Number needed to treat and cost-effectiveness in the prevention of ventilator-associated pneumonia 英文参考文献.docVIP

Wyncoll and Camporota Critical Care 2012, 16:430 /content/16/3/430 LETTER Number needed to treat and cost-e? ectiveness in the prevention of ventilator-associated pneumonia Duncan Wyncoll* and Luigi Camporota While clinicians continue to rede? ne ventilator-asso- equivalent to an extra 7 days of intensive care unit (ICU) ciated pneumonia (VAP), numerous innovations that stay. What should we consider when assessing the cost- claim to reduce pulmonary microaspiration and its e? ectiveness of VAP prevention? consequences – that is, novel endotracheal cu? shapes and cu? materials, subglottic drainage, automatic cu? We have calculated (Table 2) the additional money (in pounds) that can be spent to prevent an episode of VAP pressure controllers, oral anti-septics, selective digestive (per 10 days of MV) to achieve cost-neutrality. If we decontamination (SDD), and devices to combat bio? lm assume a hypothetical VAP cost of ￡10,000, then with a formation within the lumen of the tracheal tube – are VAP rate of 8% and an RRR of 45%, it is cost-e? ective to coming to the marke ere are two questions that spend up to ￡360. Furthermore, even for an ICU with a clinicians ask when deciding whether to incorporate a VAP rate of only 4% and an intervention that reduces new product or intervention into a VAP prevention VAP by just 25%, it is still cost-e? ective to spend up to bundle. Firstly, what are its e? cacy and e? ectiveness? In ￡100 per 10 days of MV. It should be noted that some other words, what is the relative risk reduction (RRR) and VAP prevention interventions (for example, a modi? ed therefore the number needed to treat (NNT) to prevent tracheal tube cu?) require just a ‘one-o?’ initial cost one additional VAP. Secondly, is this new intervention whereas other intervention