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Observational Study
. 2015 Jun 2;5(6):e008147.
doi: 10.1136/bmjopen-2015-008147.

The ETTAA study protocol: a UK-wide observational study of 'Effective Treatments for Thoracic Aortic Aneurysm'

Priya Sastry  1 , Victoria Hughes  1 , Paul Hayes  2 , Srinivasa Vallabhaneni  3 , Linda Sharples  4 , Matt Thompson  5 , Pedro Catarino  1 , Narain Moorjani  1 , Luke Vale  6 , Joanne Gray  6 , Andrew Cook  7 , John A Elefteriades  8 , Stephen R Large  1 ; ETTAA Collaborators
Collaborators, Affiliations
Observational Study

The ETTAA study protocol: a UK-wide observational study of 'Effective Treatments for Thoracic Aortic Aneurysm'

Priya Sastry et al. BMJ Open. .

Abstract

Introduction: Chronic thoracic aortic aneurysm (CTAA) affecting the arch or descending aorta is an indolent but life-threatening condition with a rising prevalence as the UK population ages. Treatment may be in the form of open surgical repair (OSR) surgery, endovascular stent grafting (ESG) or best medical therapy (BMT). Currently, there is no consensus on the best management strategy, and no UK-specific economic studies that assess outcomes beyond the chosen procedure, but this is required in the context of greater demand for treatment and limited National Health Service (NHS) resources.

Methods and analysis: This is a prospective, multicentre observational study with statistical and economic modelling of patients with CTAA affecting the arch or descending aorta. We aim to gain an understanding of how treatments are currently chosen, and to determine the clinical effectiveness and cost-effectiveness of the three available treatment strategies (BMT, ESG and OSR). This will be achieved by: (1) following consecutive patients who are referred to the teams collaborating in this proposal and collecting data regarding quality of life (QoL), medical events and hospital stays over a maximum of 5 years; (2) statistical analysis of the comparative effectiveness of the three treatments; and (3) economic modelling of the comparative cost-effectiveness of the three treatments. Primary study outcomes are: aneurysm growth, QoL, freedom from reintervention, freedom from death or permanent neurological injury, incremental cost per quality-adjusted life year gained.

Ethics and dissemination: The study will generate an evidence base to guide patients and clinicians to determine the indications and timing of treatment, as well as informing healthcare decision-makers about which treatments the NHS should provide. The study has achieved ethical approval and will be disseminated primarily in the form of a Health Technology Assessment monograph at its completion.

Trial registration number: ISRCTN04044627.

Keywords: VASCULAR MEDICINE.

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Figures

Figure 1
Figure 1
The decision-making process for treatment for chronic thoracic aortic aneurysm (CTAA; ESG, endovascular stent grafting; OSR, open surgical repair).
Figure 2
Figure 2
The expected UK populations (BMT, best medical therapy; ESG, endovascular stent grafting; OSR, open surgical repair; WW, watchful waiting).
See this image and copyright information in PMC

References

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