About: Is Protocolised Weaning that Includes Early Extubation Onto Non-Invasive Ventilation More Cost Effective Than Protocolised Weaning Without Non-Invasive Ventilation? Findings from the Breathe Study

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About: Is Protocolised Weaning that Includes Early Extubation Onto Non-Invasive Ventilation More Cost Effective Than Protocolised Weaning Without Non-Invasive Ventilation? Findings from the Breathe Study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Is Protocolised Weaning that Includes Early Extubation Onto Non-Invasive Ventilation More Cost Effective Than Protocolised Weaning Without Non-Invasive Ventilation? Findings from the Breathe Study
Creator	Perkins, Gavin Couper, Keith Dipesh Mistry, · Dritsaki, Melina Gates, Simon Khan, Iftekhar Lall, Ranjit Lamb, Sarah Maredza, Mandy Petrou, Stavros
source	PMC
abstract	BACKGROUND: Optimising techniques to wean patients from invasive mechanical ventilation (IMV) remains a key goal of intensive care practice. The use of non-invasive ventilation (NIV) as a weaning strategy (transitioning patients who are difficult to wean to early NIV) may reduce mortality, ventilator-associated pneumonia and intensive care unit (ICU) length of stay. OBJECTIVES: Our objectives were to determine the cost effectiveness of protocolised weaning, including early extubation onto NIV, compared with weaning without NIV in a UK National Health Service setting. METHODS: We conducted an economic evaluation alongside a multicentre randomised controlled trial. Patients were randomised to either protocol-directed weaning from mechanical ventilation or ongoing IMV with daily spontaneous breathing trials. The primary efficacy outcome was time to liberation from ventilation. Bivariate regression of costs and quality-adjusted life-years (QALYs) provided estimates of the incremental cost per QALY and incremental net monetary benefit (INMB) overall and for subgroups [presence/absence of chronic obstructive pulmonary disease (COPD) and operative status]. Long-term cost effectiveness was determined through extrapolation of survival curves using flexible parametric modelling. RESULTS: NIV was associated with a mean INMB of £620 ($US885) (cost-effectiveness threshold of £20,000 per QALY) with a corresponding probability of 58% that NIV is cost effective. The probability that NIV is cost effective was higher for those with COPD (84%). NIV was cost effective over 5 years, with an estimated incremental cost-effectiveness ratio of £4618 ($US6594 per QALY gained). CONCLUSIONS: The probability of NIV being cost effective relative to weaning without NIV ranged between 57 and 59% overall and between 82 and 87% for the COPD subgroup. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s41669-020-00210-1) contains supplementary material, which is available to authorized users.
has issue date	2020-04-02(xsd:dateTime)
bibo:doi	10.1007/s41669-020-00210-1
bibo:pmid	32240532
has license	cc-by-nc
sha1sum (hex)	d902bc3f73233ef1e64677d5185f0e11199af88e
schema:url	https://doi.org/10.1007/s41669-020-00210-1
resource representing a document's title	Is Protocolised Weaning that Includes Early Extubation Onto Non-Invasive Ventilation More Cost Effective Than Protocolised Weaning Without Non-Invasive Ventilation? Findings from the Breathe Study
has PubMed Central identifier	PMC7223248
has PubMed identifier	32240532
schema:publication	Pharmacoecon Open
resource representing a document's body	covid:d902bc3f73233ef1e64677d5185f0e11199af88e#body_text
is schema:about of	named entity 'patients' named entity 'NIV' named entity 'wean' named entity 'ventilator-associated pneumonia' named entity 'wean' named entity 'cost effectiveness' named entity 'weaning' named entity 'mechanical ventilation' named entity 'patients' named entity 'efficacy' named entity 'non-invasive ventilation' named entity 'cost effective' named entity 'key' named entity 'Results' named entity 'determine' named entity 'threshold' named entity 'cost effectiveness' named entity 'IMV' named entity 'invasive mechanical ventilation' named entity 'NIV' named entity 'UK National Health Service' named entity 'NIV' named entity 'weaning' named entity 'ventilator-associated pneumonia' named entity 'COPD' named entity 'cost effective' named entity 'incremental cost' named entity 'cost effectiveness' named entity 'parametric bootstrapping' named entity 'long-term' named entity 'NIV' named entity 'trial protocol' named entity 'ICU' named entity 'long-term' named entity 'weaning' named entity 'cost effectiveness' named entity 'weaning' named entity 'cost-effectiveness analysis' named entity 'SBT' named entity 'cost effectiveness' named entity 'COPD' named entity 'cost effectiveness' named entity 'COPD' named entity 'industrialised countries' named entity 'COPD' named entity 'non-medical' named entity 'ICU' named entity 'case report form' named entity 'follow-up' named entity 'QALY' named entity 'NIV' named entity 'weaning' named entity 'ICU' named entity 'respiratory rate' named entity 'tracheostomies' named entity 'IMV' named entity 'AIC' named entity 'NIV' named entity 'treatment allocation' named entity 'economic evaluation' named entity 'mmHg' named entity 'weaning' named entity 'antiviral' named entity 'NIV' named entity 'cost effectiveness' named entity 'extubation' named entity 'weaning' named entity 'self-care' named entity 'IMV' named entity '4.3' named entity 'NHS' named entity 'long-term'

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