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Health economic burden that wounds impose on the National Health Service in the UK
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  • Published on:
    Health economic burden that wounds impose on the National Health Service in the UK: request for further methodological information.
    • Jo C Dumville, Senior Lecturer in Applied Health Research University of Manchester
    • Other Contributors:
      • Sarah Rhodes, Statistician
      • Ross Atkinson, Research Fellow
      • Nicky Cullum, Head of Division of Nursing, Midwifery and Social Work
      • Gill Norman, Research Fellow
      • Maggie Westby, Research Fellow
      • Louise Hussey, Research Fellow
      • Emily Petherick, Lecturer in Epidemiology and Biostatistics
      • Naseer Ahmad, Consultant Vascular Surgeon

    Guest et al use routinely collected primary care data to estimate an annual prevalence of wounds in the UK of 4.5%.(1) They then report annual prevalence estimates for different wound sub-types, including venous leg ulcers. We have become aware of differences in the venous ulcer prevalence estimates of Guest et al (1) and our own estimates from THIN (2) and from surveys in Leeds (3) and Greater Manchester (data on file). We have calculated an annual UK prevalence of venous leg ulcers of 1.3 per 1000 (or 0.13%) compared with Guest’s estimate of 5.6 per 1000 (or 0.56%).

    Briefly our annual estimate was calculated by combining our 2011 point prevalence values (row B and C from Table 1: rounded to 0.3 per 1000. Please note since response format does not allow tables we have converted to text) with the 2006 UK annual incidence rate of venous leg ulcers estimate (row D Table 1), assuming that the annual incidence has not changed since 2006. Our value is very similar to the crude estimate of annual UK venous leg ulcer prevalence of 1.4 per 1000 people directly calculated by Petherick et al (2) using THIN and G(C)PRD (Row E: Table 1).

    We note that the annual prevalence estimate for venous leg ulcers of Guest et al (row A: Table 1) is four times higher than the others presented here. We also note that this is the most conservative estimate of the UK annual prevalence from Guest’s data given the large number of unspecified leg ulcers reported in this paper– a large...

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    Conflict of Interest:
    None declared.
  • Published on:
    Questions about Comorbidities

    There was never any intention to match the wound patients with their matched controls on the basis of their comorbidities, since differences in comorbidities between the groups is an outcome we wanted to measure. The patients' records did not describe the severity of their comorbidities in all cases. Furthermore, it would have been difficult to disentangle resource use for the comorbidities from that associated with wound...

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    Conflict of Interest:
    None declared.
  • Published on:
    Questions about Comorbidities

    Guest et al are to be congratulated on a well-conducted study providing further insight into the economic burden of chronic wounds in the UK.

    I assume that random sampling was chosen because of the considerable work required just to assess the economic resources used in the 1,000 patients sampled in each group. The authors then chose to employ sensitivity analysis in regard to the number of comorbidities rather...

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    Conflict of Interest:
    None declared.