Troëng T, Bergqvist D, Janzon L, Jendteg S, Lindgren B
Department of Surgery, Central Hospital, Karlskrona, Sweden.
Eur J Vasc Surg. 1993 Jul;7(4):438-43. doi: 10.1016/s0950-821x(05)80263-4.
to compare possible outcomes of the non-operative treatment for intermittent claudication with that of surgery.
decision tree approach using published and vascular registry data. The valuation of clinical outcomes was estimated by index weights using the Rosser index and the Quality of Well-Being scale.
routine health care in Sweden.
published data on 224 non-operatively treated claudicants and data from 805 claudicants treated with surgery or angioplasty from the Swedvasc registry. No diabetics were included. Chief outcome measure: expected utility value at one year after decision on treatment given the clinical data and the estimated health status valuations.
it was possible to identify a success rate for surgery above which it was the better alternative. However, depending on which of two health indices that was used, and if reconstruction was supra- or infrainguinal, this threshold value varied from 0-81%.
reliable measures of the value of outcomes have to be developed and, in addition, long-term data on outcome and costs in routine care have to be collected before a comprehensive economic assessment based on the decision tree approach can be made to support decisions on treatment for intermittent claudication.
比较间歇性跛行非手术治疗与手术治疗的可能结果。
采用已发表数据和血管登记数据的决策树方法。使用罗瑟指数和幸福感量表通过指数权重估计临床结果的价值。
瑞典的常规医疗保健。
224例非手术治疗的跛行患者的已发表数据，以及来自瑞典血管登记处的805例接受手术或血管成形术治疗的跛行患者的数据。未纳入糖尿病患者。主要结局指标：根据临床数据和估计的健康状况评估，治疗决策后一年的预期效用值。
有可能确定一个手术成功率阈值，高于该阈值手术是更好的选择。然而，根据所使用的两个健康指数中的哪一个，以及重建是在腹股沟上还是腹股沟下，这个阈值从0%到81%不等。
必须制定可靠的结果价值衡量标准，此外，在基于决策树方法进行全面经济评估以支持间歇性跛行治疗决策之前，必须收集常规护理中结局和成本的长期数据。
