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托帕兹便携式胸腔引流管理数字系统:NICE 医疗技术指导

Thopaz+ Portable Digital System for Managing Chest Drains: A NICE Medical Technology Guidance.

机构信息

Cardiff University, Cardiff, Wales, UK.

Cedar, Cardiff and Vale University Health Board, Cardiff, Wales, UK.

出版信息

Appl Health Econ Health Policy. 2019 Jun;17(3):285-294. doi: 10.1007/s40258-019-00461-y.

Abstract

The Thopaz+ portable digital system was evaluated by the Medical Technologies Advisory Committee (MTAC) of the National Institute for Health and Care Excellence (NICE). The manufacturer, Medela, submitted a case for the adoption of Thopaz+ that was critiqued by Cedar, on behalf of NICE. Due to a lack of clinical evidence submitted by the manufacturer, Cedar carried out its own literature search. Clinical evidence showed that the use of Thopaz+ led to shorter drainage times, a shorter hospital stay, lower rates of chest drain re-insertion and higher patient satisfaction compared to conventional chest drainage when used in patients following pulmonary resection. One comparative study of the use of Thopaz+ in patients with spontaneous pneumothorax was identified and showed shorter drainage times and a shorter length of hospital stay compared to conventional drainage. No economic evidence was submitted by the manufacturer, but a simple decision tree model was included. The model was improved by Cedar and showed a cost saving of £111.33 per patient when Thopaz+ was used instead of conventional chest drainage in patients following pulmonary resection. Cedar also carried out a sub-group analysis of the use of Thopaz+ instead of conventional drainage in patients with pneumothorax where a cost saving of £550.90 was observed. The main cost driver for the model and sub-group analysis was length of stay. The sub-group analysis was based on a single comparative study. However, the MTAC received details of an unpublished audit of Thopaz+ which confirmed its efficacy in treating patients with pneumothorax. Thopaz+ received a positive recommendation in Medical Technologies Guidance 37.

摘要

Thopaz+ 便携式数字系统由英国国家卫生与保健优化研究所(NICE)的医疗技术咨询委员会(MTAC)进行了评估。制造商美德乐(Medela)提交了一份采用 Thopaz+ 的申请,由 Cedar 代表 NICE 对此申请进行了评审。由于制造商提交的临床证据不足,Cedar 进行了自己的文献检索。临床证据表明,与传统的胸腔引流相比,在肺切除术后患者中使用 Thopaz+可缩短引流时间、缩短住院时间、降低胸腔引流管再次插入率和提高患者满意度。一项关于 Thopaz+在自发性气胸患者中应用的比较研究被确定,并显示与传统引流相比,引流时间更短,住院时间更短。制造商没有提交经济证据,但纳入了一个简单的决策树模型。Cedar 对该模型进行了改进,结果显示,在肺切除术后患者中使用 Thopaz+代替传统胸腔引流时,每个患者可节省 111.33 英镑。Cedar 还对 Thopaz+代替传统引流在气胸患者中的应用进行了亚组分析,观察到节省了 550.90 英镑的成本。该模型和亚组分析的主要成本驱动因素是住院时间。亚组分析基于一项单独的比较研究。然而,MTAC 收到了一份未发表的关于 Thopaz+的审计报告的详细信息,该报告证实了其在治疗气胸患者方面的疗效。Thopaz+ 在医疗技术指南 37 中获得了积极的推荐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf71/6535154/b4fb2635e6a8/40258_2019_461_Fig1_HTML.jpg

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