Cost-effectiveness of computed tomographic colonography: a prospective comparison with colonoscopy.
نویسندگان
چکیده
PURPOSE To estimate the cost-effectiveness of detecting colorectal polyps with computed tomographic colonography (CTC) and subsequent polypectomy with primary colonoscopy (CC), using CC as the alternative strategy. MATERIAL AND METHODS A marginal analysis was performed regarding 103 patients who had had CTC prior to same-day CC at two hospitals, H-I (n = 53) and H-II (n = 50). The patients were randomly chosen from surveillance and symptomatic study populations (148 at H-I and 231 at H-II). Populations, organizations, and procedures were compared. Cost data on time consumption, medication, and minor equipment were collected prospectively, while data on salaries and major equipment were collected retrospectively. The effect was the (previously published) sensitivities of CTC and CC for detection of colorectal polyps > or = 6 mm (H-I, n = 148) or > or = 5 mm (H-II, n = 231). RESULTS Thirteen patients at each center had at least one colorectal polyp > or = 6 mm or > or = 5 mm. CTC was the cost-effective alternative at H-I (euro187 vs. euro211), while CC was the cost-effective alternative at H-II (euro239 vs. euro192). The cost-effectiveness (costs per finding) mainly depended on the sensitivity of CTC and CC, but the depreciation of equipment and the staff's use of time were highly influential as well. CONCLUSION Detection of colorectal polyps > or = 6 mm or > or = 5 mm with CTC, followed by polypectomy by CC, can be performed cost-effectively at some institutions with the appropriate hardware and organization.
منابع مشابه
Probiotics in inflammatory bowel disease: yet another mechanism of action?
Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. Prospective blinded evaluation of computed tomographic colonography for screen detection of colorec-tal polyps. Virtual colonoscopy using oral c...
متن کاملCost-effectiveness of computerized tomographic colonography versus colonoscopy for colorectal cancer screening.
BACKGROUND Computerized tomographic (CT) colonography is a potential alternative to colonoscopy for colorectal cancer screening. Its main advantage, a better safety profile, may be offset by its limitations: lower sensitivity, need for colonoscopy in cases where results are positive, and expense. METHODS We performed an economic evaluation, using decision analysis, to compare CT colonography ...
متن کاملPerformance of computed tomographic colonography for the screening of colorectal polyp in acromegalic patients: a prospective study.
CONTEXT Acromegalic patients have better chances to develop colorectal polyps and cancer and, considered a high-risk group, need to undergo frequent screening examinations. Moreover, in acromegalia, the increased bowel length and the intestinal loop complexity can lead to higher levels of technical difficulties and increase the risks of complications at conventional colonoscopy. Computed tomogr...
متن کاملAt what costs will screening with CT colonography be competitive? A cost-effectiveness approach.
The costs of computed tomographic colonography (CTC) are not yet established for screening use. In our study, we estimated the threshold costs for which CTC screening would be a cost-effective alternative to colonoscopy for colorectal cancer (CRC) screening in the general population. We used the MISCAN-colon microsimulation model to estimate the costs and life-years gained of screening persons ...
متن کاملCOMPUTED TOMOGRAPHIC COLONOGRAPHY (VIRTUAL COLONOSCOPY) FOR SCREENING OF COLORECTAL CANCER INTRODUCTION The California Technology Assessment Forum is requested to review the scientific evidence for the use of computed Tomographic Colonography (virtual colonoscopy) for screening of colorectal cancer
متن کامل
ذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Acta radiologica
دوره 48 3 شماره
صفحات -
تاریخ انتشار 2007