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Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial
OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study. METHODS: Patients in the Early Endovenous Ablation in Venous Ulceration (EVRA) trial had between 1 year and 5.5 years (median 3 years) of follow-up under early...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991820/ https://www.ncbi.nlm.nih.gov/pubmed/35392924 http://dx.doi.org/10.1186/s12962-022-00351-6 |
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author | Diop, Modou Epstein, David |
author_facet | Diop, Modou Epstein, David |
author_sort | Diop, Modou |
collection | PubMed |
description | OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study. METHODS: Patients in the Early Endovenous Ablation in Venous Ulceration (EVRA) trial had between 1 year and 5.5 years (median 3 years) of follow-up under early or deferred endovenous ablation. This study compares complete-case-analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM), Bayesian parametric approach using the R package missingHE (BPA), repeated measures fixed effect (RMFE) and repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life years (QALYs) at different time horizons (1 year, 3 years and 5 years). RESULTS: All methods found no statistically significant difference in cost at the 5% level in all time horizons, and all methods found statistically significantly greater mean QALY at year 1. By year 3, only BPA showed a statistically significant difference in QALY between treatments. Standard errors differed substantially between the methods employed. CONCLUSION: CCA can be biased if data are MAR and is wasteful of the data. Hence the results for CCA are likely to be inaccurate. Other methods coincide in suggesting that early intervention is cost-effective at a threshold of £30,000 per QALY 1, 3 and 5 years. However, the variation in the results across the methods does generate some additional methodological uncertainty, underlining the importance of conducting sensitivity analyses using alternative approaches. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12962-022-00351-6. |
format | Online Article Text |
id | pubmed-8991820 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89918202022-04-09 Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial Diop, Modou Epstein, David Cost Eff Resour Alloc Research OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study. METHODS: Patients in the Early Endovenous Ablation in Venous Ulceration (EVRA) trial had between 1 year and 5.5 years (median 3 years) of follow-up under early or deferred endovenous ablation. This study compares complete-case-analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM), Bayesian parametric approach using the R package missingHE (BPA), repeated measures fixed effect (RMFE) and repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life years (QALYs) at different time horizons (1 year, 3 years and 5 years). RESULTS: All methods found no statistically significant difference in cost at the 5% level in all time horizons, and all methods found statistically significantly greater mean QALY at year 1. By year 3, only BPA showed a statistically significant difference in QALY between treatments. Standard errors differed substantially between the methods employed. CONCLUSION: CCA can be biased if data are MAR and is wasteful of the data. Hence the results for CCA are likely to be inaccurate. Other methods coincide in suggesting that early intervention is cost-effective at a threshold of £30,000 per QALY 1, 3 and 5 years. However, the variation in the results across the methods does generate some additional methodological uncertainty, underlining the importance of conducting sensitivity analyses using alternative approaches. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12962-022-00351-6. BioMed Central 2022-04-07 /pmc/articles/PMC8991820/ /pubmed/35392924 http://dx.doi.org/10.1186/s12962-022-00351-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Diop, Modou Epstein, David Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title | Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title_full | Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title_fullStr | Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title_full_unstemmed | Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title_short | Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial |
title_sort | comparing methods for handling missing cost and quality of life data in the early endovenous ablation in venous ulceration trial |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991820/ https://www.ncbi.nlm.nih.gov/pubmed/35392924 http://dx.doi.org/10.1186/s12962-022-00351-6 |
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