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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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An Economic Evaluation of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE

Amy Von Huben1,2, Martin Howell1,2, Deborah Richards3

  • 1School of Public Health, The University of Sydney, Sydney, Australia.

The Journal of Urology
|April 11, 2024
PubMed
Summary

The eADVICE web-based program for children with urinary incontinence is cost-saving and effective. This digital health intervention improves continence and reduces healthcare costs for children awaiting specialist appointments.

Keywords:
childreneconomic evaluationenuresistelemedicineurinary incontinence

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Area of Science:

  • Digital Health
  • Pediatric Urology
  • Health Economics

Background:

  • Children with urinary incontinence face long waits for specialist care, potentially worsening their condition.
  • Timely interventions during the waiting period can improve outcomes and reduce treatment complexity.
  • Web-based programs offer a scalable solution for managing chronic pediatric conditions.

Purpose of the Study:

  • To evaluate the cost-effectiveness of the eADVICE program for children with urinary incontinence awaiting specialist appointments.
  • To compare the eADVICE program with usual care in terms of clinical outcomes and healthcare costs.
  • To assess the feasibility of using an embodied conversational agent for delivering a web-based health program.

Main Methods:

  • A trial-based cost-effectiveness analysis was conducted as a substudy of a randomized controlled trial.
  • The study compared the eADVICE program (supervised by a primary physician and delivered via a conversational agent) to usual care.
  • Outcomes included continence status and quality of life, analyzed on an intention-to-treat basis, with uncertainty examined through sensitivity analyses.

Main Results:

  • The eADVICE program was found to be cost-saving and beneficial compared to usual care.
  • A significantly higher proportion of children achieved dryness for over 14 days at 6 months (risk difference 0.13, P = .03).
  • Mean healthcare costs were reduced by $188 per participant.

Conclusions:

  • An individualized, evidence-informed, web-based program using an embodied conversational agent is cost-saving for children with urinary incontinence.
  • The eADVICE program demonstrates a favorable and substantial economic impact.
  • This approach may be transferable to other chronic pediatric health conditions in outpatient settings.