In the absence of evidence from randomized controlled trials on the relative effectiveness of treatments, cost‐effectiveness analyses increasingly use observational data instead. Treatment assignment is not, however, randomized, and naive estimates of the treatment effect may be biased. To deal with this bias, one may need to adjust for observed and unobserved confounders. In this work we explore and discuss the challenges of these adjustment strategies within a case‐study of negative pressure wound therapy (NPWT) for the treatment of surgical wounds healing by secondary intention. We could not demonstrate that existing uncontrolled confounding affects NPWT effectiveness, and thus there was no evidence that NPWT was cost effective compared with standard dressings for the treatment of surgical wounds healing by secondary intention.

中文翻译：

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贝叶斯计量经济学的观测数据建模，用于成本效益分析：建立负压伤口疗法在开放性手术伤口愈合中的价值

在缺乏随机对照试验有关治疗相对有效性的证据的情况下，成本效益分析越来越多地使用观察数据。但是，治疗分配不是随机的，对治疗效果的幼稚估计可能会有偏差。为了解决这一偏见，可能需要针对观察到的和未观察到的混杂因素进行调整。在这项工作中，我们在负压伤口治疗（NPWT）的案例研究中探讨和讨论了这些调整策略的挑战，该研究用于治疗继发性目的的手术伤口愈合。我们无法证明现有的不受控制的混杂会影响NPWT的有效性，因此没有证据表明与标准敷料相比，NPWT在通过次要目的治疗外科伤口愈合方面具有成本效益。