Lack of cost analysis

Although this study highlights improvements in speed of treatment delivery, the suggested benefits of cost-reduction had no costing data at all. There were no comments on additional costs, such as time to review referral letters, send out Boston questionnaires and book them into the one-stop clinic. I assume that the clinical assessment of the patients taking approximately 1 h would mean that the allocated operating theatre would be empty and unused for this time, hence under-using theatre time resources. The nursing and clinic costs for monitoring the patients pre- and postopera-tively may be less than a day-surgery bed but no costs are given. A presumption is made that the surgeon routinely arranges wound care follow-up with the general practitioner but, again, this is not clear. It is obviously beneficial to have treatment as soon as practicable but I think proper cost-analysis would have added weight to this study.