@misc{10481/74699,
year = {2022},
month = {4},
url = {http://hdl.handle.net/10481/74699},
abstract = {Objectives: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the
context of a clinical study.
Methods: Patients in the Early Endovenous Ablation in Venous Ulceration (EVRA) trial had between 1 year and
5.5 years (median 3 years) of follow-up under early or deferred endovenous ablation. This study compares completecase-
analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM),
Bayesian parametric approach using the R package missingHE (BPA), repeated measures fixed effect (RMFE) and
repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life
years (QALYs) at different time horizons (1 year, 3 years and 5 years).
Results: All methods found no statistically significant difference in cost at the 5% level in all time horizons, and all
methods found statistically significantly greater mean QALY at year 1. By year 3, only BPA showed a statistically significant
difference in QALY between treatments. Standard errors differed substantially between the methods employed.
Conclusion: CCA can be biased if data are MAR and is wasteful of the data. Hence the results for CCA are likely to be
inaccurate. Other methods coincide in suggesting that early intervention is cost-effective at a threshold of £30,000
per QALY 1, 3 and 5 years. However, the variation in the results across the methods does generate some additional
methodological uncertainty, underlining the importance of conducting sensitivity analyses using alternative
approaches.},
organization = {National Institute for Health Research (NIHR HTA) Programme (EVRA)	11/129/197},
organization = {European Commission	733203},
publisher = {BMC},
keywords = {Longitudinal missing outcome},
keywords = {Repeated measure},
keywords = {Mixed model},
keywords = {Fixed effect},
keywords = {Multiple imputation},
keywords = {Complete-case-analysis},
keywords = {Bayesian parametric approach},
keywords = {Cost-effectiveness analysis},
title = {Comparing methods for handling missing cost and quality of life data in the Early Endovenous Ablation in Venous Ulceration trial},
doi = {10.1186/s12962-022-00351-6},
author = {Diop Wayal, Modou and Epstein, David Mark},
}