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class="bkr_bib"><h1 id="_NBK561977_"><span itemprop="name">Evidence review for preoperative management of anaemia</span></h1><div class="subtitle">Perioperative care in adults</div><p><b>Evidence review E</b></p><p><i>NICE Guideline, No. 180</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2020 Aug</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3827-8</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div></div><div class="bkr_clear"></div></div><div id="niceng180er5.s1"><h2 id="_niceng180er5_s1_">1. Preoperative management of anaemia</h2><div id="niceng180er5.s1.1"><h3>1.1. Review question: What is the most clinically and cost effective oral iron supplementation strategy for the preoperative management of iron deficiency anaemia?</h3></div><div id="niceng180er5.s1.2"><h3>1.2. Review question: What is the most clinically and cost effective management strategy for the preoperative management of iron deficiency anaemia?</h3></div><div id="niceng180er5.s1.3"><h3>1.3. Introduction</h3><p>Anaemia is a recognised predictor of adverse postoperative outcome. It is associated with an increased rate of perioperative blood transfusion and increased postoperative morbidity and mortality. Furthermore anaemia is common in the surgical population, particularly in the high risk group undergoing intermediate or major surgery. These data have led to an establishment of rapid access anaemia clinics employing patient blood management strategies including the administration of preoperative oral and intravenous iron. However, the question of whether these preoperative interventions, such as oral or intravenous iron therapy, can improve preoperative haemoglobin levels, reduce the need for postoperative blood transfusions and improve clinician and patient reported outcomes are unanswered. This section of the guideline aims to review the evidence for clinical and cost effectiveness of such strategies to inform clinical practice.</p></div><div id="niceng180er5.s1.4"><h3>1.4. PICO table</h3><p>For full details see the review protocol in <a href="#niceng180er5.appa">Appendix A</a>:.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab1"><a href="/books/NBK561977/table/niceng180er5.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab1" rid-ob="figobniceng180er5tab1"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab1/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab1/?report=previmg" alt="Table 1. PICO characteristics of oral iron." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab1"><a href="/books/NBK561977/table/niceng180er5.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of oral iron. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab2"><a href="/books/NBK561977/table/niceng180er5.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab2" rid-ob="figobniceng180er5tab2"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab2/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab2/?report=previmg" alt="Table 2. PICO characteristics of IV iron." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab2"><a href="/books/NBK561977/table/niceng180er5.tab2/?report=objectonly" target="object" rid-ob="figobniceng180er5tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of IV iron. </p></div></div></div><div id="niceng180er5.s1.5"><h3>1.5. Clinical evidence</h3><div id="niceng180er5.s1.5.1"><h4>1.5.1. Included studies for oral iron</h4><p>No relevant clinical studies comparing alternate day oral iron therapy with daily oral iron therapy were identified.</p><p>See also the study selection flow chart in <a href="#niceng180er5.appc">appendix C</a>.</p></div><div id="niceng180er5.s1.5.2"><h4>1.5.2. Included studies for IV iron</h4><p>Four studies from three randomised controlled trials were included in the review comparing IV iron to oral iron;<a class="bibr" href="#niceng180er5.ref29" rid="niceng180er5.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng180er5.ref30" rid="niceng180er5.ref30"><sup>30</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng180er5.ref32" rid="niceng180er5.ref32"><sup>32</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a> these are summarised in <a class="figpopup" href="/books/NBK561977/table/niceng180er5.tab3/?report=objectonly" target="object" rid-figpopup="figniceng180er5tab3" rid-ob="figobniceng180er5tab3">Table 3</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK561977/table/niceng180er5.tab4/?report=objectonly" target="object" rid-figpopup="figniceng180er5tab4" rid-ob="figobniceng180er5tab4">Table 4</a>).</p><p>See also the study selection flow chart in <a href="#niceng180er5.appc">appendix C</a>, study evidence tables in <a href="#niceng180er5.appd">appendix D</a>, forest plots in <a href="#niceng180er5.appe">appendix E</a> and GRADE tables in <a href="#niceng180er5.appf">appendix F</a>.</p></div><div id="niceng180er5.s1.5.3"><h4>1.5.3. Excluded studies</h4><p>See the excluded studies list in <a href="#niceng180er5.appi">Appendix I</a>:.</p></div><div id="niceng180er5.s1.5.4"><h4>1.5.4. Summary of clinical studies included</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab3"><a href="/books/NBK561977/table/niceng180er5.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab3" rid-ob="figobniceng180er5tab3"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab3/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab3/?report=previmg" alt="Table 3. Summary of clinical studies included." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab3"><a href="/books/NBK561977/table/niceng180er5.tab3/?report=objectonly" target="object" rid-ob="figobniceng180er5tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of clinical studies included. </p></div></div><p>See <a href="#niceng180er5.appd">appendix D</a> for full evidence tables.</p></div><div id="niceng180er5.s1.5.5"><h4>1.5.5. Quality assessment of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab4"><a href="/books/NBK561977/table/niceng180er5.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab4" rid-ob="figobniceng180er5tab4"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab4/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab4/?report=previmg" alt="Table 4. Clinical evidence summary: IV iron compared to oral iron for preoperative management of anaemia." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab4"><a href="/books/NBK561977/table/niceng180er5.tab4/?report=objectonly" target="object" rid-ob="figobniceng180er5tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: IV iron compared to oral iron for preoperative management of anaemia. </p></div></div><p>See <a href="#niceng180er5.appf">appendix F</a> for full GRADE tables.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab5"><a href="/books/NBK561977/table/niceng180er5.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab5" rid-ob="figobniceng180er5tab5"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab5/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab5/?report=previmg" alt="Table 5. Clinical evidence summary: Evidence not suitable for GRADE analysis." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab5"><a href="/books/NBK561977/table/niceng180er5.tab5/?report=objectonly" target="object" rid-ob="figobniceng180er5tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Evidence not suitable for GRADE analysis. </p></div></div></div></div><div id="niceng180er5.s1.6"><h3>1.6. Economic evidence</h3><div id="niceng180er5.s1.6.1"><h4>1.6.1. Included studies</h4><p>No health economic studies were included.</p></div><div id="niceng180er5.s1.6.2"><h4>1.6.2. Excluded studies</h4><p>No relevant health economic studies were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#niceng180er5.appg">Appendix G</a>:.</p></div><div id="niceng180er5.s1.6.3"><h4>1.6.3. Unit costs</h4><p>Relevant unit costs are provided below to aid consideration of cost effectiveness.</p><div id="niceng180er5.s1.6.3.1"><h5>Oral iron</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab6"><a href="/books/NBK561977/table/niceng180er5.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab6" rid-ob="figobniceng180er5tab6"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab6/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab6/?report=previmg" alt="Table 6. UK costs of oral iron drugs." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab6"><a href="/books/NBK561977/table/niceng180er5.tab6/?report=objectonly" target="object" rid-ob="figobniceng180er5tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">UK costs of oral iron drugs. </p></div></div></div><div id="niceng180er5.s1.6.3.2"><h5>IV iron</h5><p><a class="figpopup" href="/books/NBK561977/table/niceng180er5.tab7/?report=objectonly" target="object" rid-figpopup="figniceng180er5tab7" rid-ob="figobniceng180er5tab7">Table 7</a> shows the drug costs associated with IV iron administration, and <a class="figpopup" href="/books/NBK561977/table/niceng180er5.tab8/?report=objectonly" target="object" rid-figpopup="figniceng180er5tab8" rid-ob="figobniceng180er5tab8">Table 8</a> shows the additional resource use associated with this approach.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab7"><a href="/books/NBK561977/table/niceng180er5.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab7" rid-ob="figobniceng180er5tab7"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab7/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab7/?report=previmg" alt="Table 7. UK costs of intravenous iron." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab7"><a href="/books/NBK561977/table/niceng180er5.tab7/?report=objectonly" target="object" rid-ob="figobniceng180er5tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">UK costs of intravenous iron. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab8"><a href="/books/NBK561977/table/niceng180er5.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab8" rid-ob="figobniceng180er5tab8"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab8/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab8/?report=previmg" alt="Table 8. Costs of administering intravenous iron." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab8"><a href="/books/NBK561977/table/niceng180er5.tab8/?report=objectonly" target="object" rid-ob="figobniceng180er5tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Costs of administering intravenous iron. </p></div></div></div><div id="niceng180er5.s1.6.3.3"><h5>Potential downstream costs</h5><p>As well as drug costs, the downstream costs which may arise from a series of different outcomes in the interventions being compared are of importance, and some costs are illustrated below.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab9"><a href="/books/NBK561977/table/niceng180er5.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab9" rid-ob="figobniceng180er5tab9"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab9/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab9/?report=previmg" alt="Table 9. Potential downstream costs." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab9"><a href="/books/NBK561977/table/niceng180er5.tab9/?report=objectonly" target="object" rid-ob="figobniceng180er5tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Potential downstream costs. </p></div></div></div></div><div id="niceng180er5.s1.6.4"><h4>1.6.4. Other calculations</h4><p>Simple costing was conducted to estimate the impact of people requiring blood transfusions and is in <a class="figpopup" href="/books/NBK561977/table/niceng180er5.tab10/?report=objectonly" target="object" rid-figpopup="figniceng180er5tab10" rid-ob="figobniceng180er5tab10">Table 10</a>. This showed that the costs associated with IV iron were much higher than oral iron when considering blood transfusion.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng180er5tab10"><a href="/books/NBK561977/table/niceng180er5.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figniceng180er5tab10" rid-ob="figobniceng180er5tab10"><img class="small-thumb" src="/books/NBK561977/table/niceng180er5.tab10/?report=thumb" src-large="/books/NBK561977/table/niceng180er5.tab10/?report=previmg" alt="Table 10. Costs including blood transfusion." /></a><div class="icnblk_cntnt"><h4 id="niceng180er5.tab10"><a href="/books/NBK561977/table/niceng180er5.tab10/?report=objectonly" target="object" rid-ob="figobniceng180er5tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Costs including blood transfusion. </p></div></div></div></div><div id="niceng180er5.s1.7"><h3>1.7. Evidence statements</h3><div id="niceng180er5.s1.7.1"><h4>1.7.1. Clinical evidence statements</h4><p>No relevant published evidence was identified for oral iron strategies.</p><div id="niceng180er5.s1.7.1.1"><h5>IV iron versus oral iron</h5><p>No evidence was found for all-cause mortality, POMS, as the critical outcomes, unplanned ICU admission, ICU length of stay, and adverse events from transfusion (for example, infections, reactions (compatibility), hypersensitivity).</p></div><div id="niceng180er5.s1.7.1.2"><h5>Health-related quality of life</h5><p>One study found no clinically important difference between IV iron and oral on quality of life (physical component summary score of the SF-39 questionnaire) at the day of surgery compared to oral iron. (1 study, n=116, moderate quality evidence).</p><p>One study found a clinically important benefit of IV iron on quality of life (mental component summary score of the SF-39 questionnaire) at the day of surgery compared to oral iron. (1 study, n=116, low quality evidence).</p><p>One study found a clinically important benefit of IV iron on quality of life (physical component summary score of the SF-39 questionnaire) at 2–3 months compared to oral iron. (1 study, n=92, low quality evidence).</p><p>One study found a clinically important benefit of IV iron on quality of life (mental component summary score of the SF-39 questionnaire) at 2–3 months compared to oral iron. (1 study, n=92, low quality evidence).</p></div><div id="niceng180er5.s1.7.1.3"><h5>Haemoglobin levels</h5><p>One study found a clinically important benefit of IV iron on haemoglobin levels at 3 weeks compared to oral iron (1 study, n=56, moderate quality evidence).</p><p>One study found no clinically important difference between IV iron and oral iron on pre-operative haemoglobin levels (1 study, n=44, very low quality evidence).</p></div><div id="niceng180er5.s1.7.1.4"><h5>Blood transfusions</h5><p>One study showed a clinically important harm of IV iron on number of patients transfused compared to oral iron (1 study, n=40, low quality evidence). A single study demonstrated a clinical important benefit of IV iron for pre-operative blood transfusions, but no clinically important difference with IV iron of intra-operative or postoperative blood transfusions, or perioperative transfusion volume compared to oral iron (1 study, n=105, low quality evidence).</p></div><div id="niceng180er5.s1.7.1.5"><h5>Adverse events</h5><p>Two studies showed no clinically important difference between IV and oral iron for rate of complications (2 studies, n=96, very low quality evidence).</p></div><div id="niceng180er5.s1.7.1.6"><h5>Outcomes not suitable for GRADE analysis</h5><p>One study showed no notable difference of IV iron compared to oral iron on quality of life (1 study, n=44, very high risk of bias).</p><p>One study found a trend to benefit with IV iron on haemoglobin levels at 3 weeks compared to oral iron (1 study, n=105, low risk of bias).</p><p>One study showed no notable difference of IV iron compared to oral iron on transfusion requirement (1 study, n=44, high risk of bias).</p><p>One study showed a significant benefit with IV iron compared to oral iron for delays in surgical procedures (1 study, n=76, very high risk of bias).</p><p>Two studies showed no notable difference for IV iron on post-operative length of stay when compared to oral iron (2 studies, n=105 & 44, low & high risk of bias).</p><p>One study showed no notable difference for IV iron on post-operative length of ICU stay when compared to oral iron (n=44, high risk of bias).</p><p>One study showed no notable difference between IV and oral iron for rate of complications (1 study, n=105, high risk of bias).</p></div></div><div id="niceng180er5.s1.7.2"><h4>1.7.2. Health economic evidence statements</h4><ul><li class="half_rhythm"><div>No relevant economic evaluations were identified for either review.</div></li></ul></div></div><div id="niceng180er5.s1.8"><h3>1.8. The committee’s discussion of the evidence</h3><div id="niceng180er5.s1.8.1"><h4>1.8.1. Interpreting the evidence</h4><p>Please see recommendations 1.3.4 – 1.3.7 in the guideline.</p><div id="niceng180er5.s1.8.1.1"><h5>1.8.1.1. The outcomes that matter most</h5><div id="niceng180er5.s1.8.1.1.1"><h5>Oral iron</h5><p>Anaemia is a recognised predictor of adverse postoperative outcome and associated with an increased rate of perioperative blood transfusion and increased postoperative morbidity and mortality. As such, the committee identified all-cause mortality, health-related quality of life, preoperative Hb level, transfusion (pre-, intra- and post-surgery), postoperative morbidity score (POMS), and change in healthcare management (for example, delayed surgery or surgery cancellation) as the critical outcomes for decision making on strategies of oral iron therapy. The following outcomes were identified as important for the preoperative management of iron-deficiency anaemia: length of hospital stay, unplanned ICU admission, ICU length of stay (planned and unplanned), adherence, adverse events from iron tablets (for example, constipation, nausea).</p><p>No relevant clinical studies were identified; therefore, no evidence was available for any of these outcomes.</p></div><div id="niceng180er5.s1.8.1.1.2"><h5>IV iron</h5><p>The committee also identified all-cause mortality, health-related quality of life, preoperative Hb level, blood transfusion (pre-, intra- and post-surgery), postoperative morbidity score (POMS), and change in healthcare management (for example, delayed surgery or surgery cancellation) as the critical outcomes for decision making on oral or IV iron therapy. The following outcomes were identified as important for the preoperative management of iron-deficiency anaemia: length of hospital stay, unplanned ICU admission, ICU length of stay (planned and unplanned), adverse events from transfusion (for example, infections, reactions (compatibility), hypersensitivity), and adverse events from iron supplementation (for example, constipation, nausea).</p></div></div><div id="niceng180er5.s1.8.1.2"><h5>1.8.1.2. The quality of the evidence</h5><div id="niceng180er5.s1.8.1.2.1"><h5>Oral iron</h5><p>No relevant clinical studies were identified for this review.</p></div><div id="niceng180er5.s1.8.1.2.2"><h5>IV iron</h5><p>The quality of evidence that was suitable for GRADE analysis ranged from very low to moderate. The majority of the evidence was graded at low quality. This was mostly due to outcome reporting bias and imprecision. The committee also noted that the studies were relatively small, limiting the confidence with which they could draw conclusions from the evidence.</p><p>Outcomes which were not suitable for GRADE analysis were considered to be a low and high risk of bias.</p></div></div><div id="niceng180er5.s1.8.1.3"><h5>1.8.1.3. Benefits and harms</h5><div id="niceng180er5.s1.8.1.3.1"><h5>Oral iron</h5><p>No relevant clinical studies were identified for this review. However, the committee felt that a research recommendation in this area was warranted.