Systematic review of clinical effectiveness and cost-effectiveness of radiofrequency ablation for the treatment of varicose veins

Adi Y, Bayliss S, Taylor R
Record ID 32005000095
English
Authors' objectives:

The objective of the report was to systematically review the clinical effectiveness and the cost/costeffectiveness of studies of radiofrequency ablation (RFA) for the treatment of varicose veins.

Authors' results and conclusions: 2 RCTs of short follow up (8 weeks in one and 4 months in the second) with total patients n=113, Jadad's score (2, 1) showed statistically significant improvements in pain in the post-operative period compared with stripping in one RCT and compared with stripping and/or ligation (S&L) in the second RCT. Quality of life (QoL) was also statistically significant in favor of RFA in the first week following the surgery. Days to return to work were statistically fewer in RFA. No difference was reported for recurrence of varicose veins. No statistically significant difference in the rate of adverse events except for the ecchymosis and haematoma which was less in RFA. The case series were generally poor due to large loss to follow up, potential selection bias and lack of masking the assessor.
Authors' recommendations: RFA is not available on NHS in the UK and those studies of patients who have had RFA may be a selected group of patients usually of higher economic status who are looking for a quick yet cosmetically pleasing answer to their problem. It may also explain why some of the patients are more willing to get back to work as soon as possible. The evidence from the two identified RCTs of poor quality suggests short-term benefit in terms of improvements in pain and quality of life and shorter sick leave relative to conventional surgery. The long-term outcomes of RFA have not yet been well established by comparative studies. One cost study shows that although RFA is more expensive it appears to be cost saving for society.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/WMHTAC/REPreports/2004/varicose_veins.pdf
Year Published: 2004
URL for published report: http://www.birmingham.ac.uk/research/activity/mds/projects/HaPS/PHEB/WMHTAC/REP/reports-list.aspx
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Catheter Ablation
  • Costs and Cost Analysis
  • Varicose Veins
Contact
Organisation Name: West Midlands Health Technology Assessment Collaboration
Contact Address: Elaena Donald-Lopez, West Midlands Health Technology Assessment Collaboration, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT Tel: +44 121 414 7450; Fax: +44 121 414 7878
Contact Name: louise.a.taylor@bham.ac.uk
Contact Email: louise.a.taylor@bham.ac.uk
Copyright: University of Birmingham
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.