Journal of Vascular Surgery
Volume 51, Issue 1 , Pages 148-154 , January 2010

Challenges in analysis and interpretation of cost data in vascular surgery

  • Kevin Mani, MD

      Affiliations

    • Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
    • Corresponding Author InformationCorrespondence: Dr Kevin Mani, Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
    • ,
  • Jonas Lundkvist, RPh, PhD

      Affiliations

    • Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
    • ,
  • Lars Holmberg, MD, PhD

      Affiliations

    • Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
    • Division of Cancer Studies, King's College, London
    • ,
  • Anders Wanhainen, MD, PhD

      Affiliations

    • Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden

Received 31 May 2009 ,Accepted 8 August 2009.

References 

  1. Jonsson B. Changing health environment: the challenge to demonstrate cost-effectiveness of new compounds. Pharmacoeconomics. 2004;22(suppl 4):5–10
  2. EUROMET 2004: The influence of economic evaluation studies on health care decision-making—a European survey. Amsterdam: IOS Press; 2005;
  3. Thompson SG, Barber JA. How should cost data in pragmatic randomised trials be analysed?. BMJ. 2000;320:1197–1200
  4. Barber JA, Thompson SG. Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med. 2000;19:3219–3236
  5. Thompson SG, Nixon RM. How sensitive are cost-effectiveness analyses to choice of parametric distributions?. Med Decis Making. 2005;25:416–423
  6. Rascati KL, Smith MJ, Neilands T. Dealing with skewed data: an example using asthma-related costs of medicaid clients. Clin Ther. 2001;23:481–498
  7. Nixon RM, Thompson SG. Parametric modelling of cost data in medical studies. Stat Med. 2004;23:1311–1331
  8. Mani K, Bjorck M, Lundkvist J, Wanhainen A. Similar cost for elective open and endovascular AAA repair in a population-based setting. J Endovasc Ther. 2008;15:1–11
  9. Efron B, Tibshirani R. An introduction to the bootstrap. Boca Raton: CRC Press; 1998;
  10. Altman DG. Practical statistics for medical research. 1st edition. London: Chapman & Hall/CRC; 1991;
  11. Tarride JE, Blackhouse G, De Rose G, Novick T, Bowen JM, Hopkins R, et al. Cost-effectiveness analysis of elective endovascular repair compared with open surgical repair of abdominal aortic aneurysms for patients at a high surgical risk: a 1-year patient-level analysis conducted in Ontario, Canada. J Vasc Surg. 2008;48:779–787
  12. Lesperance K, Andersen C, Singh N, Starnes B, Martin MJ. Expanding use of emergency endovascular repair for ruptured abdominal aortic aneurysms: disparities in outcomes from a nationwide perspective. J Vasc Surg. 2008;47:1165–1167
  13. Hynes N, Sultan S. A prospective clinical, economic, and quality-of-life analysis comparing endovascular aneurysm repair (EVAR), open repair, and best medical treatment in high-risk patients with abdominal aortic aneurysms suitable for EVAR: the Irish patient trial. J Endovasc Ther. 2007;14:763–776
  14. Prinssen M, Buskens E, de Jong SE, Buth J, Mackaay AJ, van Sambeek MR, et al. Cost-effectiveness of conventional and endovascular repair of abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg. 2007;46:883–890
  15. Visser JJ, van Sambeek MR, Hunink MG, Redekop WK, van Dijk LC, Hendriks JM, et al. Acute abdominal aortic aneurysms: cost analysis of endovascular repair and open surgery in hemodynamically stable patients with 1-year follow-up. Radiology. 2006;240:681–689
  16. EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet. 2005;365:2179–2186
  17. Hayter CL, Bradshaw SR, Allen RJ, Guduguntla M, Hardman DT. Follow-up costs increase the cost disparity between endovascular and open abdominal aortic aneurysm repair. J Vasc Surg. 2005;42:912–918
  18. Rosenberg BL, Comstock MC, Butz DA, Taheri PA, Williams DM, Upchurch GR. Endovascular abdominal aortic aneurysm repair is more profitable than open repair based on contribution margin per day. Surgery. 2005;137:285–292
  19. Watson DR, Tan J, Wiseman L, Ansel GM, Botti C, George B, et al. The clinical and fiscal impact of endovascular repair of abdominal aortic aneurysms. Heart Surg Forum. 2004;7:E503–E507
  20. Dryjski M, O'Brien-Irr MS, Hassett J. Hospital costs for endovascular and open repair of abdominal aortic aneurysm. J Am Coll Surg. 2003;197:64–70
  21. Rothman K, Greenland S. Modern epidemiology. 2nd edition. Philadelphia: Lippincott-Raven; 1998;

 Financial support was received by the Swedish Heart and Lung Foundation, the Selander Foundation, the Sigurd and Elsa Golje Foundation, and the Royal Society of Arts and Sciences of Uppsala.

 Competition of interest: none.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)01683-8

doi: 10.1016/j.jvs.2009.08.042

Journal of Vascular Surgery
Volume 51, Issue 1 , Pages 148-154 , January 2010

Article Tools

* Image Usage & Resolution