</p><p>The committee acknowledged the possible side-effects of oral iron supplementation including constipation or diarrhoea, nausea and vomiting. It was considered that an understanding of varying oral iron therapy regimes may elucidate potential benefits with regards to managing the side effects of supplementation as well as patient compliance with therapy. The committee agreed that alternate day iron regimens can be considered if the side effects of daily dosing cannot be tolerated.</p></div><div id="niceng180er5.s1.8.1.3.2"><h5>IV iron</h5><p>The committee discussed the evidence on the preoperative management of iron deficiency anaemia.</p><p>The committee discussed evidence from three studies showing IV iron had an improved capacity to increase preoperative haemoglobin levels compared with oral iron. This benefit was considered by the committee to be clinically important.</p><p>Evidence from one study showed a clinical benefit of IV iron for the number of preoperative transfusions. However, the committee noted that there was no clinically important difference between oral iron and IV iron on the number of patients transfused on the day of surgery, after surgery or the total blood transfusion volume. A second study showed an increased risk of patients requiring blood transfusion with IV iron compared to oral iron. Given that blood transfusion was recognised as a critically important outcome, the committee felt that the overall lack of difference between oral and IV iron therapy to an extent negated the potential benefits of the aforementioned increase in haemoglobin levels.</p><p>The committee also considered the evidence from two studies reporting the health-related quality of life of people with iron deficiency anaemia planned to undergo surgery. Evidence from one study with 116 participants showed no difference in the physical component summary score of the SF-39 questionnaire at the day of surgery, but noted a clinically important benefit with IV iron administration in mental component summary score of the SF-39 questionnaire at the day of surgery, and in both the physical and mental component summary scores at the day of surgery. The second study found with 44 participants found no statistically significant differences in any subset of the EQ-5D or SF-36 considering the effects of treatment during study visits.</p><p>Evidence reviewed by the committee also showed no significant difference in, length of hospital stay or rate of complications between those receiving oral or IV iron. The committee also noted that there was no data reported on any complications from blood transfusion.</p><p>No evidence was found for all-cause mortality, POMS as the critical outcomes, or unplanned ICU admission, and adverse events from transfusion (for example, infections, reactions (compatibility), hypersensitivity).</p><p>The committee referenced a general acceptance that increased haemoglobin levels in anaemic patients reduces the risk of morbidity associated with surgery and recognised this as a noteworthy benefit of IV iron therapy. However, the committee noted that a reduction in morbidity was not reflected in the reported rates of transfusions in people receiving IV iron therapy compare to oral iron therapy. The committee were aware of the recommendations in the NICE guideline on blood transfusions to offer iv iron if the time interval between the diagnosis of anaemia and surgery is predicted to be too short for oral iron to be effective.</p><p>The committee highlighted that preoperative anaemia is associated with adverse post-operative outcomes. However, there is uncertainty that treating anaemia in the preoperative period reduces these risks.</p></div></div></div><div id="niceng180er5.s1.8.2"><h4>1.8.2. Cost effectiveness and resource use</h4><div id="niceng180er5.s1.8.2.1"><h5>Oral iron</h5><p>No economic evidence was identified.</p><p>The committee were presented with some examples of unit costs for the different oral iron administrations, as well as excess bed day costs and blood transfusion costs. Ferrous sulfate is a common type of oral iron that is prescribed in the NHS, and requires adults taking 200mg tablets three times a day. For the daily oral iron regime, the total cost is £10.36. For the alternate day regime the total cost is £5.18. Costs were based on taking the tablets for three months, as this is the time it usually takes to get iron and haemoglobin levels back to normal. The committee discussed that oral iron results in unpleasant side effects such as constipation and nausea, which can lead to adherence issues particularly if people have to take it on a daily basis. No clinical evidence was identified. However, the committee noted that there may be emerging evidence in non-surgical populations that taking oral iron on alternate days results in the same effectiveness on haemoglobin levels, but fewer side effects which can also resolve the issue around adherence. A higher adherence rate could reduce the chances of adults having their surgery delayed, which can have a negative impact on the adult’s quality of life and their condition. Also, a more effective intervention, in terms of increasing an adult’s haemoglobin level, could reduce the chances of needing a blood transfusion and of having an adverse event, which can lead to extra days in hospital</p><p>Current practice is to administer daily oral iron, which is the more expensive option. As there was no relevant clinical evidence in the surgical population, there is uncertainty about which intervention is more effective and therefore on the impact of downstream costs and effects. If further research could demonstrate that the alternate day option is as, or more, effective than the daily option, it could lead to future savings for the NHS. Therefore the committee made a research recommendation.</p></div><div id="niceng180er5.s1.8.2.2"><h5>IV iron</h5><p>No economic evaluations were identified.</p><p>The committee were presented with some examples of unit costs for oral iron and IV iron, as well as excess bed day and blood transfusion costs.</p><p>The committee felt the clinical data demonstrated that oral and IV iron had similar effectiveness. Oral iron is a very cheap drug to administer, costing only £1.19 for three weeks. On the other hand, IV iron can cost an average of £112 for three weeks. IV iron results in much higher costs, as the drug is more expensive and requires staff time in hospital and clinic space and some adults may require NHS transport. Other downstream costs were considered, such as the cost of a blood transfusion, which can cost around £133 and the cost of excess bed days, which ranges from £260 to £415.</p><p>The IV iron group had a larger increase in haemoglobin levels in all three studies. This can prevent other complications, such as wound infections, which were not measured in the studies. Wound infections can have a negative impact on the patient’s quality of life and incur downstream costs to the NHS in order to manage and treat them. Also, if an adult has not reached an optimum haemoglobin level their surgery might be delayed, which is another outcome that was not measured. This can have a negative impact on their condition and quality of life. However, the committee felt that although there is evidence to support the increase in haemoglobin levels in IV iron, it is an area that requires more evidence to indicate whether this increase in haemoglobin levels leads to less surgeries being delayed and a reduction in complications. The committee also highlighted that although the haemoglobin levels increased, the magnitude of benefit is dependent on the baseline haemoglobin level. For example, if an adult’s haemoglobin level increases from 8 to 10, this is an important clinical difference. But if their haemoglobin level increases from 10 to 12, this is likely to be less significant.</p><p>A simple costing example was calculated to see what the estimated cost per patient would be if we were to include the number of blood transfusions reported in the clinical review, as well as the intervention costs. The intervention cost for oral iron was based on a cost of £1.19 for taking ferrous sulfate for 3 weeks, and the unweighted average cost of intravenous iron was £397. One study reported blood transfusions on the day of surgery as well as pre and post-operatively. This showed that 20% of people in the IV iron group had a blood transfusion and 25% in the oral iron group. Using the cost of blood transfusion and adding it to the cost of the drug (as well as administration costs) resulted in IV iron costing £424per person and oral iron costing £36 per person, a difference of £387. This is a large difference and the committee felt that this cost magnitude of IV iron was too high to justify. The committee discussed that there were risks associated with blood transfusions, and felt that there would be an additional cost associated with these. They felt that the quality of clinical evidence was too weak to make any judgment on the number of transfusions in total, based on the wide confidence intervals.</p><p>The blood transfusion guideline indicated that IV iron should be considered when the interval between diagnosis of anaemia and surgery was too short for oral iron to work. This question aimed to clarify what constitutes ‘too short’, as there is uncertainty and variation in current practice. As the committee discussed that the quality and quantity of the evidence was insufficient, and therefore considered the costs associated with IV iron and agreed that the magnitude of benefit that IV iron produced was not great enough to result in it being cost-effective. Therefore they recommended offering oral iron and considering IV iron in circumstances where oral iron was not tolerated or sufficient. All studies had a similar time frame so there was no information to help inform the issue around timing, and a research recommendation was made around this.</p><p>This recommendation could result in some changes to current practice and could lead to some cost-savings as clinicians might stop using IV iron and prescribe oral iron during a ‘short’ time frame.</p></div></div><div id="niceng180er5.s1.8.3"><h4>1.8.3. Other factors the committee took into account</h4><div id="niceng180er5.s1.8.3.1"><h5>Oral iron</h5><p>The committee reviewed recommendations made in [NG24] the blood transfusion guideline and agreed that these were relevant to the perioperative care population.</p><p>The committee commented that alternate day therapy may address an issue of non-adherence in patients undergoing surgery; however, this needs to be balanced against the possibility that alternate-day therapy might be complicated for patients who are required to take multiple tablets otherwise taken daily. As a large proportion of adults presenting with iron-deficiency anaemia may be elderly, the committee expressed some concern around introducing the alternate day regime as it can be confusing. However, this could be rectified by adherence strategies like adults using compliance devices (for example, pill boxes). The committee also made consideration for the side effects associated with oral iron treatment which may be affected with alternate day therapy.</p><p>After the commencement of an alternate day oral iron regimen for iron deficiency, people should be followed up by healthcare professionals. This would enable assessment of how effective the treatment has been.</p></div><div id="niceng180er5.s1.8.3.2"><h5>IV iron</h5><p>The committee also noted that the evidence from one of the three included studies was taken from a specific population of menorrhagic women scheduled to undergo gynaecologic surgery. While this group of people were identified as having iron deficiency anaemia, the committee questioned whether it would be possible to generalise the findings from this study for all people with iron deficiency anaemia.</p><p>The committee noted that IV iron is indicated in people with FID who have normal iron levels but are unable to use it efficiently.</p><p>The committee was aware of a large ongoing trial (PREVENTT) which may add insight into the efficacy of IV iron in major abdominal/pelvic surgery.</p></div></div></div></div><div id="niceng180er5.rl.r1"><h2 id="_niceng180er5_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng180er5.ref1">Abraham
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DP, Zacharowski
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MM, Geisen
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P, Nassar-Mansur
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BD, Dickson
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BD, Simpson
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A, Chilvers
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CR, Sexton
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M, Ingram
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YH, Chung
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HH, Kang
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SB, Kim
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A, Carter
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AJ. Effect of a patient blood management programme on preoperative anaemia, transfusion rate, and outcome after primary hip or knee arthroplasty: a quality improvement cycle. British Journal of Anaesthesia. 2012; 108(6):943–52 [<a href="https://pubmed.ncbi.nlm.nih.gov/22593128" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22593128</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="niceng180er5.ref34">Kumar
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A, Carson
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JL. Perioperative anemia in the elderly. Clinics in Geriatric Medicine. 2008; 24(4):641–8, viii [<a href="https://pubmed.ncbi.nlm.nih.gov/18984378" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18984378</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="niceng180er5.ref35">Layton
|
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JL, Rubin
|
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LE, Sweeney
|
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JD. Advanced blood management strategies for elective joint arthroplasty. Rhode Island Medicine. 2013; 96(3):23–5 [<a href="https://pubmed.ncbi.nlm.nih.gov/23641434" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23641434</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="niceng180er5.ref36">Lee
|
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SH, Shim
|
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JK, Soh
|
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S, Song
|
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JW, Chang
|
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BC, Lee
|
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S
|
|
et al. The effect of perioperative intravenously administered iron isomaltoside 1000 (Monofer) on transfusion requirements for patients undergoing complex valvular heart surgery: study protocol for a randomized controlled trial. Trials. 2018; 19(1):350 [<a href="/pmc/articles/PMC6031132/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6031132</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29973224" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29973224</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="niceng180er5.ref37">Lidder
|
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PG, Sanders
|
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G, Whitehead
|
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E, Douie
|
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WJ, Mellor
|
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N, Lewis
|
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SJ
|
|
et al. Pre-operative oral iron supplementation reduces blood transfusion in colorectal surgery - A prospective, randomised, controlled trial. Annals of the Royal College of Surgeons of England. 2007; 89(4):418–421 [<a href="/pmc/articles/PMC1963583/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1963583</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17535624" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17535624</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="niceng180er5.ref38">Lilaramani
|
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GR, Ghooi
|
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AM. Correction of anaemia in surgical cases. Clinician. 1974; 38(9):368–375</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="niceng180er5.ref39">Munoz
|
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M, Gomez-Ramirez
|
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S, Martin-Montanez
|
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E, Auerbach
|
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M. Perioperative anemia management in colorectal cancer patients: a pragmatic approach. World Journal of Gastroenterology. 2014; 20(8):1972–85 [<a href="/pmc/articles/PMC3934467/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3934467</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24587673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24587673</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="niceng180er5.ref40">Munoz
|
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M, Gomez-Ramirez
|
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S, Martin-Montanez
|
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E, Pavia
|
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J, Cuenca
|
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J, Garcia-Erce
|
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JA. Perioperative intravenous iron: an upfront therapy for treating anaemia and reducing transfusion requirements. Nutricion Hospitalaria. 2012; 27(6):1817–36 [<a href="https://pubmed.ncbi.nlm.nih.gov/23588429" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23588429</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="niceng180er5.ref41">Najafi
|
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M, Faraoni
|
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D. Hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery. World Journal of Cardiology. 2015; 7(7):377–82 [<a href="/pmc/articles/PMC4513488/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4513488</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26225197" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26225197</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="niceng180er5.ref42">Napolitano
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LM. Perioperative anemia. Surgical Clinics of North America. 2005; 85(6):1215–27, x [<a href="https://pubmed.ncbi.nlm.nih.gov/16326203" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16326203</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="niceng180er5.ref43">National Clinical Guideline Centre. Blood transfusion. NICE guideline 24. London. National Clinical Guideline Centre, 2015. Available from: <a href="https://www.nice.org.uk/guidance/ng24" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org.uk/guidance/ng24</a></div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="niceng180er5.ref44">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26677490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26677490</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="niceng180er5.ref45">Ng
|
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O, Keeler
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BD, Mishra
|
