Evidence map›Paper›PMID 33793734›Full record

Trial reportThe British journal of surgery2021

Cost-effectiveness of immediate total-body CT in patients with severe trauma (REACT-2 trial).

K Treskes, J C Sierink, M J R Edwards, B J A Beuker, E M M Van Lieshout, J Hohmann, T P Saltzherr, M W Hollmann, S Van Dieren, J C Goslings and 2 more

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

Trial report in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Artificial intelligence fracture recognition on computed tomography: review of literature and recommendations.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Review
  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

12 authors.

K TreskesTrauma Unit, Department of Surgery, Amsterdam University Medical Centre, Location AMC, Amsterdam, the Netherlands.ORCID 0000-0002-9462-5372
J C SierinkTrauma Unit, Department of Surgery, Amsterdam University Medical Centre, Location AMC, Amsterdam, the Netherlands.
M J R EdwardsTrauma Unit, Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands.
B J A BeukerTrauma Unit, Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands.
E M M Van LieshoutTrauma Unit, Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
J HohmannDepartment of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
T P SaltzherrDepartment of Surgery, Haaglanden Medical Centre, Den Haag, the Netherlands.
M W HollmannDepartment of Anaesthesiology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
S Van DierenDepartment of Surgery, Amsterdam University Medical Centre, Location AMC, Amsterdam, the Netherlands.
J C GoslingsTrauma Unit, Department of Surgery, Amsterdam University Medical Centre, Location AMC, Amsterdam, the Netherlands.
M G W DijkgraafDepartment of Epidemiology and Data Science, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
REACT-2 study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effect of immediate total-body CT (iTBCT) on health economic aspects in patients with severe trauma is an underreported issue. This study determined the cost-effectiveness of iTBCT compared with conventional radiological imaging with selective CT (standard work-up (STWU)) during the initial trauma evaluation.

methodsIn this multicentre RCT, adult patients with a high suspicion of severe injury were randomized in-hospital to iTBCT or STWU. Hospital healthcare costs were determined for the first 6 months after the injury. The probability of iTBCT being cost-effective was calculated for various levels of willingness-to-pay per extra patient alive.

resultsA total of 928 Dutch patients with complete clinical follow-up were included. Mean costs of hospital care were €25 809 (95 per cent bias-corrected and accelerated (bca) c.i. €22 617 to €29 137) for the iTBCT group and €26 155 (€23 050 to €29 344) for the STWU group, a difference per patient in favour of iTBCT of €346 (€4987 to €4328) (P = 0.876). Proportions of patients alive at 6 months were not different. The proportion of patients alive without serious morbidity was 61.6 per cent in the iTBCT group versus 66.7 per cent in the STWU group (difference -5.1 per cent; P = 0.104). The probability of iTBCT being cost-effective in keeping patients alive remained below 0.56 for the whole group, but was higher in patients with multiple trauma (0.8-0.9) and in those with traumatic brain injury (more than 0.9).

conclusionEconomically, from a hospital healthcare provider perspective, iTBCT should be the diagnostic strategy of first choice in patients with multiple trauma or traumatic brain injury.

Indexed as

AdultBrain Injuries, TraumaticCost-Benefit AnalysisFemaleHospital CostsHumansInjury Severity ScoreMaleMiddle AgedMultiple TraumaNetherlandsRadiographySwitzerlandTomography, X-Ray ComputedWhole Body Imaging

Identifiers

PMID33793734
PMCPMC10364909

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Registered trials

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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.