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@article{Epstein:2019:10.1002/bjs.11082,
author = {Epstein, DM and Gohel, MS and Heatley, F and Liu, X and Bradbury, A and Bulbulia, R and Cullum, N and Nyamekye, I and Poskitt, KR and Renton, S and Warwick, J and Davies, AH and Gohel, MS and Read, D and Hargreaves, S and Dhillon, K and Anwar, M and Liddle, A and Brown, H and Mercer, K and Gill, F and Liu, A and Jepson, W and Wormwell, A and Rafferty, H and Davies, AH and Dhillon, K and Kaur, R and Solomon, E and Sritharan, K and Velineni, R and Lim, CS and Busuttil, A and Bootun, R and Bicknell, C and Jenkins, M and Lane, T and Serjeant, E and Poskitt, K and Bulbulia, R and Waldron, J and Wolfrey, G and Slim, F and Davies, C and Emerson, L and Grasty, M and Whyman, M and Wakeley, C and Cooper, A and Clapp, J and Hogg, N and Howard, J and Dyer, J and Lyes, S and Teemul, D and Harvey, K and Pride, M and Kindon, A and Price, H and Flemming, L and Birch, G and Holmes, H and Weston, J and Joseph, T and Eiffel, R and Ojimba, T and Wilson, T and Hodgson, A and Robinson, L and Todhunter, J an},
doi = {10.1002/bjs.11082},
journal = {British Journal of Surgery},
pages = {555--562},
title = {Cost-effectiveness analysis of a randomized clinical trial of early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration},
url = {http://dx.doi.org/10.1002/bjs.11082},
volume = {106},
year = {2019}
}

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TY  - JOUR
AB  - BackgroundTreatment of superficial venous reflux in addition to compression therapy accelerates venous leg ulcer healing and reduces ulcer recurrence. The aim of this study was to evaluate the costs and costeffectiveness of early versus delayed endovenous treatment of patients with venous leg ulcers.MethodsThis was a withintrial costutility analysis with a 1year time horizon using data from the EVRA (Early Venous Reflux Ablation) trial. The study compared early versus deferred endovenous ablation for superficial venous truncal reflux in patients with a venous leg ulcer. The outcome measure was the cost per qualityadjusted lifeyear (QALY) over 1 year. Sensitivity analyses were conducted with alternative methods of handling missing data, alternative preference weights for healthrelated quality of life, and per protocol.ResultsAfter early intervention, the mean(s.e.m.) cost was higher (difference in cost per patient £163(318) (€184(358))) and early intervention was associated with more QALYs at 1 year (mean(s.e.m.) difference 0·041(0·017)). The incremental costeffectiveness ratio (ICER) was £3976 (€4482) per QALY. There was an 89 per cent probability that early venous intervention is costeffective at a threshold of £20 000 (€22 546)/QALY. Sensitivity analyses produced similar results, confirming that early treatment of superficial reflux is highly likely to be costeffective.ConclusionEarly treatment of superficial reflux is highly likely to be costeffective in patients with venous leg ulcers over 1 year. Registration number: ISRCTN02335796 (http://www.isrctn.com).
AU  - Epstein,DM
AU  - Gohel,MS
AU  - Heatley,F
AU  - Liu,X
AU  - Bradbury,A
AU  - Bulbulia,R
AU  - Cullum,N
AU  - Nyamekye,I
AU  - Poskitt,KR
AU  - Renton,S
AU  - Warwick,J
AU  - Davies,AH
AU  - Gohel,MS
AU  - Read,D
