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首页> 外文期刊>Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland >Cost‐effectiveness of sacral neuromodulation for chronic refractory constipation in children and adolescents: a Markov model analysis
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Cost‐effectiveness of sacral neuromodulation for chronic refractory constipation in children and adolescents: a Markov model analysis

机译：成本优先骶神经调节的有效性hronic儿童难治性便秘和adolescents:马尔可夫模型分析

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Abstract Aim This study aimed to assess the cost‐effectiveness of sacral neuromodulation ( SNM ) compared with conservative treatment in children and adolescents with constipation refractory to conservative management. Method A Markov probabilistic model was used, comparing costs and effectiveness of SNM and conservative treatment in children and adolescents aged 10–18?years with constipation refractory to conservative management. Input for the model regarding transition probabilities, utilities and healthcare costs was based on data from a cohort of patients treated in our centre. This cohort consisted of 30 female patients (mean age 16?years) with functional constipation refractory to conservative management. The mean duration of laxative use in this group was 5.9?years. All patients had a test SNM , followed by a permanent SNM in 27/30. Median follow‐up was 22.1?months (range 12.2–36.8). The model was run to simulate a follow‐up period of 3?years. Results The mean cumulative costs for the SNM group and the conservative treatment group were €17?789 ( SD €2492) and €7574 ( SD €4332) per patient, respectively. The mean quality adjusted life years ( QALY s) in the SNM group was 1.74 ( SD 0.19), compared with 0.86 ( SD 0.14) in the conservatively managed group. The mean incremental cost‐effectiveness ratio was €12?328 per QALY ( SD €4788). Sensitivity analysis showed that the outcomes were robust to a wide range of model assumptions. Conclusion Chronic constipation seriously affects the quality of life of children and adolescents. Preliminary evidence suggests that SNM can improve symptoms and quality of life at a reasonable cost.
机译：摘要本研究目的旨在评估成本优先骶神经调节的有效性(球形结构与保守治疗儿童和青少年便秘耐火材料保守的管理。使用马尔科夫概率模型,比较成本和核材料和保守的有效性治疗儿童和青少年10 - 18 ?保守的管理。关于转换概率,公用事业和医疗费用是基于数据从一个队列患者的中心。由30名女患者(平均年龄16 ?年)与功能性便秘耐火材料保守的管理。泻药使用这组为5.9 ?。患者一个测试核,紧随其后的是一个永久性的核材料在27/30。(范围12.2 - -36.8)。一个遵循3期?。核组和累积成本保守治疗组€17吗?€2492)和€7574 (SD€4332)每个病人,分别。年(QALY s)核组为1.74 (SD0.14 - 0.19),而0.86 (SD)保守组管理。增量成本效果比应承担€12 ?每QALY (SD€4788)。结果是广泛的健壮模型的假设。便秘严重影响质量儿童和青少年的生活。证据表明,球形结构可以改善症状和生活质量在一个合理的成本。

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