The Surgery Collagen Incontinence Trial (SCIT) is a randomized controlled trial evaluating the comparative efficacy of surgery versus collagen injection to treat female stress urinary incontinence (SUI). This thesis investigated two issues from SCIT: (1) the trial investigators' use of a consensus estimate that assumed collagen would be preferred as a first line treatment if it was at most 20% less efficacious than surgery; and (2) the cost-effectiveness of surgery and collagen. / A physician survey was conducted to help verify the SCIT investigators' consensus estimate. Respondents on average believed surgery was more efficacious than collagen, and they generally had stronger beliefs in the ability of surgery to meet their requirements for remaining the first line treatment for SUI. However, on average, respondents indicated a willingness to use collagen if it was at most approximately 23% less efficacious than surgery. The survey also provided baseline data for future research into how SCIT's results may or may not play a role in changing the views of clinicians. / The cost-effectiveness analysis was based on a risk-benefit model (decision-tree) that delineated the success rates, side-effects and complication rates of both surgery and collagen. Probabilities from the physician survey and the published literature were used in the model. Collagen was found to be less costly than surgery, but also less efficacious. Until more is known about collagen's long-term durability, the injection material will probably not gain coverage under Canada's provincial health insurance plans.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.30719 |
| Date | January 2000 |
| Creators | Oremus, Mark, 1968- |
| Contributors | Collet, Jean-Paul (advisor), Shapiro, Stan (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001754443, proquestno: MQ64424, Theses scanned by UMI/ProQuest. |
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