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Chase Hollman, Mike Paulden, Petros Pechlivanoglou, Christopher McCabe
The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison of four software programs: TreeAge Pro, Microsoft Excel, R and MATLAB. Our focus is on software commonly used for building Markov models and decision trees to conduct cohort simulations, given their predominance in the published literature around cost-effectiveness modelling...
May 9, 2017: PharmacoEconomics
Carlos King Ho Wong, Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Cindy Lo Kuen Lam, Kenneth Man Chee Cheung
PURPOSE: To compare the yearly cost involved per patient in the use of magnetically controlled growing rod (MCGR) and traditional growing rods (TGRs) in the treatment of early onset scoliosis (EOS) and to assess the overall cost burden of MCGR with reference to patient and health-care infrastructure. METHODS: For a hypothetical case of a 5-year-old girl with a diagnosis of EOS, a decision-tree model using TreeAge Software was developed to simulate annual health state transitions and compare the 8-year accumulative direct, indirect, and total cost among the four groups: (1) dual MCGRs with exchange every 2 years, (2) dual MCGRs with exchange every 3 years, (3) TGR with surgical distraction every year, and (4) TGR with surgical distraction every 6 months...
May 2017: Journal of Orthopaedic Surgery
Denny John, Rajul Parikh
OBJECTIVES: Population-based screening for glaucoma has been demonstrated to be cost-effective if targeted at high-risk groups such as older adults and those with a family history of glaucoma, and through use of a technician for conducting initial assessment rather than a medical specialist. This study attempts to investigate the cost-effectiveness of a hypothetical community screening and subsequent treatment programme for glaucoma in comparison with current practice (i.e. with no screening programme but with some opportunistic case finding) in the urban areas of India...
July 2017: Public Health
Sameer Kumar, Nidhi Ghildayal, Neha Ghildayal
Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective...
March 13, 2017: International Journal of Health Care Quality Assurance
Stephan Seklehner, Karl-Dietrich Sievert, Richard Lee, Paul F Engelhardt, Claus Riedl, Thomas Kunit
OBJECTIVE: To evaluate the outcome and the costs of stenting in uncomplicated semirigid ureteroscopic stone removal. MATERIALS AND METHODS: A decision tree model was created to evaluate the economic impact of routine stenting versus non-stenting strategies in uncomplicated ureteroscopy (URS). Probabilities of complications were extracted from twelve randomized controlled trials. Stone removal costs, costs for complication management, and total costs were calculated using Treeage Pro (TreeAge Pro Healthcare version 2015, Software, Inc, Williamstown Massachusetts, USA)...
February 14, 2017: International Urology and Nephrology
Grant J Dornan, J Christoph Katthagen, Dimitri S Tahal, Maximilian Petri, Joshua A Greenspoon, Patrick J Denard, Stephen S Burkhart, Peter J Millett
PURPOSE: To determine the most cost-effective treatment strategy for patients with massive rotator cuff tears and pseudoparalysis of the shoulder without osteoarthritis of the glenohumeral joint (PP without OA). Specifically, we aimed to compare arthroscopic rotator cuff repair (ARCR) versus reverse total shoulder arthroplasty (RTSA) and investigate the effect of patient age on this decision. METHODS: A Markov decision model was used to compare 3 treatment strategies for addressing PP without OA: (1) ARCR with option to arthroscopically revise once, (2) ARCR with immediate conversion to RTSA on potential failure, and (3) primary RTSA...
December 6, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Karoline Freeman, Martin Connock, Peter Auguste, Sian Taylor-Phillips, Hema Mistry, Deepson Shyangdan, Rachel Court, Ramesh Arasaradnam, Paul Sutcliffe, Aileen Clarke
BACKGROUND AND OBJECTIVES: Systematic reviews and economic modelling of clinical effectiveness and cost-effectiveness of therapeutic monitoring of tumour necrosis factor alpha (TNF-α) inhibitors [using LISA-TRACKER(®) enzyme-linked immunosorbent assay (ELISA) kits (Theradiag, Marne La Vallee, France, or Alpha Laboratories, Heriot, UK), TNF-α-Blocker ELISA kits (Immundiagnostik AG, Bensheim, Germany) and Promonitor(®) ELISA kits (Proteomika, Progenika Biopharma, Bizkaia, Spain)] versus standard care for Crohn's disease (CD)...
