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Methods Inf Med 1998; 37(01): 53-58
DOI: 10.1055/s-0038-1634503
Original Article
Schattauer GmbH

Randomized Observational Studies on the Economics of Therapies – Biometrical Experience of Two Trials

J. Högel
1   IDepartment of Biometry and Medical Documentation, University of Ulm
,
A. C. Rodloff
2   Institute for Medical Microbiology and Epidemiology of Infections, University of Leipzig
,
G. Büchele
1   IDepartment of Biometry and Medical Documentation, University of Ulm
,
W. Gaus
1   IDepartment of Biometry and Medical Documentation, University of Ulm
› Author Affiliations
Further Information

Publication History

Publication Date:
07 February 2018 (online)

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Abstract:

Economic studies in medicine are intended to investigate costs, associated with a particular problem dealing with the indication, diagnosis or therapy, for instance, whether the high costs involved in a highly intensive or innovative therapy could be balanced by the eventual savings made, due to the shorter periods of treatment. In such situations a randomized controlled trial is necessary to find out which therapy or which therapeutical strategy is least expensive in the long run. Economic studies do, however, present some specific problems. Making a list of all the cost-relevant treatment items can be very laborious, but the use of flat rates and lump sums alone cannot lead to a complete cost analysis. Often, costs between hospitals vary more than between treatment regimens.

Early and sudden deaths incur low costs and may bias the results. Furthermore, costs are distributed with a long and heavy upper tail incltJding extreme outliers. This does, in fact, complicate the estimation of the sample size. In this article, these problems are outlined and, with the help ofthe data obtained from two randomized economic trials in health care, solutions are proposed and discussed.

Keywords

Pharmaco-Economy - Economic Studies - Costs Analyses - Nosocomial Pneumonia - Peritonitis - Randomized Studies
 

  • REFERENCES

  • 1 Rodloff AC, LaubenthaL HJ, Schmidt WE. et al. Vergleichende Untersuchung zum Kosten/Effektivitäts-Verhältnis einer initialen Therapie mit Imipenem/Cilastatin bei der nosokomialen Pneumonie (in German). Anäslhesiologie, Intensiv- und Notfallmedizin, Schmerztherapie 1996; 31: 172-80.
    PubMedGoogle Scholar
  • 2 Rodloff AC, Kujath P, LUnstedt B. et al. Vergleichende Untersuchung zum Kosten-/ Effektivitätsverhältnis einer initialen Therapie mit Imipenem/Cilastatin bei der sekundären Peritonitis (in German). Submitted to Der Chirurg.
    PubMedGoogle Scholar
  • 3 Högel J, Schntid W, Gaus W. Robustness of the Standard deviation and other measures of dispersion. Biom J 1994; 36: 411-27.
    CrossrefPubMedGoogle Scholar
  • 4 Machin D, Campbell MJ. Statistical Tables for the Design of Clinical Trials. Oxford, London, Boston, Melbourne: Blackwell Scientific Publ; 1987
    Google Scholar