Clinical Safety and Cost-Effectiveness of Follow-up Virtual Clinic for Bladder Outflow Obstruction Surgery

2020 ◽  
Vol 34 (11) ◽  
pp. 1161-1166
Author(s):  
Piyush Bhargav Sarmah ◽  
Graham Alexander Broadley ◽  
Sikandar Khwaja ◽  
George Henry Delves
Keyword(s):  
Cost Effectiveness ◽  
Outflow Obstruction ◽  
Clinical Safety ◽  
Bladder Outflow Obstruction ◽  
Virtual Clinic

scholarly journals Ultrasound estimated bladder weight in the detection and post-operative follow-up of bladder outflow obstruction

2018 ◽  
Vol 11 (2) ◽  
pp. 185
Author(s):  
Mohammad Shafiqur Rahman ◽  
Mohammad Khairuzzaman ◽  
Mohammad Saiful Islam ◽  
Muhammad Humayun Kabir ◽  
Faika Farah Ahmed
Keyword(s):  
Wall Thickness ◽  
Bladder Wall ◽  
Surgical Correction ◽  
Therapeutic Effects ◽  
Outflow Obstruction ◽  
Bladder Wall Thickness ◽  
Bladder Outflow Obstruction ◽  
Non Invasive ◽  
Bladder Weight

<p class="Abstract">This study was performed to standardize the ultrasound estimated bladder weight as an additional non-invasive test for the measurement of the bladder outflow obstruction and to measure the therapeutic effects of bladder outflow obstruction in the follow-up after surgical correction of obstruction. This study was conducted from December 2012 to May 2014 where the sample size was 55 and sampling technique was purposive. In bladder outflow obstruction patient, transabdominal sonography was performed using a 7.5 MHz. probe. The anterior bladder wall thickness was measured in three points in the midline 1 cm apart and the average value was recorded. After that bladder volume was measured by ultrasonogram. In pre- and post-operative groups ultrasound estimated bladder weight was measured from bladder wall thickness and bladder volume. In this study, the mean ± SD of age was 48.8 ± 15.0 years. In bladder outflow obstruction patient, the pre-operative ultrasound estimated bladder weight was 117 ± 45.1 g which was reduced to 53.9 ± 10.8 g three months after surgical correction of obstruction. The ultrasound estimated bladder weight is a non-invasive, cheap and easily available additional diagnostic tool for detecting bladder outflow obstruction as well as it can measure the therapeutic effects in post-operative period.</p>

447 Cost-Effectiveness of a 3-Year Tele-OSA Intervention

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A177-A177
Author(s):  
Jaejin An ◽  
Dennis Hwang ◽  
Jiaxiao Shi ◽  
Amy Sawyer ◽  
Aiyu Chen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Incremental Cost ◽  
Economic Benefits ◽  
Small Sample ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Group 2 ◽  
The Cost

Abstract Introduction Trial-based tele-obstructive sleep apnea (OSA) cost-effectiveness analyses have often been inconclusive due to small sample sizes and short follow-up. In this study, we report the cost-effectiveness of Tele-OSA using a larger sample from a 3-month trial that was augmented with 2.75 additional years of epidemiologic follow-up. Methods The Tele-OSA study was a 3-month randomized trial conducted in Kaiser Permanente Southern California that demonstrated improved adherence in patients receiving automated feedback messaging regarding their positive airway pressure (PAP) use when compared to usual care. At the end of the 3 months, participants in the intervention group pseudo-randomly either stopped or continued receiving messaging. This analysis included those participants who had moderate-severe OSA (Apnea Hypopnea Index &gt;=15) and compared the cost-effectiveness of 3 groups: 1) no messaging, 2) messaging for 3 months only, and 3) messaging for 3 years. Costs were derived by multiplying medical service use from electronic medical records times costs from Federal fee schedules. Effects were average nightly hours of PAP use. We report the incremental cost per incremental hour of PAP use as well as the fraction acceptable. Results We included 256 patients with moderate-severe OSA (Group 1, n=132; Group 2, n=79; Group 3, n=45). Group 2, which received the intervention for 3 months only, had the highest costs and fewest hours of use and was dominated by the other two groups. Average 1-year costs for groups 1 and 3 were $6035 (SE, $477) and $6154 (SE, $575), respectively; average nightly hours of PAP use were 3.07 (SE, 0.23) and 4.09 (SE, 0.42). Compared to no messaging, messaging for 3 years had an incremental cost ($119, p=0.86) per incremental hour of use (1.02, p=0.03) of $117. For a willingness-to-pay (WTP) of $500 per year ($1.37/night), 3-year messaging has a 70% chance of being acceptable. Conclusion Long-term Tele-OSA messaging was more effective than no messaging for PAP use outcomes but also highly likely cost-effective with an acceptable willingness-to-pay threshold. Epidemiologic evidence suggests that this greater use will yield both clinical and additional economic benefits. Support (if any) Tele-OSA study was supported by the AASM Foundation SRA Grant #: 104-SR-13

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