context: If the diameter of an aneurysm increases by more than 6 cm, the risk of aortic rupture increases by 50% within 10 years. Therefore, rupture of aneurysm, which is usually asymptomatic, can lead to severe complications and increase the risk of mortality. The current study aimed to systematically review studies comparing the cost-effective endovascular aneurysm repair (EVAR) and open surgical repair (OSR) as the primary treatment options for patients with ruptured abdominal aortic aneurysms (AAAs). Methods: An electronic search was conducted in PubMed, EMBASE, Science Direct, Scopus, and other scientific economic databases. Relevant articles were searched from 1999 to 2020 using keywords, such as “abdominal aortic aneurysm”, “endovascular”, “open surgery”, “rupture”, “economic evaluation”, and “cost-effectiveness”. The quality of articles was assessed using the Quality of Health Economic studies (QHES) checklist; finally, five articles were included in this review. Results: The results of the QHES checklist showed that most studies had a good quality. A third-party payer’s perspective was the dominant perspective in all selected studies, comparing EVAR with OSR. All studies considered the direct medical costs and did not disclose any discount rates, except for one study, reporting a 3.5% discount rate. Almost all included studies found EVAR to be a cost-effective intervention; only one study concluded that EVAR, with a cost-effectiveness ratio of €424,542, was not the best treatment option. Conclusion: In patients with ruptured AAAs, the EVAR intervention improved the quality of life, decreased the mortality rate, and shortened the hospital stay as compared to OSR.

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“…According to the results, all studies met the checklist items. One study showed an average quality (26), while other studies were found to have excellent quality.…”

Section: Quality Assessment Of Studiesmentioning

confidence: 97%