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dc.contributor.authorGoranitis, I
dc.contributor.authorBarton, P
dc.contributor.authorMiddleton, LJ
dc.contributor.authorDeeks, JJ
dc.contributor.authorDaniels, JP
dc.contributor.authorLatthe, P
dc.contributor.authorCoomarasamy, A
dc.contributor.authorRachaneni, S
dc.contributor.authorMcCooty, S
dc.contributor.authorVerghese, TS
dc.contributor.authorRoberts, TE
dc.date.accessioned2020-12-18T03:48:32Z
dc.date.available2020-12-18T03:48:32Z
dc.date.issued2016-08-11
dc.identifierpii: PONE-D-16-08817
dc.identifier.citationGoranitis, I., Barton, P., Middleton, L. J., Deeks, J. J., Daniels, J. P., Latthe, P., Coomarasamy, A., Rachaneni, S., McCooty, S., Verghese, T. S. & Roberts, T. E. (2016). Testing and Treating Women after Unsuccessful Conservative Treatments for Overactive Bladder or Mixed Urinary Incontinence: A Model-Based Economic Evaluation Based on the BUS Study. PLOS ONE, 11 (8), https://doi.org/10.1371/journal.pone.0160351.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/255927
dc.description.abstractOBJECTIVE: To compare the cost-effectiveness of bladder ultrasonography, clinical history, and urodynamic testing in guiding treatment decisions in a secondary care setting for women failing first line conservative treatment for overactive bladder or urgency-predominant mixed urinary incontinence. DESIGN: Model-based economic evaluation from a UK National Health Service (NHS) perspective using data from the Bladder Ultrasound Study (BUS) and secondary sources. METHODS: Cost-effectiveness analysis using a decision tree and a 5-year time horizon based on the outcomes of cost per woman successfully treated and cost per Quality-Adjusted Life-Year (QALY). Deterministic and probabilistic sensitivity analyses, and a value of information analysis are also undertaken. RESULTS: Bladder ultrasonography is more costly and less effective test-treat strategy than clinical history and urodynamics. Treatment on the basis of clinical history alone has an incremental cost-effectiveness ratio (ICER) of £491,100 per woman successfully treated and an ICER of £60,200 per QALY compared with the treatment of all women on the basis of urodynamics. Restricting the use of urodynamics to women with a clinical history of mixed urinary incontinence only is the optimal test-treat strategy on cost-effectiveness grounds with ICERs of £19,500 per woman successfully treated and £12,700 per QALY compared with the treatment of all women based upon urodynamics. Conclusions remained robust to sensitivity analyses, but subject to large uncertainties. CONCLUSIONS: Treatment based upon urodynamics can be seen as a cost-effective strategy, and particularly when targeted at women with clinical history of mixed urinary incontinence only. Further research is needed to resolve current decision uncertainty.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleTesting and Treating Women after Unsuccessful Conservative Treatments for Overactive Bladder or Mixed Urinary Incontinence: A Model-Based Economic Evaluation Based on the BUS Study
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0160351
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titlePLoS One
melbourne.source.volume11
melbourne.source.issue8
dc.rights.licenseCC BY
melbourne.elementsid1309701
melbourne.contributor.authorGoranitis, Ilias
dc.identifier.eissn1932-6203
melbourne.accessrightsOpen Access


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