Cost-effectiveness of CTA, MRA and DSA in patients with non-traumatic subarachnoid haemorrhage

Sailer, Anna M. H.; Grutters, Janneke P.; Wildberger, Joachim E.; Hofman, Paul A.; Wilmink, Jan T.; van Zwam, Willem H.

doi:10.1007/s13244-013-0264-6

Insights into Imaging

Table 1 Model input parameters

From: Cost-effectiveness of CTA, MRA and DSA in patients with non-traumatic subarachnoid haemorrhage

Model parameter	Mean	SE/SD/range^a	Distribution	Source
Discount rates
cDR (cost discount rate)	4 %		fixed	[21]
oDR (outcome discount rate)	1.5 %		fixed	[21]
Treatment independent parameters
Probabilities, (p)
pAneurysm in case of non-traumatic SAH	0.85		fixed	[14]
Costs, c (€)
Diagnostics
cDSA	725 €		fixed	[21]
cMRA	252 €		fixed	[21]
cCTA	197 €		fixed	[21]
Treatment
cCoiling	38,238 €	1,833 €	gamma	[10]
cClipping	31,739 €	2,503 €	gamma	[10]
Health state costs
Number of days in nursing home per year (d)	365
Costs per day in nursing home (euros/d)	241 €
cDisability	87,975 €			[21]
Event costs
cDeath	2,741 €			[18, 23]
Utilities (u)
uWell	0.78	0.019	beta	[18, 22]
uWell after SAH	0.72	0.65–0.80	triangular	[18, 22]
uDisabled	0.25	0.21–0.30	triangular	[18, 22]
uDead	0.00		fixed	[18, 22]
Clinical outcome probabilities
Probability of being well after clipping	0.69	0.014	beta	[7]
Probability of being disabled after clipping	0.21	0.013	beta	[7]
pClipdead (probability of being dead after clipping)	0.10	0.009	beta	[7]
pClipwell (probability of being well after survived clipping)	0.77			[7]
Probability of being well after coiling	0.76	0.013	beta	[7]
Probability of being disabled after coiling	0.16	0.011	beta	[7]
pCoildead (probability of being dead after coiling)	0.08	0.008	beta	[7]
pCoilwell (probability of being well after survived coiling)	0.83			[7]
Probability of being well after DSA	0.998	0.001	beta	[17, 24]
Probability of being disabled after DSA	0.002	0.001	beta	[17, 24]
pDSAdead (probability of being dead after DSA)	0.000		fixed	[17, 24]
pDSAwell (probability of being well after survived DSA)	0.998
Probability of being dead/disabled after surgery without aneurysm
pSurgdead	0.025	0.004	beta	[30]
pSurgdisab	0.132	0.008	beta	[30]
pCoilTP (probability coiling is feasible in true-positive aneurysm)	0.585	0.061	beta	[19]
pCoilFP (probability coiling is feasible in false-positive aneurysm)	0		fixed	[19]
Treatment dependent parameters	Value	SE/SD/range^a	Distribution	Source
Probabilities
pMRAtpD (sensitivity of MRA in diagnosing aneurysm)	0.954	0.018	beta	[19]
pMRAtnD (specificity of MRA in diagnosing aneurysm)	0.833	0.061	beta	[19]
pCTAtpD (sensitivity of CTA in diagnosing aneurysm)	0.915	0.024	beta	[19]
pCTAtnD (specificity of CTA in diagnosing aneurysm)	0.944	0.038	beta	[19]
pMRAtpT (sensitivity of MRA in determining whether coiling is feasible)	0.606	0.058	beta	^b
pMRAtnT (specificity of MRA in determining whether coiling is feasible)	0.814	0.050	beta	^b
pCTAtpT (sensitivity of CTA in determining whether coiling is feasible)	0.719	0.056	beta	^b
pCTAtnT (specificity of CTA in determining whether coiling is feasible)	0.754	0.057	beta	^b
pDSAtpD (sensitivity of DSA in diagnosing aneurysm)	1		fixed	[19]
pDSAtnD (Specificity DSA in diagnosing aneurysm)	1		fixed	[19]
pDSAtpT (sensitivity of DSA in determining whether coiling is feasible)	1		fixed	[19]
pDSAtnT (specificity of DSA in determining whether coiling is feasible)	1		fixed	[19]

^aRange presented for triangular distributions
^bData based on study [19]

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