Evidence map›Paper›PMID 36863066›Full record

Trial reportValue in health regional issues2023

Seemingly Unrelated Regression Analysis of the Cost and Health-Related Quality of Life Outcomes of the REVAMP Randomized Clinical Trial.

Tamlyn A Rautenberg, Shu Kay Ng, Gavin George, Mahomed-Yunus S Moosa, Suzanne M McCluskey, Rebecca F Gilbert, Selvan Pillay, Isaac Aturinda, Kevin L Ard, Winnie Muyindike and 11 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Value in health regional issues, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

21 authors.

Tamlyn A RautenbergCentre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Allied Health Services, Metro North Hospital and Health Service, Brisbane, QLD, Australia. Electronic address: t.rautenberg@griffith.edu.au.
Shu Kay NgCentre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia.
Gavin GeorgeHealth Economics and HIV Research Division, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Division of Social Medicine and Global Health, Lund University, Lund, Sweden.
Mahomed-Yunus S MoosaSchool of Clinical Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Suzanne M McCluskeyDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Rebecca F GilbertDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Selvan PillaySchool of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Isaac AturindaDepartment of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Kevin L ArdDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Winnie MuyindikeDepartment of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Nicholas MusinguziDepartment of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Godfrey MasetteDepartment of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Melendhran PillayDepartment of Virology, National Health Laboratory Service, Durban, South Africa.
Pravi MoodleyDepartment of Virology, National Health Laboratory Service, Durban, South Africa; Department of Virology, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Jaysingh BrijkumarNelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Rajesh T GandhiDepartment of Medicine, Harvard Medical School, Boston, MA, USA.
Brent JohnsonDepartment of Biostatistics and Computation Biology, University of Rochester, Rochester, NY, USA.
Henry SunpathDepartment of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Mwebesa B BwanaMbarara University of Science and Technology, Mbarara, Uganda.
Vincent C MarconiDepartment of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.
Mark J SiednerDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; Africa Health Research Institute, KwaZulu-Natal, South Africa.

Funding

Resistance testing versus adherence support for management of patients with virologic failure on first-line antiretroviral therapy in sub-Saharan Africa: An open-label randomized controlled trialR01AI124718 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI MUYINDIKE, WINNIE, SIEDNER, MARK J · 2016 to 2020
$3.0M
NIAID NIH HHS R01 AI124718
6 · The paper itself

Abstract

objectiveThis study aimed to evaluate the 9-month cost and health-related quality of life (HRQOL) outcomes of resistance versus viral load testing strategies to manage virological failure in low-middle income countries.

methodsWe analyzed secondary outcomes from the REVAMP clinical trial: a pragmatic, open label, parallel-arm randomized trial investigating resistance versus viral load testing for individuals failing first-line treatment in South Africa and Uganda. We collected resource data, valued according to local cost data and used the 3-level version of EQ-5D to measure HRQOL at baseline and 9 months. We applied seemingly unrelated regression equations to account for the correlation between cost and HRQOL. We conducted intention-to-treat analyses with multiple imputation using chained equations for missing data and performed sensitivity analyses using complete cases.

resultsFor South Africa, resistance testing and opportunistic infections were associated with statistically significantly higher total costs, and virological suppression was associated with lower total cost. Higher baseline utility, higher cluster of differentiation 4 (CD4) count, and virological suppression were associated with better HRQOL. For Uganda, resistance testing and switching to second-line treatment were associated with higher total cost, and higher CD4 was associated with lower total cost. Higher baseline utility, higher CD4 count, and virological suppression were associated with better HRQOL. Sensitivity analyses of the complete-case analysis confirmed the overall results.

conclusionResistance testing showed no cost or HRQOL advantage in South Africa or Uganda over the 9-month REVAMP clinical trial.

Indexed as

Anti-HIV AgentsHumansQuality of LifeSouth AfricaAnti-HIV Agentscost-effectivenesshealth economicsresistance testingseemingly unrelated regressionvirological failure

Identifiers

PMID36863066
PMCPMC10256267

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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.