{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:31:52Z","timestamp":1783006312138,"version":"3.54.5"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2009,8,11]],"date-time":"2009-08-11T00:00:00Z","timestamp":1249948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"UK NHS Culyer Funding"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,8,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This randomized controlled trial compared the cost\u2013utility of early laparoscopic cholecystectomy with that for conventional management of newly diagnosed acute gallbladder disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Adults admitted to hospital with a first episode of biliary colic or acute cholecystitis were randomized to an early intervention group (36 patients, operation within 72 h of admission) or a conventional group (36, elective cholecystectomy 3 months later). Costs were measured from a National Health Service and societal perspective. Quality-adjusted life year (QALY) gains were calculated 1 month after surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean(s.d.) total costs of care were \u00a35911(2445) for the early group and \u00a36132(3244) for the conventional group (P = 0\u00b7928), Mean(s.d.) societal costs were \u00a31322(1402) and \u00a31461(1532) for the early and conventional groups respectively (P = 0\u00b7732). Visual analogue scale scores of health were 72\u00b794 versus 84\u00b763 (P = 0\u00b7012) and the mean(s.d.) QALY gain was 0\u00b785(0\u00b726) versus 0\u00b793(0\u00b713) respectively (P = 0\u00b7262). The incremental cost per additional QALY gained favoured conventional management at a cost of \u00a33810 per QALY gained.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this pragmatic trial, the cost\u2013utilities of both the early and conventional approaches were similar, but the incremental cost per additional QALY gained favoured conventional management. Registration number: ISRCTN81663421 (http:\/\/www.controlled-trials.com).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6685","type":"journal-article","created":{"date-parts":[[2009,8,11]],"date-time":"2009-08-11T17:15:37Z","timestamp":1250010937000},"page":"1031-1040","source":"Crossref","is-referenced-by-count":103,"title":["Prospective randomized trial using cost\u2013utility analysis of early <i>versus<\/i> delayed laparoscopic cholecystectomy for acute gallbladder disease"],"prefix":"10.1093","volume":"96","author":[{"given":"D A L","family":"Macafee","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J","family":"Humes","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Bouliotis","sequence":"additional","affiliation":[{"name":"Trent Research and Development Support Unit, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I J","family":"Beckingham","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D K","family":"Whynes","sequence":"additional","affiliation":[{"name":"School of Economics, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D N","family":"Lobo","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,8,11]]},"reference":[{"key":"2021070910380236900_bib1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1046\/j.1572-0241.2003.04002.x","article-title":"Timing of cholecystectomy for acute calculous cholecystitis: a meta-analysis","volume":"99","author":"Papi","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"2021070910380236900_bib2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.amjsurg.2007.03.004","article-title":"Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials","volume":"195","author":"Siddiqui","year":"2008","journal-title":"Am J Surg"},{"issue":"4","key":"2021070910380236900_bib3","first-page":"CD005440","article-title":"Early versus delayed laparoscopic cholecystectomy for acute cholecystitis","author":"Gurusamy","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"2021070910380236900_bib4","volume-title":"Economics of Surgical Procedures","author":"Szucs","year":"2001"},{"key":"2021070910380236900_bib5","volume-title":"Economic Analysis in Health Care.","author":"Morris","year":"2007"},{"key":"2021070910380236900_bib6","author":"Oppe","year":"2008","journal-title":"EQ-5D User Guide"},{"key":"2021070910380236900_bib7","volume-title":"NHS Reference Costs 2005","author":"Department of Health","year":"2006"},{"key":"2021070910380236900_bib8","author":"Personal Social Services Research Unit","journal-title":"Unit Costs of Health and Social Care 2003"},{"key":"2021070910380236900_bib9","volume-title":"BNF 55","author":"British National Formulary","year":"2007"},{"key":"2021070910380236900_bib10","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/135581969700200410","article-title":"Confidence intervals for cost-effectiveness ratios: the use of \u2018bootstrapping\u2019","volume":"2","author":"Campbell","year":"1997","journal-title":"J Health Serv Res Policy"},{"key":"2021070910380236900_bib11","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/qjmed\/92.3.177","article-title":"Bootstrapping: estimating confidence intervals for cost-effectiveness ratios","volume":"92","author":"Campbell","year":"1999","journal-title":"QJM"},{"key":"2021070910380236900_bib12","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1017\/S0266462399153157","article-title":"Uncertainty of incremental cost-effectiveness ratios. 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