Patients with medically intractable temporal lobe epilepsy are potential candidates for anterior temporal lobectomy (ATL), in which epileptogenic temporal lobe tissue is localized and surgically removed.
This surgical approach can eliminate or drastically reduce seizures in the majority of patients.
The authors used a decision-analysis model to examine the cost-effectiveness of a surgical evaluation and treatment protocol for medically intractable temporal lobe epilepsy.
This model compared a cohort treated with the new protocol with a continuation of their immediate preoperative medical management and projected these differences over the patient's lifetime.
The Markov model incorporated postoperative seizure status, patient quality of life, death from surgical and natural causes, discounting. and the direct medical costs associated with outpatient evaluation, hospitalization, surgery, antiepileptic drugs, and lifetime outpatient treatment.
The intent-to-treat analysis included patients who underwent evaluation but were not eligible for ATL.
Sensitivity analyses were also performed on the variables in the model.
Data from the baseline model indicated that evaluation for ATL provided an average of 1.1 additional quality-adjusted life years (QALYs) compared with continued medical management, at an additional cost of $29,800.
Combining the clinical and economic outcomes yielded a cost-effectiveness ratio of $27,200 per QALY. (...)
Mots-clés Pascal : Epilepsie temporale, Réfractaire, Lobectomie temporale, Antérieur, Analyse coût efficacité, Modèle Markov, Analyse décision, Traitement, Economie santé, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Epilepsie partielle complexe, Chirurgie
Mots-clés Pascal anglais : Temporal lobe epilepsy, Refractory, Temporal lobectomy, Anterior, Cost efficiency analysis, Markov model, Decision analysis, Treatment, Health economy, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Complex partial epilepsy, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0361274
Code Inist : 002B25J01. Création : 12/09/1997.