Cost-effectiveness of indocyanine green angiography in postmastectomy breast reconstruction

Cost-Effectiveness of Radar Localisation Versus Wire Localisation for Wide Local Excision of Non-palpable Breast Cancer

“…A break-even point analysis was performed by using the equation: “Number of cases to break-even” = “Fixed Cost”/ (“Savings per case” − “Variable cost”) . 18 , 19 The fixed cost was the purchase price of the SCOUT Surgical Guidance System (AUD$77,150). The variable cost was the cost of each use of SCOUT, including the reflector and delivery unit (AUD$498), and for each use of WL, including the hookwire (AUD$61.50).…”

“…The surgery delay reduction rate was the difference in rate of surgery delay between the RL and WL cohorts. 18 , 20 …”

“…Utility measures the success or failure of a surgical intervention based on how well the intervention impacts a patient’s final health outcome. 18 , 22 A successful localisation for WLE and a surgery delay were defined as distinct “health states” with associated costs, probabilities, and utilities for use in the decision model. The costs for preoperative localisation and WLE were based on Medicare item numbers.…”

“…The utilities were converted to QALYs for all health states: “QALY” = (“Utility of health state”) x (“Duration of health state”) + (“Utility of successful procedure”) x (“Remaining life years”), where “Remaining life years” = “Average life expectancy” − “Average age of patient,” and “Duration of health state” = “Estimated recovery time in weeks”/52 weeks. 18 , 21 The remaining life years value was calculated from the estimation that a female patient undergoing WLE is 59 years old and has a life expectancy of 85 years based on Australian Institute of Health and Welfare statistics. 1 For a successful operation, defined as a successful localisation for WLE resulting in clear margins, the duration of health state was 0 while the duration for a delay in surgery was 1 day (1/365 years).…”

A feasibility study assessing quantitative indocyanine green angiographic predictors of reconstructive complications following nipple-sparing mastectomy

“…Intraoperative perfusion assessment with indocyanine green fluorescence angiography (ICGFA) using near-infrared (NIR) cameras has been demonstrated to cost-effectively diminish postoperative complications in autologous and implant-based oncoplastic reconstructions. 10 , 11 A recent study also investigated its routine use in selecting patients who may benefit from a temporary delay in performing reconstruction (termed staged immediate breast reconstruction, SIBR) by measuring fluorescence intensity from still images 11 in decision-making albeit with modest sensitivity and specificity regarding complication prediction (62.5% and 69.5%, respectively). 12 , 13 , 14 …”