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A, Simpson
|
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A, Neal
|
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K, Brookes
|
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MJ
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et al. Iron therapy for pre-operative anaemia. Cochrane Database of Systematic Reviews
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2015, Issue 12. Art. No.: 26694949. DOI: 10.1002/14651858.CD011588.pub2. [<a href="https://pubmed.ncbi.nlm.nih.gov/26694949" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26694949</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD011588.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="niceng180er5.ref46">NHS Blood and Transplant. NHS blood and transplant price list 2019/20. NHS Blood and Transplant, 2019. Available from: <a href="https://hospital.blood.co.uk/components/portfolio-and-prices/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://hospital<wbr style="display:inline-block"></wbr>​.blood<wbr style="display:inline-block"></wbr>​.co.uk/components/portfolio-and-prices/</a></div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="niceng180er5.ref47">Okuyama
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M, Ikeda
|
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K, Shibata
|
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T, Tsukahara
|
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Y, Kitada
|
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M, Shimano
|
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T. Preoperative iron supplementation and intraoperative transfusion during colorectal cancer surgery. Surgery Today. 2005; 35(1):36–40 [<a href="https://pubmed.ncbi.nlm.nih.gov/15622462" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15622462</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="niceng180er5.ref48">Padmanabhan
|
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H, Siau
|
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K, Nevill
|
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AM, Morgan
|
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I, Cotton
|
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J, Ng
|
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A
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et al. Intravenous iron does not effectively correct preoperative anaemia in cardiac surgery: a pilot randomized controlled trial. Interactive Cardiovascular and Thoracic Surgery. 2019; 28(3):447–454 [<a href="https://pubmed.ncbi.nlm.nih.gov/30107449" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30107449</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="niceng180er5.ref49">Peters
|
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F, Ellermann
|
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I, Steinbicker
|
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AU. Intravenous iron for treatment of anemia in the 3 perisurgical phases: A review and analysis of the current literature. Anesthesia and Analgesia. 2018; 126(4):1268–1282 [<a href="https://pubmed.ncbi.nlm.nih.gov/29261547" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29261547</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>50.</dt><dd><div class="bk_ref" id="niceng180er5.ref50">Petis
|
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SM, Lanting
|
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BA, Vasarhelyi
|
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EM, Naudie
|
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DDR, Ralley
|
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FE, Howard
|
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JL. Is there a role for preoperative iron supplementation in patients preparing for a total hip or total knee arthroplasty?
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Journal of Arthroplasty. 2017; 32(9):2688–2693 [<a href="https://pubmed.ncbi.nlm.nih.gov/28529107" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28529107</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="niceng180er5.ref51">Quinn
|
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EM, Meland
|
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E, McGinn
|
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S, Anderson
|
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JH. Correction of iron-deficiency anaemia in colorectal surgery reduces perioperative transfusion rates: A before and after study. International Journal of Surgery. 2017; 38:1–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/28011177" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28011177</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="niceng180er5.ref52">Quinn
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M, Drummond
|
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RJ, Ross
|
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F, Murray
|
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J, Murphy
|
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J, Macdonald
|
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A. Short course pre-operative ferrous sulphate supplementation--is it worthwhile in patients with colorectal cancer?
|
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Annals of the Royal College of Surgeons of England. 2010; 92(7):569–72 [<a href="/pmc/articles/PMC3229346/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3229346</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20573311" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20573311</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>53.</dt><dd><div class="bk_ref" id="niceng180er5.ref53">Richards
|
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T, Clevenger
|
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B, Keidan
|
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J, Collier
|
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T, Klein
|
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AA, Anker
|
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SD
|
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et al. Erratum to: PREVENTT: preoperative intravenous iron to treat anaemia in major surgery: study protocol for a randomised controlled trial. Trials. 2015; 16:312 [<a href="/pmc/articles/PMC4513685/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4513685</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26204933" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26204933</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>54.</dt><dd><div class="bk_ref" id="niceng180er5.ref54">Rineau
|
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E, Stoyanov
|
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A, Samson
|
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E, Hubert
|
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L, Lasocki
|
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S. Patient blood management in major orthopedic surgery: Less erythropoietin and more iron?
|
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Anesthesia and Analgesia. 2017; 125(5):1597–1599 [<a href="https://pubmed.ncbi.nlm.nih.gov/28514321" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28514321</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>55.</dt><dd><div class="bk_ref" id="niceng180er5.ref55">Schack
|
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A, Berkfors
|
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AA, Ekeloef
|
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S, Gogenur
|
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I, Burcharth
|
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J. The effect of perioperative iron therapy in acute major non-cardiac surgery on allogenic blood transfusion and postoperative haemoglobin levels: A systematic review and meta-analysis. World Journal of Surgery. 2019; 43(7):1677–1691 [<a href="https://pubmed.ncbi.nlm.nih.gov/30824959" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30824959</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>56.</dt><dd><div class="bk_ref" id="niceng180er5.ref56">Sheth
|
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SS, Das
|
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SB. Preoperative management of anemia to avoid blood transfusion. International Journal of Gynaecology and Obstetrics. 2002; 77(3):245–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/12065137" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12065137</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>57.</dt><dd><div class="bk_ref" id="niceng180er5.ref57">Stoffel
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NU, Cercamondi
|
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CI, Brittenham
|
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G, Zeder
|
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C, Geurts-Moespot
|
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AJ, Swinkels
|
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DW
|
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et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol. 2017; 4(11):e524–e533 [<a href="https://pubmed.ncbi.nlm.nih.gov/29032957" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29032957</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>58.</dt><dd><div class="bk_ref" id="niceng180er5.ref58">Stokes
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EA, Wordsworth
|
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S, Staves
|
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J, Mundy
|
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N, Skelly
|
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J, Radford
|
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K
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et al. Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service. Transfusion. 2018; 58(4):846–853 [<a href="https://pubmed.ncbi.nlm.nih.gov/29380872" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29380872</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>59.</dt><dd><div class="bk_ref" id="niceng180er5.ref59">Stoneham
|
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M, Iqbal
|
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R. Clinical strategies to avoid blood transfusion. Anaesthesia and Intensive Care Medicine. 2007; 8(2):52–55</div></dd></dl><dl class="bkr_refwrap"><dt>60.</dt><dd><div class="bk_ref" id="niceng180er5.ref60">Tang
|
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GH, Dhir
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V, Scheer
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AS, Tricco
|
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AC, Sholzberg
|
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M, Brezden-Masley
|
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C. Intravenous iron versus oral iron or observation for gastrointestinal malignancies: a systematic review. European Journal of Gastroenterology and Hepatology. 2019; 31(7):799–806 [<a href="https://pubmed.ncbi.nlm.nih.gov/31082997" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31082997</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>61.</dt><dd><div class="bk_ref" id="niceng180er5.ref61">Taylor
|
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SE, Cross
|
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MH. Clinical strategies to avoid blood transfusion. Anaesthesia and Intensive Care Medicine. 2013; 14(2):48–50</div></dd></dl><dl class="bkr_refwrap"><dt>62.</dt><dd><div class="bk_ref" id="niceng180er5.ref62">Tseliou
|
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P, Apostolopoulos
|
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DJ, Chronopoulos
|
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G, Antonopoulos
|
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A, Korovesis
|
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P. Experience with predeposition of autologous blood in elective orthopaedic and plastic surgery: the role of oral iron medication. Haematologia. 2002; 32(4):355–61 [<a href="https://pubmed.ncbi.nlm.nih.gov/12803110" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12803110</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>63.</dt><dd><div class="bk_ref" id="niceng180er5.ref63">Wilson
|
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MJ, Dekker
|
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JW, Bruns
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E, Borstlap
|
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W, Jeekel
|
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J, Zwaginga
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JJ
|
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et al. Short-term effect of preoperative intravenous iron therapy in colorectal cancer patients with anemia: results of a cohort study. Transfusion. 2018; 58(3):795–803 [<a href="https://pubmed.ncbi.nlm.nih.gov/29250797" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29250797</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng180er5.appa"><h3>Appendix A. Review protocols</h3><p id="niceng180er5.appa.et1"><a href="/books/NBK561977/bin/niceng180er5-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 11. Review protocol: Preoperative management of anaemia (oral iron)</a><span class="small"> (PDF, 186K)</span></p><p id="niceng180er5.appa.et2"><a href="/books/NBK561977/bin/niceng180er5-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 12. Review protocol: Preoperative management of anaemia (IV iron)</a><span class="small"> (PDF, 194K)</span></p><p id="niceng180er5.appa.tab1"><a href="/books/NBK561977/table/niceng180er5.appa.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5appatab1" class="figpopup">Table 13. Health economic review protocol</a></p></div><div id="niceng180er5.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual 2014, updated 2018.<a class="bibr" href="#niceng180er5.ref44" rid="niceng180er5.ref44"><sup>44</sup></a></p><p><i>For more detailed information, please see the</i>
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<a href="/books/NBK561977/bin/niceng180er5_bm2.pdf">Methodology Review</a>.</p><div id="niceng180er5.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies for interventions as these concepts may not be well described in title, abstract or indexes and therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><p id="niceng180er5.appb.tab1"><a href="/books/NBK561977/table/niceng180er5.appb.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab1" class="figpopup">Table 14. Database date parameters and filters used</a></p><p id="niceng180er5.appb.tab2"><a href="/books/NBK561977/table/niceng180er5.appb.tab2/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="niceng180er5.appb.tab3"><a href="/books/NBK561977/table/niceng180er5.appb.tab3/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="niceng180er5.appb.tab4"><a href="/books/NBK561977/table/niceng180er5.appb.tab4/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="niceng180er5.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to the perioperative care population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional health economics searches were run on Medline and Embase.</p><p id="niceng180er5.appb.tab5"><a href="/books/NBK561977/table/niceng180er5.appb.tab5/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab5" class="figpopup">Table 15. Database date parameters and filters used</a></p><p id="niceng180er5.appb.tab6"><a href="/books/NBK561977/table/niceng180er5.appb.tab6/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="niceng180er5.appb.tab7"><a href="/books/NBK561977/table/niceng180er5.appb.tab7/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="niceng180er5.appb.tab8"><a href="/books/NBK561977/table/niceng180er5.appb.tab8/?report=objectonly" target="object" rid-ob="figobniceng180er5appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="niceng180er5.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="niceng180er5.appc.fig1"><a href="/books/NBK561977/figure/niceng180er5.appc.fig1/?report=objectonly" target="object" rid-ob="figobniceng180er5appcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of preoperative management of anaemia (oral iron)</a></p><p id="niceng180er5.appc.fig2"><a href="/books/NBK561977/figure/niceng180er5.appc.fig2/?report=objectonly" target="object" rid-ob="figobniceng180er5appcfig2" class="figpopup">Figure 2. Flow chart of clinical study selection for the review of preoperative management of anaemia (IV iron versus oral iron)</a></p></div><div id="niceng180er5.appd"><h3>Appendix D. Clinical evidence tables</h3><div id="niceng180er5.appd.s1"><h4>1.8.4. Oral iron</h4><p>No clinical evidence identified.</p></div><div id="niceng180er5.appd.s2"><h4>1.8.5. IV iron</h4><p id="niceng180er5.appd.et1"><a href="/books/NBK561977/bin/niceng180er5-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (171K)</span></p></div></div><div id="niceng180er5.appe"><h3>Appendix E. Forest plots</h3><div id="niceng180er5.appe.s1"><h4>E.1. IV iron versus oral iron</h4><p id="niceng180er5.appe.fig1"><a href="/books/NBK561977/figure/niceng180er5.appe.fig1/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig1" class="figpopup">Figure 3. Quality of life (SF-36: Physical component summary), at surgery</a></p><p id="niceng180er5.appe.fig2"><a href="/books/NBK561977/figure/niceng180er5.appe.fig2/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig2" class="figpopup">Figure 4. Quality of life (SF-36: Mental component summary), at surgery</a></p><p id="niceng180er5.appe.fig3"><a href="/books/NBK561977/figure/niceng180er5.appe.fig3/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig3" class="figpopup">Figure 5. Quality of life (SF-36: Physical component summary), at 2–3 months post-op</a></p><p id="niceng180er5.appe.fig4"><a href="/books/NBK561977/figure/niceng180er5.appe.fig4/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig4" class="figpopup">Figure 6. Quality of life (SF-36: Mental component summary), at 2–3 months post-op</a></p><p id="niceng180er5.appe.fig5"><a href="/books/NBK561977/figure/niceng180er5.appe.fig5/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig5" class="figpopup">Figure 7. Change in Hb levels from preoperative to postoperative</a></p><p id="niceng180er5.appe.fig6"><a href="/books/NBK561977/figure/niceng180er5.appe.fig6/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig6" class="figpopup">Figure 8. Preoperative Hb levels</a></p><p id="niceng180er5.appe.fig7"><a href="/books/NBK561977/figure/niceng180er5.appe.fig7/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig7" class="figpopup">Figure 9. Patients transfused</a></p><p id="niceng180er5.appe.fig8"><a href="/books/NBK561977/figure/niceng180er5.appe.fig8/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig8" class="figpopup">Figure 10. Preoperative blood transfusion</a></p><p id="niceng180er5.appe.fig9"><a href="/books/NBK561977/figure/niceng180er5.appe.fig9/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig9" class="figpopup">Figure 11. Blood transfusion on the day of surgery</a></p><p id="niceng180er5.appe.fig10"><a href="/books/NBK561977/figure/niceng180er5.appe.fig10/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig10" class="figpopup">Figure 12. Postoperative blood transfusion</a></p><p id="niceng180er5.appe.fig11"><a href="/books/NBK561977/figure/niceng180er5.appe.fig11/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig11" class="figpopup">Figure 13. Perioperative blood transfusion volume</a></p><p id="niceng180er5.appe.fig12"><a href="/books/NBK561977/figure/niceng180er5.appe.fig12/?report=objectonly" target="object" rid-ob="figobniceng180er5appefig12" class="figpopup">Figure 14. Complications</a></p></div></div><div id="niceng180er5.appf"><h3>Appendix F. GRADE tables</h3><p id="niceng180er5.appf.tab1"><a href="/books/NBK561977/table/niceng180er5.appf.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5appftab1" class="figpopup">Table 16. Clinical evidence profile: IV iron compared to oral iron for preoperative management of anaemia</a></p></div><div id="niceng180er5.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="niceng180er5.appg.fig1"><a href="/books/NBK561977/figure/niceng180er5.appg.fig1/?report=objectonly" target="object" rid-ob="figobniceng180er5appgfig1" class="figpopup">Figure 15. Flow chart of health economic study selection for the guideline</a></p></div><div id="niceng180er5.apph"><h3>Appendix H. Health economic evidence tables</h3><p>None.</p></div><div id="niceng180er5.appi"><h3>Appendix I. Excluded studies</h3><div id="niceng180er5.appi.s1"><h4>I.1. Excluded clinical studies</h4><p id="niceng180er5.appi.tab1"><a href="/books/NBK561977/table/niceng180er5.appi.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5appitab1" class="figpopup">Table 17. Studies excluded from the clinical review (oral iron)</a></p><p id="niceng180er5.appi.tab2"><a href="/books/NBK561977/table/niceng180er5.appi.tab2/?report=objectonly" target="object" rid-ob="figobniceng180er5appitab2" class="figpopup">Table 18. Studies excluded from the clinical review (IV iron)</a></p></div><div id="niceng180er5.appi.s2"><h4>I.2. Excluded health economic studies</h4><p id="niceng180er5.appi.tab3"><a href="/books/NBK561977/table/niceng180er5.appi.tab3/?report=objectonly" target="object" rid-ob="figobniceng180er5appitab3" class="figpopup">Table 19. Studies excluded from the health economic review</a></p></div></div><div id="niceng180er5.appj"><h3>Appendix J. Research recommendations</h3><div id="niceng180er5.appj.s1"><h4>J.1. Management of anaemia</h4><p><b>Research question:</b> For people with iron-deficiency anaemia, how long before surgery should oral iron supplementation be started, and what is the clinical and cost effectiveness of daily oral iron compared with oral iron given on alternative days?</p><p>
