While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .
Three-year follow-up of the Argentine Randomized Trial of Percutaneous Transluminal Coronary Angioplasty Versus Coronary Artery Bypass Surgery in Multivessel Disease (ERACI).
OBJECTIVES The purpose of this study was to report the 3-year follow-up results of the ERACI trial ( Argentine R and omized Trial of Percutaneous Transluminal Coronary Angioplasty Versus Coronary Artery Bypass Surgery in Multivessel Disease ) . BACKGROUND Although coronary angioplasty has been used with increased frequency in patients with multivessel coronary artery disease , its value , compared with bypass graft surgery , has not been established . Thus , controlled , r and omized clinical trials such as the ERACI are needed . METHODS In this trial 127 patients who had multivessel coronary artery disease and clinical indication of myocardial revascularization were r and omized to undergo coronary angioplasty ( n = 63 ) or bypass surgery ( n = 64 ) . The primary end point of this study was event-free survival ( survival with freedom from myocardial infa rct ion , angina and new revascularization procedures ) for both groups of patients at 1 , 3 and 5 years of follow-up . RESULTS Freedom from combined cardiac events ( death , Q-wave myocardial infa rct ion , angina and repeat revascularization procedures ) was significantly greater for the bypass surgery group than the coronary angioplasty group ( 77 % vs. 47 % ; p < 0.001 ) . There were no differences in overall ( 4.7 % vs. 9.5 % ; p = 0.5 ) and cardiac ( 4.7 % vs. 4.7 % ; p = 1 ) mortality or in the frequency of myocardial infa rct ion ( 7.8 % vs. 7.8 % ; p = 0.8 ) between the two groups . However , patients who had bypass surgery were more frequently free of angina ( 79 % vs. 57 % ; p < 0.001 ) and required fewer additional re interventions ( 6.3 % vs. 37 % ; p < 0.001 ) than patients who had coronary angioplasty . CONCLUSIONS 1 ) Freedom from combined cardiac events at 3-year follow-up was greater in patients who had bypass surgery than in those who had coronary angioplasty . 2 ) The coronary angioplasty group had a higher incidence of recurrence of angina and the need for repeat revascularization procedures . 3 ) Cumulative cost at 3-year follow-up was greater for the bypass surgery group than for the coronary angioplasty group
While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .