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Analysis of cost-effectiveness in the diagnosis of fever of unknown origin and the role of (18)F-FDG PET-CT: a proposal of diagnostic algorithm.
MedLine Citation:
PMID:  22153992     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: To analyze the costs of Fever of Unknown Origin (FUO) prior to the PET-CT study. To determine the effectiveness of PET-CT in the diagnosis of FUO. A proposal of diagnostic algorithm. MATERIAL AND METHODS: A retrospective study was performed that included 20 patients who had been studied between January 2007 and January 2011, with a mean age of 57.75 years and FUO diagnosis. All underwent a PET-CT study with (18)F-FDG. Individual and mean costs of FUO in these patients were assessed, including hospitalization days and complementary tests prior to the PET-CT study. The effectiveness of the PET-CT study in the diagnosis of FUO was analyzed. Costs of the FUO process were determined, including those of the PET-CT study, and if it had been done earlier in the diagnostic process. RESULTS: Mean hospital stay per patient until the PET-CT study was 28 days. The cost per hospitalization day was 342 €. Average cost per patient in complementary tests was 1395 €. Total cost of the FUO process until the PET-CT study was around 11167 € per patient. The PET-CT study showed a 78% sensitivity, 83% specificity, 92% PPV and 62% NPV. If PET-CT had been performed earlier in the FUO process, assuming the same effectiveness, 5471 € per patient would have been saved. CONCLUSION: The PET-CT study could be cost-effective in the FUO process if used at an early stage, helping to establish an early diagnosis, reducing hospitalization days due to diagnostic purposes and the repetition of unnecessary tests.
Authors:
E M Becerra Nakayo; A M García Vicente; A M Soriano Castrejón; J A Mendoza Narváez; M P Talavera Rubio; V M Poblete García; J M Cordero García
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-5
Journal Detail:
Title:  Revista espanola de medicina nuclear     Volume:  -     ISSN:  0212-6982     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208726     Medline TA:  Rev Esp Med Nucl     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.
Affiliation:
Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
Vernacular Title:
Análisis de costo-efectividad en el diagnóstico de fiebre de origen desconocido y el papel de la (18)F-FDG PET-TC: propuesta de algoritmo diagnóstico.
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