The cost-effectiveness of a real-time seizure detection application for people with epilepsy

被引:0
作者
Cai, Yiying [1 ]
Chang, Kevin [2 ]
Nazeha, Nuraini [1 ]
Gosavi, Tushar Divakar [3 ]
Shen, Jia Yi [3 ]
Hong, Weiwei [2 ]
Tan, Yee-Leng [3 ]
Graves, Nicholas [1 ]
机构
[1] Duke NUS Med Sch, Programme Hlth Serv & Syst Res, 8 Coll Rd, Singapore 169857, Singapore
[2] SingHealth, Off Serv Transformat, 10 Hosp Blvd,SingHlth Tower, Singapore 168582, Singapore
[3] Natl Neurosci Inst, Dept Neurol, 11 Jln Tan Tock Seng, Singapore 308433, Singapore
关键词
Health technology assessment; Economic evaluation; Epilepsy management; Seizure detection devices; Seizure-related injury; QUALITY-OF-LIFE; EXPECTED VALUE; INFORMATION; RISK; UNCERTAINTY; DEPRESSION; FREQUENCY; ACCIDENTS; INJURIES; ANXIETY;
D O I
10.1016/j.yebeh.2023.109441
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Objectives: Automated seizure detection modalities can increase safety among people with epilepsy (PWE) and reduce seizure-related anxiety. We evaluated the potential cost-effectiveness of a seizure detection mobile application for PWE in Singapore.Methods: We used a Markov cohort model to estimate the expected changes to total costs and health out-comes from a decision to adopt the seizure detection application versus the current standard of care from the health provider perspective. The time horizon is ten years and cycle duration is one month. Parameter values were updated from national databases and published literature. As we do not know the application efficacy in reducing seizure-related injuries, a conservative estimate of 1% reduction was used. Probabilistic sensitivity analysis, scenario analyses, and value of information analysis were performed.Results: At a willingness-to-pay of $45,000/ quality-adjusted life-years (QALY), the incremental cost-effectiveness ratio was $1,096/QALY, and the incremental net monetary benefit was $13,656. Probabilistic sensitivity analyses reported that the application had a 99.5% chance of being cost-effective. In a scenario analysis in which the reduction in risk of seizure-related injury was 20%, there was a 99.8% chance that the application was cost-effective. Value of information analysis revealed that health utilities was the most important parameter group contributing to model uncertainty.Conclusions: This early-stage modeling study reveals that the seizure detection application is likely to be cost-effective compared to current standard of care. Future prospective trials will be needed to demonstrate the real-world impact of the application. Changes in health-related quality of life should also be measured in future trials. (c) 2023 Elsevier Inc. All rights reserved.
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页数:8
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