Evidence map›Paper›PMID 26880056›Full record

Trial reportInternational journal of stroke : official journal of the International Stroke Society2016

Cost-utility analysis of stenting versus endarterectomy in the International Carotid Stenting Study.

Stephen Morris, Nishma V Patel, Joanna Dobson, Roland L Featherstone, Toby Richards, Ramon Luengo-Fernandez, Peter M Rothwell, Martin M Brown, International Carotid Stenting Study investigators

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of stroke : official journal of the International Stroke Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Cost-effectiveness of carotid artery stenting vs endarterectomy: A simulation.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023
    Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Stephen MorrisDepartment of Applied Health Research, University College London, London, UK steve.morris@ucl.ac.uk.
Nishma V PatelDepartment of Applied Health Research, University College London, London, UK.
Joanna DobsonDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Roland L FeatherstoneDepartment of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, UK.
Toby RichardsDivision of Surgery and Interventional Science, University College London, London, UK.
Ramon Luengo-FernandezHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Peter M RothwellStroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Martin M BrownDepartment of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, UK.
International Carotid Stenting Study investigators

Funding

Department of HealthMedical Research Council G0300411The Dunhill Medical Trust OSRP2/1006Wellcome Trust 095626Wellcome Trust 104040
6 · The paper itself

Abstract

backgroundThe International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsistent.

aimsWe compared the cost-effectiveness of stenting versus endarterectomy using International Carotid Stenting Study data.

methodsWe performed a cost-utility analysis estimating mean costs and quality-adjusted life years per patient for both treatments over a five-year time horizon based on resource use data and utility values collected in the trial. Costs of managing stroke events were estimated using individual patient data from a UK population-based study (Oxford Vascular Study).

resultsMean costs per patient (95% CI) were US$10,477 ($9669 to $11,285) in the stenting group (N = 853) and $9669 ($8835 to $10,504) in the endarterectomy group (N = 857). There were no differences in mean quality-adjusted life years per patient (3.247 (3.160 to 3.333) and 3.228 (3.150 to 3.306), respectively). There were no differences in adjusted costs between groups (mean incremental costs for stenting versus endarterectomy $736 (95% CI -$353 to $1826)) or adjusted outcomes (mean quality-adjusted life years gained -0.010 (95% CI -0.117 to 0.097)). The incremental net monetary benefit for stenting versus endarterectomy was not significantly different from zero at the maximum willingness to pay for a quality-adjusted life year commonly used in the UK. Sensitivity analyses showed little uncertainty in these findings.

conclusionsEconomic considerations should not affect whether patients with symptomatic carotid stenosis undergo stenting or endarterectomy.

Indexed as

AgedCarotid StenosisCost-Benefit AnalysisEndarterectomy, CarotidFemaleFollow-Up StudiesHealth Care CostsHumansMaleQuality-Adjusted Life YearsRiskStentsStrokeTime FactorsTreatment OutcomeUnited Kingdomcarotid endarterectomycarotid stenosiscarotid stentingclinical trialCost factorseconomics

Identifiers

PMID26880056
PMCPMC5341766

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.