PubMed · 9888885
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J Bogousslavsky. 1999-01-16. Consensus in stroke management?. https://doi.org/10.1136/bmj.318.7177.140
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BACKGROUND: Our aims were to compare coronary artery bypass grafting (CABG) and stenting for the treatment of diabetic patients with multivessel coronary disease enrolled in the Arterial Revascularization Therapy Study (ARTS) trial and to determine the costs of these 2 treatment strategies. METHODS AND RESULTS: Patients (n=1205) were randomly assigned to stent implantation (n=600; diabetic, 112) or CABG (n=605; diabetic, 96). Costs per patient were calculated as the product of each patient's use of resources and the corresponding unit costs. Baseline characteristics were similar between the groups. At 1 year, diabetic patients treated with stenting had the lowest event-free survival rate (63.4%) because of a higher incidence of repeat revascularization compared with both diabetic patients treated with CABG (84.4%, P<0.001) and nondiabetic patients treated with stents (76.2%, P=0.04). Conversely, diabetic and nondiabetic patients experienced similar 1-year event-free survival rates when treated with CABG (84.4% and 88.4%). The total 1-year costs for stenting and CABG in diabetic patients were $12 855 and $16 585 (P<0.001) and in the nondiabetic groups, $10 164 for stenting and $13 082 for surgery. CONCLUSIONS: Multivessel diabetic patients treated with stenting had a worse 1-year outcome than patients assigned to CABG or nondiabetics treated with stenting. The strategy of stenting was less costly than CABG, however, regardless of diabetic status.
BACKGROUND: As part of the EU-project ProESOR (Project for the European Standardisation of Outcome Measurement in Rehabilitation), a survey was undertaken to investigate the use of Outcome Measures (OM) within rehabilitation across Europe. This paper presents some of the Danish results of this survey. AIM: Evaluate the extent of use of OMs in rehabilitation. MATERIAL: All 37 Rheumatology/Physical Medicine and Rehabilitation departments and institutions in Denmark. METHOD: A questionnaire was mailed to the institutions. This included questions about the institution and its personnel, and nine diagnostic groups: Low back pain, multiple sclerosis, neuromuscular disorders, rheumatoid arthritis, spinal cord lesions, stroke, traumatic brain injury, hip and knee replacement, and lower limb amputees, with estimation of the number of patients treated and the extent of use of OMs. RESULTS: The majority of the departments treated more than 200 in- and out-patients per year. Patients with low back pain and rheumatoid arthritis were the largest patient groups, followed by patients with hip and knee replacement and stroke. OMs were most frequently used with rheumatoid arthritis and, to a lesser extent, patients with low back pain. Although many departments used one or more OM, several did not use any at all. For each diagnostic group more OMs were used if the patient was treated in a department specialised for patients with the particular diagnosis. More OMs were used with patients who tended to have longer inpatient stays. CONCLUSION: There is little consensus regarding which OMs should be used. We recommend that this challenge be taken up.
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