November 2016: Health Technology Assessment: HTA
Matthew Moore, Glenn R Barnhart, Walter Randolph Chitwood, John A Rizzo, Candace Gunnarsson, Swetha R Palli, Eugene A Grossi
OBJECTIVE: The recent development of the EDWARDS INTUITY Elite™ (EIE) valve system enables the rapid deployment of a prosthetic surgical heart valve in an aortic valve replacement (AVR) procedure via both the minimally invasive (MISAVR) and conventional (CAVR) approaches. In order to understand its economic value, this study performed a cost evaluation of the EIE valve system used in a MIS rapid-deployment approach (MIS-RDAVR) vs MISAVR and CAVR, respectively, compared to standard prosthetic aortic valves...
October 2016: Journal of Medical Economics
Marilyn Moro, Balaji Goparaju, Jelina Castillo, Yvonne Alameddine, Matt T Bianchi
INTRODUCTION: Periodic limb movements of sleep (PLMS) may increase cardiovascular and cerebrovascular morbidity. However, most people with PLMS are either asymptomatic or have nonspecific symptoms. Therefore, predicting elevated PLMS in the absence of restless legs syndrome remains an important clinical challenge. METHODS: We undertook a retrospective analysis of demographic data, subjective symptoms, and objective polysomnography (PSG) findings in a clinical cohort with or without obstructive sleep apnea (OSA) from our laboratory (n=443 with OSA, n=209 without OSA)...
2016: Nature and Science of Sleep
Lara Senekjian, Raminder Nirula, Brandon Bellows, Richard Nelson
BACKGROUND: Patients with phlegmonous appendicitis can be managed nonoperatively, yet debate continues about the need for interval appendectomy (IA), given the low risk of recurrence or neoplasm. We sought to determine for which patient age interval appendectomy is cost-effective. METHODS: Using TreeAge software, a cost-effectiveness model was developed. Two strategies were compared, IA and no interval appendectomy (NIA). Interval appendectomy patients were modeled with probability of benign pathology, cancer or inflammatory bowel disease, and possible operative complications...
October 2016: Journal of the American College of Surgeons
Mauro Batista de Morais, José Vicente Spolidoro, Mário César Vieira, Ary Lopes Cardoso, Otavio Clark, Alvaro Nishikawa, Ana Paula Moschione Castro
AIMS: To estimate the cost-effectiveness of a new strategy that uses an amino acid formula in the elimination diet of infants with suspected cow's milk allergy (CMA). MATERIALS AND METHODS: This pharmacoeconomic study was developed from the perspective of the Brazilian Public Healthcare System. The new strategy proposes using an amino acid formula in the diagnostic elimination diet of infants (≤24 months) with suspected CMA. The rationale is that infants who do not respond to the amino acid formula do not suffer from CMA...
December 2016: Journal of Medical Economics
Carlos Kilchemmann Fuentes, Carlos Vallejos Vallejos, Andrés Román Navarro
Inhaled nitric oxide (iNO) is currently the first-line therapy in severe hypoxaemic respiratory failure of the newborn. Most of regional neonatal centres in Chile do not have this therapeutic alternative. OBJECTIVE: To determine the cost effectiveness of inhaled nitric oxide in the treatment of respiratory failure associated with pulmonary hypertension of the newborn compared to the usual care, including the transfer to a more complex unit. PATIENTS AND METHOD: A clinical decision tree was designed from the perspective of Chilean Public Health Service...
November 2016: Revista Chilena de Pediatría
Roberto Gasparini, Paolo Landa, Daniela Amicizia, Giancarlo Icardi, Walter Ricciardi, Chiara de Waure, Elena Tanfani, Paolo Bonanni, Carlo Lucioni, Angela Testi, Donatella Panatto
The European Medicines Agency has approved a multicomponent serogroup B meningococcal vaccine (Bexsero®) for use in individuals of 2 months of age and older. A cost-effectiveness analysis (CEA) from the societal and Italian National Health Service perspectives was performed in order to evaluate the impact of vaccinating Italian infants less than 1 y of age with Bexsero®, as opposed to non-vaccination. The analysis was carried out by means of Excel Version 2011 and the TreeAge Pro® software Version 2012. Two basal scenarios that differed in terms of disease incidence (official and estimated data to correct for underreporting) were considered...
