Evidence map›Paper›PMID 35135774›Full record

Observational studyBMJ open2022

Observational retrospective study calculating health service costs of patients receiving surgery for chronic rhinosinusitis in England, using linked patient-level primary and secondary care electronic data.

Caroline S Clarke, Elizabeth Williamson, Spiros Denaxas, James R Carpenter, Mike Thomas, Helen Blackshaw, Anne G M Schilder, Carl M Philpott, Claire Hopkins, Stephen Morris and 1 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 54% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

11 authors at 8 institutions in 1 country.

Caroline S ClarkeResearch Department of Primary Care and Population Health, University College London, London, UK caroline.clarke@ucl.ac.uk.ORCID 0000-0002-4676-1257
Elizabeth WilliamsonDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Spiros DenaxasHealth Data Research UK, London, UK.
James R CarpenterDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Mike ThomasPrimary Care and Population Science, University of Southampton, Southampton, UK.
Helen BlackshawENT Clinical, Zeist, The Netherlands.
Anne G M SchilderNIHR UCLH Biomedical Research Centre, London, UK.
Carl M PhilpottNorwich Medical School, University of East Anglia, Norwich, UK.ORCID 0000-0002-1125-3236
Claire HopkinsENT Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID 0000-0003-3993-1569
Stephen MorrisPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-5828-3563
MACRO programme team
London School of Hygiene & Tropical Medicine · GBGuy's and St Thomas' NHS Foundation Trust · GBHealth Data Research UK · GBUCL Biomedical Research Centre · GBUniversity College London · GBUniversity of Cambridge · GBUniversity of East Anglia · GBUniversity of Southampton · GB

Funding

Medical Research Council MC_UU_12023/21Medical Research Council MC_UU_12023/29Medical Research Council MR/K006584/1Wellcome Trust
6 · The paper itself

Abstract

objectivesChronic rhinosinusitis (CRS) symptoms are experienced by an estimated 11% of UK adults, and symptoms have major impacts on quality of life. Data from UK and elsewhere suggest high economic burden of CRS, but detailed cost information and economic analyses regarding surgical pathway are lacking. This paper estimates healthcare costs for patients receiving surgery for CRS in England.

designObservational retrospective study examining cost of healthcare of patients receiving CRS surgery.

settingLinked electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics databases in England.

participantsA phenotyping algorithm using medical ontology terms identified 'definite' CRS cases who received CRS surgery. Patients were registered with a general practice in England. Data covered the period 1997-2016. A cohort of 13 462 patients had received surgery for CRS, with 9056 (67%) having confirmed nasal polyps. OUTCOME MEASURES: Information was extracted on numbers and types of primary care prescriptions and consultations, and inpatient and outpatient hospital investigations and procedures. Resource use was costed using published sources.

resultsTotal National Health Service costs in CRS surgery patients were £2173 over 1 year including surgery. Total costs per person-quarter were £1983 in the quarter containing surgery, mostly comprising surgical inpatient care costs (£1902), and around £60 per person-quarter in the 2 years before and after surgery, of which half were outpatient costs. Outpatient and primary care costs were low compared with the peak in inpatient costs at surgery. The highest outpatient expenditure was on CT scans, peaking in the quarter preceding surgery.

conclusionsWe present the first study of costs to the English healthcare system for patients receiving surgery for CRS. The total aggregate costs provide a further impetus for trials to evaluate the relative benefit of surgical intervention.

Indexed as

RhinitisSinusitisAdultChronic DiseaseElectronicsEnglandHealth Care CostsHealth ServicesHumansQuality of LifeRetrospective StudiesSecondary Health CareState Medicineclinical trialshealth economicsotolaryngology

Identifiers

PMID35135774
PMCPMC8830221
OpenAlexW4210851059

What OpenQuestion holds

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LicenceCC BY
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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.