Annual meeting of the American Association for the Study of Liver Diseases. , 1996/11.
The risk of a major complication from « blind » percutaneous liver biopsy is reported to be in the range of 0.24% to 3.8%. In a recent randomized trial, patients whose liver biopsies were performed with ultrasonography had a significant reduction in complications requiring hospitalization compared with patients without ultrasound-guided biopsies (0.5% vs. 2.2%, P<. 05).
Despite this, routine use of ultrasonography for liver biopsies has not been implemented because of controversies with respect to cost-effectiveness.
The aim of our study was to analyze the relative cost-effectiveness of performing ultrasound-guided liver biopsies using decision analysis.
A decision tree was constructed to compare a strategy of liver biopsy using ultrasonography with a strategy without ultrasonography.
The major outcomes included were minor complications such as pain requiring analgesics and major complications, which require hospitalization.
Costs included were direct medical costs from the payer's perspective.
In our baseline model, the cost from complications per patient with and without ultrasonography was $62 and $129, respectively.
The marginal effectiveness expressed as the number of major complications avoided was 1.2/100 liver biopsies.
The incremental cost to avoid one major complication was $2,731.
The model was most sensitive to the frequency of major complications and the additional cost of ultrasonography. (...)
Mots-clés Pascal : Biopsie, Foie, Echographie, Assistance technique, Guidage, Incidence, Complication, Analyse avantage coût, Homme, Appareil digestif pathologie, Foie pathologie, Exploration ultrason, Economie santé
Mots-clés Pascal anglais : Biopsy, Liver, Echography, Technical assistance, Guidance, Incidence, Complication, Cost benefit analysis, Human, Digestive diseases, Hepatic disease, Sonography, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0248407
Code Inist : 002B24C05. Création : 11/09/1998.