Richard Grieve

Learn More
BACKGROUND Early, goal-directed therapy (EGDT) is recommended in international guidelines for the resuscitation of patients presenting with early septic shock. However, adoption has been limited, and uncertainty about its effectiveness remains. METHODS We conducted a pragmatic randomized trial with an integrated cost-effectiveness analysis in 56 hospitals(More)
CONTEXT Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients with severe acute respiratory distress syndrome (ARDS), but its role has remained controversial. ECMO was used to treat patients with ARDS during the 2009 influenza A(H1N1) pandemic. OBJECTIVE To compare the hospital mortality of patients with H1N1-related ARDS(More)
OBJECTIVES To determine whether combined therapy with interferon-alpha and ribavirin was more effective and cost-effective than no treatment for patients with mild chronic hepatitis C. DESIGN A multicentre, randomised, controlled, non-blinded trial assessed the efficacy of combination therapy. A Markov model used these efficacy data combined with data on(More)
BACKGROUND For patients with mild chronic hepatitis C the cost effectiveness of antiviral therapy is unknown. AIMS To assess whether antiviral therapy (either interferon alpha or peginterferon alpha combined with ribavirin) is cost effective at a mild stage compared with waiting and only treating those cases who progress to moderate disease. PATIENTS(More)
OBJECTIVES This study assesses whether pegylated interferon and ribavirin is cost-effective compared with no antiviral treatment provided in routine clinical practice, for different patient subgroups. METHODS The cost-effectiveness analysis (CEA) uses a Markov decision model to estimate the lifetime cost per quality-adjusted life-year (QALY) of antiviral(More)
Cost-effectiveness analyses (CEA) alongside randomised controlled trials commonly estimate incremental net benefits (INB), with 95% confidence intervals, and compute cost-effectiveness acceptability curves and confidence ellipses. Two alternative non-parametric methods for estimating INB are to apply the central limit theorem (CLT) or to use the(More)
BACKGROUND AND PURPOSE Policy makers require evidence on the costs and outcomes of different ways of organizing stroke care. This study compared the costs and survival of different ways of providing stroke care. METHODS Hospitalized stroke patients from 13 European centers were included, with demographic, case-mix, and resource use variables measured for(More)
OBJECTIVE To compare the cost effectiveness of the three most commonly chosen types of prosthesis for total hip replacement. DESIGN Lifetime cost effectiveness model with parameters estimated from individual patient data obtained from three large national databases. SETTING English National Health Service. PARTICIPANTS Adults aged 55 to 84 undergoing(More)
Statistical methods have been developed for cost-effectiveness analyses of cluster randomised trials (CRTs) where baseline covariates are balanced. However, CRTs may show systematic differences in individual and cluster-level covariates between the treatment groups. This paper presents three methods to adjust for imbalances in observed covariates: seemingly(More)