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<b>Why this is important:</b>
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</p><p>Iron deficiency anaemia is common in the surgical population. The time from identification of iron deficiency anaemia in a surgical patient, to the time of surgery is variable; it can be months for an elective procedure such as joint replacement or two weeks for cancer surgery. Treatment options include oral supplementation and/or intravenous preparations. There are limited randomised controlled clinical trials examining the clinical and cost effectiveness of oral versus intravenous iron for the treatment of iron deficiency anaemia prior to surgery. This has led to variation in clinical practice in the treatment of iron deficiency prior to surgery and requires further research to inform development of guidelines and standardisation of routine care.</p><p id="niceng180er5.appj.tab1"><a href="/books/NBK561977/table/niceng180er5.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng180er5appjtab1" class="figpopup">Criteria for selecting high-priority research recommendations</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.3.4 to 1.3.7 in the NICE guideline</p><p>This evidence review was developed by the National Guideline Centre</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and, where appropriate, their carer or guardian.</p><p>Local commissioners and providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2020.</div><div class="small"><span class="label">Bookshelf ID: NBK561977</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/32931174" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">32931174</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng180er5tab1"><div id="niceng180er5.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of oral iron</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng180er5.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng180er5.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults 18 years and over having surgery who have been identified during preoperative assessment as having iron deficiency anaemia (haemoglobin <130 g/L (13 g/dL) in men older than age 15 years, <120 g/L (12 g/dL) in non-pregnant women older than age 15 years, and <110 g/L (11 g/dL) in pregnant women) undergoing surgery).</td></tr><tr><th id="hd_b_niceng180er5.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng180er5.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alternate day oral iron therapy</td></tr><tr><th id="hd_b_niceng180er5.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng180er5.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Daily oral iron therapy</td></tr><tr><th id="hd_b_niceng180er5.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng180er5.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Critical outcomes:
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<ul><li class="half_rhythm"><div>all-cause mortality</div></li><li class="half_rhythm"><div>health-related quality of life</div></li><li class="half_rhythm"><div>preoperative Hb level</div></li><li class="half_rhythm"><div>transfusion (pre-, intra- and post-surgery)</div></li><li class="half_rhythm"><div>postoperative morbidity score (POMS)</div></li><li class="half_rhythm"><div>change in healthcare management (for example, delayed surgery or surgery cancellation)</div></li></ul>
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Important outcomes:
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<ul><li class="half_rhythm"><div>length of hospital stay</div></li><li class="half_rhythm"><div>unplanned ICU admission</div></li><li class="half_rhythm"><div>ICU length of stay (planned and unplanned)</div></li><li class="half_rhythm"><div>adherence</div></li><li class="half_rhythm"><div>adverse events from iron tablets (e.g. constipation, nausea)</div></li></ul></td></tr><tr><th id="hd_b_niceng180er5.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng180er5.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Randomised controlled trials (RCTs), systematic reviews of RCTs.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab2"><div id="niceng180er5.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">PICO characteristics of IV iron</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab2_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng180er5.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng180er5.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults 18 years and over having elective surgery who have been identified during preoperative assessment as having iron deficiency anaemia.</td></tr><tr><th id="hd_b_niceng180er5.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng180er5.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Preoperative intravenous iron therapy</td></tr><tr><th id="hd_b_niceng180er5.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng180er5.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Preoperative oral iron therapy</td></tr><tr><th id="hd_b_niceng180er5.tab2_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng180er5.tab2_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Critical outcomes:
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<ul><li class="half_rhythm"><div>all-cause mortality</div></li><li class="half_rhythm"><div>health-related quality of life</div></li><li class="half_rhythm"><div>preoperative Hb level</div></li><li class="half_rhythm"><div>blood transfusion (pre-, intra- and post-surgery)</div></li><li class="half_rhythm"><div>postoperative morbidity score (POMS)</div></li><li class="half_rhythm"><div>change in healthcare management (for example, delayed surgery or surgery cancellation)</div></li></ul>
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Important outcomes:
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<ul><li class="half_rhythm"><div>length of hospital stay</div></li><li class="half_rhythm"><div>unplanned ICU admission</div></li><li class="half_rhythm"><div>ICU length of stay (planned and unplanned)</div></li><li class="half_rhythm"><div>adverse events from iron infusion(e.g. constipation, nausea)</div></li><li class="half_rhythm"><div>adverse events from transfusion (e.g. infections, reactions (compatibility), hypersensitivity to)</div></li></ul></td></tr><tr><th id="hd_b_niceng180er5.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng180er5.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Randomised controlled trials (RCTs), systematic reviews of RCTs.</p>
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<p>Prospective cohort studies if no RCT evidence is identified.</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab3"><div id="niceng180er5.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of clinical studies included</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Study</th><th id="hd_h_niceng180er5.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Intervention and comparison</th><th id="hd_h_niceng180er5.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Population</th><th id="hd_h_niceng180er5.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th><th id="hd_h_niceng180er5.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Keeler 2017<a class="bibr" href="#niceng180er5.ref30" rid="niceng180er5.ref30"><sup>30</sup></a>/Keeler 2019<a class="bibr" href="#niceng180er5.ref29" rid="niceng180er5.ref29"><sup>29</sup></a></td><td headers="hd_h_niceng180er5.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>IV iron:</b> Ferric carboxymaltose diluted in 250 ml 0.9% saline. Dose calculated using body weight and Hb level. Maximum dose of 1000mg per week and 2000mg during the trial. Treatment for at least 2 weeks before surgery, median 3 weeks.</p>
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<p>(n=55)</p>
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<p><b>Oral iron:</b> Ferous sulphate 200mg twice daily until surgery. Treatment for at least 2 weeks before surgery, median 3 weeks. (n=61)</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Patients diagnosed with colorectal cancer with haemoglobin <11 g/dl for women and <12 g/dl for men, scheduled to undergo surgery.</p>
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<p>Median age (range): 74 (67–81)</p>
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<p>UK</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Quality of life</div></li><li class="half_rhythm"><div>Perioperative Hb level</div></li><li class="half_rhythm"><div>Blood transfusion</div></li><li class="half_rhythm"><div>Length of hospital stay</div></li><li class="half_rhythm"><div>Adverse events</div></li></ul></td><td headers="hd_h_niceng180er5.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng180er5.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kim 2009<a class="bibr" href="#niceng180er5.ref32" rid="niceng180er5.ref32"><sup>32</sup></a></td><td headers="hd_h_niceng180er5.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>IV iron:</b> Iron sucrose calculated following formula: weight (kg) × [10 Hb (g/dl) - actual Hb (g/dl) × 2.4 = 500 mg, rounded to the nearest multiple of 100 mg. Most patients received iron sucrose infusion at a rate of 200 mg every other day, 3 times a week, beginning 3 weeks before surgery.</p>
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<p>(n=39)</p>
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<p><b>Oral iron:</b> 2 ampoules of oral protein succinylate (total of 80 mg of elementary iron) per day, 3 weeks before surgery until time of surgery.</p>
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<p>(n=37)</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Menorrhagic patients with established IDA who had haemoglobin levels <9 g/dl and were scheduled to undergo surgical treatment.</p>
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<p>Mean age (SD): 42 (7.5)</p>
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<p>South Korea</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Perioperative Hb level</div></li><li class="half_rhythm"><div>Adverse events</div></li></ul></td><td headers="hd_h_niceng180er5.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng180er5.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Padmanabhan 2019<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng180er5.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>IV oral therapy: Patients received FCM (Ferinject) treatment in accordance with the manufacturer’s instructions (maximum dose 1000 mg). FCM was diluted in 250 ml of 0.9% sodium chloride using an aseptic technique and administered over 30 min during the preoperative clinic. The dose of FCM was calculated using a fixed FCM dosing regimen. A second dose was offered when required.</p>
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<p>(n=22)</p>
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<p>Oral iron therapy: Patients received 200mg of ferrous sulphate twice daily for 3–8 weeks until surgery.</p>
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<p>(n=22)</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Patients scheduled for elective cardiac surgery, defined as coronary artery bypass graft and/or open valve surgery, were included if they were also anaemic according to the World Health Organization criteria (haemoglobin <120 g/l for women and <130 g/ l for men).</p>
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<p>Mean age (SD): 74 (11)</p>
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<p>UK</p>
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</td><td headers="hd_h_niceng180er5.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Quality of life</div></li><li class="half_rhythm"><div>Perioperative Hb level</div></li><li class="half_rhythm"><div>Transfusions</div></li><li class="half_rhythm"><div>Adverse events</div></li><li class="half_rhythm"><div>Length of hospital stay</div></li><li class="half_rhythm"><div>Length of ICU stay</div></li></ul></td><td headers="hd_h_niceng180er5.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab4"><div id="niceng180er5.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence summary: IV iron compared to oral iron for preoperative management of anaemia</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng180er5.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng180er5.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng180er5.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng180er5.tab4_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng180er5.tab4_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_niceng180er5.tab4_1_1_1_5" id="hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Oral iron</th><th headers="hd_h_niceng180er5.tab4_1_1_1_5" id="hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with IV iron (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF36 – Physical component summary)</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>116</p>
|
|
<p>(1 study)</p>
|
|
<p>day of surgery</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: physical component summary), at surgery in the control groups was</p>
|
|
<p>43</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: physical component summary), at surgery in the intervention groups was</p>
|
|
<p>0 higher</p>
|
|
<p>(3.84 lower to 3.84 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF36 – Mental component summary)</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>116</p>
|
|
<p>(1 study)</p>
|
|
<p>day of discharge</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: mental component summary), at surgery in the control groups was</p>
|
|
<p>48</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: mental component summary), at surgery in the intervention groups was</p>
|
|
<p>3 higher</p>
|
|
<p>(0.64 lower to 6.64 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life (SF-36: Physical component summary), at 2–3 months post-op</p>
|
|
<p>Scale from: 0 to 100.</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>92</p>
|
|
<p>(1 study)</p>
|
|
<p>2–3 months</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: physical component summary), at 2–3 months post-op in the control groups was</p>
|
|
<p>43</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: physical component summary), at 2–3 months post-op in the intervention groups was</p>
|
|
<p>4 higher</p>
|
|
<p>(0.31 to 7.69 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life (SF-36: Mental component summary), at 2–3 months post-op</p>
|
|
<p>Scale from: 0 to 100.</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>92</p>
|
|
<p>(1 study)</p>
|
|
<p>2–3 months</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: mental component summary), at 2–3 months post-op in the control groups was</p>
|
|
<p>51</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life (sf-36: mental component summary), at 2–3 months post-op in the intervention groups was</p>
|
|
<p>6 higher</p>
|
|
<p>(2.69 to 9.31 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Change in Hb levels from preoperative to postoperative</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>56</p>
|
|
<p>(1 study)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in Hb levels from preoperative to postoperative in the oral group was</p>
|
|
<p>0.8 g/dl</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in Hb levels from preoperative to postoperative in the IV group was</p>
|
|
<p>2.2 higher</p>
|
|
<p>(1.46 to 2.94 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Preoperative Hb levels</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>44</p>
|
|
<p>(1 study)</p>
|
|
<p>postoperatively</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean preoperative Hb levels in the control groups was</p>
|
|
<p>118.3 g/L</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean preoperative Hb levels in the intervention groups was</p>
|
|
<p>1.80 higher</p>
|
|
<p>(4.67 lower to 8.27 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Patients transfused</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 study)</p>
|
|
<p>postoperatively</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 1.33</p>
|
|
<p>(0.88 to 2.02)</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1 hd_h_niceng180er5.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">600 per 1000</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>198 more per 1000</p>
|
|
<p>(from 72 fewer to 612 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Pre-operative blood transfusion</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>105</p>
|
|
<p>(1 study)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Peto OR 0.15</p>
|
|
<p>(0.01 to 2.36)</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1 hd_h_niceng180er5.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91 per 1000</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>80 fewer per 1000</p>
|
|
<p>(from 90 fewer to 100 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Blood transfusion on the day of surgery</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>105</p>
|
|
<p>(1 study)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 1.10</p>
