a) The clinical study was a case-series and this might weaken clinical conclusions.
b) Power calculations for the sample size and analysis of the statistical significance of the effectiveness result provided were not undertaken.
c) There is inaccuracy in reporting the sample size after loss to follow up (numbers do not add up). Moreover analysis of treatment completers may bias results.
d) Costs were not exhaustive.
e) Reducing length of stay in the UK only saved variable costs unless beds are filled by other patients. This was an issue of best alternative use (the opportunity costs) of freed resources which has not been addressed.