Limitations
PAD
The first limitation to be mentioned is that this was not a blinded study, as the intervention using the intermittent pneumatic compression device could not be simulated in placebo form for the control group. Thus, a bias because of any influence by the treating physicians cannot be ruled out completely. What was also not taken into account was the time and resources needed to ensure adequate treatment adherence, i.e. instruction of device usage, answering questions that arose or removing and reapplying the pad if dislocated. However, compared to the actual costs incurred and estimated, this would only be a small amount, assuming a time of 20–30 min per patient.The main limitation is of course that the transfer of the potential savings from a controlled study population upon everyday treatment is only an extrapolation. If the possible savings reach the estimated number needs to be proved in further studies. However, that there is an actual possible economic benefit had been shown by the data of the RCT that had been conducted before this analysis was even planned. So there’s only a limited chance that an observer bias for example could have influenced the data in this regard. Especially figures like OR time and number of revision surgeries as objective parameters should not be susceptible to being influenced by this.