Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Instituto Nacional de Salud
2008
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| _version_ | 1876451802009829376 |
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| author | Álvaro Sanabria |
| author_facet | Álvaro Sanabria |
| contents | Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Álvaro Sanabria Miguel Angarita Juan Carlos Varón Javier Romero Medicina cost diagnosis tomography Appendicitis ultrasonography Introduction. Diagnosis of acute appendicitis is difficult in almost 30% ofpatients with pain in low right quadrant. Diagnostic imaging could help tomake a more accurate diagnosis.Objective. To calculate cost-effectiveness of diagnostic image testscompared with physical exam in patients with abdominal pain suspicious ofappendicitis.Materials and methods. We designed a cost-effectiveness economicanalysis, using a decision analysis model. Standard case selected was apatient with abdominal pain in right lower quadrant and suspicion ofappendicitis. Three independent alternatives were selected (ultrasonography,abdominal tomography and physical exam with in hospital observation lowerthan six hours). Operative characteristics, study design and costs ofinterventions and outcomes were assessed. Main outcome was confirmeddiagnosis of appendicitis. Point of view used was that from healthmaintenance organizations. Medical direct and indirect medical costs weremeasured. Time horizon used was three months. A one way sensitivityanalysis was made.Results. For prepaid system, the most cost-effective strategy was abdominaltomography, with a cost-effectiveness ratio of US$965/diagnosed patient. Forpublic system, the most cost-effective strategy was abdominal tomographywith a cost-effectiveness ratio of US$491.8/diagnosed patient. Conclusions. Imaging diagnostic methods in cases of abdominal painsuspicious of appendicitis, are most cost-effective than physical exam to takea therapeutic decision. Tomography offers a best cost-effectiveness inprepaid system and in public health system. 2008 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84328110 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.1 Vol.28 |
| format | Artículo científico |
| id | redalyc_84328110 |
| institution | Redalyc |
| language | en |
| publishDate | 2008 |
| publisher | Instituto Nacional de Salud |
| spellingShingle | Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Álvaro Sanabria Medicina cost diagnosis tomography Appendicitis ultrasonography Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis Álvaro Sanabria Miguel Angarita Juan Carlos Varón Javier Romero Medicina cost diagnosis tomography Appendicitis ultrasonography Introduction. Diagnosis of acute appendicitis is difficult in almost 30% ofpatients with pain in low right quadrant. Diagnostic imaging could help tomake a more accurate diagnosis.Objective. To calculate cost-effectiveness of diagnostic image testscompared with physical exam in patients with abdominal pain suspicious ofappendicitis.Materials and methods. We designed a cost-effectiveness economicanalysis, using a decision analysis model. Standard case selected was apatient with abdominal pain in right lower quadrant and suspicion ofappendicitis. Three independent alternatives were selected (ultrasonography,abdominal tomography and physical exam with in hospital observation lowerthan six hours). Operative characteristics, study design and costs ofinterventions and outcomes were assessed. Main outcome was confirmeddiagnosis of appendicitis. Point of view used was that from healthmaintenance organizations. Medical direct and indirect medical costs weremeasured. Time horizon used was three months. A one way sensitivityanalysis was made.Results. For prepaid system, the most cost-effective strategy was abdominaltomography, with a cost-effectiveness ratio of US$965/diagnosed patient. Forpublic system, the most cost-effective strategy was abdominal tomographywith a cost-effectiveness ratio of US$491.8/diagnosed patient. Conclusions. Imaging diagnostic methods in cases of abdominal painsuspicious of appendicitis, are most cost-effective than physical exam to takea therapeutic decision. Tomography offers a best cost-effectiveness inprepaid system and in public health system. 2008 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84328110 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.1 Vol.28 |
| title | Cost-effectiveness of computed tomography and ultrasound in the diagnosis of appendicitis |
| topic | Medicina cost diagnosis tomography Appendicitis ultrasonography |
| url | https://www.redalyc.org/articulo.oa?id=84328110 |