Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-27T00:21:44.868Z Has data issue: false hasContentIssue false

Principles for the design of the economic evaluation of COLOR II: An international clinical trial in surgery comparing laparoscopic and open surgery in rectal cancer

Published online by Cambridge University Press:  27 February 2006

Ingela Björholt
Affiliation:
Institute of Surgical Sciences
Martin Janson
Affiliation:
CLINTEC Karolinska Institutet and Karolinska University Hospital Huddinge
Bengt Jönsson
Affiliation:
Stockholm School of Economics
Eva Haglind
Affiliation:
Institute of Surgical Sciences and Sahlgrenska University Hospital

Abstract

Objectives: The objective is to describe the principles for the design of the economic evaluation of COLOR II, a randomized, multi-country study comparing laparoscopic and open surgery for rectal cancer.

Methods: By using the experiences gained in a recent economic evaluation in colon cancer, where the same surgical techniques were compared, we could improve the method for identifying and measuring resource use items and also accommodate the use of data from the global study population.

Results: In the design of the study, the uncertainty in the resource-use variables was reduced by considering (i) what aspects drive each variable, (ii) what resource use is related to the intervention, (iii) how data from different countries affects the variable.

Conclusions: The aim was to refine the data collection so that the economic research question could be answered in the best possible way, given the circumstances in the clinical study. Thus, (i) some variables were treated as stochastic variables and others as deterministic variables, (ii) aggregate key cost-driving resource items were developed that corresponded to clinical events, and (iii) a surrogate variable was selected, instead of the “obvious variable”, to reduce the impact of confounding factors for one particular resource unit.

Type
GENERAL ESSAYS
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berggren U, Gordh T, Grama D, et al. 1994 Laparoscopic versus open cholecystectomy: Hospitalization, sick leave, analgesia and trauma responses. Br J Surg. 81: 13621365.Google Scholar
Brouwer W, Rutten F, Koopmanschap M. 2001: Costing in economic evaluations. In: Drummond M, McGuire A, eds. Economic evaluation in health care: Merging theory with practice. New York: Oxford University Press Inc; 6893.
Cook J, Drummond M, Glick H, Heyse J. 2003 Assessing the appropriateness of combining economic data from multinational clinical trials. Stat Med. 22: 19551976.Google Scholar
Coyle D, Davies L, Drummond MF. 1998 Trials and tribulations. Emerging issues in designing economic evaluations alongside clinical trials. Int J Technol Assess Health Care. 14: 135144.Google Scholar
Drummond M, Pang F. 2001: Transferability of economic evaluation results. In: Drummond M, McGuire A, eds. Economic evaluation in health care: Merging theory with practice. New York: Oxford University Press Inc; 256276.
Janson M, Björholt I, Carlsson P, et al. 2004 Randomised clinical trial of the costs of open and laparoscopic surgery for colonic surgery. Br J Surg. 91: 409417.Google Scholar
Johnston K, Buxton M, Jones D, Fitzpatrick R. 1999 Assessing the costs of healthcare technologies in clinical trials. Health Technol Assess. 3: 176.Google Scholar
Jonsson B, Zethraeus N. 2000 Costs and benefits of laparoscopic surgery: A review of the literature. Eur J Surg. (Suppl 585): 4856.Google Scholar
Kald A, Anderberg B, Carlsson P, Park PO, Smedh K. 1997 Surgical outcome and cost-minimisation-analyses of laparoscopic and open hernia repair: A randomised prospective trial with one year follow up. Eur J Surg. 163: 505510.Google Scholar
Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. 2002 Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: A randomised trial. Lancet. 359: 22242229.Google Scholar
Laine S, Rantala A, Gullichsen R, Ovaska J. 1997 Laparoscopic vs conventional nissen fundoplication. A prospective randomized study. Surg Endosc. 11: 441444.Google Scholar
Pang F. 2002 Design, analysis and presentation of multinational economic studies: The need for guidance. Pharmacoeconomics. 20: 7590.Google Scholar
Reed S, Anstrom KJ, Bakhai A, et al. 2005 Conducting economic evaluations alongside multinational clinical trials: Towards a research consensus. Am Heart J. 149: 434443.Google Scholar
The colon cancer Laparoscopic or Open Resection Study Group. 2005 Laparoscopic surgery versus open surgery for colon cancer: Short-term outcomes of a randomised trial. Lancet Oncol. 6: 477484.
Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G. 2002 Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer. JAMA. 287: 321328.Google Scholar
Willke R, Glick H, Polsky D, Schulman K. 1998 Estimating country-specific cost-effectiveness from multinational clinical trials. Health Econ. 7: 481493.Google Scholar