of referral to secondary care. Whited To The -The A Clinical -The -In the base-case Selection of 2003 study trial effectiveness analysis, the comparators based evidence median time to Affair came from a initial definitive the The selection Health prospective, intervention was clinical of the Care (TD) randomised 137.5 days for UC comparator patients system service clinical trial and 50 days for from a was referred for that was TD (p=0.0027). clinical appropriate as for a patients carried out This resulted in trial with it reflected the referred at a single an incremental cost -The conventional for a centre. Of effectiveness of estimates -The study approach to the 110 TD 87.5 days. to report setting sample patient patients who Variations a cost was management. were performed in the analysis 275 The authors was scheduled sensitivity analysis and a made an for a clinic did not alter care. of extreme The visit, 21 substantially the The which comparison in (19.1%) did base-case results, 140 the model, not present and the were in because for their incremental analysis study the UC exclusive use visit. One effectiveness of to was group of TD was reviewed patient was TD ranged from compare and compared a digital not 86 to 87.5 days. a in 125 in with exclusive image scheduled the the TD use of UC. and a but showed USA. group. -Cost results for a clinic Other visit anyway. In the base-case Validity of history, Of the 140 consult analysis, the estimate of
of referral to secondary care. Whited 2003 To the clinical from a clinical trial with cost estimates to report a cost analysis and a analysis to compare a consult The study patients referred for a -The Affair Health Care system -The setting was care. The study was in the USA. A (TD) service for patients referred for a was The reviewed a digital image and a history, Clinical trial based -The study sample 275 of which 140 were in the UC group and 125 in the TD group. Other -The effectiveness evidence came from a prospective, randomised clinical trial that was carried out at a single centre. Of the 110 TD patients who were scheduled for a clinic visit, 21 (19.1%) did not present for their visit. One patient was not scheduled but showed for a clinic visit anyway. Of the 140 -In the base-case analysis, the median time to initial definitive intervention was 137.5 days for UC and 50 days for TD (p=0.0027). This resulted in an incremental effectiveness of 87.5 days. Variations performed in the sensitivity analysis did not alter substantially the base-case results, and the incremental effectiveness of TD ranged from 86 to 87.5 days. -Cost results In the base-case analysis, the Selection of comparators The selection of the comparator was appropriate as it reflected the conventional approach to patient management. The authors made an extreme comparison in the model, because exclusive use of TD was compared with exclusive use of UC. Validity of estimate of
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