The Health Economic Evaluation of Bariatric Surgery Versus a Community Weight Management Intervention Analysis from the Idiopathic Intracranial Hypertension Weight Trial (IIH:WT).
The Health Economic Evaluation of Bariatric Surgery Versus a Community Weight Management Intervention Analysis from the Idiopathic Intracranial Hypertension Weight Trial (IIH:WT).
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DOI：
10.3390/life11050409
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发表时间：
2021-04-30
期刊：
影响因子：
--
通讯作者：
Sinclair AJ
中科院分区：
文献类型：
--
作者：
Aguiar M;Frew E;Mollan SP;Mitchell JL;Ottridge RS;Alimajstorovic Z;Yiangou A;Singhal R;Tahrani AA;Sinclair AJ
背景：特发性颅内高压体重试验(IIH：WT)确定了减肥手术与社区体重管理干预在降低活动期IIH患者颅内压方面的疗效。这项成本-效果分析的目的是评估这些减肥疗法对IIH的经济影响。方法：IIH：WT是在英国进行的一项为期5年的随机、对照、平行组、多中心试验，IIH活动、体重指数≥为35公斤/平方米的参与者被随机分配(1：1)接受减肥手术或社区体重管理干预。在基线、12个月和24个月时记录所有的临床和生活质量数据。进行了经济评估，以评估保健费用和成本效益。评估建立在意向治疗原则上，然后使用每种方案分析进行敏感性分析。结果：24个月来，社区体重管理组的平均总医疗费用为1353英镑，减肥手术组的平均总医疗费用为5400英镑。减肥手术的大部分费用与手术过程本身有关。接受减肥手术的85%在24个月时实现了12.5%的颅内压下降，而社区体重管理组的这一比例为39%；支持减肥手术的平均差异为45%。减肥手术的成本效益随着时间的推移而提高。结论：在随机对照试验中，IIH：WT首次比较了减肥手术和社区体重管理干预的疗效和成本效益。减肥手术的成本效益随着时间的推移而提高，因此，与12个月的随访相比，24个月后手术的增量成本在抵消了颅内压的增量降低后有所改善。
Background: The Idiopathic Intracranial Hypertension Weight Trial (IIH:WT) established the efficacy of bariatric surgery as compared to a community weight management intervention in reducing intracranial pressure in active IIH. The aim of this cost-effectiveness analysis was to evaluate the economic impact of these weight loss treatments for IIH. Methods: IIH:WT was a five-year randomised, controlled, parallel group, multicentre trial in the United Kingdom, where participants with active IIH and a body mass index ≥35 kg/m2 were randomly assigned (1:1) to receive access to bariatric surgery or a community weight management intervention. All clinical and quality of life data was recorded at baseline, 12 and 24 months. Economic evaluation was performed to assess health-care costs and cost-effectiveness. Evaluations were established on an intention to treat principle, followed by a sensitivity analysis using a per protocol analysis. Results: The mean total health care costs were GBP 1353 for the community weight management arm and GBP 5400 for the bariatric surgery arm over 24 months. The majority of costs for the bariatric surgery arm relate to the surgical procedure itself. The 85% who underwent bariatric surgery achieved a 12.5% reduction in intracranial pressure at 24 months as compared to 39% in the community weight management arm; a mean difference of 45% in favour of bariatric surgery. The cost effectiveness of bariatric surgery improved over time. Conclusions: The IIH:WT was the first to compare the efficacy and cost-effectiveness of bariatric surgery with community weight management interventions in the setting of a randomised control trial. The cost-effectiveness of bariatric surgery improved over time and therefore the incremental cost of surgery when offset against the incremental reduction of intracranial pressure improved after 24 months, as compared with 12 months follow up.
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DOI：
10.1108/ijhcqa-04-2017-0060
发表时间：
2019-02-11
影响因子：
1.5
作者：
Murphy, Sean;Friesner, Daniel L.;Tanne, Emanuel
通讯作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
2.9
作者：
Ottridge R;Mollan SP;Botfield H;Frew E;Ives NJ;Matthews T;Mitchell J;Rick C;Singhal R;Woolley R;Sinclair AJ
通讯作者：
Sinclair AJ