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QoL Better With Laser Ablation, Surgery for Varicose Veins

THURSDAY, Sept. 5, 2019 -- For patients with varicose veins, disease-specific quality of life is better after laser ablation or surgery than after foam sclerotherapy at five years after treatment, according to a study published in the Sept. 5 issue of the New England Journal of Medicine.

Julie Brittenden, M.D., from the University of Glasgow in the United Kingdom, and colleagues conducted a randomized trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom. Disease-specific quality of life, generic quality of life, and cost-effectiveness were compared for laser ablation, foam sclerotherapy, and surgery. Seventy-five percent of participants completed quality-of-life questionnaires.

The researchers found that scores on the Aberdeen Varicose Vein Questionnaire were lower among patients who underwent laser ablation or surgery than for those who underwent foam sclerotherapy (effect size, −2.86 for laser ablation versus foam sclerotherapy; effect size, −2.60 for surgery versus foam sclerotherapy) after adjustment for baseline scores and other covariates. No significant difference was noted among the treatment groups in generic quality-of-life measures. At a threshold willingness-to-pay ratio of £20,000 per quality-adjusted life year, laser ablation was favored in 77.2 percent of the cost-effectiveness model iterations. In a two-way comparison between foam sclerotherapy and surgery, surgery was favored in 54.5 percent of model iterations.

"Our results are generally in keeping with our previously reported model-based estimates derived from an existing network meta-analysis of trials," the authors write.

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Posted: September 2019

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