|
|
<p>(0.38 to 3.19)</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1 hd_h_niceng180er5.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">109 per 1000</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>11 more per 1000</p>
|
|
<p>(from 68 fewer to 234 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Post-operative blood transfusion</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>105</p>
|
|
<p>(1 study)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.73</p>
|
|
<p>(0.22 to 2.45)</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1 hd_h_niceng180er5.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">109 per 1000</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>29 fewer per 1000</p>
|
|
<p>(from 85 fewer to 158 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Perioperative blood transfusion volume</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>105</p>
|
|
<p>(1 study)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean volume of transfusion from preoperative to postoperative in the oral group was</p>
|
|
<p>0.63 units</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean volume of transfusion from preoperative to postoperative in the IV group was</p>
|
|
<p>0.07 units higher</p>
|
|
<p>(0.58 lower to 0.71 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Complications</td><td headers="hd_h_niceng180er5.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>96</p>
|
|
<p>(2 studies)</p>
|
|
<p>3 weeks</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RR 0.93</p>
|
|
<p>(0.65 to 1.32)</p>
|
|
</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1 hd_h_niceng180er5.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">413 per 1000</td><td headers="hd_h_niceng180er5.tab4_1_1_1_5 hd_h_niceng180er5.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>29 fewer per 1000</p>
|
|
<p>(from 145 fewer to 132 more)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng180er5.tab4_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng180er5.tab4_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab5"><div id="niceng180er5.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Clinical evidence summary: Evidence not suitable for GRADE analysis</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcome</th><th id="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention results</th><th id="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention group (n)</th><th id="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comparison results</th><th id="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comparison group (n)</th><th id="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of bias</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Padmanabhan 2019<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3 hd_h_niceng180er5.tab5_1_1_1_4 hd_h_niceng180er5.tab5_1_1_1_5 hd_h_niceng180er5.tab5_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">No statistically significant differences in any subset of the EQ-5D or SF-36 were identified when considering the effects of treatment during the 3 study visits.</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very high</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Keeler 2017<a class="bibr" href="#niceng180er5.ref30" rid="niceng180er5.ref30"><sup>30</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Hb level change from baseline to surgery (g/dl)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 1.55 (0.93–2.58)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 0.5 (−0.13–1.33)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_3 hd_h_niceng180er5.tab5_1_1_1_4 hd_h_niceng180er5.tab5_1_1_1_5 hd_h_niceng180er5.tab5_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Change score of intervention vs control was statistically significant. P<0.001</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Padmanabhan 2019<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transfusion requirements</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 2.0 units (1.0–4.8)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 1.5 units (0–2.0)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kim 2009<a class="bibr" href="#niceng180er5.ref32" rid="niceng180er5.ref32"><sup>32</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Change in healthcare management</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3 hd_h_niceng180er5.tab5_1_1_1_4 hd_h_niceng180er5.tab5_1_1_1_5 hd_h_niceng180er5.tab5_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Delays in surgical procedures were significantly reduced with IV iron compared to oral iron administration.</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very high</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Keeler 2017<a class="bibr" href="#niceng180er5.ref30" rid="niceng180er5.ref30"><sup>30</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Complications</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3 hd_h_niceng180er5.tab5_1_1_1_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Post-infusion headache was the most frequent complication (reported by three people). One significant adverse event was reported, a rash that required intervention of oral antihistamine medication. (n=55)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5 hd_h_niceng180er5.tab5_1_1_1_6" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Two people reduced their dose because of complication (dyspepsia and constipation). (n=61)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Keeler 2017<a class="bibr" href="#niceng180er5.ref30" rid="niceng180er5.ref30"><sup>30</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Post-operative length of stay (days)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 6 (5–10)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 6 (4–9)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_3 hd_h_niceng180er5.tab5_1_1_1_4 hd_h_niceng180er5.tab5_1_1_1_5 hd_h_niceng180er5.tab5_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Change score of intervention vs control was not statistically significant. P=0.950</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Padmanabhan 2019<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Length of hospital stay</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 7days (3–49)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 9 days (3–30)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_niceng180er5.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Padmanabhan 2019<a class="bibr" href="#niceng180er5.ref48" rid="niceng180er5.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng180er5.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Length of ICU stay</td><td headers="hd_h_niceng180er5.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 88.0 hours (lower IQR not reported-106)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng180er5.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median (IQR): 69 hours (12–190)</td><td headers="hd_h_niceng180er5.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_niceng180er5.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab6"><div id="niceng180er5.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">UK costs of oral iron drugs</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Drug</th><th id="hd_h_niceng180er5.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Formulation</th><th id="hd_h_niceng180er5.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Dose</th><th id="hd_h_niceng180er5.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Unit cost</th><th id="hd_h_niceng180er5.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost – 3 weeks</th><th id="hd_h_niceng180er5.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost – 3 months</th><th id="hd_h_niceng180er5.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source of dosage</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferrous sulfate</td><td headers="hd_h_niceng180er5.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tablets</td><td headers="hd_h_niceng180er5.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">210mg 3 times daily</td><td headers="hd_h_niceng180er5.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pack of 28 = £1.06</td><td headers="hd_h_niceng180er5.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2.39</td><td headers="hd_h_niceng180er5.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£10.36</td><td headers="hd_h_niceng180er5.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">GC member</td></tr><tr><td headers="hd_h_niceng180er5.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferrous sulfate</td><td headers="hd_h_niceng180er5.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tablets</td><td headers="hd_h_niceng180er5.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">210mg 3 times a day, on alternate days</td><td headers="hd_h_niceng180er5.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pack of 28 = £1.06</td><td headers="hd_h_niceng180er5.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.19</td><td headers="hd_h_niceng180er5.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5.18</td><td headers="hd_h_niceng180er5.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stoffel 2017<a class="bibr" href="#niceng180er5.ref57" rid="niceng180er5.ref57"><sup>57</sup></a></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: British National Formulary, September 2019<a class="bibr" href="#niceng180er5.ref27" rid="niceng180er5.ref27"><sup>27</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab7"><div id="niceng180er5.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">UK costs of intravenous iron</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Drug</th><th id="hd_h_niceng180er5.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Iron mg/vial</th><th id="hd_h_niceng180er5.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No. of vials per vist</th><th id="hd_h_niceng180er5.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No. of visits</th><th id="hd_h_niceng180er5.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost/vial</th><th id="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Total drug cost</th><th id="hd_h_niceng180er5.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source of dosage</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferric carboxymaltose</td><td headers="hd_h_niceng180er5.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1000mg</td><td headers="hd_h_niceng180er5.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£154.23</td><td headers="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£154</td><td headers="hd_h_niceng180er5.tab7_1_1_1_7" rowspan="3" colspan="1" style="text-align:left;vertical-align:top;">Blood transfusion guideline<a class="bibr" href="#niceng180er5.ref43" rid="niceng180er5.ref43"><sup>43</sup></a></td></tr><tr><td headers="hd_h_niceng180er5.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron dextran</td><td headers="hd_h_niceng180er5.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500mg</td><td headers="hd_h_niceng180er5.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng180er5.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£39.85</td><td headers="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£80</td></tr><tr><td headers="hd_h_niceng180er5.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron isomaltoside 1000</td><td headers="hd_h_niceng180er5.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500mg</td><td headers="hd_h_niceng180er5.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng180er5.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£84.75</td><td headers="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£170</td></tr><tr><td headers="hd_h_niceng180er5.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron sucrose</td><td headers="hd_h_niceng180er5.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100mg</td><td headers="hd_h_niceng180er5.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng180er5.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£8.70</td><td headers="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£44</td><td headers="hd_h_niceng180er5.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">GC opinion</td></tr><tr><td headers="hd_h_niceng180er5.tab7_1_1_1_1 hd_h_niceng180er5.tab7_1_1_1_2 hd_h_niceng180er5.tab7_1_1_1_3 hd_h_niceng180er5.tab7_1_1_1_4 hd_h_niceng180er5.tab7_1_1_1_5" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Unweighted average</td><td headers="hd_h_niceng180er5.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>£112</b>
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</td><td headers="hd_h_niceng180er5.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Sources: British National Formulary, May 2018<a class="bibr" href="#niceng180er5.ref27" rid="niceng180er5.ref27"><sup>27</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab8"><div id="niceng180er5.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Costs of administering intravenous iron</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Drug</th><th id="hd_h_niceng180er5.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Preparation (minutes)<sup>(a)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Infusion time (minutes) <sup>(a)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Observation (minutes)<sup>(a)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Nurse costs<sup>(b)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Consumables<sup>(b)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Transport<sup>(b)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Admin time<sup>(b)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Clinic space<sup>(b)</sup></th><th id="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Total costs (inc. drug)</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferric carboxy maltose</td><td headers="hd_h_niceng180er5.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng180er5.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng180er5.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£49</td><td headers="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3</td><td headers="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>£222</b>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron dextran</td><td headers="hd_h_niceng180er5.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng180er5.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">300</td><td headers="hd_h_niceng180er5.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£562</td><td headers="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3</td><td headers="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>£685</b>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron isomaltoside 1000</td><td headers="hd_h_niceng180er5.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng180er5.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£122</td><td headers="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3</td><td headers="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£7</td><td headers="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>£312</b>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Iron sucrose</td><td headers="hd_h_niceng180er5.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_niceng180er5.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£305</td><td headers="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3</td><td headers="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£7</td><td headers="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<b>£369</b>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.tab8_1_1_1_1 hd_h_niceng180er5.tab8_1_1_1_2 hd_h_niceng180er5.tab8_1_1_1_3 hd_h_niceng180er5.tab8_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Unweighted average</td><td headers="hd_h_niceng180er5.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£259</td><td headers="hd_h_niceng180er5.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng180er5.tab8_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3</td><td headers="hd_h_niceng180er5.tab8_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£12</td><td headers="hd_h_niceng180er5.tab8_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>£397</b>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng180er5.tab8_1"><p class="no_margin">Source: Blood Transfusion, NICE guideline, NG24, Appendix N, costs used in the guideline were inflated to 2017<a class="bibr" href="#niceng180er5.ref43" rid="niceng180er5.ref43"><sup>43</sup></a></p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng180er5.tab8_2"><p class="no_margin">Source: Curtis, L. & Burns, A. (2018) Unit Costs of Health and Social Care 2018, Personal Social Services Research Unit, University of Kent, Canterbury<a class="bibr" href="#niceng180er5.ref13" rid="niceng180er5.ref13"><sup>13</sup></a>, cost of nurse time includes the ratio of direct to indirect time with patients and qualification costs from the PSSRU</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="niceng180er5.tab8_3"><p class="no_margin">Transport cost is based on committee assumption that 10% of patients would require transport</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab9"><div id="niceng180er5.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Potential downstream costs</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">HRG code</th><th id="hd_h_niceng180er5.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Description</th><th id="hd_h_niceng180er5.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost per unit</th><th id="hd_h_niceng180er5.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source, Assumptions</th></tr></thead><tbody><tr><th headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_h_niceng180er5.tab9_1_1_1_2 hd_h_niceng180er5.tab9_1_1_1_3 hd_h_niceng180er5.tab9_1_1_1_4" id="hd_b_niceng180er5.tab9_1_1_1_1" colspan="4" rowspan="1" style="text-align:left;vertical-align:middle;">
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<i>Blood transfusion cost</i>
|
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</th></tr><tr><td headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n/a</td><td headers="hd_h_niceng180er5.tab9_1_1_1_2 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Standard red cells (BC001)</td><td headers="hd_h_niceng180er5.tab9_1_1_1_3 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£133.44</td><td headers="hd_h_niceng180er5.tab9_1_1_1_4 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHSBT Price list 2019<a class="bibr" href="#niceng180er5.ref46" rid="niceng180er5.ref46"><sup>46</sup></a></td></tr><tr><td headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n/a</td><td headers="hd_h_niceng180er5.tab9_1_1_1_2 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Red blood cell transfusion on a day unit</td><td headers="hd_h_niceng180er5.tab9_1_1_1_3 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>£57.19 (first unit)</p>
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<p>£36.13 (subsequent units)</p>
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</td><td headers="hd_h_niceng180er5.tab9_1_1_1_4 hd_b_niceng180er5.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stokes 2018<a class="bibr" href="#niceng180er5.ref58" rid="niceng180er5.ref58"><sup>58</sup></a></td></tr><tr><th headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_h_niceng180er5.tab9_1_1_1_2 hd_h_niceng180er5.tab9_1_1_1_3 hd_h_niceng180er5.tab9_1_1_1_4" id="hd_b_niceng180er5.tab9_1_1_4_1" colspan="4" rowspan="1" style="text-align:left;vertical-align:middle;">
