Economic evaluation of compression therapy in venous leg ulcer randomised controlled trials: A systematic review

To review literature and examine the type of economic evaluation conducted alongside compression therapy randomised controlled trials (RCTs) that reported VLU healing outcomes. Design: We examined types of economic analyses included in compression RCTs, and investigated how economic evaluation methods were utilised and reported alongside RCTs. A systematic review was undertaken on the basis of pre-specified criteria for the assessment of the RCTs for inclusion. The databases searched included: The Cochrane library, MEDLINE, CINAHL, EMBASE, PUBMED, EBM Reviews. Main outcome measures: Two review authors independently assessed the risk of bias of each included trial against key criteria: random sequence generation; allocation concealment; blinding of participants, personnel and outcomes; incomplete outcome data; selective outcome reporting; and other sources of bias, in accordance with methods recommended by the Cochrane Collaboration. Results: We reviewed 85 abstracts, excluded 72 that did not fulfil the protocol inclusion criteria. Thirteen full text articles were reviewed, of which five studies met the inclusion criteria and were included in this review. We found little consistency in reporting between studies; in three studies compression treatments description were unclear. All included studies reported direct costs that showed incremental clinical benefit but only study one reported the difference in costs. Conclusion: Future compression RCTs would benefit from standardised protocol for inclusion of economic evaluation alongside RCTs in wound management to ensure clinical and economic outcomes are measured and reported.