Process Utility for Imaging in Cerebrovascular Disease

Swan, J. Shannon; Sainfort, François; Lawrence, William; Kuruchittham, Vipat; Kongnakorn, Thitima; Heisey, Dennis M.

doi:10.1016/s1076-6332(03)80100-9

Cited by 32 publications

(30 citation statements)

References 18 publications

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“…The patient is asked to trade-off extended time with the condition being diagnosed or treated in order to avoid the noxious effects of the test or treatment in favour of a similarly effective test or treatment but one not having side-effects [22]. A QALY toll is reflected in the wait-trade-off by an individual's willingness to wait longer to avoid more noxious experiences [23] and may be measured by disutility, being the fraction of a year of perfect health a patient would be willing to give up to avoid having to undergo a diagnostic test and to avoid its short-term morbidity [24]. This tool was originally designed for use in states related to diagnostic screening and testing [25].…”

Section: Cost-effectivenessmentioning

confidence: 99%

Radial probe EBUSversusCT-guided needle biopsy for evaluation of peripheral pulmonary lesions: an economic analysis

2012

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Selection of the optimal procedure for minimally invasive diagnosis of peripheral pulmonary lesions (PPLs) may be based on clinical factors; however, selection of diagnostic strategy may also be influenced by cost. Economic analysis of minimally invasive diagnosis of PPL has not been performed previously.Decision-tree analysis was applied to compare downstream costs of endobronchial ultrasoundguided transbronchial lung biopsy (EBUS-TBLB) with computed tomography-guided percutaneous needle biopsy (CT-PNB). Calculations were based on real costs derived from patient data. Sensitivity analyses and probabilistic sensitivity analysis were undertaken to identify the more cost-beneficial approach for varying input parameter values. Cost-effectiveness calculations were based on estimated disutility, according to the wait-trade-off technique.For base-case analysis, initial evaluation with CT-PNB was cost-beneficial (AU$2,724 versus EBUS-TBLB AU$2,748). The variable which exerted the most influence on cost-benefit outcomes was the cost of managing complications. CT-PNB remained the more cost-effective procedure at base-case parameters, although thresholds were identified during sensitivity analysis where EBUS-TBLB became more cost-effective.The costs of EBUS-TBLB and CT-PNB to evaluate PPL appear to be equivalent, but specific clinicalradiologic factors known to influence procedural outcomes will influence cost-benefit outcomes. Further evaluation of patient preferences and their influence on cost-effectiveness are required.

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Section: Cost-effectivenessmentioning

confidence: 99%

Radial probe EBUSversusCT-guided needle biopsy for evaluation of peripheral pulmonary lesions: an economic analysis

2012

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“…Subsequent breast biopsy has also been evaluated in terms of its effects on future screening behavior [14] using qualitative measurement [15], and measurement of anxiety [16]. Recently, it has been shown that variants of the time trade-off (TTO) preference technique and visual analog scales can be used to obtain a quality-adjusted life year (QALY) decrement or ''toll'' caused by angiography, MRI, and breast biopsy [6,[17][18][19][20][21]. Liang [22] showed that women were willing to pay an average of $611 for an accurate, yet non-invasive alternative to a breast biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…This instrument could inform cost-effectiveness analysis by generating a QALY toll from the morbidity of any testing/screening event that is subtracted from quality-adjusted life expectancy. This instrument would extend the recently developed preference methodology mentioned above [6,18,19] to a generic index more easily completed by subjects. Multiattribute utility theory (MAUT) can be used to develop a HRQoL index for our purposes, the best known example being the Health Utilities Index [27,28].…”

Section: Introductionmentioning

confidence: 99%

Initial development of the Temporary Utilities Index: a multiattribute system for classifying the functional health impact of diagnostic testing

et al. 2010

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“…Humphrey et al studies (10,(14)(15)(16)(17). The participants were asked to describe their biopsy encounter in terms of the seven attributes of diagnostic testing that make up the TMI: (a) pain or discomfort before the test, (b) pain or discomfort during the test, (c) fear or anxiety before the test, (d) fear or anxiety during the test, (e) embarrassment during the test, (f) physical function after testing, and (g) mental function after testing.…”

Section: Breast Imaging: Percutaneous Breast Biopsy: Effects On Shortmentioning

confidence: 99%

Percutaneous Breast Biopsy: Effect on Short-term Quality of Life

Humphrey¹,

Lee²,

Donelan³

et al. 2014

Radiology

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women undergoing percutaneous breast biopsy in an academic medical center were recruited to participate in a mixed-mode survey 2-4 days after biopsy. Patients described their biopsy experience by using the Testing Morbidities Index (TMI), a validated instrument for assessing short-term quality of life related to diagnostic testing. The scale ranged from 0 (worst possible experience) to 100 (no adverse effects). Seven attributes were assessed: pain or discomfort before and during testing, fear or anxiety before and during testing, embarrassment during testing, and physical and mental function after testing. Demographic and clinical information were also collected. Univariate and multivariate linear regression analyses were performed to identify significant predictors of TMI score. Results:In 188 women (mean age, 51.4 years; range, 22-80 years), the mean TMI score (6standard deviation) was 82 6 12. Univariate analysis revealed age and race as significant predictors of the TMI score (P , .05). In the multivariate model, only patient age remained a significant independent predictor (P = .001). TMI scores decreased by approximately three points for every decade decrease in patient age, which suggests that younger women were more adversely affected by the biopsy experience. Conclusion:Younger patient age is a significant predictor of decreased short-term quality of life related to percutaneous breast biopsy procedures. Tailored prebiopsy counseling may better prepare women for percutaneous biopsy procedures and improve their experience.q RSNA, 2013

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Process Utility for Imaging in Cerebrovascular Disease

Cited by 32 publications

References 18 publications

Radial probe EBUSversusCT-guided needle biopsy for evaluation of peripheral pulmonary lesions: an economic analysis

Radial probe EBUSversusCT-guided needle biopsy for evaluation of peripheral pulmonary lesions: an economic analysis

Initial development of the Temporary Utilities Index: a multiattribute system for classifying the functional health impact of diagnostic testing

Percutaneous Breast Biopsy: Effect on Short-term Quality of Life

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