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<i>Cost of hospital stay</i>
|
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</th></tr><tr><td headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ED22A – ED23C</td><td headers="hd_h_niceng180er5.tab9_1_1_1_2 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Cost of elective excess bed days in high risk of bleeding</p>
|
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<p>(Complex, coronary artery bypass graft with single heart valve replacement or repair)</p>
|
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</td><td headers="hd_h_niceng180er5.tab9_1_1_1_3 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£260</td><td headers="hd_h_niceng180er5.tab9_1_1_1_4 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>NHS reference costs, 2017/18<a class="bibr" href="#niceng180er5.ref14" rid="niceng180er5.ref14"><sup>14</sup></a></p>
|
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<p>This was based on the costs used in the blood transfusion guideline NG24)<a class="bibr" href="#niceng180er5.ref43" rid="niceng180er5.ref43"><sup>43</sup></a>, cost-effectiveness analysis of tranexamic acid and cell salvage (The blood transfusion GDG considered these surgeries to be reflective of surgeries used in the clinical evidence of the guideline)<sup>(a)</sup></p>
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<p>Weighted average was calculated</p>
|
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</td></tr><tr><td headers="hd_h_niceng180er5.tab9_1_1_1_1 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HN12A – HN24C and HT12D – HT24C<sup>(b)</sup></td><td headers="hd_h_niceng180er5.tab9_1_1_1_2 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Cost of elective excess bed days in moderate risk of bleeding</p>
|
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<p>(Hip and knee procedures, trauma and non-trauma</p>
|
|
</td><td headers="hd_h_niceng180er5.tab9_1_1_1_3 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£415</td><td headers="hd_h_niceng180er5.tab9_1_1_1_4 hd_b_niceng180er5.tab9_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>NHS reference costs 2017/18<a class="bibr" href="#niceng180er5.ref14" rid="niceng180er5.ref14"><sup>14</sup></a></p>
|
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<p>Assumptions as above</p>
|
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<p>Weighted average was calculated</p>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng180er5.tab9_1"><p class="no_margin">Taken from NICE Blood Transfusion guideline (NG24), Appendix M<a class="bibr" href="#niceng180er5.ref43" rid="niceng180er5.ref43"><sup>43</sup></a>, Costs used in the guideline were updated to NHS reference costs 2017/18<a class="bibr" href="#niceng180er5.ref14" rid="niceng180er5.ref14"><sup>14</sup></a>.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng180er5.tab9_2"><p class="no_margin">HN13G, HN13H, HN14F, HN14G, HN14H, HN23D, HN23E and HT23E excluded as based on people 18 years and under.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5tab10"><div id="niceng180er5.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Costs including blood transfusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.tab10_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.tab10_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng180er5.tab10_1_1_1_1" style="text-align:left;vertical-align:bottom;"></th><th id="hd_h_niceng180er5.tab10_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Oral iron</th><th id="hd_h_niceng180er5.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">IV iron</th><th id="hd_h_niceng180er5.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;"></th></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_2" id="hd_h_niceng180er5.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of people requiring blood transfusions</th><th headers="hd_h_niceng180er5.tab10_1_1_1_2" id="hd_h_niceng180er5.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">N</th><th headers="hd_h_niceng180er5.tab10_1_1_1_3" id="hd_h_niceng180er5.tab10_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of people requiring blood transfusions</th><th headers="hd_h_niceng180er5.tab10_1_1_1_4" id="hd_h_niceng180er5.tab10_1_1_2_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">N</th></tr></thead><tbody><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1 hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_h_niceng180er5.tab10_1_1_2_2 hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" id="hd_b_niceng180er5.tab10_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:middle;">
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<i>Data from study</i>
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</th></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1" id="hd_b_niceng180er5.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Total</th><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_2 hd_b_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_b_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4 hd_b_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1 hd_b_niceng180er5.tab10_1_1_2_1 hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_h_niceng180er5.tab10_1_1_2_2 hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" id="hd_b_niceng180er5.tab10_1_1_3_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:middle;">
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<i>Calculations</i>
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</th></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1" id="hd_b_niceng180er5.tab10_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">% of people having transfusion</th><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_4_1 hd_b_niceng180er5.tab10_1_1_3_1 hd_h_niceng180er5.tab10_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">25%</td><td headers="hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_b_niceng180er5.tab10_1_1_4_1 hd_b_niceng180er5.tab10_1_1_3_1 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">20%</td></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1" id="hd_b_niceng180er5.tab10_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Costs of blood transfusion</th><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_5_1 hd_h_niceng180er5.tab10_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">£33.97<sup>(a)</sup></td><td headers="hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_b_niceng180er5.tab10_1_1_5_1 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">£26.69<sup>(a)</sup></td></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1" id="hd_b_niceng180er5.tab10_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Costs of iron</th><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_6_1 hd_h_niceng180er5.tab10_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">£2.39</td><td headers="hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_b_niceng180er5.tab10_1_1_6_1 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">£397</td></tr><tr><th headers="hd_h_niceng180er5.tab10_1_1_1_1" id="hd_b_niceng180er5.tab10_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost including blood transfusion</th><td headers="hd_h_niceng180er5.tab10_1_1_1_2 hd_h_niceng180er5.tab10_1_1_2_1 hd_b_niceng180er5.tab10_1_1_7_1 hd_h_niceng180er5.tab10_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>£36</b>
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<sup>
|
|
(a)
|
|
</sup>
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</td><td headers="hd_h_niceng180er5.tab10_1_1_1_3 hd_h_niceng180er5.tab10_1_1_2_3 hd_b_niceng180er5.tab10_1_1_7_1 hd_h_niceng180er5.tab10_1_1_1_4 hd_h_niceng180er5.tab10_1_1_2_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>£424</b>
|
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<sup>
|
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(a)
|
|
</sup>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng180er5.tab10_1"><p class="no_margin">Blood transfusion costs were taken from the NHS Blood transfusion price list (£133.44)<a class="bibr" href="#niceng180er5.ref46" rid="niceng180er5.ref46"><sup>46</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng180er5appatab1"><div id="niceng180er5.appa.tab1" class="table"><h3><span class="label">Table 13</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_niceng180er5.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All questions – health economic evidence</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Objectives</b>
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</td><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To identify health economic studies relevant to any of the review questions.</td></tr><tr><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search criteria</b>
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</td><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the clinical review protocol above.</div></li><li class="half_rhythm"><div>Studies must be of a relevant health economic study design (cost–utility analysis, cost-effectiveness analysis, cost–benefit analysis, cost–consequences analysis, comparative cost analysis).</div></li><li class="half_rhythm"><div>Studies must not be a letter, editorial or commentary, or a review of health economic evaluations. (Recent reviews will be ordered although not reviewed. The bibliographies will be checked for relevant studies, which will then be ordered.)</div></li><li class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li class="half_rhythm"><div>Studies must be in English.</div></li></ul></td></tr><tr><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search strategy</b>
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</td><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A health economic study search will be undertaken using population-specific terms and a health economic study filter – see <a href="#niceng180er5.appb">appendix B</a> below.</td></tr><tr><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<b>Review strategy</b>
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</td><td headers="hd_h_niceng180er5.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Studies not meeting any of the search criteria above will be excluded. Studies published before 2003, abstract-only studies and studies from non-OECD countries or the USA will also be excluded.</p>
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<p>Each remaining study will be assessed for applicability and methodological limitations using the NICE economic evaluation checklist which can be found in appendix H of Developing NICE guidelines: the manual (2014).<a class="bibr" href="#niceng180er5.ref44" rid="niceng180er5.ref44"><sup>44</sup></a>
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<a class="bibr" href="#niceng180er5.ref44" rid="niceng180er5.ref44"><sup>44</sup></a></p>
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<p><b>Inclusion and exclusion criteria</b>
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<ul><li class="half_rhythm"><div>If a study is rated as both ‘Directly applicable’ and with ‘Minor limitations’ then it will be included in the guideline. A health economic evidence table will be completed and it will be included in the health economic evidence profile.</div></li><li class="half_rhythm"><div>If a study is rated as either ‘Not applicable’ or with ‘Very serious limitations’ then it will usually be excluded from the guideline. If it is excluded then a health economic evidence table will not be completed and it will not be included in the health economic evidence profile.</div></li><li class="half_rhythm"><div>If a study is rated as ‘Partially applicable’, with ‘Potentially serious limitations’ or both then there is discretion over whether it should be included.</div></li></ul>
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<b>Where there is discretion</b></p>
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<p>The health economist will make a decision based on the relative applicability and quality of the available evidence for that question, in discussion with the guideline committee if required. The ultimate aim is to include health economic studies that are helpful for decision-making in the context of the guideline and the current NHS setting. If several studies are considered of sufficiently high applicability and methodological quality that they could all be included, then the health economist, in discussion with the committee if required, may decide to include only the most applicable studies and to selectively exclude the remaining studies. All studies excluded on the basis of applicability or methodological limitations will be listed with explanation in the excluded health economic studies appendix below.</p>
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<p>The health economist will be guided by the following hierarchies.</p>
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<p><i>Setting:</i>
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<ul><li class="half_rhythm"><div>UK NHS (most applicable).</div></li><li class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li class="half_rhythm"><div>Studies set in non-OECD countries or in the USA will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Health economic study type:</i>
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<ul><li class="half_rhythm"><div>Cost–utility analysis (most applicable).</div></li><li class="half_rhythm"><div>Other type of full economic evaluation (cost–benefit analysis, cost-effectiveness analysis, cost–consequences analysis).</div></li><li class="half_rhythm"><div>Comparative cost analysis.</div></li><li class="half_rhythm"><div>Non-comparative cost analyses including cost-of-illness studies will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Year of analysis:</i>
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<ul><li class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li class="half_rhythm"><div>Studies published in 2003 or later but that depend on unit costs and resource data entirely or predominantly from before 2003 will be rated as ‘Not applicable’.</div></li><li class="half_rhythm"><div>Studies published before 2003 will be excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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<i>Quality and relevance of effectiveness data used in the health economic analysis:</i>
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<ul><li class="half_rhythm"><div>The more closely the clinical effectiveness data used in the health economic analysis match with the outcomes of the studies included in the clinical review the more useful the analysis will be for decision-making in the guideline. For example, economic evaluations based on observational studies will be excluded, when the clinical review is only looking for RCTs,</div></li></ul></p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab1"><div id="niceng180er5.appb.tab1" class="table"><h3><span class="label">Table 14</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Database</th><th id="hd_h_niceng180er5.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Dates searched</th><th id="hd_h_niceng180er5.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 – 30 May 2019</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusions</td></tr><tr><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 – 30 May 2019</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusions</td></tr><tr><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library (Wiley)</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cochrane Reviews to 2019 Issue 5 of 12</p>
|
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<p>CENTRAL to 2019 Issue 5 of 12</p>
|
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<p>DARE, and NHSEED to 2015 Issue 2 of 4</p>
|
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<p>HTA to 2016 Issue 4 of 4</p>
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</td><td headers="hd_h_niceng180er5.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab2"><div id="niceng180er5.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Preoperative Care/ or Preoperative Period/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre-operat* or preoperat* or pre-surg* or presurg*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((before or prior or advance or pre or prepar*) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 4 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/ or exp infant/) not (exp adolescent/ or exp adult/ or exp middle age/ or exp aged/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5 not 6</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/8–15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/18–24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 not 25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Anemia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anemi* or anaemi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 or 28</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26 and 29</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab3"><div id="niceng180er5.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*preoperative care/ or *preoperative period/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre-operat* or preoperat* or pre-surg* or presurg*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((before or prior or advance or pre or prepar*) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–3</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 4 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/ or exp infant/) not (exp adolescent/ or exp adult/ or exp middle age/ or exp aged/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5 not 6</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/8–12</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 not 14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/15–22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 not 23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Anemia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anemi* or anaemi*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 or 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 and 27</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab4"><div id="niceng180er5.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Preoperative Care] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Preoperative Period] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Perioperative Nursing] this term only</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre-operat* or preoperati*or pre-surg* or presurg*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before or prior or advance or pre or prepar*) near/3 (surg* or operat* or anaesthes* or anesthes*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1–#5)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anemia] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anemi* or anaemi*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7 or #8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6 and #9</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab5"><div id="niceng180er5.appb.tab5" class="table"><h3><span class="label">Table 15</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Database</th><th id="hd_h_niceng180er5.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Dates searched</th><th id="hd_h_niceng180er5.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 30 May 2019</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 30 May 2019</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
