TY  - BOOK
AU  - Fayed, Islam
TI  - An Initial Cost-Effectiveness Analysis of Magnetic Resonance-Guided Laser Interstitial Thermal Therapy in Pediatric Epilepsy Surgery
SN  - 1016-2291
PY  - 2020///
KW  - *Cost-Benefit Analysis/mt [Methods]
KW  - *Drug Resistant Epilepsy/su [Surgery]
KW  - *Hyperthermia, Induced/mt [Methods]
KW  - *Intraoperative Neurophysiological Monitoring/mt [Methods]
KW  - *Laser Therapy/mt [Methods]
KW  - *Magnetic Resonance Imaging/mt [Methods]
KW  - Adolescent
KW  - Child
KW  - Child, Preschool
KW  - Drug Resistant Epilepsy/dg [Diagnostic Imaging]
KW  - Drug Resistant Epilepsy/ec [Economics]
KW  - Extracellular Fluid/ph [Physiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Hyperthermia, Induced/ec [Economics]
KW  - Intraoperative Neurophysiological Monitoring/ec [Economics]
KW  - Laser Therapy/ec [Economics]
KW  - Magnetic Resonance Imaging/ec [Economics]
KW  - Male
KW  - Retrospective Studies
KW  - Young Adult
KW  - MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Journal Article
N2  - CONCLUSION: Our data suggests that MRgLITT may be a cost-effective alternative to traditional surgical resection in pediatric epilepsy surgery. Copyright (c) 2020 S. Karger AG, Basel; INTRODUCTION: Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a new technology that provides a clinically efficacious and minimally invasive alternative to conventional microsurgical resection. However, little data exist on how costs compare to traditional open surgery. The goal of this paper is to investigate the cost-effectiveness of MRgLITT in the treatment of pediatric epilepsy; METHODS: We retrospectively analyzed the medical records of pediatric patients who underwent MRgLITT via the Visualase R thermal therapy system (Medtronic, Inc., Minneapolis, MN, USA) between December 2013 and September 2017. Direct costs associated with preoperative, operative, and follow-up care were extracted. Benefit was calculated in quality-adjusted life years (QALYs), and the cost-effectiveness was derived from the discounted total direct costs over QALY. Sensitivity analysis on 4 variables was utilized to assess the validity of our results; RESULTS: Twelve consecutive pediatric patients with medically refractory epilepsy underwent MRgLITT procedures. At the last postoperative follow-up, 8 patients were seizure free (Engel I, 66.7%), 2 demonstrated significant improvement (Engel II, 16.7%), and 2 patients showed worthwhile improvement (Engel III, 16.7%). The average cumulative discounted QALY was 2.11 over the lifetime of a patient. Adjusting for inflation, MRgLITT procedures had a cost-effectiveness of USD 22,211 per QALY. Our sensitivity analysis of cost variables is robust and supports the procedure to be cost--effective
UR  - https://dx.doi.org/10.1159/000509329
ER  -