Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach

To conduct an economic evaluation of intracranial pressure (ICP) monitoring on the basis of current evidence from pediatric patients with severe traumatic brain injury, through a statistical model. Methods: The statistical model is a decision tree, whose branches take into account the severity of th...

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Autores: MANUEL RENE MEDINA MORENO, RITA ESTHER ZAPATA VAZQUEZ, FERNANDO JOSE ALVAREZ CERVERA, JOSE RAMON GARCIA LIRA, VICTOR DAVID GRANADOS GARCIA, NORMA ELENA PEREZ HERRERA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:México
Institución:Universidad Autónoma de Yucatán
Repositorio:Repositorio Digital Institucional de la Universidad Autónoma de Yucatán
Idioma:inglés
OAI Identifier:oai:redi.uady.mx:123456789/1952
Acceso en línea:http://redi.uady.mx:8080/handle/123456789/1952
Access Level:acceso abierto
Palabra clave:info:eu-repo/classification/cti/3
Brain injuries
Cost-benefit analysis
Decision support techniques
Physiologic monitoring
Probabilistic models
Uncertaint
id MX_500d9ba4e1f705a5ed0b0a165ac52de4
oai_identifier_str oai:redi.uady.mx:123456789/1952
network_acronym_str MX
network_name_str México
repository_id_str
spelling Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approachMANUEL RENE MEDINA MORENORITA ESTHER ZAPATA VAZQUEZFERNANDO JOSE ALVAREZ CERVERAJOSE RAMON GARCIA LIRAVICTOR DAVID GRANADOS GARCIANORMA ELENA PEREZ HERRERAinfo:eu-repo/classification/cti/3Brain injuriesCost-benefit analysisDecision support techniquesPhysiologic monitoringProbabilistic modelsUncertaintTo conduct an economic evaluation of intracranial pressure (ICP) monitoring on the basis of current evidence from pediatric patients with severe traumatic brain injury, through a statistical model. Methods: The statistical model is a decision tree, whose branches take into account the severity of the lesion, the hospitalization costs, and the quality-adjusted life-year for the first 6 months post-trauma. The inputs consist of probability distributions calculated from a sample of 33 surviving children with severe traumatic brain injury, divided into two groups: with ICP monitoring (monitoring group) and without ICP monitoring (control group). The uncertainty of the parameters from the sample was quantified through a probabilistic sensitivity analysis using the Monte-Carlo simulation method. The model overcomes the drawbacks of small sample sizes, unequal groups, and the ethical difficulty in randomly assigning patients to a control group (without monitoring). Results: The incremental cost in the monitoring group was Mex$3,934 (Mexican pesos), with an increase in quality-adjusted life-year of 0.05. The incremental costeffectiveness ratio was Mex$81,062. The cost-effectiveness acceptability curve had a maximum at 54% of the cost-effective iterations. The incremental net health benefit for a willingness to pay equal to 1 time the per capita gross domestic product for Mexico was 0.03, and the incremental net monetary benefit was Mex$5,358. Conclusions: The results of the model suggest that ICP monitoring is cost-effective because there was a monetary gain in terms of the incremental net monetary benefit.FELIPE MANUEL ALONZO VAZQUEZ2017-10-31info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://redi.uady.mx:8080/handle/123456789/1952urn:issn:2212-1099reponame:Repositorio Digital Institucional de la Universidad Autónoma de Yucatáninstname:Universidad Autónoma de Yucatáninstacron:UADYengInvestigación aplicadainfo:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-nd/4.0oai:redi.uady.mx:123456789/19522024-10-04T19:04:13Z
dc.title.none.fl_str_mv Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
title Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
spellingShingle Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
MANUEL RENE MEDINA MORENO
info:eu-repo/classification/cti/3
Brain injuries
Cost-benefit analysis
Decision support techniques
Physiologic monitoring
Probabilistic models
