Five-year outcomes of a randomized trial of treatments for varicose veins

Julie Brittenden, Seonaidh Cotton, David Cooper, Maria Dimitrova, Graham Scotland, Andrew Elders, Graeme MacLennan, Craig Ramsay, J Norrie, Jennifer Burr, Bruce Campbell, Paul Bachoo, Ian Chetter, Michael Gough, Jonothan Earnshaw, Tim Lees, Julian Scott, Sara Baker, Emma Tassie, Jill FrancisMarion Campbell

Research output: Contribution to journalArticle

Abstract

BACKGROUND Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, -2.86; 95% confidence interval [CI], -4.49 to -1.22; P
Original languageEnglish
Pages (from-to)912-922
Number of pages11
JournalNew England Journal of Medicine
Volume381
Issue number10
DOIs
Publication statusPublished - 5 Sep 2019

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Varicose Veins
Laser Therapy
Sclerotherapy
Quality of Life
Therapeutics
Quality-Adjusted Life Years
Health Care Costs
Cost-Benefit Analysis
Randomized Controlled Trials
Confidence Intervals
Costs and Cost Analysis
Surveys and Questionnaires

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Brittenden, J., Cotton, S., Cooper, D., Dimitrova, M., Scotland, G., Elders, A., ... Campbell, M. (2019). Five-year outcomes of a randomized trial of treatments for varicose veins. New England Journal of Medicine, 381(10), 912-922. https://doi.org/10.1056/NEJMoa1805186
Brittenden, Julie ; Cotton, Seonaidh ; Cooper, David ; Dimitrova, Maria ; Scotland, Graham ; Elders, Andrew ; MacLennan, Graeme ; Ramsay, Craig ; Norrie, J ; Burr, Jennifer ; Campbell, Bruce ; Bachoo, Paul ; Chetter, Ian ; Gough, Michael ; Earnshaw, Jonothan ; Lees, Tim ; Scott, Julian ; Baker, Sara ; Tassie, Emma ; Francis, Jill ; Campbell, Marion. / Five-year outcomes of a randomized trial of treatments for varicose veins. In: New England Journal of Medicine. 2019 ; Vol. 381, No. 10. pp. 912-922.
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Brittenden, J, Cotton, S, Cooper, D, Dimitrova, M, Scotland, G, Elders, A, MacLennan, G, Ramsay, C, Norrie, J, Burr, J, Campbell, B, Bachoo, P, Chetter, I, Gough, M, Earnshaw, J, Lees, T, Scott, J, Baker, S, Tassie, E, Francis, J & Campbell, M 2019, 'Five-year outcomes of a randomized trial of treatments for varicose veins', New England Journal of Medicine, vol. 381, no. 10, pp. 912-922. https://doi.org/10.1056/NEJMoa1805186

Five-year outcomes of a randomized trial of treatments for varicose veins. / Brittenden, Julie; Cotton, Seonaidh; Cooper, David; Dimitrova, Maria; Scotland, Graham; Elders, Andrew; MacLennan, Graeme; Ramsay, Craig; Norrie, J; Burr, Jennifer; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara; Tassie, Emma; Francis, Jill; Campbell, Marion.

In: New England Journal of Medicine, Vol. 381, No. 10, 05.09.2019, p. 912-922.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Five-year outcomes of a randomized trial of treatments for varicose veins

AU - Brittenden, Julie

AU - Cotton, Seonaidh

AU - Cooper, David

AU - Dimitrova, Maria

AU - Scotland, Graham

AU - Elders, Andrew

AU - MacLennan, Graeme

AU - Ramsay, Craig

AU - Norrie, J

AU - Burr, Jennifer

AU - Campbell, Bruce

AU - Bachoo, Paul

AU - Chetter, Ian

AU - Gough, Michael

AU - Earnshaw, Jonothan

AU - Lees, Tim

AU - Scott, Julian

AU - Baker, Sara

AU - Tassie, Emma

AU - Francis, Jill

AU - Campbell, Marion

N1 - Acceptance in SAN AAM: not permitted by journal VoR provided by author; 6m embargo required. ET 13/9/19

PY - 2019/9/5

Y1 - 2019/9/5

N2 - BACKGROUND Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, -2.86; 95% confidence interval [CI], -4.49 to -1.22; P

AB - BACKGROUND Endovenous laser ablation and ultrasound-guided foam sclerotherapy are recommended alternatives to surgery for the treatment of primary varicose veins, but their long-term comparative effectiveness remains uncertain. METHODS In a randomized, controlled trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of laser ablation, foam sclerotherapy, and surgery. Primary outcomes at 5 years were disease-specific quality of life and generic quality of life, as well as cost-effectiveness based on models of expected costs and quality-adjusted life-years (QALYs) gained that used data on participants' treatment costs and scores on the EuroQol EQ-5D questionnaire. RESULTS Quality-of-life questionnaires were completed by 595 (75%) of the 798 trial participants. After adjustment for baseline scores and other covariates, scores on the Aberdeen Varicose Vein Questionnaire (on which scores range from 0 to 100, with lower scores indicating a better quality of life) were lower among patients who underwent laser ablation or surgery than among those who underwent foam sclerotherapy (effect size [adjusted differences between groups] for laser ablation vs. foam sclerotherapy, -2.86; 95% confidence interval [CI], -4.49 to -1.22; P

U2 - 10.1056/NEJMoa1805186

DO - 10.1056/NEJMoa1805186

M3 - Article

VL - 381

SP - 912

EP - 922

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 10

ER -