Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins

Brittenden, Julie; Cooper, David; Dimitrova, Maria; Scotland, Graham; Cotton, Seonaidh C.; Elders, Andrew; MacLennan, Graeme; Ramsay, Craig R.; Norrie, John; Burr, Jennifer M.; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A.; Tassie, Emma; Francis, Jill; Campbell, Marion K.

Abstract

Copyright © 2019 Massachusetts Medical Society. 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

Citation

Brittenden, J., Cooper, D., Dimitrova, M., Scotland, G., Cotton, S. C., Elders, A., MacLennan, G., Ramsay, C. R., Norrie, J., Burr, J. M., Campbell, B., Bachoo, P., Chetter, I., Gough, M., Earnshaw, J., Lees, T., Scott, J., Baker, S. A., Tassie, E., Francis, J., & Campbell, M. K. (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

• Journal Article Type: Article
• Acceptance Date: Aug 29, 2019
• Publication Date: Sep 5, 2019
• Deposit Date: Dec 2, 2019
• Publicly Available Date: Dec 2, 2019
• Journal: New England Journal of Medicine
• Electronic ISSN: 1533-4406
• Publisher: Massachusetts Medical Society
• Peer Reviewed: Peer Reviewed
• Volume: 381
• Issue: 10
• Pages: 912-922
• DOI: https://doi.org/10.1056/NEJMoa1805186
• Keywords: General Medicine
• Public URL: https://hull-repository.worktribe.com/output/2702049
• Additional Information: © 2019 Massachusetts Medical Society. Reprinted with permission.
• Contract Date: Dec 2, 2019