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Javidan AP, Naji F, Li A, Wu A, Srivatsav V, Rapanos T, Harlock J. A Systematic Review of Economic Evaluations in Vascular Surgery. Ann Vasc Surg 2020; 67:511-520.e1. [PMID: 32234577 DOI: 10.1016/j.avsg.2020.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND With increasing healthcare costs and the emergence of new technologies in vascular surgery, economic evaluations play a critical role in informing decision-making that optimizes patient outcomes while minimizing per capita costs. The objective of this systematic review is to describe all English published economic evaluations in vascular surgery and to identify any significant gaps in the literature. METHODS We conducted a comprehensive English literature review of EMBASE, MEDLINE, The Cochrane Library, Ovid Health Star, and Business Source Complete from inception until December 1, 2018. Two independent reviewers screened articles for eligibility using predetermined inclusion criteria and subsequently extracted data. Articles were included if they compared 2 or more vascular surgery interventions using either a partial economic evaluation (cost analysis) or full economic evaluation (cost-utility, cost-benefit, and/or cost-effectiveness analysis). Data extracted included publishing journal, date of publication, country of origin of authors, type of economic evaluation, and domain of vascular surgery. RESULTS A total of 234 papers were included in the analysis. The majority of the papers included only a cost analysis (183, 78%), and there were only 51 papers that conducted a full economic analysis (22%). The 51 papers conducted a total of 69 economic analyses. This consisted of 32 cost-effectiveness analyses, 29 cost-utility analyses, and 8 cost-benefit analyses. The most common domains studied were aneurysmal disease (89, 38%) and peripheral vascular disease (50, 21%). Economic evaluations were commonly published in the Journal of Vascular Surgery (83, 35%) and Annals of Vascular Surgery (32, 14%), with most study authors located in the United States (127, 54%). There was a trend of economic evaluations being published more frequently in recent years. CONCLUSIONS The majority of vascular surgery economic evaluations used only a cost analysis, rather than a full economic evaluation, which may not be ideal in pursuing interventions that simultaneously optimize cost and patient outcomes. The literature is lacking in full economic evaluations-a trend persistent in other surgical specialties-and there is a need for full economic evaluations to be conducted in the field of vascular surgery.
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Affiliation(s)
- Arshia Pedram Javidan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
| | - Faysal Naji
- Division of Vascular Surgery, Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Allen Li
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Annie Wu
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Varun Srivatsav
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Theodore Rapanos
- Division of Vascular Surgery, Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - John Harlock
- Division of Vascular Surgery, Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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McDaniel MD, Nehler MR, Santilli SM, Hiatt WR, Regensteiner JG, Goldstone J, McCarthy WJ, White JV. Extended outcome assessment in the care of vascular diseases: revising the paradigm for the 21st century. Ad Hoc Committee to Study Outcomes Assessment, Society for Vascular Surgery/International Society for Cardiovascular Surgery, North American Chapter. J Vasc Surg 2000; 32:1239-50. [PMID: 11107103 DOI: 10.1067/mva.2000.109747] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M D McDaniel
- Department of Surgery and the Department of Community and Family Medicine, Dartmouth Medical School, Hannover, NH 03755-3863, USA.
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