Document Detail


Cost-effectiveness of functional imaging tests in the diagnosis of Alzheimer disease.
MedLine Citation:
PMID:  11012424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the cost-effectiveness of functional neuroimaging in the work-up of patients at specialized Alzheimer disease clinics. MATERIALS AND METHODS: A decision model was used to calculate costs and benefits (in quality-adjusted life-years [QALYs]) that accrued to hypothetical cohorts of patients at presentation to an Alzheimer disease center. Sensitivity analysis was performed to examine the effects of diagnostic test characteristics, therapeutic efficacy, disease severity, and costs on cost-effectiveness. RESULTS: The incremental cost-effectiveness ratio of dynamic susceptibility contrast material-enhanced magnetic resonance (MR) imaging was $479,500 per QALY (compared with the usual diagnostic work-up), while visual or quantitative single photon emission computed tomography (SPECT) was dominated (higher costs, lower effectiveness) by the usual diagnostic work-up. These results depend critically on the sensitivity and specificity of the standard diagnostic work-up, the effectiveness of drug treatment, and the disease severity. Varying these parameters resulted in estimates of incremental cost-effectiveness for dynamic susceptibility contrast-enhanced MR imaging of $24,680 to $8.6 million per QALY. SPECT either was dominated by the usual diagnostic work-up or had cost-effectiveness ratios of $180,200 to $6 million per QALY. CONCLUSION: The addition of functional neuroimaging to the usual diagnostic regimen at Alzheimer disease clinics is not cost-effective given the effectiveness of currently available therapies.
Authors:
P M McMahon; S S Araki; P J Neumann; G J Harris; G S Gazelle
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiology     Volume:  217     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-17     Completed Date:  2000-10-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  58-68     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Decision Analysis and Technology Assessment Group, the Computer-Assisted Diagnostics Laboratory, Massachusetts General Hospital, Zero Emerson Pl, Ste 2H, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Alzheimer Disease / diagnosis*,  drug therapy,  radionuclide imaging
Contrast Media
Cost-Benefit Analysis
Decision Trees
Health Care Costs
Humans
Indans / therapeutic use
Magnetic Resonance Imaging / economics*
Markov Chains
Models, Economic
Nootropic Agents / therapeutic use
Piperidines / therapeutic use
Quality-Adjusted Life Years
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon / economics*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Indans; 0/Nootropic Agents; 0/Piperidines; 120011-70-3/donepezil

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


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