Document Detail


Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease.
MedLine Citation:
PMID:  15223684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163 patients. The effectiveness of an investigation was defined as the percentage of patients with no need for further evaluation after the investigation in question had been performed. Costs were assumed from the budget-holder's point of view. RESULTS: MRCP, EUS and ERCP had a total accuracy of 0.91, 0.93 and 0.92, respectively. Eighty-four (52%) patients needed endoscopic therapy in combination with ERCP, giving an effectiveness of MRCP, EUS, and ERCP of 0.44, 0.45 and 0.92, respectively. The cost-effectiveness of MRCP, EUS, and ERCP was 6622, 7353 and 4246 Danish Kroner (DKK) per fully investigated and treated patient (1 DKK=0.14 EUR). CONCLUSION: Within a patient population with a probability of therapeutic ERCP in 50% of the patients, ERCP was the most cost-effective strategy.
Authors:
A P Ainsworth; S R Rafaelsen; P A Wamberg; T Pless; J Durup; M B Mortensen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  39     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-29     Completed Date:  2004-11-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  579-83     Citation Subset:  IM    
Affiliation:
Dept. of Surgery and Radiology, Vejle Hospital, Denmark. alan.ainsworth@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biliary Tract Diseases / diagnosis*,  economics,  therapy
Cholangiopancreatography, Endoscopic Retrograde / economics*
Cost-Benefit Analysis
Endosonography / economics*
Female
Humans
Length of Stay / economics
Magnetic Resonance Imaging / economics*
Male
Middle Aged
Pancreatic Diseases / diagnosis*,  economics,  therapy
Reproducibility of Results
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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