May 10, 2016: Human Vaccines & Immunotherapeutics
Mauro Batista de Morais, José Vicente Spolidoro, Mário César Vieira, Ary Lopes Cardoso, Otavio Clark, Alvaro Nishikawa, Ana Paula Moschione Castro
OBJECTIVE: To estimate the cost-effectiveness of a new strategy that uses an amino acid formula in the elimination diet of infants with suspected cow's milk allergy (CMA). METHODS: This pharmacoeconomic study was developed from the perspective of the Brazilian Public Healthcare System. The new strategy proposes using an amino acid formula in the diagnostic elimination diet of infants (≤ 24 months) with suspected CMA. Our rationale is that infants who do not respond to the amino acid formula do not suffer from CMA...
May 6, 2016: Journal of Medical Economics
Ryan C Hutchinson, Varun Sundaram, Michael Folkert, Yair Lotan
PURPOSE: We conducted a decision analysis to evaluate the cost effectiveness of a newly Food and Drug Administration approved rectal spacer gel (SpaceOAR, Augmenix) for the reduction of rectal toxicity of prostate radiation therapy (RT). METHODS: A decision tree model (TreeAge Pro) was used to compare the strategy of pretherapy placement of a spacing hydrogel before RT to RT alone. The model compared costs associated with rectal complications because of rectal toxicity over a 10-year period across 3 different RT modalities...
July 2016: Urologic Oncology
Jeffrey D Voigt, Gene Barnett
BACKGROUND: The objective of this analysis was to determine the value (incremental cost/increment benefit) of a brain LITT system versus employing current surgical options recommended by NCCN guidelines, specifically open resection (i.e. craniotomy) methods or biopsy (collectively termed CURRENT TREATMENTS) in patients where maximal safe resection may not be feasible. As has been demonstrated in the literature, extent of resection/ablation with minimal complications are independently related to overall survival...
2016: Cost Effectiveness and Resource Allocation: C/E
Erika F Werner, Alisse K Hauspurg, Dwight J Rouse
OBJECTIVE: To develop a decision model to evaluate the risks, benefits, and costs of different approaches to aspirin prophylaxis for the approximately 4 million pregnant women in the United States annually. METHODS: We created a decision model to evaluate four approaches to aspirin prophylaxis in the United States: no prophylaxis, prophylaxis per American College of Obstetricians and Gynecologists (the College) recommendations, prophylaxis per U.S. Preventive Services Task Force recommendations, and universal prophylaxis...
December 2015: Obstetrics and Gynecology
Pinakin R Jethwa, Tapan D Patel, Aaron F Hajart, Jean Anderson Eloy, William T Couldwell, James K Liu
BACKGROUND: Although prolactinomas are treated effectively with dopamine agonists, some have proposed curative surgical resection for select cases of microprolactinomas to avoid life-long medical therapy. We performed a cost-effectiveness analysis comparing transsphenoidal surgery (either microsurgical or endoscopic) and medical therapy (either bromocriptine or cabergoline) with decision analysis modeling. METHODS: A 2-armed decision tree was created with TreeAge Pro Suite 2012 to compare upfront transsphenoidal surgery versus medical therapy...
March 2016: World Neurosurgery
Sera Thomas, William Hodge, Monali Malvankar-Mehta
Glaucoma is the leading cause of irreversible vision loss and costs the American economy $2.9 billion. Teleglaucoma remotely detects glaucoma improving access to ophthalmic care in rural areas. It helps manage glaucoma more efficiently to preserve vision and reduce healthcare costs. A cost-effectiveness analysis was conducted using healthcare provider or third-party payer perspective within rural Canada. The study population were patients at-risk of glaucoma which includes those with diabetes and/or hypertension, family history of glaucoma, adults older than 50 years, and concurrent ocular conditions in rural Alberta...
2015: PloS One
Hui Xue, Jiangping Sun, Duo Shan, Yiyun Hu
OBJECTIVE: To conduct a cost utility study on the HIV/AIDS 'one-stop service' at county level. METHODS: Financial records and questionnaires were used to collect the information about the resource allocation and the effectiveness of antivirus treatment (ART) during the two period which were January 2012-June 2013 and July 2013-December 2013 in the three pilot counties providing 'one-stop service'. Treeage Pro 2009 was used to build the Markov model to simulate the evolution of 5 different HIV statuses, including HIV infection, AIDS, HIV infection receiving ART, AIDS receiving ART and death...
June 2015: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
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