Protocol for a systematic review and economic evaluation of the clinical and cost-effectiveness of non-hospital-based non-invasive ventilation NIV in patients with stable end-stage COPD with hypercapnic respiratory failureReportar como inadecuado




Protocol for a systematic review and economic evaluation of the clinical and cost-effectiveness of non-hospital-based non-invasive ventilation NIV in patients with stable end-stage COPD with hypercapnic respiratory failure - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Systematic Reviews

, 3:32

First Online: 27 March 2014Received: 31 October 2013Accepted: 03 March 2014DOI: 10.1186-2046-4053-3-32

Cite this article as: Dave, C., Turner, A., Dretzke, J. et al. Syst Rev 2014 3: 32. doi:10.1186-2046-4053-3-32

Abstract

BackgroundChronic obstructive pulmonary disease COPD remains a significant public health burden. Non-invasive ventilation NIV is a method of supported breathing used as standard care for acutely unwell patients in hospital with COPD, but there is uncertainty around the potential benefits of using NIV in the treatment of stable patients in a non-hospital setting. This is a protocol for systematic reviews of the clinical and cost-effectiveness of NIV in this context, being undertaken in support of a model based economic evaluation.

Methods-DesignStandard systematic review methods aimed at minimising bias will be employed for study identification, selection and data extraction for both the clinical and economic systematic reviews. Bibliographic databases for example MEDLINE, EMBASE and ongoing trials registers will be searched from 1980 onwards. The search strategy will combine terms for the population with those for the intervention. Studies will be selected for review if the population includes adult patients with COPD and hypercapnic respiratory failure, however defined. Systematic reviews, randomised controlled trials and observational studies with n >1 will be included, and quality assessment will be tailored to the different study designs. The primary outcome measures of interest are survival, quality of life, and healthcare utilisations hospitalisation and Accident and Emergency attendances. Meta-analyses will be undertaken where clinical and methodological homogeneity exists, supported by predefined subgroup analyses where appropriate. A systematic review of the evidence on the cost-effectiveness of non-hospital NIV will be completed, and a model-based cost-utility analysis undertaken to determine the cost-effectiveness of non-hospital-based NIV compared with standard care.

DiscussionThese reviews will attempt to clarify the clinical effectiveness of non-hospital NIV in COPD patients as well as the cost-effectiveness. The findings may indicate whether NIV in a non-hospital setting should be considered more routinely in this patient group, and what the likely cost implications will be.

PROSPERO registration2012:CRD42012003286.

KeywordsCOPD Non-hospital-based non-invasive ventilation Hypercapnia Clinical effectiveness Cost-effectiveness Systematic review Meta-analysis AbbreviationsCOPDchronic obstructive pulmonary disease

FEV1forced expiratory volume in one second

FVCforced vital capacity

LTOTlong-term oxygen therapy

NIVnon-invasive ventilation

PaCO2partial pressure of carbon dioxide in arterial blood

QoLquality of life

RCTrandomised controlled trial

VoIvalue of information.

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Autor: Chirag Dave - Alice Turner - Janine Dretzke - Sue Bayliss - Deirdre O’Brien - Sue Jowett - David Moore

Fuente: https://link.springer.com/







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