Evidence map›Paper›PMID 32414740›Full record

ArticleClinical medicine (London, England)2020

The cost of providing mechanical thrombectomy in the UK NHS: a micro-costing study.

Joyce S Balami, Diamuid Coughlan, Phil M White, Peter McMeekin, Darren Flynn, Christine Roffe, Indira Natarajan, Jayan Chembala, Sanjeev Nayak, Ivan Wiggam and 18 more

Open access · diamondAbstract read
In one paragraph

Article in Clinical medicine (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
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

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Review
  3. How a thrombectomy service can reduce hospital deficit: a cost-effectiveness study.Cost effectiveness and resource allocation : C/E · 2022
    Article
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

28 authors at 17 institutions in 1 country.

Joyce S BalamiCentre for Evidence-Based Medicine, Oxford, UK and Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK joyce.balami@kellogg.ox.ac.uk.
Diamuid CoughlanNewcastle University, Newcastle upon Tyne, UK.
Phil M WhiteNewcastle University, Newcastle upon Tyne, UK and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Peter McMeekinNorthumbria University, Newcastle upon Tyne, UK.
Darren FlynnTeesside University, Middlesbrough, UK.
Christine RoffeUniversity Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent, UK and Keele University, Keele, UK.
Indira NatarajanUniversity Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent, UK and Keele University, Keele, UK.
Jayan ChembalaUniversity Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent, UK and Keele University, Keele, UK.
Sanjeev NayakUniversity Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent, UK and Keele University, Keele, UK.
Ivan WiggamRoyal Victoria Hospital, Belfast, UK.
Peter FlynnRoyal Victoria Hospital, Belfast, UK.
Robert SimisterUniversity College Hospital, London, UK.
Yazen SammaraieeUniversity College Hospital, London, UK.
Don SimsUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Kurdow NaderUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Anand DixitNewcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Dawn CraigNewcastle University, Newcastle upon Tyne, UK.
Hannah LumleyNewcastle University, Newcastle upon Tyne, UK.
Stephen RiceNewcastle University, Newcastle upon Tyne, UK.
David BurgessNorth East and North Cumbria Stroke Patient & Carer Panel, Newcastle upon Tyne, UK.
Lisa FoddyUniversity Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent, UK and Keele University, Keele, UK.
Emer HopkinsHealth and Social Care Board, Belfast, UK.
Beverley HudsonUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Rachael JonesUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Martin A JamesRoyal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Alastair M BuchanUniversity of Oxford, Oxford, UK and John Radcliffe Hospital, Oxford, UK.
Gary A FordOxford University, Oxford, UK, visiting professor, Newcastle University, Newcastle upon Tyne, UK and consultant stroke physician, John Radcliffe Hospital, Oxford, UK.
Alastair M GrayUniversity of Oxford, Oxford, UK.
Newcastle University · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBUniversity Hospitals of North Midlands NHS Trust · GBJohn Radcliffe Hospital · GBKeele University · GBAcademic Health Science Network North East and North Cumbria · GBBelfast Health and Social Care Trust · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBNorfolk and Norwich University Hospitals NHS Foundation Trust · GBNorthumbria University · GBRoyal Devon & Exeter NHS Foundation Trust · GBRoyal Victoria Hospital · GBTeesside University · GBUniversity College Hospital · GBUniversity College London · GBUniversity of Oxford · GBUniversity of Ulster · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe clinical efficacy and cost-effectiveness of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke is well established, but uncertainty remains around the true cost of delivering this treatment within the NHS. The aim of this study was to establish the cost of providing MT within the hyperacute phase of care and to explore differences in resources used and costs across different neuroscience centres in the UK.

methodThis was a multicentre retrospective study using micro-costing methods to enable a precise assessment of the costs of MT from an NHS perspective. Data on resources used and their costs were collected from five UK neuroscience centres between 2015 and 2018.

resultsData were collected on 310 patients with acute ischaemic stroke treated with MT. The mean total cost of providing MT and inpatient care within 24 hours was £10,846 (95% confidence interval (CI) 10,527-11,165) per patient. The main driver of cost was MT procedure costs, accounting for 73% (£7,943; 95% CI 7,649-8,237) of the total 24-hour cost. Costs were higher for patients treated under general anaesthesia (£11,048; standard deviation (SD) 2,654) than for local anaesthesia (£9,978; SD 2,654), mean difference £1,070 (95% CI 381-1,759; p=0.003); admission to an intensive care unit (ICU; £12,212; SD 3,028) against for admission elsewhere (£10,179; SD 2,415), mean difference £2,032 (95% CI 1,345-2,719; p<0001).The mean cost within 72 hours was £12,440 (95% CI 10,628-14,252). The total costs for the duration of inpatient care before discharge from a thrombectomy centre was £14,362 (95% CI 13,603-15,122).

conclusionsMajor factors contributing to costs of MT for stroke include consumables and staff for intervention, use of general anaesthesia and ICU admissions. These findings can inform the reimbursement, provision and strategic planning of stroke services and aid future economic evaluations.

Indexed as

Brain IschemiaStrokeHumansRetrospective StudiesState MedicineThrombectomyUnited KingdomAcute ischaemic strokecostsmechanical thrombectomymicro-costingtreatment

Identifiers

PMID32414740
PMCPMC7354051
OpenAlexW3024269242

What OpenQuestion holds

Textmetadata
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.