An evaluation of the clinical and cost-effectiveness of pulmonary artery catheters in patient management in intensive care: a systematic review and a randomised controlled trial

Abstract

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of clinical practice throughout the NHS.The HTA Programme was set up in 1993. Its role is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care.The HTA Programme commissions research only on topics where it has identified key gaps in the evidence needed by the NHS. Suggestions for topics are actively sought from people working in the NHS,...

Methodological Issues Surrounding the Use of Baseline Health-Related Quality of Life Data to Inform Trial-Based Economic Evaluations of Interventions Within Emergency and Critical Care Settings: A Systematic Literature Review

“…The mean time horizon for the withintrial component of the economic evaluations in the remaining 18 studies was 8 months (median 9 months and range 1 to 12 months). Some studies extrapolated outcomes beyond the trial follow-up period using decision analytic modelling methods [25,26,28] with up to 60 months [25] and lifetime [15,16,28,29] extrapolations beyond the study follow-up periods. Most economic evaluations were conducted from the perspective of the UK National Health Service (NHS) (n=4) or the NHS/Personal Social services (n=9) in accordance with NICE guidance for appraising health technologies [30].…”

“…Most of the economic evaluations did not discount costs and effects in line with the relatively short time horizons of the within-trial analyses. Where studies had extrapolated cost and effects beyond the trial follow-up, discount rates of between 3.0% [25] and 3.5% [16,28,29,33] per annum were applied to both costs and effects. In terms of study quality, all 19 (100%) studies reported using a randomisation process that was assessed as adequate according to the criteria described in Appendix B in the supplementary online material; 16 (84%) were un-blinded and 9 (47%) reported ≥80% completion rates for the primary outcome at end of follow-up.…”

“…Nine (47%) of the 19 studies used the EQ-5D to measure health-related quality of life of patients, 5 (26%) used the EQ-5D in combination with another instrument (primarily the SF-12/36 [26,33,35], HUI-3 [32] and the paediatric PedsQL [36]), 1 (5%) [18] used the 15D instrument [34] and another 1 (5%) used the HUI-3 [28]. The remaining 3 (17%) studies [29] [25,27] did not report a primary health-related quality of life data collection process. Rather, the economic evaluations in these 3 studies were informed by utility data extracted from external sources.…”

“…Rather, the economic evaluations in these 3 studies were informed by utility data extracted from external sources. In the study by Harvey and colleagues [29], age-and gender-specific utility values for the UK adult population were combined with survival estimates from the trial in order to estimate QALYs in the cost-utility analysis. Specifically, Harvey and colleagues "estimated the quality-adjusted life expectancy for each survivor at hospital discharge based upon the Office of National Statistics age and sex-specific life expectancy tables and the EQ-5D age-and sex-specific quality of life weights".…”

Hemodynamic monitoring development: helpful technology or expensive luxury?

“…What is the solution to this dilemma? Every technologic development of a device is based on the central fundamental value of the technique used [15]. On the other hand, a huge development (bubble) may represent an increase or rise over that fundamental value.…”