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对CODIFI2随机对照试验中感染糖尿病足的抽样与组织采样的成本效益

Chris Bojke¹, Henrietta Konwea¹, E Andrea Nelson²

¹Faculty of Medicine and Health, University of Leeds, Leeds, UK.

Diabetic medicine : a journal of the British Diabetic Association

|February 27, 2025

概括

伤口擦拭比感染糖尿病足的组织采样更具成本效益,提供更高的质量调整寿命 (QALY) 和更低的成本. 由于费用较高和QALYs降低,组织采样主要采用伤口擦拭.

科学领域:

糖尿病足管理糖尿病足管理
卫生经济学卫生经济学
临床试验方法论临床试验方法论

背景情况:

糖尿病足 (DFU) 是致病率和死亡率的重要原因.
准确的伤口培养对于有效治疗DFU感染至关重要.
目前的方法包括伤口擦拭和组织采样,具有不同的成本影响.

研究的目的:

为了比较伤口擦拭与感染糖尿病足的组织采样的成本效益.
在52-104周的时间内评估临床和经济结果.

主要方法:

一个多中心,第三阶段,随机对照试验,比较抽样与组织采样.
在104周内收集了资源使用和患者报告的结果 (QALYs的EQ-5D-3L).
从英国NHS的角度使用2021/2022价格进行经济分析,并进行基于回归的调整和灵敏度分析.

主要成果:

该试验招募了149名参与者 (75名抽样,74名组织) 并因招募率低而提前停止.
与26周,52周和104周的组织采样相比,片采样导致更高的预期质量调整寿命年 (QALYs).
组织采样比伤口擦拭成本更高,包括抗生素和住院费用.

结论:

伤口擦拭在成本效益分析中主导了组织采样.
组织采样与更高的成本和更低的QALY相关,没有证明的好处.
试验的弱势地位可能影响了关于治愈差异的最终结论.

关键词:

抗菌剂是一种抗菌剂.成本效益分析分析成本效益分析糖尿病患者的糖尿病脚经质量调整的寿命年数.随机对照试验是一种随机对照试验.伤口采样伤口采样

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相关概念视频

Diabetic Foot Ulcer

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...