</td></tr><tr><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and Dissemination (CRD)</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HTA - Inception – 02 May 2019</p>
|
|
<p>NHSEED - Inception to 02 May 2019</p>
|
|
</td><td headers="hd_h_niceng180er5.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab6"><div id="niceng180er5.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Preoperative Care/ or exp Perioperative Care/ or exp Perioperative Period/ or exp Perioperative Nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((pre-operative* or preoperative* or preop* or pre-op* or pre-surg* or presurg*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((perioperative* or peri-operative* or intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((postoperative* or postop* or post-op* or post-surg* or postsurg*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((care* or caring or treat* or nurs* or recover* or monitor*) adj3 (before or prior or advance or during or after) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 or 2 or 3 or 4 or 5</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat* or perioperat* or peri-operat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((during or duration) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 or 8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">postoperative care/ or exp Postoperative Period/ or exp Perioperative nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(postop* or post-op* or post-surg* or postsurg* or perioperat* or peri-operat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(after adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(post adj3 (operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 or 11 or 12 or 13</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Preoperative Care/ or Preoperative Period/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre-operat* or preoperat* or pre-surg* or presurg*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((before or prior or advance or pre or prepar*) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 or 16 or 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 or 9 or 14 or 18</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/20–27</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 not 29</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/30–36</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19 not 37</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 38 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/ or exp infant/) not (exp adolescent/ or exp adult/ or exp middle age/ or exp aged/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 not 40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “costs and cost analysis”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">economics, pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Fees and Charges”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effectiv* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/42–57</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41 and 58</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab7"><div id="niceng180er5.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*preoperative period/ or *intraoperative period/ or *postoperative period/ or *perioperative nursing/ or *surgical patient/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((pre-operative* or preoperative* or preop* or pre-op* or pre-surg* or presurg*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((perioperative* or peri-operative* or intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((care* or caring or treat* or nurs* or recover* or monitor*) adj3 (before or prior or advance or during or after) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 or 2 or 3 or 4</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">peroperative care/ or exp peroperative care/ or exp perioperative nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat* or perioperat* or peri-operat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((during or duration) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 or 7 or 8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">postoperative care/ or exp postoperative period/ or perioperative nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(postop* or post-op* or post-surg* or postsurg* or perioperat* or peri-operat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(after adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(post adj3 (operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 or 11 or 12 or 13</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp preoperative care/ or preoperative period/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pre-operat* or preoperat* or pre-surg* or presurg*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((before or prior or advance or pre or prepar*) adj3 (surg* or operat* or anaesthes* or anesthes*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 or 16 or 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5 or 9 or 14 or 18</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/20–24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 not 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/27–34</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19 not 35</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 36 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(exp child/ or exp pediatrics/) not (exp adult/ or exp adolescent/)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37 not 38</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp health care cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effectiv* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/40–52</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 and 53</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appbtab8"><div id="niceng180er5.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Preoperative Care EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Perioperative Care EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Perioperative Period EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Perioperative Nursing EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((perioperative* or peri-operative* or intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((care* or caring or treat* or nurs* or recover* or monitor*) adj3 (before or prior or advance or during or after) adj3 (surg* or operat* or anaesthes* or anesthes*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((pre-operative* or preoperative* or preop* or pre-op* or pre-surg* or presurg*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((postoperative* or postop* or post-op* or post-surg* or postsurg*) adj3 (care* or caring or treat* or nurs* or monitor* or recover* or medicine)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(* IN HTA)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(* IN NHSEED)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 AND #10</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 AND #11</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Intraoperative Care EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 OR #2 OR #3 OR #4 OR #14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((intraoperative* or intra-operative* or intrasurg* or intra-surg* or peroperat* or per-operat* or perioperat* or peri-operat*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((during or duration) adj3 (surg* or operat* or anaesthes* or anesthes*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((postop* or post-op* or post-surg* or postsurg* or perioperat* or peri-operat*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((after adj3 (surg* or operat* or anaesthes* or anesthes*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((post adj3 (operat* or anaesthes* or anesthes*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((pre-operat* or preoperat* or pre-surg* or presurg*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((before or prior or advance or pre or prepar*) adj3 (surg* or operat* or anaesthes* or anesthes*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10 AND #23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11 AND #23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12 OR #13 OR #24 OR #25</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobniceng180er5appcfig1"><div id="niceng180er5.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20preoperative%20management%20of%20anaemia%20(oral%20iron).&p=BOOKS&id=561977_niceng180er5appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of preoperative management of anaemia (oral iron)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of preoperative management of anaemia (oral iron)</span></h3></div></article><article data-type="fig" id="figobniceng180er5appcfig2"><div id="niceng180er5.appc.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20preoperative%20management%20of%20anaemia%20(IV%20iron%20versus%20oral%20iron).&p=BOOKS&id=561977_niceng180er5appcf2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appcf2.jpg" alt="Figure 2. Flow chart of clinical study selection for the review of preoperative management of anaemia (IV iron versus oral iron)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Flow chart of clinical study selection for the review of preoperative management of anaemia (IV iron versus oral iron)</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig1"><div id="niceng180er5.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Quality%20of%20life%20(SF-36%3A%20Physical%20component%20summary)%2C%20at%20surgery.&p=BOOKS&id=561977_niceng180er5appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef1.jpg" alt="Figure 3. Quality of life (SF-36: Physical component summary), at surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Quality of life (SF-36: Physical component summary), at surgery</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig2"><div id="niceng180er5.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20Quality%20of%20life%20(SF-36%3A%20Mental%20component%20summary)%2C%20at%20surgery.&p=BOOKS&id=561977_niceng180er5appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef2.jpg" alt="Figure 4. Quality of life (SF-36: Mental component summary), at surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Quality of life (SF-36: Mental component summary), at surgery</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig3"><div id="niceng180er5.appe.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20Quality%20of%20life%20(SF-36%3A%20Physical%20component%20summary)%2C%20at%202%020133%20months%20post-op.&p=BOOKS&id=561977_niceng180er5appef3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef3.jpg" alt="Figure 5. Quality of life (SF-36: Physical component summary), at 2–3 months post-op." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Quality of life (SF-36: Physical component summary), at 2–3 months post-op</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig4"><div id="niceng180er5.appe.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Quality%20of%20life%20(SF-36%3A%20Mental%20component%20summary)%2C%20at%202%020133%20months%20post-op.&p=BOOKS&id=561977_niceng180er5appef4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef4.jpg" alt="Figure 6. Quality of life (SF-36: Mental component summary), at 2–3 months post-op." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Quality of life (SF-36: Mental component summary), at 2–3 months post-op</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig5"><div id="niceng180er5.appe.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Change%20in%20Hb%20levels%20from%20preoperative%20to%20postoperative.&p=BOOKS&id=561977_niceng180er5appef5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef5.jpg" alt="Figure 7. Change in Hb levels from preoperative to postoperative." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Change in Hb levels from preoperative to postoperative</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig6"><div id="niceng180er5.appe.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%208.%20Preoperative%20Hb%20levels.&p=BOOKS&id=561977_niceng180er5appef6.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef6.jpg" alt="Figure 8. Preoperative Hb levels." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 8</span><span class="title">Preoperative Hb levels</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig7"><div id="niceng180er5.appe.fig7" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%209.%20Patients%20transfused.&p=BOOKS&id=561977_niceng180er5appef7.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef7.jpg" alt="Figure 9. Patients transfused." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 9</span><span class="title">Patients transfused</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig8"><div id="niceng180er5.appe.fig8" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2010.%20Preoperative%20blood%20transfusion.&p=BOOKS&id=561977_niceng180er5appef8.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef8.jpg" alt="Figure 10. Preoperative blood transfusion." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 10</span><span class="title">Preoperative blood transfusion</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig9"><div id="niceng180er5.appe.fig9" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2011.%20Blood%20transfusion%20on%20the%20day%20of%20surgery.&p=BOOKS&id=561977_niceng180er5appef9.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef9.jpg" alt="Figure 11. Blood transfusion on the day of surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 11</span><span class="title">Blood transfusion on the day of surgery</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig10"><div id="niceng180er5.appe.fig10" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2012.%20Postoperative%20blood%20transfusion.&p=BOOKS&id=561977_niceng180er5appef10.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef10.jpg" alt="Figure 12. Postoperative blood transfusion." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 12</span><span class="title">Postoperative blood transfusion</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig11"><div id="niceng180er5.appe.fig11" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2013.%20Perioperative%20blood%20transfusion%20volume.&p=BOOKS&id=561977_niceng180er5appef11.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef11.jpg" alt="Figure 13. Perioperative blood transfusion volume." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 13</span><span class="title">Perioperative blood transfusion volume</span></h3></div></article><article data-type="fig" id="figobniceng180er5appefig12"><div id="niceng180er5.appe.fig12" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2014.%20Complications.&p=BOOKS&id=561977_niceng180er5appef12.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appef12.jpg" alt="Figure 14. Complications." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 14</span><span class="title">Complications</span></h3></div></article><article data-type="table-wrap" id="figobniceng180er5appftab1"><div id="niceng180er5.appf.tab1" class="table"><h3><span class="label">Table 16</span><span class="title">Clinical evidence profile: IV iron compared to oral iron for preoperative management of anaemia</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng180er5.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:middle;">Quality assessment</th><th id="hd_h_niceng180er5.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:middle;">No of patients</th><th id="hd_h_niceng180er5.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:middle;">Effect</th><th id="hd_h_niceng180er5.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng180er5.appf.tab1_1_1_1_4" style="text-align:left;vertical-align:middle;">Quality</th><th id="hd_h_niceng180er5.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_niceng180er5.appf.tab1_1_1_1_5" style="text-align:left;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">No of studies</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Design</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Risk of bias</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Inconsistency</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Indirectness</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Imprecision</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1" id="hd_h_niceng180er5.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Other considerations</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_2" id="hd_h_niceng180er5.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">IV iron</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_2" id="hd_h_niceng180er5.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Oral iron</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_3" id="hd_h_niceng180er5.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_3" id="hd_h_niceng180er5.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Quality of life (SF-36: Physical component summary), at surgery (follow-up day of surgery; range of scores: 0–100; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 0 higher (3.84 lower to 3.84 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Quality of life (SF-36: Mental component summary), at surgery (follow-up day of discharge; range of scores: 0–100; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 3 higher (0.64 lower to 6.64 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Quality of life (SF-36: Physical component summary), at 2–3 months post-op (follow-up 2–3 months; range of scores: 0–100; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 4 higher (0.31 to 7.69 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Quality of life (SF-36: Mental component summary), at 2–3 months post-op (follow-up 2–3 months; range of scores: 0–100; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 6 higher (2.69 to 9.31 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Change in Hb levels from preoperative to postoperative (follow-up mean 3 weeks; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 2.2 higher (1.46 to 2.94 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⊝⊝⊝◯</p>
|
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<p>MODERATE</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Pretoperative Hb levels (follow-up post-operatively; Better indicated by higher values)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 1.80 higher (4.67 lower to 8.27 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⊝◯◯◯</p>
|
|
<p>VERY LOW</p>
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|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_13_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Patients transfused (follow-up postoperatively)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>16/20</p>
|
|
<p>(80%)</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60%</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.33 (0.88 to 2.02)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">198 more per 1000 (from 72 fewer to 612 more)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊝⊝◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_15_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Pre-operative blood transfusion (follow-up median 3 weeks)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>0/50</p>