Uncertaint
title_short Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
title_full Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
title_fullStr Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
title_full_unstemmed Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
title_sort Cost-efectiveness of intracraneal pressure monitoring in pediatric patients with severe traumatic brain injury: A simulation modeling approach
dc.creator.none.fl_str_mv MANUEL RENE MEDINA MORENO
RITA ESTHER ZAPATA VAZQUEZ
FERNANDO JOSE ALVAREZ CERVERA
JOSE RAMON GARCIA LIRA
VICTOR DAVID GRANADOS GARCIA
NORMA ELENA PEREZ HERRERA
author MANUEL RENE MEDINA MORENO
author_facet MANUEL RENE MEDINA MORENO
RITA ESTHER ZAPATA VAZQUEZ
FERNANDO JOSE ALVAREZ CERVERA
JOSE RAMON GARCIA LIRA
VICTOR DAVID GRANADOS GARCIA
NORMA ELENA PEREZ HERRERA
author_role author
author2 RITA ESTHER ZAPATA VAZQUEZ
FERNANDO JOSE ALVAREZ CERVERA
JOSE RAMON GARCIA LIRA
VICTOR DAVID GRANADOS GARCIA
NORMA ELENA PEREZ HERRERA
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv FELIPE MANUEL ALONZO VAZQUEZ
dc.subject.none.fl_str_mv info:eu-repo/classification/cti/3
Brain injuries
Cost-benefit analysis
Decision support techniques
Physiologic monitoring
Probabilistic models
Uncertaint
topic info:eu-repo/classification/cti/3
Brain injuries
Cost-benefit analysis
Decision support techniques
Physiologic monitoring
Probabilistic models
Uncertaint
description To conduct an economic evaluation of intracranial pressure (ICP) monitoring on the basis of current evidence from pediatric patients with severe traumatic brain injury, through a statistical model. Methods: The statistical model is a decision tree, whose branches take into account the severity of the lesion, the hospitalization costs, and the quality-adjusted life-year for the first 6 months post-trauma. The inputs consist of probability distributions calculated from a sample of 33 surviving children with severe traumatic brain injury, divided into two groups: with ICP monitoring (monitoring group) and without ICP monitoring (control group). The uncertainty of the parameters from the sample was quantified through a probabilistic sensitivity analysis using the Monte-Carlo simulation method. The model overcomes the drawbacks of small sample sizes, unequal groups, and the ethical difficulty in randomly assigning patients to a control group (without monitoring). Results: The incremental cost in the monitoring group was Mex$3,934 (Mexican pesos), with an increase in quality-adjusted life-year of 0.05. The incremental costeffectiveness ratio was Mex$81,062. The cost-effectiveness acceptability curve had a maximum at 54% of the cost-effective iterations. The incremental net health benefit for a willingness to pay equal to 1 time the per capita gross domestic product for Mexico was 0.03, and the incremental net monetary benefit was Mex$5,358. Conclusions: The results of the model suggest that ICP monitoring is cost-effective because there was a monetary gain in terms of the incremental net monetary benefit.
publishDate 2017
dc.date.none.fl_str_mv 2017-10-31
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://redi.uady.mx:8080/handle/123456789/1952
url http://redi.uady.mx:8080/handle/123456789/1952
dc.language.none.fl_str_mv eng
language eng
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-nd/4.0
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0
dc.format.none.fl_str_mv application/pdf
dc.coverage.none.fl_str_mv Investigación aplicada
dc.source.none.fl_str_mv urn:issn:2212-1099
reponame:Repositorio Digital Institucional de la Universidad Autónoma de Yucatán
instname:Universidad Autónoma de Yucatán
instacron:UADY
instname_str Universidad Autónoma de Yucatán
instacron_str UADY
institution UADY
reponame_str Repositorio Digital Institucional de la Universidad Autónoma de Yucatán
collection Repositorio Digital Institucional de la Universidad Autónoma de Yucatán
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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