Decision uncertainty and value of further research: a case-study in fenestrated endovascular aneurysm repair for complex abdominal aortic aneurysms

Table 4 Mean costs and QALYs estimated by the model and sensitivity analyses

	Cost OSR	QALY OSR	Cost fEVAR	QALY fEVAR	Difference in cost	95% CI		Difference in QALY	95% CI		ICER	p (20 k)	p (30 k)
Base-case	16,067	4.333	31,673	4.542	15,606	8391	22,512	0.209	− 0.124	1.311	74,580	0.090	0.158
Model2	16,246	4.626	31,604	4.544	15,358	8126	22,902	− 0.082	− 0.167	0.090	Dominated	0.001	0.003
Model3	15,860	4.017	31,694	4.554	15,834	8383	23,611	0.537	− 0.072	1.944	29,498	0.269	0.401
Model4	15,801	3.923	31,648	4.295	15,848	8467	23,859	0.372	− 0.318	1.707	42,584	0.224	0.318
Model5	16,194	4.525	31,762	4.615	15,567	8126	23,379	0.090	− 0.083	0.612	173,452	0.019	0.046
Model6	16,032	4.303	31,876	4.547	15,843	8438	23,193	0.243	− 0.071	1.136	65,154	0.077	0.165
Model7	18,292	4.353	31,665	4.548	13,373	6089	20,803	0.196	− 0.118	1.101	68,348	0.100	0.169
Model8	16,047	4.344	22,948	4.545	6901	− 804	14,238	0.201	− 0.123	1.308	34,373	0.249	0.330

OSR open surgical repair, fEVAR fenestrated endovascular aneurysm repair, ICER incremental cost effectiveness ratio, QALY quality-adjusted life years, Pr(X) probability that fEVAR is cost-effective at threshold of X(£), Dominated fEVAR had greater cost and lower health benefit
Scenario 2: Odds ratio (OR) of operative mortality favours OSR
Scenario 3: OR of operative mortality is more favourable to fEVAR than the base-case
Scenario 4: Greater base-line risk of operative mortality
Scenario 5: Lower base-line risk of operative mortality
Scenario 6: No difference in late-aneurysm related deaths between groups
Scenario 7: No difference in late re-interventions between groups
Scenario 8: Lower price of endovascular device

ISSN: 1478-7547