Evidence map›Paper›PMID 28087548›Full record

Trial reportBMJ open2017

Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial.

Mehdi Javanbakht, Augusto Azuara-Blanco, Jennifer M Burr, Craig Ramsay, David Cooper, Claire Cochran, John Norrie, Graham Scotland

Open access · goldAbstract readMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Systematic methodological review of health state values in glaucoma cost-utility analyses.The European journal of health economics : HEPAC : health economics in prevention and care · 2024
    Pooled it
  2. Article
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Role of Cataract Surgery in the Management of Glaucoma.International ophthalmology clinics · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Mehdi JavanbakhtHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Augusto Azuara-BlancoWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
Jennifer M BurrSchool of Medicine, University of St Andrews, St Andrews, UK.
Craig RamsayHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
David CooperHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
Claire CochranHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
John NorrieHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
Graham ScotlandHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
University of Aberdeen · GBQueen's University Belfast · GBUniversity of St Andrews · GB

Funding

Chief Scientist Office HERU1Chief Scientist Office HSRU1
6 · The paper itself

Abstract

objectiveTo investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care.

designCost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon.

setting22 hospital eye services in the UK. POPULATION: Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC).

interventionsLens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). OUTCOME MEASURES: Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care.

resultsThe mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions.

conclusionsWe find that lens extraction has a 67-89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. TRIAL REGISTRATION NUMBER: ISRCTN44464607; Results.

Indexed as

AgedCataract ExtractionCost-Benefit AnalysisCost of IllnessDirect Service CostsFemaleGlaucoma, Angle-ClosureHumansLens Implantation, IntraocularMaleMiddle AgedQuality-Adjusted Life YearsQuality of LifeSeverity of Illness IndexSurveys and QuestionnairesTime-to-TreatmentAngle closure glaucomaCost-effectivenessLaser peripheral iridotomyLens extractionQALYrandomised controlled trial

Identifiers

PMID28087548
PMCPMC5253715
OpenAlexW2574470185

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.