Strengths and limitations
Given that the data came from a range of regions in the UK1, the results of this economic evaluation are generalisable across the NHS. Considerable differences exist in infrastructure and resource availability between high and low-income countries and so further research is required before these results can be generalised internationally.
The main limitation of this economic evaluation was the need to make assumptions regarding the patient journey to construct the decision tree model. In this process some branches may have been omitted, notably that of patients with no pain but relevant perineum related complications.