在患有深静脉血栓瘤的患者中执行参考超声波的成本效益
Cindy M M de Jong1, Wilbert B van den Hout2, Christel E van Dijk3
1Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Thrombosis and haemostasis
|November 20, 2023
概括
对于疑似复发性深静脉血栓 (DVT) 的例行参考压缩超声波 (CUS) 增加了医疗保健成本,但没有改善患者的生存率. 这种诊断策略对于管理DVT复发来说并不具有成本效益.
科学领域:
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
- 卫生经济学 卫生经济学
背景情况:
- 诊断复发性深静脉血栓塞 (DVT) 可能是具有挑战性的,因为之前的DVT的残留阻塞.
- 参考压缩超声波 (CUS) 提供基线图像进行比较,但它的实用性仍在争论中.
研究的目的:
- 评估在怀疑复发性ipsilateral DVT.患者中例行执行参考CUS的成本效益.
主要方法:
- 一个决策分析模型比较了12个可疑复发性DVT的诊断管理场景.
- 利用了前性研究中的患者数据和索赔数据.
- 在第一年的随访中,成本和死亡率进行了比较.
主要成果:
- 有参考CUS的情景比没有CUS的情景 (€1,192-€1,474) 产生更高的一年成本 (€1,763-€1,913).
- 在所有情景中,估计的死亡率相似.
- 参考CUS结果往往没有被使用,因为20%的患者出现了疑似复发.
结论:
- 对于疑似复发性DVT的常规参考CUS更昂贵,并且没有死亡率的好处.
- 研究结果表明,从成本效益的角度来看,不应该经常使用参考CUS.
- 结果可以指导医疗保健资源分配用于DVT后续.
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