|
|
<p>(0%)</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.1%</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 0.15 (0.01 to 2.36)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80 fewer per 1000 (from 90 fewer to 100 more)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊝⊝⊝◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_15_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_17_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Blood transfusion on the day of surgery (follow-up median 3 weeks)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>6/50</p>
|
|
<p>(12%)</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.9%</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.1 (0.38 to 3.15)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 more per 1000 (from 68 fewer to 234 more)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊝⊝◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_17_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_19_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Post-operative blood transfusion (follow-up median 3 weeks)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>4/50</p>
|
|
<p>(8%)</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.9%</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.73 (0.22 to 2.45)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 fewer per 1000 (from 85 fewer to 158 more)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊝⊝◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_19_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_21_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Perioperative blood transfusion volume (follow-up median 3 weeks)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD 0.07 higher (0.58 lower to 0.71 higher)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊝⊝◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_h_niceng180er5.appf.tab1_1_1_1_5" id="hd_b_niceng180er5.appf.tab1_1_1_23_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Complications (follow-up mean 3 weeks)</th></tr><tr><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_1 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_2 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_3 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_4 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_5 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_6 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_1 hd_h_niceng180er5.appf.tab1_1_1_2_7 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_8 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>18/50</p>
|
|
<p>(36%)</p>
|
|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_2 hd_h_niceng180er5.appf.tab1_1_1_2_9 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.3%</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_10 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.93 (0.65 to 1.32)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_3 hd_h_niceng180er5.appf.tab1_1_1_2_11 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 fewer per 1000 (from 145 fewer to 132 more)</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_4 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⊝◯◯◯</p>
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<p>VERY LOW</p>
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|
</td><td headers="hd_h_niceng180er5.appf.tab1_1_1_1_5 hd_b_niceng180er5.appf.tab1_1_1_23_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng180er5.appf.tab1_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng180er5.appf.tab1_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs.</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobniceng180er5appgfig1"><div id="niceng180er5.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2015.%20Flow%20chart%20of%20health%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=561977_niceng180er5appgf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK561977/bin/niceng180er5appgf1.jpg" alt="Figure 15. Flow chart of health economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 15</span><span class="title">Flow chart of health economic study selection for the guideline</span></h3><div class="caption"><p>* Non-relevant population, intervention, comparison, design or setting; non-English language</p></div></div></article><article data-type="table-wrap" id="figobniceng180er5appitab1"><div id="niceng180er5.appi.tab1" class="table"><h3><span class="label">Table 17</span><span class="title">Studies excluded from the clinical review (oral iron)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Reference</th><th id="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Abraham 2017<a class="bibr" href="#niceng180er5.ref1" rid="niceng180er5.ref1"><sup>1</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Alexander 2017<a class="bibr" href="#niceng180er5.ref2" rid="niceng180er5.ref2"><sup>2</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Systematic review not relevant to review PICO</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Armas-Loughran 2003<a class="bibr" href="#niceng180er5.ref4" rid="niceng180er5.ref4"><sup>4</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Ashby 1967<a class="bibr" href="#niceng180er5.ref5" rid="niceng180er5.ref5"><sup>5</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Baele 2002<a class="bibr" href="#niceng180er5.ref6" rid="niceng180er5.ref6"><sup>6</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Bisbe 2012<a class="bibr" href="#niceng180er5.ref7" rid="niceng180er5.ref7"><sup>7</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Borstlap 2015<a class="bibr" href="#niceng180er5.ref9" rid="niceng180er5.ref9"><sup>9</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Systematic review not relevant to review PICO</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Clevenger 2015<a class="bibr" href="#niceng180er5.ref12" rid="niceng180er5.ref12"><sup>12</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Fischer 2015<a class="bibr" href="#niceng180er5.ref17" rid="niceng180er5.ref17"><sup>17</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Grant-Casey 2010<a class="bibr" href="#niceng180er5.ref23" rid="niceng180er5.ref23"><sup>23</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Guinn 2016<a class="bibr" href="#niceng180er5.ref24" rid="niceng180er5.ref24"><sup>24</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Hare 2011<a class="bibr" href="#niceng180er5.ref25" rid="niceng180er5.ref25"><sup>25</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Jans 2018<a class="bibr" href="#niceng180er5.ref26" rid="niceng180er5.ref26"><sup>26</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate population</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Kansagra 2016<a class="bibr" href="#niceng180er5.ref28" rid="niceng180er5.ref28"><sup>28</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Kotze 2012<a class="bibr" href="#niceng180er5.ref33" rid="niceng180er5.ref33"><sup>33</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Kumar 2008<a class="bibr" href="#niceng180er5.ref34" rid="niceng180er5.ref34"><sup>34</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Layton 2013<a class="bibr" href="#niceng180er5.ref35" rid="niceng180er5.ref35"><sup>35</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Lidder 2007<a class="bibr" href="#niceng180er5.ref37" rid="niceng180er5.ref37"><sup>37</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Lilaramani 1974<a class="bibr" href="#niceng180er5.ref38" rid="niceng180er5.ref38"><sup>38</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Munoz 2012<a class="bibr" href="#niceng180er5.ref40" rid="niceng180er5.ref40"><sup>40</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design; interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Munoz 2014<a class="bibr" href="#niceng180er5.ref39" rid="niceng180er5.ref39"><sup>39</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Systematic review not relevant to review PICO</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Najafi 2015<a class="bibr" href="#niceng180er5.ref41" rid="niceng180er5.ref41"><sup>41</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design; interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Napolitano 2005<a class="bibr" href="#niceng180er5.ref42" rid="niceng180er5.ref42"><sup>42</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Ng 2015<a class="bibr" href="#niceng180er5.ref45" rid="niceng180er5.ref45"><sup>45</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Systematic review not relevant to review PICO</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Okuyama 2005<a class="bibr" href="#niceng180er5.ref47" rid="niceng180er5.ref47"><sup>47</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Petis 2017<a class="bibr" href="#niceng180er5.ref50" rid="niceng180er5.ref50"><sup>50</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Quinn 2010<a class="bibr" href="#niceng180er5.ref52" rid="niceng180er5.ref52"><sup>52</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Rineau 2017<a class="bibr" href="#niceng180er5.ref54" rid="niceng180er5.ref54"><sup>54</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Sheth 2002<a class="bibr" href="#niceng180er5.ref56" rid="niceng180er5.ref56"><sup>56</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Stoffel 2017<a class="bibr" href="#niceng180er5.ref57" rid="niceng180er5.ref57"><sup>57</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate review population</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Stoneham 2007<a class="bibr" href="#niceng180er5.ref59" rid="niceng180er5.ref59"><sup>59</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Taylor 2013<a class="bibr" href="#niceng180er5.ref61" rid="niceng180er5.ref61"><sup>61</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study design</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Tseliou 2002<a class="bibr" href="#niceng180er5.ref62" rid="niceng180er5.ref62"><sup>62</sup></a></td><td headers="hd_h_niceng180er5.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Excluded due to inappropriate study comparison</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appitab2"><div id="niceng180er5.appi.tab2" class="table"><h3><span class="label">Table 18</span><span class="title">Studies excluded from the clinical review (IV iron)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appi.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appi.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Study</th><th id="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alexander 2017<a class="bibr" href="#niceng180er5.ref2" rid="niceng180er5.ref2"><sup>2</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Andrews 1997<a class="bibr" href="#niceng180er5.ref3" rid="niceng180er5.ref3"><sup>3</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design. Incorrect interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bisbe 2014<a class="bibr" href="#niceng180er5.ref8" rid="niceng180er5.ref8"><sup>8</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Borstlap 2015<a class="bibr" href="#niceng180er5.ref10" rid="niceng180er5.ref10"><sup>10</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design - review protocol</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Borstlap 2015<a class="bibr" href="#niceng180er5.ref11" rid="niceng180er5.ref11"><sup>11</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design - abstract</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Derzon 2019<a class="bibr" href="#niceng180er5.ref15" rid="niceng180er5.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: references screened</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Edwards 2009<a class="bibr" href="#niceng180er5.ref16" rid="niceng180er5.ref16"><sup>16</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Froessler 2012<a class="bibr" href="#niceng180er5.ref20" rid="niceng180er5.ref20"><sup>20</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design - review protocol</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Froessler 2013<a class="bibr" href="#niceng180er5.ref19" rid="niceng180er5.ref19"><sup>19</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO. Relevant study already included in review</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Froessler 2016<a class="bibr" href="#niceng180er5.ref18" rid="niceng180er5.ref18"><sup>18</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Garrido 2010<a class="bibr" href="#niceng180er5.ref22" rid="niceng180er5.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Garrido-Martin 2012<a class="bibr" href="#niceng180er5.ref21" rid="niceng180er5.ref21"><sup>21</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Khalafallah 2015<a class="bibr" href="#niceng180er5.ref31" rid="niceng180er5.ref31"><sup>31</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">study design - structured abstract</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee 2018<a class="bibr" href="#niceng180er5.ref36" rid="niceng180er5.ref36"><sup>36</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design - review protocol</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ng 2015<a class="bibr" href="#niceng180er5.ref45" rid="niceng180er5.ref45"><sup>45</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevant study already included in review</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peters 2018<a class="bibr" href="#niceng180er5.ref49" rid="niceng180er5.ref49"><sup>49</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO. Relevant study already included in review</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quinn 2017<a class="bibr" href="#niceng180er5.ref51" rid="niceng180er5.ref51"><sup>51</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design. Inappropriate comparison</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Richards 2015<a class="bibr" href="#niceng180er5.ref53" rid="niceng180er5.ref53"><sup>53</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design - review protocol</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Schack 2019<a class="bibr" href="#niceng180er5.ref55" rid="niceng180er5.ref55"><sup>55</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: references screened</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tang 2019<a class="bibr" href="#niceng180er5.ref60" rid="niceng180er5.ref60"><sup>60</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: references screened</td></tr><tr><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wilson 2018<a class="bibr" href="#niceng180er5.ref63" rid="niceng180er5.ref63"><sup>63</sup></a></td><td headers="hd_h_niceng180er5.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions. Incorrect study design</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appitab3"><div id="niceng180er5.appi.tab3" class="table"><h3><span class="label">Table 19</span><span class="title">Studies excluded from the health economic review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appi.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appi.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng180er5.appi.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Reference</th><th id="hd_h_niceng180er5.appi.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng180er5.appi.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">None.</td><td headers="hd_h_niceng180er5.appi.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng180er5appjtab1"><div id="niceng180er5.appj.tab1" class="table"><h3><span class="title">Criteria for selecting high-priority research recommendations</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK561977/table/niceng180er5.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng180er5.appj.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PICO question</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Population: Adults 18 years and over having surgery who have been identified during preoperative assessment as having iron deficiency anaemia (haemoglobin <130 g/L (13 g/dL) in men older than age 15 years, <120 g/L (12 g/dL) in non-pregnant women older than age 15 years, and <110 g/L (11 g/dL) in pregnant women undergoing surgery).</p>
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<p>Intervention(s): Preoperative alternate day oral iron therapy and daily oral iron therapy</p>
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<p>Comparison: Compared to each other, compared to different durations of therapy before surgery</p>
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<p>Outcome(s): All-cause mortality, health-related quality of life, preoperative Hb level, transfusion (pre-, intra- and post-surgery), postoperative morbidity score (POMS), change in healthcare management (for example, delayed surgery or surgery cancellation), length of hospital stay, unplanned ICU admission, ICU length of stay (planned and unplanned), adherence and adverse events from iron tablets (e.g. constipation, nausea)</p>
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</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance to patients or the population</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research in this field would help to define the most acceptable, clinically effective and cost effective treatment option for patients allowing them to make an informed choice on the best treatment option</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to NICE guidance</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There is current uncertainty concerning the optimal preoperative intervention for iron deficiency anaemia</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to the NHS</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research in this area will inform NICE recommendations for service delivery (for example the need for rapid access anaemia clinics) and provide information about clinical and cost-effectiveness.</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">National priorities</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None identified</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No studies were identified comparing daily oral iron therapy with alternate oral iron therapy. There were three RCTs comparing IV iron with oral iron however there is uncertainty which reduces the probability of adverse post- operative outcomes</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT ideally, if not then a large non-randomised cohort study with adequate adjustment for key confounders including age, ethnicity, co-morbidities and some measure of baseline health (e.g. quality of life)</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Feasibility</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">With the expansion of rapid access anaemia clinics administering intravenous iron it may be difficult for clinicians to accept equipoise and recruit patients to such a study</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other comments</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr><tr><th id="hd_b_niceng180er5.appj.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance</th><td headers="hd_b_niceng180er5.appj.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>High: the research is essential to inform future updates of key recommendations in the guideline.</div></li></ul></td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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