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ASCVTS 2015|Christopher Cao: 循证医学下的系统综述与荟萃分析

Published at: 2015年第1卷第S1期

关键词:

第23届亚洲心胸血管外科年会(ASCVTS)于5月14日落下帷幕。本次大会上,除了国内研究的喜报频传,来自澳大利亚悉尼大学附属医院心胸外科,AME旗下ACS杂志编辑团队的Christopher Cao博士的报告也在本次大会上赢得良好反响。

在ASCVTS大会上,Cao博士共有7篇poster,4个大会报告,并担任ASCVTS Video Presentation的Chair。

Christopher Cao博士所在团队由澳大利亚悉尼大学附属医院的Tristan D. Yan教授带领,专注于心胸外科领域,是世界上外科临床研究和数据综合最为多产的团队之一。该团队成员间的合作具有凝聚力和效率性,同时开展培训工作,为团队成员指导系统综述,荟萃分析,倾向积分分析和学术写作。

不久前,Christopher Cao博士所在团队历史一年,完成“学术型外科医生如何撰写系统评价和meta分析?”一文,旨在总结外科学领域全面严格的系统评价和meta分析的重要特征,强调几个未广泛应用的统计学方法(相对于传统的两两对照数据合成,这些方法可能会开阔更广泛有趣的视野),进而为全面分析和结果撰写提供一个指南。

值得一提的是,在5月16-17日于广州医科大学附属第一医院举行的第一届全国全腔镜气管隆突手术学术研讨会暨第八届中国肺癌微创治疗论坛上,Tristan D. Yan教授和Christopher Cao博士都会作会议发言,就心胸外科领域以及系统综述、荟萃分析撰写等方面跟大家作进一步分享交流。

ASCVTS Abstracts presented by Dr. Cao:

Oral

- A meta-analysis of robotic versus conventional mitral valve surgery

- A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma

- Mid-term angiographic outcomes of radial artery versus saphenous vein in coronary artery bypass graft surgery – a meta-analysis of randomized controlled trials

- A Systematic Review and Meta-analysis of Clinical and Cost-effective Outcomes of Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement

Poster

- A Systematic Review of the Cost-effectiveness of Transcatheter Aortic Valve Implantation

- Could less be more? - A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection

- Systematic Review of Pleurectomy in the Treatment of Malignant Pleural Mesothelioma

- A systematic review of percutaneous interventions for malignant pericardial effusion

- Should Clopidogrel be Discontinued Prior to Coronary Artery Bypass Graft Surgery for Patients with Acute Coronary Syndrome? – A Systematic Review and Meta-analysis

- A Meta-Analysis of Endoscopic Versus Conventional Open Radial Artery Harvesting for Coronary Artery Bypass Graft Surgery

- Systematic Review of Percutaneous Coronary Intervention and Transcatheter Aortic Valve Implantation for Concomitant Aortic Stenosis and Coronary Artery Disease

其中,Cao博士关于“TAVI成本效益分析”汇报内容概要如下:

A Systematic Review of the Cost-effectiveness of TranscatheterAortic Valve Implantation

Authors: Praveen Indraratna, Su C. Ang, Hemal Gada, Tristan D. Yan,Con Manganas, Paul Bannon, Sohaib Virk, Christopher Cao

Category: Adult Cardiac Surgery

Objective

Transcatheter aortic valve implantation (TAVI) has emerged as analternative treatment to aortic valve replacement (AVR) for selected patientswith severe aortic stenosis. The present systematic review was conducted toanalyse the cost-effectiveness of this novel technique within reimbursedhealthcare systems.

Methods

Two reviewers used seven electronic databases from January 2000 –November 2012 to identify relevant cost-effectiveness studies on TAVI versusAVR or medical therapy. The primary endpoints were the incrementalcost-effectiveness ratio (ICER) and the probability of cost-effectiveness.Eligible studies for this systematic review included those in whichcost-effectiveness data was measured or projected for TAVI and either medicaltherapy or AVR. All forms of TAVI were included and all retrieved publicationswere limited to English language.

Results

Eight studies were included for quantitative assessment. The ICERfor TAVI compared with medical therapy for surgically inoperable patientsranged between US$26,302 and US$61,889 per quality-adjusted life year gained(PQG). The probability of TAVI being cost-effective compared to medical therapyranged between 0.03 and 1.00. ICER values for TAVI in comparison to AVR forhigh-risk surgical candidates ranged between US$32,000 and US$975,697 PQG. Theprobability of TAVI being cost-effective in this cohort ranged between 0.116and 0.709.

Conclusions

Depending on the ICER threshold selected, TAVI is potentiallyjustified on both medical and economic grounds in comparison to medical therapyfor patients deemed to be surgically inoperable. However, in the high-risksurgical patient cohort, there is currently insufficient evidence toeconomically justify the use of TAVI in preference to AVR.

第一届全国腔镜气管隆突手术研讨会暨第八届中国肺癌微创治疗论坛明日开幕!论坛将以现场手术、录像分享及交流讨论的形式,就胸腔镜下高难度气管隆凸手术技巧与术中气道管理方法等热点问题进行重点讨论。欢迎大家届时参会,现场与同行共赏这场视觉盛宴!

第一届全国腔镜气管隆突手术研讨会暨第八届中国肺癌微创治疗论坛明日开幕!

2015年5月16日-17日

广州市广州医科大学附属第一医院新大楼

30楼国际会议厅(广州市沿江路151号)

精彩看点

♦ 让医生操作更易——历史性推出广州医大附一院与超多维光电子公司共同原研的“裸眼3D腔镜显示系统”。

♦ 让患者恢复更易——推出“Tubeless VATS”理念,混合型创新的无气管插管,无胸管的无管胸腔镜手术,让胸外科手术历史性地成为“日间手术”,这也意味着微创胸外科在快速康复方面再次实现了新的突破。

♦ 让微创胸外科手术范围更广——以现场手术、录像分享及交流讨论的形式,就胸腔镜下高难度气管隆凸手术技巧与术中气道管理方法等热点问题进行重点讨论。

♦ 里程碑式学术著作发布——进入个体化医学时代的第一本中英文版本的专业书籍《Lung Cancer》大陆地区发布会与签售会。

长按下图,识别图中二维码,即可加入ASCVTS会议播报微信群,了解更多前线汇报。

点击链接可阅读“学术型外科医生如何撰写系统评价和meta分析?”一文中文译本:http://kysj.amegroups.com/articles/2355

Doi:10.3978/kysj.2014.1.728

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