We can work on Controlled trial of post-acute care of older people

Question -1:
(3+1+2=6 marks)
a) Discuss the main motivations of this trial-based cost-effectiveness study by O’Reilly et al.
b) What perspective for the economic evaluation was considered in the study?
c) Has the study applied a discounting of costs and effects in the cost-effectiveness analysis? If
yes or no, justify your answer
Question -2:
(7×2= 14 marks)
Identify and briefly describe briefly the following PICO terms of the cost-effectiveness analysis
in the study.
Patient/Population ________________________________________________




Duration of the Economic Evaluation

No. of patients randomized to ‘Intervention’ group__________________________________
No. of patients randomized to ‘Control’ group __________________________
Question -3:
(5+ 2+ 3=10 marks)
a) Discuss in details ( at least in 5 sentences) how health outcome (quality of life (QoL) and
Quality Adjusted Life Year, QALY) data were captured in the study
b) How health care resources use data were collected in the study?
c) State five (5) different types of primary and hospital care resources use considered in the cost-
effectiveness study
Question -4:
(4+3+3= 10 marks)
In Table 1, the study shows that, from ‘all patients’ analysis the average observed QALY over 6
months study period in the community hospital group is 0.38 and the observed QALY in the
district hospital group is 0.35. However, the difference (95% CI) in QALY over 6 months
between two groups is 0.06 (-0.05 to 0.18).
i) How does the study estimate this difference in QALY between two groups? State in
TWO sentences?
ii) What are the main impacts on health outcome (QALY) by considering two approaches of
analyses – ‘all patients’ and ‘surviving patients’?
iii) Is the difference in QALY between two treatment groups statistically significant or not?
Justify your answer in TWO sentences.
Question -5:
(2+4 + 2+1 +1=10 marks)
Based on results presented in the study, state the average costs and effects (QALYs) over 6
months study period between two options, and indicate which treatment option is more
cost-effective in the ‘base case’ cost-effectiveness analysis and why (state in THREE
Discuss various sensitivity analyses (both deterministic and stochastic) methods adopted in
the study
Discuss how various sensitivity analyses showed differential cost-effectiveness results
from the ‘base case’ analysis?
Figure 2 on page no. 4 is showing the cost-effectiveness acceptability curve (CEAC),
representing the sensitivity analysis in probability term. If the policy makers is willing to
pay (WTP) £10000 per QALY, then what is the probability that community hospital care
would be more cost-effective than district hospital care?
If the policy makers increases the WTP threshold to £30000 per QALY, there is a small
decrease in probability that community hospital care would be more cost-effective than
district hospital care – TRUE or FALSE

A cost effectiveness analysis within a randomised controlled trial of post-acute care of older people in a community hospital

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