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Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus

Publication ,  Journal Article
Gray, DT; Weinstein, MC
Published in: Medical Decision Making
January 1998

Decision and cost-utility analyses considered the tradeoffs of treating patent ductus arteriosus (PDA) using conventional surgery versus transcatheter implantation of the Rashkind occluder. Physicians and informed lay parents assigned utility scores to procedure success/complications combinations seen in prognostically similar pediatric patients with isolated PDA treated from 1982 to 1987. Utility scores multiplied by outcome frequencies from a comparative study generated expected utility values for the two approaches. Cost-utility analyses combined these results with simulated provider cost estimates from 1989. On a 0-100 scale (worst to best observed outcome), the median expected utility for surgery was 99.96, versus 98.88 for the occluder. Results of most sensitivity analyses also slightly favored surgery. Expected utility differences based on 1987 data were minimal. With a mean overall simulated cost of $8,838 vs $12,466 for the occluder, surgery was favored in most cost-utility analyses. Use of the inherently less invasive but less successful, more risky, and more costly occluder approach conferred no apparent net advantage in this study. Analyses of comparable current data would be informative.

Duke Scholars

Published In

Medical Decision Making

DOI

EISSN

1552-681X

ISSN

0272-989X

Publication Date

January 1998

Volume

18

Issue

2

Start / End Page

187 / 201

Publisher

SAGE Publications

Related Subject Headings

  • Health Policy & Services
  • 4206 Public health
  • 4203 Health services and systems
  • 3801 Applied economics
  • 1402 Applied Economics
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gray, D. T., & Weinstein, M. C. (1998). Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus. Medical Decision Making, 18(2), 187–201. https://doi.org/10.1177/0272989x9801800208
Gray, Darryl T., and Milton C. Weinstein. “Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus.” Medical Decision Making 18, no. 2 (January 1998): 187–201. https://doi.org/10.1177/0272989x9801800208.
Gray DT, Weinstein MC. Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus. Medical Decision Making. 1998 Jan;18(2):187–201.
Gray, Darryl T., and Milton C. Weinstein. “Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus.” Medical Decision Making, vol. 18, no. 2, SAGE Publications, Jan. 1998, pp. 187–201. Crossref, doi:10.1177/0272989x9801800208.
Gray DT, Weinstein MC. Decision and Cost-Utility Analyses of Surgical versus Transcatheter Closure of Patent Ductus Arteriosus. Medical Decision Making. SAGE Publications; 1998 Jan;18(2):187–201.
Journal cover image

Published In

Medical Decision Making

DOI

EISSN

1552-681X

ISSN

0272-989X

Publication Date

January 1998

Volume

18

Issue

2

Start / End Page

187 / 201

Publisher

SAGE Publications

Related Subject Headings

  • Health Policy & Services
  • 4206 Public health
  • 4203 Health services and systems
  • 3801 Applied economics
  • 1402 Applied Economics
  • 1117 Public Health and Health Services