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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...
July 21, 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...
June 3, 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]
Mika S Ohno, Monica L Richardson, Eric R Sokol
INTRODUCTION AND HYPOTHESIS: For the surgical correction of apical prolapse the abdominal approach is associated with better outcomes; however, it is more expensive than the transvaginal approach. This cost-effectiveness analysis compares abdominal sacral colpopexy (ASC) with sacrospinous ligament fixation (SSLF) to determine if the improved outcomes of ASC justify the increased expense. METHODS: A decision-analytic model was created comparing ASC with SSLF using data-modeling software, TreeAge Pro (2013), which included the following outcomes: post-operative stress urinary incontinence (SUI) with possible mid-urethral sling (MUS) placement, prolapse recurrence with possible re-operation, and post-operative dyspareunia...
February 2016: International Urogynecology Journal
Ahizechukwu Chigoziem Eke, Andrea Leigh Buras, Sheila Drnec, Joanna Yen-Jung Woo
OBJECTIVE: The optimal method for repair of third-degree perineal lacerations remains controversial. Both the end-to-end and overlap methods of repair have been shown to be equally effective. However, the economic merits of the end-to-end approach compared with the overlap approach are unknown. The aim of this study was to evaluate the cost-effectiveness of the end-to-end compared with the overlap method of repair based on the results of six randomized clinical trials. METHODS: We performed a Markov-based decision analytic model of two management strategies for perineal lacerations-the end-to-end approach and the overlap approach...
May 2015: Obstetrics and Gynecology
Francis M Hacker, Emily E Griffin, Brian L Shaffer, Aaron B Caughey
OBJECTIVE: In May 2014, the Fetal Imaging Workshop endorsed ultrasonographic follow-up in fetuses with isolated choroid plexus cysts that lacked a complete targeted scan for additional findings associated with trisomy 18 or had an elevated a priori risk. Our goal was to estimate outcomes and costs associated with this recommendation in women with prior aneuploidy screening. METHODS: A decision-analytic model was constructed using TreeAge software and probabilities derived from the literature...
May 2015: Obstetrics and Gynecology
Wouter Hogendoorn, Anthi Lavida, M G Myriam Hunink, Frans L Moll, George Geroulakos, Bart E Muhs, Bauer E Sumpio
OBJECTIVE: Open repair (OPEN) and conservative management (CONS) have been the treatments of choice for splenic artery aneurysms (SAAs) for many years. Endovascular repair (EV) has been increasingly used with good short-term results. In this study, we evaluated the cost-effectiveness of OPEN, EV, and CONS for the treatment of SAAs. METHODS: A decision analysis model was developed using TreeAge Pro 2013 software (TreeAge Inc, Williamstown, Mass) to evaluate the cost-effectiveness of the different treatments for SAAs...
June 2015: Journal of Vascular Surgery
Ronda Henry-Tillman, Katherine Glover-Collins, Michael Preston, Kristalyn Gallagher, Evan Tummel, Yara V Robertson, Daniela Ochoa, Soheila Korourian, Kent Westbrook, V Suzanne Klimberg
BACKGROUND: Health care reform goals involve more cost-effective methods of delivering health care. The cost-effectiveness of axillary ultrasound-guided core needle biopsy (AUS-CNB) was compared with sentinel lymph node biopsy (SLNB) when evaluating the status of the axilla in operable invasive breast cancer. STUDY DESIGN: We performed an IRB-approved retrospective review of patients undergoing ultrasound of the axilla plus core needle biopsy at our institution from 2007 to 2012...
April 2015: Journal of the American College of Surgeons
Yizhen Lai, Kai Li, Junbo Li, Sheena Xin Liu
OBJECTIVES: Real-time virtual sonography (RVS) is a promising navigation technique for percutaneous radiofrequency ablation (RFA) treatment, especially in ablating nodules poorly visualized on conventional ultrasonography (US). However, its cost-effectiveness has not been established. The purpose of this study is to evaluate the cost-effectiveness of RVS navigated RFA (RVS-RFA) relative to US guided RFA (US-RFA) in patients with small hepatocellular carcinoma (HCC) in China, from the modified societal perspective...
October 2014: International Journal of Technology Assessment in Health Care
Grace Baik, Scott Brietzke
OBJECTIVES: To use a utility-based Markov decision analysis model to compare outcomes of short-term grommet tympanostomy tubes (TTs), intermediate-type tubes, and permanent T-Tubes and to use a detailed sensitivity analysis to determine the most important factors influencing outcomes with one type of TT versus another. STUDY DESIGN: Markov decision analysis. SETTING: Hypothetical cohort. SUBJECTS AND METHODS: A Markov cohort decision analysis model was created using computer software (TreeAge Software, Inc, Williamstown, Massachusetts) comparing the 3 types of TT...
June 2015: Otolaryngology—Head and Neck Surgery
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