{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:24:06Z","timestamp":1788261846815,"version":"build-2803163510"},"reference-count":65,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["14\/166\/01"],"award-info":[{"award-number":["14\/166\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Parastomal hernia (PSH) is a common problem following colostomy. Using prophylactic mesh during end colostomy creation may reduce PSH incidence, but concerns exist regarding the optimal type of mesh, potential long\u2010term complications, and cost\u2010effectiveness of its use. We evaluated the cost\u2010effectiveness of mesh prophylaxis to prevent PSH in patients undergoing end colostomy creation for rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision\u2010analytical model, stratified by rectal cancer stages I\u2013IV, to estimate the lifetime costs, quality\u2010adjusted life\u2010years (QALYs) and net monetary benefits (NMBs) of synthetic, biologic and no mesh from a UK NHS perspective. We pooled the mesh\u2010related relative risks of PSH from 13 randomised controlled trials (RCTs) and superimposed these on the baseline (no mesh) risk from a population\u2010based cohort. Uncertainty was assessed in sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Synthetic mesh was less costly and more effective than biologic and no mesh to prevent PSH for all rectal cancer stages. At the willingness\u2010to\u2010pay threshold of \u00a320,000\/QALY, the incremental NMBs (95% CI) ranged between \u00a31,706 (\u00a31,692 to \u00a31,720) (stage I) and \u00a3684 (\u00a3678 to \u00a3690) (stage IV) for synthetic versus no mesh, and \u00a32,038 (\u00a31,997 to \u00a32,079) (stage I) and \u00a31,671 (\u00a31,653 to \u00a31,689) (stage IV) for synthetic versus biologic mesh. Synthetic mesh was more cost\u2010effective than no mesh unless the relative risk of PSH was \u22650.95 for stages I\u2013III and \u22650.93 for stage IV. [Correction added on 05 October 2021 after first online publication: The estimation of health outcomes (QALYs) for all three interventions evaluated (synthetic mesh; biologic mesh; no mesh) have been corrected in this version.]<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Synthetic mesh was the most cost\u2010effective strategy to prevent the formation of PSH in patients after end colostomy for any rectal cancer stage; however, conclusions are dependent on which subset of RCTs are considered to provide the most robust evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.15848","type":"journal-article","created":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T13:38:02Z","timestamp":1627738682000},"page":"2967-2979","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A semi\u2010Markov model comparing the lifetime cost\u2010effectiveness of mesh prophylaxis to prevent parastomal hernia in patients undergoing end colostomy creation for rectal cancer"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4585-3392","authenticated-orcid":false,"given":"Syed","family":"Mohiuddin","sequence":"first","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnaby C.","family":"Reeves","sequence":"additional","affiliation":[{"name":"Bristol Trials Centre (CTEU) Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil J.","family":"Smart","sequence":"additional","affiliation":[{"name":"Royal Devon &amp; Exeter Hospital Royal Devon &amp; Exeter NHS Foundation Trust Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hollingworth","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CIPHER study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"National Bowel Cancer Audit (NBOCA)An audit of the care received by people with bowel cancer in England and Wales. 2020; Available from:https:\/\/www.nboca.org.uk\/content\/uploads\/2020\/12\/NBOCA\u20102020\u2010Annual\u2010Report.pdf.Accessed 14 Feb 2020."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001903"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4220"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4417"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002542"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02006.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000369279"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12156"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-016-1367-6"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520701858470"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-019-03359-2"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3107-4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0186"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2011.10.006"},{"key":"e_1_2_11_16_1","first-page":"CD008905","article-title":"Prosthetic mesh placement for the prevention of parastomal herniation","volume":"7","author":"Jones HG","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15197"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-018-1774-5"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1394090"},{"key":"e_1_2_11_20_1","unstructured":"National Institute for Health and Care Excellence (NICE)Interventional procedure overview of reinforcement of a permanent stoma with mesh to prevent a parastomal hernia. 2019. 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