尽量降低治疗无症状尿结石病的成本
Remy W Lamberts1, Emily Lines1, Simon L Conti1,2
1Department of Urology, Stanford University School of Medicine, Stanford, California.
Urology practice
|June 10, 2023
概括
选择尿道结石的正确治疗方法取决于自发通道的可能性. 对于高通道概率来说,观察是最好的,而尿路透镜用于低概率. CT扫描指导中级病例.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
背景情况:
- 在未经证实通过的情况下管理尿路结石是具有挑战性的.
- 不同治疗策略的成本效益需要分析.
研究的目的:
- 分析尿路结石的各种治疗策略的成本效益.
- 根据自发石头通过概率确定最佳的治疗途径.
主要方法:
- 成本最小化分析,比较尿路透镜,成像 (CT,X射线,超声波) 和观察.
- 利用已公布的疗效数据和医疗保险补偿费用.
- 对石头通过率和成像灵敏度进行了灵敏度分析.
主要成果:
- 对高自发通道概率 (>62%) 的观察最具成本效益.
- 计算机断层扫描 (CT) 是最便宜的中间通道概率 (21%-62%).
- 超声波变得具有高灵敏度 (>79%) 的成本效益;尿路透镜对于低通道概率 (<21%) 最便宜.
结论:
- 自发尿道结石通道的概率决定了最佳的,具有成本效益的治疗方法.
- 观测和尿路检查在通道概率谱的相反端具有成本效益.
- CT成像为中等概率提供了具有成本效益的方法,如果高度敏感,超声波是可行的.
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