PT  - JOURNAL ARTICLE
AU  - Joseph S Solomkin
TI  - Cost-Effectiveness Issues in Ventilator-Associated Pneumonia
DP  - 2005 Jul 01
TA  - Respiratory Care
PG  - 956--964
VI  - 50
IP  - 7
4099  - http://rc.rcjournal.com/content/50/7/956.short
4100  - http://rc.rcjournal.com/content/50/7/956.full
AB  - Ventilator-associated pneumonia has attracted considerable interest as a subject of clinical efficacy assessment research. This article summarizes recommendations made by the United States Public Health Service Panel on Cost-Effectiveness in Health and Medicine and by a panel convened by the American Thoracic Society to address economic analyses in critical care. The following recommendations are made for the performance of cost-efficacy studies in ventilator-associated pneumonia. For mortality-based studies, only data from prospective and blinded randomized trials are suitable for analysis. For cost-minimization studies, observational studies may be useful but should use rigorous matching schemes. Estimates for the quality of life of patients surviving an episode of ventilator-associated pneumonia should be based on the disease that required mechanical ventilation or compared to data available for survivors of the respiratory distress syndrome, whichever diagnosis provides a lessened quality of life. Within an individual intensive care unit the greatest cost savings come from constructing a cohesive and unified approach to many issues seen in the unit.