Evidence map›Paper›PMID 39680515›Full record

Trial reportPloS one2024

Economic evaluation of an adjunctive intraocular and peri-ocular steroid vitreoretinal surgery for open globe trauma: Cost-effectiveness of the ASCOT randomised controlled trial.

Victory 'Segun Ezeofor, Bethany F Anthony, Lucy Bryning, Edward J Casswell, Suzie Cro, Victoria R Cornelius, Catey Bunce, Elizabeth Robertson, Joanna Kelly, Caroline Murphy and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02873026 (A Phase 3 Multi-centre Double-masked Randomised Controlled Trial of Adjunctive Intraocular and Periocular Steroid), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT02873026 phase3completednot on this map

A Phase 3 Multi-centre Double-masked Randomised Controlled Trial of Adjunctive Intraocular and Periocular Steroid (Triamcinolone Acetonide) Versus Standard Treatment in Eyes Undergoing Vitreoretinal Surgery for Open Globe Trauma.

TypeinterventionalSponsorMoorfields Eye Hospital NHS Foundation TrustRan2014 to 2021Enrolled300ConditionsEye Injury TraumaArmsTriamcinolone Acetonide
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

13 authors.

Victory 'Segun EzeoforCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, Wales.ORCID https://orcid.org/0000-0002-4211-8942
Bethany F AnthonyCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, Wales.
Lucy BryningCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, Wales.
Edward J CasswellVitreoretinal Department, Moorfields Eye Hospital, London, United Kingdom.
Suzie CroImperial Clinical Trials Unit, Imperial College London, London, United Kingdom.
Victoria R CorneliusImperial Clinical Trials Unit, Imperial College London, London, United Kingdom.
Catey BunceRoyal Marsden Clinical Trials Unit, Royal Marsden Hospital, National Health Service Trust, London, United Kingdom.
Elizabeth RobertsonVitreoretinal Department, Moorfields Eye Hospital, London, United Kingdom.
Joanna KellyKing's Clinical Trials Unit, King's College London, London, United Kingdom.
Caroline MurphyKing's Clinical Trials Unit, King's College London, London, United Kingdom.
Philip J BanerjeeVitreoretinal Department, Moorfields Eye Hospital, London, United Kingdom.
David G CharterisVitreoretinal Department, Moorfields Eye Hospital, London, United Kingdom.
Rhiannon Tudor EdwardsCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, Wales.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the United Kingdom, it is estimated that 5,000 patients sustain eye injuries or ocular trauma requiring hospital admission annually, of which 250 patients will be permanently blinded. This study explores the cost-effectiveness of Adjunctive Steroid Combination in Ocular Trauma (ASCOT) given during surgery versus standard treatment in vitreoretinal surgery in patients with open globe trauma.

methodsThis economic evaluation was embedded alongside the ASCOT RCT (ClinicalTrials.gov Identifier: NCT02873026). We conducted a primary cost-effectiveness analysis from a National Health Service perspective using the proportion of patients who achieved a visual acuity of 10 or more letter improvement on the Early Treatment Diabetic Retinopathy Study (ETDRS) scale as the measure of effect, in developing incremental cost-effectiveness ratios (ICERs). Secondary cost-utility analysis using the EuroQol 5 Dimension 5 Level (EQ-5D-5L) to generate a cost per quality-adjusted life-year (QALY), and a cost-effectiveness analysis using vision-specific quality of life (QoL) was conducted. Sensitivity analyses were also applied to investigate parameter uncertainties.

resultsThe sample size of the ASCOT intervention arm and standard care arm of this study was 130 and 129, respectively. The intervention cost per patient was estimated at £132. The proportion of participants with an ETDRS of 10 or more letter improvement was 0.47 for the ASCOT group with a mean cost of £5,526 per patient, while the standard care group had an effect of 0.43 with a mean cost of £5,099 per patient. The ICER value of the primary outcome was £12,178 per 10 or more letter improvement on the ETDRS score. The secondary result in terms of cost per QALYs gained had a probability of 44% being cost-effective at a willingness-to-pay threshold of £30,000/QALY gained.

conclusionsThough there is no formally accepted cost-effectiveness willingness-to-pay threshold for 10-letter or more improvement, the ASCOT intervention for open globe trauma is a low-cost intervention. The ASCOT intervention is not cost-effective when compared to the standard care in this group and setting. The proportion of patients in the ASCOT intervention arm with 10 or more letter improvement produced some positive results but this is outweighed by the costs.

Indexed as

Cost-Benefit AnalysisEye InjuriesQuality-Adjusted Life YearsVitreoretinal SurgeryAdultFemaleHumansMaleMiddle AgedQuality of LifeUnited KingdomVisual Acuity

Identifiers

PMID39680515
PMCPMC11649106

What Socratic holds

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LicenceCC BY
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Registered trials

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.