Cost-Effectiveness of Open vs. Endoscopic Repair of Zenker's Diverticulum. (May 2022)
- Record Type:
- Journal Article
- Title:
- Cost-Effectiveness of Open vs. Endoscopic Repair of Zenker's Diverticulum. (May 2022)
- Main Title:
- Cost-Effectiveness of Open vs. Endoscopic Repair of Zenker's Diverticulum
- Authors:
- Lee, Paul B.
Hojjat, Houmehr
Lucas, Jordyn
Chung, Michael T.
Spillinger, Aviv
Meleca, Joseph B.
Svider, Peter
Shkoukani, Mahdi
Johnson, Andrew
Folbe, Adam - Abstract:
- Objective: To evaluate the cost-effectiveness of open versus endoscopic surgical repair of Zenker's diverticulum. Methods: In this study, an economic decision tree was utilized to compare the cost-effectiveness of open surgery compared to endoscopic surgery. The primary outcome in this analysis was the incremental cost-effectiveness ratio (ICER) that was calculated based on the economic decision tree. The probability of post-operative esophageal perforation complications, revision rates, and effectiveness of each procedure along with associated costs were extracted to construct the decision tree. Univariate sensitivity analysis was then utilized to determine how changes in esophageal perforation rate affect the cost-effectiveness of each surgical approach. Results: The ICER of open surgery for Zenker's diverticulum was $67 877, above most acceptable willingness to pay (WTP) thresholds. Additionally, if the probability of esophageal perforation with endoscopic surgery is above 5%, then open surgery becomes a more cost-effective option. Probabilistic sensitivity analysis using Monte Carlo simulations also showed that at the WTP thresholds of $30 000 and $50 000, endoscopic surgery is the most cost-effective method with 83.9% and 67.6% certainty, respectively. Conclusion: Open surgery and endoscopic surgery are 2 treatment strategies for Zenker's diverticulum that each have their own advantages and disadvantages that can complicate the decision-making process. With no previousObjective: To evaluate the cost-effectiveness of open versus endoscopic surgical repair of Zenker's diverticulum. Methods: In this study, an economic decision tree was utilized to compare the cost-effectiveness of open surgery compared to endoscopic surgery. The primary outcome in this analysis was the incremental cost-effectiveness ratio (ICER) that was calculated based on the economic decision tree. The probability of post-operative esophageal perforation complications, revision rates, and effectiveness of each procedure along with associated costs were extracted to construct the decision tree. Univariate sensitivity analysis was then utilized to determine how changes in esophageal perforation rate affect the cost-effectiveness of each surgical approach. Results: The ICER of open surgery for Zenker's diverticulum was $67 877, above most acceptable willingness to pay (WTP) thresholds. Additionally, if the probability of esophageal perforation with endoscopic surgery is above 5%, then open surgery becomes a more cost-effective option. Probabilistic sensitivity analysis using Monte Carlo simulations also showed that at the WTP thresholds of $30 000 and $50 000, endoscopic surgery is the most cost-effective method with 83.9% and 67.6% certainty, respectively. Conclusion: Open surgery and endoscopic surgery are 2 treatment strategies for Zenker's diverticulum that each have their own advantages and disadvantages that can complicate the decision-making process. With no previous cost-effectiveness analysis of open versus endoscopic surgery for Zenker's diverticulum, our results support the endoscopic approach at most common WTP thresholds. Particularly with the current focus on rising healthcare costs, our results can serve as an important adjunct to medical decision-making for patients undergoing treatment for Zenker's diverticulum. … (more)
- Is Part Of:
- Annals of otology, rhinology & laryngology. Volume 131:Number 5(2022)
- Journal:
- Annals of otology, rhinology & laryngology
- Issue:
- Volume 131:Number 5(2022)
- Issue Display:
- Volume 131, Issue 5 (2022)
- Year:
- 2022
- Volume:
- 131
- Issue:
- 5
- Issue Sort Value:
- 2022-0131-0005-0000
- Page Start:
- 499
- Page End:
- 505
- Publication Date:
- 2022-05
- Subjects:
- Zenker's diverticulum -- open surgery -- endoscopic surgery -- miscellaneous -- cost effectiveness -- cost analysis
Otolaryngology -- Periodicals
617.51 - Journal URLs:
- http://aor.sagepub.com/ ↗
http://www.sagepublications.com/ ↗
http://www.Annals.com/ ↗ - DOI:
- 10.1177/00034894211028507 ↗
- Languages:
- English
- ISSNs:
- 0003-4894
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 20050.xml