AU  - Hargreaves,S
AU  - Dhillon,K
AU  - Anwar,M
AU  - Liddle,A
AU  - Brown,H
AU  - Mercer,K
AU  - Gill,F
AU  - Liu,A
AU  - Jepson,W
AU  - Wormwell,A
AU  - Rafferty,H
AU  - Davies,AH
AU  - Dhillon,K
AU  - Kaur,R
AU  - Solomon,E
AU  - Sritharan,K
AU  - Velineni,R
AU  - Lim,CS
AU  - Busuttil,A
AU  - Bootun,R
AU  - Bicknell,C
AU  - Jenkins,M
AU  - Lane,T
AU  - Serjeant,E
AU  - Poskitt,K
AU  - Bulbulia,R
AU  - Waldron,J
AU  - Wolfrey,G
AU  - Slim,F
AU  - Davies,C
AU  - Emerson,L
AU  - Grasty,M
AU  - Whyman,M
AU  - Wakeley,C
AU  - Cooper,A
AU  - Clapp,J
AU  - Hogg,N
AU  - Howard,J
AU  - Dyer,J
AU  - Lyes,S
AU  - Teemul,D
AU  - Harvey,K
AU  - Pride,M
AU  - Kindon,A
AU  - Price,H
AU  - Flemming,L
AU  - Birch,G
AU  - Holmes,H
AU  - Weston,J
AU  - Joseph,T
AU  - Eiffel,R
AU  - Ojimba,T
AU  - Wilson,T
AU  - Hodgson,A
AU  - Robinson,L
AU  - Todhunter,J
AU  - Heagarty,D
AU  - Mckeane,A
AU  - McCarthy,R
AU  - Barwell,J
AU  - Northcott,C
AU  - Elstone,A
AU  - West,C
AU  - Chong,P
AU  - Gerrard,D
AU  - Croucher,A
AU  - Levy,S
AU  - Martin,C
AU  - Craig,T
AU  - Carradice,D
AU  - Firth,A
AU  - Clarke,E
AU  - Oswald,A
AU  - Sinclair,J
AU  - Chetter,I
AU  - El-Sheikha,J
AU  - Nandhra,S
AU  - Leung,C
AU  - Scott,J
AU  - Dewhirst,N
AU  - Woods,J
AU  - Russell,D
AU  - Darwood,R
AU  - Troxler,M
AU  - Thackeray,J
AU  - Bell,D
AU  - Watson,D
AU  - Williamson,L
AU  - Coulston,J
AU  - Eyers,P
AU  - Darvall,K
AU  - Hunter,I
AU  - Stewart,A
AU  - Moss,A
AU  - Rewbury,J
AU  - Adams,C
AU  - Vickery,L
AU  - Foote,L
AU  - Durman,H
AU  - Venn,F
AU  - Hill,P
AU  - James,K
AU  - Luxton,F
AU  - Greenwell,D
AU  - Roberts,K
AU  - Mitchell,S
AU  - Tate,M
AU  - Mills,H
AU  - Garnham,A
AU  - Hobbs,S
AU  - McIntosh,D
AU  - Green,M
AU  - Collins,K
AU  - Rankin,J
AU  - Poulton,P
AU  - Isgar,V
AU  - Renton,S
AU  - Dhillon,K
AU  - Trivedi,M
AU  - Kafeza,M
AU  - Parsapour,S
AU  - Moore,H
AU  - Najem,M
AU  - Connarty,S
AU  - Albon,H
AU  - Lloyd,C
AU  - Trant,J
AU  - Vohra,R
AU  - McCormack,J
AU  - Marshall,J
AU  - Hardy,V
AU  - Rogoveanu,R
AU  - Goff,W
AU  - Garnham,A
AU  - Gidda,R
AU  - Merotra,S
AU  - Shiralkar,S
AU  - Jayatunga,A
AU  - Pathak,R
AU  - Rehman,A
AU  - Randhawa,K
AU  - Lewis,J
AU  - Fullwood,S
AU  - Jennings,S
AU  - Cole,S
AU  - Wall,M
AU  - Ranaboldo,C
AU  - Hulin,S
AU  - Clarke,C
AU  - Fennelly,R
AU  - Cooper,R
AU  - Boyes,R
AU  - Draper,C
AU  - Harris,L
AU  - Mead,D
AU  - Bradbury,A
AU  - Kelly,L
AU  - Bate,G
AU  - Davies,H
AU  - Popplewell,M
AU  - Claridge,M
AU  - Gannon,M
AU  - Khaira,H
AU  - Scriven,M
AU  - Wilmink,T
AU  - Adam,D
AU  - Nasr,H
AU  - Dodd,D
AU  - Nawaz,S
AU  - Humphreys,J
AU  - Barnes,M
AU  - Sorrell,J
AU  - Swift,D
AU  - Phillips,P
AU  - Trender,H
AU  - Fenwick,N
AU  - Rittoo,D
AU  - Baker,S
AU  - Mitchell,R
DO  - 10.1002/bjs.11082
EP  - 562
PY  - 2019///
SN  - 0007-1323
SP  - 555
TI  - Cost-effectiveness analysis of a randomized clinical trial of early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration
T2  - British Journal of Surgery
UR  - http://dx.doi.org/10.1002/bjs.11082
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000462248200006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://bjssjournals.onlinelibrary.wiley.com/doi/full/10.1002/bjs.11082
VL  - 106
ER  -

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